Sleep is not a luxury even for new mothers – it’s a medical necessity. As Postpartum Depression for Dummies states, chronic sleep deprivation can cause postpartum depression (PPD) and anxiety as well as other mental health complications, and it’s the most ignored causal factor for postpartum depression.
Don’t believe the myth that you will have an added capacity to function without sleep when you become a mother. If anything, I believe the opposite is true – we need more to build ourselves back up after pregnancy so that we can care for a newborn. More on PPD in a moment.
“Sleep Is Sleep, Right?” Not So!
Daytime sleep does not replace nighttime sleep. It is nighttime sleep that restores the brain. Make every effort to catch as many zzzss at night as you can and supplement during the day when you are able.
Shoot for the longest chunk of uninterrupted sleep possible at night. Five to six hours straight will leave you much better able to function the next day than three hours here and another three hours there. Longer chunks of sleep are needed to help ward off postpartum depression and anxiety. A good sleep coach is worth her weight in gold. Consider hiring one to help your baby rest more soundly during the night. You’ll all sleep longer and better.
Newborn Sleep “Rules”
Newborns come with their own set of “rules” for sleep. They are not developmentally ready for self-soothing until about 6 months of age (some 4.5 month olds are ready, but they are the exception). Their circadian rhythms (sleep cycles) as well as the size of their tummy(!) are not mature enough for sleeping for long chunks of time. But there are several things you can do to lay the groundwork for good sleeping.
Help Your Newborn Learn Day From Night
At first your newborn seems to sleep round-the-clock. Then he “wakes up” after a few days and you may notice that, just like when he was in utero, he will sleep during the noisy, busy days and wake up at night when all gets quiet. They really do not know their days from nights in the way we do! But you can now begin to gently nudge them in the right direction.
Once your newborn is a week old consider these ideas:
During The Day
- Open the curtains, blinds, or shutters and let the sunshine in! If Mr. Sun is hiding behind the clouds then be sure you make your room brightly lit during the daylight hours.
- Weather-permitting, take him for a stroll outside in the fresh air and sunshine. If he is well-bundled when cold or lightly clothed when hot, he will benefit from the activity and exposure to some sunshine for a few minutes. This will give you some gentle exercise and help you sleep better at night as well.
- Encourage some developmentally appropriate playtime when he has an awake/alert window. Even 5 minutes of interaction is helpful for stimulating him and saying “this is daytime and this is when we are awake more.” Some ideas: singing songs, walking around the home showing him objects and talking about them, and telling him how much you love him and why he is so special to you. As he gets older you can begin tummy time on a floor mat or play gym.
- Don’t be tempted to think that “if a little works, then more is better!” when it comes to activity. Too much running around during the day will overstimulate your child and keep him awake at night.
- Fill him up! Your newborn will eat every 2.5 to 3 hours (even if you need to wake him up). A newborn will usually sleep for a 4 hour stretch but let that happen at night and not during the day. You can wake him during the day by unswaddling, picking him up, tickling his arms and legs gently, or changing his diaper.
- If you are nursing your child then consider avoiding caffeine in the afternoon. Caffeine goes to your breastmilk and will stimulate your newborn just like it does you!
- On the flip-side, when he wakes in the middle of the night, avoid lots of talking and playing. Instead quietly tend to him with a quiet, calm, and soothing manner.
- Provide a dark environment for sleep at night. If you need a light at night to change a diaper, then keep it as dim and ambient as possible.
- Tend to him more quickly and business-like at night and help him back to sleep right away. This helps him learn that nighttime is for sleeping and not playing.
- Keep all electronics (tvs, cell phones) off or out of his room at night. The lights stimulate him and will distract him from sleep.
- White noise machines are helpful if the rest of the home has noise nearby at night (a busy street, older children, creaky floors).
- Swaddling your newborn may help him not wake from his own startle reflex.
You cannot spoil a newborn baby! Always respond to and attend to his needs. Hold him close or carry him in a baby carrier next to you during the day. You are increasing his confidence when you connect with him as well as creating a lasting bond between you two.
Sleep is an important piece of the wellness strategy, but there are other pieces too. My colleague, Dr. Shosh, has first-hand experience with the trauma of postpartum depression. I want you to listen to her story and her advice now.
Postpartum Depression Is A Possibility
Dr. Shosh is a survivor of two life-threatening postpartum depressions. She explains, “At the time of my illnesses, there was no help for me. The great news is that, if you’re suffering from depression in pregnancy or postpartum or know someone who is, there’s great help now.
For the last 27 years my mission has been to educate medical and mental health professionals, and work directly with women and their families around the world to make sure they don’t suffer the way my family and I did. I’ve worked with over 21,000 women, and I’ve never met one who did not fully recover when given proper help.
Women are most vulnerable to mood and anxiety disorders during pregnancy and the postpartum period. If depression or anxiety is going to surface, it typically happens at this time. PPD affects about 15 percent of mothers around the world.
How It Begins
The primary cause of PPD is thought to be the huge hormonal shifts after the baby is delivered which then affects the neurotransmitters (brain chemicals). There are also psychosocial factors such as moving, illness, poor partner support, financial hardship, and social isolation that can negatively affect the woman’s emotional state.
Facts About PPD:
- If the normal Baby Blues don’t go away by two weeks following delivery, it is considered then to be PPD.
- The condition often worsens if the mother doesn’t receive help.
- Although the onset of PPD is usually gradual, it can be rapid and may occur immediately after delivery.
- PPD can begin any time during the first year postpartum.
- It is extremely important to treat PPD, because if it goes untreated, the symptoms may become harder to treat.
- Twenty-five percent of mothers untreated for PPD remain depressed after one year.
- PPD can occur after the birth of any child, not just the first.
- Once a woman has had one occurrence, she is high risk for another after a subsequent birth.
- PPD can often be avoided or at least minimized when a wellness strategy is in place.
The most common symptoms of postpartum depression are excessive worry, anger, feelings of guilt, sadness, hopelessness, sleep problems, uneasiness around the baby, poor concentration, loss of pleasure, decreased sex drive, and changes in appetite. Although there are factors that make some women high risk, no one is immune.
- 50 to 80 % chance of PPD if there was a previous PPD
- Depression or anxiety during pregnancy
- Personal or family history of depression/anxiety
- Abrupt weaning
- Social isolation or poor support (especially poor partner support)
- History of mood problems with her menstrual cycle
- Negative mood changes while taking a birth control pill
- Health problems with the mother or baby
The Warning Signs
There are warning signs for which professionals, family, and friends can watch. Your friend or family member may need help if she exhibits some of these behaviors:
- Misses her doctor appointments
- Worries excessively about her health or the health of the baby
- Looks unusually tired
- Requires a support person to accompany her to appointments
- Experiences major change in appetite
- Has physical complaints without any apparent cause
- Has poor milk production
- Evades questions about herself
- Cries easily
- Shows discomfort being with her baby
- Is not willing to let another person care for the baby
- Cannot sleep at night when her baby is sleeping
- Has low self-esteem
If a woman with PPD remains untreated there is an increased risk of her child(ren) developing psychiatric disturbances. There is also a potential for child abuse or neglect, an increased risk for the woman to develop chronic depression or relapse, and there is a negative impact on the marriage and on all the family relationships.
Postpartum depression is a serious illness that requires professional attention and support. Increasing sleep at night, therapy with a specialist, medication or alternative treatment, emotional support, regular breaks, exercise, and good nutrition will help the woman who is struggling.
One thing is sure – it is possible for each woman to regain her old self (or even a better self) and achieve 100% wellness when provided proper help. The earlier she receives help, the faster she recovers and the better her prognosis. The sooner a new mom starts enjoying her life, the better it is for her whole family.”
Both Dr. Shosh and I encourage you to seek the help you need if you suspect you are suffering from PPD. She can be reached easily through her website www.DrShosh.com and she works with moms and dads (dads get depressed too) worldwide. Follow the tips for newborn sleep we have provided as well as getting the intervention you need to recover. Your health is worth it. Your baby is worth it!