As a busy Postpartum Doula, the thing I get the most questions about is SLEEP! So, I want to share the tips I give my families to help make their transition to a life with a newborn a little easier. The first thing I share is that expectations about sleep with an infant will “kill you”! What they need are intentions and good information about what is normal for babies and their sleep. So, what is normal?
New babies can sleep a lot. Normal sleep for full-term, healthy newborns after the first week or so, is anywhere from 13 to 16 hours for a 24-hour period (of course there are outliers on either side of this). This includes nighttime sleep and naps. Naps for new babies up to about 6 months old can be as little as 20 minutes or up to over an hour at a time. New babies usually sleep at every feed cycle, dropping naps and starting to consolidate them around 3-6 months of age.
Nighttime sleep can be as little as 2 hours at a time in the beginning, extending to up to 10 hours by 6 months for some babies. This is a gradual process and is not linear. A baby may sleep up to 8 hours at night by 3 months and then be waking one or two times a night at around 4 months. This can be frustrating for new parents, but if they know to expect wakings around the 4-month mark, they tend to handle it better and don’t think something is wrong.
As the baby gets a little older, sleep starts to get better again, but there may still be a night waking after 5 or 6 hours. Other sleep disturbances happen in the first year around motor skill development, like crawling and walking, and usually occur during teething or illness. When new parents know that this is all normal, they are much more able to coup and are less likely to stress over their baby not “sleeping through the night”.
How can parents get the maximum sleep for themselves and their babies? It is definitely easier to start at the very beginning with families educating them about newborn sleep and food. Understanding that food is the driving force for infant nighttime sleep is crucial. The more food a baby gets during the day (whatever their day is), the longer their sleep at night can be. In the beginning, parents are instructed to feed their baby at least every 3 hours around the clock and to wake the baby to feed if they don’t wake on their own.
Once the baby is back to their birth weight (at least 6 1/2 pounds) and their care provider has approved, they can “let the baby go” at night. To maximize night sleep, the recommendation is to feed the baby every 2 hours during the day (if breastfeeding on demand, baby is usually doing this already) and “let them go” at night. This can look like a 3 to 4 hour stretch in the first part of the night, working up to 5 or 6 hours as the baby gets older with wakings every 2 to 3 hours after that first stretch. The parents should plan on at least one of them sleeping during this long stretch even if it is earlier in the evening. As the baby gets bigger and older, the subsequent wakings happen less and less and eventually disappear. A 6-8-month-old may still need to wake for a feeding at night.
In the beginning, some parents wake every hour or less to feed the baby because they hear them or see them moving around and misinterpret this as feeding cues. Understanding how babies sleep is important for new parents. They are told to feed the baby whenever they cue so they are very vigilant about this. Knowing that babies have 2 sleep cycles and that their light sleep is where the REM sleep happens and that this cycles with deep sleep is helpful in understanding when the baby is truly awake and wanting food.
The baby cycles in and out of these 2 phases of sleep every 40 minutes to an hour. If the parent picks up the baby in light sleep and offers food, the baby will probably eat for a minute or so and then fall into a deep sleep. This can be detrimental to breastfeeding as well as to anyone getting good sleep. Parents need to listen to the baby during those times of movement and noise and to determine if they are going to escalate of deescalate. Usually the baby will cycle back into deep sleep in a few minutes or less. If they are truly hungry, parents will hear them amp up and feed them.
There are many books written about infant sleep and how to get babies to sleep better and longer, some good and some not. The above are simple techniques that can start a family on the right path with some easy to follow guidelines. Being consistent, having positive intentions, and understanding. Normal infant sleep can be much more helpful then reading the books and searching the internet.
The following list can be good reminders for new parents:
- Every baby is different…what works for “their” baby/babies may not work for yours.
- Newborns have cycles of sleep with brief awakenings.
- Sleep begets sleep.
- Crying may indicate fatigue, crying is communication.
- Infants are active in their sleep.
- Bright lights can disrupt nighttime sleep. Use a red light bulb.
- Limit social interaction and play at night…do not look them in the eye.
- Night sleep is a direct result of daytime calories.
- Have a bedtime routine that is age appropriate.
- Above all else, listen to your intuition about your baby.
- The No-Cry Sleep Solution, Elizabeth Pantley
- Creating Sweet Dreams, Rachelle Gershkovich
- Sweet Sleep, Diane Wiessinger & Diana West
- Sleep Matters, a training by Patience Bleskan
CLD, CPD, CAPPA Faculty
Carolyn is a mother, a grandmother, and former elementary school teacher who grew up in a very large family, caring for babies from an early age. In addition to a BA in Elementary Education, she has a Masters in Applied Communication. Carolyn has many years of experience in adult education; teaching marketing, public speaking, memory techniques, and neuro linguistic programming topics. She has pursued a variety of interesting and rewarding careers in addition to teaching that include retail management, marketing, public relations, and interior design. Everything Carolyn has done before led her to finding her true passion in this doula work. “I see it as making a huge difference in the world of families and babies, as well as making a difference in our present and future world.” She is committed to sharing and teaching the experiences and information she has learned, making doula services more available to more families. Contact Carolyn at firstname.lastname@example.org or visit her website Doulawise.com.