Why do so many newborn infants have night and day reversed?

Many newborns confuse day and night because babies in-utero typically sleep when the mother is moving around during the day and wake up at night. When a baby has night and day reversed, he or she will not only be awake more at night, but will also do more of everything -- eat, excrete, fuss and need attention. When finally sleeping, the baby may be easily disturbed.

How do we know night from day?

We all have light-sensing cells in our retinas that communicate with the part of the brain that controls our diurnal rhythm, or biological clock. To take advantage of this natural rhythm, make sure your baby is exposed -- with eyes open, if possible -- to bright light during the day.

How can I help my baby adjust to a normal night and day pattern?

During the day:

• Do not swaddle so that the baby wakes more frequently. Dress the baby warm enough that he or she will not need extra blankets.
  
• Place the baby's bed by a bright window (although not directly in the sun).
  
• Avoid steady background noise (like music) as this will encourage the baby to sleep.
  
• Avoid activities that put the baby to sleep.
  
• If you take a break during a feeding (to burp the baby or change the diaper) see if the baby will spend some time being social with you before you complete the feeding.

In the evening:

• Gently try to keep the baby awake and feed him or her as often as possible.

At night:

• Swaddle the baby securely. You can buy blankets specifically for swaddling to make this easier.
  
• Consider having the baby sleep in the car seat (or similar infant seat). A small and cozy space will help the baby feel secure.
  
• Try to avoid overhead lights.
  
• Music or other steady white noise is helpful, especially simulated in-utero sounds.
  
• If the baby typically poops just after falling asleep, use generous quantities of a diaper cream to prevent irritation.
  
• Be prepared for your baby to be hungrier at night. Toward the end of the feeding, swaddle the baby so that he or she will fall asleep ready for bed.
  
• Make sure the baby does not touch anything cool as you put him or her down to sleep.

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