Sleep and settling - what to expect in the first three months

Expectations regarding your baby’s sleep can be the source of great anxiety if you believe your baby is not sleeping ’well’ or ‘enough’.

Understanding how variable babies’ sleep patterns are from baby to baby, and from week to week according to individual feeding, growth and developmental stages can help relieve your concerns, and help you to ‘go with the flow’ of your baby’s individual needs.

Comfort and reassurance

When babies are born they must adapt to their new world and will be comforted by familiar sensations experienced in the womb:

  • Warmth – close to their mother’s body in skin to skin contact
  • Security – contained in soft wraps and held in loving arms
  • Nurture – receiving food as frequently as needed – warm, nutritious and sweet breastmilk and the delicious comfort of suckling mother’s breast
  • Movement and soft sounds – gentle rocking and swaying simulating mother’s movements as she went about her day whilst pregnant, and the soft vibrations and sounds of her voice.

Light, sound, touch, pain, clothing, poos and wees, sucking, swallowing and breathing are all new experiences for your baby. It should not be surprising that they takes some time to adapt to sleeping in a place away from his mother, and needs to revisit the familiar comforts often for reassurance that all is well in this new strange world.

You will learn to read your baby’s signals to understand their various awake and sleep states – yes, there are more than two! When awake, babies can be quiet alert, active alert or crying, which is your baby’s principal means of communicating a need. Your baby’s sleep states transition between active sleep and quiet sleep. Drowsiness upon waking transitions to the quiet alert state often combined with feeding cues – the perfect time to feed baby. Young babies often move from state to state quickly so parents who swiftly respond to baby’s changing cues encounter fewer feeding and sleep problems.

As the early weeks of baby’s life unfolds a pattern emerges and you can begin to relax and embrace your new lifestyle. This does not mean your baby is dictating the terms of existence forever after. It means that you are meeting your baby’s needs responsibly and sensitively as your new family becomes a cohesive, functioning unit.

Tired signs

You will quickly learn to recognise and respond to your baby’s early 'tired signs' to avoid them becoming overtired. An overtired baby may find it very difficult to go to sleep even though rest is what he desperately needs.

A newborn baby will become tired when they have been awake for an hour or more – including the time taken for feeding. The movements of your baby’s arms and legs become jerky, they may yawn, frown, fuss, and look away from stimulating toys or faces. Their hands may be in fists, their arms become tense, and they may arch backwards when being held. Fussing turns to crying and when very overtired they may ‘lose the plot’ and it can be difficult to calm an overtired crying baby.

To calm and settle a tired baby, remove them from a stimulating environment to a quieter zone, change their nappy if needed, cuddle them close and reassure them in a relaxed soothing voice, and offer a feed if baby seems hungry. When your baby is calm and their need of comfort (e.g. nappy change) and hunger are met, a state of drowsiness will follow. Your baby can then be swaddled and either cuddled until drowsy or asleep, or placed gently in his bed to drift off to sleep.

If your baby does not settle easily, stay with them with your hands resting on them for reassurance so they feel they are still being held. Rhythmic patting gently on his bottom often helps babies to relax. Sometimes your baby will settle more easily laid on their side. This is fine if you are with them. They can be gently moved onto their back when they are asleep, or on their side if they prefers it.

If your baby does not settle when expected, it is likely they actually need to be fed some more. Don’t ignore feeding cues when your plan is to settle your baby to sleep – the need to feed will over-rule your best efforts to settle them. If in doubt, offer another feed. This will save you time and energy in the long run, and will not 'spoil' or over feed baby. Young babies under 3 months old need feeds in multiple instalments. They often need topping up after a bowel movement and nappy change to feel full again and ready to sleep. Follow your baby’s cues and the bliss of dreamland will soon be yours.

Young babies are dominated by their needs for food, comfort and sleep rather than the environmental stimuli of light and dark, day and night. Newborn babies are oblivious to day and night and do not develop circadian rhythms until about 2 months of age. However, the breastfeeding mother’s cycle of sleep/wake hormones gradually influence her baby’s circadian rhythm to develop, and the environmental cues of the morning and evening help establish baby’s rhythm in sync with the family over time.

One strategy I have found to be helpful for babies and parents in the first few months is to avoid baby having a long sleep during the daytime – unless of course the mother needs to go to bed to sleep as well. Most babies will naturally have a longer sleep at some time during the 24 hours of each day. It’s quite OK to wake your young baby to feed during the daytime if they do not self-waken after four hours have passed since the start of the last feed. This will ensure your baby has a consistent food intake through the daytime and they may be more able to have the longer stretch of sleep during the night time hours. Bliss!

Most parents crave order and predictability from day to day so knowing what patterns to expect as your baby develops physically and mentally will make adaptation to their new lifestyle easier for them too. Getting into a routine will happen naturally in response to baby’s individual developmental patterns which the parents will recognise and adapt to as they unfold.

Following the highly structured and inflexible routines offered by 'sleep trainers' are an outdated, 'one-size-fits-all' concept which lock parents into rigid timeframes too. When something happens which confounds the ‘routine’ the parents are challenged to somehow get back on track, and many experience added anxiety and a sense of failure if their baby does not fit into the routine devised by the ‘sleep experts’ who do not know the baby’s or family’s unique story.

Babies respond to their needs being met rather than a rigid series of actions to enable sleep to follow. Responding appropriately to baby’s early ‘tired signs’ is the most important message to take on board. Health professionals now recognise there are potential hazards for babies’ physical and mental development associated with rigid feeding routines and sleep training. Cue-based responsive parenting enhances baby’s wellbeing and parents’ confidence in caring for and understanding their baby’s changing needs.

Expect changes

Your baby’s sleep patterns will change from time to time associated with growth and developmental phases, sometimes called 'wonder weeks', so don’t despair if the settling strategies that worked for weeks suddenly don’t work and your baby resists sleeping when they have slept easily in the past. Flexibility is the answer to these times of change and will have you many wasted hours trying unsuccessfully to coax a baby to sleep when it just is not what they need.

Often mistaken for 'wind', these unsettled times are usually driven by hunger and more feeding will be the answer to the situation because your baby’s nutritional requirements are in a state of change in response to growth. If your baby does not need to feed, they simply won’t.

Next try a strategy involving movement – pram/stroller, car, swing, rocking in arms. In the end it is a matter of ‘try this, try that’, but always give the new strategy at least 15 minutes before moving to another settling strategy. It often takes that amount of time for baby to re-set and respond by calming down. Take some deep breaths, close your eyes and relax yourself in order to recharge your own energy and focus on your lovely little person. All parents experience these challenges at some time, it is part of the parenthood deal!

If you are finding it very hard to cope, talk about it with a close friend, your Child Health Nurse or GP. Don’t despair, help is nearby.