Newborn Sleep Problems

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How much sleep do babies need, how you can help your baby fall, or stay asleep.

Babies need a lot of sleep during the first few months of their lives, so it is important to ensure that they are sleeping as much as possible.

Because babies have been “molded" since conception to prepare for life outside of the uterus, they have also been preparing for the all-important aspect of sleep. From the moment the fetus is fully formed, their body goes through a period of rapid transformation during the remainder of their time in the uterus in preparation for sleep. 

Let’s take a look at the various stages of development within the little fetus’ body, (in utero) and how they set the stage for his/her sleeping patterns after birth, as well as the ways in which you can safely and productively assist your baby in getting the best sleep possible at every opportunity. 


Sleeping - Skills Development: In the Womb

  • At 12 weeks, the little fetus can be seen yawning on ultrasound and becomes sensitive to light.
  • At 15 weeks the arms have grown long enough for the hands to grasp each other.
  • At 17 weeks the infant starts to show auditory responses.
  • At week 21 rapid eye movement begins.
  • At 22 weeks the fetus is following a regular schedule of sleeping, turning, sucking and kicking. 
  • At 26 weeks the fetus can sense light through the abdominal wall.
  • At 27 weeks the fetus is continually surrounded by sound from the mother’s heartbeat, churning of the mother’s digestive system, throbbing of the umbilical cord and voices through the abdominal wall.
  • At 32 weeks REM sleep occurs for the first time in the young infant’s life.


How much Sleep do Infants Need: Stages and Ages

Week 1 – 5. For the first weeks of life, your infant will sleep and nurse for most of the day. Your baby will fall asleep almost instantly during or after nursing. At this time your baby will need approximately 16 – 18 hours of sleep a day, he/she may wake every 2-3 hours for feeds (including nights), but only be awake for 45 minutes at a time.

There are six stages of consciousness through which your infant will cycle every day. 

  • The first stage is deep sleep when the baby sleeps quietly without moving and is unresponsive.
  • Lighter sleep follows.
  • State three is one of drowsiness; this is when your baby’s eyes may roll back under drooping eyelids and he may yawn or stretch his limbs.
  • Stage 4 is when baby awakens to a state of quiet alertness. Your baby’s eyes may be wide open, and his body will be relaxed.
  • Stage 5 is an active alert stage. Your baby’s face and body movements become more active and engaging.
  • Stage 6 is when your baby is crying with more disorganized body movements.

Week 6 – Your baby wants to be fed more this week as he is going through his first growth spurt around this time. Your baby may start to spend more time awake now as his/her eyesight improves. 

Week 7 – Babies will start to sleep a little bit better now. It is a perfect time to start initiating a good bedtime routine for your little one.

Week 8 – Your baby will start to anticipate events. He may also begin to associate bathroom time with a bath, nursing items with feeding, toys and certain sounds with wakefulness and quiet, less active times with bedtime. If you’ve already started a daily routine, and consistent bedtime routine with your baby, you will be rewarded with extended periods of sleep, and a more relaxed, calmer baby when it’s time to sleep again.

Week 9 – 11. At this time your baby is giving you his clues as to when playtime is over, and he would like some downtime. Some of these clues might be: Fussing, yawning or staring off into space.

Week 12 – At three months of age, your baby may begin to sleep for an extended period at night. Your baby can store milk to get through the night, requiring less feeds. These stretches can last for up to six hours. Because of all the learning and growing taking place, your baby needs more hours of sleep from 3 months of age. Your baby may be awake for up to 90 minutes during the day, waking every 4 hours to feed. This pattern may continue for the next six months. 

At nine months until your baby reaches his first year, your baby may sleep through the night, waking only for a single extended feed during the night. If your baby is put to bed at 19 pm, you may find he/she will sleep until 12/01 am before waking for a feed, then falling asleep again and only awaken at 5/  the morning. (Not always the case and is only a general guideline)


Foundations for a Good Sleeping Pattern/routine:

  • A consistent routine

From 6 weeks you will begin to notice your baby’s days and nights may follow a regular pattern. Consistency will help cue your baby’s brain and body as to when it is time to sleep and when it is time to be awake. Interact with her when she is alert during the day, and minimize all interaction at night to help her understand that night-time is for sleeping.

  • Bath time

For the nine months, water has been your baby’s “home." So, bathing him/her won’t be a strange or even unusual experience, but rather a soothing and comforting one as your baby is placed back into the water, giving him/her memories and sensations that they are familiar with; this may help baby settle down before their evening/afternoon nap.

Sonia Rochel's Bathing Technique with videos.

  • Self-soothing methods

For your baby, the outside world may be a strange, scary and wondrous place. Your baby will need to learn a few coping techniques or strategies to help them deal with this new world of theirs. 

When a baby is stressed, they may find comfort in a soothing voice, rocking, rubbing or massaging; this can help your baby to settle down again, and help them feel safe and comforted.

If your baby is over-stimulated (especially closer to bed/nap times) you may find it harder for them to settle down. Quiet, soothing sounds may help them transition from being awake to being sleepy. 

Research shows that putting a baby down for a nap works better if all his/her needs have been met.. If you put your baby down before this time, it may result in a restless sleep, or shorter sleeping time. 


How does Oxytocin assist in Good sSleeping Patterns/Habits?

  • Oxytocin decreases stress hormones
  • Oxytocin can increase the pain threshold (fewer aches and pains)
  • Helps the body to feel sleepiness, and feeling of laziness.
  • Reduces muscle tension, relaxation (less circulation to muscles)
  • It has a calming, peaceful effect on the body and brain.

What can help stimulate the release of Oxytocin?


Natural Sleep Aids – Products and Accessories:

The swaddle/wrap

  • Helps your baby settle quicker
  • Can help establish a peaceful sleep routine
  • It replicates your baby’s behavior in the womb, allowing movement of their hands to self-soothe.
  • Comfortable, breathable and safe.
  • Minimizes a baby’s startle reflex to aid in a peaceful, extended sleep.

Read more about swaddling here.

Co-sleeping camp cot/snuggle nest

  • Helps parents and baby enjoy the benefits of a good night’s rest with more extended periods of uninterrupted sleep.
  • Baby may settle down faster when he/she can hear the gentle breathing of their parents.
  • Parents can respond to their baby’s needs sooner, so they may settle down again with minimal fuss.

Read more about safe co=sleeping here. 

Life wedge and mattresses

  • The wedge has an elevated wedge base cushion/pillow for perfect head support and comfort.
  • Offers an ideal angle to assist with the relief of refluxnasal congestion and earache in babies

Sleeping sac

  • Keeps baby covered at a constant temperature all night.
  • Your baby’s head is open at all times.


Things that might Disturb your Baby's Sleep

When deciding on how sick your baby is, what might be causing them to have sleeping problems, as well as the risks to your baby, particularly in the middle of the night, there are a few things you need to consider. Here we will take a look at the three most common problems you are likely to have to deal with at night, how to recognize each one, and deal with them safely and efficiently so you and baby can continue to get a good night’s rest once again.

Fever

At the top of the list, the most common problem you may have to deal with during the night is a fever. A high temperature in itself is not detrimental, but rather a typical physiological response to an infection or illness. Any fever in a small infant below three months of age is significant and should be investigated.

Read more about breastfeeding an ill baby here.

Symptoms and signs of fever

  • The skin is hot and dry to the touch
  • The child looks flushed (face, abdomen)
  • Breast refusal.
  • Mood changes

How to bring down a temperature

  • Give your baby the recommended dose of ibuprofen or paracetamol medication according to your healthcare professional’s advice.
  • Do not cover your child with blankets or any bulky items; this can raise his/her temperature even higher. When are blankets safe?
  • Give extra feeds, to replace fluids lost by sweating. If your baby is not interested in drinking at all, try expressing and freezing a little bit of your breastmilk and giving it as an ice lolly instead.

NB. The first time your baby has a fever may be after his/her first immunizations at six weeks. You do not need to be anxious about this, and it does not require treatment. You can give your baby the appropriate recommended dose of fever medication for their age/weight and allow for lots of rest. Your baby will have recovered within a few short hours.

Vomiting and diarrhea

  • The next most common problem you are most likely to encounter at night is vomiting and diarrhea. 

Symptoms and signs of vomiting and diarrhea.

  • Vomiting is the forceful, unintended expulsion of fluid from the digestive tract.
  • Diarrhea is a runny or liquid stool with an increase in frequency/regularity.

How to treat vomiting and diarrhea at home.

  • You can continue breastfeeding safely. 
  • The most critical issue is to ensure that your baby does not become dehydrated. Breastfeed as much as possible. 
  • Comfort feeding will do just that; comfort your baby.
  • Give your baby small, frequent amounts to drink instead of large quantities. 
  • Stomach discomforts can also benefit from gentle, light massage. Rubbing from side to side gently just under the rib-cage area; this can help ease nausea and stomach cramps. 

A runny nose and coughs

When a baby has a runny nose, it is important to take note of the color and the consistency of the discharge. 

Types of runny noses and coughs:

  • A clear, thin discharge is no cause for concern.
  • A green, thicker mucous is a sign that there may be an infection and this may need treatment. 
  • When a cough becomes productive (your child is coughing up a green mucous), this again is cause for concern, and you would be best advised to go and see a doctor as soon as possible.
  • For a runny nose, there are a variety of applications you can purchase over the counter and at your grocer which may help suck the mucus safely and gently from within the nasal passages.
  • For a blocked nose, you may need to use a saline spray/mist or drops depending on your child’s age. These products help to open up irritated, blocked nasal passages naturally and gently.

NB: Take your baby to the doctor immediately should he/she show the following signs or symptoms:

  • A very high fever (that is not responding to treatment – at home or otherwise)
  • Extreme sleepiness (you will know how much sleep your baby averages a day, listen to your instincts.)
  • Seizures

The brain consolidates knowledge during times of sleep. And for your baby everything is new. Your baby needs to sleep well to process all this new information they’ve been exposed to. 

Trust your maternal instinct and enjoy the journey with your new baby. Remember, if you are experiencing a difficult time with your baby’s sleeping habits it is important to look at their routine, health, milestones and nursing habits. 

You can also ask your healthcare professional or a certified sleep consultant for help if you’re at a loss. What works for one newborn, may not necessarily work for another. You will soon learn what your baby likes/dislikes when it comes to soothing techniques. 

Do what comes naturally, what feels right for you and your baby. The better the quality of sleep your baby receives, the more sleep mom and dad will get in return.


RESOURCES:

  • The expectant mother’s guide 2017
  • Heike Millar – Midwife, good night certified sleep consultant.
  • MHF-sleep-report 2011
  • Sleepbenefits.pdf
  • Academy of sleep medicine Virginia



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