Newborns and Sleep Part 2: Weeks 7-16
Congratulations! We bet you are amazed at how quickly the first six weeks passed! Perhaps you are reading this blog because the glow of new parent-hood is wearing off, you face going back to work, meals and packages have stopped arriving, and exhaustion is setting in. Or, maybe you are doing okay, but anticipating what’s to come in your baby’s sleep future and want to get started on the right foot.
This age range can be very hard for new parents who are seriously sleep deprived, yet still have a baby whose sleep is very much in development (aka: erratic). It’s also a time when some babies start to experience such issues as reflux, allergy symptoms or “colic”. Your new idea of a Friday night? It will get better!
This blog is long for a reason and will cover night sleep first, and then day sleep in later sections so be sure to scroll through the whole thing. We hope you had a chance to look at our first Newborn Blog on sleep during the first 6 weeks. Other important blogs topics not covered here are the blogs on swaddling, pacifiers, important sleep basics for all parents and pediatricians, night feeding expectations, and night sleep expectations. We strongly recommend reading these blogs as well.
Note: Remember to continue to adjust for prematurity if your baby was born before due date and calculate your baby’s sleep age based on due date if your baby was born early. Ex: if your baby was born 2 weeks before due date and is 9 weeks old, your baby is 7 weeks old in terms of sleep development.
Sleep Maturation, Sleep in Motion, and Importance of Environment:
This 7-16 week stage brings some remarkable changes in your baby’s life and sleep! Around 7-9 weeks, when you start to see the onset of some regular social smiling and the evening fussiness is tapering off (remember learning about this phenomenon in the 0-6 week blog), you’ll start to notice your baby becoming more able to spend a few moments quietly in her baby seat or swing looking at a sibling, toy, mobile, or simply the world around her. Continue to spend lots of time soothing, holding and snuggling your baby, but it’s also okay to give her some supervised alone time with an interesting toy, activity mat or mobile to help her get used to the sensation of being out of your arms at times.
This social development around 7-9 weeks will signal your baby is getting ready to make some really strong attachments to her means and location for sleep. Because of this, as you move along in this age range your baby’s sleep environment becomes more and more important. Your baby will become more aware of the world around her and become more distracted by all she’s seeing and doing each day. If your goal is to have your baby become a predictable sleeper in a consistent location (ex: at home in a crib) you’ll want to start offering that opportunity to your baby more and more. Take a look at our blog on sleep environment for tips on creating an ideal sleeping location!
This does not mean you can’t go anywhere or take your baby out for a walk or in a stroller, it simply means start keeping an eye towards your future goals and giving your baby the chance to experience the sleep location you’d ultimately like her to have on a regular basis. At first you might simply start feeding or rocking your baby to sleep in your room or a nursery, creating an ideal sleep environment, so your baby is simply getting used to falling asleep in the room you’ll ultimately like her to sleep or nap in. From there you can use the steps described below for the earliest, most interactive way to begin to teach independent sleep. Again, not necessarily at every sleep episode! Give yourself small goals. For families who have other children who have needs and schedules too it becomes a balancing act. We encourage you not to overschedule. If you know that you will have your baby out and about during a time when she would otherwise be ready for a nap at home, see if you can induce the nap on the go by wearing her in a soft carrier, or holding, stroller or rocking your baby in another way.
Weeks 7-16 Night Sleep:
So, what you should be expecting as your baby enters his third and fourth month of night sleep? This is when some really positive sleep changes are starting to occur! As you see those evening fussy periods taper off, and you see more social smiling and fewer BM diapers overnight you know your baby’s circadian rhythm is maturing. This is the time when your baby will be capable of having a much earlier bedtime – 10-11pm can start to drift earlier and earlier and most babies will be able to sleep 9-11 hours at night (with wake ups for feeding). At this point, it doesn’t actually matter what time your baby goes to bed as long as she’s getting enough sleep. If you put your baby to bed ultra early at night, she’ll wake ultra early in the morning, too!
How to move bedtime earlier: In order to accomplish this early bedtime drift, start to think about a bedtime that works best for your family. Keep in mind a time that you can do most days – week days and weekends – and consider other family members activities and schedules. Once you determine your target bedtime range ( use a 30 min window), you’ll want to start having a calm, quiet, dim environment for your baby from that time on. Your baby may still catnap and be a little erratic for another week or so, but you will start to see that last late “nap”, drift earlier and earlier and turn into some serious stretches of night sleep as the sleep cycles develop in that first third of the night. Going forward you will probably want your baby to be up from any last daytime naps for about 1-2 hours before getting him ready for bed, depending on the age of your baby. Ex: a 4 month old will probably need a full 2+ hours of awake time after last nap and before bedtime, but a 9 week old, may be comfortable with just 90 minutes.
Here’s a real life example: Your baby is 9 weeks old and is smiling like crazy! You’d love him to take his last nap in your partner’s arms or a baby chair from about 6-6:45 while you fix dinner or get your older child ready for bed and then go to bed at 8 – 8:30pm. But, so far your baby has been napping/eating on and off in the evening in his baby seat or rocker near you in the living room while you and your partner make dinner, get ready for the next day and maybe watch TV or catch up on emails. Sometimes he’s fussy and you have to take turns rocking and holding him. Finally after a few hours of fitfulness he eats again and is asleep for a long stretch around 10:30 pm. You carry him to his bassinet in your room and you all go to sleep. Here’s how to change: Change, wipe or bathe your baby, and give him a great feeding between 7:30-8pm (your goal bedtime). Put your baby down for “the night” at 8pm (use rocking, holding, or sucking to assist your baby to sleep if needed at this point) in his bassinet in your room (or sleep location). When he pops up from his “nap” as usual around 8:45 – 9pm and seems ready to play for a bit, go to him as you usually do, but keep it dark, calm and boring – treat it as NIGHT – rather than taking him into the living room with you to play, turning on lights, or turning on screens. You and a partner may cycle in and out of your baby’s room soothing, rocking, holding in the dark and simply wait until your baby is ready to fall back asleep. Try to increase evening feedings before 8pm, even cluster feedings, so you can decrease those snacks/feedings in the 8pm – 12am hours. See our blog on night feeding expectations here. Within a few days your baby will no longer be taking mini naps and snacks from 8pm – 11 or 12am, but will be asleep that whole time!
By about the three months mark you will be looking for your baby’s bedtime to have settled into roughly the same 30 min window each night and with deep sleep dominating those first hours you should be getting one nice long stretch of sleep at this time too – some lucky parents end up getting 7-9 hour stretches at this point! If your baby is a stellar napper with upwards of 4-5 hours of daytime sleep, he may only be sleeping 9-10 hours at night. If your baby is napping more like 3-4 hours or less during the day, you are probably seeing 10.5 – 11.5+ hours nights WITH 1-2, perhaps even three nighttime feedings.
Start A Bedtime Routine: Now that your baby has a predictable bedtime, it makes it MUCH MUCH easier to plan, predict and begin a bedtime routine! By the 7-10 weeks mark, as the social smiling begins and bedtime starts to shift earlier you’ll want to be implementing your baby’s first bedtime routine. Be sure to read the blog on bedtime routines. Be sure also to read the blog on dream feeding as this is the time you’ll want to stop doing this if you had been.
Expectations, Expectations: And so, although bedtime and the first third of your baby’s night is getting nice and predictable, the last half to third of the night is still a challenge. That’s the time when sleep pressure is lower, and your baby is doing more REM sleep which, if you recall, can lead to lots of movements and even cry outs in sleep! So, first things, first: if your baby wakes up, especially in the last third of the night – be sure he’s actually awake before you respond! He might be having a normal REM sleep movement so be sure you aren’t inadvertently waking him by picking him up. Continue to swaddle your baby as long as it’s safe and he hasn’t started rolling. You’ll still be nursing/feeding on demand at this age except perhaps during the first four – six hours. If your pediatrician gives you the green light, take a look at the blog on how to reduce nighttime feedings. You may want to slowly reduce an early-night feeding (a 9-10pm feed) at this point and transition to rocking, holding, and ultimately just patting your baby back to sleep during the first four – six hours. Of course, continue room sharing as recommended by the AAP and have a super sleep environment: cool, dark, quite, use white noise, miminal diapering, and keep things calm and boring overnight.
Starting Early Sleep Training: Some families will have no interest in working towards early sleep independence and will continue to rock, nurse, feed, or soothe their baby to sleep in other ways. If this is you, it’s no problem! As long as your baby is getting enough sleep and you are happy with your approach, we support you. For other families, it will be important to start work on this early independence right away and this is the age you can start the earliest “Sleep Training” technique to teach your baby how to begin to fall asleep on her own!! The idea is, if your baby can get to sleep on his own at bedtime, he may be able to do it in the night as well when there is not another competing need such as hunger or discomfort.
Your options at this age are limited to just one, most commonly attributed to Tracey Hogg, but variations are published in other sleep books as well. There should be little, if any, sleep-related crying at this young age. You will probably have the most success with this technique at bedtime, rather than a nap at this age because it is still very hard to predict when your baby will need to nap (see nap sections below). At night, after the regular bedtime has been established, it will be very hard for your baby to resist his sleep pressure for more than 30 minutes, so bedtime will be the best opportunity for success!
Here’s what this technique might look like in your house:
Anticipate your baby’s need to sleep and make sure the environment is ideal and conducive to sleep. Swaddle your baby (if not rolling) and begin employing the methods you know he likes for soothing – rocking, bouncing on a yoga ball, etc. When you see he’s getting sleepy in your arms (or in the swing, seat, stroller, etc) stop what you are doing and place your baby in his sleeping location. Perhaps he’ll lie there and look around for a few minutes….great! Maybe he will start to fuss or cry for you right away and maybe, just maybe he’ll go to sleep! If he fusses or cries, go ahead and pick him up. If you’re up for it, try again once, twice, or several more times to see if you can get him to fall asleep on his own. If you’re both just too exhausted – don’t worry about it. Soothe him fully to sleep and try again another time! That’s it!
Teaching your baby how to fall asleep on his own IS of course a critical factor in your baby’s ability to consolidate sleep and learn to go back to sleep in the night or a nap after a brief arousal without waking your for assistance. And so, for many families, it can be worth it to start to practice this early and often. That said, please don’t make yourself stressed, or overwhelmed with this. In these first few months, practice and exposure to a sleep cue is all you can do. If your baby isn’t responding as well as you’d hoped, or you have some other challenges to deal with (ex: multiples, reflux, illness, unusual life circumstances, colic/fussiness, etc) don’t be afraid to soothe your baby to sleep. If putting your baby down awake and aware isn’t resulting in sleep or someone (your or baby) is becoming stressed go ahead and rock, soothe, nurse, hold or settle your baby in any other (safe) way. It’s more important at this age your baby is getting adequate sleep than it is how your baby is actually falling asleep!
Your baby’s daytime napping is driven by her homeostatic (sleep) pressure or how simply a measure of how sleepy she is. Because nap length and timing is still erratic and unpredictable, wakeful periods between naps will be too. Daytime sleep totals may vary, but typically between 3.5 – 5 hours of napping which may be divided between 3-4, and sometimes even more naps. Predictability will come, but for now continue to nap your baby as often as she’s appears sleepy. Continue to swaddle your baby for day sleep by planning ahead and anticipating her needs before she’s overtired. She’s still very portable, but is becoming less so because of her new-found awareness of her surroundings so be sure to have a napping environment that is nice and dark, calm, and soothing for those naps when you are home!
Sometimes in this 3-4 month range parents report their baby starts taking single sleep cycle naps of about 30-45 mins. And, for a few unlucky parents their babies take about that long to soothe and settle into a nap! If you are experiencing short naps, sometimes the following approach can work!
“SOOTHE THROUGH SLEEP CYCLES”. This is an interactive, supportive way to try to help your baby connect one sleep cycle into the next. It goes like this: most babies have a predictable sleep cycle duration of 30-45 minutes. Time your baby from the time he falls asleep until the time he wakes to determine how long his sleep cycle lasts. You will probably find that he sleeps an exact duration each time (e.g. 37 minutes or 41 minutes etc.). The next time you put your baby down for his nap, go into his room or place of sleep a few minutes before you expect him to stir and start soothing by jiggling him gently, replacing his pacifier, placing a heavy hand on his tummy, “shhhing” or stroking his cheek. In other words, stay in the room with him for about 5-7 minutes and see if you can soothe him through that sleep cycle and into the next! Sometimes picking up and re-rocking or re-nursing is needed. The reality is, babies wake briefly as part of their sleep cycles. We expect your baby to have a brief arousal during naps every 30-45 mins. If your baby doesn’t know how to put himself back to sleep, this turns into a full blown wake up so try to preempt that with soothing! True, this requires about 10 minutes of work by you in between sleep cycles, but if it gives you another 37 minutes to finish up some emails, prep a meal, or just take a rest we think it’s worth it!
This technique may work beautifully for your baby regularly and all of a sudden you notice naturally longer naps. For other babies it might be a 50/50 scenario – where it’s sometimes helpful and sometimes not. If you find this to be true and your attempts at connecting the sleep cycles were unsuccessful, you might choose to pick up your baby, rock, bounce, hold or soothe and extend the nap by holding your baby (safely please – stay awake!). Or, if you’ve simply had it, and want to get out and run an errand or see a friend, that’s okay too! Remember, there is no set schedule yet – do the best you can, keep your baby rested, start to establish good habits,but don’t be afraid to soothe! If things aren’t going well and your baby is getting tired please don’t ever feel like you “shouldn’t” rock, hold, snuggle, nurse, or wear your baby to sleep in an effort to keep her rested. It is more important that your baby IS sleeping and less important HOW she’s sleeping at this age, as long as it’s safe.
Morning Wake Up and First Nap: As you approach the 3-4 month mark your baby will be able to have some morning nap predictability and you’ll want to be sure you start to encourage that to happen. Just as his circadian rhythm is maturing to drive for a more regular bedtime and organized first stretch of the night, you’ll want to start encouraging a predictable morning wake up time as well. Begin to turn on lights, play or have a feeding, and start your day with your baby at around the same time each day – within the same 30 minute window. As you start to see your baby’s body clock taking over and he’s naturally waking at a similar time each morning, you’ll start to be able to predict the first nap too. For newborns, 90 mins is usually a comfortable awake period before they are ready for that first nap in the morning. It’s very possible that by 4 months of age you have a regular bedtime, wake up time, and first morning nap time! Although schedules seem too structured for some families, knowing when your baby is ready for sleep makes it SO MUCH easier to help him learn to fall asleep if you ever find yourself needing to make a change!
Day Sleep Location and Introducing a Nursery or Crib: Hand in hand with your baby’s sleep environment, practicing “soothing through sleep cycles” and encouraging the first morning nap to develop, is your baby’s sleeping location. By about 8-10 weeks or so you want to start looking forward at your medium term sleep goals. If you’d like your baby to transition into her own crib or her own room at some point in the near future, even though she may currently be in a bassinet or crib in your room at night, it’s a good idea to start to practice some daytime naps in the crib. At the time of publication, room sharing is recommended by the AAP until six months of age so we are not talking about nighttime sleep. Rather, make attempts to place your baby into her crib for some naps during the day. If you have the crib in your room, you can set up a pack n play or travel crib in your baby’s room so she can still get used to sleeping in that location. If the crib just isn’t working for you, you can still get you baby used to her room environment by moving a swing, stroller, or sleeping seat into her room – just make sure she is observed for safety if not in her crib for sleep.
As always, we are here if you need more support. If your baby is in this age range, there is a lot of variability in what is normal. If you have specific questions about your baby’s pattern ask on Facebook or consider booking a consultation with us to talk through your questions and get your baby on the right track.