As a professional sleep coach, doula, caregiver or parent it is important to understand what state of consciousness your baby is in so you can understand their needs and behavior. A state is a group of characteristic behaviors and physiologic changes that recur together in a regular pattern (Brazelton & Nugent, 1996; Wolff, 1966).
Each state has its own set of characteristics that can be identified through body activity, eye and facial movements, breathing and how they respond to their environment around them. Being familiar with the state they are in can help parents and caregivers know how to best meet their needs. This makes for a happier parent and happier baby.
These states include:
- Deep Sleep
- Light Sleep (active sleep)
- Quiet alert
- Active alert
In Deep sleep baby has little or no body activity. She is very still and relaxed and breathing is smooth and regular. She may make a sucking movement occasionally but does not wake up. She would not be responsive to any stimulation and it would not be a good time to eat or play. If awakened she would most likely go back to sleep. In this state you just need to let her sleep and do something else until she moves through it into quiet sleep.
Quiet or active sleep is associated with processing and learning in infants. It is also known as REM sleep (rapid eye movement). Babies in this state may twitch, smile or make a quick crying sound followed by silence. Eyes may flutter behind closed eyelids and breathing is irregular. She can more easily respond to a caregiver’s effort to arouse and wake her if it is time to get up or eat. Parents, postpartum doulas and caregivers should remember that sometimes babies are just passing through this stage back into deep sleep and it may not be ready to wake up. A few mewing sounds are okay. So don’t rush in right away especially if she has only been sleeping 30 to 45 minutes, wait a minute or two and see if baby will go put herself back to sleep. If she continues you may need to help her go back to sleep or if it is time to eat get her up.
Drowsiness is pretty easy to identify. Her eyes are heavy lidded or slit-like. Body movements vary and she may startle. Her breathing is irregular and she reacts to things drowsily. If it is time to sleep put her to bed quickly with no stimulation. If it is time to wake you can interact with her by talking, singing, holding her or providing some kind of stimulation.
My favorite state is the Quiet alert state. This is where baby looks at you with wide bright eyes. She is very alert and calm. She is very interested in you and will be responsive to you. This is a good time to play, talk, feed and interact with her. By providing her with something to see, hear or do you can keep her in this state longer. However, please remember as a newborn or younger baby this state only lasts a short time and when baby gets over stimulated she will let you know by turning away or becoming fussy. Enjoy this time with her but don’t overdo it.
In Active alert baby’s eyes are still open but not as bright and may be slightly glazed. Breathing is irregular. She will have more body movements and delayed movements than in quiet alert and she maybe irritated if her needs are not met at this time so less stimulation. Hunger, noise and fatigue may begin to bother her or she may have periods of fussiness. Tend to her needs so she can return to a quiet active state or even a drowsy or sleep state. Interventions to comfort her is a must or she may move to the crying state.
Crying is the last state and one that is challenging for all parents and caregivers. No one likes to see their baby cry least of all a parent. She may close her eyes tightly or leave them open. Often her skin color will become pink or red and breathing is irregular. A grimace and color change usually happens right before she begins to cry. Remember crying is a way for baby to communicate with you that she can no longer cope and needs comforting. Be there for her, give her what she needs and help her return to a quiet or active alert, drowsy or sleep state.
As simple as these states may seem understanding them and following their cues can go a long way toward helping infants move smoothly from one state to another. It will also help them sustain longer sleep states when you as a parent or postpartum doula know how to modify your social interactions with them so they can learn to cope. All babies have different personalities and learning how to respond appropriately to their individual needs will make parenting and caregiving easier.