“Sleep Readiness” is the title of Chapter 11 of the United States of America Department of the Army field manual (FM 7-22) that prepares young men and women to become soldiers. It is the official document that describes how all young recruits will acquire necessary skills during the process that is sometimes referred to as basic training or “boot camp.” Updated in 2020, it is based on empirical data using traditional scientific methods. Sleep is serious business.
If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial, from the point of view of the United States of America Department of the Army. I have lightly edited, added emphasis, and condensed Chapter 11 in order to show you how “Sleep Readiness” can also help parents help their child sleep better.
Initially, I posted Chapter 11 (Blog Posts 1 through 5) to emphasize the value of healthy sleep. Based on the material presented in Chapter 11 of the Army field manual, Blog Posts 6 through 15 show how basic principles of sleep apply, not only to military basic training, but also to parenting.
Going forward, 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. For now, only read the single, age-appropriate Chapter for your child. Later, if you wish, read Chapters on What is Healthy Sleep, Why Healthy Sleep is Important, and Preventing Sleep problems. Finally, if needed, read the Chapter on Sleep Solutions.
Let’s go!
A common goal in a baby sleep training plan is to have a bedtime routine that includes soothing (Blog Post 10) followed by putting your child down and then your child falls asleep, without crying. The idea behind self-soothing is that during the sleep period, your child is not in your arms, swing, stroller, nor riding in the car. Your child remains asleep without your effort. Also, your child is able to fall into a deep sleep unassisted, or has the ability to self-soothe. If your child has self-soothing ability, at sleep onset, the transition to deep sleep appears effortless. And importantly, during naturally occurring brief arousals in the middle of the night, your child also has the ability to return to sleep without your assistance. Thus, consolidated sleep (Blog post 11) is more likely to occur.
Self-soothing is learned behavior. How do parents encourage the ability for their child to self-soothe? The answer is complicated by the fact that specific circumstances (Blog Post 14) might create challenges so there is no one-size-fits-all strategy. Please keep this in mind as I describe what will help children learn self-soothing. Hopefully, some of these items will be available to your own family. Because self-soothing is learned behavior, the earlier you begin to help your child, the easier and faster your child will acquire the ability to self-soothe. If you start to encourage self-soothing when your child is older, it may be more difficult, for example, because your child associates sleeping only when rocked in your arms.
When your child begins to show drowsy signs (Blog Post 9), begin soothing to sleep and bedtime routines (Blog Post 10). Then your child begins to associate the sensation and timing of drowsiness with a quiet, calm, and relaxing environment conducive to falling asleep. The association helps establish the habit of falling asleep without crying.
After bedtime routines and soothing to sleep, one goal is to put your child down drowsy, but still awake. Then your child will make the transition to deep sleep unassisted and acquires self-soothing skills. Another goal is to leave the room after you have put your child down. Parental presence at sleep onset is more common in Asian than English-speaking countries and predicts more night wakings and shorter sleep durations. Research suggests that your child will learn self-soothing better if you leave the room after you put your child down. When thinking about encouraging self-soothing to prevent sleep problems, leaving the room might be something you routinely practice from the get-go. Alternatively, you might feel more comfortable doing this in a gradual fashion, that is, slowly reduce the amount of time that you are present after your child falls asleep.
After your child has fallen asleep at night, your child will make non-distress sounds (Blog Post 11). At 3 months of age, delaying a parental response just a few minutes to non-distress sounds predicted self-soothing ability in the child at 12 months of age. However, an immediate response to distress sounds that includes minimal soothing, but not feeding, might also encourage self-soothing ability.
During the day, there are many naps because the baby’s brain goes into sleep mode after only brief periods of wakefulness. The duration of wakefulness varies but it is usually less than 2 hours. It might only be 30 minutes! Expect many naps of variable duration with no predictable schedule until about 4 months of age. If you respect the need for many naps, your baby remains calm when awake and is more able to learn self-soothing when drowsy. If you keep your child up too long, a second-wind develops and then your baby becomes aroused and agitated which interferes with self-soothing.
Allowing different people to practice soothing and bedtime routines gives the baby an opportunity to practice self-soothing under different circumstances. In contrast, if the child always falls asleep at mother’s breast, the child might have difficulty falling asleep in other situations. Before her child is in a deep sleep, a nursing mother, after feeding, can pass her drowsy child to someone else for soothing to sleep.
Fathers might be more successful than mothers in putting your baby down drowsy but awake. In addition to directly helping with nighttime parenting, during the day, the fathers support of the mother in general indirectly helps care for the baby. This general care, during the day, supporting the mother, may actually be more powerful regarding the baby’s sleeping than father’s directly caring for the baby at night.
Dear Dr. Weissbluth,
I read your book and at 6 months old decided to start sleep training my baby boy. The main objective was to teach him self-soothing because he got accustomed to falling asleep only in my presence with me lying next to him in bed. He naps regularly usually for 45min to 1.5hrs/nap twice to three times a day and also has no trouble sleeping at night. We also put him to bed early in the evening between 6pm and 7pm according to drowsy signs and his night sleep is not fragmented. He usually wakes up between 6.00 and 7am.
We tried extinction for 5 nights in a row by putting him in his crib drowsy but awake and he cried for the following amounts of time: Night 1: 58′; Night 2: 45′; Night 3: 30′; Night 4: 23′; Night 5: 47′. He woke up a couple of times each night but we ignored him and he went back to sleep on his own, sometimes crying just for a few minutes. As for naps, we tried to put him down drowsy but awake once a day for 5 days in row (same days we did the night sleep training on) but he cried for an hour on each day so we stopped trying.
I was wondering if you recommend carrying on with the night sleep training or stopping for now and trying again later on? Also is it counterproductive to do sleep training at night but not for naps at the same time? How many nights in a row should we use extinction for before resorting to another method which might work better for our child? Thank you in advance for your advice.
Thank you for your detailed description. Please describe, in detail, the drowsy signs in the evening that you use as a prompt to begin soothing to sleep at bedtime. Also, when do the naps usually begin?
The first nap starts between 8.40 and 9.30. He takes the second nap, depending on the length of the first one, either between 12.00 and 13.00 or between 14.00 and 15.00. Again, depending on the length and timing of the second nap he either takes a third nap between 15.00 and 17.00 or doesn’t nap in the afternoon until bedtime (this does not happen often, it happens if he wakes up from his second nap at around 16.00). Sometimes when his naps are short during the day he gets tired around 17.00 and takes a short nap then. I was wondering if, in this case, we should put him directly to bed for the evening. The only thing is that, at that time, he usually isn’t hungry enough to have dinner so that would mean putting him to bed for the night without feeding him.
As for drowsy signs in the evening, he usually becomes very calm and starts playing silently with his pacifier or looking at his hands although sometimes it seems to us that he goes suddendly from being attentive and playing with his toys to rubbing his eyes and becoming mildly fussy or whining which you describe as fatigue signs.
The usual evening routine includes a bath around 17.30/18.00 (this seems to cause agitation instead of calming him since he loves to play with water so we try to keep it very short), a bottle (he is no longer breastfed, switched to formula at 3 months old) and, as soon as we notice him starting to be drowsy, a short story and quick soothing by rocking in the arms and singing a lullaby before putting him in his crib. If he seems tired we skip the story and go straight to soothing and crib.
Nap rhythms are well established by 4 months of age so it is age-appropriate for you to work on both naps and night sleep for your 6 month old son.
In general, you begin a bedtime routine around 5:30-6pm and put him to bed between 6-7pm. He has self-soothing skills because when he woke up a couple of times at night , he went back asleep on his own.
My suggestion is to stay the course for 4-5 days and nights with these modifications:
When tired at 5pm, no nap, skip the bath, shorten the bedtime routine, lights off by 5:30pm for night sleep.
The 3rd nap is variable and sometimes naps are 45 minutes. So, for now, consider a bedtime of 7pm to be too late. During the next 4-5 days, skip baths at night (bathe some other time), do a shorter bedtime routine, and lights off always between 5:30-6:30pm. The earlier the better. Later, when napping better, perhaps the bedtime might around 7pm, or not.
Keep a detailed diary record of nap and night sleep onset and duration, crying with extinction, and night wakings.
Send me a detailed progress report after 4-5 days.
How involved is the father?
Sweet Dreams, DrW.
Dear Dr. Weissbluth,
Thank you, we are proceeding as advised. I just had a question but first a quick update on how it went the first day.
The night before we started nap training again, we put him to bed earlier, as you recommended, so lights off at 18.00 (with dad). He didn’t cry much. He whined and kicked his feet for 20′ then slept until 4.50 and woke up 4 times after that. At 4.50 when he started crying we fed him because we thought he was hungry (he wasn’t very hungry). At 5.23 we let him cry, he fell back asleep after a few minutes. He woke up crying again at 5.45 so we changed his diaper, soothed him, and put him back in his crib. He cried until 6.20 so we ended up picking him up and putting him in bed with us because we were exhausted. He fell asleep and woke up at 7.30.
Day 1:
Wake-up time 7.30
First Nap: put down in crib at 9.00, he cried for 45′ then fell asleep, slept until 11.35
Second Nap: put down at 13.35 cried until 14.20 then kicked for another 40′ without making sounds and didn’t fall asleep
Didn’t take any more naps during the day
Lights off at 18.10 (with dad), cried for a few minutes then started kicking without making sounds, fell asleep at 18.28
Woke up at 3.00 cried for 10′ then silence, from 3.24 to 3.36 bouts of crying then fell asleep
Woke up at 6.30
I was wondering if we should put him down drowsy but awake for all naps even if he skips 2 naps a day this way because he doesn’t manage to fall asleep on his own after one hour in his crib? Or should we instead attempt to maximize sleeping hours during the day by soothing him the usual way for the next nap if he ends up skipping the first (so putting him down already asleep)? I ask because I wonder if total nap hours during the day impact the length of uninterrupted sleep during the night.
As for dad’s involvement, he works full-time so I have been mainly the person putting him to bed at night and for naps. He’s been helping out more these past 2 weeks since we are on vacation and decided to start sleep training.
Thank you again.
Yes, continue to put him down drowsy but awake for naps. Please read ‘Nap Drill’ on page 289 in my book for a detailed discussion about your issue(s) with naps.
Bringing him to your bed early in the morning teaches him to cry longer and louder in the morning for your comfort; please stop. Perhaps try to go to bed earlier yourself. It is possible that if he had started the day at 5:45am (as in your note) instead of 7:30am, he might have gone down for his first nap around 8:30-9am without any crying. For this week-end watch carefully for drowsy signs during the day, give extra soothing if needed and strive for naps around 9am and 1pm. Caution: If he is sleepy before those times and you keep him up with extra soothing to catch those times, he might get a second wind. The competing goals are to sleep him in synch with his nap rhythms and to not allow him to get too overtired; trial and error and patience is key.
Dear Dr. Weissbluth,
Here is how it went during the following days.
Day 2: Saturday August 20th
Woke up at 6.30
Midmorning nap: put down in crib at 8.00 cried and kicked until 9.00. Couldn’t get him to sleep at home after that so we went out for a walk at 9.45. He fell asleep in the stroller at 10.15, came home and put him directly in bed at 10.30 without waking him. He woke up at 11.15. I realized that I may have put him to sleep a bit too early.
Midday nap: he started showing fatigue signs at 12.30, I put him in his crib he cried and kicked until 13.15 then fell asleep. Woke up at 14.00.
No third nap
Lights off at 18.05 with dad, kicking without making sounds, fell asleep at 18.27.
Woke up at 1.24 cried for a minute then fell asleep, woke up again at 3.40 cried for a minute then fell asleep
Day 3: Sunday August 21st
Woke up at 6.30
Midmorning nap(with dad): 8.58 cried until 9.07 then fell asleep, woke up at 9.37, we failed to extend the nap (Total nap duration 30′)
Midday nap (with dad): 12.05 cried an hour and didn’t fall asleep. He seemed already drowsy to us at that time but we may have put him in his crib too early.
Afternoon nap: he was drowsy again around 14.30, we soothed him and tried to put him in his crib but he cried so we picked him up immediately.
From 14.30 to 15.00 he started becoming very tired so we started soothing again, he almost fell asleep in dad’s arms. When dad put him in his crib at 15.00 he protested for a few seconds then crashed (he was for sure overtired and already sleeping a bit so not “drowsy but awake”), he woke up after 40′ still a bit tired. We kept him up and put him to bed earlier.
Lights off at 17.36, cried until 17.57 (He was very loud and upset with respect to the previous nights, also much more tired).
Woke up at 3.20 cried for a minute then fell asleep, woke up again at 5.40 cried for less than a minute then fell asleep or was absolutely silent for around 20′.
Day 4: Monday August 22nd
Woke up at 5.40/6.03
Midmorning nap (with mom): in his crib at 8.42 cried until 8.47 then fell asleep. Woke up at 9.20, my attempt to extend the nap by soothing failed. (Total nap duration 33′). He woke up still tired because he rubbed his eyes a few times while we played.
Midday nap (with mom): in his crib at 12.15 cried until 12.21 then fell asleep. Woke up at 13.56
(Total nap duration 1hr 35min).
No third nap
Lights off at 17.55 (with dad), cried for less than 1′ then fell asleep.
Cry heard for a second at 18.49 then he went back to sleep.
Woke up between midnight and 3.00 (not sure what the time was) and cried for about a minute then went back to sleep, woke up at 3.50 cried for a few minutes then went back to sleep.
Note: he had a soiled diaper in the morning (which is unusual) so one of the wakings might have been because of the diaper.
Day 5: Tuesday August 23rd
Woke up at 5.38
Midmorning nap (with mom): in his crib at 8.28 whined for 1 minute then fell asleep. Woke up at 9.26 (Total nap duration 58′).
Midday nap (with mom): in his crib at 11.55 (a bit of whining and a lot of eye rubbing a few minutes before), cried until 12.01 then fell asleep. Woke up at 13.17 (Total nap duration: 1hr 16′)
Third nap (with mom): he started showing drowsy signs at 15.15. I put him in his crib but he cried so I picked him up (as instructed in the “Nap Drill”). We played a bit but he clearly started getting tired so I tried to put him in his crib again but he cried so I picked him up and we made it to 16.30, at which time he was clearly very tired so I fed and changed him and started soothing . He was in his crib at 17.10. Cried until 17.35 then fell asleep.
Woke up at 18.21 and cried for a couple of minutes then went back to sleep.
Woke up at 4.50 cried for less than a minute then fell asleep.
Woke up at 5.56.
Note: he had a soiled diaper in the morning so one of the wakings might have been because of the diaper.
Day 6: Wednesday August 24th
Midmorning nap (with mom): eye rubbing started at 7.15. In his crib at 8.29, cried for 8 minutes then fell asleep. Woke up at 9.25 (Total nap duration: 48′).
I will be putting him down drowsy but awake for the next nap as well while I wait for your feedback.
Here are my overall comments, doubts and questions:
Nap time without mom by his side is going better but it is quite hard sometimes to put him down drowsy because he seems to go from attentive and playful to tired (eye rubbing and whining) very quickly sometimes. I guess this is because he is tired because of missed naps/short naps?
What do you suggest can be done about the third nap if we know he is sleepy around 15.00 but he refuses to go to sleep without crying? He was clearly overtired in the afternoon on Day 5 but I had no idea how to handle the situation so I kept him up as long as possible and put him to bed earlier than usual. The crying was very loud.
For the third nap, as a general rule, I am trying to not let him nap after 16.00 because we are striving to put him to bed earlier but if he gets very tired around 16.00 what do you advise us to do?
Our son will be 7 months old in 5 days (born at 38 weeks, birth weight within average). He has an easy temperament and did not have extreme fussiness/colic.
Thank you in advance for your feedback and advice.
Thank you for your detailed report. Regarding naps, please clarify the phrases ‘(with Dad)’ and (‘with mom)’. Please describe in detail what you and your husband do around nap times after you have put him down (after the soothing process).
The third nap disappears between 6-9 months of age and because of brief naps midmorning and midday, your son is often tired in the afternoon. However, if you allow a third nap to occur, a super early bedtime is less likely to occur. Because of his age, how do you feel about never allowing a third nap and focusing your efforts on a temporary super-early bedtime around 5-5:30pm? How about your husband; would he permit this? The notion is that more sleep early in the evening will cause him to wake up in the morning better rested and be better able to nap midmorning and mid-day. When this occurs, weeks later, the bedtime will be able to moved to a later time. If you want to try this, I will give you more specific advise regarding implementation. Also, look at ‘Crystal’ in comments on Blog Post 25 and my Instagram Reels (#marcweissbluth) Sleep Tips.
Dear Dr. Weissbluth,
Thank you for getting back to me so fast. After soothing, we both leave the room, close the door and turn on the baby monitor. So we’ve been letting him cry until he falls asleep at night. We do the same thing for the midmorning and midday naps (except when he cries for an hour then we go and pick him up). I put “with dad” and “with mom” between parentheses just to let you know who has been doing the soothing and putting down in the crib.
I read the comments of Crystal and it indeed rings a bell because I can see that he may be ready to go to bed by 5pm on most nights. I have to admit that sleep training has been particularly hard on him because, before we started (we’ve been doing extinction at night for 13 days now and extinction for all 3 naps for 6 days), he was regularly napping for at least 2.5hrs a day (most of the time split into 3 naps, the last not necessarily taking place before 4pm). The naps involved crying sometimes even if I was by his side but I realize now that that was mainly due to the fact that I was missing his drowsy signs.
The fact of the matter is that I am on maternity leave until September 13th so, until then, I can manage to go to bed early and wake up super early with my son. After that date, my husband will take care of our son for another month (so he will stay home from work) until he starts daycare on October 10th. My concern is that it will be already very tiring for my husband to take care of our son all day as he is not used to it. So, I am not sure he can tollerate a very early wake-up time in the morning. I will talk to him tonight to see how he feels about it and get back to you. I am assuming a 5pm bedtime means at most a 6am wake-up time, correct?
Do you think we might already achieve some results in 3 weeks time (when I will have to go back to work) or would it be too soon if he starts napping well by then to restart pushing the bedtime to a bit later?
In the meantime, here is how it went for the rest of the day today and my questions in the end:
Day 6: Wednesday August 24th
Midmorning nap (with mom): eye rubbing started at 7.15. In his crib at 8.29, cried for 8 minutes then fell asleep. Woke up at 9.25 (Total nap duration: 48′).
He became very whiny around 10am so I fed him. He was hungry but, after eating, he kept whining and didn’t want to play or interact so we went out for a 35′ walk. I put him in the baby carrier so that I would be able to see if he was falling asleep. After we came back home, things went better because he started playing calmly on his own and then we played together until 11.15 when he started rubbing his eyes. I kept him awake to reach at least 12.00, trying not to get him overtired, and put him in his crib at 12.08.
Midday nap: From 12.19 to 13.46 (total nap duration= 1hr 27′), so he cried for 11′ before falling asleep.
In the afternoon, he was still quite active at 15.45 (not showing any drowsy signs) so we went out for a walk again. Unfortunately, he started rubbing his eyes around 16.45 so by the time we got home, I bathed him (we unfortunately could not skip the bath before going to bed today) and tried to feed him (he was so tired he ate very little). I realized that had already missed the window and he was super tired when I put him to bed at 17.45. He cried for 15′ then fell asleep.
Do you think we should keep on using extinction for naps even though he is still crying a little almost every time or should we go back to staying by his side until he falls asleep? The latter would, however, mean that we would then need to move him from the bed to the crib. Sometimes this ends up waking him up.
For bedtime, I can try tomorrow to start soothing as soon as I see minimal drowsiness signs and put him to bed even if it means putting him to bed super early to see if the crying might disappear completely. Do you think that would be a good idea?
Another thing I wanted to ask you about is moving the crib to another room. In 4 days, we will be going back home to our city apartment. The plan is to buy him a bigger crib and put it in a separate room (his crib is at present in our room). Do you think this change can be a setback in some way with regards to his sleeping habits/patterns? I don’t know if this can help but, a few days before we started sleep training, I started putting him to sleep for naps in the complete dark because I noticed he would fall asleep much faster this way. So I am wondering if maybe he won’t even notice the change?
Thank you again for your advice. It has been really challenging these last 2 weeks but we really want to find the best solution to make him and ourselves sleep better!
Be optimistic, there can be a lot of improvement in 3 weeks with a super-early bedtime! Depending on naps, it might be anytime between 5-6pm.
Continue with extinction for naps.
If able and desirable, make the separate room for naps pitch black and consider a white noise machine.
Most importantly, the general goal is to nap him around 9am and 12-2pm and not let him sleep at other times. For example:
“Midmorning nap (with mom): eye rubbing started at 7.15. In his crib at 8.29, cried for 8 minutes then fell asleep. Woke up at 9.25 (Total nap duration: 48′).” [Maybe he would have napped longer if he had fallen asleep around 9am]
“He became very whiny around 10am so I fed him. He was hungry but, after eating, he kept whining and didn’t want to play or interact so we went out for a 35′ walk. I put him in the baby carrier so that I would be able to see if he was falling asleep. After we came back home, things went better because he started playing calmly on his own and then we played together until 11.15 when he started rubbing his eyes. I kept him awake to reach at least 12.00, trying not to get him overtired, and put him in his crib at 12.08.'”[Congratulations!! By gently stretching him towards 12 noon and not putting him down for a nap much earlier, he was able to sleep longer]
Midday nap: From 12.19 to 13.46 (total nap duration= 1hr 27′), so he cried for 11′ before falling asleep.
So, if before about 9am and 12-2pm he is appearing drowsy or fussy from lack of sleep, attempt to soothe him for comfort and simultaneously distract him with movement, activity, noise, music, etc so he is calmer and awake. If this fails and he gets more upset, then sleep him. But what you want to avoid is a situation that will lull him to sleep substantially before about 9am and 12-2pm such as a car ride. Walking outside might be calming and stimulating (wind, fresh air, street noises, dogs, children playing) or puts him to sleep (rhythmic rocking motions). You decide. Please note that I used the word ‘about’ because these times are goals and approximations, not rigid rules.
Please read, and have your husband read, Blog Posts 23 and 38 so he will be more able to help your child sleep better.
Please keep your detailed record going.
How do you feel about going forward?
Dear Dr. Weissbluth,
Thank you for your advice and for your support. I read the Blog Posts you indicated and I agree that sleep is fundamental. I saw the direct effects of sleep deprivation on myself during these months and cannot begin to imagine how much lack of sleep/poor sleep can be detrimental to a growing brain.
A few months back (after reading your book) I started protecting his naps like a maniac and I felt that some family members didn’t understand but what other people think has never discouraged or stopped me from doing what I know is right for my family. I will have my husband read the blog posts as well.
We will proceed as per your advice and I will get in touch if we have any doubts.
For the sound machine, do you advise to use it for both naps and at bedtime? Should we keep it on the whole night until he wakes up the next morning? Are there any specific sounds in your experience that are best?
Thank you again and I hope to write soon to report some major improvements!
Continuous sounds drown out the signal intensity of intermittent sounds so even the hum of a desk-top fan might work.Quiet noises are best to protect baby’s ears. Sounds of nature or music that has a narrow dynamic range (harpsichord or guitar) is better than music that alternates between very loud and very quiet.
You might appreciate reading Blog Post 38 that discusses what you experienced from family members.
Please send me an update.
Sweet Dreams,
DrW
Dr.Weissbluth
I have a 5 month old son who will only go to sleep nursing. The process is usually very easy and short to get him to sleep and most of the time his naps are long and great. The problem is he will only go to sleep nursing. On the days I work my mother in law has a horrendous time getting him to go to sleep for his naps. Then, when he falls asleep his naps are often short and he isn’t well rested causing him to be very fussy all day.
Since birth, we have had trouble getting him to go to sleep. He stayed up for hours at a time, followed by hours of inconsolable screaming and then brief bouts of sleep. He was a very alert baby from day 1 and would be wide eyed the entire awake period. As first time parents we didn’t know about wake times and sleep times. If he was awake we were interacting with him even if it was hours. We thought when he became fussy is when it was time for sleep.
After restless days and nights of googling, I stumbled upon you and your book. At around 1 month old I started to sleep train him. We took the slower method and would let him fuss but when he began screaming we soothed. This worked for a few weeks as most of the time he would fall asleep on his own with little whining or some not at all anywhere from 5-20 minutes after laying down. He then went through a fussy period and this no longer was working. He would scream and cry until he couldn’t breathe. We stopped the training and I nursed him to sleep.
For naps, he would fall asleep in his swing until he grew out of it around 3.5 months. (He is a big baby) So then, nap time consisted of nursing to sleep as well because nothing else seemed to work.
Even though it is mostly easy for me to nurse him to sleep, it is not ideal for anyone else. At the end of the day when my mother in law brings him home he is fussy and exhausted and does not sleep good at night with a lot of night awakenings in which consist of crying that can sometimes be soothed with just simply touching him but most of the time result in him being nursed back to sleep.
How can I sleep train him without it resulting in him purple crying?
Perhaps your child has the post-colic sleeping problem of impaired ability to self-soothe as described in my book. Do you agree? Also, based on his behavior in the late afternoon and his naps during the day and the fact that some days you work outside the house, do you think that sometimes the bedtime is too late?
Yes, I would agree. He does occasionally fall asleep on his own. Typically when I’ve been nursing him and he seems to be a bit squirmy, I then lay him down and leave the room. He will be loud for around 5 minutes, no screaming or crying just loud grumbling basically. Then, he moved his head side to side a few times and makes this humming noise and falls asleep. He only seems to do this if he’s been nursed first, but will not do this every time I try, just occasionally.
As for late bedtime on the days I work, I would agree. His bedtime gets pushed back to about 8:15.. I get home at 7:30 and because I work in the medical field I am exposed to a lot. I have to shower immediately when I get home before touching him. By the time i do so as quickly as possible and then change him it’s around 8pm. I have shortened the time frame a little by skipping his night bath on these days going from bedtime at 830 to 815.
Now, for that being said. Do you think that on the days I work it throws off his night time sleep and the following day naps?
I have dropped down to part time only working 2-12 hour days. But I still feel like He only gets about 2 good days of night sleeps and daytime naps. My work days are sometimes back to back or a few days apart.
Lastly, say he has had a few days of good sleep and naps and the next day I have to work. Even though he is well rested and happy, my mother in law still has trouble getting him to sleep. She follows the same routine as I do, besides the final step of nursing. He will occasionally suck on his thumb for her but it just doesn’t seem to soothe him enough to sleep.
Because he only falls asleep well after nursing, but twice a week (when you work) the bedtime is way too late, I think that the 3 variables (lacks self-soothing skills, dependency on nursing to sleep, and working late twice a week) are intertwined and you have to change at least one in a dramatic fashion. I do not know what is doable for you or what your preferences are so I am unable to make a specific recommendation. Perhaps a community sleep consultant or lactation consultant can better guide you to a solution.
Nursing him to sleep will be the dramatic change I need. With accomplishing this he will also learn self soothing skills. I am just at a stand still of figuring out how to stop him from associating nursing with sleeping. I reached out to my lactation consultant as recommend.
Thank you.
Please keep me informed how it goes.
Hello,
I have a 4.5 old baby. His naps are great. 3 naps averaging 1.5 hours each with the last one up at 430. His naps are like this. I take him to his dark room, lay him in bed where sleep sack is and put pacifier in and walk out.
Before reading your content I would put him to bed at 730 nightly. Night routine is bath, lotion, sleep sack and bottle. I make sure he’s not fully asleep before I lay him in his crib ( separate room than ours). He would be asleep by 730 and wake every-night at 4. Some nights I would replace the paci and others he wouldn’t fall back asleep so I would feed him. He would suck that 8 ounce bottle down in 10 min and I would lay him in his crib after awake and leave the room. I would watch him on monitor and sometimes it would take an hour for him to go back to sleep on his own without fussing. Last night I put him down at 7 and he woke up at 3. I let him cry off and on for 30 min and I went in and put in his pacifier. He went back to bed until 6. Is that ok?
Does his 3rd nap end at 4:30PM?
Did you observe drowsy signs (see Blog Post 115X) before naps and at 7pm last night?
Yes his nap ended at 430. Yes on drowsy signs before bed. Honestly I was seeing it even at 530 pm yesterday and just entertained him until bath time at 630.
He will fall asleep easier and have consolidated night sleep if you respect his drowsy signs. If he is becoming drowsy at 5:30pm, then his brain wants to sleep then. Don’t withhold sleep. If he has a need for a lot of sleep (lots of daytime sleep and an early bedtime, it is a symptom of superior intelligence!). Please read the Blog Posts or the sections in my book why an early bedtime is very important.
Thank you so much . I will reference this in your book and try this tonight
Hi Dr. Weissbluth,
We recently used the extinction method with our 5 month old daughter. She went from waking every 40-80 minutes through the night to sleeping 11 hours without a peep (thank you!!). We started this two weeks ago and she has been sleeping through the night since night 4.
While she puts herself back to sleep throughout the night without crying, she continues to cry quite a bit (~30 minutes) every night when we put her in the crib awake. I follow drowsy cues to determine bed time (her signals are yawning and zoning out) but it is generally at or around 6:30 PM (dependent on her last nap – I aim to put her down within 90 mins of her last nap but rely more heavily on drowsy signals).
We continue to let her cry herself to sleep since she always does eventually get there, but I wonder if the lack of improvement in the time it takes her to get herself to sleep is concerning. I would appreciate any advice you have. Thank you!
“While she puts herself back to sleep throughout the night without crying, she continues to cry quite a bit (~30 minutes) every night when we put her in the crib awake.”
During those 30 minutes: Is the crying continuous or intermittent? Is the crying mostly mild, moderate, or intense? How much does the crying bother you?
Perhaps put her to bed 10 minutes earlier than is your current custom and see if she falls asleep at this slightly earlier time and what happens to the crying. This trial would be for only 3 nights.
I have read your book almost in its entirety and returned back to it many times for my first child, so I’m familiar with the methods you describe and know that they work.
Now I have a 4 week old baby (our 2nd). Occasionally it is not feasible to put her down when she’s drowsy but awake and she gets overtired. Then she takes lots of soothing and we have to wait until she’s asleep to put her down, otherwise she sobs. But she sleeps for a much shorter period of time when put down this way.
How much crying it out is acceptable for this age? I’m wondering if maybe letting her cry a bit might be necessary to help her sleep well and longer.
At 46 weeks post-conceptual age, normal infant fussiness/crying peaks and then afterwards, infants sleep more at night, fuss/cry less, and want an earlier bedtime. So some of what you are observing might be due to normal developmental changes and/or your inability to put her down when she’s drowsy.
Going forward, take a step back and ask how you might be able to reduce the frequency of late sleep times or make the too late sleep times a little less late or both. Especially for bedtimes after 6 weeks of age. The more you are able to do this, the less presleep arousal you will see and the less crying there will be. The opposite is also true. Maybe your specific family circumstances means that you will have to ignore some crying sometimes because the reality is that sometimes the falling asleep time is too late. Remember, a falling asleep time that is a little too late is better than a falling asleep time that is way too late.
Does this help?
To clarify why we can’t avoid letting her get overtired: she is one of those babies who sleeps almost constantly. She can’t handle more than 30-45min of awake time at a time; maximum 1 hour. She sleeps best in her dark bassinet with white noise at home.
At a minimum, we have to leave the house to go to church on Sundays, and she gets overtired from the stimulation/ being away from her bassinet for too long. The other need to leave the house is to go to the grocery store; she’ll get overtired then because by the time she’s finished nursing we only have ~10-30 min of awake time left before she needs to go down again.
When she gets overtired it is MUCH more difficult to get her to sleep.
Understood, could you go shopping on the week-end while she stays at home with Dad?
Didn’t see your comment until now. Yes, I think that helps! Thank you
Yes, I could go grocery shopping only on weekends while dad is home. However, I’m not sure that never leaving the house during the week would be mentally healthy for me. I know that few things are more important than her sleep. But our space is not huge and we live with two other families, so a bit of outside time is important for us all.
Do you think it would be acceptable to try to let her nap once a day or a few naps per week in a stroller while I go on a walk / jog? I know it’s not ideal. But I could make it somewhat dark with a cover and use a portable white noise machine. All other naps would be in the bassinet…. Would that be enough to help her develop self-soothing skills? At what point (age) should all naps be taken at home?
Thank you.
Please focus now on your mental health and follow your heart. Do your best to help your baby sleep well but not at the expense of your well-being.
Hi Dr Weissbluth,
I hope you are well. Thank you again for all your help with our first, now 2.5 year old daughter. Your book, blog, and responses have been tremendously helpful.
Our daughter now has a 6 week old baby brother and his sleep is proving a little more tricky than hers.
Specifically, he has reflux, which means that we end up having to hold him upright quite a while after each feed. He thus always falls asleep while being held upright by me or my husband, and we would like your advice on how to teach him to self soothe. When we put him down drowsy but awake he ends up bringing up milk and waking himself up.
This has a few knock on effects, such as that in the day, he only naps in the sling for a long time. If we do manage to get him into the cot or the pram, he wakes after 45min and can’t settle himself back to sleep.
He also takes a very long time to settle in the evening – we always aim for an early bedtime of between 5pm and 6:30pm depending on when he wakes from his last nap, but he ends up falling asleep only 2.5-4hrs after he last woke, with us settling him for 1-2hrs. His bedtime routine is currently a bath as soon as he wakes (or we wake him once it gets to 4:30/5pm), bottle, lots of winding, swaddle, and holding upright whilst swaddled until he falls asleep. With our daughter it was so easy – we could put her down at 6pm ish and she would be asleep by 6:30pm latest all by herself!
In the night he settles very quickly weirdly – he falls asleep almost immediately after the feed and does a good 3-4hr stretch or more. He usually either does a 5-6 hr stretch initially (with an unsettled period 3 hrs in but sometimes we can soothe him to a deeper sleep so he doesn’t wake) and then 1 wake at 2am ish, and then up at 6am, or he wakes at 9pm, 1-2am and 5-6am.
Over the last week, his average total sleep is 14hrs, daytime sleep is 4hrs 50 min. We try and get him down for a nap as soon as he exhibits drowsy signs (for him it’s a few big yawns). His wake windows seem to be 45-60 min, but he doesn’t always go down that quickly unless we put him in the sling. He is exclusively formula fed and dad has been on paternity leave the last 6 weeks (we also have a nanny, so there are “many hands”). He was born at 39 weeks.
Any advice much appreciated!
Thank you,
Helena
Before talking about sleep, please clarify the GER issue.
Who diagnosed it and is he on medicine for it? If so, what is his dose schedule?
When did it begin?
When did not sleeping well begin?
Is he breast fed, formula fed, or combination?
Is the weight gain satisfactory or not?
What was his gestational age at birth?
Looking ahead, please red Blog Posts 190 and 231 and give me your thoughts.
Hi Dr Weissbluth, thank you for the quick reply.
The reflux was diagnosed by a GP, based on just me saying that he brings up milk during and after his feeds a lot. They said I can, but probably don’t need to, use infant Gaviscon. We aren’t using it as he hadn’t seemed that bothered about spitting up, but more recently he has started crying during and after his feeds (intermittently, not as much as to describe him as “extreme fussiness/colic” though). In the night he is absolutely fine and doesn’t bring up any milk, and settles quickly and well pretty much immediately after his bottle.
He has been difficult to settle at night pretty much from week 1/2, and naps probably from week 3/4.
He is exclusively formula fed (about 80/20 breast / formula at birth and then tapered down to just formula now) and was 39 wks at birth (btw – not sure if my full post is visible, as I included that information in there?). We haven’t had him weighed since he regained his birthweight at 10/14 days, but he has grown out of some of his clothes and is about 3-4cm longer, so we are happy with it. Next weigh in is in two weeks.
Thank you for referring to the blog posts. I guess you would like to know whether we miss drowsy signs given the elder sibling and our thoughts on an early bedtime? We are lucky to have a nanny and my husband is on paternity leave, so we are able to pay very close attention to our son. We start soothing him to sleep as soon as we see the drowsy signs (for him it is a few bit yawns about 45-75 min after he last woke), but given the reflux this sometimes works (pretty much only in the sling), and sometimes he is sick and wakes himself up again (during soothing or once put into cot). We always aim for bedtime between 5pm and 6:30pm but given the above dynamic he ends up becoming overtired and even more difficult to settle.
We’re.a bit stumped as to what to do to help him sleep better and learn to self soothe
Thank you!
Helena
Q: Is Ger over diagnosed in infants?
A: Google AI:
Yes, there is evidence suggesting that GER (gastroesophageal reflux) and GERD (gastroesophageal reflux disease) are overdiagnosed and overtreated in infants. Studies show that many infants are diagnosed with GERD and prescribed medication without clear evidence of acid-related disease, and that symptoms alone should not be the sole basis for diagnosis.
Here’s why this is happening:
• Non-specific symptoms:
Infant symptoms like spitting up and fussiness can be due to various reasons, not just GER.
• Overreliance on clinical symptoms:
Doctors often diagnose GER and GERD based on symptoms alone without further investigation, which can lead to misdiagnosis.
• Parental concerns:
Parents may be more likely to seek medical advice and treatment for reflux-like symptoms, leading to increased diagnoses.
• Pharmaceutical influence:
Promotion of acid-suppressing medications can contribute to increased diagnosis and treatment rates.
Consequences of overdiagnosis:
• Unnecessary medication: Prescribing medications without a proper diagnosis can expose infants to potential risks and side effects.
• Increased healthcare costs: Unnecessary medical procedures and medications add to healthcare costs.
• Potential for misinterpretation of symptoms: Labeling healthy infants with GERD can lead to parents seeking further interventions, potentially masking other underlying issues.
Key points:
• GER is common in infants and often resolves on its own: Many babies spit up or regurgitate, but it’s not always indicative of GERD.
• Diagnosis should be based on a thorough evaluation and not just symptoms: Doctors should consider other potential causes of infant discomfort and may order additional tests.
• Treatment should be individualized and based on the specific needs of the infant: Not all infants with GER require medication or other interventions.
In summary, while GER and GERD are common in infants, overdiagnosis and overtreatment are a concern. Parents should discuss their concerns with their pediatrician and seek further investigation only if necessary.
Another reason for over diagnosis is that the health care provider can substantially shorten the time of the visit by quickly talking about a feeding schedule and maybe prescribe medication and not spend time explaining normal or physiological reflux in a healthy spitting baby and most importantly, not talk about and deal with fussiness/crying/ not sleeping well which takes a lot of time.
Thankfully, your baby has normal weight gain. He may have significant GER and needs the approach outlined by his physician or maybe not. If not, the focus might be helping him sleep better and not worry about the spitting.
Maybe there is a clue in the answers to the next 2 questions.
1.What started first, the spitting or crying?
2.Please describe in detail your feeding schedule and volumes fed.
Think about whether you want to focus on fussiness/crying/sleeping for 3-5 days and not worry about spitting or not; please consider discussing this with the GP.
Let me know your thoughts.
Hi Dr Weissbluth,
Thank you for your reply. I agree that it may not be significant and his spitting up may be exacerbated by his not sleeping well (and thus getting agitated) – the reason for this being that he is absolutely fine at night (when he is very calm and relaxed).
We are definitely keen to prioritise sleep as this is so important developmentally. We are trying to pace his feeding even more by giving him a dummy throughout the feed so that he slows down (but doesn’t get annoyed / agitated by the “teat” being taken away.
In answer to your two questions:
1.What started first, the spitting or crying?
The spitting up, for sure. The crying has only started recently (within the last week).
2.Please describe in detail your feeding schedule and volumes fed.
In the last week, he has had an average of 800ml per day, varying from 500ml to 1L, with a median of 700-750ml. His first feed is at around 6am (usually 120ml). His daytime naps are still variable, but more often than not there is one long or two short naps in the morning (if two short ones, then he usually gets a top up prior to the second nap; 60-80ml at about 8am), then a feed at circa 10:30 (120-160ml). The mid day nap is also variable – sometimes he doesn’t settle for a while. But usually the feed is at around 1:30/2:30pm (120-150ml). Then there is usually an afternoon nap and his next feed is after his bath at around 4:30/5:30pm depending on how long his nap is. We would wake him by 5pm latest. This is then usually 120-150ml and then another 40-100ml in the following 1.5-2hrs as he ends up awake for a long time given the spitting up following that initial feed and then doesn’t settle unless he is fed again (we always try the dummy for a while first but he keeps waking himself up). He then wakes sometimes at 9pm ish (small feed of 60-80ml) and then like clockwork at 1/2am (130-150ml) and stirs at 5am but we are able to settle him back to sleep until about 6am.
Hopefully this is enough detail?
Thank you,
Best,
Helena
I should add that often his naps (and thus daytime feeds) are so variable because he ends up awake for too long given he spits up (as he falls asleep / or once he is put down after being held upright / or wakes after 45min so we need to soothe him back to sleep again)
What was his birthdate?
What is his current weight?
Typically, what is the total duration of the feeding time when he consumes around 4 oz (120ml) or more and also when he consumes around 3 oz.(90ml) or less.
Currently please describe a common pattern of spiting: frequency and volume.
Hi Dr Weissbluth,
We took a few days to try and observe a pattern in his spitting up as per your question.
What was his birthdate?
7 March.
What is his current weight?
4.5kg (birth weight was 3.5kg, which he regained at the 2 week mark).
Typically, what is the total duration of the feeding time when he consumes around 4 oz (120ml) or more and also when he consumes around 3 oz.(90ml) or less.
It really varies – most of the time, if he’s hungry, he does that in 5-10 minutes. When he isn’t hungry and takes in less than 120ml it can take about 30 minutes.
Currently please describe a common pattern of spiting: frequency and volume.
Again, there seems to be no discernible pattern. Most of the time it happens after a burp (even though we wait 3-5 minutes before burping and do it gently), and it is most often 10ml or so, sometimes 20ml. However it can also go on for a while – up to an hour or 1.5 hrs later he is still having wind and then spits up (or just spits up if he changes position). He rarely seems to spit up more than 20ml).
His evening settling hasn’t got any better unfortunately as all the spitting up is leading to him getting over tired and staying up for 2hrs +, even though we try to settle him within an hour to 1.5 hrs of getting up from the last nap (and it’s always an intended bedtime of 5:30-6:30 pm).
Thank you,
Helena
GER & Feeding:
Because the volume of spitting is so small (10-20ml) and his weight gain is great, it appears that GER is currently not much of a medical problem. It is knot known whether the spitting would dramatically increase if you put forth less effort to prevent it.
“When he isn’t hungry and takes in less than 120ml it can take about 30 minutes.” My guess is that attempting to feed him when he is not hungry was suggested by the GP as a counter-GER strategy when he was younger to protect weight gain. Now it seems counter productive because overfeeding causes more spitting. How do you feel about only feeding him when he appears hungry?
Sleep:
Based on his gestational age at birth (39 weeks) and his birthdate (March 7) his corrected age is about 6-7 weeks. Normal fussing/crying behavior usually peaks around 6 weeks of age and then decreases. Specific social smiling starts about 6 weeks of age. The brain wants an earlier bedtime around 6 weeks of age and longer periods of night sleep also appear then (day sleep rhythms emerge later and become well developed by 6 months of age). Would you wish to try for better night sleep now? If so, I will give you specific advice for an earlier bedtime that probably would involve crying (and maybe more spitting at night that you would attend to) and father involvement. You would commit to a 2-3 day trial and abandon it if spitting or crying worsened. For peace of mind regarding safety, please discuss this with your GP. Let me know your thoughts.
Thank you for your quick reply.
Re the feeds where he seems less hungry – he does show hunger cues, but then once we start feeding he isn’t as ravenous as at other times. These feeds will still be 3 hrs + split apart. We are trying to sort of follow a schedule where he feeds at about 6/7, 10/11, 1:30/2ish, and then 4:30/5ish, so that he gets the bulk of his feeds in during the day. We typically don’t explicitly wake him from his naps to do so, but rather encourage him to wake (eg take him out the sling and put him in the Moses basket)
That’s helpful to know re fussiness. His night sleep is actually ok – he wakes once or twice in the night (mostly twice) which is quite manageable. If you think it’s possible to improve this then we would love to! The key thing we would love to “fix” now is the long time it takes to settle him for his first evening sleep (after the 4:30/5pm feed) – we’re always trying to have him down by 5:30/6:30pm but he takes ages to soothe to sleep due to the spitting up (is my theory at least). In the night he falls asleep very quickly and with minimal spitting up. Dad is already doing the evening soothing most days, and we also split the night feeds between us.
Let us know what we can do – much appreciated!
Helena
OK
Stop: “We typically don’t explicitly wake him from his naps to do so, but rather encourage him to wake (eg take him out the sling and put him in the Moses basket)”. Do what ever you can to maximize day sleep (extra soothing, contact naps, swings, car rides, etc) with no regard to a schedule.
Stop attempting to ‘top him off’.
Feed him whenever you think he is hungry, but if he does not seem interested at all or after a very small volume he loses interest, stop the feeding. Do not try to impose a feeding schedule on him, trust your instincts. Feed him only as long as he has an eager suck and stop when he slows down or has many sucks and few swallows.
No new nap starts after 3pm; if he is asleep then, let him sleep. He may need extra distraction or soothing before bedtime.
Temporarily, for the next 2-3 nights, his bedtime is rigidly 5:30pm (he is bathed, fed, and soothed and you are leaving the room at 5:30pm).
If you have a monitor or suspect he is spitting then or shortly thereafter, father quickly attends, cleans, and leaves the room without soothing.
Expect him to be hungry and have father feed him at or after 9:30pm and perhaps again in the very early morning, but crying is ignored at all other times. Again, father attends if spitting is suspected (remember, no soothing) any time at night.
Keep a written record of feeding and crying and spitting.
Do not do this if you cannot commit to a 2-3 night trial.
How does this sound?
Do you have any practical suggestions/ step by step suggestions for how to wean a pacifier at 3months old?
Will only sleep with pacifier. We’re experiencing lots of 10 minute naps because the pacifier keeps falling out.
My wife is not quite ready for full extinction/Cry It Out over the pacifier but is this our only option? Rocking, shushing and sound machine all don’t seem to help/soothe.
How would you describe her self-soothing skills at sleep onset for naps and at bedtime?
He can be put down awake in the crib with a pacifier and he will fall asleep by himself.
If you put him drowsy but awake in the crib without a pacifier. It isnt pretty. We’ve tried rocking, shushing, noise machine (without a pacifier) and he does everything he can to latch to an arm
For naps—if the pacifier falls out-he is awake (usually 10-45 minute naps). We used to be able to replace and he would continue to nap but that hasn’t been the case as of late. These 10 minutes are especially brutal.
Night—he usually needs it replaced a 2-4 times in the evening (630-930pm) and then a few times again early morning (2-5am)…occasionally not at all.
Also at 3months if he is ready for a nap at 430pm would you put him down for the night?
What is his most common day and night sleep schedule?
Describe his mood and behavior when alone with toys (no screens or parental involvement) during the 60 minutes before you begin the bedtime routine?
In my Chapter on Sleep Solutions, which one comports with your values?
Our new 3 month old will typically eat around 4am and go immediately back to sleep until 7-8am.
Nap around 60-90 minutes after waking. Today he napped for 80 straight minutes (not normal)
Naps 10-45 minutes then awake for 45-90 minutes before napping again. No set pattern. We put him down for naps when he starts to stare off, slow down or stops tracking or smiling at a pare t.
Typically around 4-430pm he becomes horribly fussy. Cannot be put down at all. Based on this should we be putting him down for the night this early? We are all for early bedtime but 4pm seems way early!
My wife said she would be most comfortable with faded bedtime/positive routines. Then maybe graduated extinction. With faded bedtime do we do this for naps as well? Or just start with bedtime ?
“Typically around 4-430pm he becomes horribly fussy.”
Before this occurs, usually, when did the previous nap start and end?
Bed 5:40pm
7-720pm (needed help with pacifier x4)
4:15 am( pacifier)
4:45 fed
6:10-645awake
645 fussy-asleep by 700, 730 woke but was able to replace pacifier and went back to sleep
830-9:05 awake
9:05-awake
925-940 yawning and fussy (so put I put him down but he didnt stay down)
9:40-1100awake
11:00-11:45asleep
11:45-105awake
1:05-1:55 asleep
1:55-345 awake
345-5:05 asleep
6:25-bed (woke at 7:10 fell back asleep with pacifier).
My wife said he didn’t have the 4-430 meltdown but he was asleep during that time today. Said he was a bit fussy after the 15 minute nap but he wouldn’t resettle.
Dear Dr Weissbluth,
Hope you are doing well.
We reached out to you in 2021 and your advice was very helpful in sleep training our now 3.5 yr old son.
We now have a 6 month old daughter. She is still breasfed but we are working on moving her exclusively to bottle feeding. She was a great sleeper waking up only once per night to feed around 4am until about 4.5 month old. Now she wakes up very frequently (5-6 times a night) sometimes because she hasn’t mastered the roll from belly to back yet so she panics and calls out for help. Sometimes however she manages to sleep for 2 hours straight on her belly without showing signs of distress.
We were wondering if you recommend postponing sleep training using extinction until she can roll back on her own?
Thank you in advance for your advice.
Michele
When do you usually begin the bedtime routine?
When does she usually actually fall asleep?
Please read Blog Posts 190 and 231 and we might see a solution.
Thank you for your comments. I read the blog posts you suggested and post 190 got me thinking that maybe I’m doing things wrong but then I read Blog post 231 and read correctly that you advise against a late afternoon nap if an early bedtime (5.30 pm) is implemented.
But before I let you know my thoughts here’s how we are doing write now.
Since she started daycare at the beginning of October, I know that her morning nap is not that great since naptime shifted from 8.45/9.00 am (on days she is home) to 10.00 (time when they put them to sleep for the fist nap at daycare). The midday nap is around 1pm both at home and at daycare. So when she’s home on the weekends she usually sleeps from 9.00 to 10.00 and from 13.00 to 14.30/15.00. At daycare she sleeps a maximum of half an hour in the morning and an hour/hour and a half in the afternoon so I know she is short on sleep and tired during weekdays. She usually gets drowsy again around 15.45/16.00 when her midday nap lasts only around 14.30pm.
I have to admit that up to around a month ago I was not that attentive to her sleep cues in the evening also due to the fact that when my husband was not working from home it was hard to keep my jealous toddler out of the room when I needed to put her down for sleep early in the evening.
But for the past month I have been trying hard to follow her cues and implement an early bedtime but maybe here’s where I am making a mistake:
When she wakes up from her last nap around 14.30 I strive to distract her until 5pm when I start the bedtime routine. By then she is tired but has her bottle and goes to sleep in about 10/15′ afterwards. I read in blog post 190 that 3 naps are possible with an early bedtime? Is this correct? So maybe I should let her sleep around 15.45 if she is drowsy/tired?
The early bedtime (5.30pm) has not been working because she ends up waking up within an hour once or twice and then again around 11pm-midnight (when I give her a bottle) and then again at 2am and around every half an hour after that. So our nights have been exhausting. To avoid her crying and screeming and thus waking up her brother, I usually sooth her back to sleep in my arms. She falls back to sleep within 5 minutes.
Ever since she started rolling on her tummy and not being able to roll back, we stopped putting her drowsy but awake in her crib because that meant she would roll over on her tummy and panic each time and start crying since she tends to prefer to sleep on her tummy.
For the first 4 months putting her down drowsy but awake worked when we were able to catch the right cues to put her down for her naps. Also becsuse she tipically uses her thumb to initiate self-soothing.
Thank you in advance for your thoughts.
Day care naps have created this problem so I think the solution might be challenging. No third nap is correct.
Week-days:
Strict 5:30 expected falling asleep time (she is bathed, dressed for sleep, fed, soothed, and you are leaving the room at 5:30PM)
“The early bedtime (5.30pm) has not been working because she ends up waking up within an hour once or twice and then again around 11pm-midnight (when I give her a bottle) and then again at 2am and around every half an hour after that. So our nights have been exhausting. To avoid her crying and screaming and thus waking up her brother, I usually sooth her back to sleep in my arms. She falls back to sleep within 5 minutes.
This is not sustainable and will exhaust your ability to care for both children and yourself. Therefore, do Extinction and feed once in the middle of the night.
Implement “Sleep Rules” and “Silent Return to Sleep” for your older child but if your infant’s crying is too stressful for him to do this, then let him hang out in your bed for comfort and reassurance when your baby is crying.
“Ever since she started rolling on her” tummy and not being able to roll back, we stopped putting her drowsy but awake in her crib because that meant she would roll over on her tummy and panic each time and start crying since she tends to prefer to sleep on her tummy.” Go back to ‘drowsy but awake’ and be optimistic because she has elf-soothing skills,(“For the first 4 months putting her down drowsy but awake worked”)
Week-ends
Do your best to maximize naps and early bedtimes.
Try this for 3-4 day, keep a written record and let me know how it’s going.
Are you OK with this?
Thank you for your fast feedback and advice.
On Friday, both her and her brother have the flu vaccine and so they might get a fever the same night. I discussed your suggestions with my husband, and we decided to start with extinction from saturday night onwards that way we can also see the impact of her night crying on her brother’s sleep during the weekend and potentially have him nap on sunday if we see he had a rough night. This will also give us an idea on how it might go during the following nights. I will report back mid next week on how it’s going.
Thank you again.
Saturday: Day 1 of sleep training
Nap 1: 8.35-10.10 (1hr 35′)
Nap 2: 12.55-14.30 (1hr 35′)
No afternoon nap
Lights off at 17.40
Put down drowsy but awake, she got very mad, turned on her stomach, regurgitated &cried until 18.00. When I went to check in on her, I changed the bed sheet & soothed, she fell asleep immediately.
Woke up at 18.50 and cried until 19.50 (60′) then fell asleep.
Woke up 23.30, fed with bottle, changed diaper and back to sleep.
Up at 3.12 cried until 3.45 (33′) then silence.
Sunday: Day 2
Woke up at 6.48 due to soiled diaper.
Nap 1: 8.45-10.15 (1hr 30′)
Nap 2: 12.45-14.15 (1hr 30′)
No afternoon nap
Tired and fussy at 16.30. Bottle at 17.15, crashed at 17.25.
Woke up at 18.15 and cried until 18.55 then fell asleep.
Woke up at 00.00, bottle then back to sleep.
Monday: Day 3
Woke up at 5.44.
Nap 1 at home: 7.25-8.15 (50′)
Nap 2 (day care reported): 10.15-10.45 (30′)
Nap 3 (day care reported): 12.50-14.45 (1hr55′)
No afternoon nap
Bedtime drowsy but awake: 17.50, fell asleep on her own.
Woke up at 00.00, fed and changed diaper then back to sleep at 00.40
Woke up again at 4.20 due to soiled diaper, changed diaper and put her back drowsy but awake at 4.33. She cried hard until 5.20 (47′) then silence until 6.49. In the morning I saw her on her tummy so probably she cried so loud because she had turned on her tummy and couldn’t turn back.
Tuesday: Day 4
Woke up at 6.49.
No home nap before daycare.
Daycare reported morning nap: 30′
Daycare midday nap: 12.50-14.45 (1hr 55′)
No afternoon nap.
Fussy around 16.00, fed, mood improved.
17.45 put down drowsy and awake, fell asleep on her own without any problem.
20.18 cry heard for a second then she fell back asleep.
Woke up at 22.50, fed and changed diaper then drowsy but awake in crib at 23.20, fell asleep immediately.
Woke up around 1.20, refell asleep on her own.
Woke up again around 4.00 refell asleep or was absolitely silent until 5.20.
At 5.20 she complained, had a soiled diaper, changed ande fed her and she went back to sleep until 6.30.
Wednesday: Day 5
Nap 1: Fell asleep in the stroller at 9.00, woke up briefly at 9.30 then fell bavk asleep until 10.30 (Total nap duration 1hr 30′).
Nap 2 at daycare: 13.00-14.00 (1hr)
17.30 put down drowsy but awake, fell asleep immediately.
21.30, woke up with a stuffy nose and fever.
After that she woke up several times so I soothed her everytime until she went back to sleep. Putting on hold for now sleep training for a couple of nights until she can breath better because self-soothing with her thumb is difficult with a strong cold.
In general, looking at the data from the the first 4 days, I can say that the number of nocturnal awakenings has drastically improved so we are really grateful! No problems with drowsy but awake either. The duration of her naps at home has also lengthened. The challenge remains, as you already mentionned, napping at day care.
So here are my questions:
Can an early bedtime compensate from a cognitive point of view for the short morning nap?
Would it be best to let her sleep 30′ to 45′ in the morning between 8.45 and 10.00 considering part of the nap would be during motion (stroller or car) while I accompany her older brother to school or, if her wake up time in the morning and tiredness permit, to have her nap for half an hour at daycare between 10.15 and 11.00? This might be our biggest problem for a while because of her early bedtime and thus early wake up time and her brother’s 9.00-9.15 timed entry at school in the morning.
So, in short, would these 2 naps be equivalent or is one option better than the other?
Also, please consider that, until mid february (when she will turn 10 month old), I will be on maternity leave so I will have the flexibility in the morning on most weekdays to maximize her nap quality/length when possible before taking her to day care.
After that date, and, unfortunately, for the rest of the school year (end of july) we will have to adapt to the day care nap schedule and keep in mind that on week days she will only get 30′ of sleep during the morning nap.
Thank you.
The early bedtime over 3-4 nights has improved her night sleep: “In general, looking at the data from the the first 4 days, I can say that the number of nocturnal awakenings has drastically improved so we are really grateful! No problems with drowsy but awake either.”
Stay the course because soon, the improved night sleep will erase early morning drowsiness and she will no longer need an early morning nap before around 9am.
An at home nap, even it is delayed a little, is probably better than a brief stroller nap when you have to take your older son to school.
If fever is absent and the common cold symptoms are mild, consider continuing what you have been doing.
How does this sound?
You have accomplished a lot in a short time! I wish you sweet dreams for your child. My sincere goal is to raise the visibility of accurate information regarding children’s sleep. To encourage other parents, please consider writing, and posting here, a narrative report of your sleep adventure (please include the role of the father) that I would use it as a Blog Post or perhaps, only if you feel comfortable, an Amazon book review. Thank you.
Unfortunately, she’s been very ill for the past two days and getting therefore very little sleep so I let her nap in my arms today both in the morning and for the midday nap. As expected, this backfired and she cried hysterically for an hour when I put her to bed tonight. It is incredible how fast they form habits! We will stay the course because we know we can get her to go back to falling asleep and staying asleep on her own.
Here you go for the blog/book review. If you prefer, I can also publish the review on Amazon. I bought the book on Amazon in 2022 and I went back and checked and I never did write a review there:
Dr. Weissbluth’s book is a must read if you want to teach your children healthy sleep habits. His research and advice were fundamental in helping us understand the importance of healthy sleep for a child’s brain, learn to put our children down for naps and have them achieve a healthy night’s sleep.
Our now 3 and a half year old went from falling asleep only in my presence and having very brief naps in the stroller or baby carrier to becoming a great napper and night sleeper. Dad’s presence and moral support was fundamental in achieving success after applying one of Dr. Weissbluth’s methods. We saw big improvements after only a week of time and effort invested in applying the best sleep training solution for our family. It took around a month to achieve a stable sleep rythm/routine following the advice in the book. With our second child, now almost 7 month old, applying Dr. Weissbluth’s recommendation of implementing an early bedtime helped reduce the number of her nocturnal awakenings drastically in just under a week.
I can definitely say that the information and advice in Dr. Weissbluth’s book saved us from a lot of stress and sleepless nights so we are beyond grateful.