Sleep: from birth to week 3-4.
The first few days: birth today 3
Your baby will probably sleep a lot on her birth-day.
Hopefully, she will have had one good breastfeed in the first hour or two after being born, and you can both doze off to recuperate from this exhausting, yet exhilarating marathon called birth.
Tips: - Put your baby skin to skin as much as possible, for as long as possible. It will help her regulate her breathing, her heart rate, help with bonding and feeding, is calming for the two of you and is the gentlest way for her to transition to extra-uterine life.
- Try to feed her regularly, the more she feeds in the first 24h, the quicker your milk will come in, the less weight she will lose (weight loss of less than 10% is normal in the first few days post-birth).
- You may find that your baby is just feeding, pooping and sleeping during the day but as you come to the late evening, early hours of the morning (11 pm-1 am), all of a sudden, she seems wide awake and constantly feeding. This is normal behaviour! One of the breastfeeding hormones, prolactin (the milk-making hormone) peaks at night.
Your baby is biologically programmed to know that and will want to feed, feed, feed and feed, probably until the early hours of the morning (5-6 am). This is called "cluster feeding". Do not worry; it will not last forever!
Tips:
- While it is hard to do so, it is not a myth that you really should sleep when your baby does in these early days.
- Honestly, I know this is an exciting time for partners, but two exhausted parents are not a great combination. Take turns! Set yourself "shifts".
Sure, men cannot breastfeed, but there are so many more things they can do: cuddle, change the nappy, settle the baby while the new mum rests.
- Harvest colostrum (more about this in the upcoming "feeding" section): pre-collected colostrum or expressing colostrum while in the hospital means you are boosting your hormones and offering your baby the wonderful "liquid gold".
Your partner can feed this to your baby while you rest.
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Day 3 and the weeks that follow:
As the milk comes in, your baby will feed for a longer period and may sleep for a longer period too. Day/night? Is my baby confused? No! Your baby may continue to sleep a lot during the day and be more alert and awake at night.
Once again, this is due to the peak of prolactin at night. It is very normal. Your baby will not produce melatonin, the sleep-inducing hormone until around 12- 16 weeks (3 to 4 months); therefore, they have no idea if it is day or night.
Additionally, night waking is very normal (all the way through their first year of life!).
Let's look at one of my favourite topics: anthropology.
Our human babies are born with strong survival instincts. Thus, they have no idea if they are living in a brick house or a cave. By the time everyone is off to bed, the house is darker; the noise is greatly reduced. As the evening and night progress, it is increasingly quiet. Your human baby's survival instinct kicks in: do I live in a cave? Is there a risk of me being eaten by a lion? Let me cry and make sure my human parents are around to protect me.
Congratulations! You have a perfect human baby who wakes up frequently to make sure she is safe!
Tips:
- Co-sleep/ bedshare* for at least 6 months.
Not only does this promotes and protects breastfeeding, but it is also the safest way for babies to sleep.
- Use white noise (brown noise after 6 months old): a little background noise will help your baby feel reassured and may sleep better.
- Swaddle the shoulders: I know first-hand that you will receive mix advice on swaddling. Due to lack of evidence, healthcare professionals are being told not to swaddle. However, some babies need it to fall asleep. The way around it to maintain safety is: + only use light, 100% cotton material + only swaddle the shoulders, leave the hips and legs loose. + loosen up the swaddle once your baby is asleep. + swaddle your baby after feeding, not before, your baby needs to touch your breast, it helps boost the flow and helps with milk production. + after a feed, you or your partner swaddle your baby, hold her upright on your chest placing a hand on her back. It will warm her up and facilitate the transition to her cot. + warm up the cot/Moses' basket with a hot water bottle (remove before putting your baby in). + lay your baby down once very sleepy/ asleep and leave your hand on her tummy until she is sound asleep.
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Myth busters: My baby needs a dummy/ pacifier/ soother. It is preferable to wait until breastfeeding has been established before offering your baby a dummy/ pacifier/ soother.
Why? + it may mask feeding cues (be aware of your baby's weight gain is slow) + it may compromise the latch at the breast: sucking on an artificial teat uses different muscles compared to breastfeeding. In some babies, the introduction of an artificial teat may impact on the latch.
This is particularly true if your baby struggles to maintain a good latch. + she might not need it! Not all babies need the dummy to fall asleep. If she can fall asleep and stay asleep without one, good on you!
Formula will make my baby sleep longer: False!
The formula makes babies sleep more deeply, not for long. It is harder to digest. Therefore the baby finds it harder to arouse from her sleep. This is not what we should seek. Remember, human babies are brilliant, and their survival instincts are designed to wake often to feed.
Exclusively breastfeeding your baby for 8 weeks reduces SIDS risks by half, the longer you breastfeed, the lower the risks.
Babies should be sleeping through the night by 8 weeks/ 3 months/ 4 months:
"Sleeping through the night" does not even have a universal definition! For some, it means 6h stretch of uninterrupted sleep (which can be 8 pm until 3 am!) for others; it may be 7 pm till 7 am. Sleeping and sleeping longer stretches is very nature-dependant: each baby (including in the same family) is different and meets this milestone at different ages. We cannot force what is physiological development.
Would you expect all babies aged 8 months to walk? While some do, the majority do not meet this milestone until a year or even 18 months! We accept this as a normal, physiological phenomenon. Why are we so pushy with our baby's sleep? Westernised societies are to blame, but this is a topic for another day.
My advice:
-Manage your own expectation.
-Do not listen to people who brag that their baby "slept through" at 8 weeks old (and between us... people lie!).
- Tune in with your baby; look at your own sleeping habits (do you wake up cold, thirsty, too hot?). You baby is no different! Let's all show a little more kindness, tolerance and understanding of our babies.
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Please note:
- If you are bed sharing (to clarify, this means sleeping with your baby in your bed), do not swaddle your baby or she may get too hot.
- Follow bed-sharing guidelines: You can download UNICEF's "Caring for your baby at night" leaflet here: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2018/08/Caring-for-your-baby-at-night-web.pdf