Written by Himani Dalmia
“Help! My baby won’t sleep!” is the exhausted cry of every new parent. We have all heard about the sleep deprivation that comes with early parenthood but actually living through it hits us like a ton of bricks. Babies often sleep in fragments throughout the day and night. Sometimes they fall asleep for a long chunk of “night sleep” only at 4 am. They wake periodically and need feeding or soothing. They take short naps and tend to wake the moment we place them down, starting off the whole cycle from the beginning. They may become fussy and cranky but not feed or sleep, need endless rocking or take short feeds very frequently. All of this is very normal for babies in the first four months of life but it’s absolutely exhausting for parents, especially breastfeeding mothers.
However, understanding how sleep biology works in the early months of newborns can help us meet their needs better, work with the tide versus against it, and make the journey just that little bit smoother.
Newborns (0 to 4 month olds) sleep slightly differently from older babies. They usually sleep and feed all day, and the two are intricately linked. Feeding and sleeping should be on demand. It is not advisable or necessary to watch the clock or follow feeding and sleeping schedules (as was recommended for much of the previous century) as babies can have wildly different needs from day to day. Instead, we need to watch our babies and educate ourselves on hunger and tiredness cues.
WHAT MOTHERS FORCING A TIME SCHEDULE FOR INFANTS SHOULD KNOW
In the first two months, babies have no concept of day and night, as they do not have circadian rhythms. While they receive some of the sleep hormone, melatonin, in the womb and from breastmilk, they do not produce it on their own. So, it’s not uncommon for newborn babies to have very late bedtimes of even 2 or 4 am, with “morning” wake up times of 11 am or 1 pm. That is absolutely fine and babies should not be woken up in the morning to set a routine. Circadian rhythms – the body’s internal day and night clock – start to form after month 2 but really start functioning only around month 4. At all points, we should follow our baby’s lead and wait for their bodies to start falling into a day/night pattern naturally.
IS YOUR BABY TOO TIRED?
One of the most critical things that parents should look into is overtiredness. It is actually the bane of baby sleep. It is extremely important to help our babies fall asleep when we observe early sleep cues, like rubbing eyes, rubbing ears, pulling hair, looking a little glazed, averting the gaze or early rooting for feeds. If we miss these cues, our babies’ bodies will compensate by releasing the stress hormone, cortisol, to keep them awake. They will suddenly seem awake again and experience a second rush of energy that is called the “second wind”, which misleads us into thinking our babies are not ready to sleep. Soon, our babies become hyperactive and, eventually, cranky. This is when most of us realize that the baby is tired but, in fact, by now, we have missed the boat.
Crankiness is actually a late sleep cue and a sign of overtiredness. Now, when they try to sleep, the cortisol in their bodies will not only make it difficult for them to fall asleep (leading to immense sleep resistance), it will also cause them to wake up frequently or wake up early (and crankily) from their naps. This cortisol will also remain in the body and cause bedtime resistance and frequent night wakings. The length of time that a baby can stay awake happily, before the body releases cortisol, is called a “wake window” and the wake window is different at every age. It is important for parents to observe for early sleep cues and educate themselves about the wake windows at every stage so that they can prevent their baby from getting overtired. Newborn babies have short wake windows – as little as 5 to 30 minutes in the first month, building up slowly to 30-90 minutes in month 4.
HOLD ONTO THEM
Another key phenomenon in the newborn stage is the need that babies have for physical contact with their caregiver. They often wake when we put them down – even if they seem to be in deep sleep. This is absolutely normal. They have a survival instinct that makes them jerk awake if they sense separation from the caregiver. Please go ahead and hold baby for all daytime naps. This is not a bad habit but a biological need that the baby will outgrow on their own with time, sometime in the first year. There is no way to avoid it if you want a well-rested baby. However, there are many practical strategies to manage daily rhythms while effectively “sleep parenting” our newborn baby. Long, restorative naps are a priority as sleep is extremely important for a baby’s growth and development. Moreover, truncated and incomplete naps lead to overtiredness, which leads to more sleep disruptions.
Though babies seem to need holding throughout their daytime naps, they can usually be put down on a bed during their chunk of “night sleep.” It is advisable to bedshare, following safe norms, as it is biologically normal, convenient and healthy for the baby. Breastfeeding a baby to sleep before or during naps or night sleep is also biologically normal. In fact, breastfeeding is one of the most convenient and powerful tools when it comes to managing newborn sleep as breastmilk contains sleep hormones, the suckling motion induces sleep and babies also find being at the breast extremely soothing and comforting.
WHY IS YOUR BABY FUSSY?
It is normal for newborns to have a fussy period in the evenings, nicknamed “the witching hour”. Babies often cry inconsolably at this time of day. They may be fussy at the breast or they may cluster feed, taking short but very frequent feeds. They may refuse to sleep, though they look tired. Sometimes, this evening fussiness crosses over into what some doctors call “colic” – the infamous, unexplained phenomenon of a baby crying for 3 hours per day, 3 times a week for more than 3 weeks.
There are several theories on what causes this evening fussiness. The first scapegoat, of course, is breastfeeding and we often hear people around us saying “baby is not getting enough milk”. However, this is usually not the case. Babies do cluster feed and nurse very frequently. They could be tanking up their little bellies for the night ahead. They could be overstimulated and overtired from the day’s happenings. They may remember mum being active at this time during her pregnancy and want to be held, rocked and nurtured in the same way.
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Interestingly, anthropologists have found that babies in many traditional societies don’t have colic or evening fussiness. These babies are usually wrapped to their parents all day, nurse several times an hour and sleep on demand. We can help our babies with evening fussiness by avoiding overtirednesss through the day, offering frequent feeds during the fussy period, burping our babies and checking for gas, rocking with a rhythmic motion and with humming or music, taking our babies outdoors, reducing lights and stimulation or wearing our babies in an ergonomic baby carrier.
Newborn sleep can seem like a dark tunnel with no light at the end of it. However, understanding the basics on how to avoid overtiredness makes a dramatic difference.
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(Dalmia is an Infant and Child Sleep Specialist and co-founder of the support group, Gentle Baby Sleep India. Last year, she co-wrote the book, Sleeping Like a Baby [Penguin India])
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