2/19/10

Day/Night Confusion


Day/night confusion is a pretty common problem with newborns. Baby wants to sleep all day and stay up all night. So now not only are you having to wake up to feed baby throughout the night, but he won't go back to sleep! He just wants to play or possibly even fuss. Not cool!

So what do you do?

Some experts out there suggest to just wait--baby will eventually figure things out. Sure he will, but how long will that take? If your lucky, only a week or so, if you're unlucky, possibly a few months. Maybe some people are OK with this, but if you're not (and I know I'm not!) you can try out
some of the following tips.

How can I fix my baby's day/night confusion?
  • Make sure to keep things calm, dark and quiet at night time. This includes when you initially put baby to sleep (to help him distinguish between bedtime and naptime - see pre-sleep routine) and when baby wakes at night to eat. As cute as baby can be, make sure you don't engage him in anyway at night. I know this is super hard to do when baby is smiling and giggling at you, but remind yourself that you can play plenty with baby during the day.
  • Don't change baby's diaper unless it is needed at night time. When my son Joshua was a newborn I changed his diaper pretty frequently at night, but as he got older and ate less, I didn't change it at all at night. If I did change it, I would usually change it in the middle of a feed so that he would get nice and relaxed again after the diaper change and more easily fall back asleep. To prevent diaper leaks at night, you might want to go up a diaper size (but be aware that if it is too big it will leak more than a smaller diaper) or use night time diapers. You might also want to consider using a wipe warmer at night so that it isn't so startling to baby.
  • When baby wakes at night and needs to eat, feed him quickly so that he doesn't become wide awake and have a hard time falling asleep again. If you are bottle-feeding, try to have all your bottle-feeding supplies close at hand so that baby can be fed as quick as possible. With my son Joshua I actually ended up waiting until he started to cry before I fed him at night. This may not sound very nice, but if I didn't wait for him to cry, he would be so sleepy that he'd stop eating after about 10 seconds of nursing. If I let him cry before eating, he'd actually eat something before falling back asleep. Obviously this won't be true for all babies, but I thought I'd mention it.
  • Establish a consistent pre-sleep routine that varies slightly from day and night to help signal to baby what time of day it is.
  • Don't let baby go more than 3 hours between feeds during the day (even if you have to wake baby for a feed). This encourages baby to eat more during the day so he will wake less to eat at night. It also helps move some of babies waketime to the day so he will be more likely to sleep at night. Another variation of this is to not let baby sleep for more than 2-3 hours at a time during the day.
  • Some experts suggest that you have baby take his naps in a light, somewhat noisy room to help him distinguish day from night. I tried this at first but found out that after a month or so, my son Joshua was very disturbed by the light and noise and wouldn't sleep well. This is true for most babies as they get a bit older. But hopefully if you decide to do this method, baby will have his days and nights figured out (and you'll have him sleeping in a dark room again) by the time he is old enough to get disturbed by his environment.
  • Sleeping Through The Night states that there is nothing you can do about day/night confusion until your baby is a few weeks old. Other books have similar opinions and go as far to say that there is nothing you can do at all, you just have to wait it out. Obviously I disagree. Every parent I have seen try out the suggestions above has seen improvements, even in newborns.
  • Sleeping Through The Night suggests you try to play with baby as much as possible during the day. I think this is a good suggestion to an extent. If you get baby overly tired or stimulated she will not sleep well for naps. And if she doesn't sleep well for naps, she won't sleep well at night time (at least not in the long run).

Additional Info:
Melatonin also starts to be released around 3-4 months of age. This makes babies feel more sleepy at night and can help resolve day/night confusion.


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1 comment :

  1. Hi! I'm not sure if it's day/night confusion or what but I'm having major middle of the night sleep issues with my little one. He is 9 1/2 weeks old and was co-sleeping at night up until about a week ago. He has been napping beautifully in his room in a rock n play. I am trying desperately to keep him on a 3 hour E/W/S routine during the day but feeding (exclusively breastfed with minimal formula supplementation the two night shifts a week I work if not enough expressed breastmilk) takes forever still-- easily an hour-- because he is so sleepy and I have to poke and prod and burp and change his diaper to keep him awake. I make sure during the day to feed him in the living room with bright lights and tv and my 4 to daughter to bug us :-) He easily goes down for a nap anywhere from 1 hr 15 mins to 1 1/2 hrs of waketime (watching cues). He will nap as long as I let him, and today (I'm struggling with little sleep following two nightshifts at work) I accidentally let him sleep 3 hours and still had to wake him. During this last week of mild sleep training (we've been doing extinction CIO with check times of 5/7/10 mins) he has gotten worse in the middle of the night. We have a last feeding in his room with low light, then I check his diaper, swaddle him up, and turn off the light. Rock with him and sing lullabies for a few more mins, then put him down extremely sleepy but I make sure I see his eyes before I put him down. He does really well, and will sleep from around 8 until 1130, then he will wake for a feed. I feed him in his room in the dark still swaddled and don't talk beyond a little "shh, momma's here" whisper to calm him as I pick him up. I make sure he's taking a decent feed (he tries to fall asleep of course), and then put him back down. Sometimes he will go right back to sleep for up to an hour or so, but sometimes it starts right away-- he cries and fusses all night. We may go in at the 5 and 7 min marks, and sometimes even the 10 (my husband had to do two 10 min checks this past weekend). When we go in we don't pick him up but I will strike his face and try to reassure him and calm him, but he doesn't calm while I'm in there. He may go back to sleep but it's a cycle we repeat anywhere from every 20 mins to hour all night. Whenever he wakes and it's been close to 5 hours (so usually 0430 or so), we will feed him again, and then he goes back down and goes to sleep and does well again until 0730/0800, which is our goal wake time ( I get home around 8 and would like to feed him when I get home instead of another bottle and me pumping). We've seen noticeable backtracking over the week-- the first night was terrible, the second night a bit better, the third night was perfect, and he actually slept a solid 6 hours but he had vaccinations that day, and from there it's gone downhill. It's still better than the first night in that he goes to sleep initially really easily. I'm at a loss and torn bc he's so little and I hate to even let him cry this much but co-sleeping is absolutely not an option bc of my work schedule-- my husband tried it my first night back, and without on demand nursing he had no use for my husband. When he takes a bottle he takes 4 oz at a time, and will sometimes leave a wee bit. Any advice is greatly appreciated!!

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