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Sleeping with your infant is a unique struggle, but this is because it is also a unique time in their life when their minds, souls, and bodies are growing to their own mysterious rhythm. While it is hard to give cut-and-dry advice about almost any aspect of parenting, particularly as every baby is different, the information below is intended to help parents understand their infant’s sleep and their role in facilitating it.
Background Information on How Infants Sleep
Circadian Rhythm, or Lack Thereof
When babies are born, they do not yet follow the day-night circadian rhythm of adults. Adults’ bodies can regulate temperature and hormones, including melatonin and cortisol, in ways that babies cannot.
Newborns' sleep hormones are not yet affected by light and darkness. In fact, from birth until 6 weeks, the baby does not interpret light or darkness as cues to wake or sleep and instead sleeps at will. During week 1, their body temperature starts to have a day-night rhythm. During the first 12 weeks, it is normal for your baby to wake up 2-5
times a night. At 15 weeks, your baby will likely have developed a set pattern of sleeping and waking hours during each 24 hour period. By three months the total amount of time sleeping during the day decreases and the night increases, showing the beginnings of an eventual day-night rhythm. From three to 6 months, the hormones involved in sleep and waking become more regulated.(1)
If you notice changes to the sleep pattern that developed, or increased crying, crankiness, or clinginess, these may be signs that your baby is experiencing a “growth spurt” of their mental and physical capabilities (sometimes called wonder weeks or baby leaps). So, when it seems like things are going wrong, have faith that they may actually be growing right.
Infant Sleep Cycles
During phase/stage 1 and 2, the baby is only lightly sleeping, so they are easily woken up. This often means you have to wait for the next phase to put them down or leave without them waking up. To see if they are in deep enough sleep for you to put them down (phase 3), you can try slightly lifting and dropping their arm to see if it falls limply or is still somewhat controlled. (1)
When you lay them down, sometimes a baby’s startle/moro reflex can be activated because it produces a sensation of falling, which may wake them up. One way to avoid this is to hold the baby toward your chest as you lay them down, breaking the connection as close to the mattress as possible. These reflexes usually only last for the first three to six months, however.
Why Do Babies Sleep Differently?
Some explanations for why babies have shorter sleep cycles include 1) having a smaller stomach, and therefore needing food more often, 2) needing to wake up and cry if something like a clogged nose or wet diaper is irritating them, and 3) waking up because they cannot yet regulate their body temperature.
It can be hard to feel like your baby is getting enough sleep because they do not have the same sleep-wake cycles as adults. However, from infancy until your child is three years old, their sleep cycle stages differ from adults'. Although concerns about your child's sleep are perfectly reasonable, don't worry if they are not "sleeping through the night" (or 5-6 hours consistently), because baby sleep is much more complicated and individualized than those blanket benchmarks. Try to trust that your baby is sleeping in the best way for them and their development.
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Where to sleep...?
The question of where the baby should sleep seems to be a fraught one. Before diving into information about different methods, hopefully, it is reassuring to note that “eventually it is the quality of the parent-child relationship, not where it plays out, that matters most to a child’s development.” (2)
Parents may plan to roomshare, bedshare, or place their child in a separate room. The common advice across varying sources supports roomsharing rather than sleeping in separate rooms because it is safer for the infant to be near you so you can hear the baby's cries and so the baby can hear you. Just knowing you are nearby can be soothing. Regardless of the sleeping method, it is recommended for the baby to be on their back and for the area to be free of loose objects, chords, crevices (ex. between bed and bedframe), or anything that could cover the baby’s face. Although some sources advise against bedsharing, many parents will end up sleeping with their infant at least once, whether by choice or accident, so every parent should know how to bedshare safely, even if they do not plan to use bedsharing as their main method.
Why is it recommended to roomshare? What are the benefits of having the baby close through roomsharing or bedsharing?
Breastfeeding: When babies sleep alone, they are shown to wean off of their parent’s breast/chestfeeding them more quickly than parents want and are shown to nurse less and take in less.(3) Feeding in the bed can decrease the likelihood of falling asleep in an armchair or sofa. It is less dangerous to fall asleep in the bed with your infant than an armchair or sofa.(4)
Hearing Cries: It is safer for the infant to be near you so you can hear its cries and so it can hear you. Knowing you are nearby can be soothing to the baby. The anthropologist, James J. Mckenna found that when babies and adults sleep together “they do sleep more lightly and rouse more often. Though that might sound undesirable, it is safer, says McKenna, especially in the first few months of life, because it creates more opportunities for caregivers to check on their babies and for babies to recalibrate their breathing to the adult’s breathing.”(5)
Ability to give contact: The proximity to your baby allows you to provide contact more readily. “The amount of contact a baby wants to sleep peacefully depends on the baby and their age,” and this contact can include everything from skin-to-skin contact to hearing your voice.(1)
Sleep Length: Cosleeping was shown to increase sleep for the parent. Additionally, infants whose parents breastfed and did not sleep alone spent more time in deep sleep.(6)
How Do You Bedshare Safely?
“A planned-ahead bed is just a seat belt.” - La Leche League
Even if you do not plan to bedshare, you can construct a safe environment in case the situation arises (as it likely will). Here are the 7 Safe Sleeping Tips(6) from La Leche League on how to build & buckle that seat belt:
Other hazards you may consider include the distance to the floor, the landing surface, and interference of pets, siblings, or partners affecting your position or the baby’s.
If you do not meet these criteria, you may want to consider choosing an alternative sleeping method and talking regularly with your provider or doula about how your sleeping method is working/not working so you can make adjustments as needed.
How to Bedshare: The position for bedsharing may come naturally to parents, particularly if they have fed the child in the bed. The position, known as the “C-position” or “Cuddle Curl,” occurs “with the infant’s head across from the adult’s breast, adult’s legs and arm(s) curled around the infant, infant on their back, away from the pillow, [and] is the optimal safe sleeping position.” (7)
Cuddle Curl
Arm above the baby’s head to prevent them from moving into the pillows
Knees tucked under the baby’s feet to prevent them from moving down into the sheets or further down the bed
Baby flat on their back, next to the parent’s chest
(7)
Why do some parents avoid bedsharing?
The most common reason cited against bedsharing is the risk of SIDS.
For Findings on Bedsharing and SIDS:
A study in the UK that combined data from two prior studies found that when the parent was not on the sofa, did not smoke, drink, or use drugs, and the infant was not born pretterm, the effect of co-sleeping on SIDS (Sudden Infant Death Syndrome) during the first 3 months was not significant. (8)
However, “The American Academy of Pediatrics recommends a safe sleep environment to reduce the risk of all sleep-related deaths. This includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include human milk feeding; avoidance of exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs; routine immunization; and use of a Pacifier.” (9)
A study on bedsharing and breastfeeding highlights that, in addition to honesty about the potential risks and benefits of bedsharing, “ending stigma around bedsharing and educating all parents about safe bedsharing have the potential to reduce infant deaths. Bedsharing evolved from innate human biological and behavioral mechanisms. It is not a singular, discrete, or coherent practice, but is composed of a diverse range of behaviors, some of which may carry risks, making it particularly important to discuss bedsharing safety.” (7)
Other Ways to Aid Infant Sleep:
After feeding, babies may be unsettled. In this situation, gentle rocking and skin-to-skin contact from the birthing person or their partner may help soothe the baby. You can also try feeding again. (10)
A warm bath during the day or at night may help aid sleep
Using a sling while you are awake can help make the baby fall asleep faster and wake up slower because they are close to you
“While it can be overwhelming when your sleep is disturbed during the night, it can also be a lovely quiet time to be with your baby away from the bustle and distractions of daytime. Babies rely on the security and comfort of being close to their parents and need this at night as well as during the day.” - UNICEF
If you find yourself in need of some sleep, a postpartum doula can help!
Sources
(1) Rijt , Hetty, et al. The Wonder Weeks: A Stress-Free Guide to Your Baby’s Behavior, Countryman Press, 2019, pp. 60–85.
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