I have been sleep consulting now for 4.5 years and have learned so much in that time. The earliest I begin working with families is once baby has reached the 16 week mark which means newborn sleep is a bit of uncharted territory for me! Or it has until recently, as my 3rd baby was born in April 2018 and I have learned so much in 7 short weeks. If you've read my 'about me' section here, you'll know that I struggled majorly with my first-born and sleep. Ignorance was not bliss! With my second, I did a lot of things differently and while it was exponentially better, I couldn't help but think if there are more ways we can help improve sleep in the first few months [or the 'fourth trimester' as some call it]. Thus began my research - I scoured the Internet and the most popular newborn sleep books for the best tips and advice on how to improve sleep in the newborn days. And it has paid off so far! This blog post is meant to outline what I've done differently this time around and what has helped shape baby W into a so-far great sleeper [hello 9 hour stretches of nighttime sleep!] Happy reading!
While I know that a lot of newborn sleep is 'luck of the draw', I also know that trying to cultivate some healthy sleep habits right off the bat is never a bad idea. While true bad habits are not created until a baby is older, oftentimes by setting baby up on the right foot, we can avoid having to do any major sleep training down the road. The key with most newborns is trying your best to avoid the overtired state, which can be tricky as babies at this age are very prone to overtiredness. So what have I found to be the most important keys in the early weeks with newborns?
Get those days and nights sorted out ASAP
Babies live in perpetual darkness in your tummy which means that when they enter the world, their circadian rhythms are all sorts of messed up. Additionally, most babies are more active at night while you are sleeping and sleep during the day when your movements help lull them to sleep. One your main priorities in the early weeks should be helping baby sort out her days and nights. A few important ways to do that include:
- Waking baby up every 3 hours during the day. Even if it's just for a quick feed and then right back to sleep, making sure baby doesn't sleep through feeds in those early weeks is important as then baby will start to try to make up for the missing intake at nighttime. This also ensures baby doesn't clock too many daytime sleep hours which then = less nighttime sleep hours. As the weeks go by, you may need to even experiment with capping naps closer to the 2-2.5 hour mark [by 6 weeks I was capping baby W's naps at 2 hours and that has helped us get some nice long stretches at night].
- Nap in the light, nights in the dark. Until you are certain baby has their days and nights sorted, put baby down for naps in a bright-lit area [we had baby W napping in her crib right away but I would keep the curtains open for naps]. Once days and nights are sorted, naps should be in the dark to ensure good-quality sleep. Nighttime should always be dark and boring - try not to interact or stimulate baby during nighttime hours [nighttime should begin somewhere between 9:00-11:00pm for babies up to 6 weeks of age and 8:00-10:00pm at 6+ weeks of age].
Attempt independent sleep from day 1
Most of us have read at some point that putting baby down 'drowsy but awake' is important. With my first 2 children, by the time I had read or thought about that, I was already in the thick of rocking/feeding to sleep. So I wanted to experiment this time around with independent sleep from day 1 [and I'm not kidding, I put baby W down awake in that plastic crib in the hospital - ha!] I was absolutely amazed at how she had this innate ability to put herself to sleep [I'm sure you've read newborns can't self-soothe - I beg to differ!] I would turn the white noise on, swaddle her up, rock her for a minute, and lay her down awake. And she'd lay there silently, close her eyes, and fall asleep. I'm not gonna lie - it almost felt wrong! It felt like I should be rocking her to sleep! But I didn't have to! My mind-set this time around has been to work on things in the early months that will make it easier on her down the road. Working on independent sleep right away should mean that sleep training is not necessary [or at least not any major sleep training!]. But trying to start right away is the key, as once baby has been accustomed to one way of falling asleep, it becomes more challenging to undo it. Now, as baby W gets older and more alert and aware, independent sleep doesn't have the 100% success rate it did in the early weeks. Just keep in mind that independent sleep is the ultimate goal, not the be all and end all. What that means is that if by attempting independent sleep baby is on the verge of becoming overtired, you want to rescue that sleep time. I gave baby W 20 minutes to attempt to fall asleep on her own. If independent sleep didn't happen within those 20 minutes, I'd resort to rocking, nursing, using a swing, carrier, etc. to help her fall asleep. At such a young age, avoiding the overtired state is extremely important.
So what would I do during those 20 minutes that I was attempting independent sleep? From the get-go I established a solid nap routine [short but sweet!] I'd walk up to her room saying, 'it's nap time!', I'd turn on the white noise [this was a HUGE cue for sleep from day 1 - I was that crazy lady using white noise in the hospital but it has proven extremely helpful in signaling sleep for her], dim the lights, swaddle her up snug [using this technique - a snug swaddle is KEY!], lights off, sing her a song while walking around the room, then stand in front of the crib and bounce/shush until she was drowsy [I gauged 'drowsy' by waiting for one long, slow blink]. I would then lay her down awake and put my hand on her chest while continuing to shush and sometimes rocking her back and forth in the crib. If she cried I would give her a few seconds [it was actually quite amazing how on a number of occasions it was almost as if she needed to have a little 10 second cry to release energy and then she would calm and close her eyes] and if the crying was escalating, I would pick her up and bounce/shush again. The crying I experience is never very intense [not nearly as intense as when I am putting on her lotion at bedtime!] and a lot of it just seems to be her releasing energy [remember, not all crying means that something is wrong, sometimes crying is just a baby saying 'I'm tired!'] I would repeat this process until baby W was calm in the crib and then I would leave. If she cried once I left, I would wait 5 minutes [I have used a baseline of a 5 minute wait from day 1 - of course if the crying was escalating I would go in sooner but this almost never happened], and go in and repeat again [until we hit that 20 minute mark where I would rescue the nap instead].
This process was very similar to how I would approach bedtime as well. The difference there is that I have been doing a bath every single night since night 1 [the bath, I think, is what really helped with sorting out days and nights and has been a big cue for bedtime]. I only use soap every 3 nights to avoid drying out her skin and we lotion every night. As well for bedtime, I split the bedtime feed in half - meaning I start the bedtime routine by nursing her on one side [if you are bottle feeding then feed half the bottle], then we proceed to bath, lotion [hates that part!], jammies, nurse on the other side [rest of bottle], swaddle, sing, bounce/shush, down in bed. Again, we attempt for 20 minutes before rescuing the bedtime [rocking to sleep, nursing to sleep, or as a last-ditch effort on a particularly rough night - using the swing].
It's not always perfect but even just attempting independent sleep in the early weeks will be helpful to establish fully independent sleep down the road! The big key to being successful with independent sleep is nailing those waketimes. Babies are SO sensitive to overtiredness in this early months that trying to put a baby down awake and overtired is a bit like trying to wrestle my cats into their carrier to go to the vet, which brings me to my next point....
Keep awake times SHORT
Keeping intervals of wakefulness short for newborns is extremely important. This was one area where I went drastically wrong with my first-born and likely contributed to her colic-like symptoms that we experienced [I thought my newborn was a genius for being able to stay awake for 6 hours but then wondered why she screamed all night every night - oy!]. Newborns need a LOT of sleep and they need to sleep often. It's sometimes hard to believe how often we should be putting young babies down for naps but as I have mentioned a few times, avoiding that overtired state is key. Once you hit that overtired point, any chance of independent sleep will be extremely difficult and if you do manage it, you will likely experience a lovely 25 minute micro-nap - not fun! Babies up to about 3 months of age should basically stay awake long enough to eat, have a change, and then it's time to go back down again. This can feel extremely frustrating and exhausting but it does get better! A few times I kept baby W up just because I wanted to hang out with her longer than 10 minutes and it majorly back-fired every single time. So how long are we shooting for?
0-1 months: 40 minutes maximum
1-2 months: 40-60 minutes maximum
2-3 months: 60-80 minutes maximum
That's it. Seems crazy, right? I hear you! But babies up to 2 months of age require 16-20 hours of sleep. That only leaves about 4-8 hours of awake time every single day. Baby W is currently 7 weeks old and I aim to start her nap routine at 40 minutes of awake time. This leaves about 10-15 minutes of 'play time' after changing and feeding. Any longer than this and we hit that overtired state and more than likely will have to rescue the nap.
Separate food from sleep AND encourage full feeds
When encouraging independent sleep, we want to ensure we remove any associations that can negatively impact sleep. An association is something that occurs at or near sleep times. Some of these associations are positive [white noise, swaddle, lovey] and others can negatively impact sleep [rocking to sleep, feeding to sleep, etc.] Basically, anything a baby cannot re-create on their own is an association we try to avoid! Milk is definitely a strong association and something that ideally we would try to separate from sleep times as much as possible. Therefore, once baby starts to have longer periods of wakefulness, it's a good idea to feed them at the beginning of their awake time, followed by changing and play, and then down for a nap [there may not be much time in the early months between the two but we can still try to separate it, even if it's only by 10 minutes!]
The other key with helping to establish good sleep in the early months is encouraging full feeds. This is something I've actively tried to do this time around and it has really helped. If baby falls asleep eating - wake baby up. I did this by feeding one side, burping [try to always get a good burp out! Newborns can be very easily bothered by gas!], changing, then feeding the other side [nighttime feeds included]. By encouraging full feeds, especially during the day, we should see longer stretches of sleep emerge earlier on as sleep is closely tied to food in the early months.
Wait it out
I have found that waiting it out [i.e. not rushing to baby] has become easier and easier with each subsequent child. With my first, I wouldn't even let her make a peep before I rushed in to rescue her. If your baby cries, that means you're doing something wrong, right?! No! Babies can be noisy sleepers and remember that a lot of crying can just be baby's way of expressing fatigue or trying to blow off steam [especially if overtired/overstimulated]. Now we're not talking about letting a newborn cry-it-out, but if baby is crying at a sleep time [either trying to fall asleep or trying to fall back asleep] try to wait a few seconds and really listen - is the crying very intense or not? Does the crying seem to be tapering off or becoming stronger? Is there a lot of breaks in the cries? You know what you're comfortable with and that is important - there's certain cries that I would go in immediately for and there's cries that I would wait out a bit. As I mentioned above I tried to have a baseline of a 5 minute wait once baby W was a few weeks old, but if the crying was getting more intense then I would go in sooner. With time, I've been able to build up to closer to 10 minutes [again, gauging it by the type of crying] and it's quite amazing how many times baby W has been able to settle or re-settle on her own if I give her that opportunity. I want her to know that I believe in her ability to self-soothe - that she can do it on her own but that I'm here to help her if she needs it. To me, this is helping her build confidence, something that I feel she might not learn as well if I do it all for her! But of course, keeping age-appropriate expectations is important, remembering that independent sleep is just a goal we are working towards, not something we insist on. Fully independent sleep can come later, right now we are just practicing.
Find that sweet spot bedtime
Newborns naturally have a later bedtime and trying to find that sweet spot bedtime for your newborn is important. With my second-born, I tried to shift bedtime too early too quickly and I believe it contributed to the shorter stretches of sleep and evening wakefulness that we experienced. While I love me an early bedtime, I've found that not trying to push bedtime too early too quickly has really helped. Sometimes the later bedtime can be stressful as those evening naps can be tricky to get [most of the time I don't even attempt the crib for the last nap of the day and instead we go for a stroller walk/jog or I use the swing or carrier] but working hard to get them in should ensure a more peaceful night of sleep.
From the get-go, I would call any sleep after 8:00pm nighttime sleep. So if baby W woke up at 8:30pm from a sleep time, I would start my bedtime routine right after she woke and the next sleep time [around 9:30pm] would be bedtime. Remember, bedtime up to 6 weeks of age can be anytime between 9:00-11:00pm [so the sweet spot may be different for your baby] but I tried to keep it on the early end so I would be able to shift it earlier more easily [I am not a night owl!] Once I had that 9:30pm bedtime established, every week I would try to shift it a bit earlier by ending the last nap earlier by 15 minutes. A good goal to have would be to end your last nap at 7:30pm by 1 month, 6:30pm by 2 months, and 5:30pm by 3 months. Additionally, if you're trying to shift bedtime earlier, try to ensure baby isn't sleeping in too late in the morning, as this can make it hard for baby to settle earlier in the evening. As a general rule, the wake-up time should be 12 hours before your goal bedtime. So if your goal bedtime is 9:00pm, I would wake baby up at 9:00am. If goal bedtime is 8:30pm, wake baby up at 8:30am. This ensures sufficient awake time during the day.
I have also found that the awake time before bed can often be a bit longer than in between naps, and it's good to aim for about 1-2 hours of awake time between last nap and bedtime up to the 3 month mark.
I hope you have found this information helpful as you navigate through those difficult early months! I am so happy to share this with you all and welcome your thoughts/opinions.
Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!