0-6 weeks Baby feeding and sleeping advice: Free
Babies and sleep, feed, wake cycle for the first 6 weeks:
There is no routine, new-born babies feed and sleep on demand. They can be quite sleepy for the first 2 weeks and then quite vigorous and wanting to feed frequently for the 2nd and 3rd weeks. However, all babies are unique and different. It is important to respond to them and not let them cry for long periods. This causes undue distress and is not good for baby or mum.
New-born babies can sleep for around 16 hours in 24 hours. New-borns do not understand the difference between night and day. They usually sleep for short bursts during the day and night. Each sleep can last from 1-4 hours. When new-borns wake it is best to feed them straight away as they wake up hungry. After the feed they will probably want to go back to sleep again. We all know that feeling!
The longest a new-born baby should be awake is an hour. Then they will be tired again, if babies are awake for too long, such as over 1.5 hours, they will get very irritable and overtired, the eyes will be red and they will be crying. They like a quiet, calm environment. Babies that are overstimulated by noise and activity get irritable and overtired. This is especially true for premature babies and babies traumatised by birth.
New-born sleep cycles
New-born babies have active and quiet sleep phases. During the active sleep phase, they are quite noisy and squirm a lot, the breathing is noisy and irregular. They can be easily woken however, so leave them to sleep a bit longer if you can resist picking them up.
During the quiet sleep phase, they are still, breathe deeply and regularly. They are not likely to wake up during quiet sleep. Each cycle of active and quiet sleep is about 40 mins in duration. After this they will rouse or wake up a bit. You can leave them and see if they will fall into the next sleep cycle or they may need some comfort like a feed, nappy change, cuddle or just a pat and a soothing voice.
Try to leave them to sleep for as long as possible before waking them up for a feed. New-borns need to feed at 3-4 hourly intervals. They do need to feed at night so wake them at 4-5 hours for a feed, if they have not already woken you up! They need a constant energy supply as they have poor glucose and fat reserves. Frequent feeding and waking also prevents sudden infant death syndrome (SIDS). It is a myth that keeping a baby awake during the day means they will sleep at night: babies need to feed and sleep regularly.
Safety: the baby must sleep in a cot or bassinet next to your bed. It is not safe to sleep with your baby in bed. You may smother them with your body or blankets by accident. This increases the risk of SIDS. It does happen.
How to settle a new-born baby:
Comfort: Check the nappy to make sure it is dry before sleep, check baby’s’ temperature, feel the back of the head and neck it should be as warm as you are. The baby’s hands and feet are often cold. The baby should be wearing one layer with a vest underneath and wrapped in a cotton blanket.
Feed: If the baby has had a feed in the last hour they should be satisfied. However, a hungry baby will not sleep; they may need a quick top up of 20-30 mls or a 5 min breastfeed. A baby’s stomach is about 30 mls capacity.
Wrap and Tap: Wrap the baby in a light muslin or cotton wrap, make sure the arms are tied in tight and the legs are free to move a bit. This will prevent their own startle reflex from waking them up 20 mins into the sleep. Many mums say the baby does not like it, but they will sleep longer and be easier to put them down in the cot when wrapped. Lightly pat the bum or leg while they go off to sleep-I do not know why but they like it!
Settling tips
Safe Sleeping:
Try not to wrap the baby too tight or have the cloth too near the face where it might suffocate the sleeping baby. Safe swaddling: https://www.lullabytrust.org.uk/safer-sleep-advice/swaddling-slings/
Hold the baby upright for 10-20 mins after a feed and put baby back into cot or bassinet once fed and nappy changed. This will prevent reflux or indigestion. Put the feet at the bottom of the cot and cover with a blanket or sheet to stop them from moving too much. You can prop the mattress up with a folder to give a slight incline at the head end.
Do not co-sleep with your baby, it is not safe. You are putting the baby at risk of SIDS. Also do not have any teddies, blankets, pillows, or bolsters in the cot at all. No smoking in the house. If someone smokes they must remove their top and wash hands before handling the baby. They are overly sensitive to smoke and it increases the risk of SIDS.
What is SIDS? https://www.lullabytrust.org.uk/safer-sleep-advice/what-is-sids/
Safe sleep guidelines: https://www.lullabytrust.org.uk/wp-content/uploads/Safer-sleep-for-babies-a-guide-for-parents-web.pdf
Reflux or indigestion
If your baby suffers from reflux or indigestion after a feed, you can tip the top of the bassinet or cot mattress up on a large folder or phone book to raise the head of the cot or bassinet about 30-45 degrees. Sit them up for 20 mins after a feed. Change the nappy before the feed, not after.
See your GP or health visitor for expert advice. You can also call me for a phone consult.
What is reflux? https://www.nct.org.uk/baby-toddler/feeding/common-concerns/what-baby-reflux-symptoms-and-support
Enhancing Sleep and reducing Overstimulation:
Some babies, especially premature babies or those who have been in Special Care Nursery really benefit from a low stimulus environment. They need periods of quiet and rest to let their brains reorganize and relax. You can also cluster their care needs, so you can change, feed and clean them all at once and then let them rest rather than disturbing them all the time. Babies are extremely sensitive to environmental stimulus like noise, light, smells and rough handling. Be incredibly careful and gentle in handling a new-born baby.
Babies like white noise or soothing background noise like wave music or rain music. The volume should be low-like the sound of a shower. They are used to the sounds of your tummy and blood flow through the umbilical cord making a whoosh sound. It blocks out other background noise and helps them to sleep longer.
Background noise for babies: https://apps.apple.com/us/app/white-noise-deep-sleep-sounds/id1083248251
It may sound obvious but place the baby in a quiet room. They need a quiet, dark area to sleep in where the noise and stimulation of people, siblings, TV and radio are reduced. My pet hate is when baby’s bassinet is placed in front of the huge TV.
Twins
Sleeping: You can sleep them in separate cots or in the same cot. They like to be near each other. Twin babies can sleep in the same cot but at opposite ends so head to head with feet at opposite ends of the bed. See the diagram below. Alternatively, you can get two bassinets and keep them next to each other. They like to hear the other twin. They have a close bond from birth.
Clothing: they need easy dressing so zip up suits and all in ones are excellent. The wonder suit is great and economical. I recommend a zip up swaddle as it is much easier to manage feeding and changing rather than wrapping twins.
Feeding: You can feed and settle them both at the same time. Tandem feeding will save a lot of time. You can tandem breast feed both at the same time and top them up with a bottle. One baby is usually more demanding than the other. One baby may prefer the breast and one the bottle. If you are bottle feeding twins you may make up 4 bottles at one time for the present feed and the next.
You can also use a double feeding pillow to put on the sofa or floor which makes it easy to pick them up and put down after feeding. I always recommend mix feeding twins as it is difficult to produce enough milk for both. You can breast feed and top up with a bottle or alternate feeds between breast and bottle. It also means someone else can help you as you will be doing 6-8 feeds a day x 2 babies! Develop a routine as soon as you can.
Travel: Be really organized and plan so you have all the nappies and equipment you need. A backpack is handy rather than a heavy nappy bag. Use baby travel chairs or pods to transport them as getting them in and out of the car is difficult and pods are very convenient. If you have the travel pod you do not need to disturb them if they fall asleep. Use a dummy to console them if they are unsettled in the car. It is the only time I recommend a dummy. If they are both crying and you are distracted, then stop the vehicle and sort them out. You can also put the air con on cooler than normal as they get hot in the travel pods and that makes them irritable.
Extra help: Having twins is unbelievably hard and can be overwhelming at times. It is important to take all the help you can get from friends and family. Do online shopping for groceries and other things, get a cleaner and establish a routine which suits you as soon as possible.
Tummy time:
Tummy time is important exercise for babies and can be started from birth. Newborn babies need tummy time to strengthen the head and neck muscles. It also prevents flat head or plagiocephaly. The bones of the head are still soft and the back of the head will become flat if the baby is not moved or given tummy time.
Simply put them on their tummy 3 times a day for 10-15 minutes. You can use a play mat, the changing mat, your lap, over your shoulder or on a fit ball. Look at their face and try to get them to push up on their arms to look at you. They also like to look in a mirror at themselves! If they already have a flat spot roll them onto the other side. Put a roll of towel under them or simply turn them.
Tummy Time https://www.pregnancybirthbaby.org.au/tummy-time
Bonding:
This is a great time to bond with your baby, lots of cuddles, be very responsive to their cry. They will learn to trust that you are responsive to their needs. Mutual gaze and affection is so important. Some babies start smiling as early as 2 weeks, but most will smile at 6 weeks.
If you find this difficult try some baby massage or put the baby in a carry sling. Their brain is developing, and they are creating bonds of trust with you already. You cannot spoil a baby too much in these early weeks, do not let anyone tell you to put the baby down. You are not creating a problem for yourself by picking them up and feeding them on demand. Babies do not have demanding or manipulative behaviors. Quite simply, they have basic needs and you are their world.
Importance of bonding: https://kidshealth.org/en/parents/bonding.html
Adjusting to parenthood:
Transitioning to parenthood is easier for some than others. It can be a big change in your life. It will be very daunting and demanding for the first few weeks. You may have arguments with your partner or close relatives. You may be questioning yourself and your capabilities as a mother. Some people struggle more than others. If you are a in a career as a critical thinker (nurse, doctor, psychologist, strategic planner) you will be having difficulty with the lack of routine and control. You will also question your every decision. This can lead to post-natal depression, so self-care is especially important.
Post Natal Depression (PND)
If you have had anxiety in the past it will exacerbated by the demands of parenthood. If you have had depression in the past you may feel it come back as parenting can trigger many early childhood traumas from your own experiences. Anxiety and depression can limit your parenting abilities and it is important to get support early on.
If you are not sure you have PND you can do an ‘Edinburgh Post Natal Depression Score’ test and take to your GP or Health Visitor. You can also call me for a consult. If you have other children, a baby will add extra work to your life, and you may be feeling overwhelmed and guilty that you are not doing everything you want to do. PND is real and it affects one in five women. It is important to discuss it and recognize the signs early. Signs of PND can be mild: 0-7 score feeling flat, low energy, no enjoyment in normal activities. Moderate: 7-15 score, crying, low mood and lack of sleep. Severe: 15-30 score, signs can include: feeling worthless, having hallucinations, hearing voices or feelings of suicide.
What is PND? https://apni.org/leaflets/post-natal-depression/
EPND Score https://healthyfamilies.beyondblue.org.au/pregnancy-and-new-parents/maternal-mental-health-and-wellbeing/mental-health-checklist-for-women