Why do toddlers wake up at night?

Toddlers wake for reasons such as short sleep cycles, separation anxiety, or nightmares — not hunger. Understanding this helps parents respond calmly and guide their child toward independent sleep.

How long does toddler sleep training take?

Most toddlers adjust to sleep coaching within 1–3 weeks, though some take longer. Consistency is key and setbacks are normal during illness or routine changes.

What is the Slingshot Method?

The Slingshot Method is a gentle sleep coaching approach where parents gradually move farther from their toddler’s bed over several nights — from sitting beside them to eventually outside the room — to teach self-soothing without tears.

Can I sleep train my toddler while co-sleeping?

Yes. Some toddlers find comfort co-sleeping during transitions. You can maintain gentle boundaries and still encourage independent sleep through communication and gradual change.

What if my toddler gets out of bed repeatedly?

Calmly return your child to bed without extended conversation or play. Expect repetition at first, but consistency helps them learn that staying in bed is the new normal.

What are the essential first aid skills every new parent should know?

New parents should know how to respond to choking, treat burns, stop excessive bleeding, handle poisoning emergencies, identify dangerous fevers, and perform infant CPR. Learning these skills before baby arrives — ideally through a certified class — gives parents confidence in an emergency.

What should I do if my baby is choking?

If your baby is coughing or making noise, encourage them to keep coughing. If they cannot breathe, cry, or make sound, position them face-down on your forearm with head lower than body, give 5 firm back blows between the shoulder blades, turn them face-up, and give 5 chest thrusts. Continue until the object is dislodged or baby becomes unresponsive. Call 911 immediately if baby becomes unresponsive and begin CPR.

When should I call the doctor for a baby fever?

Call your pediatrician if your newborn up to 3 months has a rectal temperature of 100.4°F or higher, your infant 3 to 6 months has a temperature of 102°F or higher, or your baby 7 to 24 months has a 102°F temperature lasting more than 24 hours. Also note that temperatures below 97°F in newborns can signal sepsis or serious illness and should be treated as urgently as a high fever.

How do I treat a burn on a baby?

For first degree burns use cool water — not ice — and apply aloe cream. Keep clean with a sterile gauze pad. Avoid adhesive bandages on young children as they can be choking hazards. For second or third degree burns seek medical assistance immediately, elevate the area, remove clothing, apply cool water for five minutes, and cover with a clean dry cloth. Call 911 for severe burns.

What should I do if my baby ingests something poisonous?

Call Poison Control immediately at 1-800-222-1222 or call 911. Do not induce vomiting without explicit guidance from a healthcare professional. Inducing vomiting is no longer recommended and can cause serious harm. Save the Poison Control number in your phone before baby arrives.

Should I give ibuprofen to a baby who is bleeding?

No. Never give ibuprofen to a baby who is bleeding as it can increase bleeding. Age-appropriate acetaminophen such as infant Tylenol is acceptable for pain. Apply firm pressure with clean gauze and seek emergency care if bleeding does not stop within 5 to 10 minutes.

Is infant CPR the same as adult CPR?

No. Infant CPR uses two fingers for chest compressions rather than the heel of the hand, and rescue breaths cover both the mouth and nose simultaneously. The ratio of 30 compressions to 2 breaths is the same. There is no substitute for taking a certified infant CPR class through the American Heart Association or American Red Cross.

What questions should I ask a night nurse?

The key questions to ask a night nurse or postpartum doula are: Are you a licensed nurse or a certified newborn care specialist — and what is the difference? What hands-on newborn care experience do you have? Do you have current CPR and First Aid certification? Can you provide recent references from families you have worked with? Do you have a current background check? What are your vaccination credentials including TDaP, MMR, Hepatitis B, and flu? What is your care and feeding philosophy — do you support breastfeeding, scheduled feeding, or baby-led approaches?

What credentials should a night nurse or night nanny have?

Professional overnight newborn care providers should have current CPR and First Aid certification (these expire every two years), continuing education in newborn care and safe sleep, verifiable references from recent families, a current background check from a highly-rated screening service, and vaccination credentials including TDaP, MMR, Hepatitis B, and flu. Certified newborn care specialists may also hold the NAPS Night Doula Certificate, which can be verified on the public NAPS Registry at newborncarespecialists.com.

Should I ask a night nanny about their vaccination status?

Yes. Babies 6 months and under cannot receive most vaccines and are a vulnerable population due to their developing immune systems. Caregivers entering a newborn's home should have proof of Hepatitis B, MMR (Measles, Mumps and Rubella), TDaP (Tetanus, Diphtheria and Pertussis), and annual flu vaccination. This is standard practice for anyone working in home health or childcare settings.

How do I do a background check on a night nanny?

There is no single national database containing all criminal records in the United States. Criminal records are maintained at local, state, and federal levels and records from one state may not be shared with another. Using a highly-rated background check service that aggregates from multiple jurisdictions, combined with recent verifiable references, gives the most complete picture of a caregiver's history. If the caregiver is a licensed nurse, their history can also be checked on their state Board of Nursing.

What should I ask a night nurse about their care philosophy?

Ask whether the caregiver supports getting baby on a schedule or a baby-led approach, their position on infant sleep training and attachment parenting, and their experience with breastfeeding support versus bottle feeding. A caregiver whose values match yours creates consistency of care and the most comfortable relationship for your family. Also ask them to describe soothing techniques for babies — someone who can explain multiple safe approaches for singletons, preemies, and twins is demonstrating both experience and attentiveness.

What are the most important questions to ask when hiring a night nurse?

References are the most important question of all. Ask whether you can speak with multiple recent parents who can provide honest feedback — not just one reference, and not references from years ago. Beyond references, verify CPR certification expiration date, background check recency, vaccination status, and whether their care philosophy aligns with yours. Credentials matter, but how a caregiver makes your family feel during the interview is also a meaningful signal.

What is normal newborn breathing?

Normal newborn breathing is 40 to 60 breaths per minute, counted over a full minute while baby is at rest. Newborns breathe irregularly and may include short pauses of 5 to 10 seconds, grunting, snorting, and rapid bursts followed by slower breathing — all completely normal. You can assess breathing by watching the abdomen rise and fall. Normal skin color is pink overall, with blue hands and feet in the first few days being a normal variation called acrocyanosis.

What is periodic breathing in newborns?

Periodic breathing is a normal pattern in newborns — especially preterm infants — where breathing pauses for 5 to 10 seconds then resumes with a burst of faster breaths. These short pauses are normal and do not require intervention. Pauses longer than 20 seconds are considered apnea and require stimulation such as rubbing baby's back, arms, or legs to resume breathing. If your baby is prone to apnea, the hospital will monitor this and may prescribe an apnea monitor for home use.

What does normal newborn breathing look like while sleeping?

Sleeping newborns breathe irregularly — short pauses, rapid bursts, grunting, and snorting are all normal during sleep. Watch the abdomen rise and fall rather than the chest. The normal rate is 40 to 60 breaths per minute but will vary between sleep states. Blue hands and feet are normal in the first days. Blue lips or tongue, breathing faster than 60 breaths per minute, or pauses longer than 20 seconds while sleeping require immediate medical attention.

Why does my newborn grunt while sleeping or breastfeeding?

Grunting during sleep or feeding is almost always normal in newborns. It is usually caused by the hard work of digestion — eating, processing, and passing breastmilk or formula is entirely new to your baby's system. Grunting can also be caused by small nasal passages. If grunting is accompanied by spitting up, irritability, and poor weight gain it may indicate gastroesophageal reflux — contact your pediatrician if you are concerned.

What is acrocyanosis in newborns?

Acrocyanosis is blue coloring of the hands, feet, and around the mouth in newborns — a normal finding in the first days of life as the circulatory system adjusts to breathing air rather than receiving oxygen through the placenta. It typically resolves on its own. Blue coloring inside the mouth — on the lips or tongue — is not normal and indicates low oxygen levels. Call 911 immediately if you see blue inside your baby's mouth.

When should I call 911 or the pediatrician about my newborn's breathing?

Call 911 immediately if your baby has blue lips or tongue, breathing pauses longer than 20 seconds, or is unresponsive. Contact your pediatrician promptly for breathing faster than 60 breaths per minute, flaring nostrils, skin retracting between the ribs with each breath, persistent grunting with every breath rather than occasionally, or lethargy with poor feeding. It is never wrong to call your pediatrician if something does not feel right.

What newborn respiratory rate is too fast?

More than 60 breaths per minute in a resting newborn is considered tachypnea — breathing too fast. Count over a full minute watching the abdomen rise and fall. Note that crying, feeding, and active states will temporarily increase the rate. If your baby is at rest and consistently breathing faster than 60 times per minute, especially with other signs of respiratory distress such as flaring nostrils or retractions, contact your pediatrician.

What is a hybrid diaper?

A hybrid diaper combines a reusable outer shell with either washable cloth inserts or disposable inserts, giving parents flexibility based on convenience, cost, and environmental preference. You keep the shell and swap the insert — tossing the disposable insert just like a regular diaper, or washing the cloth insert and reusing it. Hybrid diapers sit between full cloth and fully disposable — more eco-friendly than plastic disposables, less laundry than full cloth.

How do you use a cloth diaper?

A cloth diaper has two parts — a reusable outer shell and a towel-like insert. The insert absorbs waste and is removed after use, rinsed if soiled, and washed. The shell can be wiped down and reused. After washing, simply replace the insert. If you are out and about use a wet bag to hold used inserts until you get home. For poo diapers dispose of solid waste in the toilet before washing the insert.

Which is better for the environment — cloth or disposable diapers?

Cloth diapers generally have less environmental impact than disposables, particularly because they do not take decades to break down in landfills. However the environmental advantage of cloth depends on how they are washed — cold water washing and line drying significantly reduces their footprint compared to hot water and machine drying. Hybrid diapers with compostable inserts offer a middle path. The Environmental Working Group also notes that harmful chemicals in plastic diapers can affect infant health.

Can I mix cloth and disposable diapers?

Yes, absolutely. Many families use cloth diapers during the day and disposables overnight, or cloth at home and disposables when out or with caregivers. There is no rule that requires consistency — using cloth most of the time while keeping disposables for grandparents, night nannies, or travel is a perfectly valid approach. As our team likes to say, do not let perfect be the enemy of good.

What if my night nanny or postpartum doula is not comfortable with cloth diapers?

Let Mommy Sleep's overnight caregivers are comfortable with whatever diapering system your family uses — cloth, hybrid, or disposable. If a caregiver or family member prefers disposables, keeping a stash on hand for those situations is completely fine. Hybrid diapers are particularly caregiver-friendly because the disposable insert option works just like a regular diaper.

Sleep Coach Your Toddler: A Parents Guide

May 26, 2023

updated, May 26, 2023 – Do you wonder why your toddler wakes up through the night? When will your child get on a routine or nap better? Parents of toddlers often have the same questions we hear about newborns. At Let Mommy Sleep our team of night nurses, nannies and postpartum doulas reassure parents: even if they haven’t been sleeping through the night, it’s not too late to sleep coach your toddler.

Getting Ready to Sleep Coach Your Toddler

A question we’re often asked at LMS is if we’ll soothe toddlers back to sleep if they wake through the night. Even though the night nannies are there to provide newborn care, the answer is yes we will try to care for toddler siblings. But here’s what we’ve learned: toddlers are usually not waking due to hunger or a wet diaper, they want MOMMY or DADDY. Understanding this distinction is crucial for successful sleep training.

Most toddlers adjust to sleep coaching within 1–3 weeks, though some take longer so remember to keep this expectation in mind. Consistency is key, and small setbacks are normal especially with illness, travel or changes in routine.

Two year old boy outdoors in striped short and jean shorts

Why Toddlers Wake at Night

Toddlers’ sleep cycles are shorter than adults’, and they’re sometimes experiencing separation anxiety, nightmares or transitions between light and deep sleep. Knowing this helps parents respond calmly rather than react in frustration. And if a toddler has never slept through the night without a parent’s help, it makes sense that they will continue to expect parent visits in the middle of the night -they don’t know any other way.

Pave the Way with Communication

Once you decide that it is appropriate for your toddler to learn to sleep through the night on their own, explain the change in an age-appropriate way:

Include your toddler in planning: Have a short family meeting to explain expectations, like staying in bed until the wake-up clock goes off. Review the plan nightly before bedtime.
Use positive reinforcement during the day. For example: “Wow, you’re growing up, and this new sleep routine is for big kids!”
Discuss nighttime expectations: “Remember, if you wake tonight, I’ll come in and lay you back down, but I won’t lie in bed with you.”
Reward charts can work too. For example, after three nights staying in bed, your child could choose a small toy.

Some parents consider sleep training when moving toddlers from the crib to the big kid bed. To learn more about that, read How to Ease Toddlers Into Big-Kid Beds.

It’s a Learned Skill

Your toddler must learn the skill of putting himself to sleep without help. But you can teach the skill without making him cry-it-out by communicating and then gradually intervening less and less through the night. Here’s how:

Slingshot Method: A Gentle Approach

When sleep training toddlers, you can do the regular wind down routine and then leave the room, checking in on your child as needed, or you can try this method:

Start awake but calm: Place your toddler in bed while drowsy but awake. Follow your usual wind-down routine (bath, books, rocking).
Gradual withdrawal:
- On Nights 1–2: Sit beside the bed, reassure with voice or touch, gently place them back if standing.
- Nights 3–4: Move chair farther from bed, reassure as needed.
- Nights 5–6+: Sit near the doorway, then eventually outside the room.

Key point: The goal is, “I’m here to help you calm down, but it is your job to fall asleep.”

Does this mean you must stop co-sleeping with your toddler? Nope. It’s completely normal for little ones to go through stages of wanting to sleep in the big bed. Like grown-ups, they may feel anxious or nervous about things. They may lack the words to verbalize their worries but they do know that being in the cozy bed with parents is comforting.

tweet about how to sleep coach your toddler — I mean…

Sleep Coach your Toddler: Handling Nighttime Out-of-Bed Behavior

If your toddler repeatedly gets out of bed and comes to your room, and you want them to sleep in their bed:

Calmly return them to bed.
Avoid lengthy interaction or play.
Expect to repeat this 10–15 times; consistency is crucial.

Tip: Use a wake-up clock that turns a different color when it’s morning time, or nightlight to reinforce the idea that it’s still bedtime.

Don’t Begin on Empty

Make sure on the day that you begin sleep coaching that your child has a full “sleep tank”; they’ve had a good nap during the day- if that means that you need to take her for a walk in the stroller, or for a car ride, then do it. Do whatever you need to do to get sleep. The naps should end 4-5 hours before bedtime. Remember, daytime sleep = nighttime sleep!

I have a plan, now what?

Soothing Bedtime Routine:

Toddlers, like babies, need a wind-down routine to transition from their energetic daytime selves to being receptive to sleep. This routine can include:

Bath or quiet play
Reading or singing
Lights dimmed

This transition signals the brain it’s time to sleep.

Bedtime cues include: Eye rubbing, yawning or fussiness indicate readiness. Missing these cues can lead to overtiredness and cortisol release, making it harder for them to settle.

Toddlers + Newborns: Maximizing Sleep for Both

In a perfect world, toddlers would be sleeping through the night before the new baby arrives. But we all know that the perfect world gets turned upside down pretty often in early parenting! Here are some strategies to help maximize sleep for your baby, your toddler and hopefully you:

Divide and Conquer – One parent gets the toddler to sleep and the other handles the infant. Getting both children to bed at the same time can help both children wind down properly, giving the toddler a better chance at uninterrupted sleep.
Gradual adjustments– If your toddler is used to having a parent present to get to sleep and you need to lessen the time spent doing this, gradually transition them to new habits. For example, you can slowly reduce the amount of time you spend rocking by moving to sitting beside their bed.
Hire help – Consider a mother’s helper or babysitter who can look after your newborn while you concentrate on your toddler’s bedtime routine for a few hours each night. You can read the Ultimate Guide to Baby Sleep Training if you’re interested in infant sleep coaching.

Once you begin, try your best stick to sleep training. Don’t go back to old habits like lying down beside your child until they are asleep, as this sends a mixed message. And that’s not fair to your toddler! It’s hard when you’re in the thick of sleep deprivation, but try to remember that your child is seeking reassurance when they wake up in the night.

We’re always happy to talk through toddler sleep on Reddit, join us anytime.

Quick Reference: Sleep Coach your Toddler at a Glance

Step	Focus	Key Actions
1	Communicate	Talk about the plan, use rewards
2	Routine	Bath, books, lights down
3	Gentle withdrawal	Slingshot Method
4	Boundaries	Return to bed calmly, consistently
5	Support	Prioritize naps and nutrition
6	Adjust	Respond to regressions with patience
7	Sustain	Rest and self-care for parents

Essential First Aid Skills for New Parents

May 18, 2023

There are so many unknowns to parents of newborns and infants! Being prepared in case of an accident or other emergency will not only help your baby, but also help you. Having the skills to help your newborn, twins or any infant in distress will not only give them the best chance of healing, but allow you to stay calm. Essential First Aid Skills for New Parents are detailed below.

Essential First Aid Skills for New Parents

Know How to Treat a Burn:

Burns are unfortunately a common childhood injury. Depending on the severity of the burn, they are categorized as first, second, or third-degree burns.

First Degree Burns: use cool water (not ice) to treat first degree burns and apply aloe cream to the area. Do not apply any other ointments or home remedies. The Mayo Clinic suggests, keeping the area clean with a sterile gauze pad for 24 hours. Take care not to use adhesive bandages on young children since they can be choking hazards.

Second and Third Degree Burns (more severe): Seek medical assistance immediately and try to elevate the burned area. While waiting for help, remove baby’s clothes, apply cool water for five minutes and then cover the area with a clean dry cloth. If the burn is chemical in nature, rinse the burn persistently before taking off his/her clothes. Then remove clothing from the burned area and continue flushing the burn.

Be able to stop excessive bleeding:

In many cases, the best way to stop bleeding is to use clean gauze and apply firm pressure. If a cut won’t stop bleeding after 5-10 minutes of applied pressure, or the cut is very wide or deep, it’s time to seek professional help by visiting an ER. Continue to apply pressure to the area while in transit to the ER.

It is okay to give your older baby an age-appropriate dose of acetaminophen (Tylenol) for the pain, but never give ibuprofen (Motrin,) which can sometimes increase bleeding. For very severe bleeding cases where blood is spurting out (arterial bleeding,) call 911 right away. While waiting for help, continue to apply pressure and elevate baby’s legs to increase the flow of blood to the heart and brain.

Essential First Aid Skills for New Parents – Save a Choking Baby:

If an object gets lodged in baby’s airway, all parents should know what to do. Please note, if baby has a strong cry or is coughing hard, do not perform this procedure. Strong cries and coughs can often push the object out without any additional intervention. But, if your baby is not coughing or crying, follow these steps, as outlined by the American Heart Association:

Saving a Choking Baby

Position infant face-down along your forearm using your thigh for support.

Keep the infant’s head lower than their body.

2. Give 5 firm back blows.

Use the heel of the hand to strike between the shoulder blades.

3. Turn infant face-up with their head lower than their body.

4. Give 5 quick chest thrusts.

Chest thrusts should be about 1 ½ inches deep.

5. Continue giving 5 back blows and 5 chest thrusts.

Continue until the infant can cough or cry or becomes unresponsive.

6. If the infant becomes unresponsive, lower them to a firm, flat surface and begin CPR (starting with compressions) according to your level of training.

Trained responders: After each set of compressions and before attempting breaths:

Open the infant’s mouth.

Look for an object.

For all the steps to help a choking baby, visit our updated guide on choking first aid for infants.

Essential First Aid Skills for New Parents – Poisoning

Part of babyproofing your home and the homes of others looking after baby means keeping harmful substances out of reach. If baby ingests something poisonous, or even if you just suspect they may have been exposed, call Poison Control or 911 immediately.

Put Poison Control in your phone contacts 1-800-222-1222. Contacting Poison Control is free and confidential.

It may be tempting to induce vomiting if your baby has ingested something harmful. But inducing vomiting in a baby should never be done without the explicit guidance of a healthcare professional.

In the past, parents were counseled to induce vomiting in a child that ingested something harmful using Ipecac syrup. This is no longer recommended. We learned that Ipecac syrup caused side effects such as prolonged vomiting, diarrhea, dehydration, and damage to the gastrointestinal tract.

Identify & Treat a Fever:

If your newborn or infant has a fever, it’s important to monitor their temperature. For babies making eye contact and responding to you, drinking fluids and/or playing, there’s probably no cause for alarm. However there are times when it’s vital to call the doctor.

Call your child’s primary care physician if:

Your newborn up to 3 months old has a rectal temperature of 100.4°F (38°C) or higher.
Your infant age 3 – 6 months old, has a temperature of 102°F (39°C) or higher
Infant age 3-6 months has a lower temperature but is acting unusually irritable, sluggish or uncomfortable
Baby age 7- 24 months has a 102°F temperature for longer than 24 hours or has additional symptoms such as cough, or diarrhea

In addition to fevers, Registered Nurse and Newborn Care Provider Liz Hawkes reminds us: “Newborns temperatures will more commonly drop when septic or fighting serious illness, temps below 97.0 should be taken just as seriously as a high fever.” A doctor or 911 should be called.

List of infant temperature to know if too high or low — Infant Fevers: When to Call the Doctor

As always, if you feel something just isn’t right with your baby, call the pediatrician or even visit the ER.

In an emergency, if your baby is unresponsive and not breathing normally, call 911 and begin CPR. Below are general CPR instructions but these do not take the place of learning proper CPR. Parents and caregivers should take a class and get certified.

Place baby on a firm, flat surface
give 30 chest compressions using two fingers in the center of the chest.
Follow it with two rescue breaths, covering the baby’s mouth and nose with your mouth while maintaining a tight seal.

The above is not a substitute for actual CPR training. Attending a class is the only way to understand proper technique and practice skills.

Let Mommy Sleep’s registered nurses and certified newborn care specialists are trained in CPR and first aid. Find overnight newborn care near you.

What Should I ask a Night Nurse?

May 4, 2023

Newborns and their parents have different needs than families with older kids. Postpartum care, breast and bottle feeding and infant sleep safety are just a few of the areas that make overnight newborn care different. If you’re wondering, What Should I ask a Night Nurse to find a great postpartum care, this blog is for you!

Question 1: Are you a Nurse?

The terms Night Nurse and Baby Nurse have been used for many years, but they are not always technically correct! Nurse is a legally protected term in most of the US and may only be used by Registered Nurses (RN) and Licensed Practical Nurses (LPN) or Licensed Vocational Nurses (LVN). Just like every tissue is not a “Kleenex” not every baby nurse is an RN or LPN! If you’re interviewing someone using this title, it’s a good idea to clarify their actual credentials.

Postpartum caregivers may use different titles such a postpartum doula, night nanny or newborn care provider. These terms are not protected and anyone can use them. While the spirit of care is the same, the level of education and focus can vary widely. However, all of these are non-medical caregivers. For example, a trained postpartum doula may be expected to prepare meals and provide care to older children, while a newborn caregiver may focus just on the baby. It’s good to clarify expectations before care begins.

What’s Your Experience?

What Should I ask a Night Nurse?

Experience can look different in newborn baby care and it’s important to know that there’s no required state registry or requirements for newborn caregivers. While there’s no substitute for hands-on experience, Let Mommy Sleep’s training is required across all of our team including newborn care specialists who often have prior certificates. We’ve compiled a list of basics that professional postpartum or newborn care providers should have:

First Aid and CPR Certification – this should also be a given for anyone in home health or child care. These expire after 2 years; an unexpired cert shows a commitment to understanding and practicing safety protocols.
Continuing Education Courses – Recommendations for baby care change over time, so continuing education is vital. Reputable agencies such as a daycare centers or online sources offer updated information in feeding, soothing and safety.
References – This is perhaps the most important question of all! Can you speak with multiple parents who can provide honest feedback? Are the references recent? And are the references excellent…or just okay?

Do You Have a Background Check?

There is no single national database that contains all criminal records in the United States. Criminal records are maintained at the local, state, and federal levels by law enforcement agencies and each agency is responsible for maintaining and providing access to its own records, subject to applicable laws and regulations. In other words, records from one state might not be shared with another.

While no background check is perfect, using a highly-rated background checking service along with references can give you a good picture of a caregiver’s character. If the night nanny has a clinical license, you can also investigate their history on the Board of Nursing.

What are your care and feeding philosophies?

Hiring a night nurse or newborn caregiver whose values and philosophy match yours can make service a true partnership. Here are some things to think about:

Are you a parent that wants to get baby on a schedule right away, or do you favor a more baby-led approach?

Do you have specific opinions about infant sleep training? How about attachment parenting? Is it important that your caregiver have these same beliefs?

How about breastfeeding vs. bottle feeding? Are you a “fed is best” parent or do you prefer to have a lactation counselor who will on coach you through potential nursing challenges?

Having a postpartum caregiver who understands and supports your philosophy as a parent allows for consistency of care and ultimately the most comfortable relationship for your family. As a follow up, you may wish to ask your night nurse or doula to share soothing techniques for baby. Someone who can explain many safe ways to comfort single babies, preemies and twins is not only demonstrating experience, but also shows that they are attentive and alert to babies’ needs.

certified newborn care provider holding baby next to smiling mom. — Night Nannies and Nurses in action!

Night Nurse Jenny looking into camera smiling. — Night Nannies and Nurses in action!

Are you vaccinated?

We know some folks have big feelings about vaccines. It’s important to note though that babies 6 months and under are a vulnerable population due to their developing immune systems and inability to receive vaccinations. Because of this, caregivers should take basic precautions to protect vulnerable newborns and infants. (NIH).

In addition to the flu vaccine, it’s recommended that all postpartum doulas and newborn care providers have proof of Hepatitis B, MMR (Measles, Mumps and Rubella) and TDaP (Tetanus, Diphtheria and Pertussis, also known as Whooping Cough). These are the childhood vaccines we all receive.

There are so many wonderful newborn care providers out there and while references and background checks are the most important part of the interview, the peace of mind of safety, good health and demeanor can be what defines a great partnership for your family. As we always say, someone may be an expert in babies, but you are the expert on your baby!

About Let Mommy Sleep

Let Mommy Sleep is a U.S. provider of newborn and postpartum care services. We’ve been caring for newborns and their families since 2010 and advocate for newborn care industry regulation and standardized care and safety practices. All staff is educated using evidence-based models, approved and overseen by a third party Advisory Board of Registered Nurses, IBCLC’s, Public Health Nurses and postpartum subject matter experts. Read Let Mommy Sleep’s policy paper The State of Newborn Care, published on SSRN.

Newborn Breathing Patterns: What’s Normal?

April 30, 2023

The pauses, the quick breaths, the tiny sighs of your newborn; it all looks so different from adult breathing. This guide, Newborn Breathing Patterns: What’s Normal? written with input from Let Mommy Sleep’s registered nurses and newborn care experts, explains what’s normal, when to call the pediatrician and how to help your baby breathe comfortably.

Newborn Breathing Patterns: What’s Normal? *image credit: RTD Photography*

Normal newborn breathing is 40 to 60 breaths per minute and often includes short pauses of 5 to 10 seconds, grunting, snorting, and irregular rhythms, all of which are completely normal. Blue lips or tongue, breathing faster than 60 breaths per minute, or pauses longer than 20 seconds require immediate medical attention.

Your newborn breaths differently than you because up until birth, baby’s lungs were filled with amniotic fluid. They didn’t need to breathe on their own because oxygen was received from the placenta. Adapting to breathing air instead of fluid happens right away, but the lungs and airway passages are underdeveloped compared to an adults.

Here is a breakdown of what normal newborn breathing looks like, and when to call the doctor:

Normal breathing patterns for newborns can vary depending on their age, activity level, and sleep state but there are general guidelines to keep in mind.

40-60 breaths per minute

You can assess your newborn’s breathing by looking at their abdomen. Your infant’s abdomen rises and falls with each breath. The normal rate is 40-60 breaths per minute in the healthy, full-term infant (counted for a full minute), and will vary depending on whether she or he is sleeping, awake, active, or crying. (More info in this study on UptoDate)

Apnea

A baby born preterm, or before 37 weeks gestation, is at risk for apnea. Apnea is a pause in breathing for more than 20 seconds. For any parent, this is a very long time! The good news is that pauses that are 5-10 seconds long are completely normal. These short pauses, also called periodic breathing, are commonly seen in preterm infants. After 15 seconds, the baby needs stimulation to resume breathing such as rubbing his or her back, arms, or legs, suggested in this article on KidsHealth.org. If your baby is prone to Apnea, the hospital will monitor this closely and may prescribe an apnea monitor upon leaving the hospital so you will know if baby ever needs stimulation.

Preemies are more prone to apnea. Learn more about what to expect if you’re bringing baby home from the NICU here.

If your baby requires home monitoring due to apnea or respiratory concerns, read Infant Pulse Oximetry: Owlet and More for guidance on prescription versus consumer devices.

Skin Color and Newborn Breathing

Another good indication that your baby is breathing well is his or her skin color.

Pink skin = good perfusion of tissues = good breathing.
Blue hands, feet, and around the mouth are actually normal in newborn babies too. This is called acrocyanosis and is often seen the first few days of life while newborns transition to life outside the womb.
Blue INSIDE the mouth is not normal and suggests that baby is not breathing well. 911 should be called immediately if this occurs at home. More on this below.

Luckily, breathing issues will resolve on their own as your baby’s brain and spinal cord mature and muscle tone strengthens. You can help your baby breathe best by laying baby on his or her back on a firm, flat crib or bassinet to ensure baby’s airway is open.

Obligate Nose Breathing

Babies are obligate nose breathers, which means they breath through their nose primarily. This is because they are born with relatively small nasal passages and underdeveloped lungs compared to adults.

How long are babies obligate nose breathers? Most babies develop the ability to breathe through their mouth around 3 to 4 months of age as their airways and lungs mature. Until then, keeping nasal passages clear with saline drops or a bulb syringe is especially important. How to Use a Bulb Syringe

Grunting and Noisy Breathing

Parents might surprised by how LOUD their babies can be! Newborns often make noises while breathing, including during sleep. Grunting, snorting, or whistling are perfectly normal. These noises are usually harmless and may be due to their small nasal passages. Grunting in particular may also be due to normal digestion. Remember that the hard work of eating, digesting and ultimately passing breastmilk or formula is new to your baby’s system.

Sometimes grunting can be a sign of gastroesophageal reflux (GER), a common condition where stomach acid flows back up into the esophagus and makes baby uncomfortable. If grunting is accompanied by spitting up, irritability, and poor weight gain and you’re concerned, contact your pediatrician.

When to Call the Doctor or 911:

Below are signs of respiratory distress that while rare, require immediate medical attention:

Rapid breathing – breathing faster than usual, taking more than 60 breaths per minute.
Flaring nostrils – Flared nostrils during breathing show that baby is working harder than normal to breathe.
Retractions – The skin between the ribs or under the ribcage may be sucked in with each breath.
Grunting – Sounds of grunting with each breath, instead if just once in a while.
Wheezing – Baby may consistently make a high-pitched whistling sound when they breathe.
Cyanosis – The baby’s skin, lips, or nails may turn blue or grayish in color. This is different than acrocyanosis which is temporary and normal as newborns circulatory systems adjust to life outside the womb.
- A new presentation of cyanosis is a sign of low levels of oxygen in the blood. New cyanosis is serious.
- Persistent cyanosis is a sign of an underlying medical problem.
Lethargy: Weak or unresponsive, with little energy to cry or move.

When to Call the Doctor or 911

Sign	What It May Mean	What to Do
Breathing pauses >20 sec	Possible apnea	Call pediatrician or 911
Blue lips/tongue	Low oxygen	Emergency – call 911
Flaring nostrils/retractions	Working hard to breathe	Contact pediatrician
Lethargy or poor feeding	Possible infection or distress	Call pediatrician ASAP

When to Call the Doctor about Baby’s Breathing

How to administer Choking First Aid to infants in an emergency.

Babies are born with relatively small nasal passages and underdeveloped lungs compared to adults. Overwhelmingly this is not cause for concern but parents and infant caregivers should always contact the child’s pediatrician if they’re concerned about baby’s health.

What Can Parents Do

To help your baby breathe comfortably:

Keep baby on their back for every sleep.
Use a firm, flat surface without loose bedding.
Keep nasal passages clear with saline drops or a bulb syringe when needed.
Avoid smoking or strong fragrances near baby.
Stay calm; while most newborn breathing quirks are completely normal it’s never wrong to contact your pediatrician for reassurance and guidance.

Read Your First Week Home with Baby: Ultimate Q&A for more information like this.

Let Someone Else Watch Tonight

If your newborn’s breathing patterns are keeping you up at night, that’s exactly what Let Mommy Sleep is here for. Our RN-led newborn care specialist model means monitoring and overnight care across 26 territories nationwide. Find care in your area. We are here to help.

Reviewed by: Kathleen Hager, RN, BSN, Perinatal Nurse and Newborn Care Specialist
Edited by: Let Mommy Sleep Clinical Team

babies will not choke sleeping on their backs — back sleeping is safest

back sleeping is safest for baby, trachea and esophagus shown unblocked — back sleeping is safest

Cloth and Hybrid Diapers

April 21, 2023

A hybrid diaper combines a reusable outer shell with either washable cloth inserts or disposable inserts, giving parents the flexibility to choose based on convenience, cost, and environmental preference. Cloth diapers are fully reusable. Disposable diapers are single-use plastic. Hybrid diapers sit in between; they’re more eco-friendly than disposables, less laundry than full cloth.

The cloth versus plastic diaper debate is not as clear cut as it seems. Plastic is known to be bad for the environment but cloth diapers while overall better for the environment do require more hot water to kill germs and adds to the mental load of parents. Written by postpartum doulas and night nannies, this blog is overview of eco-conscious diapering options so parents can make the decision that works for them.

First things first-

We are all just doing our best! If you’re eco-conscious but cloth diapering seems like 1 more thing you can’t put on your plate, that’s okay! You can:

Try cloth diapering when the amount of diapers subsides a little or become more predictable.
You can use cloth diapers during the day and then disposables at night.
You can cloth diaper but keep a stash of disposables for grandparents, postpartum doulas or night nannies to use.

Cloth, Hybrid and Biodegradable Diapers – Which is Really the Best for the Environment?

There have been several recent studies comparing the environmental impact of cloth and disposable diapers, and while cloth diapers emerge as the winner, the results are often complex and depend on various factors. Here’s what we mean:

A 2019 study compared the environmental impact of cloth and disposable diapers in the United States. Cloth diapers have a lower environmental impact but only if they are washed in cold water and line-dried instead of using a dryer.

Overall, cloth diapers have less environmental impact, particularly because they do not take decades to break down. They may not be ethical if the family is not in a drought prone area and these are considerations for individual families.

The Environmental Working Group also notes that harmful chemicals in plastic diapers can affect baby’s health.

Cloth diapers arranged in a circle with text, — Cloth, Hybrid and Biodegradable Diapers

Cloth, Hybrid and Biodegradable Diapers – FAQ’s

How Exactly Do I Cloth Diaper?

Instead of one plastic disposable diaper, a cloth diaper is 2 parts. The reusable outer shell is on the outside and then a towel-like insert on the inside. The insert can be washed and reused again and again. Simply throw the insert in the wash and replace with a clean one the same way you throw the dirty diaper in the trash and replace with a new one.

The shell protects baby’s skin from waste and holds the insert. The insert actually absorbs and holds the urine/poo. After the insert is used you can place it in your diaper pail, but if it’s a “poo diaper” you’ll want to dispose of the actual waste in a toilet first. If you’re out and about or not near your home diaper pail, you can use a plastic diaper bag to hold the wet diaper until you get home to dispose of the waste and wash the insert. (Yes, it’s a *plastic* bag but that’s okay! As our friend Voltaire said, “Don’t let perfect be the enemy of good!”)

What’s a Hybrid Diaper?

A hybrid diaper has a reusable shell just like a traditional cloth diaper system but uses disposable inserts, usually made of cotton. So you keep the shell but flush, throw away, – or if you have the time and room – compost the inserts. Unless you are composting, there is no need to “scrape” the diaper of its contents, you simply throw away the insert with the waste inside, just as you would a plastic diaper. Any cloth diaper brands can use the disposable inserts.

I have twins…what diapers should I use?

For parents of twins or multiples, hybrid diapers are especially worth considering. Twins use a minimum of 5,000 diapers per year, so the cost savings of reusable shells add up quickly even if you use disposable inserts. Many twin parents start with a small hybrid stash to test the system before committing fully. Like anything new, cloth diapering takes a little practice.

What about Grandparents or Babysitters that Don’t Want to use the Cloth Diapers? And what if I change my mind?

If baby is going to stay with a caregiver who isn’t confident using cloth diapers, that’s okay! It’s also fine if you try it and don’t want to cloth diaper forever. You can still be green by using biodegradable diapers. There are other planet friendly products such as organic diaper creams or reusable DIY wipes too! And if you are committed to one way of diapering, it’s FINE if you are able to do it your chosen way most of the time. Allow others to do what they are comfortable with.

Diapering is just like any other parenting choice. Cost, convenience, comfort and social responsibility can be taken into consideration. Whatever decision you make will be the right one for your family.

For more info, our Amazon Shop contains everything you’ll need to make cloth diapering easy…and cute! Amazon.com/Shop/LetMommySleep

Overnight, Let Mommy Sleep’s night nannies and postpartum doulas are comfortable with whatever diapering system your family uses; cloth, hybrid, or disposable. If you’d like overnight support in those early weeks, please let us know!

Blog

Sleep Coach Your Toddler: A Parents Guide

Getting Ready to Sleep Coach Your Toddler

Why Toddlers Wake at Night

It’s a Learned Skill

Slingshot Method: A Gentle Approach

Sleep Coach your Toddler: Handling Nighttime Out-of-Bed Behavior

I have a plan, now what?

Toddlers + Newborns: Maximizing Sleep for Both

Essential First Aid Skills for New Parents

Essential First Aid Skills for New Parents

Know How to Treat a Burn:

Be able to stop excessive bleeding:

Essential First Aid Skills for New Parents – Save a Choking Baby:

Essential First Aid Skills for New Parents – Poisoning

Identify & Treat a Fever:

What Should I ask a Night Nurse?

Question 1: Are you a Nurse?

What’s Your Experience?

What Should I ask a Night Nurse?

Do You Have a Background Check?

What are your care and feeding philosophies?

Are you vaccinated?

About Let Mommy Sleep

Newborn Breathing Patterns: What’s Normal?

When to Call the Doctor or 911:

What Can Parents Do

Let Someone Else Watch Tonight

Cloth and Hybrid Diapers

Cloth, Hybrid and Biodegradable Diapers – Which is Really the Best for the Environment?

Cloth, Hybrid and Biodegradable Diapers – FAQ’s

How Exactly Do I Cloth Diaper?

What’s a Hybrid Diaper?

I have twins…what diapers should I use?

What about Grandparents or Babysitters that Don’t Want to use the Cloth Diapers? And what if I change my mind?

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