Sleep in the First 16 weeks
After creating a safe sleep environment, we must understand how our baby’s sleep will change over time based on biological factors that are occurring. This will help you to know what to expect and what is considered developmentally appropriate at that time in your child’s sleep timeline.
Overall your goal is to help create the foundation for healthy sleep habits to occur. Components for establishing this foundation include:
o Developing a consistent soothing routine for sleep
o Helping your child learn to self-soothe
o Respecting the circadian rhythms that impact sleep behavior
o Establishing a consistent sleeping place/environment
o Being flexible with bedtime
o Establishing a healthy attitude in your home related to sleep
o Remembering that babies need more sleep than adults
So let’s look more closely at the first 8 weeks of life. During this time, sleep is very disorganized. There are no sleep patterns established and circadian rhythms are not developed. Day/night confusion is common at at this age. While day/night confusion can be challenging remember that the goal is NOT to keep your baby up during the day so they will sleep at night. If you take this route the result will be a very over-tired baby that is cranky! Typically day/night confusion is gone by 8 weeks, so try to be patient and let your baby lead the way!
So what are the priorities at this time for parents?
o Do what you can as a parent to get as much sleep as you can. I remember when my twins were newborns my husband and I would take “shifts” during those early weeks. One would be on “duty” with the boys (and my 2 year old daughter!) and the other would go take a nap. Working as a team and asking for help is the key!
o Swaddling can be effective at this time, but remember to avoid hip wrapping
o Don’t worry about creating bad “habits”…you can’t spoil a baby at this time
o Your baby’s rest is the priority and of course safety first!
o Take time for bonding and breastfeeding….this is such an important time in early development
o Remember mom is also healing at this time, so get rest and take care of you! *If possible a post-partum doula or lactation specialist is a great resource.
One thing that can also be common at this time is late day crying or fussiness referred to as “the witching hour” or “purple crying”. This tends to happen late in the day (e.g., 4-7 pm) and can last for several hours. This can be challenging given that this may also be when you are getting dinner ready, welcoming older children home, or trying to take a short break yourself. I remember when my daughter was at this age, between 5-7pm in my house was awful! It seemed to come out of nowhere….fussiness and crying for 1-2 hours. Nothing seemed to soothe her. I found that trading off with my husband during this time was helpful, walking away and stepping outside while I knew she was safe with him, helped to reset me. Remember to ask for that help and if you need a break and don’t have help, put baby in the crib where you know they are safe and step away to collect yourself. One technique that I was introduced to during this time was the five S’s:
o Swaddle
o Side position
o Shushing (mimics the sound of being in the womb….heart pumping and blood flow)
o Sucking (trying to promote the sucking reflex can be calming for baby)
o Swinging (not in an actual swing)
*A great resource for this is Dr. Harvey Karp's book: Happiest Baby on the Block
*Remember this time will pass and research has shown that “purple crying” typically peeks around 8 weeks and then decreases from there.
Around 6-8 weeks we hit our first sleep milestone! As nighttime sleep becomes more organized, babies begin to sleep for longer stretches of time at night (e.g., 4-6 hours). This is also the timeframe when day/night confusion ends. Another fun thing about this time is this is when your baby typically has their first smile! Such a great milestone you will never forget!
So what can you be doing at this time to help establish healthy sleep habits?
o Establish a consistent sleep space
o Establish a consistent soothing sleep routine
o Give your baby opportunities to self-soothe
o Remember that bedtime will slowly become earlier as patterns slowly emerge
As your baby grows they will be less able to just close their eyes and go right to sleep. So this is the time to really learn your baby’s sleep cues. The key is to avoid baby being over-tired.
o At about 45 min-1 hour look for sleepy signs: zoning out, rubbing eyes, pulling on ears, turning head to the side
o If baby is already putting themselves to sleep let that happen.
o This is the time for establishing that soothing routine: rocking, singing, nursing, bottle
o Put baby down in the crib. The goal is to put down still awake but relaxed and heading off to sleep, NOT asleep.
o If baby is getting fussy during the routine it may be a cue they are getting over-tired. If baby is starting to fall asleep part way through the routine, put them down.
o Remember to confidently put your baby down as they will pick up on the apprehension or nervous energy. You will learn the “sweet spot” over time as you practice this routine. This is going to take practice!
o If your baby fusses when you put them down it is ok to pick them up and try again to soothe. However you also want to observe a bit as your child may just be “working it out” by making little noises as they drift off to sleep. Again, this will take time to figure out how your child transitions into sleep.
At this point, we don’t have real control over when baby naps or for how long. The goal is practice, learning your child’s sleepy cues, learning to avoid over-tiredness, and starting to experiment with self-soothing. Some naps may be long and some may be short. While this can be frustrating, it is all part of you and your child’s learning process!
So what happens after this timeframe between 8 to 16 weeks? During this time, you should continue to practice the routines I just described. Establishing the soothing routine, looking for sleepy cues, practicing with self-soothing, trying to reduce sleep props if possible (e.g., bottle or breast) are your priority. A few things that are important to note about this timeframe are:
o Wake times will lengthen
o Bedtime will continue to get earlier
o You will begin to see patterns of day sleep as circadian rhythms develop
o Your baby’s morning nap tends to be most predictable first
Remember these first 16 weeks are a time of bonding for the entire family. Take time for you as healthy moms and dads create healthy families. Ask for help and lean on those who want to support you. There will be many ups and downs during this timeframe, but remember you are setting the stage for healthy sleep habits to emerge over time.
Dr. Hampshire