Sleep and tiredness after a birth

A baby who wakes repeatedly can leave you exhausted, even when you spend plenty of time in bed. Frequent waking is common in the early months. Sharing the work can help, but persistent or overwhelming tiredness also needs medical attention.

Ask for time to rest

Try using some of your baby’s sleep time to rest. Housework can wait for a while. If a friend or relative offers help, ask them to look after the baby while you sleep. If you are parenting on your own, an overnight stay from someone you trust may make a rest possible.

Make the request specific: “Could you look after the baby while I lie down?” or “Could you do the morning change?” Pick the task you most want taken off your hands.

Share the work around feeding

If you have a partner and use formula, sharing feeds can divide the night work. If you breastfeed, another adult can take care of nappies and dressing so you can return to bed. Once breastfeeding is established, an occasional bottle of expressed milk is another possibility to discuss 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 daytime rest or someone to take over a change after a feed. Friends and relatives can help with these tasks too.

Plan for the moment you feel drowsy

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

Do not fall asleep with your baby on a sofa or armchair. These are particularly dangerous places to doze during a feed. US NICHD guidance recommends a separate infant sleep surface and advises returning your baby to it as soon as you wake if you accidentally fall asleep while feeding in bed.

Before bringing your baby into bed for a feed, think about whether you might fall asleep. If that is possible, NICHD advises removing all items and bedding from your side of the bed first, including pillows, blankets and loose sheets. Return your baby to their own sleep space as soon as you wake. These steps reduce risk; bed sharing is still not recommended by NICHD.

Advice about bed sharing is framed differently across countries. NHS guidance describes when bed sharing is unsafe and ways to reduce risk if it happens; US NICHD guidance advises against bed sharing. Both recommend a separate infant sleep space close to you. Ask your care team to talk through your night-time setup.

NHS advice says not to share a bed if your baby was premature or had a low birth weight, or if you or the other adult sharing the bed smoke, have drunk alcohol, have taken recreational drugs or have taken medicine that causes drowsiness.

When sleep loss is not the whole explanation

Iron deficiency anaemia can cause low energy, a noticeable heartbeat and breathlessness. Thyroid problems can also affect energy and sleep. Postpartum thyroiditis is inflammation of the thyroid after a birth; symptoms can include tiredness, trouble sleeping, feeling unusually hot or cold and difficulty concentrating.

A clinician may arrange blood tests to check for anaemia or thyroid problems. The symptoms overlap, so you will need help to find the cause. Describe what you are experiencing, when it began and whether rest makes a difference.

Difficulty sleeping even when your baby sleeps, feeling hopeless or losing enjoyment can be signs of postnatal depression. Talk to your GP, health visitor or doctor promptly if this sounds familiar. You can ask for mental health support whatever amount of sleep you have missed.

Get help for exhaustion

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

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. Do not assume these symptoms are caused by 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 cannot get up to care for your baby. CDC lists overwhelming tiredness among urgent maternal warning signs. Do not put this down to a difficult 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, without the warning signs above. Bring a brief description of the nights and the help available to you, along with any other physical or mood changes you want checked.