0 to 4 Month Newborn Sleep

Find out what's going on in the sleep realm of a newborn
and why is it so different from our own.

Find out what's going on in the sleep realm of a newborn and why is it so different from our own.

We’re all aware of the old adage “sleep like a baby”. I don’t know about you but I scoffed at this once I became a parent. If babies are such great sleepers then why am I so dang tired?!

Well this saying is probably nested in the fact that newborns may spend upwards of 16-18 hours a day in a blissful state of slumber.

Why is no one sleeping?

Those first months after introducing a little person into your home can be punctuated by some of the longest, most restless nights tending to the cries of such a small individual (how can that sound possibly be produced from such a tiny body?).

It is so impactful, that nearly every conversation that you enter into following the arrival of baby will at some point gravitate towards the inevitable question – “So, how are you sleeping?”.

If you’re not sleeping well (or at all), you get the sympathetic head nod and a “I know how you feel”; if you are sleeping well, you get the furrowed brow, query of disbelief “how do you do it?!”.

Newborns sleep short and sleep often.

What may come as a shocker during those long nights of the early months as a new parent is that the length of each sleep interval is comparably short. In other words, babies sleep in many short bouts, rather than one consolidated stint in the night as we do as adults.

In addition, because the internal rhythm that controls the 24-hour sleep cycle is immature, daytime and nighttime sleep is physiologically equivalent. Remember, your babe spent the first 9 months in complete darkness.

An infant may also startle awake more easily during this period of development than an older baby might, particularly because the pesky startl (Moro) reflex is in full tilt and the mechanisms for keeping baby snoozing soundly have not yet developed.

On a positive note, with no real differentiation between day and nighttime sleep, they do not rely heavily on sleep cues in order to enter the sleep state.

Newborns simply fall asleep because the drive to sleep is so strong – sometimes this will occur spontaneously, while anything that even closely mimics life in the womb (rocking, bouncing, skin-to-skin contact, white noise or mom’s heartbeat) will certainly lull your baby into a deep slumber.

That said, development of your baby’s 24-hour circadian clock is significantly influenced by external environmental cues (e.g., light-dark cycles, feeding schedules, mother’s activity and rest routines), so now is a great time to start introducing a sleep-positive environment: the brain is plastic and receptive at this time and can learn very quickly.

An infant’s preference for more sleep at night and more activity during the day might be established by as early as 10 days to a few weeks old; however, many newborns exhibit a pattern of sleeping all day only to be up frequently through the night. This makes sense since the daytime is full of sounds and motions that are comforting to your little one, while nighttime sleep is generally laying on a flat surface in the supine (on the back) position. Not exactly your baby’s idea of 5-star (yet). 

A few tips to help tip the scales? 

  • Get lots of natural light during the day
  • Include your baby in your daily rhythms and routines
  • Wake your baby every 2 hours and encourage brief intervals (45-90 mins) of engagement

So while the total duration of sleep is high, frequent waking is common – and necessary if you consider this is an essential drive to ensure they are getting enough to eat for growth and development. The good news is, once sleep architecture matures (around 4 months), sleep takes on a more “adult-like” appearance and the number and length of baby’s sleep bouts begin to sync with mom and dad.

Feed to sleep, wake to feed.

If there’s one thing newborns seem to do more than sleep it’s EAT. Non-stop. Like every two hours. Day AND night! And feeding an insatiable pea-belly means long hours of restful sleep is on temporary hiatus. 

And since a feed can last up to 30 or 40 minutes, it can literally feel like all you do is nurse. Human breastmilk contains a much lower concentration of fat and protein when compared with other mammals, and as a result is quickly digested (Note that formula is derived from the milk of another species or from soy, which is why it tends to tied babies over for longer durations between feeds). And because a newborn’s stomach can only hold 2 ounces of breastmilk at a time, this translates to frequent nighttime wakings to refuel.

If your baby is formula-fed, she will be eating about 2-3 ounces every three to four hours – but keeping up with bottle prep, cleaning, sterilizing, and maybe even pumping and you may feel that there is never a moment of down time. This, of course, is normal and feeding does tend to taper out to a more manageable three (breast-fed) or four (formula-fed) hour schedule after the first month of life.

In addition, along with sleep architecture being immature in the early weeks to months, baby’s digestive system is still developing. Feeds can be associated with painful bouts of gas or reflux, especially if lying still in the supine position. And digestion is diminished during sleep, only exacerbating the length of these uncomfortable GI spasms. Therefore, feeding immediately before a sleep stint may heighten discomfort and perpetuate more frequent waking.

What to do about this? Well, the textbook answer is break the association; don’t feed to sleep and instead place feeding times in a schedule that promotes feeding upon waking (check out E.A.S.Y is hard). But feeding can be an incredible time for bonding with your little one and may be the most calming part of the day (cough, night). On the other hand, it can be an all-consuming, seemingly unnatural, incredibly stressful event during the newborn months, to a point where you can’t imagine focusing on anything but.

So in reality my answer would be to get your baby nourishment in the best way you know how, focus on a positive sleep environment and the establishment of daily rhythms, and slowly shift towards a feed-sleep disentanglement once the blur of the first months are behind you.

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