Gina Johnson
The first few weeks with a newborn are a whirlwind of joy, excitement, and sleep deprivation. While newborns tend to sleep a lot, they follow their own schedule, and it may take a while for them to settle into a routine. As a new parent, you may find yourself struggling to get a good night's rest, both in the hospital and at home. Here are some tips to help you navigate those sleepless nights and make the most of your newborn's sleep patterns.
| Characteristics | Values |
|---|---|
| Rooming-in | The American Academy of Pediatrics recommends rooming-in, where the baby sleeps in the same room as the parents but in a separate crib. This has been shown to be safe and healthy for both the baby and the parents. |
| Room-sharing | The American Academy of Pediatrics recommends room-sharing but not bed-sharing for the first 6 months. The baby should sleep in the same room as the parents, close to their bed, but on a separate surface designed for infants. |
| Sleep position | Babies should be placed on their back for sleep and naps to reduce the risk of SIDS, aspiration, and choking. |
| Immunization | Immunizing the baby can reduce the risk of SIDS by 50%. |
| Breastfeeding | The American Academy of Pediatrics recommends breastfeeding for at least 6 months. |
| Tummy time | Supervised, awake tummy time is recommended to facilitate development and minimize the risk of a flat head. |
| Sleep schedule | Newborns should be awakened to feed every 3–4 hours until they show good weight gain, which usually happens within the first few weeks. After that, it's okay to let them sleep for longer periods at night. |
| Sleep environment | The sleep environment should be quiet and calm with low lights during nighttime feedings and diaper changes. Avoid hanging mobiles, wall hangings, and blind cords within the baby's reach. |
| Swaddling | Swaddling mimics the feel of the womb and can help soothe the baby. However, stop swaddling if the baby starts trying to roll over. |
| Dressing | Dress the baby in comfortable clothing, such as a onesie and footed pajamas, with a swaddle blanket for sleep. |
| Vital signs | In the hospital, nurses will regularly monitor the vital signs of both the mother and the baby, including blood pressure and heart rate. |
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What You'll Learn
- Safe sleep practices: Immunise, breastfeed, and place your baby on their back
- Swaddling: Wrapping your baby snugly in a light blanket can be soothing
- Rooming-in: The benefits of rooming-in and how to do it safely
- Sleep schedules: How to establish a routine and what to expect
- Sleep environment: What to avoid to keep your baby safe
Safe sleep practices: Immunise, breastfeed, and place your baby on their back
The first few days in the hospital with your newborn are critical for your baby's health and also an important time for you to get support with breastfeeding. UNICEF and WHO launched the Baby-Friendly Hospital Initiative to encourage hospitals to support breastfeeding.
Breastfeeding is an important part of safe sleep practices as it has been shown to decrease the risk of Sudden Infant Death Syndrome (SIDS). While room-sharing with your baby is recommended, bed-sharing is not, as this increases the risk of SIDS. Instead, your baby should sleep in a separate, safe space, such as a bassinet or crib next to your bed.
Another safe sleep practice is to place your baby on their back to sleep, known as the supine position. This position significantly lowers the risk of SIDS and is recommended from the very first day, for every sleep, day and night. Once your baby can move themselves from their back to their front and back again, they will be able to find their own sleeping position.
To keep your baby warm, use a sleep sack or wearable blanket instead of loose blankets. Keep your baby's sleep surface flat and firm, in a crib with tightly fitted sheets. Avoid soft bedding, comforters, pillows, loose sheets, blankets, and toys in the crib, as these could cause suffocation.
Finally, immunisation is an important way to protect your child from diseases as they grow. Vaccines such as DTaP (which protects against tetanus, diphtheria, and pertussis) and MMR (which protects against measles, mumps, and rubella) are recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the CDC.
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Swaddling: Wrapping your baby snugly in a light blanket can be soothing
Swaddling is a technique where you wrap your baby snugly in a thin, light blanket to help them feel safe and secure. It mimics the environment of the womb, which is why newborns find it soothing. It can be especially helpful when your baby needs extra comfort at bedtime or naptime, or when they are crying or experiencing colic.
To swaddle your baby, spread out a thin baby blanket with one corner folded over slightly. Lay your baby face-up on the blanket with their head above the folded corner. You can put their arms at the sides, cross them, or even leave them out of the swaddle. Wrap the left corner over your baby's body and tuck it behind their back, going under the arm on the right. Bring the bottom corner up over your baby's feet and fold it down at their chest. Keep the blanket from touching your baby’s face. Their hips and knees should be slightly bent and turned out.
Make sure the swaddle is not too tight around the hips and legs. Wrapping too tightly may lead to hip dysplasia. You should be able to slip a hand between the swaddle and your baby’s chest. The fabric of your baby swaddle wrap can make a difference, too. Look for materials like cotton, muslin, linen, or other natural fabrics that promote breathability, which helps prevent your baby from overheating during sleep.
Swaddling is generally safe during your baby’s first couple of months. However, you should stop swaddling your baby when they show signs of starting to roll over, like turning onto their side. This usually happens around 2 months.
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Rooming-in: The benefits of rooming-in and how to do it safely
Rooming-in, where healthy newborns stay with their mothers in post-labor recovery rooms instead of in a nursery, provides several benefits for both mother and baby.
Benefits of rooming-in
For the baby:
- They will feed better, cry less, and lose less weight.
- They will develop a more regular sleep-wake cycle earlier, which will help ease the transition to day/night routines.
- They will show more stable body temperatures and blood sugars, and typically have lower levels of stress hormones.
- They will be exposed to the normal bacteria on the mother's skin, which may protect them from becoming sick due to harmful germs.
For the mother:
- Mothers will have more confidence in their ability to care for their baby and will report more positive feelings toward them.
- Mothers will get used to the baby's routines and will be able to learn about their behaviors and what they mean.
- Mothers are more likely to get the same amount of rest whether the baby is in the room or in the nursery.
- Mothers who room-in are less likely to develop postpartum depression.
- Rooming-in makes it easier for the baby to experience more skin-to-skin contact with the mother.
How to do rooming-in safely
- Make sure to follow safe sleep practices. Do not let your baby fall asleep on a product that is not specifically designed for sleeping babies, such as a sitting device (like a car seat), a feeding pillow, or an infant lounger.
- Do not use products or devices that claim to lower the risk of SIDS, such as sleep positioners or monitors that can detect a baby's heart rate and breathing pattern.
- Make sure that all sleep surfaces and products you use to help your baby sleep have been approved by the U.S. Consumer Product Safety Commission (CPSC) and meet federal safety standards.
- While you are awake, you can hold your baby in your bed or in a chair. While you are sleeping, your baby should be put in a crib next to your bed. Another alert adult caregiver, such as your partner, may hold the baby while you sleep.
- Remember that it is normal for mothers and babies to be woken up by nurses every few hours to check vital signs, monitor bleeding and healing, and ask about feeding.
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Sleep schedules: How to establish a routine and what to expect
The first few weeks with a newborn can be challenging for new parents, especially when it comes to sleep. Here are some tips to establish a healthy sleep schedule for your newborn and what to expect during this time.
In the Hospital
After birth, newborns are typically awake and alert for the first few hours, providing an excellent opportunity for bonding and skin-to-skin contact with the mother. They then become sleepy and tend to sleep for long stretches. In the hospital, it is common for nurses to wake mothers and babies every few hours to monitor vital signs, feeding, and other postnatal care aspects.
At Home
Once you're at home, it's essential to establish a consistent sleep routine. The American Academy of Pediatrics (AAP) recommends room-sharing but not bed-sharing for the first six months. This means setting up a separate sleep surface for your baby in your room, such as a crib, bassinet, or infant bed.
Safe Sleep Practices
To ensure safe sleep practices, always place your baby on their back to sleep or nap, adhering to recommendations to reduce the risk of SIDS. Avoid using loose bedding, pillows, or soft objects in the sleep area, and ensure any products you use are approved by the relevant safety organizations.
Feeding and Sleep
For the first few weeks, it's important to wake your baby every 3-4 hours to feed until they show good weight gain. After that, you can let them sleep for longer periods at night. Babies of healthy weight typically don't need to be woken up to feed, but always consult your healthcare provider for guidance.
Establishing a Routine
To establish a bedtime routine, try to keep things calm and quiet during nighttime feedings and diaper changes. Keep the lights low, and avoid playing or talking with your baby to signal that night-time is for sleeping. Encourage your baby to fall asleep in their crib or bassinet, so they associate it with sleep.
Daytime Sleep
Don't keep your baby awake during the day in the hopes of better nighttime sleep. Overly tired infants often have more difficulty sleeping at night. Newborns tend to sleep or catnap frequently during the day, and swaddling can be a comforting technique to help soothe them.
Remember, each baby has a unique sleep pattern, and it may take a few weeks for them to differentiate between night and day. Consult your healthcare provider if you have any concerns or questions about your baby's sleep.
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Sleep environment: What to avoid to keep your baby safe
Sleep environment plays a crucial role in keeping your baby safe. Here are some recommendations to ensure a secure sleep environment for your newborn:
Room-sharing, not bed-sharing: It is recommended that your baby sleeps in the same room as you but on a separate sleep surface designed for infants. The American Academy of Pediatrics (AAP) advises room-sharing without bed-sharing to reduce the risks associated with Sudden Infant Death Syndrome (SIDS) and sleep-related deaths. A flat bassinet or crib next to your bed is ideal. Ensure your baby sleeps alone, without blankets, stuffed animals, pillows, comforters, or loose bedding, on a flat, firm mattress and flat on their back.
Avoid certain sleep products: Do not use products or devices that claim to reduce the risk of SIDS, such as sleep positioners or monitors that detect an infant's heart rate and breathing. These claims are unfounded, and the only proven way to reduce the risk of SIDS is to follow safe sleep practices. Additionally, avoid using infant seats, car seats, strollers, infant carriers, swings, hammocks, and similar products for routine sleep and daily naps, as they may obstruct your baby's airway.
Be cautious of hanging items: Hanging mobiles, wall hangings, draperies, window blind cords, and similar items can be hazardous if within your baby's reach. Ensure these are well out of reach or secured safely to avoid any potential risks.
Avoid weighted items and over-bundling: Refrain from using weighted blankets, sleepers, or swaddles on or around your baby. Also, avoid over-bundling or overdressing your baby, as it can increase the risk of overheating, which is linked to SIDS.
Immunization and breastfeeding: Immunization and breastfeeding are recommended by the AAP to reduce the risk of SIDS. Ensure your baby is fully immunized, and if possible, breastfeed for at least the first six months.
Safe sleep practices: Always place your baby on their back for sleep and naps. Never put your baby on their side or stomach. Supervised tummy time while your baby is awake is recommended for development and to prevent a flat head.
Remember, the first few months of a baby's life can be challenging for parents, with frequent nighttime awakenings. It's normal for newborns to have varied sleep patterns, and you can gradually establish a bedtime routine and teach your baby to fall asleep independently.
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Frequently asked questions
Rooming-in is when a newborn stays in the same room as the mother in the hospital. The American Academy of Pediatrics recommends rooming-in as it is safe and healthy for the mother and the baby. It also helps get breastfeeding off to a good start.
Newborns who sleep for longer stretches should be awakened to feed. Wake your baby every 3-4 hours to eat until they show good weight gain, which usually happens within the first couple of weeks. After that, it's okay to let your baby sleep for longer periods of time at night.
Recognizing signs of sleep readiness, teaching them to fall asleep on their own, and comforting them with awakenings can help your baby sleep. Establishing a bedtime routine is also a good idea. Swaddling or wrapping the baby in a light blanket can also help to soothe a crying baby.
The rule of thumb is that the baby should wear what you would be comfortable in, plus one layer. For example, a recommended outfit for a baby to sleep in is a onesie, footed pajamas, and a swaddle blanket.
The American Academy of Pediatrics recommends room-sharing but not bed-sharing for the first 6 months. This means that your baby should sleep in the same room as you but on a separate surface designed for infants. Always place your baby on their back for sleep or naps to reduce the risk of SIDS.
