25th June 2018

Optimising Newborn Sleep

Everyone knows that newborn babies wake up a lot. They actually need to sleep for far more time than they are awake but in the early days this sleep often falls little and often which is the opposite of how adults typically sleep meaning it can feel pretty horrendous for the parents. 

These early days are not the time to worry about a little one's sleep habits. Rather it is a time for bonding with your baby, resting and recovering from their arrival into the world. A baby cannot be spoilt by cuddles, kisses or being quickly responded to, no matter what you may hear about "creating a rod for your own back". 

Can pregnancy influence infant sleep?

In a word, yes! Research shows that a pregnancy diet that is high in Omega 3 fatty acids (found in algae, oily fish and DHA-enriched eggs for example) is linked to a newborn having more deep/quiet sleep than babies born to mothers with a lower pre-natal Omega 3 intake. 

Another great tip for mums-to-be is to keep those stress-levels as low as possible - easier said than done sometimes but studies have found that infant stress, both in-utero and once born, is associated with more infant crying, fussing and anxiety in infants - which when taken together are typically described as "colic". Whilst pre-natal stress is certainly not the only contributing factor to colic, it's one of the few we have some level of control over and given that colic is unpleasant for babies and their parents (and will almost certainly adversely interfere with a child's sleep) it's worth trying to keep as relaxed as pregnancy allows - some pregnancy yoga or guided meditation can work wonders! 

Whilst it won't help your child to sleep better, parents can make the impact of their baby's arrival less pronounced by addressing how they themselves sleep. Babies, even when sleeping at their best, are typically "larks" - rising early for day (6-something is the norm, anything starting with a 7 is a bonus!) and being ready for bed somewhere between 6 and 8pm. Whilst some adults are also natural larks, others are "owls" who are happy being awake late into the evening and making up for it with a nice morning lie-in when life allows. Owl parents will typically find the baby-induced disruption to their sleep harder to manage than their lark counterparts. Whilst both physically ad practically an adult is unlikely to be able to shift themselves onto a 7pm-7am schedule, it is feasible to turn an 11pm bedtime into a 10pm one - I would suggest shifting it very gradually, perhaps just 15 minutes a week until the parents feel refreshed even on a 6am start.

ten top tips for once baby arrives

  1. Remember that you cannot spoil your baby with cuddles, love or responding quickly to their cries. No irreversible "bad" habits can be created in these precious (yet tiring) early months. This is a special time where the priorities are recovering from the birth, resting as much as possible and bonding with your new bundle of loveliness. Take sleep (for both you and your baby) however you can get it (subject to safety of course).
  2. Help your baby to establish their body-clock. Infants are not born with circadian rhythmicity, it is something they develop in their first few months of life and it is not until they do that they feel any difference between night and day. You can help this process along by exposing your baby to 12 hours of broad spectrum light - daylight if it is available but artificial light is still helpful if natural light not be available. During those "daytime" hours, keep noise and activity levels in or out of the house consistent with waking hours. Then aim for a 12 hour period of dark and quiet time with reduced levels of stimulation. Whilst a newborn will not be able to sleep for a 12 hour stretch without periods of awake time, if you can keep the lights, noise and activity levels low once you have entered "nighttime" mode it will certainly assist with your baby setting their circadian rhythm. 
  3. Keep your baby close, both when awake and asleep. It is very natural and normal for a baby to want to be close to his parents, especially in these early months (often referred to as the "fourth trimester"). Additionally, parental presence in the room where an infant is sleeping (whether day and night) reduces the risk of Sudden Infant Death Syndrome (SIDS). Taking into account the suggestion of a 12 hour "night" above, this can present something of a conundrum for parents as many, understandably, don't particularly want to sit in dark silence through the evening whilst their baby sleeps close-by! It is however worth considering whether the lights can be dimmed and noise levels reduced during the evening for this relatively short period whilst baby establishes his body-clock. 
  4. Infants typically have a remarkably short "wakeful window" (the period of time they can be comfortably awake between periods of sleep). For a newborn it is not uncommon for the wakeful window to be as short as 45 minutes! At the end of that period, if the baby isn't able to go to sleep then their bodies respond in order to keep them awake and taking in the stimulation around them, despite their tiredness. Signs of being ready for sleep can be easy to miss with a new baby, especially in the midst of frequent visitors and trying to get to grips with managing both and shower and clean your teething your teeth on the same day! Ensuring baby gets enough daytime sleep is however key to optimising sleep in the early days as one of the most closely-guarded secrets of child sleep is that sleep begets sleep. It's possibly the most counter-intuitive aspect of infant sleep but it's true, children can very easily become too tired to sleep! Cue then an exhausted, crying baby and a parent walking an ultra-marathon around the lounge trying to rock, bounce or otherwise coax said screaming child into the land of nod. By watching for tired signs from their baby, but not necessarily waiting for them if the baby has already been awake for 45 minutes to an hour, and seeing if the child will take a nap, parents have the best chance of keeping their little one in the most optimal state for restful sleep.
  5. Whilst feeding a newborn to sleep will not create a irreversible habit, parents may find they get off to a flying start by following the EASY way of parenting: Eat, Activity, Sleep, You time. Whilst I'm yet to meet a parent who makes full use of "you time" (unless loading the dishwasher or having a 3 second shower is your idea of fun and relaxation!), the concept of feeding-on-waking rather than prior to daytime sleep is a helpful one. Feeding a baby will naturally make them feel relaxed and sleepy. Given the short wakeful window of a young baby if the feed happens at the end of the awake period rather than the beginning, it is very likely that baby will fall asleep on the feed. Whilst feeding-to-sleep during the night is somewhat inevitable with a newborn, if this is repeated throughout the day also, it can become the only way that a baby knows how to fall asleep. If this habit develops it can, of course, be gently worked out further down the line but some babies are actually very amenable to learning to fall asleep in a different way from their early months. Some babies aren't keen and I would never advise pushing this. However if you are following the EASY routine, when nap time comes around you can try cuddling your baby until they are very drowsy but just still awake then placing them down into their sleep space and reassuring them with lots of touch and soothing words. If baby isn't happy then pick him up and help him to sleep however you usually would. If you practice with baby going down awake little, often and gently, never leaving your little one in their sleep space for longer than they are happy with, you may find that over time your baby is able to fall asleep with you comforting and supporting him from the cot-side. If a baby can fall asleep in this way it is a significant step towards being able to sleep well. 
  6. It's a great idea to start a short and simple bedtime routine from as early as 2-3 weeks old. Some parents prefer to bath their little ones daily whereas others choose to do it less frequently. Whilst bathroom activities are a usual step of a bedtime routine, what happens within that step does not need to be the same every night. The younger the baby the shorter routine should ideally be. It will potentially feel fairly pointless reading a story to a newborn but softly saying some nursery rhymes whilst holding your baby skin-to-skin for example can be a lovely way to wind-down and bond before bedtime. Over time, doing the same steps in the same order at the same time each day will start to cue your baby for what comes after and help him anticipate bedtime. 
  7. Newborns often sleep best in conditions that mimic the womb so far as this is possible. Babies are unlikely to be afraid of the dark (as the womb is dark) but may have an issue with total silence. For this reason, a white noise machine can be helpful in encouraging baby to settle. Some babies like to be swaddled although many health professionals no longer recommend this practice. Swaddling is certainly not appropriate for a baby who is able to roll (or close to being able to do so). 
  8. Whilst many parents decide that their baby will not have a dummy, there is actually good evidence that in babies under 6 months, having a dummy at the onset of sleep reduces the SIDS risk. This protective effect does not increase however if the dummy is replaced throughout the night. Many babies have a strong desire to suckle and lots find a dummy soothing. Parents are often worried about either being judged for giving their child a dummy or that removing it further down the line will be a battle. I have written a separate post on the dummy debate and whether to use one or not is a personal decision for the individual family. From a child sleep perspective however, some babies do find a dummy immensely comforting and whilst removing the dummy is likely to cause an unsettled few nights whilst the child adjusts, if a little one is really struggling to settle without being/staying on the breast or bottle throughout the night then a dummy may be worth considering (once breastfeeding has been established if relevant).
  9. A child will start to produce melatonin (the "sleepy" hormone) somewhere between their first and third month of life. Melatonin works in conjunction with the emerging body-clock to help a baby wind-down and be ready for sleep as bedtime approaches. Melatonin production is inhibited by exposure to blue-light which is emitted from televisions, tablets, smart-phones and similar devices. It is therefore preferable to avoid having these devices on around a baby in the hour or two before bedtime - even if the child isn't watching the screen, blue-light will still be emitted and potentially inhibit the child's efforts to make themselves ready for sleep. For the same reason, during the third month and onward it can be helpful to start dimming the lights and making the environment slightly darker in the hour before bedtime to stimulate the melatonin response in your baby. 
  10. Contrary to what you may have heard, my final tip to achieving better sleep with your newborn is to breastfeed if you are able. Myths abound regarding formula milk as a panacea for baby sleep but whilst there is anecdotal support for this claim, several studies have found that it is in fact breastfeeding mothers who ultimately get more sleep. Not only does breastfeeding reduce the risk of SIDS, breast-milk contains tryptophan which is the pre-cursor to melatonin and can both optimise sleep for a newborn as well as reducing the risk of infant colic. 

 

SURPRISING THINGS THAT CAN INFLUENCE HOW WELL YOUR NEWBORN SLEEPS

There are many variables outside of a parent's control that affect how well their child is likely to sleep. The gestational age of the baby at birth plays a part as well as the mode of delivery - as an example babies born by planned caesarean-section will typically spend less time in deep sleep than their contemporaries where labour started spontaneously. Similarly medical intervention in the first hours or days of life can impact a child's sleep habits thereafter. 

Genetics and temperament also play their parts as do any difficulties that may arise with a baby's ability to feed well, colic and common medical conditions such as reflux.

In fact such a myriad of factors play into how well a baby will naturally sleep that I always advise parents to resist the almost overwhelming temptation to compare their child's sleep with that of other similar-aged babies they know. Unless two babies have identical genetics, were born at the same time in the same way and have the exact same temperament and experiences (both pre and post-natal) then the comparison is at best useless. At worst, parents become anxious that their child isn't sleeping as well as he "should" be - this anxiety around sleep is likely to translate to baby and anxiety is most definitely not an ingredient in the recipe for a good night's sleep! 

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Lauren Peacock - Sleep Specialist - UK
Book a free 15 minute introductory phonecall
07977583728 | lauren@littlesleepstars.com