This blog is for Moms and Dads who have limited time and need quick parenting tips.

25 August 2010

Sleep - Newborns

As much as we would love it to be different, babies need to be fed during the night and will not sleep through the night (around 8 hrs straight) for at least 3-4 months depending on their temperament, birth size and how well you establish good sleep behaviors.

You can do a lot to help babies become good sleepers. For newborns these are my top tips:
  • Swaddle - buy a a few good swaddle blankets and do them up firmly.
  • Put baby to bed in their crib so they associate crib with sleep.  If you must use a swing then you may have difficulty latter when they are too big for it and you have to use the crib.
  • Darken the room for day-time naps.
  • Invest in a white noise machine.
  • Do not rock or hold to sleep unless you want to establish this as a pattern!
  • Wake-up the baby at the same time each day and expose to sunlight.
  • Do not play with the baby at night-time wakings otherwise they can't learn the difference between daytime activities and night-time activities (which should be just eating and sleeping)

A few words about "schedules".  Firstly I hate this word and prefer to use the word "routine" - this implies a predictable series of activities but with some flexibility to make adjustments as needed. Babies can develop a routine from day one. My twins, born at 34 weeks, were on a 3 hourly feeding routine in the NICU which we continued - it was my sanity.  It was the best thing to know that it was time for naps and I could have a shower and know they would sleep through it.

Establishing a routine:
You can start this from day one. Be prepared to be flexible - babies will have great days and unsettled days.  If your baby is really upset, I do not recommend letting them cry it out (CIO) at this age.
  • Eat, Activity, Sleep, You (EASY) - This is from The Baby Whisperer book.  In essence it is an order of activities - feed the baby, do some activity (like diaper changing and playing), put the baby to sleep and then YOU get some time to re-energise!   
  • Wake at the same time each day and expose baby to sunlight - they learn to associate day-light with waking.
  • A typical newborn will be on a 3 hourly routine.  Personally I am happy to vary things by about 1/2 hr at this age.  Here is a basic guide with a 7am start time:
    • 7am - wake-up.  
    • 7am - 8.30am. Change diaper and feed baby.  Playtime.
    • 8.30 - 10am - Sleep
    • 10am - wake-up
    • 10am - 11.30.  Change diaper and feed baby.  Playtime.
    • 11.30 - 1pm - Sleep
    • 1pm - 2.30pm.  Change diaper and feed baby.  Playtime.
    • 2.30 - 4pm - Sleep.
    • 4 - 5.30pm - Change diaper and feed baby. Playtime.
    • 5.30 - 7pm - Sleep.
    • 7pm - Change diaper and feed baby.  Bath-time and then straight to bed - around 7.30 - 8pm
    • At night you feed at 10pm, 1am, 4am and then start the day at 7am.  No playing - just feeding and back to bed!  I do not recommend waking the baby to feed unless they have gone 5 hours between feeds.
  • If your baby is sleeping more than 2 hours in the day, I suggest waking and feeding them.  If you let them sleep they can start to confuse day with night-time.
  • Warning:  If you feed your baby to get them to sleep they may get into the habit of wanting a feed to go to sleep - this becomes a problem when they get teeth!  Milk has sugars in it and if you feed your baby and lie them down, the milk pools in the mouth and causes tooth decay.

Soothing a Baby To Sleep
  • Most babies need to learn to go to sleep so don't pick them up at their first little whimper.  Let them have a chance at putting themselves back to sleep.  Set yourself a 5 minute goal (use a clock as it can seem like eternity) - if the baby is still upset or has escalated go to the next point.
  • Gently make some slow "shhh" noises and rub their back - try to do it in time with a slow heartbeat.  If you pick them up at this stage then they learn that crying results in being held - they will have trained you! 
  • If the baby starts to really let loose with the crying after doing the shhh noise and back rubbing, pick up and cuddle.  Gently rub their back and as soon as they are reasonably settled (not necessarily asleep), put them down and go back to shh noises.
  • Sometime the baby will cry for a genuine reason - wet diaper, clothes uncomfortable or gas.  I recommend checking all of these (even to the extent of undressing completely).  Eg., A loose thread could be caught on their toe!

Crying It Out (CIO)
 If you establish good sleep habits using the tips above you should never have to use CIO techniques.  You will know that they are crying because they are hungry (it is the time you usually feed them) or they are tired (it is nap-time).  If you do not have a routine, you are guessing at why your baby is crying and this can be hard.

 Moving to a 4 Hourly Routine
As your baby gets older (generally around 4 months) you will move naturally to a four hourly routine - 2 hours of awake time followed by 2 hours of nap-time.  My youngest baby started sleeping through the night at 4 months - 7.30pm - 7am - bliss - until teething started.

Last tip - sleep when baby sleeps.  Let the washing and other cleaning go and look after yourself.  I happy, rested Mommy is best for all.

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