Breastfeeding Newborns: Tips For Getting A Good Night's Sleep

how to sleep when breastfeeding newborn

Breastfeeding a newborn baby can be a tiring and challenging experience for new mothers. Babies wake up frequently to breastfeed, and mothers may find themselves waking up every two to three hours to nurse their baby in the first few weeks. This is because babies digest breast milk faster than formula milk. It is important for mothers to get enough sleep, as a lack of sleep can reduce their breast milk supply. There are several tips and tricks that mothers can use to improve their sleep and their baby's sleep, such as skin-to-skin contact, switching breasts while feeding, and creating a safe sleep environment. Additionally, bedsharing, or sleeping on the same surface as the baby, can be a way to increase sleep time and lower stress for both the mother and the baby, as long as it is done safely.

Characteristics Values
Baby's sleep surface Safe surface, free from breathing hazards and smothering risks
Baby's sleep position Not face-down
Mother's habits Non-smoking
Mother's sleep surface Not a couch or recliner
Mother's sleep position Curved around the baby in a "cuddle curl"
Mother's sleep location Same room as the baby or same surface as the baby
Baby's sleepwear Warm, comfortable, and dry
Baby's sleep environment Quiet and dark
Baby's diaper Changed only if soiled
Baby's hunger cues Subtle wiggles or other feeding signals
Baby's feeding Frequent, following the baby's needs
Baby's feeding position Skin-to-skin
Baby's feeding techniques Nipple shields, switching breasts, breast compressions, stroking hands and feet

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Safe bedsharing

Safe bed-sharing, also known as co-sleeping, is when a breastfeeding mother shares a sleep surface with her baby. This practice has been recognised as a result of innate human biological and behavioural mechanisms. It is important to note that not all forms of bed-sharing are the same, and certain factors can increase the risks associated with bed-sharing.

There are several guidelines to follow for safe bed-sharing:

  • Ensure the baby is healthy and full-term. Premature or sick infants may not be able to rouse themselves.
  • The baby should be placed on their back, which is the safest position whether they are co-sleeping or not.
  • The baby should be lightly dressed and unswaddled to avoid overheating and allow them to adjust their body position.
  • Avoid using pillows, props, comforters, or soft bedding near the baby, as these increase the risk of suffocation.
  • Only the breastfeeding parent and/or partner should be in bed with the newborn. Other adults, older siblings, or pets should not be in the same bed.
  • The bed should not be too soft, and any cords or gaps should be monitored to ensure the baby's safety.
  • Keep covers and blankets away from the baby's head to reduce the risk of suffocation.
  • The breastfeeding mother should be sober and a non-smoker. Smoking increases the risk of Sudden Infant Death Syndrome (SIDS).

Additionally, it is important to understand the feeding cues of your baby. Babies are biologically programmed to fall asleep at the breast due to the release of the hormone cholecystokinin (CCK), which makes them feel full and sleepy. However, there may be times when a newborn needs to be awakened to breastfeed, such as in cases of jaundice, congenital heart disease, or inadequate weight gain. To keep a baby awake during feeding, you can try techniques like skin-to-skin contact, gently stroking their hands and feet, sitting them up and giving them a back rub, or changing their nappy mid-feed.

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Hunger cues

Breastfeeding a newborn can be challenging, and it's important to be able to recognise your baby's hunger cues to make the process easier for both of you. Crying is often a late indicator of hunger, and your baby will likely show other signs that they are hungry before they start to cry.

In the first few weeks of your baby's life, they will likely sleep a lot and may not exhibit hunger cues as often as they need to feed. Newborns should be nursed at least every two hours during the day and at least once during the night. You should continue this feeding schedule until your baby has established a good weight gain pattern (at least four ounces per week for babies under four months). Once your baby has reached this milestone, you can let them set their own feeding pattern.

Some common early hunger cues to look out for include:

  • Fists moving towards the mouth
  • Head turning to look for the breast
  • Becoming more alert and active
  • Sucking on hands or lip-smacking
  • Opening and closing the mouth
  • Rooting (during the first few weeks, your baby will turn towards the breast or bottle and make sucking motions if you stroke their cheek)

If your baby is still hungry after finishing the first breast or bottle, they may continue to show interest in sucking. This could be their way of letting you know that they are not yet full.

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Skin-to-skin contact

The physiologically normal place for a newborn baby is in the arms of their mother, against her skin. When placed in this position, babies instinctively feel safe and protected. Skin-to-skin contact helps to regulate their temperature, heart rate, and respiration. If a newborn is not in skin-to-skin contact, they may instinctually feel unsafe, which can dysregulate their brain and increase stress.

The first hour after birth is a unique and sensitive period for both mother and infant, offering a biologically predetermined opportunity for bonding. During this time, the mother's high oxytocin levels and the newborn's high catecholamine levels facilitate a special connection. Skin-to-skin contact stimulates the release of oxytocin, the "love hormone," which helps both mother and baby relax and bond. This connection can also be facilitated with the help of the father or other family members, allowing for "zero separation" and helping the mother spend as much time as possible with the baby.

While skin-to-skin contact is typically associated with the mother, it is important to note that fathers and other surrogates chosen by the mother can also provide this care. This practice has been demonstrated to be beneficial even for premature infants, helping to regulate their vital signs and providing a sense of safety and protection.

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Self-settling

If you are struggling with sleep deprivation and feel that it is affecting your physical or mental health, it may be time to start encouraging your baby to self-settle. Australian research has shown that teaching a baby to self-settle can resolve many cases of postnatal depression. It is important to remember that continued exhaustion can make life with a newborn stressful and impact your relationships, ability to work, and overall enjoyment of life.

There are several techniques you can use to teach your baby to self-settle:

  • Establish sleep associations: Create positive sleep associations by using a super-dark room, loud white noise, a swaddle, or a baby sleeping bag. These associations will help your baby relax and fall asleep more easily.
  • Feed, Awake Time, Sleep routine: Instead of relying on feeding your baby to sleep, try the Feed, Awake Time, Sleep routine. This will help encourage self-settling and reduce the reliance on feeding before every sleep.
  • Put your baby down drowsy: Start teaching your baby to self-settle from the beginning by putting them down when they are drowsy rather than waiting until they are already asleep.
  • Responsive settling strategies: In the early weeks, you can wrap your baby in a light cotton fabric or use a sleeping bag with fitted arm holes and no hood. Hold them in your arms and use gentle rhythmic patting, rocking, or stroking to soothe them before putting them into the cot drowsy or asleep.
  • Self-settling for older babies: For babies over 6 months, talk quietly and cuddle your baby to help them calm down. Put your baby on their back in the cot when they are awake or drowsy and make gentle 'ssshhh' sounds or use gentle rhythmic patting or rocking to soothe them. Lie down or sit beside the cot within sight of your baby and pretend to be asleep. If your baby remains awake, give a little cough or quietly say 'ssshh, time to sleep' to let them know you're still there.

Remember, it is normal for babies to wake up at least once during the night, and it is okay to respond to their needs. Self-settling does not mean leaving your baby to cry it out. You can find what works best for you and your baby and make adjustments as needed.

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SIDS risks

Breastfeeding a newborn can be challenging, and it is common for babies to fall asleep at the breast. This is due to a hormone called cholecystokinin or CCK, which makes your baby feel full and sleepy as soon as they start sucking. Younger babies tend to have higher concentrations of CCK, which can make it harder to keep them awake during a feed. However, there are times when a newborn baby needs to be awakened to breastfeed, such as in cases of jaundice, congenital heart disease, illness, or inadequate weight gain. Here are some tips to keep your baby awake during breastfeeding:

  • Keep your baby in the skin-to-skin position, which can help ignite their natural feeding instinct and encourage them to feed.
  • Understand your baby's feeding signals and respond to them promptly.
  • Change breasts during feeding to make it easier for your baby to fill their tummy.
  • If your baby falls asleep, gently stroke their hands and feet to stimulate them to stay awake.
  • Sit your baby up and give them a gentle back rub to wake them up and help expel any trapped wind.

Now, here are some key points regarding SIDS risks:

Sudden Infant Death Syndrome (SIDS), also known as Crib Death or Cot Death, is the unexpected and unexplainable death of a baby, with the highest risk occurring during the first six months. It is important to take precautions to reduce the risk of SIDS:

  • Smoking: Smoking during pregnancy and exposing your baby to cigarette smoke increases the risk of SIDS. If you smoke, it is best to avoid sharing a bed with your baby.
  • Sleep Position: Always place your baby on their back to sleep, both during the day and at night. Sleeping on their side or tummy increases the risk of SIDS. Once your baby can roll over onto their front and then back again by themselves, you don't need to worry if they turn onto their tummy or side while sleeping.
  • Bed-sharing: Sharing a bed with your baby, especially if you are a smoker or under the influence of drugs or alcohol, increases the risk of SIDS. It is safer to keep your baby in the same room as you but on a separate sleep surface until they are at least 6 months old.
  • Sleep Surface: Use a firm, flat, well-fitting, clean, and waterproof baby mattress. Cover it with a single sheet and tuck the covers securely under your baby's arms to prevent the blanket from slipping over their head.
  • Head Covering: Keep your baby's head uncovered during sleep. Place them in the "feet to foot" position in their crib or Moses basket to prevent them from wriggling down under the covers.
  • Breastfeeding: Breastfeeding your baby reduces the risk of SIDS. It is recommended to breastfeed exclusively for at least the first six months, as it provides all the nutrition your baby needs during this period.
  • Vaccinations: Keep your baby up to date with their routine vaccinations. This provides protection against childhood illnesses that may increase the risk of SIDS.
  • Dummy Use: While evidence is mixed, some sources suggest that using a dummy at the start of sleep may reduce the risk of SIDS. However, if you are breastfeeding, it is recommended to wait until breastfeeding is well established (around 1 month) before introducing a dummy, and stop giving it to your baby between 6 and 12 months.

Frequently asked questions

It is normal for newborns to fall asleep at the breast due to the release of the hormone cholecystokinin, which makes them feel full and sleepy. To keep them awake, try stroking their hands and feet, sitting them up, or giving them a gentle back rub. You can also try changing their nappy mid-feed or keeping them in the skin-to-skin position to encourage feeding.

Newborns feed frequently, sometimes at regular intervals and sometimes at irregular intervals. For most newborns, the longest stretch between feeds is around three to four hours. In the first few weeks, you may find yourself waking up to breastfeed every two to three hours.

It is normal for newborns to feed frequently throughout the night, but there are some things you can try to help them sleep for longer. Use a good quality, absorbent disposable nappy so that they don't wake up because they're soaked, and make sure they are dressed warmly and comfortably. You can also try offering both breasts during the day and evening feeds and placing your baby in their cot before they're fully asleep.

Bedsharing, or sleeping on the same surface as your baby, can be safe if you follow certain guidelines. Research indicates that the risk of Sudden Infant Death Syndrome (SIDS) is no greater in your bed than in a crib, provided you meet the Safe Sleep Seven criteria and the Safe Surface Checklist. However, it is important to avoid any breathing hazards, such as pillows, props, or soft bedding, and to ensure that all caregivers are non-smoking and sober.

Prioritising your sleep is important, as losing sleep can reduce your breast milk supply. Try to sleep when your baby sleeps, and consider wearing your baby in a ring sling, wrap, or front carrier during the day so that they can feel close to you while you have your hands free. You can also try following Dr. Harvey Karp's 5 S's for soothing babies, which can help promote sleep and encourage nursing success.

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