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.
When children frequently awake during the night and return to sleep, either with or without their parent’s assistance, unhealthy night sleep fragmentation occurs. The opposite, lengthy bouts of unbroken night sleep or sleep consolidation, is discussed in Blog Posts 11 and 125. Videos show that all young infants normally awaken at night, and they are perfectly able to return to sleep by themselves. In other words, they are capable of self-soothing during the night and can return to sleep again, unassisted.
How can parents encourage this self-soothing behavior at night so their child has more consolidated sleep, and both parents can get more sleep?
A 2022 study had mothers, fathers, and infants wear sleep monitors for 1 week when the infants were 6, 15, and 24 weeks old. During the night, when the objective recordings showed that both the mother and father were asleep, sometimes, an infant would awaken and then return to sleep without any parental involvement (‘infant-only wake bouts’). More of this infant behavior, self-soothing back to sleep or ‘infant-only wake bouts’, was associated with 3 parenting practices:
How about the bedtime? Perhaps parents who practiced the 3 strategies above put their child to bed early? Blog Posts 7 and 123 review the importance of early bedtimes.
The authors did not discuss the bedtime in their paper, but I asked the lead author, Professor Elizabeth Adams, to reanalyze the data to see if the bedtime was a significant variable. Her response was, “When infants were 15 weeks old, earlier nighttime sleep onset was associated with greater infant-only wake bouts (indicative of more frequent self-soothing).” So early bedtimes are associated with the child’s unassisted return to sleep at night after a normal awakening!
Blog Posts 109, 129 and 130 describe 5 additional parent-related variables associated with better child’s sleep. However, in each paper, the power of an early bedtime was not mentioned in the paper but an early bedtime was only recognized as a significant variable after the data were reanalyzed.
9.5 month old is going to bed around 5:50pm. She is waking up around 1230 and 3-4am. Shes babbling and talking to herself but then after awhile it turns into fussing and then crying. If I get up and give her a pacifier she will go back to sleep. Or do I let her cry? The other factor is the 3.5 year old who will wake up at 4:15 from her crying and be unable to go back to sleep.
Please describe a common nap schedule.
Please describe her mood and behavior between 4-5:30pm when alone (no screens or parental interaction).
Usually she naps for 1.5-2 hours between 9-930 and about sn hour around 1-130. However yesterday she only took a 40 minute morning nap and an 2.5 hour nap in the afternoon.
Between 4-5 she was pleasant except for when hungry.
The night waking might be because she is slightly overtired from a bedtime that is a little too late. Please review drowsy signs and pay closer attention in the late afternoon and early evening. It is common for child #1 to distract parents from subtle drowsy signs in child #2. Please read Blog Post 190. Let me know what you observe.
For now, just move the bedtime 20 minutes earlier for 3 nights and observe whether or not she falls asleep earlier.
Will do.
Is putting her down before 530pm an option? She was definitely tired by 430. by 530 she was a trainwreck. She cried for atleast 30 minutes before falling asleep. (Note she only napped 60 min and 45 minutes).
I think moving the bedtime 10-20 minutes earlier for 3 nights only might help, even if she gets up 10-20 minutes earlier. Even if this earlier bedtime is before 5:30pm. Let me know your thoughts or what happens if you try it.
My daughter is almost 8 weeks old. She uses a pacifier. We implemented a bedtime routine a couple weeks ago and started by having her in bed by 930… then 9. I’m trying to push it earlier (wasn’t successful last night as she fussed and kept losing her pacifier until she was asleep by 930) we attempted around 730 last night. She typically wakes up twice in the night for feedings (every 3 hrs mostly) but the second half of the night she makes more noise and loses the pacifier more and needs it to be replaced for her. I’m getting tired of having to get up and replace the pacifier… I’m considering quitting it altogether but wanted to get your opinion on that!
Also, should I be gradually putting her to bed earlier and earlier or just try going for a 7pm time (around there). She hasn’t given us anymore than 3-4 hrs of sleep at night. She naps frequently through the day but we haven’t established a specific schedule for that yet.
She isn’t an overly fussy baby. She does get the pacifier when awake too.
What was her gestational age at birth?
When does her last nap end?
Do you use ‘drowsy but awake’?
Is she breast milk, formula, or combination fed?
She was delivered via c section at 38 weeks and 4 days.
Yes she is usually drowsy but awake when I put her to bed at night – the odd time she does fall asleep first when feeding but kind of wakes when she feels me putting her in the crib.
She is mainly formula fed, some breast milk.
I haven’t started tracking her naps yet as they are random and the length varies from cat nap to longer stretch. Some are on the go while I’m out or driving in the car. Some days she naps a ton and other days she has longer wake windows. She sometimes will fall asleep around dinner time or before 5, wake and then seem ready to sleep again early like 6-7 pm.
Today she woke up around 630am, was mostly awake with a short nap on our stroller walk which was around 830/9 and then awake. We have a school aged child to get off to school so mornings are busy before 830. I tried putting her in her crib to nap around 11 and it didn’t last more than 15 mins…as she had pooped and then was wide awake. put her in her nest on my bed around noon and she has been out for a good 30 mins so far and will likely stay asleep in that for awhile.
At 6 weeks of age (corrected), all babies need an earlier bedtime and often an older sibling distracts parents from observing drowsy signs that occur early evening in the baby.
Please look at Blog Posts 83 and 115X and tell me when she is becoming drowsy in the evening; you want to observe her when alone with toys (no screens or parental interaction) to wtch her mood and behavior.
Do you have to take to or pick up your older child from school?
Thank you for your responses! I had a look at the blog post you mentioned. I will watch more closely tonight for what time she seems drowsy at… although I do think I have observed it which has prompted me to think it’s time to start the bedtime routine but maybe I’m starting that too late (we start with a bath) and need to do the bath before she gets there. When she is drowsy has also been different because her daytime naps haven’t been consistent.
Last night I had her in bed around 730 and I believe she was asleep by 745. She slept until about 11:30pm (woke up to noticing she had a major spit up in her crib likely awhile before this). She was quite upset and quite hungry. I was able to get her back to sleep after changing and feeding around 12:15… she slept until about 4am and then was finally up by 630am. The stretch from 11:30am onwards was not restful. We kept having to get up and replace the pacifier… although she still seemed relatively asleep some of the time and would settle again as soon as she had it back.
This morning we did our school routine for our older child and they were out the door before 830. I had noticed before then that she was sitting in her bouncer and staring off into space (drowsy sign). So I placed her in her nest to relax for a nap. She seemed like she was falling asleep but kept waking up again having lost the soother but I’ve kept at it. Seemed hungry so gave her some formula around 9 and then noticed her trying to sleep again, lost pacifier, replaced it and now I think she may be sleeping by 930.
I do have to pick up a child from school and it’s usually around 220 in the afternoon although sometimes 4pm when she has after school care. I can see that being an issue when we really get into more scheduled naps…
For now my main issue is this soother replacing and wanting to get longer stretches of good sleep at night for her and us!
For day sleep: One suggestion is to attempt to always nap her in her crib in a dark and quiet room and keep the intervals of wakefulness very brief and perhaps on this week-end, with your husband caring for your older child, pay especially close attention to drowsy signs during the day.
For night sleep: How do you feel about extinction or graduated extinction as described in my book?
I am not totally against extinction but may gravitate towards gradual… I struggle if the crying escalates to her cries getting to a 10 in intensity.
My husband will struggle with extinction. She is sleeping in a crib in our bedroom at night currently.
If it’s been 3 hours since her last feeding/diaper change I generally don’t question her cries because I assume she wants to eat! And she does. Sometimes though she doesn’t even appear fully awake when crying. It’s difficult to tell if she’s needing a change/feed or is just getting fussy/crying.
Last night she was asleep by 7:45pm, awake at 10:30 for change/feed and then awake again by 1:30pm until after 2 and again at 4-430am and again by 6, back sleeping again on and off. Super short stretches but was up constantly pooping so needed diaper changes and then was put back to bed. She seemed quite uncomfortable.
We keep the room dark and use a night light and keep interaction low during the change/feeds.
So I’m not opposed to trying the extinction or gradual extinction but I think I’d need to figure out at what point is she really needing something and am I changing/feeding her when I don’t really need to.
I did put her in her crib in her bedroom for a nap yesterday and she got a good solid 2 hours in the middle of the day and had the morning nap as well. Another nap around 530.
Forget extinction and graduated extinction for now.
Was “I did put her in her crib in her bedroom for a nap yesterday and she got a good solid 2 hours in the middle of the day and had the morning nap as well.” this an improvement in her naps?
On 11/18: “We implemented a bedtime routine a couple weeks ago and started by having her in bed by 930… then 9. I’m trying to push it earlier…should I be gradually putting her to bed earlier and earlier or just try going for a 7pm time (around there).”
On 11/20: “Last night she was asleep by 7:45pm,
Now you know that her previous bedtime around 9-9:30 was too late and has caused presleep arousal. Please read carefully Blog Posts 159, 171, 172, and 204 to appreciate my next suggestion.
At 6 weeks of age (corrected) all babies need a much earlier bedtime (not a late nap “Another nap around 530.”)
My suggestion is to try for 3-4 nights only, a bedtime of 5:30 pm (she is bathed, fed, soothed, and she is drowsy but awake when you are leaving the room at 5:30PM). Plan to feed and change, if needed, about 4 or more hours later and again 4 or more hours later. No new nap starts after 3pm but if she is asleep then from a previous nap, do not wake her. Don’t do this if you cannot commit to 3-4 nights. Try to ignore non-distress sounds and use low-intensity soothing, if needed, as described in Blog Post 145, in between feedings.
How does this sound?
Ok I took some time to try an earlier bedtime before I came back to read your reply. We’ve been doing a 7pm bedtime for over a week now.. at first it seemed to go well. The first few nights she would sleep until 1 or 2 am then would wake up for a diaper change and a bottle… then again around 4 am for the same thing and up at 7 which I thought was perfect. Then it’s been getting worse with shorter sleep periods and frequent wakings due to pacifier being lost, pooping, gas, fussiness and hunger. The last couple nights were horrible with multiple wake ups and trouble settling, especially after the first waking. Last night she woke at 1030 pm for a feed and change then 2am (and couldn’t get her back to sleep until 3:15am) then awake again on and off in there until 530 am and an hour later I still can’t get her to go back down without her fussing and crying. We are exhausted. I am not picking her up from her crib unless it’s been at least 3 hrs and I know she is likely hungry or if it seems to be a distress issue like gas. Usually it’s just a pacifier issue and I replace it and leave.
Ideally I’d love a 7pm bedtime and 7am wake time with the two wake ups for a bottle and change. 530pm is just too early of a bedtime for our family with what we have going on in our days. Last night she was crying quite a bit before 7 and I imagine I should have put her to bed at 630 or earlier. She had napped from 4 until 5pm which I figured would be fine given a 7pm bedtime. Her wake window seems to be about 90 mins before I should be thinking about getting her to sleep, sometimes 2 hrs.
My concern is putting her to bed so early and then her getting up before 7am.
“Ideally I’d love a 7pm bedtime and 7am wake time with the two wake ups for a bottle and change. 530pm is just too early of a bedtime for our family”
Perhaps 5:30 is impossible; but 7pm is too late.
Please carefully read Blog Posts 8, 112, and 196 to fully understand why fighting her circadian rhythms for sleep will end badly for her and the family.
Please carefully read or re-read Blog Posts 159,171, 172, and 204 to fully understand why late bedtimes mess up sleep and the opposite, early bedtimes is the key to why sleep begets sleep.
A super early bedtime is temporary. It will produce better quality night sleep. Better quality night sleep will produce better quality naps to develop by 4-6 months of age. Better quality naps will then permit a later bedtime.
Ok I will try an earlier bedtime and see how it goes. If I try for 6 or 630 tonight, then I imagine she would need to be up from her last nap by 4 or 430pm (90 min-2hr wake window) And if she goes to bed at 6 or 630, then do I plan to have our morning wake up be 12 hrs later?
Thank you again for your replies! I did go back and read the blog posts you had suggested on the earlier bed times and will read the additional ones you suggested!
Currently, usually when does her last nap begin and end?
Hi Dr. Weissbluth,
We have used the advice in your book with our first two and now trying with our third.
She is now 5 months and we are struggling with very short daytime naps. She is at a center during the week and consistently sleeps for 45 minute stretches. Like clockwork.
We are trying a 7 pm bedtime but willing to go earlier. I am having one of my older children sit beside her car seat to help keep her awake on our 20 minute drive home each night.
We have begun extinction and seems to be going fairly well (last night I walked out of her bedroom at 6:56 pm, she fell asleep but woke about 8:00 pm and we let her CIO for about ten minutes. She fell back asleep and woke around 3 am. We let her fuss for about 40 minutes and finally went in around 3:40 when I briefly fed her. She woke this morning at 7:30 and was napping by 8:25. She woke from this nap at 9:15.
My questions are:
– how can we help extend her daytime naps?
– do we let her CIO when she wakes in the middle of the night or just as she goes down for the night?
– do we let her CIO when she wakes at the 45 minute mark during the daytime?
Appreciate any advice!
I will respond in mor3 detail later, but for this week-end, watch closely for subtle drowsy signs when alone with toys ( no screens or parental or sibling involvement) between 4-6pm.
“We are trying a 7 pm bedtime”
A. Perhaps the naps at the center are unavoidably too short in duration (too much light, noise, timing) and if so, a 7pm bedtime is way too late.
B. Perhaps the two older children are distracting you and her bedtime is a little late. A too late bedtime might cause difficulty in napping well.
Subtle drowsy signs will guid you in choosing an earlier bedtime to see if she will nap better and have fewer night wakings. If night wakings continue, then do extinction as described in my book.
Does this help?
Thank you!
Yes that does. Thank you! One more question, if we let her CIO at nap time at home, do we go in and sooth after an hour but keep her in her crib or pick her up and start the wake window count over?
For naps, please read the section ‘Nap Drill’ in my book.
Hello there, I’m a single mom to a 9MO boy. Joshua used to be a good night sleeper but never good at naps. I’ve tried CIO twice in his lifetime, it did not work and I’m not interested in trying again. I cannot do it. Now I’m thinking about trying fading to see if it works. I’ve been doing early bedtime at 5:30 for a couple of days now. Joshua falls asleep while breastfeeding. He wakes up usually 2 times a night for feedings. He can fall asleep on his own at least on the second awake time after breastfeeding. Some nights he stays awake for 1 hour or up to 3 hours. He’s been skipping the afternoon nap a lot and taking late morning naps of 1 hour to 2 hours in length. I’ve done the nap drill before and now he stays in the crib awake and playing or crying and doesn’t sleep. If he cries I try rocking and breastfeeding. Joshua is teething and on the verge of crawling. I’m exhausted and desperate but will not let my boy cry. Any other tips?
Because you are exhausted, it might be appropriate to temporary abandon all attempts to fix his sleep issues and instead do whatever works to get you better rested (for example, contact naps or family bed). Consider how others (friends, relatives, neighbors, faith-based organizations) might help you. Then when you have more energy try:
Fading or check and console are no-cry sleepy options.
At his age, he does not need to be fed at night so perhaps gradually reducing your interaction (weaning) should also be tried.
How does this sound?
I don’t mind breastfeeding for comfort. Main concern is Joshua not getting quality sleep or enough sleep. He has proven that he can self soothe but not consistently
It’s unlikely that he is hungry at night and if you agree, then know that feeding him at night for comfort is fragmenting his sleep. Read Blog Post 145 to slowly move to low intensity soothing at night to promote more consistent self-soothing.
Hello Dr. Weissbluth,
My 14 month old had his first dentist visit. The dentist recommended no more pacifier to not interfere with palate development as molars come in.
So we tried it. Last night no pacifier was given and he did fine. No crying or relying on it. TOday his first nap went for 30 minutes though. He sat up and just sat there without going back to sleep. Usually when this happens he finds a pacifier in his crib and goes back to sleep. But no more pacifier. Do you have any tips? Maybe I should give him pacifiers for nap time but not bed time?
For reference, we dont have any sleep problems right now. Sleeps well at night and for naps, until this change we are making. Its only one nap but I dont want short naps to become a habit now due to no pacifier.
Thanks
Google “Do Pacifiers cause malocclusion?” for more information.
My understanding (please remember that I have dentistry expertise) and from experience in practice (40 years) is that pacifiers might cause problems when used a lot during the day as well as the night. If you and your dentist agree, then continue to use the pacifier only for sleep. Or perhaps use it only for naps.
Please let me know what you learn and what you do.
Ok thank you. I’m going to try a few days of no pacifier at all. Prior to this we only used it for sleep. If he doesn’t nap well over the next few days I’ll allow it for naps only. I will update you in a week or so.
Dr W., Report on no pacifier. Sooner than I thought I would share but I am eager. I forgot to mention we bought home a new baby who is now 3 weeks old. There is some jealousy and I think acting out. Not sure how much this plays in but before removing the pacifier from my 14 month olds life on Monday his sleep didn’t seem affected by the new baby.
Night sleep is basically unphased due to no pacifier but may be suffering slightly due to poor napping now. We do have some slight crying once in crib at night sometimes. It stops. His time to fall asleep has increased.
Naps: Total nap time each day has decreased from about 2h30m to a little under 2h. Crying is present that didn’t exist with pacifier.
Monday night: in crib by 610pm. 645pm – 509am (10h24m) took awhile to fall asleep. went back to sleep 620am-717am (57m)
Tuesday: Nap1 in crib by 9am 944am-1014am (31m) woke up crying
Nap 2 in crib by 1pm. 136pm-313pm (1h37m)
Night in crib about 6pm? 645pm-545am (11h)
Wednesday: Nap 1 9am-1019am (1h19m)
Nap2 in crib 1pm 151pm-228pm (38m) woke up crying couldn’t go back to sleep
Night in crib at 540pm 655pm-541am (10h46m)
Thursday: Nap1 907am-1017am (1h10m)
Nap2 133pm-215pm (41m) woke up fussing
Night in crib at 530pm. 635pm-625am (11h50m)
Friday: Nap1 907am-1020am (1h13m)
Nap2 cried when put down for 15m 135pm-201pm (25m) woke up crying. Back to sleep 219pm-248pm (28m) woke up fussy
Night TBD. will put him down about 530p probably.
I cant remember when I put him down for all these sleep opportunities but he is taking longer to go to sleep now.
I am strongly considering giving pacifier for naps only now but still no pacifier for night sleep. What would you suggest? A few more days of no pacifier at all to see if he can get thought this? Only for naps? Pacifier for naps and night sleep? We dont give a pacifier for awake time at all.
Returning the pacifier for naps seems like a good idea.
Hi Dr. Weissbluth. This may be a trivial question, but what is actually considered a night waking. I’ve seen you mention infants are active and sit up or eyes open during sleep. Does sitting up from night sleep automatically count as a night waking? Is there a time limit? Is sitting up with eyes open for a minute or two then laying back down to sleep a waking or not?
Thanks
Self-Soothing:Arousals from sleep with an unassisted return to sleep are normal (see Blog Post 145). This is still considered to be consolidated sleep.
Parent Soothing: ‘Signaling’ is the term sometimes used when the baby awakens at night and cries until the parent soothes the baby back to sleep. This is fragmented sleep.
Does this help?
Yes. My son will sit up sometimes during the night for 30 seconds – 2 minutes or so and then lay back down and continue sleeping. Just wanted to know if that was considered fragmented sleep. Thanks