Newborn feeding and sleep can be quite a mystery for new parents. Both are essential for infant wellbeing and are closely connected. In this article, we will look at the connection between infant feeding and sleep, patterns and cues to watch for, the importance of safe sleep, and the power of a bedtime routine.
How Feeding & Sleep Connect
The connection is simple: babies wake to eat and eat to sleep. This connection is a biological need, especially during the first six months of life when sleep and wake windows are shorter. Newborns are influenced by routines, and when their schedule is essentially eat, sleep, repeat, it is easier for them to settle. Also, when infants eat well, they are more likely to sleep better. Studies have also shown that infants who consume more calories during the day wake less frequently for nighttime feeds. However, night waking is normal and healthy during the newborn period! Watching for early signs, also called cues, that an infant is hungry or tired can lead to more effective feedings and quality sleep.
Hunger & Sleepy Cues
Babies give many subtle signals when they are hungry or sleepy. Recognizing these early cues can help caregivers respond before the baby becomes upset or overtired.
Hunger Cues Include:
- Rooting or “searching for the nipple”
- Hands to mouth
- Lip smacking or licking
- Grunting sounds
Sleepy Cues Include:
- Yawning
- Rubbing eyes
- Staring off
- Red eyebrows
Once a baby reaches the point of crying because they are hungry or tired, they are likely too distressed to have an effective feeding or to have as restful sleep. Offering a feed at the first signs of hunger can help prevent distress and support a better latch. When a baby shows sleepy cues, putting them to bed promptly helps them fall asleep more easily and leads to a more restful sleep.
Sleep and Feeding Patterns
Infants typically sleep about 11 to 17 hours daily, and this varies from baby to baby. Newborn sleep happens in short cycles and does not follow a regular schedule at first. What Are Baby Wake Windows? from Cleveland Clinic can help caregivers become familiar with how long babies typically stay awake at each stage. How often babies wake to feed largely depends on whether they are fed formula or breast milk, as well as their age. Infants who are formula fed may sleep slightly longer stretches of three to four hours before waking to eat. Babies who are breastfed, on the other hand, may eat more often because breast milk is digested more quickly and easily than formula. Most breastfed babies feed about 10 to 12 times in 24 hours, throughout the day and night. These more frequent night wakings are also why breastfeeding is associated with a lower risk of Sudden Infant Death Syndrome (SIDS). Waking frequently to feed is normal and supports growth and milk supply, if breastfeeding.
Infant Feeding Basics
It is essential to know the basics of infant feeding when bringing home a newborn.
- Experts recommend exclusively breastfeeding for the first six months of life, and continuing for several more years, if desired. Breastfeeding offers complete nutrition for infants and has many health benefits for mothers as well.
- Vitamin D supplementation is recommended for all breastfed infants. Experts advise offering 400 IU of vitamin D daily unless infants are consuming at least 32 ounces of formula each day. 400 IU is typically one “drop” of a liquid vitamin D supplement, and can be added to expressed milk, formula, or directly onto the nipple prior to nursing. Caregivers should discuss vitamin D supplementation with their child’s pediatrician.
- If choosing to fully formula feed or combination feed with both formula and breast milk, be sure to understand how to properly prepare infant formula. Incorrectly mixing infant formula can either deprive infants of needed calories if it is over-diluted or stress the body if it is too concentrated. Read the container directions carefully and review the American Academy of Pediatrics’ steps for correctly preparing infant formula.
- The same level of importance must be placed on storing and handling expressed breast milk, as it is especially prone to spoiling. Learn about the Guidelines for Proper Breast Milk Expression, Storage, and Handling from Clemson Extension.
- Once an infant is around six months old, other foods and drinks may begin to be introduced in addition to breastmilk or formula. This is referred to as complementary feeding and is an exciting time during an infant’s first year of life! Talking with the pediatrician and becoming familiar with how to introduce solid foods can help set the stage for success.
Safe Sleep for Infants
Providing a safe sleeping space is crucial when caring for an infant:
- Infants should always be placed on their backs to sleep. This includes naps and nighttime.
- Infants and their caregiver should sleep in the same room for at least the first six months.
- While room sharing is recommended, bed sharing is not. Infants should have their own sleep space, such as a crib or bassinet.
- An infant’s sleep space should have a flat, firm mattress with one fitted sheet and no toys, bumpers, blankets, or pillows.
- Swaddling an infant can help them sleep soundly. However, once rolling over on their own, infants should no longer be swaddled. A wearable blanket can be used at this point to safely provide warmth.
- Studies show that pacifiers may reduce the risk of SIDS and can help soothe infants as they sleep. If breastfeeding, consider waiting to offer a pacifier until breastfeeding is well established.
- An infant’s room should be kept around 68–72°F to keep them from becoming cold or overheating.
- As previously mentioned, breastfeeding coincides with safe sleep for infants, as it has been shown to reduce risks of overall infant death. This is likely due to more frequent night wakings to feed.
- While experts agree that a crib or bassinet is the safest sleep space for an infant, breastfeeding parents who might accidentally fall asleep should prepare ahead to protect their infant.
Tips for parents who might accidentally fall asleep:
- The American Academy of Pediatrics notes that it is safer to prepare a bed for accidental sleep rather than falling asleep with an infant on a couch or reclining chair.
- Prepare the adult bed by removing all pillows, blankets, and loose bedding. Nurse in the “Cuddle Curl” position to protect baby in case of accidental sleep. Ensure no older children or pets are also in the bed.
- If the parent does fall asleep, once waking, promptly place the baby back in their own sleep space.
Learn more about what a safe sleep environment looks like according to the National Institute of Child Health and Human Development.
Healthy Habits to Promote Sleep
Parents may assume that they will be severely deprived of sleep during their infant’s first year. However, there are many steps that can be taken to help promote infant sleep. First, using light and activity during the daytime, and then keeping the environment calm, quiet, and darker at night can help infants begin to distinguish day versus night. The power of a simple bedtime routine can also work wonders in helping babies wind down before bed. About 30 minutes before bedtime, giving a bath, offering a feeding, and then reading a book each night can help babies understand that it is almost time to sleep. For any feedings overnight, turn on as little light as possible to help the baby understand that after feeding, they go back to sleep. Breastfeeding is also a healthy habit that promotes rest as breast milk contains hormones and fats that naturally support infant sleep. Remember to place more importance on the cues shown rather than the clock, and adjust routines as needed.
When to Ask for Help
If pain, feeding troubles, or extreme fussiness become concerns, caregivers should reach out to the infant’s pediatrician for support. For breastfeeding support, reaching out to a Certified Lactation Counselor can help! Clemson Extension offers Ask a CLC, a monthly, virtual breastfeeding support program, to support expecting and new parents. It is also important to note that caregiver wellbeing is essential, too, as the whole family cannot thrive unless every member’s needs are being met. Caregivers should have open conversations with their health care provider and family to help ensure that they are also receiving the support they need while navigating this stage in life.
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References:
- Barney, J. (2024, November 13). Many moms fall asleep while feeding, endangering their babies, study finds. UVA School of Medicine. https://news.med.virginia.edu/research/many-moms-fall-asleep-while-feeding-endangering-their-babies-study-finds/.
- Centers for Disease Control and Prevention. (2023). Foods and drinks for infants and toddlers. https://www.cdc.gov/infant-toddler-nutrition/foods-and-drinks/index.html.
- Centers for Disease Control and Prevention. (2023). Safe sleep for your baby. https://www.cdc.gov/sudden-infant-death/sleep-safely/index.html
- Children’s Hospital of Philadelphia. (2023). Newborn sleep patterns. https://www.chop.edu/pages/newborn-sleep-patterns
- Cleveland Clinic. (2024). Sleep in your baby’s first year. https://my.clevelandclinic.org/health/articles/14300-sleep-in-your-babys-first-year.
- Feldman-Winter, L. (2024, May 17). Breastfeeding: AAP policy explained. HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Where-We-Stand-Breastfeeding.aspx
Author:
- Hannah Shifflette, Rural Health and Nutrition, Chester and York Counties
Reviewed by:
- Michelle Altman, Extension Associate, Rural Health and Nutrition
- Melissa Bales, Extension Associate, Rural Health and Nutrition
- Ellie Lane, Extension Associate, Rural Health and Nutrition
