Newborn Sleep & the Fourth Trimester

This is a blog post I’ve had written for months but I am always conscious on voicing my opinions on controversial topics like this. I’m aware that my opinion on newborn sleep isn’t for everyone.. but from my research as a midwife and then having my own babies, it’s a topic I’ve become passionate about.  In the hopes that it perhaps just gives one mum hope to know that what they are doing is more than ok, it’s worth voicing.

Some of the most common questions I get asked as a midwife postnatally is ‘how can I get my baby to sleep well?, ‘why does my baby always wake when I put him/her down’ or ‘why does my baby only stay asleep for a short period of time’?

It seems that in society we expect that our babies to go to sleep easily after we put them in their cots. We don’t understand why so many babies need to be held by us to settle at times & the fact that babies aren’t born knowing how to self-settle. Those first few days / weeks of sleepiness often wears off, leaving us with a baby that needs to be taught how to go to sleep and also how to stay asleep.

To empathize with our newborns feelings, we need to put ourselves in their place, to imagine what their ‘world’ was like; the only world they have known, the world that they spent the previous 9 months in. To fully understand we need to be aware of the huge transition they have made, a concept known as ‘The Fourth Trimester’.

A baby moves from a dark, warm, comforting environment which has constant noise, a constant food supply and constant touch from their mother lulling them to sleep as they please. They then move to a world that is often bright, cold, they have periods of quietness & loudness, they have reduced contact with their mum and the feeling of hunger and thirst becomes known to them. We often then expect these new babies once they are born, to fall in to our ideal routines and go to sleep with little assistance.

Now don’t get me wrong, I am all for routines. For a lot of us it helps us keep some form of sanity, allowing us to feel that we still have some control on this new journey as a mother, one that is hugely unpredictable. But I do feel our expectations are a bit high for these new babies that have come from the environment I described earlier. The aim of educating people on the fourth trimester is to try to encourage you to think more often about the world your baby has known, so during those times that they appear clingy or unsettled – it gives you tools to help transition your baby to this side side of the world.

The fourth trimester is a time where your old life intersects with your new life and you learn how join the two together. It’s not a process that happens overnight, it will take time. I often encourage people to allow the fourth trimester to become your ‘babymoon’ period. Whether you choose the time frame to be those three months, much longer than that or just a few weeks; think of it like you would your honeymoon. Don’t feel bound by a clock, needing to do certain things at a certain time. Take time to allow yourself to get to know your baby, let your body rest, heal and recover. Allow yourself to learn how to become a parent! When you  throw in a bit (okay, maybe a LOT) of tiredness and it results in a huge amount of change in a short amount of time.

I’m no expert when it comes to raising babies, but having dealt with countless newborns as a midwife and having 4 babies in a few short years of my own I have learnt a few things. What I have found to be true is that your best bet in the fourth trimester is let go of your need to schedule or have a strict routine and instead follow your baby’s cues. I followed cues when my babies needed to eat, when they needed to sleep and when they needed to be held and comforted. I think as a result I have been a relaxed mum and in turn, I have had content and relaxed babies. (I have also been lucky that none of my babies have dealt with reflux or any other health issues but I am aware that issues like these can change how the fourth trimester can look at times).

Newborn sleep is one of the main concerns that new parents seem to have. I have big section dedicated to this in my antenatal courses as it wasn’t an area I was well educated on prior to my first baby. Yes, I was a midwife but I had no idea about the true reality of having a baby and the fact that she would be so reliant on me 24/7 and what to really expect with newborn sleep. I just assumed I would feed her, she would fall asleep and stay asleep.

Once you have a baby one of the most common things that people ask is if your baby’s a good sleeper? Newborns sleep like newborns in my opinion!! There is so much expectation from the moment your baby is born that they must sleep a certain way. What even makes a good sleeper anyway? I think a lot of it comes from the fact that we are bombarded with articles and books and blogs that perpetuate the myth that babies shouldn’t have night time feeds from a certain age. It is NORMAL for babies (actually it’s the way they’re designed) to wake several times throughout the time or want to feed just for comfort. We need to let go of the expectation before our baby is born that they are going to sleep a certain way. If our expectations for our babies were not so different from their own expectations of themselves much of this ‘problem’ may disappear.

One thing I didn’t realize with my first baby Rosie, was that there were things you can put in place to encourage your baby to go to sleep easier and hopefully stay asleep. No easy task with some babies!

Rosie wasn’t a baby that appeared to need a huge amount of sleep and I wasn’t aware of her tired signs. Get to know these in your baby as they will be your first cue to avoid an overtired baby which in turn becomes a much more difficult task to get off to sleep and to stay asleep for a decent amount of time.  Some of your baby’s early tired signs may be: grizzling, jerky leg and arm movements, wriggling, making a tight fist, a fixed stare and so on. Over-tired signs are; crying, yawning & eye rubbing.  Be aware on a general guide for your babies age and how long they will roughly stay awake for. A newborn will become tired and ready for a sleep around the 45-60 minute mark. This goes quickly in between a feed, nappy change and cuddle.

From here I think it’s important to have a sleep routine so your baby gets to know when it’s their sleep time. These babies are aware of so much more than we think so they’ll pick up on this routine quickly if done consistently.

I’m a big believer in swaddling most babies, their startle reflex is strong as newborns which can disturb their sleep if left un-swaddled. The feeling of being swaddled and contained is also replicating what life was like for them back in the womb which is instantly calming for a lot of babies. There will be some babies that prefer not to be swaddled but I do find majority of them find it very settling. There are hundreds of swaddles out on the market so do what works for you best in regards to what you want to use. (My personal preferences are the Mum 2 Mum swaddles, with the zip and velcro – similar to a miracle blanket but a little bit more simple. As they get a bit bigger I adore the Love to dream swaddles, I just find these don’t suppress the startle reflex enough in the early few weeks when they are a bit smaller. A traditional wrap done with a muslin works perfectly well when you get the technique down too).

I would then pick up your baby a give them a cuddle or a rock for a few minutes once you have swaddled them as part of the sleep routine. Try not to rush the going to bed process as I think babies can often pick up on our stress or anxiety so try and stay as calm during this process. I personally love white noise and have always used that for my babies sleep so often encourage parents to try it. It’s definitely not a must but if you are having issues settling your baby it may help. Again it’s just a method to help replicate life back in the womb for your baby (the constant noise they were used to). Again there are a hundred white noise options; iPad/iPhone apps, white noise machines, CD’s or even playing static radio. I personally love the Hushh machine which I have from The Sleep Store ($79.95). It’s portable and charges via a USB so it doesn’t always need to be attached to a power plug. If you use white noise, you can either just choose to use it (or a baby shusher etc) for the first 20/30 minutes of their sleep or the whole time they are asleep. Using it the whole time can be beneficial when your baby rouses in-between sleep cycles, encouraging them to resettle a bit easier.

I often had a dark room for my babies to sleep in but having your baby in the lounge or a room with the curtains open is also fine (you may find later down the track your baby may sleep better in a darkened room). As you’re giving your baby a cuddle, let them know they are safe, that you’ll see them when they wake. As your baby gets older and if you have been consistent with this method, you should find you can probably shorten or even skip this step (although my children still always get a kiss and cuddle every time they go sleep). Don’t be scared of talking to your baby at this time, it reassuring for them to know that you are there while they learn how to go to sleep (a good little tip I learnt from listening to Vicki-K who is a sleep consultant, the baby guru when it comes to sleep).

As a tiny newborn, your baby may already be asleep before any of these steps, but as they get a bit older (ideally with your baby still awake), pop them down in to their cot / bassinet and stand there beside them with a hand on their side and on their tummy. Gently pat and shhh them for a minute or so, if they look sleepy or they are going off to sleep slow down your patting and start to remove your hands. Hopefully they will go off to sleep but if they don’t move away from the cot for a minute to see if they will doze off.

Remember that babies aren’t born knowing how to self settle so this is a skill you need to teach your baby.  With consistency – they will get it!! If your baby is grizzling or it is a cry you can handle, leave them for a small amount of time to see if they settle to sleep (I’m talking 1-2 minutes). If at any point they are becoming really upset, pick your baby up and comfort them. When they become hysterical they will rarely calm down on their own to settle easily. Continue these steps until your baby falls asleep. If you can’t settle your baby in their cot, you can pick them up and rock them, feed them again, pop them in the front pack, whatever works for YOU. The aim is just to get your baby sleep however that may be! I find a baby that is well slept is so much easier to deal with so it doesn’t really matter how you get them to sleep in the early days!! If you are consistent with this method within a few weeks your baby will learn to self settle on their own, initially you’re just helping them learn how.

So the aim with a new born is roughly to do a feed, cuddle, sleep routine. This is tricky to give exact times for as your baby may sleep for 30 minutes at one sleep (no matter how hard you try to get them back down) and 2 hours the next. This is probably the main reason why I’m opposed to strict routines in the early days as it seems to cause extra anxiety or stress with new parents to try and get their baby to fit into a book schedule.

I’m personally not a fan of leaving babies to cry themselves to sleep (whether it’s cry it out, controlled crying etc) in the fourth trimester. Or at all actually, but this sin’t written to put judgment on the women that do this or have done. We all can handle a certain amount of broken sleep / sleep deprivation and we all reach a threshold of how often we can wake to our babies in the night at different stages in our journey.

Personally if I go with what is instinctive to me, hearing my baby cry made wanted to run to my baby, pick them up and comfort them which is something I think all mums would agree on. It is just what is put in us as mothers.  I just feel that there are ways you can teach your baby to sleep well without leaving them to cry. Like I described earlier there may be some crying (for a few minutes) but I couldn’t leave my babies crying and walk away hoping for the best. But like I said, each mum will feel differently about this. And thats the beauty of parenting our own children, we are entitled to make these decisions for them and what we think is best for our OWN families.

I read these next few paragraphs on on a natural parenting website called becoming mama, and one hundred percent agree.

There is of course the big fact that us mums needs to sleep too, and that’s where much of the concern over “sleeping through the night” comes from.  Adjusting your expectations about sleep may also mean changing some of your sleep habits.  If baby has her longest stretch of sleep from 8pm to midnight – maybe you need to adjust your own bedtime temporarily to take advantage of that. Nap during the day when/if you can when your baby naps. It also helps to remember that this stage won’t last for ever.  All babies will sleep longer stretches eventually, I promise.  If you let go of the expectation that your baby should sleep 8 hours or more straight by 2 or 3 months, it’s a little easier to handle those night wakings; it felt much better to me to consider my baby’s behavior as “normal” instead of trying to figure out what I was doing “wrong.”

Like I mentioned earlier, think about routines instead of schedules. Just because you’ve decided to follow baby’s cues doesn’t mean your life will be devoid of order.  Babies are pretty good at falling into a routine and there are simple things we can do to encourage that development.  Many newborns are born with their days and nights confused (makes sense when you consider they spent their days in the womb lulled to sleep by your movement and nights more awake when you were sleeping and still).  You can nudge them towards sorting out their sleep habits by keeping things dark and quiet at night (during feedings, nappy changes, night wakings, etc.) and bright and “noisy” during the day.  All babies will have different tolerances for noise levels of course, but in general you can be “louder” during day sleeps.

Many babies respond well to a bed time routine.  While your newborn isn’t going to have a set in stone sleep schedule or bed time, you can incorporate the same nightly rituals into your evenings – maybe a bath or massage or favorite book or lullabies.  Remember too that many babies will have an evening “witching hour” – these calming rituals can help alleviate that.  Many newborns will also want to cluster feed in the evenings so take that into account when thinking about your own evening activities – a good book or catching up on your Netflix might be the way to go.

Just remember that nothing you will do will ruin your baby, spoil them or set them up for bad sleeping habits forever.  No matter how much you rock, cuddle, wear, or hold your baby, they will turn into an independent little person.  Children are not spoiled by love and affection; they thrive on it.

If something is working for YOU, then it’s not an issue until it’s no longer working for you.  Some people choose to have their baby in their own room from day one, others may have their baby sleep on them for the first 3 months. Don’t forget there’s no right or wrong in this parenting journey.

C xx