Sleep in the Perinatal Period

Sleep is one of the biggest discussions that comes up when you become pregnant. It can induce anxiety, annoyance and maybe thoughts of ‘it can’t be that bad… can it?’. Well meaning advice such as ‘sleep now, before the baby comes’ can taste bitter if you just want to look forward to meeting your baby or if you are already struggling to sleep. Conceptualising baby sleep can also be difficult. Often people are blindsided by the adjustment to newborn infant care overnight regardless of how much they felt prepared. But sleep disruption across pregnancy and postnatally is biologically normal and focus should be on compassionate support rather than fixes.

Why does pregnancy sleep suck?

Pregnancy sleep can be all sorts of weird. From physical discomfort to vivid dreams, pregnancy hormones can have a lot to answer for! But as time goes on or as pregnancy throws up questions and uncertainties, sleep can become quite elusive. Processing information and emotions can disrupt the brains ability to shut off. Sometimes the irritability or low mood that stems from a lack of sleep and physical exertion through pregnancy can cause further sleep disruption. This is all frustrating.

Will I ever sleep again?

Postnatal sleep can be equally fraught with worry, but is also naturally disrupted by infant care. Babies wake and feed frequently for survival and have no circadian rhythm for up to the first 3 months of life. Adjustment to life outside the womb can bring its own challenges such as babies needing to be close to you, being noisy and active during sleep periods and relying on parents for safety. Whilst this fragmented sleep is normal and necessary for babies, adults can struggle with this a lot more. The baby sleep industry would have you think that this is wrong and should be fixed with special cots, blankets, swaddles, pods, milks, medications, bottles, nappies, training programmes… But what if you and your baby need some support to get through this tricky bit? Because infant sleep in the first year isn’t linear and research shows that sleep needs vary hugely. It’s not something to be "fixed" but something to be supported compassionately.

When sleep is disrupted, our emotional wellbeing can be impacted significantly. As we will cover in the future in Postnatal Nutrition Beyond Body Size, physical depletion can lead to low mood, irritability, poor memory and concentration, anxiety and poor emotional resilience. In other words, when we don’t sleep, it’s harder to function and cope with the day to day. In turn, this emotional downward spiral can make it harder to switch off and rest even when we have the chance as our bodies are on high alert and feel in threat mode. Bringing about a sense of calm can sometimes feel more than our emotional bandwidth can handle.

So what do we do when we enter this spiral? It’s different for every family and we have to do what works for our circumstances. But some ideas could be:

-          Set your wake time for the same time every day. By ‘wake time’ I mean your ‘home wake up’. That’s your get out of bed, open the curtains, move around, make noise time. Babies thrive on predictability and this can support the development of their circadian rhythm whilst supporting yours through the disruption.

-          Early natural light. Get outside if you can. A bad night does not necessarily mean a bad day. Exposure to natural light supports your circadian rhythm and movement through the day can help your body to rest at the end of the day.

-          Don’t spend too much time in bed awake if sleep is a problem for you when baby is asleep. If you struggle to sleep, get out of bed before frustration sets in, move somewhere comfortable and do something relaxing without a screen.

-          Let go of trying to schedule or extend your baby’s sleep. Get on with your life and let them sleep on the go. If the environment is right and they just aren’t dropping off, change it up and try again later. Unsettled babies aren’t always ‘just tired’… they could be bored, too stimulated, too hot, too cold, have an itchy butt, be hungry, gassy…. If you need additional individualised support for understanding your baby's sleep, I can point you in the right direction. Check the links below too.

-          Wearing your baby could help them to regulate through the day which may make sleep feel less of a battleground and help you regulate too. This could be the reset you need after a run of sleep disruptions.

-          Whether you plan or intend to co-sleep or not, knowing how to do this safely is hugely important so you aren’t caught off guard falling asleep with your baby in arms. Safe co-sleeping may be a way for you to get some more rest if you are able to follow the advice. Information on how to do this safely is in the links below.

-          Write down some of the thoughts and feelings you’re having during the day and acknowledging these can lift the weight of them before bed. A simple task could be to write one good thing about the day and how to take that forward into the next day, one bad thing about the day and what you could do differently the next day.

-          Rope in some help if things are getting too much. This doesn’t have to be overnight help, this could be someone to take some weight off your day, allow you a lie down or a warm bath. Could this be a neighbour, a relative, your partner, a doula? Supporting your nervous system could help you feel rested more than an extra hours sleep could.

Most parents will struggle with the sleep deprivation ('Can I die from lack of sleep' is in my search history too!) but that doesn’t mean your baby is broken and needs to be fixed. The successes of sleep training programmes rely heavily on a baby’s temperament, perception of the original issue, completion of the programme (drop outs aren’t often included in final success figures) and there is usually no long term follow up. However, if your baby is a fine sleeper but you aren’t able to sleep even when you get the chance, it could be time for some more support. Check in with your GP or health visitor for a referral for more support. It’s likely that you have other things on your mind you could get off your chest when you speak to them too and that will put you on the path for better days.

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Safe infant sleep

Sleep Information