Newborn Sleep Tips For The 4th Trimester (0-3 months)

We’re going to get into some helpful tips and we’ll talk about the development of healthy sleep habits, but first, and most importantly for this stage of your baby’s development is following safe sleep practices.

The American Academy of Pediatrics recommends placing baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet free of any soft bedding like blankets, crib bumpers, pillows, lovies or stuffed animals. Infants should sleep in the same bedroom as their parents ideally until age one, but at least for the first six months. To decrease the risks of sleep-related accidents, the American Academy of Pediatrics recommends babies sleep on a separate surface than their parents, such as a crib or bassinet, and never on a couch, armchair or soft surface.

We also want to make sure that their sleep environment is conducive to sleep.

• Darken room with blackout blinds, use Velcro around the corners.
• Introduce a white noise machine – one that runs continuously can be helpful for both naps and night sleep.
• Temperature between 68 and 72 degrees.
• Practice safe sleep – no blankets, bumpers, or big stuffed animals.
• Keep cellphones and screens out of the room which emits blue light and suppresses natural melatonin.

At this stage it’s important for you not to have too many expectations of your baby. Their sleep is unorganized with no patterns and they haven’t yet developed Circadian Rhythms. You can expect babies to sleep 18-20 hours a day in the first few weeks. I wouldn’t be too concerned with baby sleeping “too much.” As long as baby is waking up to feed enough, or you can successfully deliver a full feed while baby sleeps, sometimes called “sleep feeding”. During this stage your baby is probably sleeping as much as they need to.

The goal in the first six weeks is really to bond with your baby, for you to get to know them and vice versa. It’s a time for you to focus on healing from childbirth and taking care of your body. That definitely means sleeping when baby sleeps and trying to nap with your baby during the day. All this unpredictability is a necessary phase for your baby and it doesn't last long – though it may seem like an eternity when you're sleep-deprived.

Really try to push aside the responsibilities – dishes, laundry, house-cleaning and focus on getting the rest your body needs. Sometimes easier said than done, but if you have a friend, family member, or partner that can take some time to support you by doing the grocery shopping, chores and errands, making you snacks and meals. Support is going to really help you get the rest you need.

Understand you can’t create bad habits in the first few weeks. Your baby will cry for a need, so tend to every cry. As you get to know your baby, pay attention to why your baby is waking and how they signal you. Hungry cry? Discomfort? If you’re baby seems uncomfortable and you’ve done everything else to meet their needs – a diaper change, nursing or bottle feeding, rocking – it may be a good idea to check with your pediatrician about possible common conditions in young babies including reflux, GERD, gas, or milk allergy and see what you can do to help get your baby more comfortable at night. Understanding your babies “language” will help us later as we start to rely on their cues for sleep.

Night time sleep at this age probably consists of a pretty late bedtime, because baby is napping regularly into the evening hours and then having time of wakefulness – and at least a few nightly wake-ups for feedings or possibly diaper changes. The most important thing for a newborn is that you be available to them upon waking – meeting their needs, including soothing them. Soothing for your baby might include nursing, rocking, a pacifier or swaddling. Maybe all of the above. At night, let your baby set their own pace. As the baby gets older, they will naturally give you longer stretches as they don’t physically need to feed as much and are growing a little less rapidly. But while babies sleep stretches are still sporadic, follow their lead.

You may notice your baby is facing some day/night confusion where they’re more wakeful at night than during the day. During pregnancy, a baby’s sleeping rhythms are closely tied to mom’s movement. When mom’s up and moving around, her movement lulls baby to sleep. By contrast, when mom lies down to rest, baby often wakes up. Babies also rely on their moms’ hormones (specifically melatonin) to help them sleep. Once your baby is born, they have to rely on their own internal clock to tell them when it is time to be awake and when it is time to sleep. However, their internal clock is not even close to being developed yet. This is another reason why they may be wide awake in the middle of the night, and sleeping soundly in the middle of the afternoon. There is no quick fix for day/night confusion but there are a couple things you can do to help.

Many parents think maybe if they keep baby awake during the day it will promote better sleep at night. But it’s really the opposite. A baby that is kept awake during the day when they want to be sleeping is going to be overtired and irritable, which is a recipe for more difficult sleep at night. So just allow your baby to sleep when they need to sleep in the first six weeks.

Another way you can help with day/night confusion is to keep the lights off at night so baby can start to recognize and associate dark with nighttime and light with daytime. Keep feedings calm and quiet, and do diaper changes quickly. Make sure your baby gets some light, preferably sunlight, during the day, during wakeful periods. Light is one of the primary things that helps ‘set’ our internal clocks. Although light cues may not instantly program your baby's internal sleep clock, routine will help your baby start to learn we sleep when it’s dark and we wake when it’s light. Circadian Rhythms will start to really develop around 8-12 weeks, but you can help support the development now with the right environment.

Ali Lazar, Certified Child Sleep Consultant

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