This is one of the most discussed topics in hospital maternal-newborn nursing.
It was also the hot topic of discussion at the Jan. 1997 International
Conference on the Art & Science of Human Lactation held in Orlando, FL. I have
worked in hospitals for many years.  Some of my observations are that babies
are sleepiest from 7-11 am - perhaps because we do nursing assessments, take
pictures, have dr. exams & leave them in the nursery for 2-4 hrs during that
time. They seem to be the most active in late afternoon and early morning
hours. Unfortunately, some nurses think moms should sleep in those early
morning hours and will feed babies in nursery with D5W or ABM!!! (This may
also contribute to late morning sleeps.) I remind moms to think about their
babies'  active & sleepy times in utero; they will often mimic these after
birth.

Suggestions:
1. Encourage nurses to allow babies to stay skin-to-skin with moms during the
1st 2 hours after birth-until baby has nursed. If baby has nursed once s/he
will again.
2. Encourage moms/nurses to allow rooming-in.
3. Teach moms about cues and sleep & wake states. It's much easier to wake
baby during active sleep than deep sleep.
4. Teach moms & dads baby massage-it's great for waking sleepy babies.
5.  Teach nurses how to assess that this is a normal, healthy newborn and may
not nurse much in 1st 24 hours. And they don't need supplements! Have them
look at the 24 hour picture of baby-not just an 8 hour view.
6. Teach nurses about breastfeeding so that they will feel confident that baby
can & will nurse. (sometimes easier said than done)
7. Discourage use of pacifier until baby is nursing 10-12 times per day.
8. Discourage swaddling-we don't need to encourage the normal healthy newborn
to sleep. (Nurses LOVE to package babies neatly. Maybe they should all work in
department stores wrapping gifts during the holidays.)

I have been teaching this to moms & nurses for years. Some get it & some
don't. It can be very frustrating. I'm always ready to sound off on this
topic!!!

I hope some of this information is helpful. Kittie Franz has some good info on
the sleepy baby, also the reluctant breastfeeder.

Laura Hart, RN, BSN, IBCLC