Facts about what to expect from your newborn baby with regards to sleeping and waking at night.

Due to our own discomfort in the final weeks of pregnancy, most moms find they suffer from broken sleep and also battle to fall back to sleep at night. It is said this prepares us for the broken sleep of the early weeks with our babies.

What to expect

But in truth, nothing can prepare us for the exhaustion that sets in soon after our baby’s birth. The first week, we tolerate and cope with the lack of sleep, but ten nights of broken sleep down the line, most parents are feeling exhausted and the focus becomes on the big question: “When will my baby sleep through the night?”

In the early days, most babies wake two to four hourly for feeds at night, especially breastfed babies. This gradually reduces and within a few weeks (usually at around 6 weeks of age) your newborn should start to stretch for one long stretch of five or more hours at night. This is usually the late evening feed (around 10 pm). Don’t be tempted to wake your baby up to feed at this time in the hope that it will do away with the 2 am feed, it won’t work and can cause longer term sleep problems! By the time your baby is around 3 months of age, he should be able to go for up to 8 hours at night without needing a feed. In time your baby will drop most night feeds but many babies only start sleeping through the night when they are on a full solids diet. So until three to six months one night waking may well be the reality.

Reversed day – night

There are many other issues that may concern us with our newborn’s sleep. One common concern with newborns is whether they have their day and night muddled up. In the dark world of the womb, little differentiates day from night, with the exception of how much mom is moving. And since movement is lulling, babies may in fact sleep more during the day and be more wakeful when mom goes to bed. Once they are born it is important that babies begin to differentiate day and night. Since newborns sleep almost constantly between feeds they will not be wakeful either day or night in the early days, however we want to encourage our babies to feed more frequently during the day and begin to stretch feeds at night. The way to do this is to feed on demand in the early days, but if he is tending to sleep his days away, and wakes frequently in the night for feeds, wake him to feed three to four hourly during the day. If your baby is gaining weight and is a healthy baby without concerns for his growth, leave him to wake you at night. By doing this, within two weeks your baby should be waking frequently for feeds during the day and sleeping for at least one longer stretch at night. For instance sleeping from 6pm to 12 midnight and then waking three to four hourly thereafter.

Too sleepy to feed

Another cause for concern in the early days is the baby who is too sleepy to feed well. If your baby is not waking himself for feeds at all during the day or night and sleeps through feeds, you may want to have your clinic sister check him for jaundice or lethargy due to low sugar levels (especially in the first few weeks). It is however very common for a normal, healthy baby to be sleepy for feeds in the early days. To deal with this, wake your baby fully from sleep by changing his nappy before the feed. Then don’t swaddle your baby for the feed, leave him uncovered and even leave his feet out of the babygro to keep him slightly cool and less comfortable. Another trick is to wet a piece of cotton wool and stroke his cheek or feet intermittently to remind him to keep sucking well.

Can’t fall asleep

Not generally a problem for the newborn, falling asleep suddenly becomes a problem between week two and three. Your sleepy baby is now more wakeful and now it’s getting him to go down to sleep that is the issue. This results in an overtired baby, which is one of the most common causes of crying in the first twelve weeks and can contribute to bad sleep habits later on. To help your baby fall asleep, watch how long he is awake. An overtired baby will fight sleep. The young baby under 6 weeks can only cope with an hour of awake time. So watch your clock and get your baby back to bed within an hour of waking. This generally only gives time for a feed and nappy change before your baby goes back down.

If your baby starts crying after being put down and you have fed him and know he is comfortable, do not assume winds are the cause of this disruption. It is more likely that he is fighting sleep. In this case picking him up will probably lead to more crying in the long run. By fiddling with your baby and burping him, carrying him and fussing over him you could well end up with ‘colic’-like irritability. Instead, when your baby cries, listen to him for 2 - 5 minutes to see if he can settle himself. If he continues to cry, then sit next to your baby’s cot and hold his hands still and ‘shsh’ him with firm, deep pressure on him. Your baby’s little hands are often flying around and irritating or scratching him. Swaddle him, offer him his hands or a dummy to suck and sit still, holding your baby’s hands until he is settled and falls asleep. In this way without over stimulating your baby, you will calm him and help him fall asleep without setting up habits that will be hard to break, such as rocking your baby to sleep.

Improve night sleep

• Finally, to set the stage for good sleep habits and improve your baby’s sleep from one week to the next, keep night feeds strictly business affairs. This means not interacting with your baby at night other than feeding.
• Don’t wake your baby for feeds – take his lead for waking at night. This allows your baby to establish natural sleep cycles. (Your clinic sister will tell you whether this is OK depending on his weight).
• Don’t smile or talk to your baby at night – keep these happy interactions for day light hours.
• Feed in semi-darkness – use a dimmer or a passage light instead of the bright bedroom light.
• Don’t change your baby’s nappy – buy the best nappy you can afford for nighttime and leave it on all night unless it is clearly dirty with poo or leaking. The new generation gel nappies are fine to leave on all night as they soak up all the urine and the bottom remains dry.
• In the early days, do not ‘dummy’ your baby in an attempt to decrease night feeds. Rather feed him when he wakes for feeds at night, if more than two and a half hours have passed since the last feed. Once he is three months or older, you can try stretching him with a dummy or some cooled, boiled water.

Nothing can prepare you for the feeling of exhaustion and desperation as sleep deprivation sets in, just know these early nights of frequent wakings are short lived.

Posted: 20 April 2007