by Sogand Ghassemi, MD

As a perinatal psychiatrist, I’ve come to believe that one of the most underutilized yet profoundly protective interventions I can offer new parents is this: prescribe sleep.

Sleep loss is so common in early parenthood that it’s often dismissed as “just part of the deal.” But research is telling us something different—and urgent. A 2022 study by Leistikow et al. in Biological Psychiatry found that fragmented sleep is an independent risk factor for postpartum depression. Not merely a symptom—a contributing cause.

And most importantly: improving sleep is protective. This makes sleep not a luxury or a “nice-to-have”—but a clinical priority in the prevention and treatment of perinatal mood and anxiety disorders.

While efforts to improve infant sleep often come up short in the first six months, we can shift the focus toward a more realistic and impactful goal: supporting parental sleep.

Here are four principles I often discuss with patients and their families:

1. Reframe the Narrative: Self-Care Is Foundational, Not Selfish

Cultural norms frequently elevate parental self-sacrifice, implying that a “good” parent always puts their child’s needs first. In reality, a depleted, sleep-deprived parent is at higher risk for mental health challenges and may struggle to attune to their baby’s needs. We need to reframe the message: Meeting a parent’s basic needs—including sleep—is essential to their ability to care for their child.

2. Prioritize Consolidated Sleep: Aim for a 4–5 Hour Block

Sleep architecture matters. A single uninterrupted stretch of 4–5 hours allows for deeper stages of sleep, which are critical for mood regulation and cognitive functioning. While total sleep time is important, consolidation is key. Educating families about this goal—and the risks of ongoing sleep fragmentation—helps frame sleep as a medical necessity, not an afterthought.

3. Normalize the Need for Help: Overnight Care Is a Shared Responsibility

We must acknowledge that caring for an infant overnight is an intensive task, best shared whenever possible. Partners, extended family members, or overnight doulas can play a vital role.

Encourage patients to coordinate at least one longer stretch of protected sleep each night—often made possible by having someone else manage 1–2 feedings using expressed breast milk or formula.

4. Support Flexible Feeding Plans: “Flex the Breast”

Exclusive breastfeeding is often idealized, but it can place significant pressure on the birthing parent—especially overnight. Discussing individualized feeding strategies that protect maternal sleep is both compassionate and evidence-based.

Options may include:

• Pumping and bottle-feeding at night
• Combining breastfeeding with formula
• Formula feeding
• Delegating nighttime feedings

These strategies are not signs of failure—they’re signs of a proactive mental health plan

Sleep should not be seen as an afterthought in perinatal care—it is a core component of maternal mental health. By reframing rest as a protective clinical intervention, we can help parents reduce their risk of postpartum depression and anxiety and support healthier outcomes for both parent and child.

So yes—when I meet with new parents, I often prescribe sleep. It’s one of the most powerful, accessible, and impactful tools we have.

https://www.sciencedirect.com/science/article/abs/pii/S0146000524000818