“Sleep with one eye open, gripping your pillow tight.” Those are the immortal words of Metallica, but they could just as well refer to life as a new parent. Having a baby is life-changing, and it comes with both sweet rewards and great sacrifice. By the end of the first night with a newborn, even as we marvel at what we’ve gained, one thing we’ve lost is obvious: a good night’s sleep. As a new mom, I accepted that a certain amount of sleep deprivation was an unavoidable consequence of bringing a tiny human into the world. Still, I figured it was nothing an afternoon nap couldn’t fix, a temporary thing that would work itself out after a few months.
For some families, this is true. Some babies are easier than others, gifted with genetics that help them settle into sleep routines sooner rather than later. Some parents may be more tolerant of sleep loss and others — especially those with some experience — find strategies that work for them early on.
But for so many of us, things don’t get better, and we’re left confused, tired, and suffering the consequences of sleep deprivation.
“Sleep deprivation was catastrophic for me,” wrote Sheila Timler from South Bend, Indiana, in a blog post about her first baby, who had to be nursed to sleep, held for all her naps, and woke several times during the night throughout her first year. “I was tired all the time, and in poor health; I remember having a cough that I couldn’t shake for a month … I discovered a nasty temper that I’d never seemed to have in pre-baby days.” She described herself during that time as “exhausted, unhealthy, angry, and anxious.”
Timler’s experience with new parenthood is common, and it’s no wonder that it made her so miserable. Sleep is essential, and without it, we just can’t function well. It was a headline in the New York Times this week: “The Simplest Way To Improve Your Life: More Sleep.” Research shows that without enough sleep, we’re more susceptible to illness, more prone to weight gain, and at greater risk of being in a car accident. Our brains are impaired in ways that affect our memory and our ability to learn and regulate our emotions, with a clear relationship between sleep deprivation and increasing anxiety, according to a study in Sleep Medicine.
Those are all consequences of everyday sleep deprivation, but parents have added challenges.
Not only are we getting less sleep, what we do get is often fragmented, with sleep cycles interrupted without warning. Another paper in Sleep Medicine shows that getting eight hours of fragmented sleep (being awoken four times during the night) has the same effects on cognition and mood as logging just four hours of sleep. At the same time, we’re navigating changing relationships with our partners as we learn to be parents, and sleep deprivation is highly correlated to both maternal and paternal depression, which isn’t good for parents or babies.
We Have Normalized Sleep Deprivation
It’s a problem Dr. Phil Boucher, a pediatrician in Lincoln, Nebraska, sees frequently in his clinic. “A lot of parents are just totally beat down by not getting sleep and then really frustrated that they aren’t as present for their family as they want to be,” he told Romper in a phone interview. Sleep loss has a domino effect on a family’s health, he says, knocking down mental health and relationships, but also leading to more screen time for kids and less energy and motivation to cook healthy meals or exercise for parents. “They’re just so darn tired, and something has to give.”
Worse, Boucher sees parents who feel helpless and incapable of making things better. “They’ve been made to feel like this is a badge that they must endure and something that everybody has to go through,” he says.
SHE’S WORKED WITH PARENTS WHO HAVE BACKED OUT OF THE GARAGE WITH THE DOOR CLOSED, EXPERIENCED HALLUCINATIONS, AND REQUIRED SHOULDER SURGERY AFTER SLEEPING IN A SIDE-LYING POSITION WITH A BABY FOR TWO YEARS.
Alexis Dubief, author of Precious Little Sleep and founder of the associated website and Facebook group, agrees. “We need to stop talking about it like it's OK to be chronically sleep-deprived and parent and drive and do all the things that we do — that that's totally normal and acceptable to maintain that kind of severe exhaustion for years,” Dubief said in a phone interview.
She says she’s worked with parents who have backed out of the garage with the door closed, experienced hallucinations, and required shoulder surgery after sleeping in a side-lying position with a baby for two years.
I’m sure new parents have always been tired, but we have a lot of external factors working against us. Our culture is failing parents in so many ways, and sleep is no exception. So what can we do about it?
When Baby Wellness Comes Ahead Of Maternal Wellness
One issue is that parenting recommendations are made in silos of experts without considering parents’ wellness, sleep included. For example, breastfeeding advocates have recommended universal “rooming-in” on maternity wards, and as a consequence, newborn nurseries are closing.
New parents are expected to care for their babies 24 hours a day, after a long labor or a C-section (or worse, both). That may work beautifully for some families, but for others, it means they start their parenting journey already behind on sleep.
“If you need a breather because newborns are inconsolable and fussy, and it’s so hard when you’ve just given birth, we should have a well-baby nursery where you can safely hand your child to a qualified nurse and actually get two hours of sleep,” says Dubief. A recent Cochrane review found no evidence that rooming-in improves breastfeeding rates (a key motivation behind “baby-friendly” practices), and meanwhile, bed-sharing in maternity wards has resulted in heartbreaking infant deaths, as a study in the Journal of Perinatology found.
In another silo, researchers have made great strides in understanding SIDS and developing strategies to mitigate the risk. The Back to Sleep campaign of the 1990s led to huge reductions in infant deaths, captured by CDC data, a testament of the value of research. When babies sleep on their backs, they arouse more easily, which turns out reduces the risk of SIDS — but it may mean that our babies are more restless sleepers than the babies of a generation or two ago. And when they aren’t sleeping, neither are we.
The American Academy of Pediatrics also recommends keeping your baby in your room for the first year as way to reduce the risk of SIDS, but some research shows that babies who room-share beyond four months wake more often during the night and sleep less overall. They’re also more likely to end up in their parents’ bed by morning, a paper in Pediatrics found, and that’s associated with an increased risk of SIDS and suffocation. Likewise, when parents are determined not to bed-share but then fall asleep feeding their babies in a recliner, their babies end up at far greater risk than they would have been feeding in a carefully planned bed-sharing environment.
Education Around Sleep Doesn’t Go Far Beyond The Maternity Ward
We all want to do everything we can to keep babies safe, but sometimes it feels like we’re making impossible choices, all in the fog of sleep deprivation, and well-intended advice can have unexpected consequences. And while parents are usually educated on safe sleep practices in prenatal classes and before leaving the hospital, most of us go home with little training on what to expect when it comes to sleep, how to soothe a baby while using safe sleep practices, or how to help babies establish healthy sleep habits.
It’s worth setting your compass towards prioritizing sleep early on and doing what you can to protect it.
And so, we muddle through as best we can. Maybe we’ll get a chance to ask our pediatricians for advice about sleep every few months, but they’re also supposed to counsel us on feeding, vaccines, diaper rash, and car seats, all in 15 minutes or so. Elsewhere, parents in the UK have visiting nurses popping in at home with support and advice; in Australia, there are government-funded residential programs where you can stay with your baby for five days of professional guidance on sleep and feeding issues. Not so in the United States, where we’re left to figure it all out on our own. On top of that, the abysmal lack of paid family leave in the United States (ranked lowest in family leave policies among 41 developed nations by Pew Research) means we’re expected to get back to work within a few weeks to months, sleep or no sleep.
What are we supposed to do? For most of us, we turn to the internet and fall into an abyss of conflicting information and opinions about infant sleep, full of harsh rhetoric. If you finally find something that works for you and you’re starting to get some sleep, whether you’re bed-sharing or sleep training, you can expect someone on the internet to criticize you for your choices and tell you that you’re harming your child.
Here’s my advice to new parents: Prioritize sleep at every stage. Know that it’s vitally important to the health of your family. If you’re struggling with sleep, find support from your pediatrician, friends, a sleep consultant, or a Facebook group, and make a plan to fix it.
There’s no universal formula for good sleep. Babies are different, and they’re constantly changing. (And sleep issues don’t stop in infancy; I’m helping my 3-year-old work through night fears right now.) It helps to be flexible and open-minded, but I do think it’s worth setting your compass towards prioritizing sleep early on, and doing what you can to protect it.
Do: Tag Team During the Newborn Stage
It’s a biological reality that newborns have no clue whether it’s day or night, need to eat frequently, and will have poop-splosions requiring a change of diaper and pajamas and swaddle and bedding in the middle of the night. Our job during this stage is to “survive it, keep everybody safe, and figure out feeding,” says Dubief, and getting some reasonable sleep for yourself should be part of your survival plan. “Think about what you can do to get four hours of sleep for all people involved because your newborn may not sleep four hours reliably for weeks,” she says. Work as a team with your partner, invite relatives to come and help, and accept help from friends.
When my babies were newborns, my husband took late evening shifts, and my mom flew in from across the country so she could take an early morning shift from about 4 a.m. to 8 a.m. Knowing that I could count on those hours of uninterrupted sleep was everything to me, and we all had a chance to practice our soothing skills and bond one-on-one with the baby.
For Emma Purdue, 37, of Queenstown, New Zealand, getting enough sleep meant going to bed at 8 p.m. until her three babies started sleeping through the night. “I think all too often we’re unprepared to change our habits to accommodate the newborn’s needs. Going to bed early is only for a few short months, and man did it save my sanity every time,” she wrote to Romper on Facebook. Purdue is now a sleep consultant, and she says this is still the advice she gives to parents of newborns.
Do: Teach Your Baby How To Fall Asleep On Their Own
During the newborn phase, Dr. Boucher says you can start shaping your baby’s sleep by reinforcing natural signals about day and night. Open blinds and get outside during the day for natural sun exposure, and keep the house dark and quiet during the night. You can also start introducing a bedtime routine so that your baby learns predictable, soothing rhythms around sleep.
The less involved you are with the onset of sleep, the less your baby will need your soothing during the night.
Dubief says that crying usually peaks at about six weeks, and then fussiness and sleep gradually get better after that. At around three months, there’s an opportunity to “pivot” from survival mode to “more of an intentional approach,” including paying attention to how long your baby is awake between sleep periods and working on falling asleep more independently. At this age, you can take a stepping stone approach. For example, if one of your newborn survival techniques was bouncing the baby to sleep on a yoga ball, you might start swaying or rocking your baby to sleep instead, then letting her fall asleep in your arms without motion, then putting her in the crib and patting her to sleep, and so on. (Dubief’s book includes many more strategies, and I highly recommend it as a resource.)
The goal here is to start letting your baby fall asleep on their own. After decades of research on infant sleep, one of the most consistent findings is that babies who can fall asleep independently at the start of the night are likely to be able to do the same during the night, leading to longer nights of sleep with fewer interruptions for you or the baby. The less involved you are with the onset of sleep, the less your baby will need your soothing during the night, and sleep can start to become more consolidated for everyone. Pausing before feeding your baby during the night, trying to soothe in other ways, and working towards reducing the number of night feedings is associated with longer stretches of sleep, as shown in the Archives of Pediatrics & Adolescent Medicine.
If the incremental approach between three and six months doesn’t work, or if you were too tired to try it, then you might be stuck bouncing or rocking or pacing with an increasingly big baby through the night. With older babies, the gradual approach is less likely to work, says Dubief, and you may be looking at sleep training to give your baby a chance to learn to go to sleep on their own.
Do: Sleep Train Without Guilt Or Worry
The research on sleep training is clear. Multiple studies show it won’t affect your baby’s attachment or stress levels. It helps babies and parents get more sleep, according to a paper in Sleep, and it can improve maternal mental health, per Pediatrics. And once everyone starts getting more sleep, families can function so much better.
Can we unhook all the language of trauma that is not founded in science or evidence and say it's OK for kids to be unhappy about a change that we're making, and that change can still be the right thing for us to do?
But there’s no doubt that sleep training is hard. Babies invariably will protest being put in their bed and left to figure out how to go to sleep on their own, and none of us like to hear our babies cry. But a big part of why it’s so hard is that vociferous opponents have claimed that it’s harmful to babies, citing unrelated studies about child neglect as evidence. Or they make comments like, “If you wanted to sleep, you shouldn't have had kids.”
“This is nonsense,” says Dubief. “There is an immense amount of shaming, judging, guilt, and just kind of traumatic language that we’ve appended to sleep training. Can we unhook all the language of trauma that is not founded in science or evidence and say it's OK for kids to be unhappy about a change that we're making, and that change can still be the right thing for us to do?”
For Sheila Timler, the exhausted mom from South Bend, Indiana, getting past the fear of letting her baby cry was the turning point towards good sleep. The first night her daughter fell asleep on her own, she cried for 23 minutes, followed by eight minutes the second night. On the third night and beyond, there were no tears. She’s since had three more children but hasn’t needed to sleep train any of them, instead focusing on setting up good sleep habits from the start, she told Romper in a Facebook message. “I worked diligently to give them sleep as soon as they looked drowsy, and the rest just took care of itself.”
Dr. Boucher’s message to parents is this: “There's good evidence that sleep training is effective. It's safe, it's not harmful and it helps families to function better.” He tells families in his clinic to try it for a few nights, and if it doesn’t work, he’ll buy them dinner. He has yet to buy anyone dinner; instead, he says parents bring him lots of chocolate in gratitude that they’re finally sleeping.
Alice Callahan is the author of The Science of Mom: A Research-Based Guide to Your Baby’s First Year.