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.
Read on my website the first several segments of ‘What a Parent Can Do’ (starting with Blog Post 6) to understand and implement the simple steps needed to prevent sleep problems in your child.
Read only 5 pages in my book, Healthy Sleep Habits, Happy Child: Pages 6-9 (Prevent Sleep Problems) and pages 9-11 (Help Your Child Sleep Through the Night). These 5 pages outline exactly what you need to do to prevent sleep problems. More detailed advice and explanations are presented in Chapter 4: Preventing Sleep problems.
For most children, about 80%, all sleep problems can be prevented without much difficulty. Sadly, about 20% of infants have colic (Blog Post 43) that may make it more difficult to prevent sleep problems.
For some parents, there might be issues (Blog Posts 39–42) that make prevention of sleep problems problematic.
If your child has colic or there are these parental issues, a Community Sleep Consultant (Blog Post 27) might be helpful.
To stay up to date with my new latest work, make sure to subscribe to my sleep training blog today.
Hello, my 4 month old sleeps 8-9 hours straight overnight. He wakes I feed him and I lay him in his crib awake after feeding. He takes about an hour to fall asleep on his own. Then up at 6. Is this normal, I am thinking of dropping that feeding. He’s close to 16 pounds.
If he is hungry feed him, if not, don’t.
“Does your method eliminate the pacifier ?”
No
Thank you. Does your method eliminate the pacifier ? He sure does love that thing and associates that with sleeps
Is it possible for a baby to get too much daytime sleep? We just established a 5:30 bedtime for our 16 week old and she naps 2.5 hours for the first two naps then about 45 min for her third and last nap, then bedtime. I’m worried we should be capping those first two naps so her overall daytime sleep isn’t so long.
Please read Blog Posts 1-5 to better understand why more sleep is always better.
Dr. Weissbluth,
I purchased your book Healthy Sleep Habits, Happy Child and I cannot find an answer I’m looking for. When baby is put down for a nap, how long do I let them sleep for? Until they wake? My 3 month old naps for long periods of time and I am unsure if I need to wake him. I’m hoping you can answer this for me. Thank you for your time and help.
Hi,
My 14 month old has slowly transitioned to 1 nap a day. For a while, he was only taking a morning nap and even though we would put him in his crib for his afternoon nap, he wouldn’t take it. So we slowly moved his morning nap and are now at a 12 pm nap (which I plan to make it to later when he starts day care). He usually naps from anywhere to 1 1/2 hours to even sometimes 3 hours (although that’s probably more rare). I originally was putting him to sleep around 5:30 pm or so when we were transitioning his nap. Or if he doesn’t take such a long nap, I would still put him in early. But he seems to have a very early wake up time, even when I put him in after 6 pm. There have been too many nights that he wakes up in the 4s and won’t go back to sleep, even though I leave him until 6 am or so. I read in your book about trying a later bed time in certain cases to try to make the wake up time later (even though I generally know to do earlier bed times). I’m not sure why he is waking up so early. I thought he has a pretty good routine.
If you have any suggestions or something to try, that would be great. Thank you!
I wish I had a simple answer to your concern. The discussion “The 5:30 Bedtime Rut” in my book addresses this issue.
okay thank you. I have the third edition of your book. Is it in that edition?
I think so but if not, it’s in the 4th and 5th edition..
Thank you!
Hi,
My almost 3 month old often does not want to wake up from her last nap of the day, causing a very early bedtime. For example, last night was the earliest — she fell asleep at 2pm, and awoke at 1am wanting to start the day. She has never gone to sleep later than 6pm. 5pm bedtime with a morning wake up of 4am is most common.
How do I gently nudge her to go to sleep a bit later and wake up later without making her overtired? Is it ok to wake her after only a 1 hour nap?
Thank you!
What was her gestational age at birth?
How often does this event occur?
Gest. age was 41 weeks & 4 days / she was born 9 days ‘late.’
She consistently sleeps 11-12.5 consecutive hours every night without a feeding during that time. Her weight gain is normal so her pediatrician gave the OK to let her sleep this long. The bed time varies depending on her sleepy cues, we don’t have a set bedtime yet at this age. Most nights her nighttime sleep is 5-6pm bedtime with a 4-5am wake up time, which is fine.
I’d say at least twice a week she seems to want a much earlier bedtime, in which she doesn’t want to wake up — her eyes usually stay closed even if I try undressing her. She’ll suck at the breast for a short time, but it seems her body has decided that it’s bedtime.
In general, on the days when this event does not occur, what does her nap schedule look like and what is a common total duration of her daytime sleep?
When awake, during the day, have you ever noticed her staring for a long time at something novel, perhaps a new item you are wearing or something that she hasn’t seen before?
Since she is not yet 3 months, I do not yet have her on a schedule for daytime naps. I watch her drowsy cues and aim for wake windows between 75-110 minutes (as recommended by another sleep expert). I’ve found this works well for my baby; she’s usually not overtired / crying if I’m attentive to her cues and this timing. She soothes herself usually within a few minutes, and naps last 45 min- 2+ hours.
I’m not sure about a total duration of daytime sleep; I’d have to keep a log and get back to you. My guess is it’s about 5-6 hours of daytime sleep. Her first nap is almost always 2 hours. Occasionally I’ll wake her if a nap goes much longer than 2.5 hours.
I have noticed the staring behavior you inquired about. Sometimes I interpret it as a drowsy cue based on my reading of your book and blog. However, that’s not always the case— several times I’ve tried to put her to sleep after observing that behavior (before her usual wake window) only to encounter much resistance because she knows I am trying to put her to bed and she is not ready (under-tired).
She seems to need a lot of sleep. ‘Prolonged visual fixation’ is the jargon term used to describe staring at novelty for a long time and it is associated with a very high IQ as is a need for large amounts of sleep. Because of her age, my gentle suggestions are to stop waking her from her naps, go with the flow, base sleep times on drowsy signs (wake windows are bogus), and experiment with very slowly moving the bedtime toward 5:30-6:00pm (maybe 10 minutes later every 4-5 nights) when the opportunity presents itself. But if she falls asleep in the afternoon and remains asleep for several hours, I would not wake her. I think this kind of event is unlikely to continue very often over the next several weeks. Keep a detailed sleep log for more data and then I might be able to help more. Is this OK?
Interesting. I agree that she does seem to need a lot of sleep. I was a bit concerned at first that she may have a health issue or be sick, but she seems healthy.
My only concern about not waking her from naps is that perhaps she won’t consume enough daytime calories. Often if she goes too long without eating, she nurses very fast, swallows a lot of air, and spits up a lot of milk. What’re your thoughts— is there *any* limit to daytime naps? Perhaps 4 hours?
Also, the “2pm— 1am” sleep occurrence has only happened once since I contacted you originally, so I’m no longer concerned about it. I’ll work on slowly adjusting bedtime. Thank you for your input.
Perhaps have an accurate weight check, don’t wake her from naps for 7 days (monitor ample wet diapers), and repeat the weight check to allay concern regarding caloric intake. Please give me an update.
Will do, re: weight check.
Regarding a sleep log, is it ok if it’s very simple? Given that I’m also caring for a toddler (her older sister) I don’t have much time to write extended comments. Is there anything in particular that I should write in the log other than times? I’ll record if we had to go out and a nap was not taken in the bassinet.
Simple is fine, times of sleep onset and wake up times help a lot.
Ok. Often during the day (esp. in the evening) she wakes up briefly from a nap and makes a little bit of noise, only to soothe herself back to sleep pretty fast. Should I get her out of her bassinet at the first sign of wakefulness during the day?
Also, do you have an email address or another way of contacting you? This website does not notify me of your responses so it would be more convenient, if you don’t mind.
Your goal is to maximize day sleep; let her stir a bit and let her return to sleep.
Above is her sleep history for the past 8 days. I never woke her as you suggested, and at some times made efforts to extend naps. Unfortunately I had a user error when I weighed her a week ago, so I was not able to determine whether she is maintaining her weight. However, she seems happy when awake, is eating well and not spitting up too much.
Most naps were taken while swaddled in her bassinet with a blackout curtain and white noise. She is always put down drowsy but awake and falls asleep in 5-25 min. The time recorded is the time she actually fell asleep, not the time I put her down (I have a video monitor).
What are your thoughts on this data? Is this still more sleep than is typical for her age? She was born Oct. 6, so she’s nearly 3.5 months old.
I’m most interested in whether you think I can put her on a schedule yet, and if so, how to go about that. I know nap times should be flexible according to drowsy cues, but I’d really like to have more of a consistent and predictable routine and timing for bedtime— is that what would be best for her sleep, health, development, etc.? Thank you!
Sorry, the data was not available. Based on her age, do whatever works to maximize day sleep and encourage self-soothing and an early bedtime. A mid-morning and mid-day nap sleep rhythm begins to emerge around 3-4 months but may not be well established until 6 months of age. Then, there will be an approximate sleep schedule but some infants are more ‘regular’ than others in temperament and sleep. Also, sleep timing will shift over the first few years. So in the long run, do not expect “a consistent and predicable routine and timing for bedtime”, rather, expect only approximate times based on drowsy signs. Does this help?
Yes, that helps. Sometimes she went to sleep at 3pm, and at other times nearly 8pm (one even later). Given ‘approximate times based on drowsy signals’, is there a certain length that the bedtime range should be? For example, between 5-7pm?
It seems unhealthy to me that her schedule should vary so wildly, but perhaps I am wrong.
Please read about ‘infant temperament characteristics’ and then describe her specific temperament to me. Then, I may be able to give you more specific advice. In the meantime, please describe her most common mood, sociability and behavior when she is alert and well rested. Will she have a 4 month visit with a pediatrician and if so when is that scheduled?
I just read your 3 blog posts (46-48) on temperament.
Activity: Mostly quite active, often kicks and coos when given face-to-face time. Slows down when drowsy.
Rhythmicity: Somewhat regular / predictable. She usually has a bowel movement first thing in the morning. She’s usually most active upon waking from her mid-morning nap. Her sleep timing, however, as you know, is not regular.
Approach/Withdrawal: Probably more approaching.
Adaptability: Very flexible w/ bathing and changes in eating & sleeping routine. Somewhat adaptable to new people. (The exception being if she is allowed to become very overtired; this has only happened a couple of times).
Intensity: Mild.
Mood: Positive. Laughs and smiles frequently. We were surprised that she had her first social smile at only 2 days old. Very rarely inconsolable. Very rarely cries loudly.
Distractibility: Somewhat distractible. YES to “Picking up the infant easily consoles a distractible infant’s fatigue or hunger”
Threshold: Not sure, because she’s not often exposed to very bright lights or very loud noises. I prefer to keep her at home. She’s pretty responsive to external stimuli in our controlled home environment.
My husband and I have both remarked that she’s an “easy” baby, especially compared to our older child. She never had “witching hour” behaviors as our older did — but I’ve also been much more on top of sleep training from the start with her given the knowledge I have now that I did not have with our first. It’s high priority to me to not allow her to get overtired.
Perhaps this is helpful — her average daily sleep duration was 16 hours and 41 min during the week that I tracked her sleep.
Her next (4 month) pediatric appt. is on Feb 19.
It appears that you are lucky to have an infant with an easy temperament. My research shows that the infants with an easy temperament, at 4 months of age have day sleep (naps) duration of 3.7 +/- 1.3 hours and night sleep duration of 11.7 +/- 1.1 hours for a total sleep duration of 15.3 +/- 1.6 hours. This is similar to the 16 hours 41 minutes that you have observed at about 3 months of age. If, and only if, parents protect and respect their child’s sleep needs, this temperament will persist.Please look at Blog Post 95 that describes sleep transitions over the first 6 months. Is this helpful? Do you have any current concerns about her growth and development? Please let me know if your pediatrician has any concerns regarding her growth and development on Feb.19
Yes, I’m wondering if her early morning wakings are a part of the “5:30pm bedtime rut” and want to know what I can do to push her awake time later without making her overtired.
Her recent morning waking times: 4am, 3:48am, 3:40am, 3:20am, 4:27am, 1:28am, 4:35am, 4am, 12:10am, 5am, 12:30am. If she’s up between 3-4am, she seems to be up for the day. However I don’t have the ability to give her the stimulation that she needs at that time. I’d prefer if she woke for the day around 5am— is that possible?
Thank you.
I have an almost 2 month old that I’ve unsuccessfully gotten on a sleep schedule for weeks. How do I get him to sleep? He sleeps 2 to 4 hours in a 24 hour period. During the daytime, he naps 10-20 minutes at a time and is up 4-7 hours straight at a time. At night, he’ll sleep an hour at a time. This is all contact sleep laying on his belly propped on a shoulder. He wakes up crying hysterically from 100% of naps. He is very fidgety, tries to suck on his fist, and only likes to be held upright on a shoulder or cries. He has gas but no other medical issues. He gets breast milk through a bottle. Once he falls asleep, if we try to transfer him to his bassinet, stroller, or any other sleeping surface, he wakes up as soon as he touches the surface, or before he is set down. I have tried putting him down drowsy but awake but fussing will escalate into agitation. I tried to follow wake windows anywhere from 30 to 90 minutes, but I’m not successful. I’ve tried letting him fuss for 5 -10 minutes but it turns into inconsolable screaming every time. I try rocking for hours, white noise, a dark room and swaddling. If I put a swaddle on him, he increasingly cries and is agitated until it’s taken off. Do I keep trying to swaddle him? He has caused scratches on his arms from trying to break out of Velcro swaddles, and sucks his fist through an arms up swaddle. He doesn’t take a pacifier. During the day and night, I am not able to put him down at all to do anything because he cries once put down. I’ve tried a bedtime ranging from 6 PM to 10 with no luck (short routine – bath, read). He is otherwise a happy baby but constantly overtired. Any ideas?
I am not criticizing you when I ask, do you think you caused this issue by not allowing hime to learn self-soothing?
I am not sure, but leaning toward no. I was hospitalized for a 1 week at 2w Post partum, he stayed in the hospital room with me but his grandma took care of him as I was sick at this time, he has always had the same sleep habits. If I leave him to self soothe, the crying will not cease and gets very hysterical. We tried the self soothing around 3 weeks til now but had the same results.
Here are three possibilities to consider:
1. Circumstances around you being ill and grandmother-care caused him to become parent-soothed and severely sleep deprived. If you think this might be the case, pick a sleep solution from my book that comports with your values and I will guide you.
2. He has colic and will spontaneously improve between 2-4 months of age. He still can be helped with extremely short intervals of wakefulness between sleep periods. But letting him cry won’t help for now. What was his gestational age at birth? When did he begin to not sleep well?
3. He has an undiagnosed medical condition interfering with sleep and needs a comprehensive evaluation. A problem here is that sleep-deprivation alone might mimic and lead to an incorrect diagnosis of a neuro-atypical condition.
How would you like to proceed?
Some things I did not add is that we had a difficult birth. prolonged induction @ 40 + 2 complicated by chorioamnionitis but baby wasnt treated. Baby has to be bottle fed as he never latched/doesnt transfer milk. I was ill since being discharged from my labor to my re-admission for sepsis. Then a week later was admitted for a day with C diff infection and have been on antibiotics from 2 weeks PP- now. I am wondering if this caused any of it? I would be interested in fading or check and console.
He began to not sleep well around 2 weeks old. He is not a fussy baby, he is wide awake looking around at everything when he is awake. He is able to focus on things and he responds, makes eye contact, smiles, and coos.
If it happened to be the third option that you mentioned, what are some typical neurological issues?
Please clarify: “He is very fidgety, tries to suck on his fist, and only likes to be held upright on a shoulder or cries.” versus “He is not a fussy baby, he is wide awake looking around at everything when he is awake. He is able to focus on things and he responds, makes eye contact, smiles, and coos.” When he is alone (no parental interaction or screens), please describe his mood and behavior. Regarding colic, colicky babies have increasing fussing and crying and wakefulness and lack self soothing skills and it is almost always worse in the late afternoon or early evening. Is he clearly worse in the late afternoon or evening?
Because he makes good eye contact and specific social smiles, it is likely that he does not have an underlying neuro-condition. Other features for a pediatrician to evaluate are reflexes and muscle tone and possible imaging studies.
You mention fading and check and console. How involved and supportive is your husband, or not? What does he want to do?
It seems like when I am trying to put him down to sleep and start the soothing/sleeping process he gets fidgety and restless, fighting the swaddle, only wanting to lie upright, wide awake etc. When he wakes up from naps, he always wakes up crying. Lately when he does nap on my chest, he is still very fidgety and the sleep seems like a very “light” sleep. Any abrupt noise or movement he will stir. About 15 minutes after he wakes up and is calm, he is in a happy state/eye contact/smiling (short lived). And then back to unhappy after being awake for about an hour/when its time to sleep again. I attempt to start the sleeping when he starts to yawn, otherwise its hard to identify other drowsy signs.
He is rarely alone. When he is on his play mat and music mat, he focuses on it, and I am able to at least use the restroom. Otherwise if he is alone he will cry, or sitting in a bouncer or swing will cry until he’s picked up.
He may be a little worse in the evening, but its consistent through the day. His longest stretch ever of sleep is about 3 hours during nighttime.
My husband wants to sleep through the night from 9 PM – 7 AM then goes to work. My mother helps at night for this reason because he is awake most hours of the day and night and I would otherwise not get any rest.
How sleep deprived are you and your husband?
Have you carefully read and fully understand how to do ‘check and console’?
How quick or slowly do you want to help your child sleep better.?
We want to help him sleep as soon as possible. My husband & I are moderate to severely sleep deprived.
Yes I re-read check & console an additional time. Thank you
Excellent.
Please do strict ‘check and console at night’ with a bedtime of 5:30pm (you have bathed, fed, and soothed him and are leaving the room at 5:30pm-lights out) for 3-5 nights.
Keep of record of how many times you go to him, how long you are with him, and what you do during the night.
Please tell me, in your own words, how you will behave with your son at night so I can clarify any misunderstandings there might be.
During the day, do whatever you can to maximize sleep and minimize crying. Keep the intervals of wakefulness very short because he is so sleep deprived. Contact sleep, rocking sleep, sleep in the stroller outside, or swing. Whatever you can do do help him nap is our temporary daytime strategy.
Any questions?
I am willing to try this. We live in a small house, he does not have his own room. The bassinet is in our room, is this ok? Do I swaddle him if he is crying while trying to put in on or just forego the swaddle? I have been attempting to do minimal interaction at night, feed, burp, change and keep the lights as low as possible during that. Thank you.
In order for him to learn self-soothing to sleep (with any method) there has to be separation at night. For example, at night, he is in your room and you temporarily sleep in the living room. Or is there any other place your baby could sleep at night? Perhaps a large closet, large enough for the bassinet and ventilation?
Here’s a plan for ‘check and console’. Don’t try it unless you can commit to 3 days. Read Blog Post 145 to understand low versus high intensity soothing.
Friday night: Mom does check and console. Mom is exhausted. Dad sleeps elsewhere. Dad does nap duty on Saturday.
Saturday night: Dad does check and console. Dad is exhausted. Mom sleeps elsewhere. Mom does nap duty on Sunday.
Sunday night: Mom does check and console. Mom is exhausted. Dad sleeps elsewhere. Dad goes to work Monday morning.
For three nights: 5:30pm lights out, swaddle, make the bedroom very dark. Always attempt to put him down drowsy but awake in order to learn self-soothing skills. Always respond promptly to cries and initially try low intensity soothing but if it fails, then use high intensity soothing, but again, always attempt to put him down drowsy but awake in order to learn self-soothing skills.
Naps: brief intervals of wakefulness, do whatever works to maximize day sleep and minimize cry/fuss.
How does this sound?
Ok, we will try this and report back to you. Thank you. I appreciate it.
Should I update you know day by day to make changes or after 3 nights?
As you wish.
Have your husband read the ‘Check and Console Section’ twice so there is no misunderstanding.
Everytime he cries out, you respond promptly, you attempt low level soothing (no pick up), if this fails, you pick up and soothe to a calm state and most importantly, he is put back down drowsy but awake, repeatedly and often throughout the night. If instead, you soothe to the point of fully asleep, the method will fail.
Is this clear?
Hi Dr W, I started last night, here is how it went
Night 1:
1730 – was soothed 5 minutes went from hysterical crying to immediately falling asleep in arms, put down (1.5 hours of daytime sleep)
1742 – crying: stroked head, rocked bassinet, pacifier, shushing & humming
1752 – escalated to hysterical: picked up, rocking, shushing
1808 – put down drowsy but awake with paci, left room
1812 – hysterical crying: changed urine diaper, picked up rocked
1822- put down awake but drowsy
1826 – fussing, put paci back & left
1837- fussing, put paci back & left
2023- woke up crying: rocked bassinet gave paci
2028- left room
2059 – fussy, replaced paci & left
2210 – woke up crying, fed, diaper changed.
2230 put back in bassinet awake and given paci- fell asleep while bassinet rocked.
2238 awoke again- fussed and stirred after paci dropped out of mouth.
Paci returned to mouth and again rocked to sleep in bassinet.
Intermittent leg movement every 15 – 20 minutes, but no intervention required
0115 woke up crying- audible poop heard. Fed, changed diaper and put back down.
0142 baby stirs with hands and feet moving – replaced paci 3x after he awoke when it fell out.
0145 Baby stirs with continuous kicking of leg and arm movement after paci falls out – eyes open and is making little cooing noises that escalate into crying over time by 0215.
O215 paci was put in baby mouth at this point and he immediately stopped all movement and settled down. I gently rubbed his forehead and head. Baby went back to sleep.
0235- when paci fell out, baby immediately became fidgety. Gently rubbed baby forehead and he fell back asleep.
0245- baby stirred and kicked feet and hands until starting to cry. I put paci in his mouth and all activity stopped and it appeared he is sleeping again
0245-0415 fidgeted – only slept incrementally until the paci fell out of his mouth.
415 awoke crying – fed, Had a lot of gas
Some nights he will take a pacifier, some he will not. For my husband he will, for me, he usually will not.
You did great!!!
Between 5:30pm and 4:15am, you picked him up for soothing only twice: for 16 minutes (5:52-6:08PM) and again for 10 minutes (6:12-6:22): Congratulations!
Between 5:30pm and 4:15am, with your low intensity soothing, he was able to sleep and when restless or fussy, return to sleep.
See how naps go today. Watch and record mood and behavior.
I think he is on the road to learn self-soothing. Share all this with your husband in minute detail and encourage him to follow your lead for tonight.
Hello, this is my update for day 1 and night 2. It seems his longest stretch at night is just under 2 hours long. He seems very restless all night, as if he is always in a light sleep. Any ideas?
Day 1:
4:15- 8:40 awake, smiling & content til 6:30, @ 0630 still very awake wouldn’t contact nap so I took him to lay down by me then restless, fidgety, crying even laying next to me
8:40-940 (60 minutes) nap on dad
10:45 – 11:30 (45 minutes) nap on mom
11:30-11:35- woke up hysterical crying
11:35- 1:30 (55 minutes) back asleep on mom
3:05- 4:20 (75 minute) nap on dad
Night 2
5:30: put down drowsy but awake
5:36: hysterically crying tried rocking bassinet, stroking head, shushing
5:40 – 5:43 picked up and rocked, put down
5:45 hysterical crying, replaced pacifier and left
5:50 hysterical crying picked up, rocked
6:00 put down and left
6:30-6:33 restless, awake, replaced paci & rocked bassinet
7:50 – restless, awake, kicking legs for 15 minutes, escalated into fussing, replaced paci & left all movement stopped
8:16 – restless, awake replaced pacifier appears asleep after
9:00 – restless, awake replaced pacifier appears asleep after
2208 – woke up crying. Changed diaper. Fed
22:50. Place him into crib
22:52. Came in and gave him pacifier
00:24. Woke up and came down to give him pacifier. Sat with himfor 5 minutes or so
02:20. Diaper change and Feed
02:58- 0315 placed down in bassinet, restless kicking legs, lost pacifier but seemed to settle down/appears asleep
0345-0400: restless kicking legs, awake, replaced pacifier, rocked bassinet
0400- 0445: restless, replacing pacifier and rocking bassinet
0515: up to eat
I’m unsure if all the day naps were a fluke as we are going on 5 hours of awake time this morning with multiple attempts to get him down. I will keep recording today & night 3 tonight.
Thank you for your help
Cingratulations!
Between 5:30pm and 5:15am, youi picked him up for soothing only twice: for 3 minutes (5:40-5:43PM) and again for 10 minutes (5:50-6:00PM); these 13 minutes are less than the 26 minutes last night. Please count the number of times you went to him for low-intensity soothing (not picking up) for each night and tell me the numbers. For 42 minutes (between 10:08-10:50pm) he was changed, fed, and soothed. Please try to shorten the duration of all of this in the middle of the night.
Keep up the good work.
Please clarify what you mean when you say the ‘the day naps were a fluke’.
The first night low intensity soothing was 16 times. (Mostly replacing the pacifier. )
The second night was about 15-16 times as well. If the pacifier falls out, he is restless til he starts crying.
I will tell my husband to try to shorten his feed/change/soothe time at night.
My son is usually awake majority of the day, but seems to be doing more contact naps yesterday & today. Should I attempt to put him down during the day or continue to let him sleep on us to catch up on sleep til his night sleep improves?
Let him sleep on us to catch up on sleep til his night sleep improves? Yes.
Here is day 2 & night 3/3. Should we continue to implement the same night routine?
Day 2
0515-1055 (slept 30 minutes, there were multiple attempts to put him down)
10:55 – 1200 (65 minutes) asleep on mom
1300 – 1530 (150 minutes) asleep on mom
Night 3
1730 – Put down drowsy but awake
1745 – crying, replaced paci, rocked bassinet, stroked head
1747 – 1802 hysterical crying, picked up, rocked & put down
1807 – 1828 crying, picked up, rocked
1905 – pacifier fell out, replaced
2017 – pacifier fell out. Put back in
2110 – woke up crying, diaper change, feed
2149- back in bassinet
0000 – crying, had gas, put in paci
0100- restless, replaced paci
0215 – soiled, outfit change, swaddle change, fed
0310 – put down to sleep
0350 – woke up and fell back asleep by himself
0430 – pacifier fell out of mouth. Kept sleeping without it
0450 – crying. Put in pacifier
0524 – startled himself awake. Went back to sleep
0600 – awake
Low soothing: 8 times
High: picked up for 15 minutes & 17 minutes for hysterical crying
He was up from 2AM-3:15 AM for a saga of soiled outfit changes, spit ups, and poops.
How do you feel? What would you and your husband like to do?
Abandon the effort because it is too stressful and/or exhausting?
Continue the effort because there is a suggestion of improvement? Times when he woke up and returned to sleep unassisted!!
(0350 – woke up and fell back asleep by himself
0430 – pacifier fell out of mouth. Kept sleeping without it
0524 – startled himself awake. Went back to sleep)
Modify the effort by considering graduated extinction or extinction (I don’t think you are ready to try extinction)?
Has there been any improvement in daytime behavior (He is very fidgety, tries to suck on his fist, and only likes to be held upright on a shoulder or cries.)?
The missing time on day 2 is 0500-1055. He was awake 5 hours that morning
In my opinion, it is more stressful holding him all night to sleep with worries that I or my husband will fall asleep and he will roll off. He is doing a good job and improving it seems. I’d like him to continue to get quality sleep. Do you have reference blogs for graduated extinction? I need to reference my book again. We are not ready to have him cry endlessly, he gets very hysterical & worked up, I don’t know that he would ever stop crying.
His daytime disposition is mostly content. he still fusses unless he’s held upright or moving (we still have to walk around a lot/do a house tour etc) , in the last 2 days I have noticed he stares at what appears to be nothing (to his right or left) opposed to making eye contact. He did this with me & his grandpa and normally loves staring at grandpa. But he focuses on his contrast book. if he’s put down anywhere to lounge he will cry.
Understood.
How about going for 3 more nights and maybe, only if you feel comfortable, if his fussing is mild, delay your response to low level soothing by 10-20 seconds. Don’t do this if you are certain that it will always escalate to intense crying.
Hi there. My son just turned 9 months old and we’ve been doing the cry it out method for two weeks. First night he was up multiple times a night crying. Second night he slept 7:30-7:30 with not a single wake up. After that, he started waking up once a night to cry about 10-15 mins and has progressed back up to waking up multiple times a night (3-4 times) and crying upwards of an hour. I thought cry it out was supposed to work in 4-5 nights, not get progressively worse over 2 weeks. Thank you for any suggestions you might have
Please describe typical naps.
Please describe his mood and behavior when alone with toys (no screens or parental interaction) between 5-7pm.
Have you read the section inmy book on ‘Extinction’?
Hi, thanks for your quick reply. He typically naps around 9:30-10:30 am in his crib or on a walk, then again from about 1:30-3:30 in his crib. These naps obviously) vary a bit and he transitioned from 3 naps to 2 naps about a month ago but on days when a nap is shorter, he will have a brief catnap around 4 or 4:30 for 15-20 min.
He is so-so with being left alone with toys. About 40% of the time, he will play and entertain himself and be happy to moderately happy, but about 60% of the time he is crying to be held, or to be sitting next to someone while playing.
I have read the Extinction chapter
“5-7 pm he’s generally fairly fussy when left alone” tells you that his falling asleep time is too late. Please reread the extinction section to appreciate why it will always fail if the bedtime is too late.
Try extinction with an expected falling asleep time at 5:30pm (he has been fed, bathed, soothed, he is drowsy but awake, and you are leaving the room, at 5:30pm) for 5 nights. Keep a detailed record of crying and sleeping and report back.
How does this sound?
Just realized that you specified 5-7 pm for independent play. He’s better at it in the morning or afternoon, 5-7 pm he’s generally fairly fussy when left alone
5:30 pm bedtime unfortunately is far too early of a bedtime for our life. Between work and our other child’s schedule, we cannot feasibly accommodate a 5:30 bedtime. Any tips on working towards a 7 pm ish bedtime?
Understood.
1. Please describe in detail your specific family circumstances that mandate a 7pm bedtime
2. Read the first 5 Blog Posts
3.I will try to help you. When he transitioned from 3 to 2 naps, he developed a sleep debt because the bedtime became too late with the less amount of day sleep. He developed presleep arousal (fussiness) which interferes with easily falling asleep and staying asleep. Try a temporary, 3 nights only, 6:30pm bedtime to see if it helps with night sleep. If he sleeps better at night, he will wake up better rested and maybe take longer naps. If so, the longer naps might allow the bedtime to be pushed back towards 7:00pm. If you do this, keep a detailed record of night sleep and day sleep.
How does this sound?
Dear Dr. Marc,
I hope you are well.
Thank you so much for all your guidance—it has been a tremendous help with both of my children’s sleep.
I would like to ask for your advice regarding my son, who is almost 9½ months old. In many ways, I’m very happy with his current sleep: he generally settles beautifully, self-soothes without crying, and naps and bedtime are predictable. However, we have been struggling with one persistent issue over the past three weeks.
Here is his current routine:
• Wake-up: around 6:00am (sometimes a bit later)
• Nap 1: 9:00–10:30/11:00 (1.5–2 hrs)
• Nap 2: 1:00–2:30/3:00 (1.5–2 hrs)
• Bedtime: usually 5:30–6:00pm (adjusted depending on last nap, but never later than 6:00pm)
He stays awake about 2.5–2.75 hours between naps, sometimes stretched to 3 hours, though this seems to make him fussy.
The concern is that, about every other night—and sometimes several nights in a row—he is wide awake in the middle of the night for 1.5 to 2 hours. During this time, he is not crying at all but rather playing, babbling, or making soft sounds. If it gets closer to 2 hours, he may start fussing or crying.
We night weaned him roughly two weeks ago, and although the transition went smoothly, these night wakings have continued. Occasionally, out of desperation, I have tried feeding him back to sleep, but it hasn’t resolved the issue—he doesn’t seem particularly hungry and remains awake for the full duration regardless. For the vast majority of these wakings, we continue with extinction as we have done since he was only a couple of months old, but in this specific scenario, extinction does not seem to shorten the wakefulness.
My concern is these long night wakings of up to 2 hours, which have now been going on for about three weeks.
My question is: What could be causing these prolonged night wakings, and what would you recommend we do to help him return to consolidated nighttime sleep?
To add: he is an extremely jolly and low fuss baby. The only time he really fusses is when he is laid on his back for diaper changes or his sister steels his toys from him!
Thank you!
Blog Post 228C and tomorrow’s Blog Post 229 explain in detail how just a few minutes short on sleep can cause pre-sleep arousal that leads to sleep problems like you describe. Even if “Bedtime: usually 5:30–6:00pm (adjusted depending on last nap, but never later than 6:00pm). He stays awake about 2.5–2.75 hours between naps, sometimes stretched to 3 hours, though this seems to make him fussy.” means that 6:00pm is just a little late or “streteched to 3 hours” occurs infrequently, either or both is the likely cause of his sleep problem.
My suggestion is for 4-6 days/nights be 100% consistent to avoid long intervals of wakefulness, keep a written record, and see what happens to night sleep and report back.
How does this sound?
Hi Dr. Marc,
Thank you very much for your response.
At times I’ve thought that if my son has had a “good nap,” then he should be able to stay awake a bit longer. I have a close friend whose baby is only two days older, and she has always said her daughter can comfortably stay awake for 3 hours without fussing. Perhaps that has been at the back of my mind, making me think I was “playing it safe” by putting my son down after 2 hours 45 minutes, and sometimes 3 hours, to reach the 1:00pm nap. I now see the flaw in that reasoning.
This evening felt like a pivotal point for our son, perhaps the result of several nights of less-than-ideal sleep. He had been awake for only 2 hours 20 minutes when he suddenly became hysterical. I quickly put him down, and he was asleep by the 2 hour 30 minute mark, with bedtime ending up at 4:50pm.
Do you suggest I work with 2 hour 30 minute intervals for the next 4–6 days instead of stretching to 2 hours 45 minutes, since he now seems short on sleep?
I also wondered about caffeine while breastfeeding/expressing milk. I currently drink 2–3 cups of coffee per day. I have never noticed an effect, but should I play it safe and reduce my intake?
Finally, we attend church most Sundays. We usually leave at 10:00am (often requiring me to wake him from his nap), and he then naps again when we return, usually asleep by 1:00pm. This makes for about a 3-hour interval once a week. Do you think this weekly disruption could have a negative impact if all other naps and bedtimes remain at shorter intervals? And do you have suggestions for how best to manage this kind of weekly occurrence?
Thank you so much again for your guidance. I will let you know how it goes.
” I have a close friend whose baby is only two days older, and she has always said her daughter can comfortably stay awake for 3 hours without fussing.” During my 40 years as a general pediatrician, I became aware of problematic parenting issues, marriage issues, child sleep issues, and so forth; put parents with these issues might make statements in public that I knew to be false. Please ignore what you hear from other parents and focus only on your child’s drowsy signs.
“Do you suggest I work with 2 hour 30 minute intervals for the next 4–6 days instead of stretching to 2 hours 45 minutes, since he now seems short on sleep?” Brief intervals of wakefulness will always protect healthy sleep; again, watch your child and not the clock.
LaLeche League’s website will answer your questions about caffeine.
When he has healthy sleep 6 days/week; a short nap sleep disruption on Sunday should not be a big deal; but an extra early Sunday bedtime might become a routine necessity.
How does this sound?
Great thank you very much Dr Marc.
That helps a great deal.