Getting Baby to Sleep (0-3 Months)
Module 3: Infant Sleep, Soothing & Safety

Newborn Feeding, Sleep, and Safety

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Newborn Sleep, Safety, and Nutrition

20 MINUTE READ

Published August 2024

AUTHORS

Melissa O’Neill, PhD PMH-C
Contributing Editor, Registered Nurse

Katie Sardone, PhD PMH-C
Head of Clinical, Licensed Psychologist & Perinatal Mental Health Specialist

Margaret Vadiee, PhD
Contributing Editor, Licensed Psychologist

Congratulations on your new baby! Parents often feel lost and have more questions than answers at this phase, which is why we’ve created the newborn-to-three month manual that never was! We cover what you need to know to care for your baby in the early days -  sleep, nutrition, safety, soothing and so much more.

It doesn’t all go by “so fast” at the beginning . . .

The first days at home from the hospital can feel like long days, which turn into long nights, which turn into more…long days. We know how wonderful this time is, but also how challenging it can be as parents. We hope this guide serves as your much needed newborn-to-three month parent manual for all the practical questions about caring for your baby. While all babies are different, having a resource to help navigate this period and to reference common concerns can alleviate so much stress. Less stress, and eventually more sleep, will help you enjoy this time. 

We know it’s a lot, so don’t feel like you need to memorize any of it. Feel free to reference this guide at any point, and know that your Coach is just a text away. We’ll meet with you several times to bring this to life in your home!

If you remember nothing else…remember this: give yourself grace, rest when you can, and accept any and all support from family and friends available.

Breaking it down further

Baby’s feeding schedule

  • At first, your mindset should be: Operation Weight Gain! Babies naturally lose weight after delivery – it’s a stressful process for both mom and baby! Ideally, we want them back up to birth weight by two weeks, which your pediatrician will help to monitor. Don’t panic if you’re not exactly on the path you thought you’d be on. Babies need to eat frequently because those tiny tummies cannot hold much -  their stomach is about the size of a marble. It starts to grow to the size of a walnut by Day 3. While feeding volumes are small, they are crucial. Expect your baby to eat every two to three hours (including overnight), and don’t hesitate to wake them during the day if they’ve gone beyond this window without eating. This will allow you and your baby to maintain some semblance of a schedule. 

    Night time feeds can sometimes feel lonely no matter how you are feeding your child.  If you are breastfeeding or have limited practical support at night, you may also be feeling the weight of it always having to be YOU.  Reach out to your coach to brainstorm ideas about how to keep yourself company during the nighttime hours. You may want to listen to something or even set up times to chat with your Coach! This program comes with tons of coaching sessions exactly for this purpose. Having someone to chat with and to listen can be incredibly stress reducing during the early days!

  • With approval from your pediatrician at your baby’s two-week weight check, you can begin implementing a consistent daytime/night time feeding and nap schedule.  Feeding every three hours is a great benchmark (including overnight), and you can allow for longer stretches of night time sleep as your baby allows. By Day 10, your baby’s stomach grows to the size of a golf ball, so it can accommodate up to 2 oz. of milk. That’s still not very much!

    We are creatures of habit and consistency feels good to you and your baby.  A consistent daytime schedule helps every day look the same (a little more predictable for you!). A schedule also helps your baby establish their circadian rhythm. Perhaps unsurprisingly, mom’s circadian rhythm is disrupted immediately postpartum, but can start to return to normal in weeks 4-8. The goal is to help your baby develop their own circadian rhythm by synchronizing with mom’s circadian rhythm. By creating a more consistent schedule early on, you are setting yourself and your baby up for a lifetime of strong sleep and nutrition habits.  A proper feeding/sleep schedule has a pretty late bedtime during these first two months (somewhere around 8:30 or 9:00 pm). We want to feed your baby right before bedtime to help get longer stretches of sleep at night. 

  • At two months and over 12lbs, most babies are capable of sleeping through the night! It’s a great time to really solidify the schedule to get you those extra nighttime “zzz’s”.  If your baby is over eight weeks and stays up longer stretches during the day, it is time for an earlier bedtime (somewhere around 7:00 or 7:30 pm now). An early bedtime is crucial to supporting a full night of sleep.  Feeding every three hours and getting in four naps per day are appropriate now.  You should keep increasing those daytime feeding volumes and your baby will drop their nighttime feeding once they are able to get sufficient calories during their daytime feeds. 

Bottles for breastfed babies

Teaching breastfed babies to eat from a bottle can be helpful for many reasons.  You want to wait until baby is nursing well, latch is comfortable, and milk supply is regulated/consistent for mom.  Starting a bottle before the sucking reflex fades around 6 weeks is also helpful.  One bottle per day or one every other day is good practice.  Babies will forget, so you want to consistently remind them they can eat both ways. The bottle is easier and as a result babies will naturally start to prefer the bottle to breast. If continuing to breastfeed is important to you, you’ll want to limit the number of bottles to encourage baby to eat from both sources (and avoid frustration at the breast).One to two bottles max per day for breast babies is a good goal.  

Burping

Babies will naturally slow down about halfway through the feeding and at the end, when they are ready to burp.  So two burps per feeding is typically sufficient.  This is also a good way to wake them up a bit to finish the feeding. Try to burp baby for a couple minutes and if you are not getting a burp, resume the feeding.  

Diaper changes during feeding

If you find your baby “snacking” (i.e. not quite getting through their meal and then waking up 20-30 minutes later hungry) you may try to keep them engaged in mealtime more purposefully. One way you can do this is by doing a quick diaper change (the cool breeze helps to wake them up a bit!). If you’re breastfeeding, change their diaper after you finish feeding on one-side and before you swap to the other side. If you’re bottle feeding you want to aim for the diaper change about ½ way through and after burping. This is also a great way to involve your partner in the feeding process, and if you’re breastfeeding allows you and baby a bit of a break / reset before you finish the feed! Remember that feeding is serious work for a baby and can make both parties very tired - giving a small break / reset can be a huge help!

Baby’s sleeping schedule

It may have been a while since you’ve gotten a full night of sleep.  It’s exhausting… really exhausting.  Hang in there. By implementing healthy sleep associations early on, many babies can sleep through the night about the 2-month mark.  Keep in mind, sleeping through the night, means waking up throughout the night but getting themselves back to sleep.  Baby’s sleep cycles are short, 30-45 minutes initially.  In between these sleep cycles are brief awakenings.  With the helpful constant sleep associations listed below, your baby is able to transition through these sleep cycles more easily and get back to sleep on their own. If your baby is older than 2 months and not sleeping through the night, you are not alone (and you’re not a bad parent and your baby is not a bad baby).  Your coach and our team of experts are here to support you and your family in reaching your sleep goals no matter your child’s age.  It’s never too late.

The American Association of Pediatrics has published 22 recommendations surrounding safe sleep for babies.

According to the American Association of Pediatrics, babies should sleep . . .

  • It’s common for parents to be concerned about choking, but in reality, the baby's airway anatomy and gag reflex prevent this from happening (even in babies with Gastrointestinal Reflux Disease (GERD). If your baby flips over to their stomach feel free to return baby to their back. As soon as baby is able to roll both forwards and backwards you no longer need to worry about flipping baby back to her back. Either way, each time you put baby down put them to sleep on their back.

  • . . .like a crib, bassinet, play yard or device that meets the safety standards of the Consumer Product Safety Commission (CPSC). Never fall asleep with baby in your bed, on your couch or anywhere else. According to the AAP, the risk of sleep-related infant death is up to 67 times higher when infants sleep with someone on a couch, soft armchair or cushion. If this happens, don't punish yourself but remember that this is a sign that YOU need sleep too! Baby is safest in their own crib or bassinet.

  • ideally in the same bedroom for the first 6 months of life. Parents often find it helpful for baby to sleep in a bassinet close to both parents to make nighttime feedings easier in the early months. It’s also OK to put baby in their crib in another room with monitoring. See the resources section below for recommended monitoring tools.

  • No extra bedding, toys, bumpers, blankets, quilts, etc in/on/around the baby anytime they are sleeping unsupervised.

  • . . . to help reduce the risk of sudden infant death syndrome (SIDS).

  • . . . to avoid overheating.

  • Avoid covering baby’s head to reduce the risk of overheating.

Also according to the American Association of Pediatrics, parents should . .

  • Feedings with breastmilk are recommended as it is associated with a reduced risk of SIDS. Unless your doctor recommends another method or breastmilk production is low, leading with breastmilk feedings will increase baby’s sleep safety.

  • . . .during pregnancy and after birth.

  • . . . like marijuana, opioids, and other illicit drugs during pregnancy and after birth.

  • Maintain ongoing postpartum care after giving birth.

  • Infants should be immunized in accordance with the guidelines from the AAP and CDC.

  • . . . unless recommended by your pediatrician.

  • . . .to encourage motor development. Immediately after hospital discharge, short periods of tummy time are recommended, increasing incrementally to at least 30 minutes daily by 7 weeks of age.

  • If you choose to swaddle your baby (there is no evidence recommending a safety benefit to swaddling, rather it provides a better sleep quality benefit), make sure they remain on their back. See our detailed section on swaddling below for more tips.

  • Ensure that your physicians, clinicians, hospital staff, and child care providers understand, communicate, and exemplify safe sleep guidelines.

  • . . . and ensure that their marketing messages and products adhere to safe sleep recommendations.

  • More information on a specific product can be found on the Consumer Product Safety Commission’s website.

What the research says

  • Focusing on baby’s feeds and weight gain early on sets them up for proper development through the years. Consistent maintenance of a healthy weight can help reduce the risk of stunted growth in later years (American Academy of Pediatrics, 2022).

  • Utilizing a sleep strategy that incorporates at least 3 soothing strategies can reduce crying and improve sleep quality for baby (Singh & Menahem, 2023). 

  • Giving your baby massages helps to promote increased attachment between mother and child, as well as reduce pain reception (helpful immediately after baby’s immunizations) and improve weight gain (to reach developmental milestones (Mrljak et al., 2022)

A couple other points on infant sleep

Your baby will also have to occasionally nap other places. It can feel like a learning curve for everyone, but it is helpful for your baby to practice napping in locations away from home. If your baby is not sleeping in something approved for infant sleep, on their back, they should be supervised 100% of the time.  

Sudden Unexpected Infant Death Syndrome (SUIDS) is a term used to describe the sudden and unexpected death of an infant under 1 year old prior to understanding the cause. SUIDS is an umbrella term that includes both Sudden infant deaths (SIDS), death from accidental suffocation while sleeping, and other causes. As much as it is painful to write about this topic, we want to provide you with the facts. According to the Centers for Disease Control, “About 3,400 babies in the United States die suddenly and unexpectedly each year.” SIDS risks can be reduced by following the safe sleep guidelines. For more information check out the Safe to Sleep resources from the NIH.

Swaddling

Your baby has a startle reflex, called the Moro Reflex, and cannot fully control those tiny hands and arms until about 4 months (for more on development please checkout our Survival Guide - The First 6 Months). The Moro Reflex causes an involuntary spreading of your baby’s arms followed by bringing the arms tight into the chest; it is thought to mimic survival grasping for their caregiver when they are startled by loud noise or sudden movements. Swaddling helps to make sure that even as your baby startles they don't accidentally wake themselves up prematurely. Swaddling not only helps your baby control the Moro Reflex but can also help facilitate a sense of being soothed and comforted (similar to how baby felt in utero), which fosters better, deeper sleep. 

We recommend a lightweight swaddle that allows you to secure your baby’s arms snuggly by their sides. This allows their arms to rest naturally and avoids stretching and hurting their arms before they have achieved a fuller range of motion. There should not be extra fabric near the baby's face and the swaddle should not be too tight across the baby's chest. Being able to insert 2 fingers between your baby’s body and the swaddle is a good rule of thumb to make sure the swaddle isn’t too loose or too tight. Babies should also be able to move their legs and knees freely, ensuring the swaddle is not too tight at their hips or knees to avoid hip dysplasia. No other items should be placed inside the swaddle. Do not use weighted swaddles as these increase the risk of SIDS.

As soon as your baby starts rolling over (even just once) it’s time to ditch the swaddle and move into a sleep sack (recommendations below). This typically happens around 3-4 months but can happen sooner!

Other helpful sleep aids

WHITE NOISE

Babies are used to a noisy environment.  A study (Smith et al., 1990) found that infants in utero listen to baseline decibel readings up to 88 db, roughly equivalent to the noise of a food blender.  Adding white noise to your baby’s sleep environment is soothing, and helpful in extending sleep stretches.

AMBIENT LIGHT

 A dark room at night and pleasantly dark for naps is optimal. If needed, you can use blackout shades to help control the amount of light in their sleep environment.  A little light will still filter in for naps, and that helps baby learn the difference of night and day. Your baby will also nap other places and be exposed to light during the day.

PACIFIERS

If your baby will take a pacifier, not only are they a useful soothing tool but they have been found to decrease SIDS risk. We recommend offering the pacifier for the first few months and taking it away when you take away around 6 months. While the pacifier helps soothe their sucking reflex in the first few months, your baby will gain more control of the muscles in their mouth, changing from an involuntary reflex to a voluntary action. If your baby continues to use the pacifier beyond 6 months, this can lead to increased risk of malformation of the jaw, tongue, and/or mouth with displacement of their teeth, which may impact dental health and speech in later months. This makes the 6 month mark the pivotal time period to wean your baby off of pacifiers.

About the authors

Melissa O’Neill, BSN
As an RN specializing in NICU and Labor & Delivery for 15+ years, Melissa is also a mother of 3.

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Katie Sardone, PhD, PMH-C
Dr. Katie Sardone is a Licensed Psychologist and the founder of Behavioral Health Dallas, PLLC.

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Margaret Vadiee, PhD
Dr. Margaret Vadiee is a Licensed Psychologist and a former Adjunct Clinical Assistant Professor at Southern Methodist University in the Psychology Department.

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Resources our Experts Love

  • NIH Safe to Sleep Resources ↗

  • American Association of Pediatrics: Safe Sleep ↗

Nutritionists

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Adult mental health

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Couples mental health

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Infant & child mental health

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Sleep coaching

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Nutritionists • Adult mental health • Couples mental health • Infant & child mental health • Sleep coaching •

When to get
expert support

If you think you need expert support, this is a great reason to pop into office hours. Sometimes you might need more support, and that's okay!

Below are a list of examples of when and how to get that support:

  • You will have frequent visits to your pediatrician at first to monitor the baby's health and weight. Use this time to ask questions that have come up regarding baby’s feeds, sleep, skin, fussiness, and whatever else pops up.

  • If your is under 2 months of age and has a fever over 100.4, call your pediatrician

  • If your baby is crying constantly for more than 2 hours straight without stopping call your pediatrician

  • If your baby is not eating well, lacks an interest in feeds, spitting up excessively and/or spit up is projectile or discolored, call your pediatrician.

  • If your baby has a persistent diaper rash that isn’t improving, call your pediatrician.

  • If your baby has a white tongue that cannot be scratched away with your clean finger, call your pediatrician to check your baby for thrush. 

  • If your baby has not had a dirty diaper in over three days or is having hard, pebble-like stools, stool is gray, black or blood tinged, call your pediatrician. 

  • If the umbilical stump or circumcision site is not healing well, has drainage and/or a bad smell, call your pediatrician. 

  • If your baby is turning blue around the mouth or lips, call 911.

  • Always trust your parental instinct. If you feel like something is wrong, reach out to your trusted medical professional asap.

  • If you find yourself feeling down, anxious, or not like yourself, reach out to a mental health professional for support.  You can also call or text the National Maternal Mental Health Hotline at 833-852-6262 (available 24/7 in the US).

  • If you are in a moment of crisis, call 911 for emergency support and/or 988 for mental health support (available 24/7).

Have a question for your coach?

Schedule time during their weekly office hours! We know not all questions come up on a schedule, which is why your coach is also available outside of the sessions included in your Learning Program.

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