Chapter 1. Newborn States

Synopsis

S. Stavros Valenti, Hofstra University

The Newborn’s Six Primary States of Arousal

quiet awake	drowsiness	deep sleep
active sleep	active awake	crying

Waking and Sleeping Cycles

The Quiet Awake State

In the quiet awake state, the newborn’s eyes are wide open, and the infant shows only slight activity. You can expect a mild response to sights, sounds, and touch. Quiet awake may occur shortly after waking, or it may follow a more active period.

The Active Awake State

In the active awake state, the newborn shows a higher level of activity moving more frequently and occasionally making sounds. The infant’s reactions to sights and sounds are stronger than they are in the quiet awake state.

The Crying State

In the earliest days, a newborn’s cry is an involuntary reflex just as breathing and eye blinks are reflexes. Crying is controlled by structures in the lower, primitive parts of the brain in response to whenever the infant is in distress and needs comfort or food. After a few months, however, crying becomes more voluntary. At that point, the infant can use her cry to get the caregiver’s attention.

The Drowsiness State

In the drowsiness state, newborns and infants open and close their eyes, which usually have a glazed-over appearance. Sleep is not far off!

The Active Sleep State

During active sleep, also known as rapid eye movement (REM) sleep, the infant shows a good deal of movement of the face and eyes under closed lids and some body movements, such as tossing and turning. Active sleep occurs at the start of a period of sleep for newborns. This differs from the normal adult pattern in which the adult sleeper first enters a deep-sleep stage and then proceeds to REM sleep.

Newborns spend about 8 hours a day, which is 50 percent of their total sleeping time, in REM sleep. The proportion of REM sleep declines rapidly in the months after birth. After age 3 or 4, children spend only about 20 percent of their total sleeping time in REM sleep.

Why do newborns spend so much time in REM sleep? Current research suggests that this is nature’s way of making up for the newborn’s lack of external visual stimulation during sleep. To develop properly, the neural circuits for vision need stimulation, and REM sleep creates patterns of brain stimulation that facilitate this development.

The Deep Sleep State

In deep sleep, also known as non-rapid eye movement (NREM) sleep, the newborn is at full rest. Muscle tone and activity are low, and the eyes are still and closed. Breathing is slow and regular.

After two or three months, the sequence of active sleep and deep sleep will reverse, and deep sleep will come before active sleep as it does in adults.

A Typical Day in the Life of a Newborn

The top segment of this diagram shows the typical portion of a 24-hour period that a newborn in the United States spends in each of the six states of arousal.

Some of you may wonder why new parents often complain of sleep deprivation when newborns are sleeping for 16 hours a day. The challenge for new parents is that newborns get their sleep in short naps that may last for a few minutes to a few hours. Therefore, they can be asleep or awake at any time of day or night.

As the chart shows, these round-the-clock bouts of sleep consolidate into a long period of sleep at night and a few naps during the day. Over time, newborns’ cycles of arousal across the day gradually shift into the typical adult patterns of sleeping and waking.

Identify the State of Arousal

In the next several pages, you will have a chance to try your hand at identifying some of the states of arousal in video clips of newborns.

When you feel confident that you can identify the state of arousal, select the newborn state below that most closely corresponds to the infant’s state that you see in the video clip.

quiet awake	drowsiness	deep sleep
active sleep	active awake	crying

Identify the State of Arousal (continued)

When you feel confident that you can identify the state of arousal in this video, select the newborn state below that most closely corresponds to the infant’s state that you see in the video clip.

quiet awake	drowsiness	deep sleep
active sleep	active awake	crying

Identify the State of Arousal (continued)

When you feel confident that you can identify the state of arousal in this video, select the newborn state below that most closely corresponds to the infant’s state that you see in the video clip.

quiet awake	drowsiness	deep sleep
active sleep	active awake	crying

Assessment: Check Your Understanding

Assessment: Check Your Understanding

Assessment: Check Your Understanding

Assessment: Check Your Understanding