Sleep Shaping

How to establish healthy sleep habits for baby

Sleep shaping, sleep hygiene and sleep conditioning are terms for essentially the same thing: establishing a healthy sleep routine and environment from the start that support a good night’s rest for baby and parents. The goal with each is to create sleep associations that babies have throughout development, helping them fall asleep independently from the beginning. Your baby may want to nurse or rock to sleep, but baby will need to be weaned from those things at some point. Don’t get me wrong, rocking is a necessary and recommended way to soothe your baby, but it should be used as a tool, not a crutch. If you rely on this method every time, it’s the only way she’ll be able to fall asleep.

Habits are very easy to start, but much harder to break.

Sleep conditioning, shaping and hygiene are not to be confused with sleep training, which comes into play when healthy habits haven’t been established from the start and it’s necessary to break unhealthy habits.

Start baby (and parents) off on the right foot with the following tips. Consider the use of an overnight doula for additional support, if needed.

Rules for Healthy Sleep Habits when Baby First Comes Home:

• Allow baby to fully wake up before trying to soothe or pick her up from the crib or bassinet.

• Do not use feeding as a way to calm baby down. Feed baby if she is hungry or because it is feeding time. Overfeeding can cause baby challenges in the long run, such as digestive issues or dependency on food to calm down when stressed.

• After feeding, baby should be fully satisfied and should not need a pacifier. Very rarely do babies need a pacifier after a full feed. If baby is still rooting after a feed, it’s possible she has discomfort and needs to be burped, she is still hungry, or she is tired and is relying on suck to sleep. If this happens, try to burp baby first, then try to offer breast or bottle again to see if she is still hungry before offering the pacifier as a last resort.

• Put baby to sleep for naps and bedtime without a pacifier. Use pacifiers as a way to soothe babies; do not make baby dependent on the pacifier to stay asleep. If baby needs a pacifier to soothe to sleep, that’s OK, but if the pacifier falls out, let it be. Don’t keep putting it back into baby’s mouth.

• Have baby sleep on a flat surface (such as their crib or bassinet) from the beginning, day and night.

• Allocate 12 hours for daytime sleep and 12 hours for nighttime sleep as soon as baby comes home from the hospital. Babies are born with an internal clock, but it’s up to parents to program it correctly. Put baby to sleep after a 7 p.m. or 8 p.m. feeding. During the following 12 hours of “nighttime,” there is no stimulation and minimal light; only feeding, diaper changes and sleep. During the day, feel free to have lots of lights and noises on. Take baby outside at least once a day to help set the internal clock.

• Babies need a lot of sleep in the beginning. Be sure not to keep baby up all day with the idea that she will sleep better at night. Babies need sleep during the day and at night. Follow age-appropriate wake windows, which for the first 12 weeks are 30-90 minutes long (and follow baby’s cues).

Nighttime Guidelines for First Four Weeks:

• Keep light as low as possible or use red or orange nightlight (which helps create melatonin in the brain).

• Keep sound machine on all night.

• Try to keep all stimulation to a minimum (low voices, calm environment).

• Un-swaddle prior to nighttime feeding for the first 2–3 weeks.

• Change diaper before feeding. This allows you to put baby down after feeding without changing her again; it also helps waken baby (if she’s asleep) for a full feed. Baby may poop during the feed, so another diaper change is possible.

• Do not feed before the three-hour mark at night (unless pediatrician says otherwise). Try to encourage full feeds every three hours. If baby is breastfeeding, you may experience nights of cluster feedings (where she wants to eat more frequently), this is especially normal if baby is going through a growth spurt; if you are bottle feeding, follow baby’s cues.

• When you first tend to baby at night, try soothing her while she’s in the crib or bassinet until it is time to feed. Use the “ladder of support” to figure out what she needs. Start with shushing and gently patting, then try light bicycle kicks (to make sure there’s no gas); if that doesn’t work, try the pacifier. If you spend a few minutes on each and baby is not soothed, then pick her up to determine if she needs to be burped, needs a diaper change or needs to eat.

Nighttime Guidelines for Weeks 5–12:

Starting with week 5, baby has usually gained enough weight that she can feed more during the day and sleep for longer stretches (and fewer wake-ups) at night. This is a good time to start focusing more on the nighttime routine.

• Start implementing your nightly routine 6 p.m.–8 p.m., based on baby’s cues.

• After nighttime routine, lay baby in her crib awake and happy (but ready for bed).

• Keep light as low as possible or use red or orange nightlight.

• Keep sound machine on all night.

• Un-swaddle prior to feed.

• Change diaper after feed (unless there is a poopy diaper beforehand that needs to be addressed). Changing baby’s diaper after the feeding will wake her if she’s fallen asleep, which helps prevent any feeding/sleep associations. v

Stevie Trujillo is a Certified Postpartum Doula and certified sleep consultant in San Diego County. Learn more at www.stevierosedoula.com.

Common Questions

What are methods to address baby’s gas?

• Bicycle kicks

• Tummy rubs

• More tummy time during the day

• Probiotics (if approved by your pediatrician)

• Visit to a specialized chiropractor

My baby makes so much noise at night. Is she OK?

Babies make a lot of noise at night, which is completely normal. If baby is grunting, moaning, wiggling or just mildly fussing, it doesn’t mean baby needs to be soothed. If baby cries for a moment, she could still be asleep. It’s best to wait until baby is at a full cry before responding. Responding too soon could actually wake your sleeping baby.

How do I know if my baby is going through a growth spurt?

Growth spurts are common in the first month, during which times babies will cluster feed (eat more frequently) to help Mom produce more milk. If you’re not sure if baby is going through a growth spurt, the Wonder Weeks app provides helpful growth spurt information based on baby’s age and due date.

I’m overwhelmed. Who can help me?

Consider hiring an overnight postpartum doula who will take care of baby’s needs while supporting Mom’s recovery and the parents’ need for sleep.

Postpartum doulas provide support to the entire family with evidencebased information, resources and emotional support to parents, as well as help with light chores such as baby’s laundry, washing bottles and meal prep.