So you are finally home with your new little bundle. You’ve been waiting for this moment, and your life is forever changed. Nothing can truly prepare you for the changes that occur when your family grows. Before parenthood, there wasn’t a little human waking you up (for 30-60 min at a time) every 2-3hrs. Nothing ever felt as unpredictable as it does now. 

With a little mix of sleep science and trusting your instincts, you can get through this newborn stage with more ease & curiosity, and sanity!

Understand your newborn’s sleep cycles

Newborn sleep alternates between active and quiet sleep. Newborns usually begin a sleep cycle in active sleep, then after about 20-25 minutes, they’ll transition to a cycle of quiet sleep, also about 20-25 minutes long. During active sleep, babies might grunt, sigh, flail their limbs, and maybe even cry. Their eyes may even open from for a moment. In quiet sleep, you might notice your baby breathing slowly and rhythmically, and that their body is more still. (7)

Here are some sleep tips for helping a baby through the active/quiet sleep cycle:

• Let’s say your baby falls asleep in your arms. Waiting until they are in a deeper sleep (15-20min later) can help with the smooth transition to their bassinet. 
• Remember that when your baby wakes after a 45-50min sleep cycle, they might need some help getting back to sleep. Helping them to extend a nap is absolutely normal.
• Sometimes active sleep looks like your baby is waking up. See if you can give it a minute, and just observe. Some babies wake briefly and get right back to sleep without help.

Babies that learn to transition between sleep cycles without your help will grow into better sleepers later in infancy, but you have to give them a chance to practice this valuable skill (8). Wait a moment or two to see if he needs your help, and if he does, soothe him quietly by placing a hand, patting or picking baby up.

Start a regular soothing bedtime routine

Bedtime routines have been shown to help babies get more sleep during the night and help them to fall asleep faster (1).  Start with some calming rituals that you repeat each night before bed. You may do something like this: bath, massage, PJ’s, milk, songs, etc. Spending time on routine is calming, and also cueing your child that it is time to prepare for sleep, for years to come this will bring a healthy sense of predictability for your child. Talk to your baby: It’s almost time for bed, so we’re taking a bath. Then we’ll have massage, then milk time, and we’ll sing our bedtime song. Then we’ll all go to sleep. 

Help your baby acclimate to falling asleep in different ways throughout the day.

It’s okay to hold your baby in arms or a carrier, during naps. Stroller rides are great ways for you all to get fresh air. Your baby might fall asleep on the breast or bottle too. Enjoy this time with your baby. Soon they’ll be too heavy and you’ll miss it! Once or twice a day, place them down in their bassinet so that they can practice sleeping independently. If they wake, you might soothe them back to sleep, and remember to stay patient. Your baby is learning a whole new world. Some babies are able to fall asleep without a lot of active soothing (i.e. feeding, rocking, bouncing, walking, driving) and these babies tend to sleep well during the night (8). Don’t worry if your baby needs more support though. Keep focusing on secure and predictable routines and you’ll be setting the stage for good sleep habits down the road.

Watch for Cues

‘Watching for Cues’ means learning your baby’s particular signals for when they are feeling sleepy. You then want to bring them into their comfortable sleep environment so that they fall asleep in the right window. Some signs of drowsiness may be:

• there is decreased activity and slower motion
• they are less vocal
• their sucking gets weaker when feeding
• they get quieter and calmer
• they appear uninterested in their surroundings
• there’s a glazed look in their eyes
• they are starting to yawn or thumb suck
• they ask to nurse, feed, or for a pacifier

Baby is becoming overtired when they are:

• already rubbing their eyes
• irritable and fussing
• cranky and fussy, even after the feeding
• harder to soothe
• crying

Newborn sleep times can vary widely

Remember that your newborn’s sleep is going to be very unpredictable during the first couple of months. It’s okay if some naps are shorter and others are longer. Some days they may even sleep more in the day, and wake for longer periods as night as they adjust to the world. Their length of sleep may range from 30min to 4hrs long during a 24hr period. 

Newborns awaken frequently, and rarely sleep more than 4 hours at a stretch. Babies may take 3-5 months before they “settle” at night- meaning that they sleep for more than 5 hours at a stretch (3).

Here are some simple ways to optimize your baby’s sleep environment:

• Make sure the room is dark. Use blackout shades, curtains, or blinds to help darken the room and keep early morning rays out. When your baby wakes, tend to them quietly and then quickly get them back to sleep afterward. This will help set the tone that nighttime is for sleeping and not playing. 

• Keep televisions, computers, cell phones off while your baby is sleeping in their room at night. Studies have shown that the light emitted from electronics can overstimulate the brain and make it harder for your baby to fall asleep and stay asleep. (9)

• White noise is a very effective tool that can help your baby sleep better. Actual “white noise” is the best rather than ocean waves or sounds of trains, birds, etc. Keep the white noise on during the entire sleep duration and turn it off as soon as your baby wakes.

• Swaddling during the newborn months can help extend sleep periods and help if your baby is sensitive to the startle reflex. Make sure to always put your baby to sleep on his back and practice safe sleeping (10).

• Keeping your baby close by (room-sharing) can help you manage feedings more efficiently and make it easier for you to settle and get your baby back to sleep quickly when he does wake.

Exposing your baby to lots of sunlight during the daytime (going for fresh air walks ) provides a natural cue to help your baby adjust to day and night rhythms. In another study of full-term infants, babies exposed to more sunlight during the afternoon tended to sleep better at night (4) 

And when your baby is alert, bring in some activities like song time, or walking around the home and pointing at objects. 

Self Care Tips for the New Parent

• Try to let the worry and the stress go and sleep when your baby sleeps. A nap can recharge your body and set you up for an easier late afternoon.
• Find some time for your own sleep by making sure you have daytime or nighttime support. Whether it’s a postpartum doula, night nurse, family member or a friend, have someone else care for your little one, so you can rest.
• If you have a partner or a nighttime helper, set up a plan to take 3-5 hr shifts. 
• Be patient as your baby develops more mature sleep patterns. Your baby will develop their self-soothing capabilities when they are ready.
• Babies under 6 months old are going through so much initial brain development, that it’s likely they will wake for comfort or nourishment. Know that sleep will not always be this challenging. 
• Trust your instincts, and get help when you feel really stressed. Preserving your mental health is crucial. Coping with sleep deprivation is very stressful, especially if your infant seems to be especially fussy. Watch for signs of postpartum anxiety and postpartum depression.

References 

1. Mindell, J. A., Telofski, L. S., Wiegand, B. & Kurtz, E. S. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep 32, 599–606 (2009).
2. Iglowstein I, Jenni OG, Molinari L, Largo RH. 2003. Sleep duration from infancy to adolescence: Reference values and generational trends. Pediatrics 111(2): 302-307.
3. Pinilla T and Birch LL. 1993. Help me make it through the night: Behavioral entrainment of breasfed infants’ sleep patterns. Pediatrics 91: 436-444.
4. Harrison Y. 2004. The relationship between daytime exposure to light and night-time sleep in 6-12-week-old infants. J Sleep Res. 13(4):345-52.
5. Lohr B, Siegmund R. 1999. Ultradian and circadian rhythms of sleep-wake and food-intake behavior during early infancy. Chronobiology international 16(2): 129-148.
6. Grigg-Damberger MM. 2016. The Visual Scoring of Sleep in Infants 0 to 2 Months of Age. J Clin Sleep Med. 12(3):429-45.
7. De Weerd, A. W. & van den Bossche, R. A. S. The development of sleep during the first months of life. Sleep Med. Rev. 7, 179–191 (2003)
8. Burnham, M. M., Goodlin-Jones, B. L., Gaylor, E. E. & Anders, T. F. Nighttime sleep-wake patterns and self-soothing from birth to one year of age: a longitudinal intervention study. J Child Psychol Psychiatry 43, 713–25 (2002).
9. https://www.sleep.org/articles/ways-technology-affects-sleep/
10. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Announces-New-Safe-Sleep-Recommendations-to-Protect-Against-SIDS.aspx

Erica Shane, pediatric gentle sleep coach, veteran doula, and childbirth expert. She is the creator of Navigating the Waters, a full service wellness program for parents that encompasses gentle sleep shaping, gentle sleep coaching, and new parent support.

Learn more about Erica Shane