My Own Newborn Sleep Plan
In case you didn’t catch the news already, I am very (very) pregnant with child #3.
I’ve been thinking a lot about my own newborn sleep plan. I was not a child sleep consultant back when I had my first two children, but I did a ton of reading when my first was an exhausted cranky mess, and learned a lot.
I am hoping to share my journey with #3 – with all it struggles as well as successes – with all of you. So this is my first post with that in mind.
“Juanita” is expected to come via induction at around 37 weeks. At her last check-up, she was in the first percentile for weight. While there is some room for error, given that this was her 5th measurement where she was less than 5%, it’s very very likely that she’ll be very small. Plus three weeks early. Which does make a difference, even if lots of folks say that 37 weeks is full term.
So given all that backstory, and given the uncertainties of pregnancy and childbirth in general, and a high-risk pregnancy (due to her small size) in particular, here is what I am thinking.
Well, this is my plan, anyway. Remembering very little of what it is like to actually have a newborn. Feel free to laugh, either now or later, when it is undoubtedly 100 times more complicated than I expect.
And if this helps anyone else who is pregnant, awesome!
And if you'd like help coming up with your own personalized sleep plan for your child, newborn or otherwise, set up a complimentary sleep consultation ASAP, before I go out on maternity leave!
The American Academy of Pediatrics recently reduced their room sharing recommendations from the first 12 months of life to the first 6 months of life.
This is good news for many parents, as sharing a room with an infant past the early months of life can lead to many night wakings. Now you can sleep well and not feel guilty. Win:win.
But Emily Oster goes a step further in her recent article, New AAP Guidelines on Breastfeeding and Safe Sleep, and says that actually, the evidence the AAP cites says that the risk of SIDS actually drops significantly at four months, not six. Meanwhile, she says, the protective benefit of room sharing is weak.
So she suggests that actually, parents could stop room sharing safely at four months, and lots of evidence she has found says that babies who sleep better at 4 months continue to be better sleepers at 9 months and even at 30 months.
And anecdotally, in my work, I see a huge decrease in the number of night wakings for both parent and child when children are moved to their own bedrooms (or to their siblings’ bedrooms, assuming their siblings are relatively good sleepers).
Of course, Emily Oster is not the AAP and if you want to be extra conservative, go with their recommendations. But I find her arguments quite persuasive.
Parents, it's not to late to finish out 2022 well-rested! Book a complimentary sleep consultation here and find out more. Better sleep is guaranteed.
New AAP Guidelines on Roomsharing
The American Academy of Pediatrics updated their safe sleep guidelines in July, stating they now recommend that parents share a room – but not a bed – with their infants for at least the first 6 months of life. Previously, the recommendation had been for 12 months.
While the AAP doesn’t state their reason for the change, I suspect it’s because the risk of SIDS drops radically after the first four months, and 90% of deaths occur in the first 6 months of life.
In other words, the risk of SIDS is much, much lower (90% lower) in the second six months of life.
Researchers don’t really know why sharing a room with a parent reduces the risk of SIDS, but hypothesize that perhaps the sounds of other humans in the room prevents the newborn from sleeping too deeply.
It is not known, unfortunately, known if room sharing with siblings provides the same protective benefit.
As a sleep coach, I was very happy to read of the updated recommendations because I almost always recommend not room sharing during sleep training.
Often times, this looks like having one or both parents sleep in the living room, since most of my clients are NYC-based and don’t have guest rooms.
Other times, if the baby is breastfed, we will have the non-breastfeeding parent (if there are two parents) sleep in the bedroom with the baby while the other parent sleeps in the living room. That’s because the smell of breastmilk very close by can make it harder for a baby to sleep through the night. Most of the time, this easily helps the baby sleep a lot more and cry a lot less.
A third option, if there is a sibling in a separate bedroom and the parents are planning to have the children share a room, is to move the baby into the sibling’s bedroom and move the sibling – temporarily – into the parents’ bedroom, into a floor bed. That way the baby can learn to sleep in the bedroom where they will eventually be sleeping every night with a sibling.
This, of course, requires a sibling that is willing to give up their bed for a few nights. But most children like the idea of having “a little nest” (it helps to describe it appealingly!) on the floor of a parent’s bedroom. And young children don’t feel the hard floor the way we adults too, so it shouldnt’ be too uncomfortable. I don't recommend having the older child sleep in the parent's bed, even temporarily, because that can be a hard habit to break!
Once the baby has met the parents’ sleep goals – and the goals should always be set by a parent, not by a sleep coach – the baby can resume roomsharing with either the adults or children in the family.
The AAP still strenuously advises never sharing a bed (or worse, a couch) with an infant.
If you are ready to get some solid sleep again, let's set up a complimentary sleep consultation and get your family sleeping blissfully in two weeks or less, guaranteed.
“Is There A Way To Teach My Newborn How To Be A Great Sleeper So I Don’t Have To Sleep Train Later On?”
This was a question I received from Fatimah, my first client in Saudi Arabia.
She hadn’t sleep trained her older son until he was a year old. At that point, he was waking up seven times a night to nurse. And sleep training him was excruciating.
Now eight-week-old Farris seemed to be following in brother’s footsteps. Fatimah really didn’t want to endure the same nightmare again.
Also, Farris was heavy, and rocking him and nursing him to sleep multiple times a night was really hurting Fatimah’s back. She has almost no time with her older son because Farris seemed to need her all the time, and she was feeling a lot of guilt about that. And of course, she was exhausted from nursing and not-sleeping all night long.
But she didn’t want to do anything that would harm him, of course. So she scheduled a free call with me, and we decided to move forward in a gradual, gentle progression. Neither of us wanted him to cry for long periods of time. Older babies can handle this but newborns aren’t ready for that.
Newborns have immature nervous systems and often need a lot of help falling asleep…. But that doesn’t mean they can’t learn to take over the job.
Here’s some of the strategies we used. None of them involved crying:
Some of the changes she noticed in Farris, “He actually now prefers to fall asleep on his back in his bassinet instead of in my arms. He often wakes up happy now, whereas before, he was really fussy. Sometimes I don’t even realize he has woken up because he wakes up happily, without crying!”
And about herself, “I have so much more energy now that I am sleeping more. I would never have been able to do this on my own. It was scary at first, because I never sleep trained my older son at this age. I am so glad that I could message you with questions, or even just to rant! That really helped.
Farris sleeping independently will make it so much easier for him when I go back to work. I am so excited that his sleep habits will continue to grow and I will never have to sleep train Farris like I did with my older son!
It's also great having some time to relax and connect with my husband in the evenings.
I am so happy I did this!"
If you would like to help gently guide your newborn to better sleep, it is absolutely possible! Better sleep is in your future. Schedule a free chat and let’s get your family the sleep you deserve.
How to Sleep Train When You Want to Maintain Night Feedings (But Maybe Not Quite So Many of Them)
Many new parents think that they have to night wean in order to sleep train.
This is not true! You can maintain night feedings AND sleep train.
Usually, the key issue here is separating sleep and eating.
Once breastfeeding and weight gain is well established, usually by 2 months of age, a breastfed baby should be able to go at least 3-4 hours between feedings at night, if the breastfeeding parent so desires. (Some parents are perfectly happy to breastfeed all night long; this post is not for them.) Check with your child’s pediatric healthcare provider to confirm that weight gain is good and that there are no feeding concerns.
Typically, by this age, the first or second stretch of sleep is the longest and then feedings are more frequent. But they need never be more frequent than every 3 hours during the night, again, as long as weight gain and breastfeeding are going well.
Formula-fed babies should be able to go at least 3-4 hours between feedings as well.
If your baby is feeding more often than this, she is most likely using nursing (or less commonly, bottle feeding) as a way to soothe herself to sleep. There’s nothing inherently wrong with this. The problem is when this interferes with either the baby’s or the parent’s ability to get restful sleep.
You can start by just logging the feedings as they are now, either on paper or in a free app like Huckleberry. If you are breastfeeding, make note during which feedings you feel a letdown or can observe your baby swallowing repeatedly during the feeding. If you are bottle feeding, make a note of which feedings are a substantial volume. If your baby takes, for example, less than one ounce in a particular feeding, you can feel confident that he wasn’t hungry at that time.
Next, pick a target time for the first night feeding. It should be at least 3 hours after bedtime but might be longer if your baby already sleeps a longer stretch.
If your baby wakes up before that target time, use a different method of soothing him back to sleep. Breastfed babies often do better if they are soothed back to sleep by a non-breastfeeding caregiver. Even if the target feeding time arrives but your baby has still not fallen back to sleep, do not feed.
Wait for your baby to fall back to sleep. The next time he wakes after the first target feeding time, promptly go to him and offer a full feeding.
The next target feeding time will be at least 3 hours after the start of the first feeding. Again, if your baby wakes up before that time, use another method of soothing to get her back to sleep. The first time she wakes up after the second target feeding time, go to her promptly and again offer a full feeding.
And so on, if there is a third feeding (or more).
Try, whenever possible, to put your baby down awake after the feeding, but with a young baby, don’t stress unduly about this. Just decoupling feeding from sleeping some of the time will help.
During the day, also work towards putting the baby down awake after feeding when possible, but again, don’t stress unduly about this. Many parents find it helps to feed when the baby first wakes up, rather than right before a nap, to separate feeding from sleeping. If your baby is only for awake for an hour at a time, he shouldn’t need to eat twice during that time.
Taking these steps are a gentle way to gradually work towards improved sleep, especially at night, without doing any forced night weaning or any "crying it out."
If you have questions about how to do this, scheduled a free chat and get your little one gradually on a track towards better sleep.
Life with my first newborn, almost nine years ago now, was often miserable.
She was generally pleasant during the day but by late afternoon, all hell broke loose. She cried for hours. I felt like the worst mother in the world. And I used to be a neonatal ICU nurse! How could it be this hard to comfort my own child?
I sat at my mother’s dining room table with a breastfeeding pillow around my waist and my shirt bunched above Calliope’s bald head, doing my best to wolf down food one-handed.
My mom would take Calliope from time to time and bounce her repeatedly, which calmed Calliope momentarily but then she would cry even harder a few minutes later.
About the time that I was nearing my breaking point with the crying, having not left the house all day, my mother would hand the baby over and chirp cheerfully, “well, I’m getting tired, I think I’m going to go get ready for bed now.”
I frantically swaddled and swayed and nursed and rocked Calliope in her little swing. Nothing seemed to help. I was exhausted. And as a single mother by choice, I didn’t have a partner to turn to. My mother changed diapers and burped Calliope after feedings when she could, but she was a full-time attorney and busy with her own life.
My blog from 2011 says,
Calliope doesn’t seem to have any comfort mechanisms besides nursing. I know they say you can’t overfeed a breastfed baby... but I don’t believe that. If she is eating for reasons other than hunger, to my mind, that’s not necessarily healthy, just like it wouldn’t be healthy at any other age.
However, I still let her nurse whenever she wants to... but when she cries and roots while the nipple is still in her mouth, I feel beyond frustrated and helpless. Clearly she isn’t hungry. But I just don’t know how to help her.
Finally she fell asleep and II left her swinging in the den. I gathered my strength to climb the stairs to my bathroom. And cried in the shower.
I don't know how I can keep going like this. I love her but I can't bear the exhaustion."
Then my friend Catherine, another Brooklyn single mom, told me about a book called The Sleep Whisperer, by Tracy Hogg. She said it helped with her newborn son, Jack, just a few weeks older than Calliope.
I was desperate. And so tired I couldn’t imagine staying awake long enough to read a book. Desperation won out. I didn’t love the author’s tone. It was a bit too colloquial for me -- she addresses her clients as “luv.” But I forgave her for that because the information she shared changed our lives.
I finally understood that I was keeping Calliope awake too long. At just a few weeks old, she should have been awake for only an hour at a time. She should go to bed before she even looked tired, at the first sign of a yawn. And those too-late naps were thus too-short naps... which were absolutely causing the late afternoon witching hour(s).
I promptly put Calliope on Hogg’s EASY routine. EASY stands for Eat, Activity, Sleep, You.
Eat. Rather than letting her eat all the time, and especially before sleep, I only fed her when she first woke up from a nap. I aimed for feeding every three hours. I stopped feeding her to sleep.
Activity. For a newborn, activity was simple. Mostly it was a few minutes lying on her activity mat but other times, it was even less. It turns out that newborns don't need all that much in the way of stimulation. As she got older, this period gradually lengthened out.
Rest. I aimed to put her back to sleep after only an hour awake. If I saw a yawn after only forty-five minutes, I would put her down even sooner. I used four of Harvey Karp’s 5 S’s: swaddling, sucking (a pacifier), swinging and shushing (white noise). Back then, it was acceptable to let babies sleep inclined in swings. Now we know this is a risk factor for SIDS, unfortunately. All babies must be put down to sleep on their backs.
You. The part I lived for. This was time for me. To shower, exercise, call a friend, check email or (less fun) pursue the disability insurance folks. Getting a guaranteed break for myself made all the difference in the world to my emotional health. I never managed to nap but getting time off during the day meant I didn't stay up too late at night, trying to soak up some personal time.
Within a few days of putting Calliope on this schedule, she was a different child. She literally never cried. I could figure out her needs just by glancing at the clock.
It was hard, sometimes, to be so ruled by a schedule... but it was worlds better than hours of crying every afternoon. And I found I could compromise let her nap in the stroller occasionally without suffering the consequences at night.
And with just this routine, including the feeding schedule, Calliope was naturally sleeping 8 hours at a stretch at night without any formal sleep training by 6 weeks old. (The swing might have been an unfair advantage, though!)
I am not exagerating when I say that this schedule saved my sanity. I know I was lucky that she was a good sleeper... but I know it wasn't all luck, since she wasnt' a good sleeper before this schedule changed everything for us.
Moreover, it saved me from having to do any hard sleep training. This method didn't involve any crying at all. (In another post, I'll talk about the sleep training method that got me to 10 hours by 10 weeks. That was even better.)
It's never too soon to instill great sleep habits in your child. I started this schedule on our first day home from the hospital with my younger daughter. I never did any sleep training with her at all. She slept ten hours by ten weeks, too.
If you would like to get your little one on track and aren't sure where to start, schedule a free consult with me and get your life back on track.
I conceived both of my children on my own, with an anonymous sperm donor. So that meant there was no eager partner offering to help at night... and no tired partner grudgingly willing to help, either. My mother helped with my first during daytime hours, but she was totally off duty at night.
And so with my first baby at night, I did it all.
Despite being weak from a postpartum hemorrhage, I roused myself with each cry. I changed the diapers, nursed the baby, and soothed her back to sleep.
Luckily for me, she was mostly a good sleeper and usually went back to sleep after a feeding. That doesn't mean I wasn't occasionally in tears from fatigue. In hindsight, I can see I made a mistake. I should have gotten nighttime help.
I was beyond exhausted. Some days, emptying the dishwasher was an insurmountable task. Luckily we were staying with my mother -- I was too weak to take care of us at home -- so she cooked and washed dishes and changed diapers and burped the baby. And by the time we returned home, I was more or less okay.
But still. I would have enjoyed those early days a lot more if I had had some nighttime help. Even once or twice, for a few hours, would have made a huge difference.
With my second, my mom was gone. I had no family member offering to pitch in. I had great friends but they were busy with their own young children. And I had a three-year-old who needed me, too. A three-year-old that tended to burst into my room at 6 am, ready to start the day. Whether or not I had been up half the night with my colicky second-born or not.
Let's just say I was not a great mother to my older child in those early days.
It was miserable. For all of us.
Finally, I realized that I needed help.
Through the grapevine, I learned of a baby "nurse" (not actually a registered nurse) in the neighborhood. Laurel ran a local daycare and a friend recommended her highly. Sold.
Laurel came one night at 10 pm. I felt all kinds of wrong, handing my newborn over to a stranger. Leaving them alone in my living room and going to my bedroom to pump and then go to sleep (with my white noise machine on high) was surreal.
But I did it anyway. Albeit nervously.
I sent an alarm to wake up and pump four hours later. Four hours after that, Laurel crept into my bedroom and eased the baby into the bassinet and quietly departed.
It felt so good that I had her come back the next night to do it again. I was stressed about the money but it was amazing to feel semi-human again.
After two nights of help, I could imagine a world in which I actually enjoyed having two children. I started to think my older child was kind of cute, after all.
From then on, Laurel came every few nights. I continued to worry about spending so much money while on maternity leave but I just couldn't see a way to survive without her.
My breastmilk supply was fine with pumping at bedtime and again once during the night. My little one was not any worse at nursing for taking the occasional bottle (she never had a great latch in the early weeks -- despite visiting a lactation specialist, her mouth was just too small -- but she didn't get worse).
And then at five weeks, everything shifted. Amelie's tummy troubles eased. The long hours of newborn fussing lessened. She started to sleep a longer stretch at night. And it was clear I didn't need help anymore. I gratefully bid Laurel a fond farewell... and started to recommend her to my friends.
In hindsight, I wish I had had her come more often. I was scared that I would need her for a long time, but it turned out that the newborn period of mixed up days and nights, plus colic, didn't last long. Most babies start to sleep a longer stretch at night by about six weeks from the due date, though some don't start to recover from colic until about 4 months of age.
I wish I could go back and tell myself that even with my firstborn, it would have been a great idea to get paid (or not) help. It would have been okay to ask for a baby gift of contributing to a night nanny instead of unecessary baby clothes.
And so I want to tell all of you that there is no shame in accepting nighttime help, or even asking for it. When people ask how they can help, say, "would you be willing to do an evening shift with the baby?"
It's not too much to ask a friend or family member to watch the baby from 8 pm for a few hours so you can go to sleep and get a few uninterrupted hours. Even just three or four hours of unbroken sleep when you aren't straining to listen for a newborn cry can be amazingly restorative.
There's a myth in our culture that moms have to do it all. And effortlessly fit back into our pre-pregnancy jeans by six weeks postpartum, to boot.
This is a disservice to new families everywhere.
The newborn period is incredibly hard (for many, not all). I promise, it will get easier.
In the meantime, accept all the help you can. When someone says, "Let me know if you need anything," say "yes, actually, would you be willing to watch the baby while I sleep?" The worst they can say is no. But most people relish the opportunity to cuddle a newborn. And truly want to contribute.
Pay someone if you need to.
It doesn't mean you are a bad mother (or father). It doesn't mean you didn't want to become a parent. It doesn't mean you are lazy, or weak, or unloving.
Getting better sleep will make a better, more loving parent. And your newborn is most likely happy with any warm body. It doesn't have to be you in the early days (except for breastfeeding, of course). Take advantage of this and get yourself some sleep.
And hopefully it goes without saying but please don't bake or clean or even shower to prepare for these helpers. They are there to help you. Focus on your own needs. Take the best care of you that you can so that later, you can take care of your new little family member.
Massive sleep deprivation is not good for breast milk production, family bonding, or postpartum blues and depression. You are doing your whole family a favor by accepting help.
Motherhood is a long game. You are not going to make or break it as a parent in the first few weeks. Do yourself a favor and build up your strength so that you have more to give in later weeks when the offers of help dry up.
And rest assured, there are things you can do to make things easier in the early days, even when you don't have help. My number one suggestion is always to keep wakeful intervals very short for newborns. I aim for about 45 minutes awake, or the first yawn, whichever comes first. Preventing overtiredness will make it much easier for your newborn to go back to sleep, whether during the day or at night.
Beyond that, use Dr. Harvey Karp's 5 S's to help soothe your little one and get her sleeping: sucking (pacifiers worked great for both my children and didn't affect breastfeeding... the latest research supports this), shushing (white noise or even the oven exhaust fan works great), swaddling (even if she seems to hate it at first), swinging (in your arms or in a stroller or baby swing), and sidelying (only while being supervised).
If you need more support -- and remember, there's no shame in that! -- let's set up a free chat and see if we can't get you and your little one sleeping better.
Why Is My Baby Fighting Sleep?
You've taken the baby out for an outing. She got plenty of fresh air and had lots to see.
Now you are back home and it should be time to sleep. But your little darling just won't go to sleep.
Your mother suggests the baby isn't tired yet, "Here, give her to me! She just needs some time to play with her Grammy."
Your best friend is puzzled and suggests you are trying too hard, "I just didn't worry about it. Little Johnny would just drop off wherever and whenever he was tired. Maybe you are stressing the baby out by focusing on the nap so much? Just live your life and don't worry!"
But neither of these strategies are working very well. By the end of the day, your baby is fussy and frazzled. And so are your nerves.
But when you try to have her nap on a schedule, that doesn't work either.
What's a tired parent to do?
Rest assured, you are on the right track. Your baby does need a nap. Sooner than you realize.
Nearly all the time, the issue is that parents are missing the ideal window for a nap. When that happens, your baby becomes overtired and her body produces cortisol, a stress hormone that makes it harder for her to sleep.
Which can lead to lots of crying -- not only from the baby -- and miles of walking the hallways of your home, patting the back of your fussy little one.
The key to avoiding this is prevention. Watch your baby carefully and put her down for a nap at the first sign that she is tired. These signs include yawning, avoiding eye contact, rubbing her eyes, or staring into space. Waiting longer to make sure she's truly tired enough to sleep will generally backfire. Once she's fussy, you've missed the magic window of opportunity and it will likely be harder to get her to sleep and the nap will likely be too short.
For newborns, you can expect the first yawn after as little as 45 minutes awake (including the feeding). It will feel like a very short time awake. This is normal!
As your baby gets older, you will be able to stretch her time a little bit. But you still want to watch your baby, not the clock. Some days she will be able to stay awake as much as an hour and a half, but other times, it will be less. Again, watch for the yawns.
It may take a few days, but if you follow her sleep cues carefully, you should see a dramatic improvement in her mood as well as more consistent, longer naps.
Want some help figuring out her cues? You aren't alone. Schedule a free chat with me or sign up for my newborn sleep consulting or child sleep support package.
Abby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and certified life coach for parents. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico.