Your new baby is finally home. So much time has been spent in anticipation of his arrival. Emotions are running high, and so is the uncertainty.

“How do we become a “family?”
“What can I do to make sure my baby stays healthy?”
“When will I ever get another good night’s rest?”
“I just feed him.  He still seems upset.  Is something wrong?”

Most people do not realize the newborn baby might be feeling stressed by his environment. New sounds in the house can cause him to startle; he needs to adjust to the hum of activity and the rhythms of your home.

By learning to recognize his signals of stress as you and he interact will help you ease him into your family life and help his adjustment into the world.
Not only is it important to understand his stress signals, it is also helpful to be able to notice his levels of alertness to better understand his needs.

Many of the stress signs are familiar, such as crying, irritation, agitation and arching of the back. Other signs might include squirming or restless movements, twitches, droopy eyelids or eyes closed, grimacing, or just a worried look.

Less obvious signs of stress include tightly fisted hands, burping or passing gas, splayed fingers, hiccoughing, yawning and looking away. Some signs are very subtle like skin color changes that may look like baby is pale, grey, blue dusky or mottled. Breathing can become erratic and movements can become increasingly disorganized— i.e., baby can’t get fists to his mouth to calm himself.

Interacting with your baby is what you have been waiting for during all the months before birth.  Other questions parents ask include, “When do I know he is ready to interact with me?” or “When is the best time for me to play with my baby?” and “Don’t babies just either sleep or cry?”

Many parents think their baby either sleeps or cries but babies have a range of moods or states. There are two sleep states and four alert states that babies move through.  Understanding the different characteristic behaviors that your baby displays will help you have a better idea what your baby needs. Despite what seems like an erratic schedule, your baby responds in his own way but typically in an organized way. The six different states help your baby control the amount of input that they can manage from the environment.

The Six States of the Newborn
The level of stress expressed by your newborn may be classified into six different states, or categories.  Each state can be identified based upon body activity, eye and facial movements, breathing pattern and level of response.

State 1-Quiet Sleep/Deep Sleep
This stage of sleep is restorative and helps the body grow.
-Lasts only 5-6 minutes
-Eyes are closed
-No visible rapid eye movements
-No sucking and almost no body movements
-Slow steady heart rate
-Regular breathing
-Difficult to arouse or wake-up
-May occasionally startle but easily returns to sleep without upset.

If you try to feed him while he is in quiet sleep you will likely feel frustrated because he will probably be unresponsive.  It may be easier to feed him when he is sleeping less soundly. Even if you try to disturb him, he will likely only awaken briefly and then go back to sleep.

State 2-Active Sleep/Light Sleep or Rapid Eye Movement (REM Sleep)
This state is associated with processing information that is associated with learning. Babies spend most of their newborn sleep in this state which precedes waking up.
-Random body actions
-Rapid eye easily seen
-Sucking movements
-Facial grimacing or twitching
-Irregular breathing and heart rate
-More fluctuations in color
-Likely to move into a more alert state

Even though your baby is asleep, he can react to hunger and handling. Sometimes parents try to feed when babies are in this state as babies may fuss or cry. These sounds typically occur during light sleep. If you try to feed him while he is in this stage of sleep he may not be ready to eat and he can stay asleep, go into quiet sleep or awaken.

State 3-Drowsy Sleep
If your baby is left alone at this stage, he may return to sleep or he may awaken. If you want to him to wake-up you can give him something to suck, hear or see to help him become more alert.
-Higher level of activity that states 1 or 2
-Transitional waking state
-Stretching movements or head turning
-Glazed appearance in the eyes
-Obvious color changes
-Readily goes back to sleep
-More fluctuations in heart and breathing rates
-Unsustained crying
-Easily awakens in response to stimulation

State 4-Quiet Alert
This is the best time to do any activity and the best time for learning as your baby is most attentive.
-Eyes open
-Awake and alert
-Very little body movement
-Responsive
-Regular breathing
-Lower muscle tone
-Limited color changes
-Frequently displays cues to engage in interactions

Some newborns experience a longer period of alertness in the first few hours after birth before going into a long sleep period. As you baby grows older, he will spend more time being quiet and alert. Giving your baby things to look at, listen to or suck will help prolong these periods of
quiet alertness.

State 5-Active Alert
Your baby is moving more during this stage than in the
previous state.
-Eyes open but not as brightly as in the quiet alert state.
-More spontaneous motor movements, may kick, squirm or stretch
-Irregular heart rate and breathing
-Rapid and obvious color changes
-Possibly fussy or irritable
-Crying less than 15 seconds
-May be giving stress signals

Your baby is more susceptible to noise, excessive handling, fatigue and hunger and may start to become fussy. You can help your baby calm before he gets too upset. Helping him to bring his fist to his mouth to teach self-calming will be a great relief to your baby.

State 6-Crying State
Crying is the most difficult state for parents to manage. It is the sign that your baby has reached his limits.
-Crying more than 15 seconds
-Irritable, fussy, upset
-Obviously stressed
-Very high motor activity level
-Needs help to calm
-Usually red in color
-May become blueish in color the longer the crying continues.

Babies tend to cry to communicate, as a response to something unpleasant in their environment or because of hunger, fatigue or discomfort. Sometimes babies can comfort themselves and return to an active or quiet alert drowsy or sleep state and sometimes he will need help from you to calm.

Signs Indicating that it’s Time to Interact
Your baby can show you signs that he is ready to interact with you. These indicators might include being in the quiet alert state (State 4), brighten facial expressions, open hands, places hand toward mouth, cooing, slows or stops sucking. Other positive signs of interaction are when he has his eyes wide open, intently gazing, relaxed muscle tone —not too stiff or too loose, turns and looks toward you or an object. His face or body is pink or evenly colored. Knowing how to read your baby’s signs of readiness and stress will help ease transition and help make the dance between you and your baby more fluid.