Sleep in Newborns

What is happening with my newborn's sleep

At birth, newborns have no circadian rhythmicity, and their sleep/wake pattern is erratic. In utero, the baby is synchronised with the mother, but this association stops at birth, and babies lose the day-night rhythm for a while, until the baby achieves their own circadian rhythmicity (after a few weeks). 
If you think of it for a moment you may see that it makes sense from your experience – before birth, your baby probably seemed to be ‘awake’ at certain times of the day, and usually settles down in the night. After birth, all bets are off, and parents are often confronted with a baby who sleeps and is wakeful at different times than they noticed before birth. But this is a normal process of adaptation. Let’s think about what influences the development of circadian rhythmicity.

The development of circadian rhythms and sleep cycles

​Newborns do not produce their own melatonin, although human breastmilk does contain tryptophan – the precursor to melatonin. Newborns also do not have a predictable, consolidated or reliable napping pattern. 
Newborns have short sleep cycles of about 30-40 minutes, and spend most of this time in dream sleep. Dream sleep seems to be important for brain development. In fact, the blood flow to the brain almost doubles during dream sleep. For parents, this means a baby that wakes very easily, specially when placed down in the cot or other sleep surface as dream sleep is lighter sleep.

In general, achieving more quiet sleep is indicative of brain maturity, with preterm babies spending a great deal of time in dream sleep. So, more mature babies spend less time in dream sleep and more time in quiet, deep sleep.

There are other factors that will influence how your baby sleeps in the early days and weeks related to what happened in birth and the mother’s habits in late pregnancy. But we often have very limited control over these.

What can you do to assist your newborn
​
Prioritise bonding - This is a time of huge adjustment and most parents require support and encouragement. Take your time to learn your baby’s tired cues and the aspects they need more support with.
Establish feeding - Feeding is a huge priority, and is likely to consume the majority of the awake time for your baby. Young babies have tiny tummies, and 

need to feed frequently, either by breastmilk or formula. ​Reach out for support if you need. Use this time to build the bond by maintaining eye contact during feeds – Feeding and eating is a lot more than a ‘task’, it is relational.
‘Talk’ to your baby - When your baby is not feeding but alert, to copy your baby’s facial expressions, interact with your infant. This is the earliest form of communication. Your baby will often stick their tongue out when that action is modelled to them, or make attempts to use facial expressions to respond to noises that you make.
Create a ‘day and night’ routine - The day-night rhythms of a newborn are often described as being ‘all over the place’. This will settle down once your baby has established their circadian rhythmicity. This can be sped up by the exposure to broad spectrum daylight for 12 hours per day, with normal activity levels during the day, normal amounts of noise and light, and then a 12-hour period of dark, quiet and reduced stimulation. ​

Some strategies that might help to optimise newborn sleep are listed below:
 
Practical Tips

• Have a predictable and brief pre-sleep routine i.e. the same song, a sleep phrase, or a lullaby. Don’t worry about the time in the clock, this routine is to be done just before your baby sleeps day and night
  
• Try white noise
  
• Use a sling
  
• Try swaddling
  
• Try shushing and patting
  
• Warm the baby’s bed before placing them down to sleep
  
• Sleep with a muslin, and then place this muslin in your baby’s bed. The scent may reassure your baby.
  
• Expose your baby to natural light for as as much as possible during the day
  
• Help your baby sleep when they are tired (look out for the early sleep cues)
  
• Ensure you are following safe sleep guidelines
  

 
And of course - remember to enjoy the crazy early weeks!