We MUST create a sleep supportive environment for new mothers after birth

Tired mother sleeping with her baby

Sleep is so important for healing, for mental health and possibly even for pain perception that it is functionally a healthcare treatment.

New mothers need to heal from childbirth, manage the pain that often results and are at risk for serious mental health disorders like postpartum depression and anxiety. They need sleep.

So why have we allowed hospitals — through the Baby Friendly Hospital Initiative — to create a sleep environment for new mothers that normalizes maternal exhaustion?

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Only one culture cruelly expects exhausted new mothers to fully care for their babies from the moment the placenta is delivered. Ours.[/pullquote]

And what can we do to create a more sleep supportive environment?

Everyone knows about the benefits of sleep.

“Sleep services all aspects of our body in one way or another: molecular, energy balance, as well as intellectual function, alertness and mood,” says Dr. Merrill Mitler, a sleep expert and neuroscientist at NIH.

And the benefits aren’t limited to the brain:

“Sleep affects almost every tissue in our bodies,” says Dr. Michael Twery, a sleep expert at NIH. “It affects growth and stress hormones, our immune system, appetite, breathing, blood pressure and cardiovascular health.”

Sleep may affect pain perception and it has a profound effect on mental health.

That’s probably why nearly all cultures, ancient and modern, mandate a period of confinement for new mothers.

Those who practice it typically begins immediately after the birth, and it lasts for a culturally variable length: typically for one month or 30 days, up to 40 days, two months or 100 days. This postnatal recuperation can include “traditional health beliefs, taboos, rituals, and proscriptions.” The practice used to be known as “lying-in”, which, as the term suggests, centres around bed rest.


“Sitting the month”: 坐月子 “Zuò yuè zi” in Mandarin or 坐月 “Co5 Jyut2” in Cantonese. The custom, going back to the year 960, is referred to as ‘confinement’ as women are advised to stay indoors for recovery from the trauma of birth and feed the newborn baby.

East Asia:

Other East Asian cultures, such as South Korean and Vietnamese, have their own versions of “sitting the month”, combining prescribed foods with proscribed activities. Similar practices are popular among Japanese women called 産後の肥立ち “Sango no hidachi” and Korean women called 삼칠일 “Samchilil” for at least 21 days. The new mother is given special postnatal foods, such as seaweed soup in Korea. Samchilil is practiced in addition to other traditions encompassed in sanhujori, which is Korea’s version of postnatal care. During this period of time that could extend beyond the 21 days, women followed principles that emphasize activities and foods that keep the body warm, rest and relaxation to maximize the body’s return to its normal state, maintaining cleanliness, eating nutritious foods, and peace of mind and heart.


Most traditional Indians follow the 40-day confinement and recuperation period also known as the jaappa (in Hindi). A special diet to facilitate milk production and increase hemoglobin levels is followed.

Latin America:

The cuarantena (literally, forty days, also meaning quarantine) is practised in parts of Latin America, and amongst immigrant communities in the United States.] It is described as “intergenerational family ritual that facilitated adaptation to parenthood”…

In other words, most cultures believe that we should mother new mothers, and adequate sleep is considered critical for both recovery of the mother and production of breastmilk for the baby.

Only one culture cruelly expects exhausted new mothers to fully care for their babies from the moment the placenta is delivered. Ours.

Our culture has normalized maternal exhaustion, portraying it as necessary for breastfeeding.

According to The Milk Meg, Meg Nagle:

Feeding your baby back to sleep. Not a mistake, the biological norm! Most babies will need a mid-nap breastfeed and frequent feeds during the night. For months or years.

Prof. Amy Brown speaks disparagingly of mothers who need sleep:

“We are told by so-called experts that you should get your baby in a feeding routine and your baby should not wake up at nights,” said Brown. “But that is really incompatible for breastfeeding. If you try and feed them less, you make less milk. You need to feed at night to make enough milk.”

And the Baby Friendly Hospital Initiative, designed to promote breastfeeding, has encouraged closing well baby nurseries where mothers can leave their babies while they sleep. The BFHI promotes mandated rooming in, leaving mothers fully responsible for the care of their babies from the very first hours after birth.

The BFHI has led to a mini epidemic of babies smothering to death in their mothers’ hospital beds and fracturing their skulls by falling from them.

A recent article asks, Has the push for breastfeeding gone too far?

“One of the requirements is that 80% of the babies need to be at least 23 hours of the day with the mom,” said neonatologist Enrique Gomez Pomar.

That is a chilling statistic. How can a new mother be expected to get hours of unbroken sleep if she is solely responsible for the care of a newborn? She can’t and lactation professionals don’t care about the harm that causes.

“The problem with this comes when you have a mother that had a C-section or when you have a mother that was laboring for two days and is exhausted,” he said.

Like the two moms mentioned earlier, and others. Finding them was no trouble, basically just a matter of posting on neighborhood Facebook groups, looking for recent delivery experiences.

Such stories are common, Pomar said, because giving moms a break — taking healthy babies to the nursery — is a “ding” against the Baby-Friendly designation.

“They’re very strict about their numbers,” he said. “Say the mom says that she wants to rest, then you take the baby to the nursery. That baby, that case, actually dings the hospital.”

What kind of healthcare system penalizes a hospital for allowing new mothers to sleep? Our system under the Baby Friendly Hospital Initiative.

But sleep is critical for healing, for mental health and potentially for pain management. If we care about women — as we claim we do — we MUST create a sleep supportive environment for new mothers.

That means reopening well baby nurseries in ALL hospitals.

That means encouraging mothers to use those nurseries if they feel a need for additional sleep.

That means prioritizing the health of women’s entire bodies and minds, not merely their breasts — as if they are nothing more than milk machines.

As cultures around the world both past and present demonstrate: exclusive, extended breastfeeding isn’t merely compatible with mothering new mothers; it is enhanced by it.

There is precisely ZERO evidence that normalizing maternal exhaustion improves anything. That’s why it’s imperative that we support sleep for new mothers!