YOUR BABY’S SLEEP
PATTERNS
Before your baby was a baby, she was a fetus, and even back then, her sleep patterns were in place!
While your baby is still in the womb, her brain will grow an average of 250,000 new cells every minute. At several developmental points, she will have generated more than 50,000 new brain cells per second. Starting at 14 to 18 weeks, fetuses show a pronounced circadian rhythm in their activity level, and after a mere 4 months, a human fetus is already having bouts of sleep, usually lasting less than 5 minutes at a time—the first of what will be millions of sleep-wake cycles over your baby’s lifetime.
Most moms begin to first experience brief fluttering feelings around 16 to 18 weeks of pregnancy. Then, stronger and more distinct sensations of movement will begin to “kick” in starting at around 20 weeks. By the time you can detect your baby’s first movements, her brain will already have created 200 billion neurons.
By about 21 weeks, your fetus will have begun a regular schedule of movement and rest. Fetuses as young as 23 weeks of age and weighing a single pound have been found to have rapid eye movement (REM) sleep states that are critical to the process of growing and cutting back brain connections.1 By 26 weeks, only about 50 percent of those 200 billion brain cells that developed just 6 weeks earlier will have survived. This pruning process is the way nature ensures that your baby’s brain is customized to provide the exact mental equipment she requires to survive in her environment.
What you’re exposed to during the second half of your pregnancy may have a vital affect on your baby’s health—and her sleep—later in life. The toxins in cigarette smoke in utero are especially dangerous during this period, because they can change the behavior of brain cells that will play a critical role in regulating breathing, sleeping, and waking. Babies younger than 6 months of age whose mothers smoked during pregnancy have triple the risk of sudden infant death syndrome (SIDS) of babies whose mothers did not smoke while they were pregnant. (For more on SIDS.)
PLANNING AHEAD WHILE YOU’RE PREGNANT
Believe it or not, we’ve heard moms ask, “Do I really have to take the full 6 weeks of maternity leave my doctor recommends?” We know that bills need to be paid, health insurance benefits must be maintained, and that for some families, taking extra time off is not an option. We know some of you are super-resilient physically and love your jobs, too. But promising your boss or clients that you’re going to be back from maternity leave asap, ready to tackle a huge project, is setting yourself up for total burnout, and, instead of proving your hardcore loyalty, will demonstrate your ability to fall asleep with your nose in a coffee cup.
Your Baby’s Sleep and Activity Stages in Utero
By the time you can feel your baby really move, she will already have developed 4 different rest-activity stages, which are collectively called non-rapid eye movement (NREM) sleep, that you can learn to detect.
1. During episodes of deep sleep, moms report that their babies are unresponsive to outside noises or motion. This stage can be alarming, because the baby seems so still. If seen on ultrasound, a deep-sleeping fetus may keep her head in the same place, while floating motionlessly.
2. During light sleep, your baby will seem to be very quiet but may have momentary bursts of arm and leg movements. She might even hiccup! Remarkably, Dutch researchers have found that the REM patterns of pregnant women during sleep change as a function of how far along they are in their pregnancies and appear to be synchronized with their babies’ sleep patterns. Women’s REMs at any stage of late pregnancy were found to be similar to REMs observed in premature babies at a similar gestational age.
3. If you happen to be having a sonogram, you may see your baby literally climbing the walls of your uterus during an active-awake period! In this stage, you will feel strong, vigorous bursts of arm and leg kicking.
4. When your baby is active and alert, her movements will have pauses, as if she’s waiting for something outside to happen. She might respond with kicks and movements to a sound, music, a touch on the belly, or other motions.
How much time should you plan to take off after you give birth? How about as much as you can get away with. It’s unlikely you’ll ever kick yourself and say, “I should’ve gone to work for those 6 months!” Don’t plan to work from home, either, unless you have a babysitter.
Taking time to bond with your baby and meet her needs during those first months will make her more independent later on, and that translates into a baby who is more capable of independent sleep, too. And on the biological front, the older she is, the more consolidated and predictable her clusters of sleep will become. All newborns wake up multiple times at night, but by 9 months, 70 percent of babies sleep through the night.
“It seems like she rarely sleeps in utero; sometimes at night, but generally she’s awake. Like, all the time. One night I lay on my side and snuggled up to my husband and he said she was keeping him awake! Him! Most people ask me if she’s most active at night. No, she’s active all the time.”
—Heather H.
And, while sending a 6-week-old to day care is usually expensive and emotionally difficult, it becomes more manageable on both fronts the older your baby is. Once she gets to be 9 months to a year, she’ll start pulling up, cruising around, and grabbing whatever she can reach and sticking whatever-it-is into her mouth. By that point, the structured naps that day care provides (not to mention all the new toys and the change of scenery) might turn out to be just the thing to help everyone sleep better.
In the meantime, can you simplify your lifestyle? (It’s not worth it to have an extra family car if you’re just going to get sleep-deprived and drive it into a ditch.)
Could you work fewer hours or take extra time off without pay?
What might happen if you straight-out quit your job and looked for another one later?
What if your husband or partner took leave when it was time for you to go back to work?
You don’t need to make any of the big decisions right this minute, but do read the section on adult sleep deprivation to get a realistic sense of what you’ll be facing. The longer you can wait to go back to work, the more sleep you will get because a baby’s ability to sleep through the night takes time to develop.
DON’T GO CRAZY OUTFITTING BABY’S BOUDOIR
When it comes to furnishing your baby’s bedroom, less is more. In fact, we’d go so far as to advise you not to even buy a crib while you’re pregnant. You read it right: You don’t need to run out and get one. The American Academy of Pediatrics recommends that babies sleep in their parents’ room for the first few months.
You may also find out, after your baby is born, that your equipment needs are different from what you anticipated. Your baby may have reflux, for instance, and be better soothed by a hammock-style crib than a more conventional one. Or someone may offer to give you a crib. You may also come across a great used crib.
Safety Tips for Used Cribs
A sturdy used crib may be an economical alternative to buying, but only if it has the following:
• Fresh mattress. Replace the used mattress with a new, very firm one so your baby isn’t exposed to mold or corrosion on the surface of the mattress.
• Directions. Make sure that the crib still has the assembly directions— and follow them to the letter.
• Intact hardware. Check that all the original screws and mattress support hardware are there and in perfect condition.
• Perfect condition. Test that all the crib’s parts are in perfect working order—that the bars, teething rail, and endboards are solid and no part has been rigged or glued back together.
• No recall. Check www.recalls.gov and know for certain that the particular crib model has not been recalled for dangerous flaws.
• Proper storage. Make sure the crib has been kept somewhere climate-controlled, not in an attic or garage where temperature and humidity changes could have caused the wood to warp and hardware or glues to corrode.
As for all the baby-bedroom furniture, keep in mind that anything beyond the basics is really for you, not the baby. The baby will not care one whit if she has a hand-painted mural of Paris on her wall, or a miniature leather chair, or curtains that match the diaper keeper. If you want to give your child the gift of interior design, put that money in the bank and wait until she’s old enough to help you pick things out herself! (For more about cribs.)
REST, REST, REST
A lot of moms-to-be try to work all the way up until their due date to maximize their allotted leave after the baby is born. That’s a personal choice, but do keep in mind that in the last month of your pregnancy your sleep cycle will begin to synch with that of your baby-to-be (plus, getting comfortable gets more difficult the larger your belly is), so you may be sleeping in stretches that are just a couple of hours long. When you’re pregnant, you should never feel guilty about taking a nap!
DON’T LISTEN TO THE “SHOULDS”
When it comes to sleep, you’ll find that (1) everyone, even people who don’t have kids, will think that they know when, where, and how your baby ought to be sleeping, and (2) even doctors and pediatric sleep experts have vastly different opinions about what ought to be happening in the family bedroom at night.
If You’re Pregnant and Working
• Know your rights under the law.
• Extend your maternity leave as long as you can.
• Talk to your boss, or whoever’s in charge of vacation and sick time at work, about your options while you’re still pregnant.
FIND OUT IF YOU CAN:
• Take more time off without pay and still keep your position.
• Find someone to fill in temporarily.
• Return part-time and still retain your health insurance.
As you prepare to embark on the various controversies of your parenting career, make it a habit to learn the facts, respect the individuality of your child and your family, and not get caught up in all of the “shoulds” and “supposed tos,” as in “He should be sleeping through the night by now!” “He shouldn’t need a pacifier to get to sleep!” “He’s supposed to nap for a half hour every 3 hours!”
Not only do these rigid “shoulds” undermine your confidence as a parent, but they can actually cause sleep and behavioral problems if you take them so seriously that you stop looking and listening to your baby’s cues and start trying to follow an externally imposed regimen.
Yes, this book is chock-full of all sorts of statistics having to do with what most babies are doing—where they sleep, how often they feed, how often they wake up at night—but as you’ll soon find out, there is a wide range of normal and healthy behavior.
Some 1-year-olds will still wake up at night. For those individual toddlers, that is normal and healthy behavior. Waking up doesn’t mean that a baby or child is emotionally or physically immature, or that if parents don’t start implementing some sort of behavioral modification program their child will never learn to sleep through the night on her own. Sure, there are things you can do to help a baby sleep longer, but like so much in life there are costs and benefits, and you and your family are the only ones qualified to decide if a particular course of action—or inaction—is worth it. What parents expect from a baby in terms of sleep often has less to do with biology than what they hear from other parents.
The reality is, during the first year, a baby’s sleep needs will be constantly evolving as her hormonal cycles develop in response to the environment. She will need to sleep every 2 to 3 hours for the first few months, and will spend a lot of that time in a half-awake state, nursing or sipping a bottle and going ballistic if someone tries to put her down.
Developing an independent, all-night sleep routine is not an “overnight” process for babies, who are born preprogrammed with a drive to be physically attached to a parent for every conscious moment, and needing to feed every 2 to 4 hours. Over time, as babies grow, they become able to sleep in longer stretches. But in the meantime, a baby’s needs can leave parents having to choose at 4 a.m. between putting the baby down in a crib to cry until she finally passes out, only to wake up again 2 hours later; to stay awake holding the baby in a rocking chair for much of the day or night; or to go against the advice of most pediatricians and bring the baby into bed, or have dad or someone else give the baby formula. These are rough choices, and there’s little consensus to be found about what the “right” way is. What is right for one family may not be right for another.
The good news is that after 6 months, as solids gradually become a greater chunk of her diet, your baby will become ever more capable of longer stretches of sleep. With help from both parents, she will be able to develop healthy sleep habits for a lifetime, and that means quality sleep for parents, too.