We do not negotiate with terrorists or toddlers, I say to myself, face buried in pillow. The faint scent of coconut momentarily transports me away from my dark bedroom to a Caribbean island. When was the last time I washed my hair? I flash back to reality as the motionless man beside me lets out a heavy, drawn out breath, bordering dangerously close to snoring. Seriously? How are you sleeping? The deeper I imagine he settles into rest the more furious I become. I push the white rectangle to silence the baby monitor but it is still angry, panels of light flashing from green to orange to red, an endless loop, overzealous fans doing the wave at a baseball game. How peaceful my husband looks breathing in and out, lips parting slightly with each breath. I want to rip his head off. I stare at him, willing him to wake, so I don’t have to decide again for the hundredth night in a row whether or not tonight will be the night we start sleep training.
Sleep (or lack thereof) is one of the hardest things about the newborn period, and frankly, parenthood in general. In the days after birth, infants eat every 2-3 hours, which means they are waking at least this frequently. In my role as newborn pediatrician and motherhood consultant (and new mom!), sleep is one of the most common topics I get asked about. How much sleep is normal? When will baby be on a predictable schedule? Why does baby sleep so much during the day? This blog is a compilation of my most frequently asked newborn sleep questions. Read on to learn what to expect from newborn sleep in the first 6 weeks after birth!
This guide is geared towards babies who are born at term (37-40 weeks gestation). If your baby is born prematurely there may be different guidelines that apply.
Newborn Sleep FAQs:
Question: When will my baby be on a predictable schedule?
Answer: Your baby will not have a predictable schedule for at least the first 6 weeks (and likely longer, devastating, I know). Newborn babies do not have a consistent pattern of sleep, i.e. they could be seemingly awake all night one day and sleep for a 4-hour stretch the next. This is NORMAL. We, as functional adults, crave schedule and routine, particularly as an anchor in the postpartum storm. The exhaustion and aberrant flow of days with a baby can be crippling. Knowing that this is normal and developmentally appropriate for newborns is half the battle.
Tip: Surrender to the chaos. Many mamas have grand ideas of what they will accomplish in the weeks after baby is born. Now is not the time to organize your closet, start that novel or even do the laundry. Your daily to do list consists of eating food (ideally that someone else has prepared and placed in front of you), feeding your baby, sleeping when your baby sleeps and maybe taking a shower. If you do those things every day for the first 6 weeks, you are winning.
While your baby will not follow a predictable schedule at first, you will start to learn your baby’s sleep cues. These signs are clues that baby is ready and asking for sleep. Some of the most common newborn sleep cues are yawning, rubbing hands against the face and nestling against your chest. The thing to avoid is an overstimulated and overtired baby. When baby shows these signs, your job is to provide the opportunity for sleep. Whether that means swaddling and placing baby in the bassinet or snuggling close against you in a quiet room, the idea is to set baby up for a successful rest.
Question: How much do newborn babies sleep?
Answer: In the first 6 weeks, newborns can sleep up to 17-20 hours/day! They are on a demand schedule, which means they eat and sleep whenever they want or need to, without predictability. Newborns eat every 2-3 hours, so sleep is in chunks between feeds. In general, newborns are awake no more than 45 minutes-1 hour before needing to go back to sleep.
Tip: Don’t be fooled! This sounds like a lot of sleep, right? How could you be tired when you have up to 20 hours a day to rest? The key is just that, you have to rest. Your mind will try and tell you that you don’t nap well during the day, or to use your “free” time to catch up on email or cook dinner. DO NOT LISTEN. As mentioned above, newborn sleep is unpredictable so take advantage of each sleep opportunity like it may be the day’s last.
Additionally, as tempting as it is to compare how much your baby sleeps to how much your best friend’s baby sleeps, DON’T DO IT! IT’S A TRAP! The comparing mind is a dangerous thing. It is a set-up for feeling less than. It’s hard not to compare, I know. We all have that friend whose baby slept 4-5 hours/night as soon as they got home from the hospital. This is the exception, not the norm. If this is you, congratulations, because you have won the baby sleep lottery. Your baby is a unicorn. Feel free to pat yourself on the back, but know all credit for your baby’s ability to sleep at this stage goes to him or herself. Do us all a favor, don’t tell your friends. New mamas have enough to feel inadequate about, we don’t need to feel guilty about this too.
Question: Where should my baby sleep?
Answer: The American Academy of Pediatrics (AAP) recommends all babies sleep in their own sleep area, crib or bassinet, and not in bed with caregivers. Baby’s sleep area should be firm, flat and free from pillows, blankets, stuffed animals and toys. Always place baby on his/her back. The AAP also recommends having baby sleep in the same room as the caregiver for the first 6-12 months.
Tip: These recommendations are intended to keep sleeping babies safe by reducing the risk of sudden infant death syndrome (SIDS) in the first year. If you have questions about your sleep situation and whether or not it is safe for your baby, ask your pediatrician! You can find the full explanation of the AAP recommendations here:
Question: Help, my baby hates the crib! What do I do?
Answer: This can be extremely frustrating, but it is common! In the fourth trimester (the first 12 weeks after giving birth) most babies want to stay close to caregivers, including during sleep. A lot of my patients and clients feel like they are doing something wrong because their baby won’t sleep in the designated sleep area, which as you know, is the safest place for unsupervised sleep. As long as you or another caregiver is awake and watching, baby can be in any position you like. It is NORMAL for baby to want to sleep curled up on your chest. This does not mean you have failed! There is nothing you can do in the first 12 weeks that will develop bad sleep habits. If the only way baby will fall asleep is nursing or snuggled against a warm body or bouncing on a yoga ball, please, bounce away! This does not mean your baby will never sleep alone in a crib. You can’t spoil a newborn!
Tip: Pacifiers are another great tool for soothing and sleep. There is no shortage of opinions about the use of pacifiers for newborns. I believe it can be beneficial to introduce a pacifier in the first few days after birth. Sucking is the biological mechanism for newborn soothing. Some of the people who suggest waiting to use a pacifier or not introducing one at all, are concerned about nipple confusion. Nipple confusion is the theory that babies will learn to prefer an artificial nipple (pacifier or bottle) to the breast, if introduced before breast feeding is established. There is no scientific evidence that nipple confusion is a real phenomenon. Pacifiers provide developmentally appropriate comfort to your baby. You want to follow your baby’s hunger signs and feed on demand. If your baby is fed and still fussing, a pacifier can be used to help calm and settle to sleep. Pacifiers have also been shown to decrease the risk of SIDS.
Newborn fussiness peaks around 6 weeks of age. Pay attention to what calms your baby (pacifier, swaddling, bouncing) and try different things. A baby carrier or wrap is an excellent companion to a fussy baby who won’t sleep in the crib. Carriers and wraps allow the caregiver to wear baby while keeping hands free! (Remember, this is not safe if you are sleeping too.) Trade off with another caregiver so you both can get some rest.
Question: Why does my baby sleep more during the day than at night?
Answer: Newborns have no sense of day or night for at least the first 6 weeks. This is because their circadian rhythm is not yet developed.
Tip: Although newborns can’t tell the difference between day or night, there are things you can do to start setting the stage for sleep. During the day, keep things light and bright. Getting outside for natural sunlight and exposing your baby to everyday sounds starts to signal the brain that daytime is for being awake. At night, do the opposite. The sleep environment should be dark, cool and quiet. Black out shades, a cool mist humidifier and white noise are my prescription for newborn sleep. When baby is up during the night for feeds and diaper changes, keep things calm. Use a soft lamp instead of turning on a bright ceiling light and talk to your baby in a quiet, soothing voice.
Question: What should the baby’s room temperature be?
Answer: The ideal room temperature for newborn sleep is mid 60s-low 70s.
Tip: If you live in a shared space, like an apartment building, or in an older home it can sometimes be difficult to control the room temperature. If this is the case, don’t worry! In general, newborns need one more layer than you do to be comfortable. If you’re sleeping in one layer, baby should have two layers (such as a onesie and swaddle). It is normal for newborn hands and feet to feel cool. For a more accurate assessment of baby’s temperature feel the center of the body, like chest or back.
Question: When can I sleep train? What’s the best method?
Answer: I do not recommend any form of sleep training prior to four months of age. Developmentally, baby’s brain is not ready for sleep training before this time.
Tip: There is no shortage of sleep training methods and resources out there. There is no magic bullet solution. Anything that sounds too good to be true, probably is. The important thing is to choose what works best for you and your family. There is no “right” way to sleep train and no one method I recommend because what method you choose depends largely on your goals and parenting philosophy. How do you feel about letting your baby cry? Is your baby still sleeping in your room? How quickly do you want your method to work? Is your baby feeding overnight? These are important questions to consider when choosing a sleep training method. Once you have decided what your goals are and how you want to move forward, consistency is key.