Ashwin Lewis
The topic of co-sleeping, or bed-sharing, with a newborn is a highly debated and often controversial one among parents and pediatricians. While some parents believe that the benefits of co-sleeping, such as bonding and convenience, outweigh the risks, others worry about the potential dangers associated with the practice. These dangers include an increased risk of sudden unexpected death in infancy (SUDI), including sudden infant death syndrome (SIDS) and fatal sleep accidents. Pediatricians recommend that infants sleep on their backs on a firm mattress without any blankets, pillows, or other items that could cause suffocation. They also advise against bed-sharing due to the risk of suffocation or other causes of sleep-related deaths. However, many parents still choose to co-sleep, and there are ways to reduce the risks, such as ensuring the baby sleeps on their back and that the sleep environment is clear of any hazards.
| Characteristics | Values |
|---|---|
| Average newborn sleep | 8-9 hours in the daytime and 8 hours at night |
| Total daily sleep | 16-18 hours |
| Sleep patterns | Newborns follow their own schedule |
| Sleep environment | Safe, comfortable, quiet, calm, and low-light |
| Sleep position | On their back, not on their side or tummy |
| Sleep aids | Pacifiers, swaddling, lullabies, mobiles, feeding |
| Co-sleeping | Bed-sharing is safer than co-sleeping in a couch or armchair |
| Sleep training | Teach self-soothing and establish a routine |
| Parental sleep | Share nighttime feedings, prioritize sleep, stick to a schedule |
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What You'll Learn
Newborn sleep patterns and cycles
Newborns sleep on and off through the day and night, and they do not know the difference between day and night. They spend most of their sleeping time in 'active sleep' and their sleep cycles are usually around 20 to 50 minutes long. The total amount of sleep varies between babies, ranging from 11 to 19 hours a day. Sleep patterns in newborn babies are mostly affected by the need to be fed, and they will wake up when they are hungry. Some babies will wake up more frequently than others.
Newborns sleep in short bursts, known as sleep cycles, and they will usually wake up every 1 to 3 hours. At around 4 to 8 weeks, a baby's sleep will start to respond more to light and dark, rather than hunger. After 8 weeks old, they might also begin to sleep for longer.
There are two types of sleep: REM (rapid eye movement sleep) and non-REM sleep, also known as active and quiet sleep. In REM sleep, your baby may move around more and make noises. In non-REM sleep, your baby sleeps more deeply and quietly. Babies spend about 50% of their sleep time in REM sleep, and as they grow, they begin to spend less time in REM sleep.
Babies may awaken as they pass from deep sleep to light sleep and may have difficulty going back to sleep in the first few months. When a newborn awakens at the end of a sleep cycle, there is typically a quiet alert phase. This is when the baby is very still, but awake and taking in the environment. During this time, babies may look or stare at objects, and respond to sounds and motion. This phase usually progresses to the active alert phase in which the baby is attentive to sounds and sights, and moves actively. After this phase is a crying phase.
You can help your newborn learn to sleep more at night by exposing them to light and gently playing with them during the day. You can also provide a dim and quiet environment at night. It is important to establish a routine at bedtime, but be sure that the baby does not fall asleep while eating or in your arms. This may become a pattern, and the baby may begin to expect to be in your arms to fall asleep.
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Safe sleep practices and environments
Safe Sleep Practices:
- Room Sharing, Not Bed Sharing: It is recommended that newborns sleep in the same room as their parents for the first year of life, or at least the first six months. This practice can help prevent Sudden Unexplained Infant Deaths (SUIDs). However, it is crucial to avoid bed sharing, as it increases the risk of SUIDS. Instead, use a separate safe surface such as a bassinet, crib, or portable play yard placed in your bedroom.
- Safe Sleep Surfaces: Ensure your baby sleeps on a firm, flat, and level surface. Use a well-fitting, firm mattress with tight-fitting sheets and a waterproof mattress protector. Avoid soft bedding, comforters, pillows, loose sheets, blankets, toys, positioners, or bumpers, as these pose a suffocation risk.
- Sleep Position: Always place your baby on their back when putting them to sleep. This position helps keep their airways open. Once your baby can roll over easily (at around 4-6 months), continue to place them on their back, but let them find their own sleeping position.
- Avoid Overheating: Do not over-bundle your baby. Dress them in one more layer of clothing than an adult would wear, and ensure they do not feel hot to the touch. Overheating can interfere with their brain's control of breathing and waking functions.
- Pacifier Use: Offering a pacifier at sleep time can help prevent SUIDS. However, if you are breastfeeding, introduce the pacifier after breastfeeding is well established.
- Swaddling: Swaddling, or wrapping your baby snugly in a light blanket, can help soothe and calm them. However, once your baby starts trying to roll over, stop swaddling to prevent restricting their movement.
Safe Sleep Environment:
- Clear the Space: Ensure there is a clear space around your baby's cot or bed. Keep items with cords, ties, or ribbons that could pose a strangulation risk out of reach. Also, remove any objects with sharp edges or corners to prevent injuries.
- Smoke and Vapour-Free: Maintain a smoke-free environment before and after birth. Smoking and vaping increase the risk of SUDI, even when done away from the baby.
- Crib Safety: If using a crib, ensure it meets safety standards with spindles no wider than 2-3/8 inches apart and fixed sides. Avoid using a crib with drop-down sides.
- Avoid Sitting Devices: Do not let your baby sleep in a sitting device such as a car seat, stroller, or infant lounger for extended periods. These can cause positional asphyxiation or restrict your baby's movement, leading to developmental issues.
Remember, creating a safe sleep environment and following recommended practices can significantly reduce the risk of sleep-related infant deaths. Always prioritise your baby's safety and well-being when making decisions about their sleep arrangements.
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Coping with sleep deprivation
Newborns sleep a lot (up to 18 hours a day), but they follow their own schedule. They can't tell the difference between night and day, so they wake up frequently and need to be fed every few hours. This can be very hard to cope with when your body is recovering from birth and adjusting to life with a newborn. Sleep deprivation can affect your mood, energy levels, and ability to think clearly, so it's important to find ways to cope with it.
Understand the impact of sleep deprivation
Recognise how it can affect your feelings and functioning. Don't be too hard on yourself, and know that it's normal to feel overwhelmed, teary, and emotional when sleep-deprived.
Prioritise your sleep
When your baby sleeps, try to rest instead of doing chores. Go to bed early for a week and do something relaxing before bed, like soaking in a hot bath. If you're breastfeeding, ask your partner to help with nappies or morning routines so you can sleep longer.
Adjust your bedtime routine
Consider tweaking your bedtime routine to ensure you get enough sleep. This may include going to bed earlier to align with your baby's sleep schedule.
Accept help
Don't hesitate to ask for help from your partner, family, or friends. They can assist with feeding, changing, or taking the baby for a walk so you can rest.
Create a soothing environment
Keep things quiet and calm during nighttime feedings and diaper changes. Maintain low lighting, and avoid playing or talking with your baby to reinforce that nighttime is for sleeping.
Establish a routine
Help your baby develop a bedtime routine, such as a consistent bedtime and sleep environment. Look for signs of sleep readiness and teach your baby to fall asleep on their own.
Be cautious with co-sleeping
While it's convenient to nap with your baby on your chest, it can be dangerous. The American Academy of Pediatrics (AAP) warns against co-sleeping on a couch or armchair due to the risk of dropping or smothering the baby. If you choose to co-sleep, do so safely in a bed without blankets or pillows.
Avoid unsafe sleep practices
Don't use weighted blankets, sleepers, or swaddles on or around your baby. Ensure all sleep products are approved by the U.S. Consumer Product Safety Commission (CPSC) and meet safety standards. Stop swaddling once your baby starts trying to roll over.
Seek professional help if needed
If you're feeling persistently low, bad-tempered, or unable to cope, talk to your GP or health visitor. They can provide support and guidance on managing your mental health and improving your sleep.
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Helping your baby sleep
Newborns don't have a sense of day and night yet, so they sleep around the clock, waking every few hours to feed. They get about 8 to 9 hours of sleep during the day and 8 hours at night, totalling 14 to 17 hours of sleep in a 24-hour period, according to the National Sleep Foundation. Some newborns may sleep up to 18 to 19 hours a day.
- Understand sleep readiness signs: Look out for signs that your baby is ready for sleep, such as yawning, rubbing their eyes, or pulling at their ears. Knowing these signs can help you establish a bedtime routine.
- Create a soothing bedtime routine: A simple and calming bedtime routine can help your baby settle. This could include singing lullabies, reading, or playing a wind-up musical mobile.
- Keep things quiet and calm at night: During middle-of-the-night feedings and diaper changes, keep the lights low and avoid playing or talking with your baby. This helps reinforce the message that nighttime is for sleeping.
- Let your baby fall asleep in their crib: Encourage your baby to fall asleep in their crib to establish a positive sleep association with their sleeping space.
- Avoid keeping your baby awake during the day: Contrary to popular belief, letting your baby sleep during the day will not necessarily lead to better nighttime sleep. Overly tired infants often have more trouble sleeping at night.
- Swaddle your baby: Wrapping your baby snugly in a light blanket (swaddling) can help soothe and calm them when they are fussy or crying. Just remember to stop swaddling once they start trying to roll over.
- Offer a pacifier: You can offer a pacifier at sleep time, but don't force it. If your baby is breastfeeding, wait until it's firmly established before introducing a pacifier.
- Be mindful of safety: Ensure that all sleep products and surfaces are safe and approved by relevant safety commissions. Avoid items with cords, ties, or ribbons that could pose a risk of strangulation, and keep blankets and pillows out of the crib.
- Understand developmental changes: Be prepared to adjust your routines as your baby grows and goes through different stages. Growth spurts, teething, and illnesses can all impact your baby's sleep patterns.
- Get help: Taking care of a newborn can be exhausting. Don't hesitate to ask your partner, family, or friends for help so you can get some rest.
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Sleep training and routines
Newborns follow their own sleep schedule and have no sense of day and night. They wake up frequently to eat, regardless of the time. Most newborns sleep for a total of about 8 to 9 hours during the day and 8 hours at night, but this varies. Some babies sleep for long periods, while others sleep in short bursts.
Sleep training can start around four months of age. It is a tool to help your baby learn to fall asleep and stay asleep through the night without your help. The goal is to help your baby self-soothe when they are put to bed awake and when they wake up in the middle of the night.
There are several sleep training methods:
- Cry It Out (CIO) or extinction: This method involves putting your baby to bed when they are still awake and leaving the room. If your baby cries, you don't go back into their room until morning or their next scheduled feeding. The idea is that the baby will eventually tire themselves out or self-soothe back to sleep.
- Ferber: This is similar to CIO, but you can re-enter the room if the baby cries. However, you should lay them back down before they fall asleep so they learn to feel confident falling asleep on their own.
- Fading: This method involves gradually increasing physical distance between yourself and your baby at night. When the baby cries, you can reassure them by shushing and patting them, but you should lay them back down before they fall asleep.
- Wave: This is a gentler type of extinction sleep training. You follow your usual bedtime routine, and if your baby cries when you leave the room, you briefly check in after five minutes with a scripted mantra, such as "Mama's right next door. I love you. You can do this." You keep checking in every five minutes until they fall asleep, but you shouldn't pick them up or make too much of a fuss.
- Gentle Sleep Training: This method focuses on helping your baby learn to sleep on their own without any crying. It leans heavily on a consistent bedtime routine.
Regardless of the method you choose, routines and consistency are key when it comes to sleep training. A bedtime routine can include a warm bath, a book, and a lullaby before putting your baby to bed. Try to get your baby up around the same time every morning and feed them and put them down for naps at consistent times during the day.
It's important to note that you should always put your baby to sleep on their back and keep blankets and pillows out of the crib. Swaddling (wrapping the baby in a light blanket) can help soothe a crying baby, but you should stop swaddling once they start trying to roll over. Additionally, make sure all sleep surfaces and products have been approved by the relevant safety organizations and meet federal safety standards.
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Frequently asked questions
It is not recommended for newborns to sleep in the same bed as their parents due to the risk of sudden infant death syndrome (SIDS) and fatal sleep accidents. However, if you do choose to bed-share, there are ways to reduce the risks, such as placing your baby on their back, removing pillows and blankets, and using a firm mattress.
It is recommended to wait until your baby is at least 4-6 months old before starting sleep training, as by this age, they probably no longer need nighttime feedings and are developmentally ready.
Co-sleeping can be convenient and provide an opportunity for physical closeness and bonding with your baby. It can also make breastfeeding easier and encourage skin-to-skin contact, which contributes to neurodevelopmental maturity and normal respiratory breathing patterns.
The main risk associated with co-sleeping is the increased chance of sudden unexpected death in infancy (SUDI), including SIDS and fatal sleep accidents. Other risks include suffocation, strangulation, and overheating.
