Saturday, 31 August 2013

Does my newborn need a routine?

As a new parent, there are many questions swirling around your head and one of them is bound to be about routine.  Your midwife or health visitor will offer one suggestion, the books you read may contradict them.  Where do you start and what is the right decision?  The key is to follow your baby's lead, feed on demand initially (particularly if breastfeeding) and then have a plan in mind that you are working towards.  Teaching your baby the skillls he or she needs to cope for longer periods between feeds as time goes on and getting baby used to a mosses basket or crib for naps and night time sleep certainly will help to establish healthy sleeping patters from day one, something that is far easier to stick with as time goes on than to implement once sleep or routine issues start to arise.
The womb environment is completely different to the outside world and while your baby was quietly rocked to sleep by Mums daily activity, you may notice how baby was active at night when Mum needed to sleep and wasn't available to provide the rocking motions that take place when up and about.  It can take some time for your newborn to realise the difference between day and night, it's not something they will automatically know to change once they're out of the womb.  The process can take days or several weeks depending on your baby and his or her personality, likes and dislikes, feeding schedule and the interaction that takes place throughout the day and night. Not particularly helpful to sleep deprived parents.  

That said, there are some very effective steps that you can take to help baby to adjust and move towards a more normal sleeping pattern, longer stretches between feeds at night with less activity or stimulation and more alert and playful times during the day.  If your baby is struggling to sleep for longer periods at night or you feel that baby has the days and nights the wrong way around, please do get in touch as this is one of the areas that I feel passionately about and have had much success in resolving.  There is no need to worry, it can be sorted out!

Initially, baby will sleep anywhere from 16 to 21 hours.  It may not seem like it at the time as feeding schedules mean it feels as though you're constantly together, feeding and rocking but by keeping a record, you'll quickly see the pattern emerging.  As times goes on, baby will be able to stay awake for longer periods which is great news, this means that baby will also start to move towards the beginnings of a routine and longer naps during the day and night.  Sleep will still consume approximately 14 to 16 hours in the early weeks and up to about the six week point and by 3 months old, the average amount of sleep in 24 hours is still roughly around 14 hours.

Your baby only has one means of communication at this early stage.  It is expected that your baby will cry for anywhere between one and three hours in a day (this is over a period of 24 hours, not all at once!) and it is a completely normal part of the process. Your baby is telling you that he or she is tired, wet, has a dirtly nappy, is hungry or uncomfortable.  Sometimes they just want a cuddle!

In approximately 5-10% of newborns, colic can be an issue.  This usually starts between the fourth and sixth week following birth and can last until baby is between three and four months.  It tends to cease as if it was never an issue rather than something that gradually gets less obvious.  In this case, baby will cry for hours on end, usually at the same time of day and it can be a very challenging issue to deal with.  There are some very effective methods and medications the help but ultimately, as a parent, you will need to comfort your baby as much as possible during the bouts of discomfort.  Recent research suggests that there may be a link between colic and probiotic treatment.

All babies are different and will develop at their own pace.  You can promot sleep by ensuring that there is a clear difference between day and night.  You can leave the tv or radio on during the day if the house tends to be quiet and you can keep things quieter at night and ensure that baby has a dark room (I always recommend blackout blinds as darkness stimulates the production of melatonin, the hormone responsible for inducing sleep) and make sure that the room temperature is between 16 and 20 degrees so that baby is comfortable.  Some babies, if over-tired or over-stimulated will have difficulty getting to sleep.  By keeping the same calm and relaxing routine before each nap time and in the lead up to bedtime, you will be laying a good foundation on which to build positive sleep associations. It is worth remembering that an over-tired baby will find it harder to sleep, so focus first on watching for your baby's sleepy cues and then work with those to establish the routine rather than forcing a time that means your baby may become cranky and over-tired, sabotaging his or her ability to self-settle at bedtime or nap time.

Some babies may find it easier than others to adjust to life outside the womb.  As parents, we all have our own unique style or interpreation of what we believe is best for our baby.  As long as you are consistent from the very beginning you will be helping your baby to identify what is coming next and thereby teaching him or her to accept the routine in the long run.
Most importantly, enjoy every minute of your new baby, the time goes by so fast and before you know it, you'll be longing for those precious times you shared together.  Happy parenting!