Newborn Sleep and Temperament

by T. Berry Brazelton, M.D., author of Sleep: The Brazelton Way

The baby's temperament shapes her patterns of sleeping and waking from the start. Although the newborn is so disorganized and affected by the events of labor, delivery, and any medication given to the mother that her style or temperament is hard to predict, there are signs even in these early days.

We used to believe that newborn babies were alike, ready to be changed by those who cared for them. Any difficult behavior that arose was assumed to be the parents' fault. We were barely aware of the influence of medication or stressful events to which the mother had been exposed while carrying the baby. Nowadays, however, we know a lot about the wonderful, complex behavior of the newborn and how it can differ from baby to baby. We also know how these differences change the ways eager parents react to their newborns. In my first book, Infants and Mothers, I wrote of three different kinds of newborns: quiet, active, and "average." Together with others, I pointed out how important it is to "understand" these different babies and how they shape the world around them. Parents of course were already aware of these differences, but their observations were not always respected by experts.

In the years that followed, I designed a newborn evaluation that can be shared with new, passionate parents. Many parents are now familiar with this test, called the Newborn Behavioral Assessment Scale (NBAS), which is used at many hospitals after birth. We learned that to identify a newborn's abilities we had to work with a baby's temperament and sleep-wake states.

Newborn Sleep—Wake Cycles

The newborn has six easily identified sleep-wake states. These are: deep sleep, light sleep (or "rapid eye movement," REM), a drowsy state between sleep and awake, wide—awake alert, fussiness, and crying. In the first and the last states the baby shuts out stimulation from her surroundings. The others are transitional and the peak is the alert state. One of the most remarkable observations of the newborn baby is that she can actively maintain the alert state and the shut-out states of sleep and crying. She uses all her resources, her heart rate and breathing, the movements of her body, in her attempts to control interruptions to these states. In order to maintain the balance of her immature nervous system, she tries not to allow stimulation to overwhelm her. Soon after birth, she learns to cycle from sleep to awake to sleep to protect herself from too much stimulation, and to seek out the stimulation she needs. Awake and sleep states balance each other.

After a period of recovery from the overwhelming stimuli of birth and the new environment, the baby can cycle into an alert state in which she opens up to her new world. In that state, the responses of a newborn are amazing. Not only can she see and hear, but she can maintain her alert state—suppressing reflexes and motions in order to respond. She can make choices about what she does or doesn't want to respond to. And, if the activity around her is too overwhelming or too boring, she can slip into what appears to be a sleep state. This sleep state is almost like deep sleep because in this state she breathes deeply and regularly, has tightly closed eyes, and a rigidly controlled body. When the overstimulation ceases, a newborn will often wake up. This shows the baby's ability to protect herself with a sleep state. We call it "habituation"—the baby's way of shutting out the world around her.

Excerpted from Sleep: The Brazelton Way © 2003 by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

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