Chapter 8: Sleep, Tiredness and Safe Sleep

From the Diary

Month 2, a grey morning. Last night our daughter woke four times, and each time she fed and then took a long while to settle again. My husband did the bottle feed in the middle of the night, as we agreed, but I woke anyway when I heard her cry, and then I lay there listening to every little sound. This morning I put the milk in the cupboard and the cereal in the fridge. I laughed, and then I cried. Everyone told us that we would be tired. Nobody explained that tiredness would feel like this: heavy arms, a foggy head, a short temper, and tears that come out of nowhere.

Month 2, later in the week. My husband and I had a silly argument tonight about a towel left on the floor. Then it turned into an argument about who is more tired, which nobody can win. I said things in a sharp voice that I did not mean, and he went quiet, which made me angrier. Afterwards, when our daughter was finally asleep, we sat on the kitchen floor and said sorry to each other. He said he feels like a machine at work these days. I said I feel like a ghost at home. We agreed that we are on the same side, even when we are too tired to act like it. We also agreed that no serious talks happen after ten at night.

Month 2, near the end. Something frightened me today, and I want to remember it. In the afternoon I sat on the sofa to feed our daughter, and I must have fallen asleep with her on my chest. I woke with a jump. She was still there, warm and fine, but she had slipped down against the cushion. My heart would not stop pounding. When I told the midwife, she was kind but very clear: never sleep with a baby on a sofa or an armchair. Now, if I feel sleep coming while I feed her, I wake my husband or put our daughter back in her cot, on her back, before I close my eyes.

Month 3. We have a new plan, and it is helping. On most nights my husband takes the first part of the night with a bottle, and I go to bed early with the door closed. Then I take the later feeds. On weekend mornings, one of us sleeps late while the other takes our daughter out for a walk. She still wakes in the night, but sometimes now she sleeps a longer stretch after the late feed. I have also started to say yes when my mother offers to come and watch the baby so that I can nap. On some days now, I feel a little more like a person again. My husband still looks tired, though. He works late and says little. I am keeping an eye on him, the way he kept an eye on me.

How Babies Sleep in the First Months

Newborn babies sleep a lot, but not in the way that adults do. In the first weeks, a baby sleeps in short pieces spread across the day and the night, waking often to feed. A newborn does not yet know the difference between day and night, so your baby may be wide awake in the middle of the night and sleepy at noon. This is normal and expected. A newborn feeds often, day and night, and this frequent waking is part of how a young baby grows. It does not mean that you are doing anything wrong, and it does not mean that your baby has a sleep problem. Night waking in the first weeks is simply what newborns do.

For much of the time, babies also sleep more lightly than adults. A sleeping baby may twitch, sigh, make little noises, breathe in an uneven rhythm, grunt, or move the arms and legs. Many parents, like the mother in the diary, wake at every sound. It can help to know that these noises are usually a normal part of a baby's sleep, and that a baby who squeaks or stirs may settle again after a moment without being picked up. If your baby has trouble breathing, works very hard to breathe, or has blue or grey lips, call the emergency number straight away.

Over the first months, sleep slowly changes. Many babies begin to sleep for somewhat longer stretches, often in the night, and to stay awake for longer periods in the day. This happens at a different speed for every baby, and it rarely goes in a straight line: a few better nights may be followed by a few harder ones, for example during a cold or a time of fast growth. Comparing your baby's nights with another baby's nights can make you feel that something is wrong when it is not. If you are worried about how your baby sleeps or feeds, ask the doctor, midwife or nurse. They can tell you what is usual at your baby's age and whether anything needs a closer look.

You can help your baby slowly learn the difference between day and night. In the daytime, keep the home light and let ordinary sounds go on around the baby. At night, keep feeds and nappy changes quiet and calm, with a dim light and few words, and put your baby back down soon after. Some families like a simple, gentle routine in the evening, such as a wash, clean clothes, a feed and a quiet lullaby. These habits do not make a young baby sleep through the night, but they give your baby small signals that night is the time for sleep.

Babies also show when they are getting tired. Common signs are yawning, rubbing the eyes or ears, staring into the distance, turning the face away, becoming quiet and still, or becoming fussy. Many parents find that a baby settles more easily when they notice these signs early and begin to calm the baby before the baby becomes overtired and upset. Every baby has their own signals, and you will learn your baby's signals little by little. Writing down for a few days when your baby sleeps and wakes can help you see a pattern, but it is not a test that you have to pass.

Safe Sleep, Every Time

Where and how your baby sleeps matters for your baby's safety, and the basic rules are the same for every sleep, by day and by night. A sleeping baby goes on the back, not on the tummy or on the side. Your baby sleeps on a firm, flat surface of their own, such as a cot, crib or bassinet with a firm, flat mattress that fits well. Nothing soft goes in with the baby: no pillows, no soft toys, no bumpers and no loose blankets. These simple steps are what doctors, midwives and public health guides advise for every baby, and they are worth following even when the baby only naps.

Many health guides advise that, for the first months, the baby sleeps in a cot in the same room as the parents. This lets you hear and see your baby easily, and it makes night feeds simpler. Keep the cot clear, and keep your baby's head and face uncovered. Your midwife or nurse can show you safe ways to keep your baby warm at night without loose blankets; many parents use a baby sleeping bag in the right size for the baby. When you stay with relatives or travel, think ahead about where the baby will sleep, so that the same rules can be followed away from home. At home, it helps to place the cot away from heaters, windows and the cords of blinds or curtains, so that the baby's sleeping place stays safe as the baby grows and starts to move.

A smoke-free home is part of safe sleep. Keep your baby away from smoke in the home, in the car and anywhere else, and ask visitors not to smoke near the baby. Babies also sleep most safely when they are not too warm. Keep the room at a comfortable temperature, dress your baby in light layers rather than heavy ones, and do not cover your baby's head for sleep. You can feel the back of the neck or the tummy to see whether your baby is too hot; your midwife or nurse can show you how to judge this and how many layers suit the room. If your baby is unwell or has a fever, do not add extra layers; ask your doctor what to do.

Never sleep with your baby on a sofa or an armchair. When a tired parent falls asleep there with a baby, the baby can slip into a gap or against a cushion and be unable to breathe. As the mother in the diary found, this can happen to any exhausted parent without warning. If you feel sleep coming while you feed or hold your baby, put your baby back in the cot on the back, or hand the baby to another adult who is awake. Advice about sharing an adult bed with a baby differs, and it is especially unsafe when a parent has been drinking alcohol, has taken medicine that causes sleepiness, or smokes. Talk to your midwife or nurse about the safest arrangement for your family.

Babies often fall asleep in a car seat, a pram or a baby carrier while you are out. When you arrive and your baby is still asleep, move your baby onto the back on a firm, flat surface of their own, such as the cot. A car seat is made for travelling, and it is not a place for a long sleep at home. Time on the tummy is important for a baby's development, but it is for when your baby is awake and someone is watching; Chapter 10 explains it. If anyone else looks after your baby, such as a grandparent or a friend, share these rules with them kindly. Safe sleep works best when every adult who cares for the baby follows the same steps.

What Tiredness Does to Parents

Broken sleep is one of the hardest parts of the first months, for almost every parent. It is not only the number of hours that matters, but the way sleep is cut into short pieces. Waking again and again leaves the body and the mind without the deep, long rest that they need. Many parents describe feeling foggy, slow, clumsy and forgetful, like the mother in the diary who put the milk in the cupboard. This is a normal effect of broken sleep, not a sign that you are failing as a parent. Most parents find that their thinking becomes clearer again as the nights slowly become longer and more settled.

Tiredness also changes feelings. A tired parent may cry more easily, feel irritable and short-tempered, and have less patience with the baby, with a partner, and with themselves. Small problems can look enormous at night. Arguments between partners about chores, or about who is more tired, are very common in these months, and they usually say more about exhaustion than about the relationship. Being able to say, as the parents in the diary did, "We are on the same side," can help after a hard night. So can a simple sorry the next morning.

Thinking can be affected too. When you are very tired, it is harder to concentrate, to make decisions and to remember things. Be careful with tasks that need your full attention, such as driving or cooking with hot oil, and put them off when you can if you are exhausted. Keep important things simple: write down feeds, questions or the time of the next appointment if it helps, and put things like keys and the baby's bag in the same place each time. Small systems like these take some weight off a tired mind. It also helps to wait before making big decisions, or before having a difficult conversation, until you have had some rest.

The parent who gave birth is also recovering, as Chapter 2 explains, and the body heals better with rest. The other parent may have gone back to work after a short time at home, and carries tiredness into long days. Both parents' tiredness is real. Comparing whose tiredness is worse rarely helps; working out together how each of you can get some sleep usually does. If you are raising your baby alone, your tiredness is real too, and it is a good reason to ask others for help rather than a reason to feel ashamed.

After a hard night, small things can make the next day easier. Daylight and a little fresh air in the morning help both the baby's body and your own to find the rhythm of day and night. Simple food, plenty to drink, and lowering what you expect of yourself for that day all help. It is fine to cancel a visit, leave the washing, or eat the same meal twice. A hard night is not a sign of how every night will be, and many parents find that the hardest weeks slowly give way to easier ones.

Sharing the Night, and Knowing When to Ask

There is no perfect way to share the night, but a plan helps. If you have a partner, sit down together in the daytime, when you are both calmer, and decide who does what. Some parents take turns, one parent covering the first part of the night and the other parent the second part, so that each gets one longer stretch of sleep. Others take alternate nights. If the baby has infant formula, or breast milk in a bottle, the other parent can take some feeds; if the baby is breastfed, the other parent can bring the baby, change the nappy, and burp and settle the baby afterwards. Every family finds its own way, and the plan can change as the baby grows and the nights change.

Protecting one longer stretch of sleep for each parent is a useful goal. The parent who is off duty can sleep in another room, or with the door closed, so that small noises do not wake them, while the parent on duty stays with the baby. Naps help too: rest when the baby sleeps if you can, even if the dishes wait. Lowering your expectations for the home is not laziness. In these months, clean clothes, simple food, a safe baby and parents who get some rest are enough.

Accepting help can make a real difference. A relative or friend might hold the baby for an hour while you sleep, bring a meal, or do some washing. Like the mother in the diary, many parents find it hard to say yes at first. It may help to remember that most people who offer are glad to be useful, and that it is easier for them when you say clearly what would help. If you are raising your baby alone, building a small circle of people you can call, and being honest with them about how tired you are, matters even more. Even one night a week when someone else stays over and takes a turn can help you recover a little.

In the middle of the night, when you are exhausted and the baby will not settle, patience can run out quickly. Feeling frustrated or even angry at those moments is common, and it does not make you a bad parent. If you feel your patience slipping, put your baby down safely on the back in the cot and step away for a few minutes. Breathe slowly, drink some water, and wake your partner or call someone if you can. Never shake a baby. Chapter 5 says more about calming a crying baby and about looking after yourself when the crying feels too much.

Sometimes tiredness and low mood mix, and it is hard to tell which is which. Ordinary tiredness usually lifts a little after a good sleep or a quieter day. It may be time to ask for help if you cannot sleep even when the baby sleeps and someone else is watching, if you feel hopeless or empty, or if low mood or worry is there most days, for more than a couple of weeks. Tell a doctor, midwife or nurse; Chapter 6 and Chapter 7 explain more. You can also talk to them about your baby's sleep when the nights feel impossible. They can listen, explain what is usual at your baby's age, and help you find a way through.

A Checklist of Things to Prepare

A safe place for every sleep: check that your baby's cot has a firm, flat mattress and is clear of pillows, soft toys, bumpers and loose blankets, and plan where the baby will sleep when you visit others.

A rule about the sofa: agree with everyone who cares for your baby that nobody sleeps with the baby on a sofa or an armchair, and that a sleepy adult puts the baby back in the cot first.

A night plan: decide with your partner or a helper who covers which part of the night, so that each adult gets one longer stretch of sleep, and try it for a week before changing it.

A quiet night corner: keep a dim light, nappies, wipes, a clean set of clothes and a drink of water for yourself near the cot, so that night feeds and changes can stay calm and short.

A list of people who can help: write down the names of two or three people who could bring a meal or watch the baby while you nap, and say yes when they offer.

A smoke-free agreement: tell visitors and family kindly that your home and your car stay smoke-free for the baby's sake.

An honest answer about your sleep: at your next check-up, or at your baby's, say how much you are really sleeping and how you feel, so that the doctor, midwife or nurse can help early.