Overnight Newborn Care

 (First night home from the hospital and thereafter) 

Bringing home a new addition to your family often means that the sleep schedule of the entire household is interrupted. Many families struggle through the early months running on little sleep and feeling exhausted. Bringing in a newborn care overnight specialist grants you the ability to receive a quality night’s rest that can make you feel like a brand-new person.  

With overnight newborn care I typically arrive at your family's home anywhere between 8:30 P.M. and 11 P.M. I ask for a recap of the day and allow you to ask any question or express concerns with anything that may have come up with your newborn(s). After we’ve completed the daytime recap my goal is to send you off for self-care! If I am bottle feeding, the first order of my night will likely be making sure all the supplies are cleaned and sterilized and everything is ready for the next feeding. I also fully support nursing and oftentimes set up a general schedule with my new moms to bring your newborn to nurse every two and a half to four hours depending on how growth and development are progressing. I then will handle all burping, changing, swaddling, and soothing required throughout the night. Additionally, I may stock the nursery for the next day or wash bottles and pump parts as needed. My goal is to limit the parent’s interaction with the baby during nighttime hours so you all can get the maximum amount of sleep with the minimum amount of worry. I typically end my morning anytime between 5:00 A.M. to 6:00 A.M. After each overnight night I email you a recap of how the night went. 

  Newborns Through Early Infancy  

When it comes to successfully sleep conditioning a newborn, many factors need to be taken into consideration. First and foremost how many weeks gestation the newborn was at birth can affect when the sleep training can begin. If a pregnancy goes to thirty-eight weeks or longer, an overnight routine can begin to be established at around the sixth week. If the baby was born before thirty-eight weeks you may need to give the newborn more time before the baby will be ready to fall into a consistent overnight routine. Having a comfortable consistent overnight routine is key to knowing when the baby is ready for the sleep training to begin!   

As the newborn night nanny, you’ll often be the primary overnight caregiver for sleep conditioning. It will be essential that you coach the daytime caregivers (and especially any other caregivers who will also be taking care of the baby during the overnight hours) on establishing a routine. Newborns, but children in general, thrive on routine and structure! I like to use 7:00 PM to 7:00 AM as the overnight hours. My goal in completing overnight sleep conditioning is for the baby to have anywhere from 7 PM to 8 PM as their official bedtime and to be sleeping a minimum of eight consistent hours. However, many of the families I’ve worked with have preferred me to stay on as their sleep conditioning specialist until I have their baby sleeping ten to twelve hours consistently overnight. This is usually accomplished between months four and six.   

Sleep conditioning can be prevented from moving forward due to colic, reflux, digestive issues, or low weight gain. As the sleep conditioning specialist, it’s important to be proactive in working with the family and any daytime caregiver to relieve any colic/reflux/digestive issues throughout the day as the symptoms will heighten overnight. The symptoms heighten due to the inability of the baby to completely relax. They are overstimulated. It’s the dark and calm atmosphere that allows the baby to turn off or lower the use of most of their five senses. When the senses are on high alert for long periods that causes the bulk of overstimulation.   

You’ll know you’ve hit the point in a baby’s development when the baby begins what many caregivers call the “witching hour.” It’s a period when the baby starts to become more and more fussy, usually around 5:00 PM and very few things soothe them. It’s important to know that overstimulation is a leading reason that babies struggle to sleep. Determining that the baby is going through overstimulation and finding the baby’s favorite ways to be soothed through the tough time will drive you toward quicker sleep training. On average, it’s at around eight weeks that you’ll have recognized your baby is in a good routine and consistently eating every two and a half to three hours. This is the ideal time to start sleep conditioning.   

As a sleep conditioning specialist, you’ll begin with the written evening routine provided by the family or postpartum doula. A routine that I love starts at around 6:00 PM with a bath. A newborn/infant should not get a bath with soap each evening (only every few nights). However, they can still enjoy a lovely hot water bath nightly. Once the bath is complete I would take the baby into their nursery and give them a nice baby massage (oil or lotion could be used). I love to turn on lullabies and provide soothing words. Even if the baby seems fussy, take your time and provide a soothing massage and care. Depending on the nursery I’ll either turn the lights off completely and just use the light from a nightlight or a small lamp. Get the baby into their pajamas and snuggled into their sleep sack, if the family chooses to use one. Then provide the final feed of the night, which leads to nighttime sleep. Even if colic or reflux is not an issue, holding the baby upright for at least thirty minutes after the final evening bottle is a great idea. If you think you may have a baby with colic or reflux then you should plan to feed the baby upright and keep them upright for thirty to forty-five minutes after EVERY feed.   

Once the baby gets to sleep with the first sleep of the night, the hope is to stretch the length of time before the first overnight feed is to occur. Initially when sleep training starts the newborn/infant is likely to have feeds every two and a half to three hours from 7:00 AM onward. Once you go to 7:00 PM and start the sleep training; the hope is that the baby is already sleeping at least three and a half to four hours. For example, you’re starting a sleep training where the first nighttime feed is at 7:00 PM and the next feed would be at around 10:30 PM or 11:00 PM, From there you will start waking the baby every three hours to feed throughout the night. This is to teach and encourage the baby that there should only ever be one long sleep stretch.   

I use three consecutive nights of the baby consistently sleeping through a stretch to determine if they are ready to move forward toward a longer sleep stretch. For instance, if your baby ate at 7:00 PM and next at 11:00 PM for three consecutive nights, then on night four you hold the baby off to eat until 11:30 PM by providing them with a snuggle dancing, soothing talk, and hushing. After a few nights of being held off, you’ll see that the baby will learn that they are waking and not getting the immediate meal they think they need, therefore there is no reason for them to wake just to be held off.   

In time, completely different for each baby, you’ll see that they sleep through that 11 PM feed and sometimes even the 11:30 PM wake-up. At any point, if you see that baby is successfully sleeping from 7:00 pm to 11:30 pm (or beyond) at least three consecutive times you’ll know you’re ready to move the hold-off time even later. Once you have the schedule set, it’s very important to be consistent in maintaining the schedule.   

In sleep conditioning, you also have to be prepared for setbacks and simply adjust accordingly! You may find yourself in a situation where you have a set schedule from 7:00 PM to 3:00 AM and the baby has consistently slept solid those eight hours without waking for three consecutive nights. Out of nowhere, the baby wakes at 1:00 AM. Do all you can to soothe them and see about getting them back to sleep without providing them a feed. It may take an all-out (dark and lullaby-driven dance party). It could also inevitably mean you do a feed before the scheduled 3:00 AM set feed. This is OK and completely normal. You’ll rebound and get back on track. Adapt and adjust as needed. As long as you are consistent most rebounds will eventually get you ahead.  The biggest obstacle to constantly moving forward when it comes to sleep conditioning is what is called a Leap. Leaps in infants are developmental. Each leap is very different, but what makes them similar is how much they can overwhelm a sweet baby! They may slow down sleep training, but it’s beautiful to see the growth and development of the baby. Once the baby is through the leap that may have caused the slow down or halt of overnight sleeping, you will most likely see a “leap” to the sleep pattern too! I love to refer families to The Wonder Weeks to follow a baby's leap.