Healthy Sleep Habits in Newborns (Part II)
Establishing Healthy Sleep Habits in Newborns: An Overview
Sleep is that elusive treasure for new parents. While it may seem like an impossible dream, establishing healthy sleep habits in your newborn can significantly improve your family's quality of life. Here's some helpful information to help you navigate the early days and set the stage for peaceful nights.
Understanding Your Newborn's Sleep Needs
Newborns sleep a lot, often 16 to 18 hours a day. However, their sleep is short. They typically sleep in short bursts, waking up every 2-4 hours to feed. Their sleep patterns will gradually change as they grow, with longer nighttime stretches and fewer daytime naps.
The first few weeks are very much baby-led. This is not the time to worry about establishing a routine. Instead, focus on getting to know your baby. There will be lots of cluster feedings and holding during these first weeks. Don't worry about "spoiling" baby. That is not going to happen. Your focus is better spent making sure your baby is fed, diapered, sleeping as much as they want, and giving LOTS of cuddles!
Here are some of our time-tested suggestions for those first few weeks:
You will continue to wake every three hours at night and feed every three hours daily. Ensure the baby eats at least every three hours (less if recommended) until the pediatrician says letting them go longer at night is okay. Sometimes, babies want more frequently in those early weeks (cluster feeding), and it is okay to do so—they are growing!
Newborns' awake times (known as wake windows*) are only 30-60 minutes or less during the first 3-4 weeks. The 30-60 minutes start when the baby wakes up, whether to feed or play. After the feed, a diaper change, and a few minutes of playtime, it won't be long before they are back down!
Try to lay the baby in their crib at least once a day for a nap. Generally, the first nap of the day works best. Don't stress if they won't stay—just keep trying! This is a way to familiarize them with their crib for future naps and nighttime.
Tummy time! Yes, tummy time starts from day one. Tummy time is important for building strong neck/back muscles and giving the baby some exercise. This also helps to prevent a flat head. Tummy time for a newborn can be lying on the tummy, across the lap, or on top of a caregiver lying flat (and awake, of course!).
Swaddle arms in for naps and nighttime sleep only (until they show signs of rolling back to tummy). Swaddled with arms in is a great sleep cue for babies and helps keep them calm and sleeping. Having arms out for feedings and awake/activity times helps the baby stay awake and enjoy playing. It allows them to exercise their arms and discover their hands. Many babies will "fight" the swaddle. This is normal. It does not mean they do not like it. It is natural to fight against the pressure. Calm baby with soothing techniques such as rocking, bouncing, and shushing. Once settled, they will rest better with arms in for sleep.
Cluster Feeding is the norm at this age. Cluster feeding is when a baby wants to nurse/bottle feed more frequently. Instead of getting your normal 2-3 hr window between feeds, the baby will want to eat every 20-60 mins. This generally happens from early evening into the late night hours. This is the baby's way of upping your milk supply. When nursing, it signals your body to produce more milk. If bottle feeding, you will add another ounce of formula to the bottle so enough formula is available. It is normal and will pass!
Babies are very noisy sleepers! They grunt. They cry out. They stretch. They whine. They kick. They are everything but quiet. Babies spend a lot of time in REM sleep. REM sleep allows for lots of movement. Babies also make all kinds of sounds as they transition through their sleep cycles (which are 30-40 minutes). Don't rush to pick them up. Give baby time to settle. Lay a hand on their chest and gently shush if they are more restless. Many times, they are just transitioning into their sleep cycle. Wait to pick them up and see if they can transition into the next sleep cycle. Picking them up immediately doesn't allow them the time they could need to settle into the next sleep cycle and will likely startle them awake and ruin any chance of falling back to sleep.
AAP recommendations for creating a safe sleep environment include**:
Place the baby on his or her back on a firm sleep surface, such as a crib or bassinet, with a tight-fitting sheet.
Avoid use of soft bedding, including crib bumpers, blankets, pillows and soft toys. The crib should be bare.
Share a bedroom with parents or caregivers but not the same sleeping surface, preferably until the baby turns one but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.
Avoid the baby's exposure to smoke, alcohol, and illicit drugs.
Weighted swaddles for sleep are no longer recommended.
Ideal Sleep Environment & Tips
Crib or bassinet with a firm mattress, fitted crib sheet, and no loose blankets, pillows, or stuffed animals.
Blackout shades—(recommended for 6 weeks+) A completely dark room is ideal for napping and night sleep. Shades should make the room as dark as it would be at 3 a.m., even if it's noon!
Velcro swaddles such as the Halo, Swaddle Me, Ollie or Sweetpea work great. Muslin blankets tend to loosen, and babies will get their hands out, which wakes them easily. Weighted swaddles are not recommended per the AAP.
A sound machine such as the Rohm (travel-sized), Hatch, Lectrofan, or Hushh (travel-sized) should be placed at least 7 feet from the baby's head and have the volume of a vacuum or hairdryer at that distance. This is about 50 decibels.
Red Nightlight—To maintain the sleep environment, it's important to keep lights low at night during feedings and diaper changes. A red light is recommended. Red light does not interfere with melatonin production, which is important for parents, too.
Keep the room temperature between 68°-72° and dress the baby in as much or as little as you would wear. No hats unless recommended by the pediatrician for newborns.
Feeding and Sleep for Newborns
Feeding Schedule: Demand Feeding: Feed your baby on demand, responding to their hunger cues.
Burping: Burp your baby after each feeding to prevent discomfort and gas.
Soothing Techniques for Newborns
Swaddling: Gently swaddle your baby to mimic the womb-like environment. However, as they grow, they may prefer to sleep unswaddled.
Pacifiers: Offer a pacifier to help soothe your baby, especially during sleep.
Gentle Rocking or Shushing: These techniques can help calm your baby and promote sleep.
Newborn Sleep Information for 0-12 weeks
0-4 weeks Newborn Sleep
The wake window* is around 30-60 minutes.
The pattern is wake, diaper, feed, tummy time, and back to sleep, all within 30-60 minutes or so.
Naps are generally short
Waking throughout the night to repeat the schedule as well
8-12 weeks Newborn Sleep
The wake window* is around 60-90 minutes.
The pattern is wake, diaper, feed, tummy time, and back to sleep, all within 60-90 minutes or so.
Naps are generally short.
Waking throughout the night to repeat the schedule as well.
Addressing Sleep Issues
Consult Your Pediatrician: If you're concerned about your baby's sleep patterns, consult your pediatrician. They can rule out any underlying medical issues and provide personalized advice.
Avoid Overtiredness: Overtired babies may have trouble falling asleep and staying asleep.
Nighttime Wake-Ups: If your baby wakes up frequently at night, try to minimize stimulation and offer a quick feed or pacifier before returning them to their crib.
Daytime Sleep: Ensure your baby gets adequate daytime sleep to prevent overtiredness.
Patience and Persistence.
Establishing healthy sleep habits takes time and patience. Don't get discouraged by setbacks. Remember, every baby is different, and what works for one may not work for another. Be flexible, adjust your approach as needed, and trust the process.
Remember, every baby is unique. What works for one may not work for another. Be patient, flexible, and trust the process. By creating a nurturing sleep environment and establishing consistent routines, you can help your baby develop healthy sleep habits that will benefit both of you.
You can find additional information in Part I.
*A wake window starts when the baby wakes up until they need to be asleep again.
