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Do babies know day from night?

Is it true babies need to know day from night, or can they get mixed up?

My son sleeps throughout the day and is up every 2 hours through the night. During the day he eats 50-60 cc every 3-4 hours. During the night he seems agitated. He eats 30-40 cc every 2 hours.

Is there something I should be doing? I bought gas drops, but haven't been able to tell a difference. I am currently breastfeeding, but I am considering switching to formula, because I thought my breast milk may be agitating him.

Elizabeth Walenz | Pediatrician

Elizabeth Walenz

It is not uncommon for newborns to have their days and nights confused. If your son is getting his good sleep during the day, he will be more awake and alert at night.  

I would work to try and shift his day and night cycles. During the day, I would have him nap where the action is. Have him sleep where the blinds are open and the sun is shining through. Have the television on or speak normally around the sleeping baby. Don't let him sleep for more than 2 hours at a time during the day. If the child is due to feed and he is still very asleep, try changing the child’s diaper. Sometimes putting a cold, wet wipe on his bottom will help to awaken a child.  

As the weather gets nicer outside, I take a step outside once or twice a day. Seeing some sunshine and fresh air can help to teach the child that this is daytime. You could take a short stroll around the yard.   

If the baby feeds during the day and immediately wants to go back to sleep, you could try undressing the baby and giving him a bath in the middle of the day. This can help to keep him awake for a short time. Conversely, I will keep the stimulation very low at bedtime. Keep the room dim while feeding and talk to the baby quietly in a whisper. Change the diaper first so that all you have to do is gently burp the baby after feeding and lay him down to sleep. 

This helps to teach the baby day and night. Once a baby is back to birth weight, I will let the baby go for longer periods in between feedings at night and continue to feed every 2-3 hours during the day. If a baby is gaining weight well, I will encourage those periods of 4-5 hours in between feedings at night, but keep them on schedule during the day.

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