Four Uninterrupted Hours: The Holy Grail of Sleep
Research has made it clear that a four-hour sleep stretch is far better than two 2-hour stretches. Mom’s breastfeeding is the obstacle for her, but at some point she can start pumping and you can take a full shift at night.
Russell: Sleep Tip (0:47)
“If it’s not critical and doesn’t have to be done, then I’m sleeping. It was hard to get her there too, but she finally got there…I still have to remind her.” -New Dad
Biology puts a new mom on the front lines with a baby, and sleep deprivation impacts moms much more deeply than dads. Moms need more sleep due to the physical demands of mothering. Not only does she need to breastfeed every two hours, her baby’s cry triggers a prehistoric biological survival mechanism she can’t ignore. The stress of being responsible for her baby’s welfare and survival interferes with sleep and drives deprivation to increasingly higher levels.
But making sleep a priority is hard for a new mom. Even when she’s desperate and has the chance to rest, she’ll prioritize all things baby over herself. When she does try to sleep, thoughts of all the things she should do for her baby (or the house) keep her awake. It’s a vicious cycle: the less she sleeps, the more her body keeps her awake, which leads to more sleep deprivation.
In order to relax enough to fall sleep, she needs to first clear her mind of all concerns. To help her do this, you can encourage and arrange for her to take naps, provide a quick back rub, and whisper that you appreciate the great job she’s doing and the baby is perfectly fine.
Even with a muted response to your baby’s cries, you’ll likely wake up and try to help Mom, and being there for your baby will get you out of bed. The tougher it gets on Mom, the more you’ll try to help, and often, at least at first, you’ll both be awake for all feedings. Generally, no one suggests (especially sleep deprived moms) that you get needed sleep so you can function at work all day.
- “Nap when the baby naps. This, a million times. Lay down right when that baby goes down. Not in ten minutes, not after you do the dishes, right now!”
- “Don't worry about doing anything but taking care of the kid. Do the bare minimum on everything else.”
- “My wife and I worked with each other in shifts. I always ended up staying up later than her, and she's always been better at getting up early, so we just used that.”
- “It wasn't nearly as bad once we started taking turns and stopped treating it like a two person job every time a diaper needed changing or she needed to be fed.”
- ”Your body will adjust to less sleep gradually. You learn to function on less.”
- "I told her he'll eventually have to learn to sleep on his own and she started crying.”
- “Hang in there. The first weeks suck, but you'll get through it.”
“I became depressed because I was very sleep deprived. It came to the point where I was very angry and sad and I couldn’t talk to my husband.” -New Mom
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Matt: Sleep Tag-Teaming (0:52)
Neal & Jaclyn: The Deal with Sleep (1:02)
"I told her he'll eventually have to learn to sleep on his own and she started crying.” - New Dad
2. Help Mom Overcome Her Prehistoric Drive
If the baby is fed, Mom should go to sleep, but new moms say this is harder than you'd imagine. Driven to do everything possible for their baby, with their mind full of worries, their last concern is taking care of themselves. So you’ll need to remind her sleep is a priority, and consistently insist she rest—if not for her own health, then for the baby’s benefit. If she stays awake when you tag team, take the baby into another room.
“The first two weeks, I was the walking dead. My wife and I quickly learned to sleep when the baby sleeps (even if it's 4:00 PM) and to give each other nap breaks a LOT. That leads to us being, like, five out of ten on tired which is livable. Take every chance to sleep...don't try to power through.” – Veteran Dad
“Get all the help you can get, because you’re definitely going to be sleep deprived. My mother-in-law jumped in before I even asked her and I thought, ‘No – I don’t want you coming into my life.’ I was arrogant. But she was the biggest help, because she’s been through it and she knew how difficult it was.” — New Mom
3. Tag Team a New Baby
You’ll need to work out a system for nights to optimize the sleep you’re both getting. With bottle feedings, you can take shifts. With breastfeeding, you can get the baby when he cries, change him, lay him down next to drowsy mom and go back to sleep, which works well if you’re a light sleeper and easily go back to sleep. If not, try the first evening or last morning shift, and when mom’s done, burp your baby and put him back to bed. You can also help her get naps in during the day. It’s not one-size-fits-all, so just work it out as best you can.
Disclaimer: Despite best efforts, you and mom will still be very tired, but not nearly as sleep deprived as you would have been.
Some ideas to keep in mind -
- Start in the hospital. If you have an opportunity for the nurses to care for your baby in the nursery, take advantage and sleep.
- Establish the priority: once you get home with your baby, feed him, tell Mom you’ll take care of the baby and she should sleep. If Grandma is at the house, take a nap with Mom.
- “Sleep when your baby sleeps.” Many parents find issues get in the way, but don’t make this mistake. It will be easier for you, but you may have to semi-drag Mom and give her a short massage to help her past the fear that her baby won’t survive unless she’s awake.
- Take advantage of grandparents, other relatives, friends, etc. One new dad’s mother-in-law handled a night shift; he said it was perfect—Grandma took care of the baby without Mom second-guessing everything.
- Start out building good baby sleep habits.
- A co-sleeper attached to your bed can make night breast feedings much easier on Mom. Since she doesn’t have to be fully awake, it’s easier for her to fall back to sleep.
- Get some exercise and fresh air– go for a walk with Mom and your baby: You’ll all sleep better.
- Make your bedroom sleep-friendly, and keep it as dark as possible.
- If you go back to work, consider naps in your car during your lunch hour.
- If you have an extra bedroom, you and Mom can take turns sleeping in it.
- Keep sleep aids on hand, like a white noise machine or phone app and earplugs.
“A big part of being able to sleep is not having logistics or tasks to take care of when the baby is actually sleeping. Take care of as much as possible before Mom even goes into labor. Have all the diapers and wipes stocked in the changing table. Have all the necessities already purchased and put where they belong and organized. Have a couple casseroles in the fridge ready to bake or a few meals in the freezer that just need to be heated up. The less you need to unpack, cook, and shop for means the more time you have to relax and catch some Zs. Think like you’re prepping the house for a zombie apocalypse…only it’s for a baby! Have your family and friends bring meals or do chores if they want to visit and see the new addition.” — New Dad
Newborns are biologically programmed to sleep a lot. They’re also programmed to learn to sleep on their own (called “self-soothing”). A common problem new parents face is being over-zealous in trying to help their little one sleep, which can hamper your baby’s natural learning process. So, lesson number one is you need to give your baby the opportunity to learn to fall asleep on his own. Babies who are breastfed and cuddled to sleep (or rocked, bounced, walked) for every nap and at night will struggle to self-soothe and this will set you up for longer-term sleep problems.
- Your baby is unique and figuring out what works may involve some trial and error based on the cues he’s giving you.
- Stay flexible in finding an approach that works best for your baby. Both parents must buy into the strategy you use and be consistent in applying it.
- Be mindful of your baby's need for sleep. Droopy eyelids, yawning, or turning their head away from you is baby's way of saying, "I'm tired," or "I've had enough."
- Your baby’s sleep education will periodically regress into fussy periods when his brain is growing. The good news is these stages often result in him developing new self-soothing skills.
- Experts and advocates tend to agree that sleep training does not work until your baby is 4 to 6 months old.
- “Cry It Out” was never proposed by anyone; it’s a great sound bite made up by those who oppose sleep training.
- Invite Mom to check on your sleeping baby with you, and marvel together at your angelic little bundle.
- If he looks a little too quiet, go ahead and make sure he’s breathing (very lightly touch his chest). We all did!
This is another hot button parenting issue. As usual, most parents fall somewhere between the extremes, and each family must choose what works best for them based upon the tradeoffs involved. There are strong advocates of having babies sleep in bed with Mom for enhanced “attachment,” despite evidence that parents can roll over on their infants and of increased risk of SIDS due to loose blankets and pillows. The attachment parenting camp is now fighting with the SIDS prevention camp over new recommendations against bed sharing. A compromise is emerging with the attachment camp indicating that keeping the baby within Mom’s reach (i.e., using a co-sleeper) is ok.
Moms who do bed-share generally like having their baby with them at night. Over the months though, their babies get used to waking up to feed more frequently, do not learn to self-soothe, and then have problems when transitioned to their own bed. Some moms decide to keep their child with them in bed, and it may be years before they go to their own bed. Some dads love co-sleeping, but most don’t as it puts a damper on their sleep and love life. Another issue for Mom and Dad to talk about and work out.
- Be consistent. As bedtime approaches, help her wind down by ditching the TV and other sources of stimulation and light. Use the same routine in the same order every night.
- Warm their cold bed with a heating pad on low, then remove it.
- Give your baby a massage.
- Tape a used breast pad to crib, as babies have a great sense of smell.
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Babies sleep often for the first couple of weeks. Put them down to sleep when you see the first signs of drowsiness (drooping eyelids or some fussiness).
- Top off her tank with more frequent feedings before bedtime or do a dream feed.
- The small, enclosed space of a cradle, bassinet or co-sleeper gives her a more secure feeling.
- Don’t engage baby (no talking or eye contact) when prepping for sleep at night as it amps them up for play.
- White noise is highly suggested. Sources include sound machines, phone apps, Spotify and CDs. Use the same sound each night to create an automatic sleep cue.
- Swaddling helps babies sleep by mimicking the snug comfort of Mom’s womb; it also keeps them from waking up due to jerky arm and leg motions.
- Infants can't tell night from day, so it helps them learn by keeping lights off at night and on during the day. Morning sunlight helps set her Circadian Rhythm (body clock).
- Attach a dimmer switch to a lamp and turn it on/off slowly for nighttime feedings.
- If it’s not a regular feeding time and she wakes up crying, wait a little so she has a chance to go back to sleep on her own.
- Around week 8, she may have discovered her thumb and suck on it to go to sleep (yea!)
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At around 3 months, your baby should be able to recognize the difference between night and day.
- Put her in the crib when she’s drowsy so she learns to go to sleep on her own. If she fusses, pat her back while she’s in the crib rather than picking her up.
- Swaddling may no longer work if she kicks her way out of the blanket or gets frustrated attempting to turn over. Try a “sleep sack” that leaves her hands free.
- Your baby will naturally start rolling over on his side or tummy; let him find a position that works.
- Around 12 weeks, fussiness increases for about a week followed by new self-soothing skills that may include face rubbing, yawning and thumb sucking.
- Don’t keep toys in the crib, as they can be stimulating versus calming.
- The key is to do less and then see what happens; your baby will let you know what works.
- When transitioning your baby to his own room, start by doing so with one nap per day.
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Babies don’t typically sleep through the night until 5 to 12 months (a big range).
- At around 4 to 5 months, anticipate new self-soothing skills such as bringing a bottle to his mouth, burrowing into you to turn off stimulation, and a new, sort of fussy, cry.
- Teething kicks in around 4 to 6 months and can present sleep challenges.
- For any changes to his routine, take incremental steps so your baby has a chance to adapt slowly.
“We found a method that worked out for us. My partner would wake up, pick up the baby, change her diaper, hand her off to me, and then I would nurse and burp. I would hand her back to him and he would put her back to sleep. We were zombies, but with that assembly line, it worked for us. It might not work for others, but it worked for us. Even though we were barely functioning, we did it. So, just find what works for you. Teamwork is so important.” —New Mom
Abnormalities of a neural network in the brain stem that controls breathing and heart rate. If an infant is not breathing enough oxygen, their brain triggers more breathing and/or heartbeats to compensate, but only if their controls work.
Studies have shown an association between specific defective genes and mild respiratory infections in infants who have died of SIDS. Many SIDS infants have an activated immune system, which may indicate they’re vulnerable to simple infections.
Maintaining optimum air flow for breathing is the main issue for babies with the above conditions. Doing so includes preventing 1) airway obstruction from a bad sleeping position, and 2) re-breathing exhaled air collected in soft material in his bed.
When sleeping on their back, a baby’s air passages are wide open and breathing isn’t restricted in any way. Their face is away from the mattress and soft materials like bedding that collect exhaled air. When an infant who is used to sleeping on their back is placed on their stomach or side, they’re at a higher risk of SIDS—so be consistent. It’s OK when your baby learns to roll over on his own, but swaddled babies who roll over are at an even higher risk of SIDS, so it’s time to stop swaddling as soon as he starts trying.
New cribs, bassinets, and other baby beds are required to have firm mattresses that don’t collect much exhaled air. If you’re considering a used baby bed, make sure the mattress is firm and cover it with a tightly fitted sheet that won’t come loose. Couches and soft mattresses are unstable and can result in a baby turning over, too.
In addition to parents rolling over onto their babies, the risks of bed sharing include the exhaled breath problem presented by pillows and bedding, and other issues reflected in this long list of precautions suggested by a proponent of bed-sharing. If you choose to co-sleep with your baby in the bed, be very careful. The highest risk comes when either parent is under the influence of drugs or alcohol while sleeping.
If they end up next to your baby’s face, they capture exhaled air. This includes your baby rolling over and putting his face into them or grabbing and pulling them onto his face.
A scientist at Kaiser thought that good room air flow could help when exhaled air is trapped by bedding, or the baby’s breath flow is so weak that his breath collects around his face. He conducted a study that found sleeping in a room with an open window reduced SIDS by 36%, and a fan on in the room reduced it by 72%. A small fan would also produce soothing white noise.
Additional risk factors for SIDS include:
A hot baby is more likely to sleep deeply and be difficult to arouse, and excessive clothing or blankets and a higher room temperature place a baby at a higher risk for SIDS. Be careful to not overdress your baby and keep the thermostat at a comfortable temperature for you (babies don’t need to be kept any warmer than an adult). Also, swaddling can overheat your baby when he’s in a warm room. In general, if you notice sweating, damp hair, flushed cheeks, or rapid breathing, remove blanket/clothes to cool him down. Overheating may increase the risk of SIDS for a baby who has a cold or infection, so don’t increase the room temperature when he’s sick.
Babies of mothers who smoke during pregnancy are three times more likely to die of SIDS. Secondhand smoke (like from Dad) in the house doubles a baby's risk of SIDS. Scientists found changes occurred in babies’ nervous systems in areas key to arousal and breathing functions. They suspect nicotine negatively affects development of these functions and raises the risk of SIDS.
Studies indicate that for infants who received any amount of breastmilk, the risk of SIDS was 60% lower. For those breastfed at 2 months of age and older, the risk was 62% lower, and for those infants who exclusively breastfed, the risk was 73% lower. Breastfeeding reduces infections and infectious diseases tied to an increased vulnerability to SIDS.
Pacifier use at naptime and bedtime decreased the risk of SIDS from 50% to 90%. Studies also show an increased risk when a baby generally used a pacifier, but not the last time they slept, so be consistent. Recent studies and reviews found pacifier use does not negatively affect breastfeeding duration or exclusivity, so you can start as soon as you think your baby might benefit. Here’s excellent information on pacifier use from the American Academy of Pediatrics.
Have Your Baby Sleep in Your Room for One Year
In 2016, the AAP recommended babies sleep in their parent’s room for a minimum of six months and, ideally, one year. We checked out the evidence in their full report, including four sources they listed and found a very credible alternate perspective. Aaron Carroll, MD is a Professor of Pediatrics and Vice Chair for Health Policy and Outcomes Research at Indiana University. In his New York Times article, this research expert described his experience as a new parent and then reviewed the AAP’s evidence on their recommendation.
He pointed out their four studies were based on data 15 to 25 years old, before major reductions in SIDS occurred and from European countries with different sleep patterns. They were “case-control” studies, among the weaker research designs in human research, that can only indicate an association, not the cause.
He also pointed out that the AAP also did not take into account the costs in terms of lack of sleep to parents: Dr. Fern R. Hauck, a member of the AAP task force that prepared the new policy, said it hadn’t given great thought to parents’ sleep before issuing the recommendation. “Parents will probably need to get used to it,” she said.
Dr. Carroll said that while “we want to do all we can to prevent SIDS, we should do so in ways that are likely to work— and unlikely to cause harm. This recommendation leaves them with the sense that they’re supposed to watch over their babies at every sleeping, as well as waking, moment. With the demands of modern-day child-rearing, parents feel enough guilt already.”
The reason the AAP SIDS committee recommended that your baby sleep in your room for a year, much longer than when SIDS is a significant risk, is the expansion of their scope to non-SIDS injury deaths of infants. There are about 1,250 per year and most are caused by suffocation; check out our Safety section to learn how to prevent them.