AWHONN thanks Huggies for their support of the Mindful Diapering & Respectful Maternity Care articles

Let Sleeping Babies Sleep!

Sleep is vital to your baby’s health and growth—even their ability to think and learn. Help your baby get all the sleep they need by learning when to let sleeping babies keep sleeping.

Healthy food. Vigorous exercise. Restorative sleep. These are essential to all human health—but did you know that babies have very different sleep patterns than adults?

We adults need 7-8 hours of uninterrupted snoozing every 24 hours. On a good night, we go through 4 sleep cycles of some 90–100 minutes each. At the end of each cycle, we either wake up or drift back to an earlier sleep stage and repeat the cycle.

Babies have only 2 sleep cycles, active sleep and quiet sleep. These cycles are short—only 50–60 minutes for the first 9 months of life before their sleep begins to change to be more like ours.

Babies first drift into an active sleep cycle. As baby begins to snooze you may see baby moving their body, fluttering eyelids or hear baby making gentle noises. About half-way through one cycle, babies begin to transition to another. In quiet sleep, you’ll see baby’s breathing drop into a slower, rhythmic pattern, and they’ll have less body movement.

In quiet sleep, babies are less likely to be disturbed by noises. Baby either wakes up from a quiet sleep cycle or transitions back to active sleep.

Benefits of Sleep

The benefits of adequate sleep for your baby are nearly boundless, says the American Academy of Pediatrics. Sleep is essential for baby’s:

  • growth
  • weight gain
  • brain development
  • increased immunity
  • stress reduction
  • self-control
  • language
  • learning
  • higher-level thinking like problem-solving, to name but a few!

Skills where movement and thinking are combined, like coordination and balance, are also affected by sleep. This includes both active and quiet sleep, which is why it’s important to protect baby’s sleep as much as possible.

Protect Baby’s Sleep

You may have heard the phrase, “Never wake a sleeping baby.” Science has confirmed this is a good rule of thumb! Think about protecting your baby’s sleep in 2 ways:

#1: Protect your baby from interruptions when they’re already asleep

Avoid waking your baby unnecessarily. For example, put your baby to bed in a clean, dry and super-absorbent diaper with a wetness indicator. Only disturb baby if you need to change a soiled diaper.

Protect baby’s sleeping environment so that noise doesn’t startle them awake. Some babies seemingly sleep through anything, while those who are light sleepers may need more support to block disturbances.

#2: Protect your baby from sleep-related risks

The American Academy of Pediatrics’ updated recommendations (2022) for a safe infant sleep environment include:

  • Placebaby on their back on a firm infant-safe sleep surface, such as a crib or bassinet on a tight-fitting sheet
  • Don’t use soft bedding or put any other items in the bed—baby’s sleeping area should be bare and free of things like blankets and stuffed animals (no crib bumpers!)
  • Pacifier use is associated with reducing SIDS risk
  • Share your room, but not your bed,  for baby’s for at least six months and up through their first year of life. Room-sharing decreases the risk of sudden infant death syndrome (SIDS) by 50%+!
  • Never expose your baby to smoke, alcohol or illicit drugs
  • Never allow your baby to sleep unattended in sitting devices, such as car seats, strollers, swings, infant carriers, and infant slings as these aren’t recommended for routine sleep in the hospital or at home, particularly for infants younger than 4 months
  • Breastfeeding reduces the risk of sleep-related infant deaths, and at least 2 months of exclusive or partial human milk feeding can significantly lower the risk of sleep-related deaths
  • Best nutrition for baby and to reduce SIDS risk is exclusive human milk feeding for at least 6 months, with continuation of human milk feeding for 1 year or longer as mutually desired by parent and infant
  • Avoid parent and infant exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs
  • Make sure your baby receives routine immunizations
  • Avoid products and devices that claim to reduce the risk of SIDS or other sleep-related deaths. There is no evidence that any of these devices reduce the risk of these deaths. Importantly, the use of products claiming to increase sleep safety may provide a false sense of security and complacency for caregivers. Don’t use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.
  • Supervised, awake tummy time is recommended for infant development and to minimize positional plagiocephaly (flat head syndrome). Regularly place your baby on their tummy while awake and supervised for short periods of time beginning soon after hospital discharge, increasing incrementally to at least 15 to 30 minutes total daily by 7 weeks of age
  • Swaddling isn’t proven to reduce SIDS risk. If baby is swaddled, always place them on their back for sleeping.
  • Weighted swaddles, weighted clothing or weighted objects on or near the baby are not safe and not recommended
  • Stop swaddling when baby shows signs to trying to roll, which usually occurs at 3 to 4 months but may occur earlier. Swaddling is no longer appropriate after baby starts trying to roll as it could increase the risk of suffocation if the swaddled infant rolls on to their tummy and is unable to roll back 

Promote Baby’s Sleep

Because babies have unique sleep cycles, it can take months from them to begin sleeping through the night. The first 6-8 weeks are often the most difficult; some parents are convinced baby has night and day mixed up. This is an exhausting and overwhelming time in any parent’s life.

Promoting sleep takes time and patience as you discover your baby’s preferences and what works in your family. Avoid “sleep training” advice and systems—these are ineffective and some are downright dangerous for baby because they ignore the developmental aspects of baby’s sleep cycles with the goal of mimicking adult sleep.

Your baby will naturally begin sleeping for longer periods—and yes, eventually through the night!—as they develop and grow.

After baby’s first 6-8 weeks, during which time baby will likely be nursing or needing to feed every 2-4 hours through the night, begin to support a predictable but personalized bedtime ritual. This will help your baby begin to recognize patterns, begin to create expectations and process information in an organized way. For example, to help baby recognize the difference between daytime and nighttime:

  • Minimize noise during sleep time, especially at night.
  • Sing, hum or play special music that is used only at nighttime as a cue that it’s time to sleep
  • Use light to emphasize the difference: During awake times, the lights can be on and sunshine can stream through the window. During sleep times, lights should be dimmed or off.
  • Practice rituals, such as rocking, cuddling skin-to-skin or swaddling, to cue baby it’s time to doze off.

Avoid playing with or talking to your baby during sleep time; shushing sounds are OK and relaxing. Diaper changes can also cue baby toward relaxation and sleep. During the day, when baby is awake and active, use a more lively approach to each diaper change; soften your tone and touch as nap time nears.

Developing a sleep routine is just one part of your baby’s development; don’t rush it or stress over it. You’ll both make it through those earliest weeks, and benefit from the restorative sleep you both deserve once baby’s old enough and developed enough to sleep through the night.

Sleep should be protected whenever possible because it plays a major role in brain growth and temperament development.

In between sleep cycles, give your baby some time to fall back asleep on his own. Sometimes babies fuss but are able to get back to sleep by themselves, especially as they get older.

Access additional tips on protecting babies sleep from our partners at Huggies.

Pointers for Preemies

Premature babies (born before 37 weeks) need extra sleep support. Sleep-deprived preemies may have more difficulty regulating their emotions and grow and learn at a slower rate.

Research shows that parents and caregivers are key to helping preemie babies get good quality sleep.  Watch for those things that help baby drift off to sleep. Some babies need a little time to soothe themselves; others need your help to calm down, relax and drift into sleep.

Your baby may like sucking his thumb or need help finding and using his pacifier. The American Academy of Pediatrics recommends using pacifiers in all babies to reduce risks of sudden infant death syndrome (SIDS). If you baby’s pacifier falls out of their mouth after they’ve drifted to sleep, there’s no need to replace it.

Protect your preemie’s sleep by helping them relax and fall asleep with:

  • gentle touch
  • skin-to-skin snuggling
  • relaxing, low music or singing and humming
  • resting baby’s head on your chest near your heartbeat
  • a super-absorbent diaper with a wetness indicator so that you don’t disturb baby’s sleep to check or change a dry diaper
  • appropriate dim lighting to promote sleep

If your baby is in a NICU, your nurses will work with you to help cluster their needed care for baby during awake cycles, when possible, to protect baby’s precious sleep.

As you tune in to your baby and respond to their needs, trust builds in your relationship and everyday actions. Protecting your preemie baby’s sleep helps optimize their growth and health for the long term.

AWHONN thanks its partner, Huggies, for support of the Diapering Zone. In partnerships with Huggies, we’re proud to say, “We’ve got you, Baby!”

For more everyday diapering tips, visit resources from our partner, Huggies.

DID YOU KNOW that one in three families do not have all the Diapers they need to keep their youngest clean, dry and healthy? Click on DIAPER DRIVE where you can both donate diapers to families in your community or receive diapers from your local diaper bank.

 

AWHONN thanks Huggies for their support of the Mindful Diapering & Respectful Maternity Care articles

Author

The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) promotes the health of women and newborns.

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