Circadian-savvy postpartum planning tips

Designing care that respects and nurtures the phases of neonatal circadian development and the young family’s recovery from pregnancy and birth

How long does postpartum last? Many women I respect in the birth space suggest it lasts much longer than we are taught. I did my first doula training in 2011 (a CAPPA-based postpartum weekend crash course), and spent the next ten years offering pregnancy and postpartum consults based on that framework. In that training, I was taught most postpartum doulas wrap up care by around 6 months at the latest. After all, “care beyond that starts looking more like nannying!” Or at least, that was the truth inside that narrow paradigm. As I went on to have my own children and to continue offering this care in my local community, I came to my own definition of postpartum. To me, postpartum lasts until the baby is both weaned and potty-independent. Today, I’m going to share some circadian research that supports this concept—it takes 2-3 years for a baby’s circadian rhythm to fully develop, too!

Circadian development is a topic we will see more and more focus on in coming years as we learn more about how this integral physiology affects every aspect of health through the complex feedback loops between the circadian structures and all the other organ systems. Learning how the circadian rhythm is programmed is a key step to understanding how to care for it.

When I learned the initial circadian programming in the womb and early life can last a lifetime¹ and have implications for outcomes as far out as how early and severe dementia can be², I know I wanted to do more to help young families understand how to better nurture rhythmicity in their new babies.

As I have learned more, I have also been increasingly deliberate about stabilizing and strengthening my own circadian rhythms in my own pregnancy and postpartum planning. I planned more for my 4th baby’s postpartum more than any others, and it was so worth it!

The image above was one I chose to focus on what I wanted for my recent Summer birth:

-a happy, healthy baby

-a beautiful, sunny and breezy environment

-a large, supportive community

And through hard work, planning, and a large dose of Serendipity, I was blessed with all of those things.

How to set up a postpartum environment for optimal circadian entrainment of the young family:

Looking at how the environment helps with circadian entrainment—a crucial factor for wellbeing at any stage of life including the perinatal period—we can see traditional wisdom was on point for young families:

• warmth is good (nourishes the production of cellular melatonin in the mother³)

• darkness is good (facilitates the production of pineal melatonin in the mother⁴)

• loving social support is good (supports safety and oxytocin in both⁵)

Mama’s circadian rhythm supports her baby’s rhythm in pregnancy and early postpartum. While it is true the baby’s SCN (the central clock in the brain) develops physically at around 40% gestation, it takes much longer to become fully functional. In the meantime, the mother’s circadian rythm in pregnancy and then her milk’s rhythm⁶ and social cues after the birth will guide her baby’s circadian development.

Baby’s circadian development after birth goes through stages⁷:

1. The first rhythm to emerge is the temperature rhythm (warmer in the day and cooler at night)

2. Next is the wake rhythm and nocturnal melatonin release

3. Lastly, the sleep rhythm

It takes about 1-6 weeks for the first signs to show up—possibly depending upon the environment the baby and family are exposed to—and about 2-3 years for the baby’s rhythm to be fully stable on its own⁸.

However, by 1 year of age, most babies have a pretty good differentiation between daytime activity and nighttime rest.

Newborn sleep/wake patterns from being round the clock to frequent naps, to 2 naps, to one nap, and eventually (not shown) the adult pattern of mostly nocturnal sleep with only occasional (or seasonal) daytime naps.

How can a baby best be supported through these developmental stages of circadian rhythmicity?

Supporting the first phase of a newborn’s circadian development:

Most cultures historically provided a month or more of bedrest for new mamas to care for their newborns around the clock. This environment was usually made womb-like: warm, dim, quiet and safe. This corresponds to that first phase of baby’s circadian development: the temperature rhythm. By the end of this phase, baby may be starting to have nocturnal melatonin secretions and a wake rhythm.

Supporting the second phase of a newborn’s circadian development:

After the postpartum lie-in, the next phase would include introducing baby to the Sun, Moon, and extended community. Outings would still be short and usually morning based. Maximizing morning light and daytime social activity will help solidify the daytime wake pattern.

Supporting the third phase of a newborn’s circadian development:

At last, baby will begin spending more time sleeping and eventually be able to sleep 6+ hours without needing to wake for feeding. Families will begin being able to take up more of their responsibilities thanks to being able to sleep better and get more morning light and activity to activate their serotonin and piezoelectric (movement) systems. This period generally lasts from around 6mos until 3+ years when teething is complete, weaning is often about done, and potty independence established with daytime bowel movements (a sign circadian development of the digestive system is stable).

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I hope this was an interesting and helpful take on postpartum care and how proper nurturing through this special time helps establish a new baby’s circadian rhythm. These stages are also helpful for allowing the mother and father to recover from the strain of pregnancy and birth. Stability of the circadian rhythm can be drastically affected—with poor outcomes, especially for mental health—in the perinatal period. This topic has been talked to death in the media, with little practical help. To bolster these practices above, invest in sleep lights that do not disrupt melatonin secretion after between sunset and dawn. Nighttime darkness is absolutely crucial to preventing the adverse outcomes and stereotypical exhaustion we have come to treat as normal for postpartum families.

Start a free trial or upgrade to paid to learn more about this in my workshop:

1. Hsu, C. N., & Tain, Y. L. (2020). Light and Circadian Signaling Pathway in Pregnancy: Programming of Adult Health and Disease. International journal of molecular sciences, 21(6), 2232. https://doi.org/10.3390/ijms21062232

2. Alachkar, A., Lee, J., Asthana, K., Vakil Monfared, R., Chen, J., Alhassen, S., Samad, M., Wood, M., Mayer, E. A., & Baldi, P. (2022). The hidden link between circadian entropy and mental health disorders. Translational psychiatry, 12(1), 281. https://doi.org/10.1038/s41398-022-02028-3

3. Tan, D. X., Reiter, R. J., Zimmerman, S., & Hardeland, R. (2023). Melatonin: Both a Messenger of Darkness and a Participant in the Cellular Actions of Non-Visible Solar Radiation of Near Infrared Light. Biology, 12(1), 89. https://doi.org/10.3390/biology12010089

4. Hsu, C. N., & Tain, Y. L. (2020). Light and Circadian Signaling Pathway in Pregnancy: Programming of Adult Health and Disease. International journal of molecular sciences, 21(6), 2232. https://doi.org/10.3390/ijms21062232

5. Onaka, T., & Takayanagi, Y. (2021). The oxytocin system and early-life experience-dependent plastic changes. Journal of neuroendocrinology, 33(11), e13049. https://doi.org/10.1111/jne.13049

6. George Anderson, Cathy Vaillancourt, Michael Maes, Russel J. Reiter (2016) Breast Feeding and Melatonin: Implications for Improving Perinatal Health. Journal Of Breastfeeding Biology- 1(1):8-20. https://doi.org/10.14302/issn.2644-0105.jbfb-16-1121

7. McGraw, K., Hoffmann, R., Harker, C., & Herman, J. H. (1999). The development of circadian rhythms in a human infant. Sleep, 22(3), 303–310. https://doi.org/10.1093/sleep/22.3.303

8. Wong, S. D., Wright, K. P., Jr, Spencer, R. L., Vetter, C., Hicks, L. M., Jenni, O. G., & LeBourgeois, M. K. (2022). Development of the circadian system in early life: maternal and environmental factors. Journal of physiological anthropology, 41(1), 22. https://doi.org/10.1186/s40101-022-00294-0