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Can you influence how well your baby will sleep, before he's born?

Updated: Mar 13

A new mother will quickly discover how precious sleep is after her baby arrives – yet it is often not something she contemplates too deeply before having a baby. The reality of sleep deprivation is not fully understood by a mother-to-be, until she finds herself in the deep end of it.

However, this article aims to piece together recent studies that show the importance of preparing for the infant’s sleep during and even before pregnancy. Research is beginning to highlight several factors in the womb, contributing to infant’s sleep patterns from newborn, up to 2 years of age.

It is widely known that the fetal sleep patterns are synchronised with maternal rest-activity, heart rate, cortisol, melatonin, and body temperature rhythms, during the last 10 weeks of gestation.

Ingersoll and Thoman found that infants with a higher gestational age (over 37 weeks) and higher birth weight show more quiet sleep at 33 weeks. This suggests that increased brain maturation has been achieved compared with early-arrival babies.

How the mother’s pre-pregnancy and pregnancy mental health affects infant sleep.

Depressive symptoms or negative thinking in pregnancy may also contribute to infant sleep issues.

Interestingly, the effect appears to last beyond infancy, into toddlerhood. A 2010 study found that children whose mothers were depressed during pregnancy slept 0.36 fewer hours/day at age 1 year and 0.38 fewer hours/ day at age 2 years compared with children whose mothers were not depressed during pregnancy (Nevarez et al). The study suggests the possibility that maternal depression can influence maternal behaviour, (such as outward expressions of stress or the manner in which the mother responds to baby) which in turn can impact infant sleep onset.

A possible complicating factor raised by Meltzer and Montgomery-Downs is that sleep disruption during pregnancy may contribute to an accumulated sleep debt that then facilitates the onset of symptoms not directly attributable to childbirth or childcare.

A further study by Kelmanson found higher levels of maternal depressive feelings were correlated with fewer bouts of self-soothing during the middle of the night in infants under 1 year of age.

The mother’s past history affects future child’s sleep

In the same study, the authors note that previous abortions may have serious and long-lasting consequences, including the course of the following maternal pregnancies. Likely due to the links of elevated rates of subsequent mental health problems, such as depression and anxiety, revealed several years after the pregnancy termination.

How the mother herself was parented can have an effect on her own child’s

sleep. A unique study in 2012 by Sheenan, found that the mother’s own perceived past maternal overprotection received from her mother predicted infant’s unsettled sleep behaviour (8% of variance explained). A likely explanation for this effect is that mothers who felt they were parented in a controlling manner, would also perceive their own child’s behaviour as difficult, and hence, may struggle with patience at bedtime.

Amazingly, how a mother slept prior to becoming pregnant also appears to hold some weight in the child’s sleep outcome, according to Sheenan’s study (5% of variance explained). Mothers with a history of insomnia may consider certain infant sleep behaviours, to be more problematic, and hence, treat the behaviours differently than women who were ‘good’ sleepers.

Smoking in pregnancy impacts the infant’s sleep duration.

Previous studies have found an association of prenatal smoking and smoking in early infancy with shorter sleep duration among infants. (Stephan-Blanchard, et al, and Nevarez, et al). This is largely due to how nicotine suppresses the ability to initiate and maintain active sleep and indirectly blocks sleep-promoting neurons. There may also be a socio-demographic link.

What can mother do to help prepare during pregnancy for baby’s sleep?

  • Seek help for depression symptoms or negative thinking.

  • Stabilise mood in pregnancy and post pregnancy.

  • Explore her past maternal overprotection perceptions and think about positive parenting strategies.

  • Seek treatment for insomnia; manage her expectations of sleep and anxieties surrounding sleep.

  • Don’t smoke.

  • Try to establish and maintain her own healthy sleep habits whilst pregnant (sleep during the night-time hours, or relax in bed if she can’t sleep), limit exposure to light from 9pm (or about 2 hours before bed) to assist in melatonin production.

And, directly following the birth:

  • Breastfeed if possible (hormones that help regulate the neonate’s sleep are passed through, as well as lactium which has a calming effect).

  • Consider her own dietary effects such as maintaining stable blood sugar and reducing irritants in the diet.

  • Develop a sense of night and day (light and dark) routine in the early neonatal weeks.

  • Relax and be kind to yourself. Avoid becoming anxious about lack of sleep.

Ingersoll, E.W., & Thoman, E.B. 1999. Sleep/wake states of preterm infants: stability, developmental change, diurnal variation, and relation with caregiving activity. Child Development.70(1):1-10.

Kelmanson, I.A. 2011. Perinatal predictors of sleep disturbances in young Infants. Somnologie. 15:39–46 

Meltzer, L.J. & Montgomery-Downs, H.E. Sleep in the family. 2011. Pediatrics Clinic North America. 58(3):765-74.

Nevarez, M.D., Rifas-Shiman., S.L., Kleinman, K.P., Gillman, M.W., & Taveras, E.M. 2010. Associations of early life risk factors with infant sleep duration. Academic Pediatrics 10:187–93.

Sheehan, J.M. 2012. Maternal Factors Affecting Reported Infant Sleep Outcome. (Unpublished Doctoral Thesis). Victoria University, Australia.

Stephan-Blanchard, E., Telliez, F, & Leke, A. 2008. The influence of in utero exposure to smoking on sleep patterns in preterm neonates. Sleep. 31:1683–1689.

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