Newborn Sleep- The Fourth Trimester
Newborn Sleep & the Fourth Trimester: What’s Actually Normal
If you’re in the early weeks with a newborn and wondering why sleep feels so unpredictable, you’re asking the right questions. Many parents are surprised by how often their baby wakes, how short sleep stretches can be, or how strongly their newborn prefers being held to sleep. This stage, often called the fourth trimester, comes with unique biological and emotional needs that directly impact sleep.
During the fourth trimester, newborn sleep looks very different from what we’re often told to expect. There is no set schedule; night wakings are frequent, and your baby is still adjusting to life outside the womb. From a developmental perspective, this isn’t a problem to fix—it’s a transition to support.
As a sleep coach and postpartum doula, I work with families who are exhausted, overwhelmed, and unsure whether what they’re experiencing is normal. The good news is that many common newborn sleep struggles—short naps, day/night confusion, contact sleeping, frequent feeding, are expected during this phase. Understanding why they happen can help you respond with confidence, protect your own rest, and lay a strong foundation for healthy sleep moving forward.
In this post, we’ll walk through what newborn sleep really looks like during the fourth trimester, what’s biologically typical, and how to gently support both your baby’s sleep and your own recovery—without pressure, rigid schedules, or fear of creating “bad habits.”
In the newborn season your baby needs you to help them sleep. Shaping their sleep actually is what helps your baby’s sleep develop overtime. Understanding where your child’s brain development is based on their age and stage helps you make informed decisions that take into consideration biological, nutritional, developmental and behavioral needs your child has.
Creating a Healthy Sleep Foundation for your newborn:
Upon welcoming your little one into their new home, your world undergoes a significant shift. Your focus shifts from "doing your own thing" to attending to your baby's needs, including diaper changes, feedings, and providing love and care to your fully dependent new housemate. This period can become overwhelming, especially as sleep becomes more fragmented in this season.
Let me assure you that there are no bad habits before 6 months of age. Your baby will not need you to rock, hold, bounce feed, etc.. to sleep forever. I’ve helped plenty of families make shifts when they are ready. And to be honest, it's never too late to improve sleep when you are ready. BUT there is no rush during the first 6 months.
The 4 Key Elements That Support Newborn Sleep in the Fourth Trimester
Newborn sleep during the fourth trimester is not meant to be long, predictable, or independent. Sleep happens when a newborn feels safe, fed, comfortable, and supported by their environment and caregivers. If you’re wondering, “Is this normal?” " Why does my newborn only sleep when held?" "Is my newborn waking because they’re hungry?" or “Why does my newborn wake so often?”—these four elements offer a helpful lens for understanding what’s really going on.
1. Safe & Secure
Newborn sleep is deeply rooted in safety and connection. In the fourth trimester, babies are neurologically immature and rely on caregivers to help regulate their nervous systems. Your presence, your voice, touch, smell, and responsiveness—signals safety and allows sleep to happen.
If your newborn:
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Wakes shortly after being put down
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Sleeps longer when held or worn
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Startles easily or seems restless
This is not a bad habit—it’s biology. Your calm, responsive care acts as a powerful co-regulator, helping your baby settle and return to sleep. For newborns, safety comes before independence, and feeling secure is the foundation for all future sleep development.
2. Satiated
Newborns have small stomachs and high nutritional needs. Frequent feeding—day and night—is both normal and necessary during the fourth trimester. Many night wakings are driven by hunger, growth spurts, or the need for comfort feeding.
Support newborn sleep by:
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Feeding on demand rather than by the clock
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Allowing cluster feeding in the evenings
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Ensuring effective feeds during the day
If your newborn wakes shortly after falling asleep or seems unsettled despite being held, hunger may still be the underlying need. In the early weeks, night feeds are not something to eliminate—they’re part of healthy development. As a postpartum doula, I often observe cluster feeding periods, which is one 4 hour period in a 24-hour day that the baby wants to eat, even after you just fed them.
3. Settled & Comfortable
A newborn who is physically comfortable will settle more easily—even if sleep remains light and broken. The goal during the fourth trimester is not long stretches, but comfortable stretches.
Support comfort by checking:
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A cool, dark, quiet sleep environment
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Swaddling (if appropriate and safe)
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A simple, predictable wind-down routine
It’s also important to remain aware of physical discomforts that are common in newborns, such as reflux, gas, or skin sensitivities. If your baby seems uncomfortable despite responsive care, it may be worth exploring what their body is communicating rather than assuming sleep is “off.”
4. Sleep Pressure
Sleep pressure is the natural buildup of tiredness in the body. For newborns, this builds quickly and needs to be released often. Unlike older babies, newborns have very short wake windows and can become overtired easily, even when they seem calm or alert.
In the fourth trimester, newborns typically need sleep after 45–60 minutes of awake time, sometimes even sooner. When wake windows stretch too long, the nervous system can become overstimulated, making it harder for your baby to fall asleep or stay asleep.
Signs your newborn may be struggling with sleep pressure include:
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Fighting sleep despite appearing tired
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Waking shortly after being put down
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Frequent startles or restless movements
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Short naps paired with unsettled evenings
Supporting healthy sleep pressure means:
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Watching your baby’s cues rather than the clock
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Offering sleep early, not waiting for overtiredness
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Allowing frequent naps throughout the day
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Keeping stimulation gentle and regulated
If your newborn seems “wired but tired,” it’s often not a schedule issue—it’s a sign their body needed sleep sooner. When sleep pressure is supported appropriately, settling becomes easier and sleep feels more restorative, even if it remains fragmented.
Sleep Doula Tip:
Babies spend about 50–60% of their sleep in active sleep, which means it’s completely normal for some babies to move, make sounds, or even sleep with their eyes partially open. This can look surprising—especially for new parents—but it doesn’t always mean your baby is waking or needs intervention.One of the things I support families with during postpartum doula care is learning how to read and understand their baby’s sleep communication. When parents know the difference between active sleep and true wakefulness, they’re able to respond more calmly and confidently—supporting better rest for everyone.
Common Questions About Newborn Sleep:
How can I help my newborn sleep well?
Establishing feeding, following your baby’s cues and being responsive are two factors to laying a healthy sleep foundation.
- Be sure feeding is well established. The goal during the first 6-8 weeks is working to get feeding established. When your baby feeds well and is satiated whether they are breastfeeding or bottle feeding, or doing a combination of both, then your little one will sleep.
Sleep develops overtime, so one of the first goals we want to see your little one achieve is having 1 stretch of sleep that is 3-4 hours in length. Ideally this would happen at night time to help you get some sleep. Remember, biologically your child will feed 8-12 times in a 24 hour day. So that means eating every 2-3 hours can result in shorter sleep. When you add all those little sleeps together, it will result in 14-17 of sleep between 3-5 daytime naps and night sleep hours in a 24 hour period.
During the first six months, keep sleep goals simple. Don't expect your baby to sleep through the night, as their sleep patterns are still developing. Create a routine that allows your baby to put themselves to sleep 1 time a day to practice.
2. Follow your baby’s cues and be responsive to meet your baby’s needs. When you learn to understand and respond to what your baby is communicating and meeting that need, it actually allows you to work with your baby.
If I’m hungry, feed me. If I’m tired, help me sleep. If I’m awake, then let’s play and engage. In the newborn season, wakeful windows can last from 30 minutes to 1.5 hours. Follow your baby to know what he or she needs.
Short sleep, shorter wakeful window. Long sleep, just a regular wakeful window. Notice that I didn’t say longer wakeful windows. Babies are extremely sensitive to becoming overtired, so tuning in and helping them sleep will help shape sleep which is one of the first steps in establishing a healthy sleep foundation.
What if I don't understand my baby's cues?
You are not alone. As new parents, sometimes you might not know what your baby’s cry is really trying to communicate to you. This was one of the big reasons I spent over 3.5 years sleep deprived — I didn’t know what I didn’t know.
I created Sleep Doula Solutions & Sleep Shaping Success Group to meet the needs of newborn families. I wanted to share and teach the education and support that I offer families when I’m with them on a postpartum doula shift. This is a learning process for both parents and baby when it comes to observing your baby’s active and deep sleep patterns. It’s one of my favorite things to navigate with parents. 
Again, it's common for new parents to feel unsure about their baby's communication so rather than surviving, reach out for support. Patience and kindness are essential in this learning process. Research also shows that when parents have education and support, parents have more positive outcomes in their parenting journey.
Is there a schedule for my newborn?
Not in the traditional sense. Trying to put your newborn on a schedule can be very frustrating for the parent and baby.
Between 6-8 weeks, you can begin to work towards a consistent wake-up time. Be flexible with naps, and gradually introduce routines for a more predictable day.
Between 4-6 months the baby's circadian rhythm begins to develop which means “adult-like” sleep patterns begin. I’ll share more on that in another post. This means now that you may have a consistent wake time, and you could begin working towards a consistent bedtime which will help you have a predictable beginning and end of your day.
Typically between 6-8 weeks, parents may begin to see some consistent patterns emerge which is how your child’s organic schedule unfolds. I have a feeding and sleeping framework I coach parents through to help parents navigate this.
Does this mean sleep is all over the place?
Not necessarily. After three to four weeks, begin introducing flexible routines. They offer a balance of structure and freedom, helping you be responsive and meet your baby's needs while enjoying some predictability. It allows you to be responsive and reflective in your decision making with your baby. It helps you understand and meet your baby’s needs and for you to be intuitive and support your baby through the day.
Creating flexible routines can help you relieve stress and anxiety & save energy because you’ll know what to expect and how to best respond to your baby. My postpartum doula clients get excited about seeing their own personal organic schedules unfold.
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More Newborn Sleep Tips
Here are my top tips to help you maximize your sleep in the newborn season:
- In the early weeks, keep visitors to a minimum and create a calm environment for baby. Allow time to “nest in” and get to know what your baby is communicating to you.
- Establish healthy feedings from day one whether you are nursing or bottle-feeding. Check with your pediatrician to assure that your baby is feeding well.
- Create a flexible routine for the day, which will be followed during the first years of your child’s life.
- Engage with your baby during floor time to help them have short periods of stimulation during wakeful times. Time on your baby’s back and belly is a great activity for your baby. This is also a great time to begin to foster self directed play.
- Decide on a safe sleep space by making an informed choice about room sharing, bedsharing, or crib sleeping—one that prioritizes safety, fits your family’s needs, and feels supportive during the early weeks.
- Implement a simple sleep routine: sleep sack or swaddle, sing a song, and time to go to sleep on a flat surface. This allows your baby to know what to expect and prepare their body for sleep.
- Explore other ways other to soothe your baby other than nursing and feeding. Sometimes our babies simply need to be held or rocked.
- Learn and observe your baby’s cues for eating and sleeping to help guide you.
- Observe your baby’s active and deep sleep patterns.
- Pause for 1 minute when your baby begins to fuss before you intervene. Use the Breathe LOVE method to help support you in responding to your baby.
- Learn to accept short and long naps during the first few months. Naps don’t fully develop until somewhere between 6-9 months of age so being flexible will help you as sleep develops and matures.
My newborn won't sleep in the bassinet or the crib. What can I do to help my baby sleep alone?
- It is biologically normal and expected that a newborn baby would like to be held for sleep, which is why I encourage parents to do contact naps.
- If it becomes unsustainable, it's important to utilize the support you have so that another parent, caregiver, or doula could help support you in the process.
- When possible, practice putting your baby down to sleep drowsy but awake one time a day. Be there and support your baby as they are learning and practicing these new sleep skills.
When should I sleep train my baby?
Wait until after six months when your baby's sleep patterns begin shifting towards more adult-like patterns. Be patient and consider seeking guidance from professionals if needed.
Developmentally your baby may not be ready to sleep through the night. And yes, it’s still common for babies to have night wakings that include night feedings. It’s important to know that sleep for children begins to shift toward adult-like patterns between 4-6 months of age.
How can I get more sleep without following the "sleep when baby sleeps" advice?
Sleep when baby sleeps is usually not the most helpful advice for parents. Instead of trying to nap during the day, give yourself permission to rest for short intervals. Lay down, set an alarm if needed, and focus on breathing. It can make a significant difference in your well-being.
Resting while feeding is also important. This means and can look like being very comfortable and supported while you are bottle or breastfeeding your baby. This can help you show up and be calm and confident, kind and compassionate, to connect with your little one.
Why isn't my baby sleeping through the night like others?
Nothing at all!
There is absolutely nothing wrong with your baby. Each baby is as individual and unique as you and I are. Each baby has their likes and dislikes. Some babies are easy going, while others may need additional support. The key is to figure out what your baby needs, love your little one right where he or she is, and use the process that works best for your little blessing.
And just so you know, you are the perfect parent for your little one! And your little one will help you learn and grow in ways you had no idea you needed to learn and grow. Not ideal or convenient, but yes, part of the loving lessons we will learn as parents.
Probably not what you wanted to hear, but the reality of what takes place in the beauty of parenthood.
As an educator, I believe everything is learnable, and you are your child's best teacher.
If you have questions or want to figure out your next step, let's hop on a call. In the meantime, make it a great night!
Sweet dreams!
