Ask Me Anything: Pre and Postnatal Sleep

Ask Me Anything: Pre and Postnatal Sleep

Dr. Maristella Lucchini addresses our community’s most urgent questions around pregnancy and postpartum sleep.
Introducing our First-Ever Audio Monitor Leiendo Ask Me Anything: Pre and Postnatal Sleep 10 minutos

It’s no surprise that one of the biggest issues across the pregnancy and postpartum experience is sleep deprivation. We’ve all been told to “sleep now” by well-wishing friends and family members during pregnancy, though many sleep issues actually surface before the baby even arrives. (Hello back pain, swelling and nausea!)

Once our babies enter the chat, it’s a whole other can of worms. Whether our infants are sleeping with siblings, sleeping exclusively in our arms, or not sleeping at all, the sleep issue is precisely what new parents are busy losing sleep over. So we brought in Dr. Maristella Luccihini, senior clinical researcher at Nanit, to help save our super exhausted, slightly cranky community of new parents with their most burning questions around pre and postnatal sleep. Because the research shows that sleep success goes beyond a happy baby. It means happier parents and happier families.

Q: I wake up every night around 4:00 am and can rarely get back to sleep. My baby is 10 months old and is sleeping wonderfully. I’m assuming it’s because I was waking up with him so often before we did sleep training. I struggle to fall asleep and stay asleep throughout the night. Any suggestions for the parents to establish healthy sleep patterns once their little one is sleeping through the night?

A: I get it! That can be very frustrating. You feel like finally you have the opportunity to catch up on all the sleep you’ve lost, but your body seems to refuse. I think there are a few ways to tackle this.

First: one of the main reasons why parents struggle to sleep is stress and anxiety. If this is your case try to identify the main reasons driving your anxiety. Are you worried about your child not doing great at daycare? Are you worried about having to juggle your work responsibilities with your new baby? These are just some examples (inspired from my own experience with my three kids!). Often pinpointing what’s making us anxious is the first step to tackling it.

Second: Your body also needs to readjust after months of waking up many times during the night. These are my suggestions: try to find the sweet spot when you start to feel sleepy. All of us have a preferred "rhythm,” and if you go to bed too early because you think you will catch up on your sleep, your body might not be ready, and you will just stay awake in bed getting more frustrated. At the same time, don't procrastinate too much, otherwise your body will start to produce hormones to fight your tiredness and it will make it very hard to unwind and fall asleep. Once you have found a sweet spot, try to stick to it. Consistency around bedtime is crucial not only for your baby, but for you as well!

Last but not least, find an activity to do before going to bed to help you unwind. When I was in your situation, I noticed that moisturizing my hand and body was a very soothing activity for me. I bought a moisturizer with a nice lavender smell and spent a few minutes doing that. It seems trivial, but after a long day taking care of your baby (and generally 100 other things as well!) you need to let your body relax and calm down. A noise machine with soothing sounds could help as well!

I hope these tips will be helpful, but if you keep struggling with your sleep, don't hesitate to discuss it with your healthcare provider! You can also reach out to your support network (partner/relatives/friends) and ask for help.

Q: I’m currently 14 weeks pregnant with my second baby. My first is nine months old and sleeps amazingly! But I’ve been having trouble staying asleep, and staying on my left side while sleeping. I have a pregnancy pillow that I use as a barrier, but it seems like I readjust in my sleep and I’ll wake up sleeping on my back again. It causes me a lot of anxiety because I’ve seen that sleeping on your back can be incredibly harmful to the baby. Do you have any tips for me to stay on my left side?

A: Congratulations on the new baby! There have been some studies linking sleeping position and negative pregnancy outcomes, but results were not conclusive and most of the studies were on mothers that were further along in pregnancy. A recent study that focused on the first 30 weeks of pregnancy did not find an association between sleeping position and negative pregnancy outcomes. My suggestion would be to always go to sleep on your left side and when you wake up, if you are on your back, just reposition yourself without getting too worried.

Generally, as pregnancy progresses, it gets more uncomfortable to sleep on your back, so you will probably favor sleeping on your side. Also, remember that excessive stress and poor sleep quality have also been linked to worse pregnancy outcomes. So worrying too much might just lead you from bad to worse. You are doing everything you can to keep that baby safe and healthy!

Q: With my last pregnancy, I started to snore at about three months onward, in part because of my swelling. This had been incredibly disruptive to both me and my partner. What can I do besides elevated sleep (I used a wedge pillow) to decrease the amount of swelling so that I can get better nights sleep? To add, I also suffered from pregnancy Carpal Tunnel Syndrome.

Snoring during pregnancy is not uncommon and is often due to weight gain, changes in hormones and blood flow. It can also grow more frequent as pregnancy progresses. Sleeping on your side and using a humidifier and nasal strip could help to reduce snoring. I would also discuss your snoring with your healthcare providers. Snoring is often harmless, but sometimes it can be associated with conditions that can affect maternal health during pregnancy, such as sleep apnea. A thorough evaluation by your OB-GYN can help you understand if you require additional care to improve your snoring, or if there is nothing to worry about.

Q: We’ve got an 11 month old and he sleeps about three to four hours before waking up. He never sleeps through the night. My wife likes to feed him a bottle when he wakes and it puts him back to sleep, but I’m afraid it’s training him to want to feed at night rather than sleeping. She’s vehemently against the “cry it out” method and anytime he wakes up, she rushes in to console him. He’s almost a year old and not sleeping through the night. She also sleeps with him every night in the nursery. I’d love some advice to find a solution.
A: By this age, babies should be able to sleep for longer stretches and not be fed during the night (if eating is going well during the day). I think, as you are describing, waking up is probably a matter of habit, but there is no blame! It can be hard and daunting to try different methods to have your child fall asleep. But the “cry it out method” is just one of many sleep interventions available.

One alternative could be what is called "modified extinction.” With this approach, rather than letting your baby cry until they fall asleep, you gradually increase the time you wait before responding to their cry. It might be worth discussing with your wife about alternative sleep training methods that might ease some of her concerns. In addition, Nanit Lab published an important article in which we found that babies that were sleep trained did not differ from non-sleep trained babies in terms of attachment to their parents, but they did sleep better! This suggests that sleep training is safe and does not harm your relationship with your baby.

Q: I have three-year-old twin boy and girl toddlers. They share a room. How do I keep them from getting out of their beds at bedtime? What is a good related consequence that can deter this behavior? How do I get them to stop?

A: There is not a magical solution unfortunately, but you can try various strategies. If they are getting out of bed when they’re supposed to sleep at night, something that might help is to have a very consistent bedtime routine. They need to know what is expected of them, and if they wake up, you will gently but firmly bring them back and avoid giving them too much attention. You can also promise to come back to visit them again in five minutes if they lay in bed quietly, and praise them if they do!

Another strategy is giving them two passes. They can get up only two times, maybe if they need water or have to go to the bathroom, or just for a kiss. For those two times you will let them do it, and then after that, you will send them back into their room. This works well for some toddlers because it gives them a sense of control, although partial.

If they wake up in the morning, you can try to buy an okay to wake clock which could help them understand when it's ok to get up. Toddlers don’t have a clear concept of time, so if they wake up at 4:00 am, they might just think that it's morning and get ready to start the day. Try to keep the room as dark as possible to avoid confusing them if the room gets light early in the morning. I hope these tips will help. Good luck!

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Dr. Maristella Lucchini serves as Senior Clinical Researcher at Nanit. In her role, Maristella works to secure grant funding in collaboration with Nanit’s university research partners and supports the development of the company’s research collaborations around the world. Previously, Maristella served as an Assistant Research Scientist in the Division of Developmental Neuroscience, Department of Psychiatry at Columbia University Irving Medical Center where she led projects across several cohorts focusing on sleep health for pregnant and postpartum women and their children. Maristella’s research focused on underserved communities and sleep health disparities in the perinatal period. During her years as a postdoctoral researcher at Columbia University Irving Medical Center in the Department of Psychiatry, Maristella was selected to participate in the American Academy of Sleep Medicine Young Investigator Research Forum. She holds a Ph.D. in Biomedical Engineering from Politecnico di Milano.

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COLABORADORES

Natalie Barnett, PhD serves as VP of Clinical Research at Nanit. Natalie initiated sleep research collaborations at Nanit and in her current role, Natalie oversees collaborations with researchers at hospitals and universities around the world who use the Nanit camera to better understand pediatric sleep and leads the internal sleep and development research programs at Nanit. Natalie holds a Ph.D. in Genetics from the University of New England in Australia and a Postgraduate Certificate in Pediatric Sleep Science from the University of Western Australia. Natalie was an Assistant Professor in the Neurogenetics Unit at NYU School of Medicine prior to joining Nanit. Natalie is also the voice of Nanit's science-backed, personalized sleep tips delivered to users throughout their baby's first few years.

Kristy Ojala is Nanit’s Digital Content Director. She spends way too much time looking at maps and weather forecasts and pictures of Devon Rex cats and no-cook dinners. A former sleep champion, she strives to share trustworthy somnabulism tips with other parents—praying for that one fine day when no tiny humans wake her up while it’s still dark out. Her kids highly recommend 3 books, approximately 600 stuffies, Chopin’s “Nocturnes,” and the Nanit Sound + Light for bedtime success.

Mackenzie Sangster is on the Brand and Community team at Nanit. She supports content development and editing for Nanit’s Parent Confidently blog as well as other marketing initiatives. Outside of work, she enjoys spending time with her friends, cooking, being active, and using the Pro + Flex Duo to keep an eye on her fur-baby, Poppy!