Sleep and tiredness after a birth

A baby who wakes again and again can leave you exhausted, even if you spend plenty of time in bed. Waking often is common in the early months. Sharing the work can help. But tiredness that won’t go away or feels overwhelming also needs a medical check.

Ask for time to rest

Try using some of the time your baby sleeps to rest yourself. Housework can wait for a while. If a friend or relative offers to help, ask them to look after the baby while you sleep. If you’re bringing up your baby on your own, an overnight stay from someone you trust may give you a chance to rest.

Make your request clear: “Could you look after the baby while I lie down?” or “Could you do the morning nappy change?” Pick the job you’d most like someone else to take on.

Share the work around feeding

If you have a partner and use formula, sharing feeds can split the night work. If you breastfeed, another adult can do the nappies and dressing so you can go back to bed. Once breastfeeding is going well, an occasional bottle of expressed milk is another option to talk about, if it suits your feeding plan.

Say what would help tonight rather than expecting someone to guess. You might want help with the early morning, a rest in the day or someone to do a change after a feed. Friends and family can help with these jobs too.

Plan for the moment you feel drowsy

Put your baby on their back in their own cot or Moses basket in your room for at least the first 6 months. Use a firm, flat mattress. Keep pillows, duvets, soft toys and loose bedding out of the sleep space.

Don’t fall asleep with your baby on a sofa or armchair. These are especially dangerous places to doze off during a feed. US NICHD guidance recommends a separate sleep surface for your baby. If you fall asleep by accident while feeding in bed, it advises putting your baby back in their own space as soon as you wake.

Before you bring your baby into bed for a feed, think about whether you might fall asleep. If you might, NICHD advises first clearing everything from your side of the bed, including pillows, blankets and loose sheets. Put your baby back in their own sleep space as soon as you wake. These steps lower the risk, but NICHD still doesn’t recommend sharing a bed.

Countries put the advice on bed sharing in different ways. NHS guidance explains when bed sharing is unsafe, and how to lower the risk if it happens. US NICHD guidance advises against bed sharing. Both recommend a separate sleep space for your baby close to you. Ask your care team to talk through how you set up for the night.

NHS advice says not to share a bed if your baby was born early or had a low birth weight. The same applies if you or the other adult in the bed smoke, have drunk alcohol, have taken recreational drugs or have taken medicine that makes you drowsy.

When sleep loss is not the whole explanation

Anaemia from low iron can cause low energy, a heartbeat you can feel and breathlessness. Thyroid problems can also affect energy and sleep. Postpartum thyroiditis means the thyroid becomes inflamed after a birth. Symptoms can include tiredness, trouble sleeping, feeling unusually hot or cold and finding it hard to concentrate.

A clinician may arrange blood tests to check for anaemia or thyroid problems. The symptoms overlap, so you’ll need help to find the cause. Describe what you’re feeling, when it started and whether rest makes a difference.

Not being able to sleep even when your baby sleeps, feeling hopeless or losing enjoyment can be signs of postnatal depression. If this sounds familiar, talk to your GP, health visitor or doctor soon. You can ask for mental health support however much sleep you’ve missed.

Get help for exhaustion

Call 999 now (UK) or 911 (US), or your local emergency number, if you have severe difficulty breathing or your chest feels tight or heavy.

Contact your maternity team now (UK), or your doctor or urgent care service (US and elsewhere), if you have new breathlessness or a racing or irregular heartbeat after birth. Don’t assume these symptoms are from anaemia or lost sleep.

Contact your maternity team now in the UK, or your doctor or urgent care service in the US and elsewhere, if you suddenly feel overwhelmingly tired and weak or can’t get up to care for your baby. CDC lists overwhelming tiredness among the urgent warning signs after birth. Don’t put it down to a bad night and wait for another nap.

Book a GP appointment in the UK, or see your doctor elsewhere, if tiredness affects daily life, comes with other symptoms or leaves you struggling to cope, and you don’t have the warning signs above. Bring a short description of your nights and the help you have. Mention any other changes in your body or mood that you’d like checked.