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The dreaded day/night confusion is worried about by all new parents. This is the theory that babies will be awake more at night than they will during the day and it is mostly geared towards newborns (birth - 4 months). When our baby comes into the world it often feels like sleep is not that bad because they kind of sleep all the time but usually after a few days or sometimes a couple of weeks we do start to notice they are fussier in the evenings and may even begin to stay awake for long periods at night. Don't worry, you are not doing anything wrong! This time with sleep is just hard. Always try to think in terms of what your baby is going through as I find this can help. What I mean by that is they have left their "home" in your womb, have been exposed to different scents, sounds and light levels and have more than likely been passed around to a few loving arms. All of this equals major stimulation overload for your baby and so it is normal for them to feel out of sorts.
I have some information on day/night confusion as well as a few tips to help your baby's body rhythm get on track! Understanding what is going on can help set realistic expectations and get us through those first hard couple of months. Just in time for the 4 month sleep regression to arrive.
Information Points on Newborn Sleep/Wake Patterns
1. It is normal for your new baby during the first couple of months to sleep more during the day than at night. There are a couple reasons for this:
First, this is the rhythm they were in when in your womb. Naturally babies are lulled to sleep with motion and so during the day while you were walking around your baby was in a loving swing helping them drift off to dreamland. At night when you were moving less this is when they could use the womb (and your bladder) as a trampoline to practice all their moves. So, naturally they spend a little more time awake at night because of this pattern.
Second, when in Utero your baby's body was controlled primarily by moms hormones. This is helpful because it means that they were getting sleep hormone (Melatonin) at night and awake hormones (Adrenaline & Cortisol) during the day but during gestation your baby cycles on and off in approximately 30 minute sleep spurts no matter what and so the stimulation they got through movement still meant they often got more sleep during the day. As soon as your baby was born these hormones were cut off and so the body is no longer running on hormones from mom. Now they wake up mostly due to the need for food! This is why they wake around the clock to eat and don't have a regular sleep/wake cycle.
2. It is not until around 12-15 weeks after being born that your baby's body begins to produce their own sleep/wake hormones. Research averages these hormones beginning around 52 weeks gestation and so 12-15 weeks is for a full term baby. If you have a premature baby then this might even be longer. This is generally when we see higher amounts of melatonin, adrenaline and cortisol in the body indicating the body is working on maturing the circadian rhythm (internal body clock). This means we can not expect our baby to really know the difference between day and night before this point although their body usually is already on the road to organizing some sleep just not so much due to hormone influences. You might notice some longer stretches at night but you may also see some long stretches during the day as well.
3. As soon as your baby is born the Circadian Rhythm is forming but it needs to mature. It doesn't have hormones impacting the organization at this point until that 12-15 week mark. It is more so being impacted due to stimulation levels which we can control to help the process!
Tips to Help Your Baby Organize Their Days and Nights
Day and night differentiation occurs when your baby is AWAKE. This is when the body is responding to different stimulis and therefore organizing information to form patterns. Don't get me wrong sleep is a very active time in the brain as well but in terms of organizing day and night patterns we want to focus on the stimulation they are receiving when awake.
We hear this old wives tale quite often, "put your baby to sleep in a bright location where it is hectic so they learn to sleep anywhere at anytime and don't get their days and nights mixed up" but this usually interrupts more sleep in the long run. Setting up healthy sleep habits right from the start can help A LOT when your baby passes into that 4 month sleep regression.
So, what can you do to help organize sleep as much as possible:
1. During the day when your baby wakes up bring them into a bright location, feed them and then change their diaper. By changing their diaper after the feed we are offering a bit more stimulation in addition to the light levels and it also may help get into an Eat/Play/Sleep routine IF this is something you were planning.
As your baby gets older they will stay awake for longer and longer periods of time and so we want stimulation to be higher during the day so that when they are awake their body is being told to interact. Lights, sounds, touch, ect are all ways we can stimulate our baby.
2. At night when your baby wakes we want to do the opposite of stimulating them. Feed them, change them if needed but then keep stimulation low. When your baby does wake up keep the lights as low as possible so that the environment is dim/dark and calm. When they are awake for longer spurts try not to turn on t.v's or take them to locations where it is brighter with more stimulation. Instead do what you can to keep it "night mode." This can be harder sometimes because some babies are happy during these times. If you can put your baby in a safe space as you get some more shut eye or not interact with them with talking and sounds this can help let their body know that now isn't a time for play.
** When your baby enters the 4 month sleep regression between months 3-4 they will be producing sleep/wake hormones on their own for the first time. These hormones are hugely impacted by light levels. Light tells the body to be awake and darkness tells the body to be asleep and so by using points 1 and 2 above we can be setting up good sleep habits as their body naturally matures by controlling when they are exposed to lights. This helps tell their body clock when it is day and when it is night.
3. Your baby will be waking around the clock but some babies do naturally have long naps during the day. I always recommend capping naps at 3 hours for new babies during daytime hours. If they are still sleeping at 3 hours you can wake them, change them and then feed them. It is totally fine if they fall right back to sleep after the feed but what we are doing is helping the body get into the pattern that longer spurts are for nights and shorter spurts are for the day. I don't wake up a baby at night unless you have been instructed to do so by your family physician.
** I stick to 3 hours and then at 4 months I limit daytime naps to 2.5 hours at a time before waking them to keep the body going in the right direction of shorter sleep spurts during the day and longer at night.
4. Try not to keep your baby awake longer during the day in hopes of making them more tired for nights. Babies are ready for sleep after very short intervals during the first few months and so keeping them awake longer usually works in the opposite way we want it to and we end up having more night wakings. The more overstimulated that they are from being kept awake too long the more restless the night will be. To see my recommendations for how long they should be awake for click here.
5. Reaching appropriate sleep hours is the most important sleep goal during the first few months. In terms of getting sleep I say DO WHAT WORKS! I'm a mom and get it! Try not to get caught up in too many sleep "rules" because until the 4 month sleep regression we are working on bonding with our baby and helping them adjust. With that being said it can help to set up a sleep space that leads to the best sleep for your baby because we want to be reaching total sleep goals.
- Have the sleep space dark. This reminds your baby of being in the womb and can help settle them and make them feel safe. If they are sleeping with you, swing, bassinet, crib, ect then have that room dark for sleep times. This will also help when the hormones do begin being produced as the darkness will be signalling sleep to be happening at night and during naps.
- Use white noise. This mimics the sounds of the womb. Having a constant static sound around your baby is similar to the sounds of blood flow, intestinal noises and other sounds of the womb. This gives that safe feeling and can help your baby sleep for longer spurts.
- Swaddle your baby. Baby was really tight in the womb and so swaddling can replicate this. If it seems like your baby does not like being swaddled it is probably not tight enough. They like their arms to be tightly in place but make sure to have room for the hips to move!
- Use motion. As mentioned above your movement is what lulled your baby to sleep a lot during the day and so using a swing for sleep can help with this. The fastest swing setting often replicates those quick womb movements the best.
Congrats on your new baby and I hope this blog helps you on your way to good sleep! Take it 1 day at a time. For more newborn advice check out my "Guide to Newborn Sleep" post.
Please share with any families with newborns :)