Newborn sleep survival guide: Helpful Tips for the First 4 Months
What to do when your new baby … well … sleeps like a baby?
Adding a newborn to the household can be exhausting! The phrase “sleep like a baby” took on a whole new meaning after my daughter was born. Her fitful sleep – and consequently, my broken sleep - seemed anything but deep and restful! Those sweet photos of peaceful sleeping newborns quickly became a distant dream. Don’t get me wrong, I loved – and still fondly remember - my daughter’s sweet sleep-induced smiles. I couldn’t help but include one, below. However, I longed for better sleep for my daughter – and, to be honest, also for myself. Although I felt reasonably well versed on other aspects of newborn care, in terms of sleep, I felt woefully unprepared. I wanted to be the parent I could possibly be - but this was proving challenging on very little sleep.
THE FIRST 6-8 WEEKS
During the first 6-8 weeks expect unpredictable sleep patterns
Babies have a lot of adjusting and learning to do after they are born … and so do parents! During the first 6 to 8 weeks of life (*see end of article for preterm infants) there are oftentimes no particular pattern to your infant’s sleep. Typically infants sleep a lot at this stage. The exact amount of daily sleep, however, varies from baby to baby. The National Sleep Guidelines provides a normal range of 14-17 hours of sleep a day for infants 0-3 months of age. Some infants may sleep less (11-13 hours) and some more (18-19 hours). Importantly, it can take some time to figure out where your baby falls within this spectrum of daily sleep. I remember worrying that my daughter seemed to sleep too little and then, 2 years later, that my son slept too much!
Typically, young infants can’t stay awake for long, usually becoming tired after 1-2 hours of wakefulness. I think many tired parents feel the same way! Some infants will struggle to stay awake even for the full hour. It is not uncommon for babies between 6-8 weeks of age to tucker out after 45 minutes after waking. Sleep periods typically range between 30 minutes and 4 hours, during the day as well as overnight. Some babies sleep for shorter periods of time and others for longer stretches. Again, there is a range of normal. Early in life, babies do not distinguish between day and night and, because of this, they may sleep more during the day than at night. This pattern of newborn sleep is called day-night confusion and can be particularly challenging for tired parents.
Unfortunately, there is little you can do at this early stage to change your baby’s sleep schedule. Trying to keep your newborn awake during the day - in the hopes she’ll sleep at night - will likely only make for a very cranky baby and, consequently, very cranky parents! So rather than worrying about scheduling your baby’s sleep, try to enjoy your new addition as much as possible and get rest when you can.
There are ways to start to gently shape your newborn’s sleep
What is a tired parent to do, then – other than try to get some rest whenever they can? There are a couple of steps you can take at this early stage to gently shape your baby’s sleep. One is to help your little one to start differentiating daytime from nighttime. The other is to work on learning your baby’s sleepy cues. I’ll address day-night confusion, first, and sleepy cues a bit later.
Adult sleep patterns are influenced by an internal biological clock, known as circadian rhythms. Our daily patterns of activity – including exposure to light – influence the running of this clock. Infants take time to develop functional circadian rhythms. An important part of this process is exposure to environmental cues, which can help get baby's clock running and calibrated. You can help foster this process by providing cues to your baby that it is day verses night. During the day play with your baby, exposure him to light and don’t try to stay overly quiet. Make baby part of the daily hustle and bustle of your household. At night, keep your baby’s room dark. When you change his diaper and feed him overnight, use a dim light and keep interactions uninteresting.
Your baby’s circadian rhythms will develop over time, typically maturing by 6 months of age. Thankfully, there is light at the end of this sleep tunnel.
THE 6-8 WEEK PERIOD
By 6-8 weeks, look forward to longer stretches of overnight sleep
Around 6-8 weeks of age, your baby’s night-time sleep will become more organized. Baby’s daytime sleep, however, will likely remain largely unpredictable. At this stage, infants will often achieve a 4-6 hour stretch of overnight sleep – an important milestone for tired parents! Also, around 6-8 weeks of age, day-night confusion typically ends and infants naturally shift towards an earlier bedtime, around 6-8pm at night. I promised there was light at the end of that sleep tunnel, right?
The emergence of a social smile indicates time to get sleep routines in place
Your baby is becoming increasingly social at this stage. Watch for that amazing social smile - signalling that your baby is becoming increasingly aware of her environment. Your baby is also starting to follow cues and make connections, including cues and connections related to sleep. This is a great time to start working on healthy sleep routines such as introducing a consistent sleeping place for overnight sleep and naps (e.g., bassinet, crib), using fewer sleep props (e.g., such as strollers, swings, car rides to lull your little one to sleep), and starting a soothing sleepy-time routine.
Given daytime sleep remains unpredictable at the 6-8 week mark, it is hard, if not impossible, to determine the timing and duration of baby’s naps. Rather than worry about scheduling day time sleep, put your efforts into discovering your baby’s sleepy cues. The goal is to get her down to sleep before she becomes overtired. Avoiding the meltdown = happy baby and happy parent! We assume that babies will sleep when they are tired. This may eventually be the case but there can be a whole lot of messy upset before that happens. Overtired babies, also, have a harder time falling asleep. This is not a nice situation for baby or parents.
Learning your baby’s sleepy signs will help you get to sleep before she becomes overtired
In early infancy, babies can shift quite quickly from alertness to sleep. At 6-8 weeks of age, however, your baby is more likely to show signs of being tired. These sleepy signs include eye rubbing, ear pulling, staring into space, decreased coordination, and increased fussiness. As mentioned above, a typical awake period for young infants is 1-2 hours, sometimes shorter. Hence, look for sleepy cues starting after 45 minutes of awake time. When your baby starts showing signs of being tired, you can see if she will put herself to sleep by placing her down in a safe sleeping spot. If your baby is not ready for sleep, this is a great time to practice a soothing sleepy time routine.
Developing a soothing sleepy time routine helps cue your baby that it’s time for sleep
A soothing sleepy-time routine consists of cues to help your baby know it's time to sleep. In adults, I liken this routine to taking a warm bath or reading quietly before bed. In other words, the soothing routine helps cue your body that it is time to settle down for a restful night of sleep. For babies, these sleepy cues can include being sung or read to, bathed, nursed, bottle fed and/or rocked. The cue does not need to be long and I suggest that it is typically no longer than 15 minutes. You may want to use a shorter routine for naps than overnight sleep. If your baby becomes irritated during the soothing routine, this is a sign that he just needs to be placed down to sleep. If your baby appears ready to sleep in the middle of the routine, you can lay him down to sleep at that point. If upon completion of the sleepy time routine your baby appears calm and awake, this is still a good time to place him down to sleep. If your baby falls asleep during the routine, you don't have to wake him. Rather see this as a learning opportunity to try again next time. Like all aspects of parenting, patience and practice are required!
Give baby the opportunity to practice self-soothing, she may surprise you!
Babies are known to spend a lot of time in “active” sleep. During this time, they will often move and make a variety of sounds. Between sleep cycles, babies may also briefly awaken or fuss before getting themselves back to sleep. If your baby appears to be awakening or awakens early from a nap, say after 20 minutes, use this as an opportunity to see if she can soothe herself back to sleep. Rather than immediately pick her up, briefly give her the chance to settle independently. She may surprise you!
THE 8 WEEKS TO 4 MONTH PERIOD
Moving forward, until your baby reaches 4 months of age, I suggest practicing the steps described above. Your baby will continue to move towards longer stretches of overnight sleep, periods of daytime wakefulness will increase, and a daytime nap pattern of napping will start to emerge. During this period of your baby’s development, I encourage you to continue enjoying your little one while practicing the foundations of great sleep!
Summary of tips for the first 4 months of life:
1. Follow your baby’s lead when it comes to sleep: don’t worry at the beginning about scheduling naps and overnight sleep
2. Help baby establish her natural biological rhythms by including baby in daytime routines and decreasing stimulation at night
3. Get attuned to your baby’s sleepy cues and get baby down before she becomes overtired
4. Watch for an emerging schedule starting first with nighttime sleep and later with daytime sleep
5. Rather than run to your baby when he stirs, give him the chance to self soothe
6. Make sleep a family priority - get rest when you can
*Please note that the sleep milestones provided in the post are based on biological rather than chronological age. If your baby was born early, use his estimated due date rather than his birth date to calculate his current "developmental sleep age". For example, if your baby was born 4 weeks early, he is expected to only meet a 6-week sleep milestone at 10-weeks of age.
A discussion about infant sleep wouldn’t be complete without raising the importance of safe sleep. I encourage you to check out my blog on safe sleep which you can find here.
Ferber, R. (2006). Solve Your Child’s Sleep Problems. New York, NY: Simon & Schuster.
Mindell, J.A. (2005). Sleeping through the night. New York, NY: HarperCollins.
Weissbluth, M. (2015). Healthy Sleep Habits, Happy Child. New York, NY: Ballantine Books.