Postpartum sleep strategies

Welcome to your fourth trimester. Whether it’s your first or fifth time around the newborn-parenting block, you’ve likely heard some wild things about sleep. The common narratives go something like this: It’s terrible! You’ll never sleep again! You’ll be up all night! Your baby will wake up every hour! Did I mention you’ll never sleep again?!

No one needs this kind of negativity, right?

There’s a whole lot of anxiety and confusion surrounding infant sleep—and parent sleep—during the first year of a baby’s life. While your baby’s sleep may feel unpredictable, yours may feel elusive (or at least frequently interrupted). Between four and eight weeks postpartum, moms wake up an average of three times per night, for 49 minutes each time, according to a recent study¹.

During these early days, you may feel overwhelmed. Trying to run a household while tending to your infant’s ever-changing needs (not to mention your own!) can be incredibly challenging. With your established habits thoroughly disrupted, you may feel like nothing is within your control. Adequate sleep is a crucial need, especially if you are planning to return to work.

Sleep loss can hit you hard. It can make you feel frantic—like you have to control your baby’s sleep in order to soothe your exhausted self. This natural response is very common but not very helpful.

This guide is designed to help you learn about ways to support yourself—and seek support from others—during the first three months of your baby’s life. You may learn some things about sleep that surprise you, or run counter to what friends or social-media posts have told you, about newborn or postpartum sleep. Don’t worry; some of this information or advice may actually feel liberating! (Hint: You probably don’t have to change your baby’s diaper at every wake-up or burp after every feeding.)

The first few months are very likely going to be more challenging than you imagined. But as your baby adjusts to life outside the womb and grows, you’ll make your own adjustments and grow as a parent. You will undoubtedly make many sleep adjustments along the way.

Take comfort in knowing that your current sleep challenges will likely change soon. There’s only so much you can know in any given moment, but you likely know more than you think you do. It sounds like a paradox, but trust your instincts.

As you are hit with the initial round of sleep deprivation, you may feel a bit betrayed, wondering, “Why didn’t anyone warn me about this?” This is normal, especially if your friends and family are wary of freaking you out. (They also know that every baby is different, particularly regarding sleep.) That said, you can pregame the sleep challenge a little bit by setting up supports and being prepared to make adjustments. Your inner circle will be there for you, once you’re in the thick of it.

There’s a lot to cover, but let’s acknowledge the proverbial elephant in the room here: your decision regarding if or when you are going to return to work. Planning to return to the office, in person or virtually, may increase your desire to get a handle on your sleep. And without a doubt, this desire can get intense.

There’s no way to sugarcoat it: A whopping 67 percent of American women, regardless of whether they’re a parent, have trouble sleeping¹. If you’re one of the lucky women who has never experienced sleep issues before becoming a mom, when you have a baby, you might be surprised that lack of sleep can be an issue.

Not every new parent is going to experience major sleep issues, of course. But here is the cold, hard truth: Parenthood brings sleep interruptions galore, especially in the first few months. One study shows that more than half of parents report losing two or more more hours of sleep for about the first 12 weeks² of their baby’s life. Another study indicates that “socioeconomically disadvantaged/racial/ethnic minority mothers” typically face ongoing sleep disruptions at 5 months postpartum, with fewer than half getting the recommended seven hours of sleep per night³.

Sometimes, the sleep interruptions are:

• Practical: Your baby has middle-of-the-night needs to address.
• Biological: Your regular circadian rhythms are disrupted due to inconsistent bedtimes and waking times⁴, which prevent you from getting deep sleep.
• Physical: Pain or discomfort stemming from pregnancy, labor, or postpartum conditions such as mastitis makes it hard to rest, let alone sleep.
• Routine-oriented: Without good sleep hygiene, you are having a hard time falling or staying asleep.
• Psychological: Parents with perinatal mood and anxiety disorders (PMADs) are significantly more likely to suffer from sleep deprivation⁵.
• Hormonal: A mother’s hormone levels significantly change during pregnancy and after delivery. Oxytocin alone can keep a mom on heightened alert.

Sometimes, of course, you’ll experience a combination of these sleep interruption factors, along with a running (and increasingly long) list of to-dos in your brain that makes it hard to snooze.

Try not to worry. Postpartum sleep struggles don’t necessarily signal a new and permanent state of affairs. This guide is designed to provide you with a better understanding of why you need sleep (and what qualifies as adequate sleep for parents of infants), what can keep you awake (beyond baby-related interruptions), how to better prepare for and optimize the sleep you do manage to get, and what to do when all your valiant efforts still result in #sleepfail.

Why is sleep so important?

Before we dig into how to repair broken-up sleep cycles, it’s worth looking into why sleep is important in the first place. We innately know that we feel better when we get enough sleep—and worse when we don’t. The most obvious red flags of insufficient sleep show up in mood changes (irritability) and cognitive function (forgetfulness, poor concentration).

Proper and adequate sleep also keeps us healthy in ways that aren’t as obvious. As behavioral sleep medicine psychologist Dr. Shelby Harris says, “Sleep at night is meant to make our days better.” If it’s not, we need to look at why we aren’t sleeping—and how to turn things around.

What’s keeping me awake?

We talked to Dr. Shelby Harris about what happens during the pregnancy and postpartum periods, as it pertains to sleep. Sleep interruptions abound when you’re taking care of a baby with needs around the clock, but there’s more to perinatal sleep issues than infant care. Your hormones are working for you and your baby, but against you and your sleep cycles. Rest assured, there are things that you can do to get better sleep when seemingly all else has failed.

Hormones and baby needs aside, interpersonal and environmental factors can also impact your sleep. These short audio excerpts highlight one parent’s issues with being exhausted, staying asleep, and attempting to coordinate the sleep schedules of multiple children.

You’re not alone in your quest for a good night’s sleep as a new parent. You’re basically renegotiating sleep and your relationship to it. To adapt to these changes, you’ll need some tactics and strategies. But if your child is sleeping better, and you are not, then it’s time to get some help.

How do I optimize my naps?

With time being a precious resource, and sleep being a coveted activity, it’s great to approach naps with a little planning and everything you need at the ready. A healthy mind-set can translate into new habits.

How do I improve my nighttime sleep?

Improving your relationship with sleep likely means taking a multipronged approach. Here are some tools to implement simultaneously—or one at a time—depending on your situation and needs.

These short audio excerpts can help you better understand your struggles with sleep and how they can impact your relationships.

How to approach your baby’s sleep

In the first three months, one of the few things you can count on is that your baby will have needs throughout the night. Night wakings are a biological imperative for newborns and a normal part of the 24-hour parenting cycle.

“Up until about 8 to 12 weeks, a baby distributes their sleep across all 24 hours, rather than sleeping more at night than during the day,” Gordon says. “Most parents find that their baby has some periods of wakefulness at night, when they seem ready to party, and times of the day when they are out like a light. This has to do with the still-developing pineal regulation of circadian rhythms.”

In short, your efforts will likely have less of an impact on your baby’s sleep during those first few months than you might think. Gordon says it’s more dependent on your little one’s stage of development, from the digestive system to the brain. There’s also only so much volume a baby’s tiny stomach can take in one feeding.

“It’s important not to set the bar unnaturally high for either the baby or yourself,” Gordon says. “Everyone needs some time—and grace—to gradually figure things out.”

Your days aren’t quite the same, now that you’ve got a newborn. Suddenly, your job description has become longer, your workload is exponentially heavier…and sleep? Well, you’re definitely not getting enough. There’s an incredible amount for you (and potentially your partner) to manage during the daytime, and you’ll need strategies to work through it. It’s a new world.

Dealing with daytime exhaustion (and chores) means employing some preventive tactics based on maximizing rest, refueling your energy, and coping with sleep deprivation. It’s a key parenthood challenge, and it’s not permanent.

Planning for the night

It might feel strange to think about sleep during the day (other than wistfully), but your daytime activities—including getting some restorative rest—can set you up for better sleep at night.

Coping with sleep deprivation

You might have had stellar sleep hygiene before kids. Well, sleep is among many important—and often routine—things up for renegotiation after the baby arrives. You’ll likely be battling a combination of exhaustion and adrenaline—and feeling overwhelmed to the core. Getting through this period requires a new daytime mind-set. You’ll need to lower your expectations in lieu of a gentler, less exacting approach to your daily living. Doula and midwife assistant Emily Varnam shares her insights and expertise about how to manage sleep deprivation.

Troubleshooting the daily workload

It may already be clear to you that moms typically do the lion’s share of the baby-related labor. If you have a partner or other help, family or employed, it’s smart to think about how to distribute the workload. Ideally, you and your partner figure out an equitable split. The sooner you start these conversations, the better—but it’s never too late to start!

Managing infant naps

Your baby is going to sleep a whole lot during the day—more than perhaps you might have realized. (So. Many. Naps.) Although you’ll often be home for naps, your baby may also fall asleep in the car, in the stroller, or in the baby carrier while you’re out and about. This scenario becomes more likely as you have more children; the baby often needs to go where you all go! Here you’ll find tips to optimize your newborn’s sleep—and help you and your family get through this challenging period more smoothly.

Let’s say you need to be hands-free to run an errand or get something done in the house, yet your baby could use a cuddle and a nap. This is a good time to strap on the baby carrier or sling. Or better yet: Strap it on to your partner or caregiver. Babywearing is a lovely way to share the load—your infant—with others while addressing your needs.

As Dr. Laurie Jones, a pediatrician and founder of Dr. MILK (Mothers Interested in Lactation Knowledge), says, babies typically give nonverbal cues, such as hand-to-mouth movements to indicate hunger, before beginning to cry. And when your baby is nuzzled against your chest in a carrier, you can feel—and even address—these cues more quickly than when your baby is sitting in a car seat, stroller, or swing.

There’s something beautiful about watching a newborn baby sleep, especially after a feeding or a long period of crying. You may feel a blissful moment of peace (and accomplishment, let’s be honest) as your baby rests. In your first three postpartum months, any sleep you can find (for you or your baby) is welcome and rewarding.

It’s commonly understood that newborns need a lot of sleep. (Eat-sleep-cry-poop, right?) But the nature of infant sleep—what it can look and sound like, and how best to facilitate it—may feel confusing or downright daunting, as you begin your motherhood adventure.

Even if you’ve spent a lot of time around newborns, your baby’s sleeping preferences and patterns likely won’t match your expectations. Not to worry. Chances are, like everything else that seems strange or unfamiliar about parenting, it’s all probably perfectly normal—and bound to change!

Nature of infant sleep

One of the first things you might notice, once you’ve brought your baby home, is the noises he or she makes when sleeping. You may at first think that you are hearing a small animal growling, giggling, burbling, or screeching. And thanks to your elevated levels of the hormone oxytocin, which are associated with excessive alertness, these sounds may alarm you and prompt you to wonder if your baby is OK. (The answer is most likely yes.)

“New parents’ brains are wired for hyper alertness,” says Emily Varnam, a midwife assistant and birth and postpartum doula, and infant sleep sounds can be downright jarring.

Infants often are quite active while sleeping. They may flutter their eyelids, grunt, stretch their limbs, breathe rapidly, or even cry, before returning to a quiet stillness. Unbeknownst to new parents, they did some of these things while sleeping in the womb too.

“Babies have active and quiet periods in utero,” says Dr. Laurie Jones, a pediatrician and founder of Dr. MILK (Mothers Interested in Lactation Knowledge). And when your baby is born, voilà, you can finally see and hear the action you’ve been feeling.

“Exposure to sunlight sets the body clock for day and night outside the womb,” Dr. Jones says. Especially during the first month, she says, taking your baby out on two 15- to 20-minute walks per day, exposing your baby's face and limbs to sunlight, is helpful in making this adjustment.

Duration of infant sleep

Newborns sleep a bit like cats. The average newborn sleeps between 16 and 18 hours a day—that’s about 70 percent of the day!—but this isn’t all detectable by the human eye. Eight to nine of those hours are at night, and the rest consists of daytime naps, snoozes, and other bits of sleep—far more during the day than you might have expected.

“Parents cannot monitor this, even if they try,” Dr. Jones says. “The actual sleep parents can observe is different from brain wave sleep through some of the lighter sleep stages.”

Dr. Jones generally advises parents to not attempt to track their babies’ sleep hours—and to try to not worry about how much sleep they’re getting.

“Infants cannot deprive themselves of sleep in any way that would hurt their body,” she says. A teenager can, but barring parental neglect in a dangerous environment, “infants and younger children will get the brain sleep their body needs to grow and thrive on their own, without any parental intervention.”

In general, newborns in good health sleep no fewer than 11 hours and no more than 19 hours per day. If your baby’s sleep hours in a 24-hour window are well outside either end of this 11- to 19-hour range, check for signs of illness:

• Take your baby’s temperature (does he have a fever?)
• Track your baby’s daily number of stools and/or wet diapers. For each day of life, a void and a stool are added until you reach day 5. From day 5 through day 30, you can expect about six to eight urine discharges, and six to eight stools, per day.
• Note how your baby responds to sleep, feedings, or being held (is she inconsolable?)

If in doubt, don’t hesitate to call your pediatrician, who likely will want to check on your baby’s body, including weight, length, ears, and lungs.

“It doesn’t matter how many times you ask for reassurance—it’s OK to ask those things, because you aren't crazy. Babies aren’t invincible,” midwife Varnam says. Your pediatrician wants to help you understand what’s normal—and what may not be. You are the best witness of your baby’s behavior, even if you aren’t 100 percent sure of what you’re experiencing.

We know how much you want to reach that “sleep through the night” milestone, but as Dr. Jones explains it, “there’s a disconnect between the medical definition and cultural norms. The medical definition is five hours of continuous sleep, but culturally, it usually means 10 to 12 hours.”

“You might witness a five-hour stretch at 8 weeks,” Dr. Jones says. “Some babies hit that sooner, some later. Some don’t sleep a full 10 hours until after 12 months. But if you’re feeling the need to sleep-train under 3 months, you don’t have enough help.”

When to start establishing routines

As parents, it’s tempting to want to impose our sleep desires on our babies—adults need sleep too! But babies will do what babies do, and that’s sleep, eat, cry, and need diaper changes. It’s all good.

“Parents really can’t enforce routines on infants before their brain will let them. You observe the infant for their routine,” Dr. Jones says.

Once you start observing some patterns, it is easier to gently introduce routines, rhythms, and sleep associations. There’s definitely some value to the process. Dr. Jones says a bedtime routine should be simple, dependable, and easily repeatable.

“It can be three to four simple steps. Babies do like a predictable sequence to create positive, dependable sleep associations,” she says, particularly at night. “This helps them connect the dots so when there are partial awakenings, the same associations will help them get back to sleep. Maybe it’s a quiet, dark room with a sound machine. Maybe it’s soft music and singing a song to your baby beforehand. Keep it short and sweet.” And make it your own—you’ll experiment and intuitively find out what works for your baby.

Once you have started to introduce elements of a routine, you might be wondering if there are some general benchmarks for when baby sleep becomes a little more predictable—or when it’s time to differentiate between daytime and nighttime routines.

“Around 3 to 4 months is the earliest time that daytime naps become predictable. But even if you identify these times, you may not be able to live your life around these naps,” Dr. Jones says. You inevitably will need to break from any established routine to run errands or take care of older siblings, she says. Don’t stress; this is OK. Your baby will get enough sleep.

However, in terms of observable sleep, if the nap is taking place in your infant’s dedicated sleep space, and they’re going for several hours at a clip, you might wonder if you should wake up your baby. “Sometimes that third nap [or whatever the last nap of the day is for your baby] can bump into bedtime,” says Dr. Jones. In those cases, she suggests waking babies up at least two hours before you want to put them down to sleep at night. “Otherwise you will be forcing them to sleep, and they won’t be ready, but if you deprive them completely of that third nap, they will have the most horrible bewitching hours,” she says. Withholding that third nap entirely, then, is not a great idea for your baby—or you.

See our guide on sleep zones to learn more about the best and safest places for your baby to catch some zzzs.