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HEALTHY INFANT SLEEP

For many women, the sleep difficulties begin well before the baby's birth. From nausea and back aches, to toilet visits and scary dreams, there are many things that can keep pregnant women up at night. You may also be interested in how your baby's sleep pattern develops in utero. Read below to see some common sleep changes at different points throughout pregnancy and the development of your baby. 

 

 

 

 

It is common to feel concerned that you baby is not getting enough sleep, or their pattern is not normal. When trying to decide whether their sleep is a problem, try to count up the hours of sleep over 24 hours rather than analysing the pattern (or lack thereof). Although all babies are different, the information below may provide some insight into what many infants experience at different ages. Remember, each time your baby has a surge in development, you will likely see a shange in their sleep... usually it does not last long.

 

 

 

Sleep during Pregnancy
Sleep during pregnancy

First Trimester

  • Some may not notice any change in their sleep pattern

  • Sleep may be affected by thoughts, excited and apprehension by your new news

  • Nausea can make sleep quite difficult. Try a moderate sized dinner quite early followed by a small snack before bed

  • Backaches may also be a factor

  • You may begin to have strange, disturbing or vivid dreams

  • As the weeks progress, you may begin waking to use the bathroom through the night

  • Thermogenic – increase in core body temperature (may affect sleep onset)

  • You may be much more fatigued and sleepy throughout the first trimester. An earlier bed time may be useful

Second Trimester

  • Usually a period of feeling better than first trimester - nausea settles and you may have more energy

  • Sleep relatively settled excluding increased fetal movement

  • As your tummy grows, you may need to find a new sleeping position - Sleeping on your side with a pillow between your legs may be most comfortable. (Left is preferable)

  • Leg cramps and back pain may also affect your ability to fall asleep. Ensure leg cramps are not restless leg syndrome which is more common during pregnancy and can sometimes be settles with magnesium and iron supplements.

  • Intestines and oesophageal sphincter displaced=reflux and heartburn. Adjusting diet and meal size may help

  • Fetal movement is wonderful but may also be a factor in keeping you awake

  • Snoring is also more common with progressing pregnancy... this will most likely end a few weeks after birth

  • If low blood pressure occurs, be sure to get out of bed slowly to avoid dizziness

Third Trimester

  • Sleep becomes more fragmented with progressing pregnancy, as you need the bathroom more times through the night

  • Breasts often enlarged and tender – uncomfortable if lying on side. sleeping in a crop top may help

  • Core body temperature higher may make sleep onset difficult especially during Aussie Summer! Night sweats may occur

  • Backaches return... Sometimes everything aches!

  • High levels of progesterone plus an elevated diaphragm result in increased respiratory rate and shortness of breath

  • Braxton-Hicks contractions more intense especially in the first pregnancy

  • Some apprehension/excitement/fear/nerves

  • Relationships may change

In Utero

  • Sleep & sleep cycles begin around 26-28 weeks gestation

  • Different sleep states signal brain maturation

    • Quiet sleep (QS)

    • Active sleep (AS)

    • Indeterminant Sleep (IS)  - large amount of time spent here

  • Between 32 & 40 weeks QS increases and indeterminant sleep decreases

  • Fetal movement can occur during active sleep as well so a lack of movement may not indicate sleep, simply inactivity

Sleep after birth
Sleep after birth

Birth - 2 weeks

2 - 4 weeks

  • Unpredictable pattern

  • Unlikely to be able to communicate sleepy signals

  • May need help to settle

  • Frequent feeding at night

  • Lots of learning to do

  • Huge adjustment!

  • Balancing rest with celebrations

  • To settle - recreate the womb: swaddle, shush & motion

     

  • Overtired babies are hard to settle…

    • be patient and persistent

  • Unlikely to remain awake for more than 1-1.5 hrs

  • Prioritise sleep for you and your baby

  • Establishment of feeding may affect sleep too

  • Learn to recognise active sleep and allowing the transition to quiet sleep

  • If colic and/or reflux is an issue, this can be a particularly difficult time. Seek help from your GP

4 - 6 weeks

  • Your baby is likely to wake at least twice through the night

  • Sleeping through the night usually means 4 – 5 hours

  • You may see you baby start to sleep more at night and less during the day

  • More aware of effective soothing techniques

  • Easily overstimulated – ensure you allow your baby ‘wind down' times before sleep

  • Baby may be fussy in the evening – circadian rhythm emerging

     

6 - 12 weeks

  • Baby may start to signal his/her own needs

  • 90 minute wake cycle emerges – start to settle back to sleep ~80-90 mins after waking.

  • Be aware of the soothing techniques as the baby may become dependent

  • Lack of attention may indicate an overtired baby

  • Reduce night-time stimulation

  • You may notice sleep cycles of ~40 mins.

  • Establish a relaxing and enjoyable pre-bed routine

  • Start to put your baby down calm but awake and settle in cot.

3 - 4 months

  • You may start to notice a more predictable pattern

  • Continue being aware of time your baby woke and when s/he gets tired - may double or triple (90 – 180 – 270 mins)

  • Remember cues for sleep – settling as soon as baby gets tired will be much easier

  • Increasing fun interaction

  • Circadian rhythm patterns emerging – may start to sleep more at night (5 hours)

  • Waking during the night may not always indicate hunger

  • Babies using dummies may start to lose their dummy through the night... this can be terribly frustrating!

  • Unswaddling when baby begins to roll may produce a few bad nights.

4 - 6 months

  • Many babies will experience a difficult period around and their sleep will regress. This usually only lasts 1 – 2 weeks so try to remain as patient and consistent as possible.

  • After a possible difficult patch, you may start to see less night waking

  • Only feed at night if the baby is hungry

  • Settling using methods other than feeding may reduce night wakes

  • A consistent, early bedtime may be useful 

  • Your baby may wake up to the world and begin to resist sleep

6 - 9 months

  • Introduction of sleep self-soothing or independent sleep skills

  • Baby is neurologically ready to fall asleep independently

  • For those who choose to use sleep interventions, this is often when to begin

  • Return to sleep is cue-dependent

  • Advice will be given about night feeds and self-soothing – have the confidence to make your own decisions and do what is right for you and your family

9 - 12 months

  • No nutritional need for a night feel from 9 months (Check with GP if unsure or baby is underweight)

  • Giving water rather than milk may help transition baby off night time milk

  • Baby will become more aware and responsive to parental behaviours so consistency is important

  • Teething may disrupt sleep around this time (if it hasn't already) - Teethers, sucking and reassurance will help baby settle. 

  • About one third of babies are still waking through the night at 12 months. Take note of parental behaviour but also note that your baby may simply have a delay in their sleep stage develpoment

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