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Challenge: Sleep Solutions

Sleep and Your Newborn: Creating Good Habits From the Beginning

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Newborn

If you have a newborn, you are most likely as baffled by his or her sleep as you are about baby clothing sizes or how to cut those tiny fingernails! If you aren’t puzzled yet, you will be. However, despite what many will tell you, there are things you can do to help figure out many of the sleep challenges that come with each and every newborn baby. It’s true you can’t spoil a newborn, but it’s also true that you can set him or her up for both good and bad habits.

I have a toddler and a newborn, and I got eight hours of sleep last night, and the night before that, and the night before that. Granted, it was not consecutive and I’m usually up for an hour around 3:00 a.m., but it’s more than many parents get! I’ve also helped many new parents set themselves and their children up for excellent sleep habits that last. The challenges of the newborn stage has, for good reason, been on my mind a lot lately as I put into practice many of the strategies I’ve used with other families and I want to share with parents how, as a sleep consultant and a new mom, have been prioritizing rest in a way I didn’t with my toddler. Sure, I am utterly exhausted at the end of each day, but it’s not from lack of sleep. It’s from doing every other thing that is part of being a parent. However, I also know that if I don’t take care of myself (of which sleep is an absolute must) then I am of no use to my children, or to the rest of the world either.

Often, it’s assumed that parents of newborns are sentenced to a minimum of 6 months of very little sleep. It’s one of the questions you’ll be asked over and over: how is he sleeping? Are you exhausted? The assumption is that this is just the way it is.

I disagree. Read on to find out how you, too, can get the rest you need even with a newborn.

First, let’s talk about some American Academy of Pediatrics Guidelines

The AAP is the gospel of pediatric guidelines regarding just about everything. Go to https://www.aap.org/ and bookmark this site. It will be helpful to you as you navigate the choppy waters of newborn-hood, safety, recommendations, recalls on baby items, and a plethora of other resources.

Here are the sleep guidelines set forth by the AAP:

  • Baby should sleep in parents’ room for the first 4-6 months
  • Baby should sleep in a bassinet, crib, or co-sleeper attachment. safe-sleep-pic-2
  • Baby’s bed should be free and clear of bumpers, loose blankets, stuffed animals, and other objects.
  • Baby should always sleep on his or her back.
  • Baby should not sleep in parents’ bed with them.
  • Baby should not be exposed to second-hand smoke.
  • Any kind of sleep training should be done after the baby reaches 12 weeks of age.
  • Baby should be fed on demand for the first month at least.
  • Baby should not sleep in a car seat for extended periods.
  • Recommendation of a pacifier after the first month, during sleep only.

There are reasons for each of these guidelines, most having to do with baby’s safety during sleep. Even one case of SIDS or suffocation is too many in my opinion.

It also bears mentioning that new moms should be very aware of any symptoms of Post-Partum Depression that can develop. Get help immediately if you notice any signs or symptoms. There are more than 3 million cases per year diagnosed, and even more go undiagnosed. You are not alone!

Finally, a word about the Purple Crying Period, something I knew nothing about until I became a sleep consultant: Almost every baby goes through a fussy period every day known as “Purple Crying.” It’s named this because sometimes baby can be so upset her face turns purple. This period is different from colic in that it lasts about 30-60 minutes and happens around the same time every day, usually late afternoon or early evening. Both my daughters had their Purple Crying time around 6:30pm and it lasted until around 7:30, the difference with my second daughter being that I expected it and knew it was totally normal. The only explanation is that baby’s senses are overloaded from the day. There is really nothing you can do about it, except to be with your baby, help her be comfortable—offer to nurse, offer a pacifier, be sure she has a clean diaper. After that, as long as you know she is safe, just be there and know it will pass. The unfortunate thing is that at this point in the day parents are also exhausted. Most cases of Shaken Baby happen during this period in the day because parents have tried everything and nothing works; they are at the end of their ropes. If you reach a point where you feel this desperate, there is nothing wrong with putting baby down in her bed or crib, or even on a blanket on the floor and taking a moment outside by yourself. Once you know the approximate time of this fussy period, you can be sure to have someone with you each evening for a while to give you a break.

Now, let’s talk about sleep environment:

  • Your room (where the baby is sleeping for now) should be dark and quiet.
  • You might purchase a sound machine or use a speaker with an ipod attached to block out extraneous household noise. The app “Sound Sleeper” by parents2parents is excellent and I’ve used it with both my girls. The nice thing about having it on a mobile device is that you can travel with it. Remember to disable the wi-fi.
  • During “night-time” hours, utilize a very low light, like a nightlight with a 4-watt bulb. More light should only be used if necessary during a diaper change. During waking hours, exposure to more light is great. Both of these will help adjust your newborn’s day/night schedule which is out of whack at first.
  • If your baby has reflux or tends to spit up after eating, elevate one end of the basinet or crib 1-2 inches to help milk flow downhill. Be sure you are burping baby after each feeding.

Planning For Sleep Success

Helping your baby sleep is all about your mindset, which is why I love talking with pregnant mamas—they are in a great headspace for planning ahead and thinking about the long term. New moms are often trying to survive moment to moment. However, whether your are expecting or you have your own newborn, you can still look at the big picture of healthy sleep.

Here is the difference when it comes to sleep:

In short term (aka, survival) thinking,

  • you might do anything you can to help baby go to sleep, especially if he or she is crying, This might involve bouncing, swaying, swinging, rocking, or nursing. It might involve running the vacuum or driving around in the car at 3:00 a.m., too. I’ve heard of everything.
  • you might jump up at the first little squeak your baby makes and rush to pick him or her up.
  • You might try to implement some habits, but give up when they don’t seem to be working.
  • Often, these short term solutions are not sustainable in the long run. When I ask parents if they could keep these habits up for 1-2 years, the resounding answer is, “Heck NO!”

In long term thinking,

  • you give your baby, even newborns, chances to sleep independently (aka, not in your arms for every sleep).
  • You give your baby chances to lie still while awake so he or she gets used to non-motion.
  • You go to baby if you sense he or she is stressed or fussy, but if baby is just making noises (and babies make lots of noises), you let him or her be.
  • You go into each sleep, especially night time, with this thought: How do I want my baby to be able to sleep in 3, 5, or 10 months from now? And make decisions that reflect those goals as best you can.
  • You practice consistency; even when progress seems to be so slow, you keep working at it. Rome wasn’t built in a day, after all. Don’t give up easily!

The difference between these two ways of thinking is what baby is learning, even in those first few weeks. With short term solutions, baby is learning that the only way to sleep is through the help of swaying, rocking, bouncing, driving, vacuuming, etc. Using long-term thinking, baby learns little by little to sleep in a still place, to put him or herself to sleep and he or she knows that if mom is needed, mom will be there. I don’t want new parents to simply survive, I want you and your family to thrive. It’s all about developing habits slowly, gently, and organically that are sustainable and healthy.

Please note, I would never recommend that you leave your newborn on his own for hours at a time. During this sleep “practice”, assume always that you will be very close, even watching over your little bundle while he or she rests, or resting yourself nearby. There is nothing wrong with helping your baby to reach a calm, sleepy state in reliable ways like snuggling, nursing, swaying, bouncing, rocking. These are very helpful when baby is upset; but using only these ways to get baby to sleep and using them for the duration of baby’s sleep, every time she sleeps may create an unsustainable situation. When my first daughter was 8 months old every day I found myself in what I called the “lap-nap-trap”. She would wake 30 minutes into her nap and only sleep if I held her and rocked her for the remaining time I knew she needed to sleep. This wasn’t something that I could logistically do every day, yet it was a habit that I had taught her somewhere along the way. Undoing that habit was difficult, but necessary for both of us.

The “Baby Industry” is also famous for marketing (expensive) things that rock, vibrate, and otherwise soothe your baby to sleep. Those might work in the short term, but they only help baby develop habits in which she’s relying on external elements to soothe her, instead of developing her own soothing abilities, gently, and from the very beginning, leaving parents with no unsustainable habits to break later on. Save your money. Here’s how these habits look week by week of baby’s first two months.

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Weeks One/Two:

These two weeks do involve a little bit of survival-mode, simply because parents are getting to know their little one. Mom is healing and learning to nurse. You’ll be checking in with your baby’s pediatrician to make sure weight gain is going well. Newborns sleep for 17-20 hours per 24 hour period. Not consecutively, of course.

  • Baby sleeps a LOT during this week. You might think you have a miracle baby who will sleep like this forever. I’m sorry to say this is not the case. Enjoy this phase and rest as much as possible!
  • Both partners need to be on the same page in regards to sleep–talk about what you want sleep to look like, ways you will soothe and not soothe, who can help with what. That way, you can be supportive of each other in those wee hours when you are extra frustrated.
  • Day/night confusion are really obvious. Your baby slept while you moved during the day and moved (danced on your bladder, more likely) while you were still. Exposure to very little light/noise during the night time hours (I always recommend 9:00 p.m.-7:00a.m for newborns) and lots of exposure to natural light and the hubbub of home noises during the day will help baby adapt over the first 8 weeks.
  • Night-time is not playtime. Your engagement with baby should be around feeding and getting back to sleep as much as possible.
  • Mom and dad should practice skin-to-skin contact with baby to help immune system, nervous system, and brain function get a jump start. This will also help baby sleep more soundly!
  • Mom should call in reinforcements as much as she needs: this might even involve a post-partum midwife or a lactation consultant. Don’t be shy or worry that you are messing up. These women LIVE for helping new moms.
  • Be calm; babies can sense frustration and anxiety. Breathe. Count to five. Ask for help.
  • Even though it will be tempting to hold baby all day and all night—he is precious and perfect and oh so fragile, after all!—when you’ve got baby to sleep or even just calm and drowsy, put him in his bed. This is especially challenging if you have a lot of company following baby’s birth because everyone wants to hold baby for hours. Prioritize your ability to feed baby, your ability to rest, and baby’s ability to practice some still sleep.
  • E ven when baby is in your arms, take a break from bouncing and swaying so still sleep becomes a habit.
  • Feed baby on demand (probably every 1-2 hours). Newborns’ stomachs are the size of a marble, and much of the digestive tract is still developing. You’ll deal with some spitting up, some painful gas/burps, and falling asleep at the breast. It’s all normal, some of it’s messy, and it will fall into place. Be patient and call a lactation consultant if you have questions.
  • Baby will only be awake for 30-45 minutes at a time; sometimes this means that he is only awake for feedings. That’s okay!
  • These two weeks are the perfect time for baby to meet his new bed. Give ample chances, asleep and awake, for him or her to spend some time in there getting used to the feel of the sheets, the smell of his blankets, the sounds of your room. Until now, baby’s senses have been dulled by a protective layer of fluid. It all takes getting used to.
  • This is also a great time for parents to get used to all of the noises baby makes: squeaks, grunts, cries for food, cries for snuggles, and tired cries, coughs, sneezes, toots…the list goes on. Babies are noisy! What’s great is that not every sound is meant to signal distress or a need for mom. Some noises are just noises. If baby is just making noises, let her be–it feels good to stretch and move. If baby appears distressed, soothe to your heart’s content.
  • Swaddling is up to individual parents. Many parents find that baby doesn’t need to be swaddled at this point and sleeps fine without it. Other babies will crave the tightly wrapped feeling that imitates the womb.
  • If your doctor recommends due to low weight gain, you may be waking your baby every 1-2 hours to feed.
  • Your Sleep: Here’s my biggest secret of all to getting 8 hours of sleep on most nights—When you lay baby down for “bedtime”, even if that’s 7:00pm, it’s YOUR bedtime, too. You might be up every hour of the night for a while, and if you wait to go to bed at 10 or 11, you are shorting yourself. It won’t take long to be worn very thin. In my house, my older daughter goes to bed around 7:15, then we work on my newborn who goes down for “bed” around 8:30. Once she’s asleep, I put myself to bed, too. It wreaks havoc on the social calendar and on any Netflix addition you may be fostering, but you will be a more rested, patient, healthy parent—and what better gift to give your little one?

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Week three/four:

  • Continue to work on straightening out day and night confusion. Low lights, no playing and soft voices all night and natural light and conversation/play during the day. A quiet, consistent place for naps if baby’s bed is not an option will also help this along.
  • You might noticed that baby is starting to be a little more alert, although, not much more. Baby is still sleeping for most of the day.
  • Baby’s limbs have started waving and jerking erratically by now. Quite the workout! Often, these movements will startle your little one out of a sound sleep. If you haven’t yet, I recommend using a swaddle to ensure still and lengthy sleep. I highly recommend the Miracle Blanket. It’s nearly impossible to break out of and doesn’t use any fasteners or Velcro. https://miracleware.com/
  • Baby might “fight” the swaddle. Don’t take this as a sign that it doesn’t work or that baby “hates” it. Their muscles are just developing, so to push against barriers is completely normal—remember those feet in your ribs?
  • If your baby is gaining adequate weight (according to your doctor), cease waking him or her during night time hours for feedings and simply feed on demand. You might notice some more extended sleeps starting to take shape during the night. And don’t worry, babies have an uncanny way of making up calories during the day, even though your milk ducts might take a few days to adjust.
  • Nursing moms, give dad a chance to get baby to sleep after you’ve fed him or her; it’s important that baby finds both parents soothing so mom isn’t left as a human pacifier down the road.
  • Try to avoid doing all daytime naps in the car or stroller.
  • By week four, you can start giving baby chances to self-soothe in his or her sleep space with you present, perhaps rubbing his forehead or placing a hand gently on her belly or chest, letting your baby know you are right there. The idea here is that when baby falls asleep in his bed, then wakes one sleep cycle later (about 30-45 minutes) he is right where he fell asleep, increasing the chances that he’ll go right back to sleep and not need to rely on any kind of soothing.
  • Baby’s sensory awareness of the world is “waking up” and kicking into high gear. You may notice that baby is tracking more with his eyes, grasping blankets and fingers more fiercely, and flapping those arms and legs. It’s so important at this stage to give baby breaks from this sensory overload when he’s resting. Having baby rest where there is a lot of noise and action, or napping only in the stroller or car, prevents him from reach deep, restorative sleep. Using a swaddle, a sound machine or fan, and a quiet room with low light will give him the break he needs from this brand new world!

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Weeks Five and Six

  • Continue everything you’ve already been doing weeks 1-4.
  • Baby is feeding anywhere from 2-5 times/night as the digestive elements are kicking into gear. Everything is still developing, so be patient as your baby gets into a feeding groove. Ask a lactation consultant for help if you need it!
  • By this point, I hope you are seeing some smiles from your baby that have nothing to do with gas! If not, you will very soon. This is called social smiling and it is the best thing you’ve ever seen. Baby is reacting to your facial expressions and voice. This is your cue to really work on baby doing most, if not all, of her sleeping (naps and nights) in her bed. She’s beginning to recognize familiar objects, sounds, and places—so what better place to link to sleep than her bed?! Make this connection now and you will never regret it!
  • While you won’t be able to expect or successfully force any kind of reliable schedule for 2-3 more months, you can start helping baby get used to day and night even more by offering some cluster-feeds late in the evening. By the end of the day, mom’s milk supply is often a little depleted. About an hour before “bed”, offer several shorter feeds with burping in between. This will not only provide a lot of comfort for your little one, but the sleep hormones in your body will be transferred through your milk. This will help baby start elongating stretches of sleep at night little by little.
  • Going Out: Arianna Huffington, author of The Sleep Revolution and CEO of the Huffington Post, is famous for saying, “We must ruthlessly prioritize sleep!” By now, mom is feeling better and getting a little more used to everything that is newly required of her body. A little cabin fever might be setting in! As I said in Week One/Two, your bedtime for the time being needs to be when your wee one finally goes to sleep for the night. If you go out in the evening and you have a very sensitive little one, you risk over-stimulating her. After an evening outing your baby might wake up more often or be more difficult to calm, just to give you fair warning. It’s absolutely normal. This will be the case well through toddler-hood.
  • If you try to put baby down later in hopes of her sleeping in, you may be disappointed. Early bedtimes will save your bacon throughout your baby’s first few years. Remember: Sleep begets sleep, and so goes the opposite.
  • Eventually, you will help your baby develop a daytime and night time schedule. Babies have a biological rhythm that incorporates how much rest they need with how much time they can spend awake. Responding quickly to “sleepy cues” like crying, eye rubbing, general fussiness, tugging on ears or extra limb flapping will set you up for developing a more predictable schedule by the time your baby is ready—usually around 4-6 months of age.

The idea behind all of these tips is to help you, as parents, avoid having to undo unsustainable habits when your baby is six, twelve, or twenty four months old and it’s much more difficult. Instead you’ll be providing a foundation of good habits as early as week one of life. There are naturally going to be exceptions to every situation and every single baby is different. Listen to your mama-gut, it’s very wise, and think about how you want sleep to look down the road for you and your family, and remember that taking care of yourself is part of taking care of your family.

These first few weeks are full of strong emotions: love like you’ve never known it, desperation like you’ve never known it, some fear, some frustration, a lot of questions, and joy that threatens to explode your heart. Take it all in and remember that this time is fleeting. If it’s difficult, it will pass. What will also pass is this stage where your little one fits so snugly against your chest, where her little hands wrap just barely around your finger, where every time she looks at you it’s like she’s found paradise. It’s important to keep in mind your long term goals for your little one, but it’s just as important to pause in those sweet, still moments and just be.

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