If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
Can parents help young babies sleep better? Yes! Is it safe? Yes! (Blog Posts 24).
It started at just 12 weeks. Katie was so fatigued she would cry for hours, screaming completely out of control, scratching her head, pulling her ears. Holding her didn’t help, so it wasn’t hard not to pick her up—she screamed anyway. Instituting a new day schedule was easy. As soon as she started getting cranky, I rushed her to her crib to sleep. She would watch her mobile, and then sleep for hours at a time. The first week, she was so tired that she only stayed up thirty to fifty minutes at a time and slept three to four hours in between. The key for me was to get her down before she got really upset. The afternoon was when she was awake the longest, and then it was hard getting her to sleep at night. The first few nights under our new regime were the worst. Positive reinforcement from my doctor was important then. I had to hear several times that this “cure” was the best thing to do. The first night under our new strategy, my husband lay on the floor in her room (I guess to make sure she didn’t choke) while I sat crying in our living room. Finally, after forty-five minutes, Katie was quiet! Hurray! Each night she cried less and less, and I handled it better and better. After a week, her hysteria was gone! Sure, she cried a little sometimes, but now she was on a schedule. She napped two or three times a day, two to four hours at a time, and slept twelve to fifteen hours a night. Sleeping promotes more sleep, and makes it easier to fall asleep. It’s a catch-22. Writing down the sleep patterns helped, too. For one week I kept track of every time I put her down and every time I picked her up from her nap. At the end of the week I noticed a distinct pattern in her baby sleep schedule. She fell into it herself!
We used extinction with a twenty-minute limit at 12 weeks. Our little guy would cry in our arms for two hours before he’d finally fall asleep. We’d take turns rocking him in our arms, swaying back and forth. When we finally decided to just try it, we were surprised at how little he cried before he fell asleep—eight minutes! The second day was equally easy, but then he quickly learned the twenty-minute time limit and would cry up to that point. We adjusted the bedtime from 6:30 to 5:30 [earlier bedtime] and removed the time limit [no cap]. First night, he cried for two hours. It was awful! But after four days, the crying stopped.
Our son was colicky and sleep was nonexistent in our house for three months. He refused to go in the swing or the bouncy seat, and hated the car even more (and still does!). If he did sleep, it was after being rocked for hours and he was put down in his crib in a dead sleep. At 12 weeks we did graduated extinction because he had no self-soothing skills. Our goal was four hours of sleep, and it worked. Within five nights, he was sleeping through the night! We were shocked to say the least. It was an absolute miracle and the best thing we ever did. Everyone in the house was much happier, and we started to really enjoy being parents. For the first 3 months he was definitely going to be an only child. Your book Your Fussy Baby helped us tremendously!
I’ll never forget the night and early morning at about 3 months of age when Eric was so sleep-deprived he could not go to sleep. I tried everything—nursing, rocking, walking, bouncing, and singing. Eventually he did fall asleep while I pushed him around the house in the stroller listening to his favorite CD, only to wake up the second I tried to move him into his crib. The hours stretched on and Eric became more and more tired, overstimulated, and agitated. He began trying to pick the flowers off my pajamas. Though he seemed to want to go to sleep, he appeared unable to get there. I felt I didn’t have any choice but to put him in his crib, awake and crying. After about twenty minutes of crying, he fell asleep. He did best with his first midmorning nap, crying only one or two minutes, if at all, before going to sleep. The evenings remained the most difficult. The longest crying episode was twenty-one minutes. My husband and I would sit in the den holding hands, listening to the baby monitor, and engaging in self-doubt: “Does he need us? Are we bad parents for letting him cry?” We kept reminding ourselves that Eric was learning a valuable skill that would serve him (and us!) well for life. After about three days, we felt he had achieved success. He has been a terrific sleeper ever since. Now, at age 11 months, he sleeps from 7:00 p.m. to 7:00 a.m. and naps twice for an hour or two. Everyone who meets him says he is happy, joyful, and alert.
We just utilized the total extinction method for our 3-month-old (13 weeks) son. It took three or four days (the first two days of which were quite difficult) but has been unbelievably successful and a lifesaver for our family and our son. At least in our case, 3 months old was the right time for him. Essentially he would only sleep tightly swaddled in his car seat with a pacifier. We had to constantly reinsert his pacifier every fifteen minutes or he would cry and wake. It was exhausting for both us and him, as his sleep was terribly choppy. We tried graduated extinction at various times from 8 to 12 weeks—waiting ten, fifteen, or twenty minutes before going in to soothe—but he would always outlast us. Last week at 3 months old we decided to utilize total extinction, and while extremely difficult emotionally, it has been an unbelievable success. The process took three or four days. The first night we put him to sleep at 6:30 p.m. and he cried almost ninety minutes—he had a second wind. It was heartbreaking, as most parents experience. He then slept until his normal feeding time of 1:00 a.m. but had several night wakings where we allowed him to cry. The second night he cried approximately sixty minutes. He woke only for his two feedings. The next night, we moved his bedtime up half an hour to 6:00 p.m. He cried for just five minutes and then woke only for his feedings. Last night he did not cry at all when he was put down! He slept his longest stretch of sleep ever—eight hours—then woke to eat. He had one second night waking to eat and then slept until 7:30 a.m. rather than the 6:00 a.m. waking he has been having. His naps are also now falling into place, and he is finally sleeping on his own, in his crib without a swaddle, taking three or four naps a day of one to three hours each. He goes down for a nap after an hour to an hour and a half of wake time. He is now going to sleep for naps and nighttime without any crying, and waking up cooing and smiling in his crib rather than crying. While it took several days and was emotionally very difficult (and perhaps not over yet), his overall crying has gone from constant to very infrequent, and he is sleeping wonderfully. When he is awake he is alert, smiling, and interactive. I am sure we will have to continue to reinstitute the technique as he grows, but it has been so worthwhile.
I have only one child, so my experience is limited to her. Based on our experience, at 6 weeks, all we were trying to do was survive. She was extremely fussy between 5 and 10 weeks. At the time, we felt that the best thing to do was soothe her and try to get the maximum sleep possible. Things were “messy” in the sense that we used swing, holding, the crib, extensive soothing—whatever worked that day/night. We made repeated attempts at drowsy but awake, but it never worked before 3.5–4 months of age. Ultimately, we felt it was more important that she get some sleep in those earliest months, so we did what it took. From my perspective, parents of colicky children should be prepared to be somewhat flexible until about 4 months. You can attempt earlier bedtimes or some extinction, but if things are really disastrous, abandon the effort and try again later. We knew it was time around 3.5 months because we were soothing more and she was sleeping less—it was like we were annoying her! I would add that dealing with colic is incredibly taxing, physically and emotionally. In the first 4 months, we were lucky to get four to five hours of consolidated sleep in a day. Most days, it was two to three hours. Add to that dealing with a fussy child almost around the clock, and you have a recipe for frazzled and distressed parents. I can certainly understand why many parents struggle with a post-colic sleep plan, as it can be hard to be resolute when you are completely burned out.
We had success with my 4-month-old son (he’s now 2 years old). We decided on extinction because it seemed to be likely to cause everyone, including my son, the least amount of stress. Our plan was to get him to a sleepy state and make sure all of his needs were met, and then put him down to bed awake. The first night, he cried for thirty-five minutes, and I cried, too. But then he slept seven hours! He woke once and went back to sleep for four more hours! I thought I’d died and gone to heaven. He was in a much better mood the next day, and his napping was much better as well. I began to wonder if this was really my son! The next night, he cried for twenty minutes and then slept for nine hours straight before waking. He was even more content and had even better naps the next day. I’ll never forget how he had his first night without waking on Labor Day, a few days after starting the extinction method. I told everyone that it felt like a gift for all of my motherly labors. After a few days, he no longer cried when I put him down. My husband and I are such believers that babies/children (and parents!) need sleep to function well. We call what we did for him “sleep empowerment.”
My baby was colicky and never slept. He did not take naps at all for the first 3 months of his life. At 4 months he started taking naps only in the car or in the swing. I feel like he was in the swing more often than not. As soon as the swing was stopped, he would wake right up. At 4 months I decided to do extinction; graduated extinction only riled him up and extended the crying. So we did extinction with no problems at night. He always went right to sleep, no crying and no night-waking problems. He wakes two times a night to nurse. The problems were his naps. He did not know how to self-soothe. So I taught him, and he caught on rather quickly. After two weeks he was going down every two hours for naps without much crying. At the beginning of this nap training there was a lot of crying. At first his naps were short, forty-five minutes or so. After a few weeks the midmorning nap lengthened to about an hour and a half, the midday nap went from forty-five minutes to an hour, and the third nap declined to about thirty-five minutes. I have been very happy with this! My family and friends think I am out of my mind because I schedule everything around his naps.
The hardest thing about dealing with colic was that we didn’t know when it would end. People kept telling us, “Don’t worry, it’ll get better,” but we had no idea whether that would be in a week, a month, a year. The need for twenty-four-hour intensive soothing efforts took a huge toll on me, emotionally and physically, and on my relationship with my husband. Almost a year later, I believe we are still dealing with the fallout from our very intense and difficult first few months. The turning point for us was when we discovered Healthy Sleep Habits, Happy Child and began sleep training at 4.5 months. It was like suddenly we had our lives back. We knew that he would be in bed at 5:30 p.m., and while he would wake up to eat a few times during the night, he would go right back to sleep. Once we had naps under control it got even better. I believe that at a certain point, his natural colicky tendencies were fading, but still being exacerbated by his being horribly overtired. I will know for my next baby (won’t be for a while!) that healthy sleep habits begin on day one, and that most babies don’t just know when to sleep—they need us to help them.
Hi Dr. Weissbluth,
My daughter is 3 days old and seems only to want to sleep if she has physical contact with a person, in her bouncy seat or car seat, or lying next to me in bed. Every time we have tried to put her into her bassinet on her back (the safest way to sleep) drowsy but awake, she fusses and does not sleep. We feel stuck at night, unable to not co-sleep even though it is not safe and I do not want to do it. Any tips? Thank you!
Have you tried a gentle swaddle?
What is a typical soothing to sleep routine (what do you do and how long does it last)?
Try putting her down drowsy but awake with a shorter interval of wakefulness preceding putting her down.
Hi Dr. Weissbluth,
My son is 14 weeks old and up until now he slept great. He has a bedtime of 7:30. Normally after being put to bed awake he would fall asleep within 10 minutes and stay asleep for at least 8 hours, when he needed to be fed. At 14 weeks (born on his due date), his sleep changed. He is taking at least an hour to fall asleep in his crib after being put down, although he is not crying, he wakes around 10:30pm and again between 1:30 and 2:30am. He often will not fall back asleep until he is fed again. I’m not sure what’s happened all of a sudden.
Please describe his mood and behavior between 5-7pm when alone with toys (no screens or parental involvement).
Please read the section on ‘Cumulative sleepiness’ in Chapter 2 of my book to understand why the change occurred “all of a sudden”.
He is usually quite happy and playful. Occasionally around 6:30pm he can become fussy in which case we will try to go to bed for 7pm but the bedtime process seems to take longer (he takes his bottle a lot slower) so it’s almost 7:30 by the time he’s in his crib anyways. Prior to this sudden change we were on vacation and this started the day we got back. I thought it might work itself out after a few days but it doesn’t seem to. Would you suggest a temporarily earlier bed time?
Cumulative sleepiness from a chronic too late bedtime caused him to become mildly sleep deprived (“around 6:30pm he can become fussy”) and the vacation pushed him over the edge. Read and view Blog Posts 9, 83, 115X, 159, 171, 172, and 204 to fully appreciate why he needs a permanent earlier bedtime to prevent brain damage (Blog Posts 148-151). Try a ‘reset’ as described in my book.
Your thoughts?
Yes, the drowsy signs of “Appears less animated, Becomes quieter, and Appears less interested in toys or people.” are definitely present earlier on in the evening. I will need to become more aware of them and their timing. If I think about it I would say the drowsy signs begin quite early around 5 or 5:30pm, we usually do a small nap around then sometimes from 5-6. I will try a full bed time routine instead.
If I do a bed time routine that early will he then wake for the day around 5am? Or his usual 7:30am? Also, when it comes to wakings during the night, if he wakes in the middle of the night (before his usual 8 hour feeding mark) should I try extinction with him or feed him? We have been doing feeding to put him back to sleep the last couple nights.
My son is 6 weeks (counting from the due date) and we started using extinction method to sleep train him yesterday. The first night, we put him down at 745pm and he cried for an hour and half but didn’t fall asleep until 10:10pm. He then woke up at 12:30am and had a bottle. The second night, we put him down at 6:45pm. He started crying at 7:10pm for almost 3 hours (awake the whole time) until about 10:30pm. The crying time increased instead of decreased. I then went inside and gave him a bottle (he appeared really hungry). Should we continue with the training? Or is he too early to start CIO? Any guidance would be helpful!
Please describe his behavior between 4-6pm when alone (no screens or parental involvement).
Hi Dr. Weissbluth,
It depends. Some days he’d be awake and sometimes day he would take a nap in that window. The length of the nap varies usually they are pretty short. Most of the time he appeared to be calm and happy if he takes good naps during the day. But generally getting fussier toward the “witching hours”. Do you think we should put him down to sleep even earlier ?
When does the “witching hour” occur and how often does it occur?
“Witching hour” happened between 6-9pm and it happened 3 times before where my son cried inconsolably for about 1-1.5 hours.
We generally tried to put him down around 7pm but he usually woke up after 30 mins then we’d soothe/feed him. He’d go back to sleep and woke up again around 8:30pm, and then every 2,3 hours after that throughout the night. This is describing his routine before he started sleep training this week.
I would suggest that he be bathed, fed, and soothed and you are leaving the room (he is drowsy but awake) at 5:30pm for 4 nights, with extinction.
Prepare to feed him anytime after 9:30pm and again after midnight, and maybe again early in the morning if he is hungry. Don’t try this unless you can commit to 4 nights. Do whatever you can to maximize day sleep and don’t expect any day sleep schedules now. No new nap begins after 3pm. Keep a detailed written record of sleep and fussiness and crying.
How does this sound?
That sounds good. Will try this out. Thank you Dr. Weissbluth.
Hi Dr Weisserblutch,
This is Michelle again. Would you recommend doing extinction with an hour cap during these 4 day period, or just doing extinction?
Extinction without a cap is more likely to succeed and improvement should be faster.
Hi Dr. Weissbluth,
I wanted to give you an update on our son’s sleep training. For the past 5-6 days, we’ve been bathing, feeding, and soothing our 7-week-old (counting from due date), and then putting him down around 5pm and starts a 3 hour extinction. Normally he starts crying around 7pm, and will continue crying for 80- 90 minutes, until 830pm. At this point, he’s been in extinction for 3 hours and then we come in to feed him (he usually appeared really hungry), soothe him, and then sleeps again until about 11-12pm.
Here are some noticeable improvements since we started sleep training: no more witching hours from 6-8pm. However, we have not seen a consolidation of night time sleep as described in the book, which states should happen around weeks 7-8 before midnight.
His naps are irregular but we’ve been doing a good job of maximining his sleep time (wake-sleep-wake-sleep pattern) and avoid him to be awake for more than 2 hours.
What do you advise us from this point on?
Thanks so much!
Michelle
“putting him down around 5pm”: When you leave the room, is he in a deep sleep or drowsy but awake? What time does he actually fall asleep?
What exactly occurs between around 5pm and about 8:30pm?
Around 8:30, you go to feed and soothe him. What is the duration of the feeding? Is the feeding formula or breast milk? What is the duration of the soothing. After soothing, when you leave the room, is he drowsy but awake or in a deep sleep?
What happens after the 8:30 feeding + soothing?
When do you start the day with him?
1. When you leave the room, is he in a deep sleep or drowsy but awake? What time does he actually fall asleep?
(For majority of the times, he is drowsy but awake) He fall asleep pretty fast. Generally within 5-10 mins.
2. What exactly occurs between around 5pm and about 8:30pm?
(It depends the day. Yesterday, we started extinction at 5:09pm, he slept briefly for 20 min and started crying from 5:25-5:35pm, slept for an hour, and started again from 6:55pm to 7:55pm and we went in his room and gave him a bottle. The day before, we started extinction at 5:30pm, he slept briefly crying started from 5:45- 5:58pm. He slept until 7:15pm and started crying until 7:45 until we went in and gave him a bottle. On both days he appeared hungry when we feed him)
3. What is the duration of the feeding? Is the feeding formula or breast milk? After soothing, when you leave the room, is he drowsy but awake or in a deep sleep?
(Duration of the feeding is 10-15 mins. I pumped breastmilk out and gave him a bottle. When we leave the room he is drowsy but awake.)
4.What happens after the 8:30 feeding + soothing?
(Some days he would fall asleep right away. Some days he’d fuss a few mins and fall asleep. He’d wake up after 2-4 hours and we’d gave him another bottle)
Please describe the quality or intensity of the crying at night. Has this changed at all over the past several days?
I think that you should be optimistic that the night waking/crying will diminish fairly quickly because:
1. Some improvement has already occurred (“no more witching hours from 6-8pm).
2. He has self-soothing skills (He is drowsy but awake when put down)
Perhaps try for 2-3 nights only, as a test, have father give one (or both) bottles at night to see if he cries less.
Are you able to stay the course for several more days?
Yes the intensity of the crying has decreased overall. Ye
Would you recommend us continue with the bedtime 5:30pm and a 4 hour extinction?
Great news! Please stay the course.
Hello Dr Weissbluth, wanted to share our son’ s sleep training in the past 4 days.
Day 1
Wake up at 7am
Bottles
7am 100ml
8:15am 60 ml
10:15am 120ml
1230pm 70ml
1:30 60ml
3:20pm 60ml
5:17 70ml
9pm: 110ml
3:40am 110ml
Nap
840am-910am
915-947am
11:15am-12pm
1:35pm-2pm
3:30-4:00pm
Extinction: 520pm start
Cried 530pm-540pm
Cried 6:15pm- 7:45pm fussed over an hour in low crying- a bit active but not bad. Ted and I were thinking about feeding him but ended up sticking out. We were RIGHT! He later fell asleep at 7:45pm. He is up again at 8:05 but didn’t cry but just making noises. Less active – we went in at 8:45pm to give him a bottle. He was awake for about 30mins after eating before he fall asleep around 9:45pm (no crying).
Slept 10pm-3:30am. 3:30-6:45am 6:50-9:15am
Day 2
Woke up 9:15am
Bottles:
6:45 am 100ml
10:10 am 100ml
12pm 60ml
1pm 100ml
3pm 60ml
4:44pm 70ml
Nap: 10:20-11:10am
11:45am-12:25pm
2:15-3pm 3:30-4pm (not a good nap)
He appears pretty tired around 4pm and fall asleep when I gave him the bottle.
Extinction starts 4:45am. Slept all the way through until 9pm. No crying
Cried at 905pm and drank 120ml milk
Day 3
Woke up at 7am
Bottles
4am 60ml
6am 60ml
8am 40ml
9:25am 40m
11:35 110ml
2pm 100ml
2:40pm 30ml
4:30pm 110ml
4:50 30ml
10pm 120ml
2:35am 120ml
Nap
8am-830am?
9:45am – 10:36am
11am- 11:15am
12pm-1:15pm
3-3:15pm
Extinction starts 4:54pm
Crying 5:19pm-5:29pm. Slept for 5 hours almost!! Until 9:46pm. Then again at 2:15am
Day 4
Woke up at 6:55am
Bottles:
7:30am. 70ml
9am 30ml
11am 120ml
1:47pm 40ml
3:55pm 70ml
4:49pm 40ml
Nap
9:15-10:40am
12pm-1:35pm
2:30-3:40pm
Appeared to be really sleepy around 4:45pm. He had 3 vaccines today.
Extinction starts 4:45pm
Cried: 5:15-5:27 (8mins)
Cried 5:45pm – 5:46pm
Cried 7:31pm – 8pm tuned into low crying. Fussed until 830pm and Dad ent in and gave him a bottle.
Has it been 11 days with using the very early bedtime?
“Slept for 5 hours almost!!” suggests to me that improvement is occurring.
Considering night wakings: Is there any suggestion of improvement regarding the intensity of night crying or the duration of night awakening?
Any improvement in mood or behavior during the day?
In summary, no crying on Day 2 and 3, but crying is back on Day 4.
We’ve been doing sleep training for the past 11 days. One thing I’ve noticed is that if he wakes up in between 5-6pm he can easy fall back to sleep but if he wakes up in between 7-8pm but then he’d have a hard time falling back to sleep. He would fuss for over an hour and we’d go give him a bottle because it’s at the end of the 4 hour extinction mark. Is that normal?
In summary, no crying on Day 2 and 3, but crying is back on Day 4.
We’ve been doing sleep training for the past 11 days. One thing I’ve noticed is that if he wakes up in between 5-6pm he can easy fall back to sleep but if he wakes up in between 7-8pm but then he’d have a hard time falling back to sleep. He would fuss for over an hour and we’d go give him a bottle because it’s at the end of the 4 hour extinction mark. Is that normal?
9 days since we started putting him down around 5pm.
During these night wakings: the intensity of the crying had decreased but the duration hasn’t changed. Especially if it happens in between 7-8pm, my son doesn’t go back to sleep. But if we gave him a bottle, he does go back to sleep.
Do you agree that there has been enough improvement to continue?
Please clarify, when he sometimes awakens around 7-8pm, if a bottle is given, based on the volume consumed and the strength of sucking, do you think he is thirsty or hungry?
He is hungry – he typically consumed around 120ml and can finish around 10-15 mins.
Do you think if he wakes up in between 7-8pm, we can just give him the bottle, instead of continue doing extinction?
YES!
If you think he is hungry, please feed him.
Gotcha! Thanks Dr Weissbluth. We will continue with the early bed time and protects his naps.
Please send me a progress report in several days.
Hi Dr. Weissbluth
I want to thank you for your advice a couple weeks ago on our son. He is now 17 weeks old. We temporarily did a 5:30pm bedtime for about 5 days and have permanently implemented a 6:00pm bedtime since then. We saw an improvement in his naps first. The first nap of the day is almost always 2 hours long. He stirs after an hour but when left alone he will fall back asleep within 10-15 minutes. The second nap is either 2 hours or 1 hour long and depending how that goes we implement a short 3rd nap however it usually is only about 30-45 minutes. If naps don’t go well bedtime gets moved to 5:30 pm. His overnight sleep has improved as well. He usually does at least 8-10 hours uninterrupted until he needs to feed. I found for the first little while it was difficult to get enough feeds in during the day with the earlier bedtime so that he could do the long 8-10 hour stretches. This is still a work in progress but has improved over the last week.
One thing we have found since we started this earlier bedtime that is unusual is he no longer is putting himself to sleep once being put down drowsy but awake like he previously was. We attempted extinction for several nights letting him go 90 minutes with crying until we decided to finally go in to soothe him. Sometimes he will fall asleep quickly but wakes up an hour later and will cry until someone comes in to comfort him. We have been able to gradually reduce the comforting, it started with me needing to nurse him to calm him enough to go back to sleep, it progressed to picking him up for a short cuddle, then to leaving him in the crib and giving him a pacifier and gently rocking him, to now just needing to give him the pacifier. This only occurs at bedtime though, he is able to fall asleep for naps on his own.
Congratulations!
Please specifically describe the question that you have.
Please describe his mood and behavior when alone (no screens or parental interaction) during the hour before you begin the bedtime routine.
Please describe the duration of the bedtime soothing routine.
Is your husband available and willing to help at the bedtime?
I guess my question is why this need for reassurance I would call it from him? It’s only since we started an earlier bed time. Will he eventually go back to self soothing independently?
He usually wakes up from a nap around 4pm. From 4pm till about 5 he is playful and chatty. Between 5 and 5:30pm is when he shows his drowsy signs like going quiet and staring. That is when we begin the bedtime routine so he is put down in his crib anytime between 5:30 and 6pm. Bedtime routine can be anywhere from 30 to 40 minutes depending on how long it takes for him to finish his bottle. He takes a bottle before bed so my husband can do the routine and we know he is fully fed. Usually we do bottle, diaper and pajama change, story then bed. The bottle and story are the only difference between night time and nap times, I nurse during the day.
“That is when we begin the bedtime routine so he is put down in his crib anytime between 5:30 and 6pm.” Does this mean that you are leaving the room at 5:30-6:00 because he has been bathed, fed, and soothed and he is drowsy but awake?
If so, for how many days has it been that, in doing so, he has not easily fallen asleep and stayed asleep?
Is it possible for the father to do the entire bedtime routine?
Please try to describe the chronology of going from self-soothing to not self-soothing in more detail.
His father does the entire bedtime routine so I am not in the room. He leaves the room as soon as he puts our son down in the crib. So yes, after our son has been bathed, fed, and changed he is left alone in his room drowsy but awake. For the last 3 weeks (since we started the earlier bed time) it will go one of 2 ways:
1) Our son will either fall asleep quickly but wake up after 45-60 minutes and cry until one of us goes in (usually we give him about an hour to see if he will fall asleep again but he never does) and gives him a pacifier holding it there for a few seconds until he calms down and we leave the room.
Or
2) He will not fall asleep and we will let him cry for 60 minutes until one of us goes in and gives him a pacifier.
After either of these 2 scenarios we will leave him drowsy but awake, he will put himself to sleep and he will stay asleep until he needs to feed which is about 8 hours later.
Please try to describe the chronology of going from self-soothing to not self-soothing in more detail.
Would you be willing to consider one of the sleep solutions that I describe in my book?
How often does #2 occur?
For our benefit, I have collected your questions and sought to address them each with more clarity.
Question – How often does situation#2 occur? (situation#2) He will not fall asleep and we will let him cry for 60 minutes until one of us goes in and gives him a pacifier.)
Answer – 4 times a week. Last three weeks since August 6th. Furthermore, for the remainder of the week he falls asleep quickly but wakes up after 45-60 minutes and cries until one of us goes in. (situation #1)
Question – Please try to describe the chronology of going from self-soothing to not self-soothing in more detail.
Answer – the chronology is as follows
Since 6 weeks of age (mid June) he was self soothing – fell asleep within 15 mins (later bedtime at 730pm)
We had a week long vacation that began July 30th – he self soothed and slept at least 8 hours
Returned home from vacation August 6th – regressed to 5 hour stretches, 60 plus minutes of crying before we would go in for reassurance. This continued for 4 days until we implemented your advice of an earlier bedtime, 5:30 pm.
Since then his overnight sleep has improved, however, he has been unable to self soothe at bedtime
This results in us entering his room to reassure him with a pacifier
Key questions we have as parents regarding this are…why is he unable to self soothe as he was so capable of doing so before? Why are we noticing the 1 & 2 situations occurring? Is this requiring us to enforce an extinction process?
Question – Would you be willing to consider one of the sleep solutions that I describe in my book?
Answer – of course, I think we are more inclined to implement full extinction as suggested in your book. I hope for this to be effective in overcoming this recent issue of his lack of success with self soothing.
Perhaps the vacation was associated with acquiring a sleep debt that led to his sleep problem. Maybe the pre-vacation bedtime was a little too late and the vacation pushed him over the edge. Perhaps your subsequent attempt to re-soothe him back to sleep led to the current issue. Do you agree?
Extinction is safe and effective and because of the early bedtime and father involvement, I would be optimistic.
Hi Dr. Weissbluth,
I recently just finished your book and wish I had started reading it sooner! I am hopeful you can help provide some specific recommendations on how to get my son on track to improve his sleep overall and address the sleep debt he has likely accrued.
He is currently 14 weeks. For background, he was born at 39 weeks gestation and I exclusively breastfeed. For the first 8 weeks, my husband and I basically did what we could to get the maximum amount of sleep for ourselves. He seemed to only sleep for longer than an a hour at a time if we held him. Whenever we would attempt to put him down in the bassinet, he would wake up. Attempting to get him to fall asleep drowsy but awake did not work. We slept in shifts to survive this time! During the day, he was not a particularly fussy infant. He could be calmed quickly when upset and we would not consider him colicky. After about 9 weeks, we gave up on the bassinet and placed him in the crib unswaddled and he finally gave us a 4 hour stretch of sleep. We would rock him to sleep, transfer him to the crib, and he would continue to sleep for 4-7 hours at a time, waking to feed, places back into the crib asleep and stay asleep until morning. Shortly after that, he started to self-soothe by sucking on his hands and we observed that he was able to put himself back to sleep in the middle of the night after waking up. We felt comfortable sleep-training him around 11 weeks using the extinction method.
Nights:
After applying the extinction method around 11 weeks old, he is now able to fall asleep independently typically in 10 minutes or less, but will cry off and on for the entire time before falling asleep. Once he is asleep, he will always wake up after about an hour but is always able to put himself back to sleep within 10 minutes or less, sometimes with crying off and on. We’ve noticed he goes into light sleep around 3-4 AM and may wake up for short periods of time but is typically able to put himself back to sleep. Recently, he has been waking up at 5 or 6 AM for a feed. He will typically fall asleep at the breast, but does not stay asleep upon transferring, so I will hold him while he sleeps until 7 AM when we are up for the day.
Naps:
We have typically done contact naps to get him to sleep for longer periods of time. He often would wake upon transfer if we attempted to move him to the crib after he fell asleep and typically would not stay asleep for longer than 20 minutes if he did not wake upon transfer. We started the nap exercise for naps 1 and 2 (4 total naps per day) about 1 week ago and he is able to fall asleep independently for the first 2 naps but does not sleep more than 30 minutes each nap. He also will cry with varying intensity for about 10 minutes before falling asleep. I have been picking him up and holding him for about another hour after the second nap to ensure he gets enough day sleep. The 3rd and 4th naps are either contact naps or in the stroller.
Our current schedule:
Up for the day at 7 AM.
Nap 1 – 9 AM – 9:30 AM
Nap 2 – around 11:45 AM – 1:00 PM (contact nap to extend nap upon waking after falling asleep independently)
Nap 3 – around 3 PM – 3:45 PM (contact nap or stroller nap)
Nap 4 – around 5:45 PM – 6:15 PM (contact nap or stroller nap)
Bedtime at 8:30 PM. This is the time we landed on around 6-8 weeks, before reading the book, as he gave us the longest stretch in the night around this time. We were advised this was his “bedtime” from the sleep resources we were using at the time.
Our naptime routine includes saying good night to various things in the house while making our way to the nursery, diaper change, put on sleep sack, book, turn on white noise and turn off lights, quick song, same good night phrase each time then placing in crib awake. This routine takes about 10 minutes total. We add a feed and a bath to the start of the nighttime routine, typically starting the feed about 45 minutes before his bedtime.
Our main issues at this point are short naps and early morning wake-ups. I am wondering if he is overtired. I suspect we have been putting him to sleep when he shows signs of fatigue, which I now know is too late. However, we were told by other sleep sources that these signs are not reliable in an infant after 3 months and could also be a sign of boredom. We were told to push through these signs and follow appropriate wake windows. I have now read your blog posts about not following wake windows and following his cues instead! Another thing that makes me suspect he is overtired is recently he will often fall asleep while nursing, even if it occurs right after a nap. If he wakes up on his own after his nap, he can be in good spirits. If we wake him from a contact nap to try to limit day sleep as it seems he could nap on us for hours, he is often crying and seems angry to be awake. He tends to be most fussy in the middle of the day. He will lose interest in toys quicker and often wants to be held right up until his nap 2nd and 3rd naps around this time. He temperament is great around 5 – 6 PM. He will play well and is happy. He typically will start to show signs of being tired around 7:30 PM. Previously, we would push through these signs to ensure we had enough “sleep pressure” built up before putting him to bed at 8:30 PM. I realize a big step will be moving to an earlier bedtime. I am unsure how to best take this step with his current schedule given his late nap in the day and concerns it will significantly mess up his current night sleep and lead to multiple middle of the night awakenings. Any specific suggestions that you have at this time would be very much appreciated as I want to see him up for a life of healthy sleep habits moving forward.
Thanks,
Teresa
You are correct, your baby is short on sleep which causes pre-sleep arousal Please read Blog Posts 159, 171, 172, and 204 to better understand why this messes up his sleep.
Choose a sleep solution from my book that comports with your life style and values and then I will give you specific advice.
Hi Dr. Weissbluth,
Thanks for the quick response. My husband and I have read your recommended blog posts and I reread the sleep solutions chapter. We feel comfortable with full extinction at this time.
Thanks,
Teresa
OK
Night sleep rhythms begin to develop around 6 weeks of age and nap rhythms develop later and become well established by 6 months of age so the focus now is on night sleep.
Temporarily, for the next 3-4 nights, the bedtime is 5:30pm (he is bathed, soothed, and fed and hopefully he is drowsy but awake and you are leaving the room at 5:30pm). If hungry, he is fed again anytime after 9:30pm and maybe again, at least 4 hours later, early in the morning. Extinction overnight.
Do whatever you can during the day to maximize sleep and minimize crying without regard to any schedule or habit formation, but keep the intervals of wakefulness brief. Watch for drowsy signs. No new nap starts after 3pm but if he is asleep then from an earlier nap, do not wake him.
Keep a written record.
The expectation is that night sleep will improve quickly and later and slowly naps will improve. When naps are better, the bedtime will be shifted later and be based on drowsy signs.
How does this sound?
Hi Dr. Weissbluth,
Thanks for the response. I had a few follow-up questions:
1. He is currently getting about 10 hours of uninterrupted sleep at night. I understand the goal of the temporary earlier bedtime is to address any sleep time debt. However, I assume in the beginning of this trial, he will wake up more throughout the night and will likely cry more because of the change in his schedule. Concretely, what should we be looking for for improvements in his night sleep? Ie, are we hoping for him to sleep at least 12 hours, looking for less fussiness during the day and less signs overall fatigue, reduction in intermittent middle of the night stirrings?
2. He doesn’t appear to show significant signs of being short on sleep between 4-5 PM. Would slowly adjusting his bedtime to an earlier time be another option?
3. “Do whatever you can during the day to maximize sleep and minimize crying without regard to any schedule or habit formation, but keep the intervals of wakefulness brief.” Should I continue to try to get him to nap independently knowing he will wake after 30 minutes? Should I continue to extend the second nap after he wakes and contact nap for the third nap? Should I be capping his contact naps? I feel he could sleep for hours on me if I let him.
Thank you,
Teresa
1. Night sleep quality depends on timing, duration, consolidation, and regularity. Better quality night sleep should reduce fussiness during the day and less fatigue signs because you are also providing nap opportunities.
2. In my experience, you will feel frustrated by lack of improvement if you go slowly.
3. Temporarily, use contact naps, swings, car rides, to maximize daytime sleep. No nap caps. Extend naps if you can. Later, when he wakes up better rested from better night sleep, a weaning process towards more self-soothing for naps will occur.
Does this make sense to you?
Hi Dr. Weissbluth,
Regarding not capping his naps, if his first nap lasts say 3 hours and extends into the timing for his nap around 12-1 PM, won’t that mess up the day and then interfere with his night sleep?
Thanks,
Teresa
Please try to be optimistic. 3 hour naps are uncommon. There is no nap schedule. If you wish, you can give me daily reports and perhaps we will make some adjustments. The key to success for now is a temporary super-early bedtime.
Hi Dr. Weissbluth,
Ok, we plan to start tomorrow. I will keep a daily log and update you for advice on adjustments.
Thank you!
Teresa
Hi Dr. Weissbluth,
I am unable to post my summary. This is a test comment.
Thanks,
Teresa
Hi Dr. Weissbluth,
Here is my log from day 1. Please let me know if you have any changes to suggest. The website didn’t allow me to copy by notes so I had to retype it. Apologies if you end up getting duplicates of the same message!
Of note, Dad was working but will be able to help out more during the day for the next few days.
Day 1
Wake up: 6:54 AM. He slept from 8:30 PM – 6:54 AM without any wake-ups (just some stirrings that he was was able to self settle). Woke up content and happy.
Signs around 8:23 AM: yawn, glazed look, less entertained with toys/mild fussing. Started nap routine, which finished at 8:28 AM.
Nap 1 – 8:36 – 10:03 AM, performed by Mom. Held in rocking chair (stopped rocking once asleep). No crying. Woke up content on his own.
Wake window temperament: happy, smiling, active
Signs around 11:33 AM: yawn, quieter, less interested in toys/people. Started nap routine, finishing at 11:38 AM.
Nap 2 – 11:48 AM – 12:45 PM), performed by Mom. Held in rocking chair. Was more fidgety when trying to soothe to sleep, but no crying. Woke up whining and attempted to soothe back to sleep for about 10 minutes, but his eyes were open and he started fussing more so we gave up and moved on.
Wake window temperament: sleepy while nursing, but didn’t fall asleep and perked up right away. Then happy and active.
Signs around 2:26 PM: yawn, nuzzling, tired eyes. Started nap routine, finishing at 3:31 PM
Nap 3 (2:38 – 3:26 PM), performed by Mom. Held in rocking chair. Was again more fidgety and fussed a bit while trying to soothe to sleep. Woke up on own, slightly fussing but no significant crying.
Wake window temperament: sleepy while nursing. A little more disinterested in toys and less engaged overall. Slightly more fussy than he had been but still generally content.
Signs before bed around 5:00 PM: nuzzling after being burped, sleepy while burping, glazed eyes. Finished nursing at 5:10 PM. Dad started bedtime routine with bath and finished routine at 5:34 PM.
Night summary:
– In crib at 5:34 PM, initially calm then quickly started crying, which was generally angry and heavy.
– 22 minutes to fall asleep, sleeping from 5:36 – 5:53 PM. Woke up crying.
– Fell back asleep after 16 minutes with <10 minutes of heavier crying.
– Slept from 6:48 PM – 2:39 AM with only brief stirrings. Woke up crying at 2:39 AM.
– Nursed and changed diaper, held upright for 10 minutes after finishing (has history of reflux) before placing back in crib at 3:22 AM. He had initially fallen asleep while burping, but woke up upon transfer to crib. Remained calm, no crying.
– Laid awake calmly from 3:22 – 3:40 AM before falling back asleep.
– From 3:40 AM – 6:30 AM was in light/restless sleep.
– Laid calmly in crib from 6:30 AM – 6:44 AM then started crying so I went to get him to start the day. He immediately stopped when he say me and was happy.
I also had questions about his naps:
1. If his last nap ends a lot earlier than 3 PM, with a bedtime of 5:30 PM, would we just try to keep him up until 5:30 PM and disregard any fatigue signs we start to see?
2. On the other hand, if his last nap goes close to 4 PM or later, do we still just put him to bed at 5:30 PM even without any drowsy signs?
Thanks!
Teresa
1. If his last nap ends a lot earlier than 3 PM, with a bedtime of 5:30 PM, would we just try to keep him up until 5:30 PM and disregard any fatigue signs we start to see?
Maybe try for a nap that starts around 2:30-2:45 even if the preceding interval of wakefulness was very short. If no nap occurs, do your best to distract and soothe him during the late afternoon before 5:30pm but not to the point where he falls asleep after 3:00pm.
2. On the other hand, if his last nap goes close to 4 PM or later, do we still just put him to bed at 5:30 PM even without any drowsy signs?l
Yes.
How do you feel about all of this? What are your husbands thoughts and feelings?
Hi Dr. Weissbluth,
We have noticed he is happier and less fussy during the day, which is very encouraging! Our concerns are:
1. We are wondering if he will get to a point where he will have too much total sleep where it causes him to wake up in the middle of the night and remain up for awhile (split night) or wake-up before 6 AM consistently, which is too early for us to sustain especially when I return to work in July. You can help inform us if our concerns are not likely based on your research and experience. I suppose this is also something that we may need to just figure out through trial and error?
2. My husband is concerned that a 5:30 PM bedtime will not be sustainable once our baby starts daycare in July once we both return to work. We likely will not get home until 5 PM or later and there is not another caregiver at home who could help put him to sleep earlier. We are hoping we may be able to keep an earlier bedtime, but possibly move it back a bit? Will this depend on how his naps improve and how he does when we trial a slightly later bedtime?
3. When would you suggest working on the nap drill again? The goal was to move away from contact naps. We have tried other soothing techniques to help him sleep in the past, but the one that works most consistently is holding/ rocking back to sleep. He does not stay asleep with transfer to the crib.
4. He had been sleeping through the night without waking for any feedings before 6 AM for the past month. Now that he is going to bed earlier and missing at least 1 feeding that was occurring around 7 PM, I realize I will need to adjust to waking up again for a feed in the middle of the night, which will disrupt my own sleep. However, I also know this is temporary and the benefits of an early bedtime for him outweigh the downsides for me!
5. Do you think we should make any adjustments to what we are doing or continue with the early bedtime trial for the next few days?
Thanks so much,
Teresa
How old is he?
“We have noticed he is happier and less fussy during the day.” should be grounds for optimism and a minor celebration. To gain some perspective, please consider writing a narrative report on his sleep issues and how why you previously tried different approaches and how you and your husband felt during that time. This might be Chapter 1 and Chapter 2 would be the current sleep journey that you are on; I know it’s just beginning but please be confident that improvements will occur. Sometime in the future, perhaps you would allow me to publish your narratives as a Blog Post.
1. An unlikely but worse case scenario is the ‘5:30am Rut’ (please read ahead on page 303), but we have time to correct that if it occurs. So do not worry. Sleep begets sleep so don’t worry about too much sleep causing night sleep fragmentation, the opposite (sleep consolidation) is much more likely.
2. Will he be in Daycare every weekday? From when to when? What nap opportunities will he have at daycare? When do you or your husband walk into the house from work? In a few days, I will give you specific advice regarding naps. Better night sleep will lead to better naps. Better day sleep will lead to a later bedtime. Please be patient.
3.Not yet and not exactly the nap drill as described in my book because of his age.
4.Will he take a bottle of expressed breast milk or formula?
5. Stay the course.
Is this OK with you?
Hi Dr. Weissbluth,
Just to clarify the first statement about getting too much sleep, we understand that sleep begets sleep and that going to bed earlier does not mean waking up earlier! We realize that if he is falling asleep, that means his body needed the sleep and that sleep begets sleep! We just hope we don’t into the situation where he doesn’t feel tired after waking up in the middle of the night and is then awake for 1+ hours or that his whole schedule shifts to a wake-up at an unsustainable hour for us to maintain.
Looking forward for your feedback and we truly appreciate your expertise!
Teresa
Hi Dr. Weissbluth,
He is 3.5 months (15 weeks). I will write the start of our narrative and provide it to you!
1. I posted the most recent comment before reading your response. I will read up on the 5:30 am rut and hope that we won’t need to address it!
2. He will be in daycare from Monday to Friday. We will likely drop him off between 7:30 AM – 8 AM and will pick up between 4:30 PM – 5 PM. The latest we likely would get home would be 5:30 PM.
4. My husband can help with the night feedings since he will take bottles.
5. We will stay the course. Unless there are no new major issues that arise, how many days longer should we try this before providing you with an update?
Thanks,
Teresa
Thank you; please include in your narrative the role of your husband.
Naps are developing now and will be well established by 6 months of age. What times will naps be offered at daycare?
Going forward, for the next few nights, if you think your baby is hungry at night, please have father go and offer a bottle and if there is eager sucking (suck/swallow) feed only as long as he is enthusiastic about feeding. No soothing afterwords but use GER precautions if you feel it to be necessary. Keep a record of time duration of feeding and volume consumed.
This initial trial should be in place for 3-5 nights and you can send me daily reports or an end-of-trial summary as you wish.
Please be rigid, temporarily, about the 5:30pm bedtime during this trial.
Hi Dr. Weissbluth,
I believe they generally offer naps around 9 AM and 12 PM, then as needed for each individual baby, but I need to clarify with the nursery before we enroll. He will be close to 6 months by that time so I am hopeful he will have made significant progress by then!
My husband will definitely be able to give him a bottle at least tonight and tomorrow night during the weekend and we will track the length of feed and amount he consumes.
We will try to be strict about the 5:30 PM bedtime for the next few days. Unfortunately, I started his last feed too late tonight and he nursed for longer than I expected, so his bedtime was delayed to 5:50 PM tonight.
I will likely send you a daily update since that’s easier for me to keep track of everything.
Thank you!
Teresa
Narrative
I would not consider my son a colicky baby. As a newborn, he was easily soothed and generally calm. My in-laws often commented on how “chill” he was. However, he loved being held and primarily relied on this method for sleeping. My son could sleep in our arms for hours at a time and we quite enjoyed the cuddles so were in no rush to change this. Meanwhile, he would only sleep for up to 2 hours in his bassinet after either being nursed or rocked to sleep. We were feeding every 2-3 hours during this time, so the frequent night wakings were manageable. We assumed he would start to sleep longer once his feeding schedule reduced.
However, even after we were cleared by our pediatrician to stop waking my son for night feeds, he continued to wake every 2 hours at night. My husband has tried to take on as much responsibility as possible with raising our son ans continues to do so! I could not have survived the postpartum period without him. During this time, we resorted to sleeping in shifts so one person could get some consolidated sleep while the other would hold our son so he could sleep for longer periods of time.
When he was about 4 weeks old and still waking every 1-2 hours throughout the night, out of desperation, we purchased a second-hand Snoo with the hopes that this smart bassinet would help him to sleep better throughout the night. Unfortunately, the Snoo did not provide us with much relief. By 6-8 weeks of age, his sleeping habits had not improved and he even started to reject his Snoo bassinet, waking up as soon as we would try to transfer him into it while asleep.
At about 9 weeks, we moved our son to the crib since he was no longer sleeping at all in his bassinet. Amazingly, he slept for 3 hours that first time. We soon got rid of his Snoo and continued to work on night crib sleep. Meanwhile, we continued with contact naps during the day.
By 10 weeks, we noticed he was able to get himself back to sleep in the middle of the night by sucking on his hands. Encouraged by his ability to self-soothe, we felt comfortable starting sleep training. We started extinction with a cap to get him to fall asleep independently at night. This seemed to work incredibly well for him and he soon was sleeping for 10.5 hour stretches from 8:30 PM to 7 AM. During the day, we were following age appropriate wake windows. The sleep sources we were primarily referring to advised capping naps and maximizing wake time in order to build up enough sleep pressure for a long night. We were also advised that drowsy signs can become unpredictable after the newborn phase and that sometimes these signs can indicate boredom instead. We were recommended to push through the fussiness and drowsy signs to maximize the wake windows.
We soon started nap training and used extinction with a cap for his first 2 naps of the day to work on independent sleep in his crib. While he was able to fall asleep on his own after the first day, it continued to take 10-15 minutes of heavy crying to fall asleep and his naps were only lasting about 30 minutes each. We also noticed him getting fussier and more irritable during the day. Our chill baby was no longer very chill.
Around this time, I had started reading Dr. Weissbluth’s book Healthy Sleep Habits, Happy Child. Before this, I was not aware of the significant benefits of an early bedtime and I felt that my son’s behavior met the criteria for chronic sleep deprivation. I believe that following the clock (wake windows) instead of following his cues, having a late bedtime, and getting poor day sleep through short naps led him to be chronically sleep deprived.
Luckily, I came across Dr. Weissbluth’s blog and posted my concerns about our son’s late bedtime, short naps, and continued crying before falling asleep. He has been so helpful with recommendations and we are now working on incorporating an earlier bedtime with the eventual goal of addressing his naps too. We have already seen improvements in our son’s temperament with one day of an earlier bedtime and are hopeful for continued future progress!
Thank you.
I appreciate the details of your narrative account.
Would it be possible to add to your narrative some comments about how your son’s sleep issues might have effected your and your husband’s feelings or your marriage before you contacted me?
Would it be possible to add to your narrative account some more comments about the sources and specifics regarding the sleep advice you got before you contacted me?
Was there any or much influence from friends or family members regarding how to help your baby sleep better before you contacted me?
Hi Dr. Weissbluth,
Here is day 2.
Wake up: 6:30 AM (out of crib at 6:44 AM)
Happy temperament.
Nap 1 from 8:40 – 10:10 AM after some fussing, less engagement. Dad performed contact nap and he cried a bit while being soothed to sleep. Was asleep in <10 minutes and happy upon waking.
He was content and happy, though maybe a bit restless in between.
Nap 2 from 12:01 – 12:59 PM performed by Mom as contact nap when he started getting more restless and had glazed look. Some mild fussing when going down, but took <10 minutes. He was initially crying when waking on his own but stopped very quickly and was soon content.
He had lower energy overall during this wake window, but was not irritable or fussy.
Dad had him on a stroller walk during the middle to end of the third wake window. We thought he might fall asleep in the stroller as he has done before and was quiet and appeared to have glazed eyes, but he was likely too hot and started crying hard. We returned home and Dad performed the contact nap from 3:00 – 3:46 PM. He woke up on his own content.
He was sleepy while nursing during the wake window but smiley and content.
For his last nursing before bedtime, he nursed longer than expected so that pushed bedtime back unintentionally. He didn’t have any signs before bedtime routine but by end of routine he had glazed eyes and was quiet. He was placed in crib with lights out at 5:50 PM.
He slept from 6:16 AM to 5:30 AM. It took him slightly longer to fall asleep than the first night (26 min vs 22 min), but there was less crying, less intensity of crying, and more calm pauses where he almost fell asleep as compared to night one. He had two separate episodes of waking up and crying for <5 minutes before 8:30 PM but he was able to put himself down on his own both times. Nothing else significant was caught by mom or dad.
At 5:30 AM, he woke up calm and started crying after a few minutes. Dad went in to feed. He had 9 oz in about 40 min. Had soiled diaper. Seemed very awake and smiley so we started the day.
I know the bedtime was later and the third nap was not ideal. We weren’t quite sure what to do about the early wake up. I read the 5:30 AM rut chapter about managing this by trying to push back the first nap. However, he is not currently on 2 naps or transitioning between 3 to 2 naps. We are planning on continuing to just follow his cues for his naps today unless told otherwise, even if this means his first nap will start before 8 AM.
Thanks,
Teresa
Please re-read and have your husband re-read Blog Posts 83 and 115X to better understand why “glazed eyes” is a fatigue sign and not a drowsy sign. My suggestion is to look carefully at Days 1 and 2 data and shorten the intervals of wakefulness before naps by 10-20 minutes to avoid fatigue signs (pre-sleep arousal).
The total nap duration on Day 1 was 3 hours 15 minutes and on Day 2, 3 hours and 4 minutes. As best as you can remember, before we started, write down common nap durations and tell me whether his current total nap duration is the same, less, or more than before.
Considering his overall mood, behavior, and temperament it appears from your description that even on Day 1 there has been some improvement. Would you please be so kind to elaborate in what specific way he has changed and whether this change is really new or perhaps just randomly occurred. Also, was this change the same on Day 2 or better or less so.
Considering fussing/crying associated with falling asleep at naps and at night, currently, on Day 2, “He was initially crying when waking on his own but stopped very quickly and was soon content.” and” there was less crying, less intensity of crying, and more calm pauses where he almost fell asleep as compared to night one. He had two separate episodes of waking up and crying for <5 minutes before 8:30 PM but he was able to put himself down on his own both times." Is this improvement really new or perhaps just randomly occurred?
I will help you avoid the '5:30 rut'; I mentioned it only as a possible complication of our current plan.
Congratulations to you and your husband!
Hi Dr. Weissbluth,
We will try to put him down for a nap 10-20 minutes earlier than we have been. It is sometimes challenging to catch those drowsy signs.
Prior to our trial, he was getting about the same amount of nap time. The total naps times from this week were 3 hours 10 min, 3 hours 27 min, 3 hours 10 min, 3 hours 32 min.
Regarding improved temperament, we have noticed he is less fussy overall, seeing more smiles, more willing to play independently with his toys, more vocal. This has continued in day 2.
Regarding this,
“Considering fussing/crying associated with falling asleep at naps and at night, currently, on Day 2, “He was initially crying when waking on his own but stopped very quickly and was soon content.” and” there was less crying, less intensity of crying, and more calm pauses where he almost fell asleep as compared to night one. He had two separate episodes of waking up and crying for <5 minutes before 8:30 PM but he was able to put himself down on his own both times." Is this improvement really new or perhaps just randomly occurred?
His crying when waking up after naps has improved. Previously, we were capping his naps or even if he woke up on his own he would be pretty upset and take a few minutes to settle. His crying in the middle of the night seems to be about the same as when he would wake up in the middle of the night prior to our trial. The crying intensity did seem to improve compared to night 1 though. His true waking seem to occur earlier in the night and are more rare after 10 PM or so. Then in the earlier morning hours, it does not appear he truly wakes for long periods of time but has more restless sleep.
Should we do anything differently if he wakes up at 5:30 AM again?
Thanks,
Teresa
I suggest that you stay the course for 1-2 more nights and then I will suggest a modification of the ‘Nap Drill’ (please read on page 289) for the first nap of the day only because of his age.
Please live with the 5:30 wake-up for a little longer.
Is this acceptable?
Hi Dr. Weissbluth,
Thank you for the feedback. We will stay the course for now and keep you updated!
Thanks,
Teresa
Updated Narrative
I would not consider my son a colicky baby. As a newborn, he was easily soothed and generally calm. My in-laws often commented on how “chill” he was. However, he loved being held and primarily relied on this method for sleeping. My son could sleep in our arms for hours at a time and we quite enjoyed the cuddles so were in no rush to change this. Meanwhile, he would only sleep for up to 2 hours in his bassinet after either being nursed or rocked to sleep. We were feeding every 2-3 hours during this time, so the frequent night wakings were manageable. We assumed he would start to sleep longer once his feeding schedule reduced. Our plan was to survive the newborn trenches before working on healthy sleep habits.
However, even after we were cleared by our pediatrician to stop waking my son for night feeds, he continued to wake every 2 hours at night. I was really struggling with the sleep deprivation and my biggest concern after my son’s wellbeing was when and for how long I could sleep next. My husband was very supportive during this challenging time and did whatever he could to reduce my own responsibilities. We also resorted to sleeping in shifts so one person could get some consolidated sleep while the other would hold our son so he could sleep for longer periods of time. While our bond grew stronger in some ways with the new challenges that come with parenthood, we did not have time to focus on anything else given our lack of sleep overall.
When my son was about 4 weeks old and still waking every 1-2 hours throughout the night, out of desperation, we purchased a second-hand Snoo with the hopes that this smart bassinet would help him to sleep better throughout the night. Unfortunately, the Snoo did not provide us with much relief. By 6-8 weeks of age, his sleeping habits had not improved and he even started to reject his Snoo bassinet, waking up as soon as we would try to transfer him into it while asleep.
At about 9 weeks, we moved our son to the crib since he was no longer sleeping at all in his bassinet. Amazingly, he slept for 3 hours that first time. We soon got rid of his Snoo and continued to work on night crib sleep. Meanwhile, we continued with contact naps during the day. Around this time, I had also started to follow the most popular social media sleep accounts recommended by friends and spent hours reading about others’ experiences through Reddit, Google, and Facebook support groups.
By 10 weeks, we noticed he was able to get himself back to sleep in the middle of the night by sucking on his hands. Encouraged by his ability to self-soothe, we felt comfortable starting sleep training. We started extinction with a cap to get him to fall asleep independently at night. This seemed to work incredibly well for him and he soon was sleeping for 10.5 hour stretches from 8:30 PM to 7 AM. During the day, we were following age appropriate wake windows recommended by Google and the sleep resources we were using. These popular sleep resources were advising capping naps to prevent too much day sleep and maximizing wake time in order to build up enough sleep pressure to be able to sleep longer through the night. I also read that drowsy signs can become unpredictable after the newborn phase and that sometimes these signs can indicate boredom instead. We read that you should push through the fussiness and drowsy signs to maximize the wake windows.
We soon started nap training and used extinction with a cap for his first 2 naps of the day to work on independent sleep in his crib. While he was able to fall asleep on his own after the first day, it continued to take 10-15 minutes of heavy crying to fall asleep and his naps were only lasting about 30 minutes each. We also noticed him getting fussier and more irritable during the day. He wasn’t playing independently with his toys as long and wanted to be held more frequently. He was waking up from naps upset and also falling asleep while nursing.
Around this time, I had started reading Dr. Weissbluth’s book Healthy Sleep Habits, Happy Child. Before this, I was not aware of the significant benefits of an early bedtime and I felt that my son’s behavior met the criteria for chronic sleep deprivation. I believe that following the clock (wake windows) instead of following his cues, having a late bedtime, and getting poor day sleep through short naps led him to be chronically sleep deprived.
Luckily, I came across Dr. Weissbluth’s blog and posted my concerns about our son’s late bedtime, short naps, and continued crying before falling asleep. Dr. Weissbluth has been so helpful with recommendations and we are now working on incorporating an earlier bedtime with the eventual goal of addressing his naps too. We have already seen improvements in our son’s temperament with incorporating an earlier bedtime and are hopeful for continued future progress!
Thank you.
What do you think is the reason that so many on-line advisors do not appreciate the harm from pre-sleep arousal and the importance of drowsy signs?
Hi Dr. Weissbluth,
Here is day 3:
Wake up: 5:30 AM
Signs around 7:15 AM: less animated, less reactive. Started nap routine.
Nap 1 (7:34 AM- 8:54 AM) – Dad performed
– Asleep holding and rocking
– Some fussing while trying to soothe to sleep, took 5 minutes and the bottle feeding episode took awhile. He was pretty much awake for over an hour during this. It seems the days we have fed him at night, he sleeps later until 6:30 am. The one day where we didn’t, he was awake at 5:30 am. We have been tracking his total sleep for awhile and it seems he does well around 14.5 hours total. He has been getting this amount of sleep during our 3 day trial and would only occasionally get it with our previous routine. We are happy he is getting the sleep he needs and this is the most important! Though admittedly, these few days have been overall harder on us with the night awakenings and long contact naps during the day. We are hoping he will continue to improve and welcome any feedback.
Thanks,
Teresa
Regarding your previous message, the common thing I read is that drowsy sound become less predictable after the newborn stage. Perhaps they suggest following wake windows as a guide to help parents instead because of this?
Hi Dr. Weissbluth,
Please ignore the prior day 3 summary. I realize parts got cut off. Here it is revised. I am writing a lot of these from my phone so I apologize for the multiple messages and errors!
Day 3 – 5/3
Wake up: 5:30 AM
Signs around 7:15 AM: less animated, less reactive. Started nap routine.
Nap 1 (7:34 AM- 8:54 AM) – Dad performed
– Asleep holding and rocking
– Some fussing while trying to soothe to sleep, took <10 min
– Woke up on own content
Wake window temperament: active, happy
Signs around 10:21 AM: calmer, less interested in toys. Started nap routine, about 5-10 minutes than prior days.
Nap 2 (10:36 AM – 12:34 PM) – Mom performed
– Asleep holding and rocking
– Very mild fussing when soothing to sleep, improved from prior naps later in the day
– Took 9 min to fall asleep
– Woke up on own generally content though was very hungry
Wake window temperament: happy, then became restless earlier but had multiple episodes of spit up
Signs around 2:04 PM: restless, yawning. Started nap routine.
Nap 3 (2:16 – PM) – Mom performed
– Asleep holding and rocking
– Fussed a bit during the routine but no crying, asleep in about 10 min
– Woke up on own content
Wake window temperament: smiley, more low key overall, whining towards the end, continued to have spit up and maybe congestion
Signs: glazed eyes, nuzzling. Finished routine at 5:28 PM.
Night:
– Lights out, in crib at 5:28 PM
– Intermittent whining (soft crying) for 8 minutes then asleep
– Asleep 5:37 PM – 6:07 PM
– Up at 6:07 PM with intermittent moderate crying that ended at 6:23 PM. Had some brief pauses where he looked almost asleep.
– Started heavy crying at 6:25 PM – 6:29 PM
– Asleep 6:29 PM – 2:38 AM
– Cried out once at 8:25 then back asleep
– 2:38 AM awake and soft crying that got harder (10 hours since last nursing)
– 2:49 AM – 4:21 AM
– Significant spit up in middle
– Changed soiled diaper and clothing
– Had to refill breast milk
– Burping pauses
– Had 8.5 oz
– Fell asleep while burping
– Asleep 4:21 AM – 5:04 AM
– Awake 5:04 am with minor crying
– 5:10 am louder shouting with periods of soothing
– 5:17am actual upset crying but appears tired
– Asleep 5:21 AM then woke up crying about 5 minutes later, back asleep at 5:33 AM through 6:28 AM. Calm when awake.
Day three was harder for us since d he had more episodes of crying at night and the bottle feeding episode took awhile. He was pretty much awake for over an hour during this. It seems the days we have fed him at night, he sleeps later until 6:30 am. The one day where we didn’t, he was awake at 5:30 am. We have been tracking his total sleep for awhile and it seems he does well around 14.5 hours total. He has been getting this amount of sleep during our 3 day trial and would only occasionally get it with our previous routine. We are happy he is getting the sleep he needs and this is the most important! Though admittedly, these few days have been overall harder on us with the night awakenings and long contact naps during the day. We are hoping he will continue to improve and welcome any feedback.
Thanks,
Teresa
Step 1 was to establish an earlier bedtime to improve the quality of night sleep and repay an accumulated sleep debt so he would be better rested during the day. Improvements in mood, behavior, or temperament suggest that you have accomplished this.
Step 2 is to work on improving naps because it appears that he is now waking up in the morning better rested than before.
Nap rhythms emerge around 3-4 months of age and are well established by 6 months of age. The mid-morning nap develops first, around 9am. But because of his age, it does not make sense to try to schedule a 9am nap. For now, the focus will be on the first nap of the day. For the first nap of the day, and only for this first nap, please follow the guidelines discussed in the section on ‘Nap Drill’ in my book. As you will read, this is the beginning of learning to self-soothe for naps. For now, all subsequent naps will be contact naps and temporarily, the 5:30pm bedtime and no new nap after 3:00pm needs to be maintained.
Often, under these circumstances, I would suggest to parents that they record the wake-up time and then bathe, feed if needed, and soothe their baby and leave the room 60 minutes after the wake-up time for this first ‘nap’. I would describe this first nap as almost a continuation of night sleep. This super-short interval of wakefulness is temporary. All subsequent naps are preceded by brief intervals of wakefulness and based on drowsy signs (if observable). However, because your son actually has ample night sleep, and you are able to observe drowsy signs, maybe this 60 minutes of wakefulness is unrealistic. Nevertheless, please consider trying to put him down for his first nap earlier (how much earlier might require some trial and error) and do the Nap Drill for the first nap only. Shortening the interval of wakefulness before all naps is the theme and on Day 3, it appears that you did this on Day 3 for the 2nd and 3rd nap and these naps were longer. Please continue to play with shorter intervals of wakefulness before all naps.
I would suggest that you try my suggestions for a minimum of 3-5 days and record the timing of naps and nap durations and latency to sleep. Because there will be variability regarding the first nap, the onset of the second nap and third nap might vary day by day. I expect that after a few days, you will see more self-soothing for the first nap. One reason for optimism is that your data shows that the first nap of the day is always the longest nap. Based on what happens during the 3-5 day trial, I will advise you regarding the subsequent naps and the bedtime.
How does this sound?
Hi Dr. Weissbluth,
Thank you for your explanation and help!
Just to clarify, because it seems he is getting good night sleep, we can continue with following his drowsy signs and work on starting the nap routine/soothing sooner rather than following the bath, feed, and hour of wake before the nap drill?
We will be traveling to his grandparents in the next few days and staying for about 1.5 weeks. The set up there is very similar to what we have in our own home and he has slept well there before. We would have our own privacy to continue our routines. Would it be ok to continue with the nap drill anyway? Otherwise, it likely would be 2 weeks before we could attempt.
Thanks,
Teresa
Yes, because of his ample night sleep, perhaps, in general, starting the first nap of the day 60 minutes after awakening is too soon. Because night sleep is variable, the first nap will begin at the first suggestion of drowsy signs but please try to anticipate when drowsy signs might appear based on past experiences so that the first nap starts super early. However, the traveling and new set-up at the grandparents might actually lead to using this 60 minute guideline. The key is to prevent pre-sleep arousal with a very short interval of wakefulness before this nap and all other sleep. periods including the bedtime. Based on your comments, I would encourage you to go ahead with the nap drill as discussed as long as it doesn’t rupture family harmony with the grandparents.
Is this OK?
Hi Dr. Weissbluth,
Yes, I think this still be ok! We will plan to stay the course for the next 1-2 days then start the nap drill once we are settled at his grandparents.
I did want to clarify something about the nap drill. Previously when we attempted this, he would only fall asleep for what I assumed was one cycle (30-45 minutes). If he is asleep for less than 30 min or a lot less than 1 hour and I want to attempt to save the nap, would I be soothing him just until he is calm then leaving? For example, if I chose to rock him, I’d rock until calm then place back in the crib to see if he can return to sleep?
Thanks,
Teresa
The intent of the nap drill is to provide an opportunity for your son to learn self-soothing at nap time. As you read, there are a few variables so there is no one-size-fits-all approach. Trial and error will guide you to your best approach.
On page 290:
2. When you put your baby down, he might fall asleep then or
sometime during the hour of being alone, but after he falls
asleep, the sleep duration is less than thirty minutes. Then you
have two choices:
A. Try to extend the nap by quickly doing minimal and brief
soothing such as feeding, rocking, shushing, patting, or
stroking, and then leave him. If this fails to extend the nap
and he cries, you might decide to end the nap opportunity
or you might decide to ignore him for thirty minutes to see
if he will return to sleep. If he has not fallen asleep after
thirty minutes, pick him up and actively play with him.
B. Ignore him for an additional thirty minutes to see if he will
return to sleep unassisted. If, at the end of that time, he is
still awake, pick him up and actively play with him.
If your attempts to extend the nap or to ignore your baby for
thirty additional minutes rarely work, then abandon them.
Please remember that if the morning nap turns out to actually be very brief, the next interval of wakefulness will be super short.
Does this help?
Yes, thanks!
Here are two other items regarding naps in the crib:
1. Ambient light. Do I need to make the room darker?/
2. Ambient noise. Do I need a sound machine?
Sometimes a crib is moved for naps to a different location (a darker and/or quieter room or large walk-in closet) for naps.
Hi Dr. Weissbluth,
Thank you! We have black out curtains and use a sound machine.
Here is day 4:
Wake up: 6:28 AM
Started nap routine around 7:43 AM when noticed he was less active and quieter. Routine finished at 7:50 AM. Took 12 minutes to fall asleep with mom soothing. No crying but some fidgeting while soothing. Napped from 8:02 – 10:08 AM. It took lots of soothing in the middle of the nap to extend it when he was transitioning between cycles, though it did not appear that he fully woke up/stayed awake. He just had lots of movement and started to fuss a bit. He woke up content.
He was happy during the wake window.
He got quieter and yawned around 11:35 AM. Dad performed routine and nap. He fell asleep in about 6 minutes ok without a fuss. Napped 11:51 AM – 12:31 PM. Dad tried to extend when he woke up but he was alert and happy. He remained this way during his wake window.
Around 1:58 PM, we noticed decrease in activity, less interest in toys. We started the nap routine. Mom performed nap 3, which lasted from 2:06 – 3:44 PM. He had mild fussing while he was being soothed to sleep. It took 8 minutes to fall asleep and he woke up content on his own.
All naps were held and rocked, while soothing to sleep.
Started bedtime routine at 5:15 PM after finishing nursing, finishing at 5:30 PM. Started yawning right before starting routine but didn’t seem too drowsy otherwise.
Night:
– In bed, lights out 5:31 PM. He had loud crying immediately (screaming) pretty much whole time until 6:07 PM (36 min from setting down) when he fell asleep. Had few brief pauses where he stopped crying and looked very calm.
– Asleep 6:07 PM – 1:30 AM. Had one brief waking at 8:47 PM, lasted maybe 15 min. Was stirring and likely in and out of sleep as there was no crying and eyes remained closed. Lots of readjusting. Otherwise did not notice any significant stirrings or wake episodes.
– Awake and Whining at 130 AM, mild with intermittent pauses then louder through 1:50 (took some time to prep bottle). Fed 5.5oz from bottle from 1:50 AM – 2:50AM with multiple burp breaks. At 2:50AM, put back in crib calm
– Asleep 2:53 -6:06 AM
– Awake 6:06 AM calm. Got out of crib when he started crying around 6:11 AM. Alert and happy.
We are traveling today to the grandparents, but it’s just a 1.5 hour drive away. We will likely plan to start the nap drill tomorrow.
Thanks,
Teresa
Perhaps the fact that his first nap (2hours, 6 minutes) was the longest first nap during the past 4 days is a sign that he is waking up better rested and gives hope that the morning nap drill will work. Fingers crossed!
Please remind me or explain in detail what you did and how he behaved during the 60 minutes from 1:50-2:50am. Is it necessary to spend so much time with him in the middle of the night?
Hi Dr. Weissbluth,
He woke up with some softer crying at 1:50 AM. Because it had been about 9 hours from his last feeding at 4:45 PM, my husband went to prep the bottle and prepare to feed him. The prep took maybe 15 minutes or so. The rest of the time was spent feeding him with the bottle. He was very calm throughout and seemed awake, though was hungry. He did not fall asleep while eating and was calm and awake when placed back in the crib.
He has frequent spit up and is being treated for GERD with Famotidine. This was started around 4 weeks old, though he has always been a healthy weight and is in the 50th percentile for length and weight. Since he has been a newborn, we pause to burp him every couple ounces and then make sure to hold him upright for 10 minutes after feeding. Even with breastfeeding, the nursing process typically takes at least 45 minutes to complete depending on how long he nurses for. We make sure to either remove the bottle or the breast when it appears he is no longer actively eating.
Thanks,
Teresa
Hi Dr. Weissbluth,
Now that we are actually here with grandparents, I’m realizing it probably won’t be a good time to attempt the nap drill. I will reach out again if and when we attempt it in the future! Thanks for all of your time and recommendations in the meantime. We are happy our baby is happier again and hopeful his napping will continue to progress as he continues to mature.
Thanks,
Teresa
Understood.
Pease consider writing a follow-up narrative report on the improvements that you have accomplished. I would post this and the previous report as a Blog Post. Mothers would be more attuned to your voice than mine and maybe other parents would be encouraged to follow your path.
Hi Dr. Weissbluth
We have 16 week old twins that refuse to sleep through the night without multiple awakenings (4-5). We want to try the extinction method for crying but twin B is relentless. Twin A can sooth back to sleep within 10 mins but the other one will wake her up and can make soothing impossible because of the noise. How long is too long to let them ‘cry-it-out’?
For back ground we are sleep training and on a good schedule during the day. Wake 7am, nap 9-10am, nap 12-2p, nap 4-4:30p then bedtime at 7-7:30. They eat well during the day and will fight the naps sometimes, mainly the mid day, 2 hour nap, waking at 1 hour often. After a pacifier they usually go back to sleep.
The first wake at night is typically around 1am and a pacifier is required. That is the start of one of them waking up basically every hour, sometimes 45 mins, until morning.
Should we try an earlier bedtime? We are also curious if they are sleep deprived.
Describe their mood and behavior when alone with toys (no screens or parental involvement) between 5:30pm and the bedtime.
Have you read my book on twins?