Healthy Sleep Habits, Happy Child
53
Naps (1 of 4)
November 15, 2021

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Introduction

A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

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.

Blog 53Naps (1 of 4)

Naps

Unhealthy sleep schedules usually evolve in infants and young children when parents keep them up too late at night. Parents do this because they enjoy playing with their baby or they cannot put the child to sleep and instead wait for their child to crash from total exhaustion, or both. Some parents leave work late, have a long commute to the daycare site to pick up their child, and then arrive home even later. This lifestyle is extremely difficult for the child if naps are not regular at the daycare center and she is put down to sleep too late at night. If it is impossible to have an early bedtime under these circumstances, do the best you can. A bedtime that is only a little late is not as harmful as a bedtime that is way too late. Don’t beat yourself up over this but do your best to protect naps and early bedtimes on weekends. Bedtimes are based on drowsy signs (Blog Post 9), not clock times, so please do not compare your child’s bedtime with that of another child. Also, realistically, circumstances may make it difficult for parents to synchronize soothing to sleep at night with the onset of drowsy signs. For some parents, the reality is that a bedtime that is too late is unavoidable. Even so, try to move the bedtime just a few minutes earlier. But an important point is that a little earlier bedtime, just a few minutes earlier, will benefit your child. A little bit of extra sleep goes a long way (Blog Post 7). Also, perhaps good quality naps might mitigate the adverse effects of a too late bedtime. Good quality naps are naps occurring before the child becomes overtired; good quality naps occur in synch with nap rhythms. However, some babies simply are brief nappers.

If parents can cause problems that interfere with good naps, why can’t parents make their babies nap longer? This question provides a good example of the asymmetry between sleep and wakefulness. Sleep is not the absence of wakefulness; rather, the brain automatically and actively turns on the sleep process and simultaneously turns off wakefulness. You and your child can force wakefulness upon sleep, but you cannot force sleep upon wakefulness. You and your child can motivate or force yourself and her into a more wakeful or alert state, but you cannot force anyone into a deeper sleep state. So sleep and wake states are different but not opposite. Nap duration between 6 and 18-24 months is a stable individual characteristic, some children are born to be short nappers and others will be long nappers.

Not napping means lost sleep. Over an extended period of time, children do not sleep longer at night when their naps are brief. Of course, once in a while—when relatives visit or when a painful ear infection keeps the child awake—a child will make up for lost daytime sleep with longer night sleep. But day in and day out, you should not expect to satisfy your child’s need to sleep by cutting corners on naps and then trying to compensate by putting your child to sleep for the night at an earlier hour. What you wind up with is a cranky or demanding child in the late afternoon or early evening. Your child pays a price for nap deprivation, and so do you.

Spending hours during the day holding your child in your arms or in a rocking chair while she is in a light, twilight sleep also is lost sleep because you have delayed the time when she will fall into a deep slumber. It is similar to having a bedtime that is too late. It’s a waste of your time as well. Brief catnaps during the day, motion sleep in cars or baby swings, light sleep in the stroller at the pool, and naps at the wrong time are all poor-quality sleep.

Sleep Begets Sleep

All previous Blog Posts relate mostly to night sleep. If your child sleeps well at night, she wakes up in the morning well rested, which permits better quality naps, which promote better quality night sleep. The reason night sleep and day sleep interact with each other is that your child remains at a lower level of neurological activation that produces a virtuous circle of healthy sleep. If either night sleep or day sleep is off, a vicious circle may occur causing your child to be at a higher level of neurological activation resulting in bedtime resistance, night wakings, short night sleep duration, and problematic naps. The reasons that previous posts focused more on night sleep then day sleep (naps) are:

Parents have more influence over night sleep than naps for three reasons:

  1. Parents are tired themselves at the end of the day and really want their child to sleep, not only for the child’s benefit but also so that the parents can have some private time for themselves. Parents are more able to have consistent bedtime routines.
  2. The night sleep rhythm is a powerful and predictable wave within the child, developing at or after about 6 weeks of age.
  3. It is darker and quieter at night, and the child is home in the crib for night sleep.

Parents have less influence over naps than night sleep for three reasons:

  1. Parents are sometimes conflicted between naps and errands, scheduled events, visitors, and the needs of their other children during the day. There may be time pressure to do other things, so nap time routines may not be consistent. Daycare, nanny care, older siblings, or grandparents may introduce more variables regarding naps. Digital distractions interfere with noticing subtle drowsy signs, so the timing of naps may be off. Dual-career parents may have a bedtime that is too late, or an oversolicitous nanny or night nurse might interfere with self-soothing at night, producing poor-quality night sleep that leads to problematic naps.
  2. Nap rhythms develop around 3–4 months, and naps become more predictable and longer around 6 months of age. So between 6 weeks and 6 months, night sleep might be highly predictable . . . but not so for naps. Naps change over time; as your child gets older, he has fewer and then no naps. This lack of regularity and the transitions to fewer naps may make it difficult to catch the wave of emerging drowsiness for naps. The congenital temperament features of sensitivity to environmental stimuli and regularity of nap rhythms create much nap variability among children of the same age. As previously mentioned, some children are born to take long naps and some are born to take short naps, adding to the variability among children of the same age.
  3. It is lighter and noisier during the day, and your child may be outside or moving about in a carrier or stroller during nap time.

(To be continued.)

My name is Marc Weissbluth and I’ve been a pediatrician since 1973. This baby sleep blog will help you create a healthy sleep schedule for your child. My baby sleep advice and sleep training will teach you how to get a baby to sleep through the night. To stay updated with my latest baby and child sleep blog posts, be sure to subscribe today.

Comments

  1. dr weissbluth, we love your books! im curious what you say is an appropriate wake time for a 7-8 month old? (if well rested). i can get her morning nap by her sleepy cues but find it harder to hit her second nap. i know to watch my baby more than the clock, but is there a time that’s an average? thank you!

  2. yes she self soothes and puts herself to sleep by herself often. of course, if i miss her sleepy cues and she’s reaching overtired (not often), it takes more soothing (as expected per your book and blog!). i usually wake her by 8 am and she’s down for her first nap between 9:30 and 10. this is usually a long nap. i aim for her next nap around 2 but sometimes she doesn’t seem as tired if she takes a longer nap. which is why i was wondering an estimated wake window so i can try to watch her more closely during that time! is it usually 2-3 hours? or more/less? she’s in bed by 7 or 7:30 for the night and sleeps well (sometimes has a quick feed and back down). any idea how long she should be able to stay awake after that first nap or even before bedtime? thank you!

  3. it kinda depends? if she naps till 11 or 12 she has a good demeanor by 1-2 (sometimes fussy around 2). and again depends on how her nap is for how she is around 5-6. lately she’s been more fussy at this time but between trying to get her “dinner” and her nighttime bottle she can’t go down too early or we can’t get that all in!

    1. Your description of “around 5-6. lately she’s been more fussy at this time” suggests that cumulative sleepiness is developing from a bedtime that is sometimes too late and the interval of wakefulness between her two naps is sometimes too late. How would you describe her drowsy signs?

  4. her drowsy signs are getting fussy, red around her eyes, staring into space, late signs are rubbing her eyes (usually don’t get to this point!). i do think she might be getting over tired! i’m trying to balance pushing her a bit (bc sometimes it seems she is tired after 1 hour of awake time!) and meeting an age appropriate age window, which is 2-3 hours? is that what you would say is an age appropriate wake window?

    1. Read my Blog Post on Drowsy Signs to understand why you are confusing drowsiness with fatigue. I think my advice regarding shorter intervals of wakefulness between naps and before bedtime will help. Use Drowsy Signs as your guide. ‘Wake windows’ is a bogus notion.
      Your thoughts?

  5. ok i agree with you! she’s had a few rough nights and last night she was up off and on till 2 am 😳. i tried to wake her at 7 to start the day and she ate a little bit and literally cried until i rocked her to sleep. she’s still sleeping and it’s almost 11 am. clearly she is tired. any tips how to reverse this so she doesn’t wake again tonight? i’m thinking we will do 1 nap based on sleepy signs and then a super early bedtime? 5:30 or 6? what are your recommendations? thank you!

  6. will try that! she ended up not waking up till noon. yikes. so we did a nap from 2-3:30 and are putting her down at 5:30 pm. I’m guessing she will wake up in a few hours and think it was just a nap? We will try to rock her, maybe do a final feed (usually eats around 7 or 7:30 on a normal night) and hope for the best! she puts herself to sleep all the time so it’s so frustrating when she is awake from being over tired!

  7. Hi Dr. Weissbluth, my daughter is 12 weeks today and I suspect she is perpetually overtired. She had serious blood sugar issues at birth and weight gain issues at first so our Dr made us wake her every 3 hours around the clock for a feeding for the first two months. It was awful and we were looking forward to a more baby controlled schedule after that. She is a decent night sleeper (giving us stretches regularly between 5.5 to 8 hours, we even had 9 hours one night) and most of the time when she has a shorter sleep window it is because she has peed through her diaper (she is prolific and goes through about 15-18 diapers a day). She will go down for a few short naps per day (about 25 minutes each) but then will not be soothed back to sleep. She will usually give us one longer nap during the day of about 1.5-3 hours but it is unpredictable when that nap will occur. I understand naps don’t become regular until later but the briefness of the naps seems concerning.

    The biggest issue is, she fights us before sleep. Before every nap. Usually for an extended period before bedtime. She gets VERY worked up. I have tried to watch for drowsy signs but she seems to be one of those babies that goes from wide awake to overtired (or maybe she is just perpetually overtired and so I am never seeing drowsy signs since she is always drowsy?). She can self soothe a little bit (she has put herself to sleep to nap twice when my back needed a break from trying to soothe her and I usually put her down drowsy but awake after her night feeding regardless of what time it is and she does not fuss and goes to sleep).

    Should we focus on just catching her up with sleep regardless of how much soothing it takes at this point and then work on self soothing, or would self soothing perhaps get her into better sleep that would then allow her to catch up on her sleep deficit? I don’t know where to start.

    1. What is a common time that she actually falls asleep at night? Describe her mood and behavior when not directly being soothed by you during the 1-2 hours before that time?

  8. We try to get her to sleep starting around 6/6:30 sometimes 7 and it will take until 8:30 or 9pm sometimes depending on when we start to actually get her to sleep. In the time before she is crying, sometimes screaming sometimes not, and will move her head from side to side looking at everything around her with her eyes wide open. She doesn’t rub her eyes but will yawn. Sometimes it feels like the soothing actually makes it worse and if I just sit and hold her she will just look around but stop crying. But she doesn’t get any closer to sleep if I hold her still or if I just put her in her crib (where she works her way up to crying).

    1. Please read and have your husband look carefully at Blog Posts 9, 83, and 115X to fully appreciate why she should be falling asleep much earlier. Based on her age and her not napping well, start with an asleep time of 5:30pm. That means that you do everything you want to do for bedtime routine feeding, bathing, and soothing, and you are putting her down and leaving the room at 5;30pm. This also means that there is no nap that starts after 3:00pm. If she is sleepy between 3-4:30ish, amuse, entertain, and soothe her but do not let her fall asleep. Outdoor stimulation or loud music might help keep her calmer and awake.
      Your thoughts?

  9. We will do that. If she is in a nap at 3pm can we let it continue or do we wake her up at 3 so that she is ready for an asleep time of 5:30?

    1. If a nap starts before 3pm and she is asleep at 3pm, do not wake her and still have the super early bedtime. But ” no nap that starts after 3:00pm” to protect the early bedtime.

  10. Hi Dr. Weissbluth, my 12 week old daughter is napping well during the day and has even started being able to put herself to sleep and back to sleep if she wakes from a nap. However, we’re having issues with night time sleep. From about 7-9 weeks of age, she was regularly sleeping for stretches up to 6 hours, even 7 hours once. Then, at 9 weeks old, she started waking every two hours all night long. We have shifted to an earlier bedtime between 7-8 and she’s napping for an average of 5 hours per day. We watch for drowsy signs and get her down quickly. She doesn’t fight sleep for naps, but it’s harder to get her down at night. Do you have any advice for how we might be able to get her night time sleep back on track?

    1. When does her last nap occur and how long is it?
      During the hour before her 7-8pm bedtime, please describe her mood and behavior when she is alone with toys (not in front of a screen or interacting with parents).

  11. Her last nap usually occurs at around 5:00 pm, +/- 15 minutes, and lasts about 45 minutes.
    Her mood in the hour before bedtime is usually quite good. She’s not fussy, and when left alone with toys she will happily play on the floor.
    I should add that she’s waking at 4:30-5:00 in the morning and it’s very difficult to get her back to sleep.

    1. Please describe common times and durations of her naps even though there is some variation from day to day.
      Please describe what you do at her night wakings and how she responds.
      What was her gestational age at birth?
      Are you using breast milk or formula?

  12. First nap of the day is usually around 8:30/9:00 and total sleep time is 2-2.5 hours though sleep is broken up by some crying spells. I put her down drowsy but awake and sometimes she goes right to sleep and others she cries for between 5-10 minutes. She almost always wakes after 30-45 minutes. I let her cry for between 5-10 minutes to see if she’ll fall back to sleep on her own. If not (and this is almost always the case) I pick her up, soothe her to sleep by bouncing on a yoga ball and the remainder of the nap is a contact nap. This is repeated for nap #2, which begins around 1:00/1:30 and is usually 2 hours total sleep time. The third nap is around 5:00 and usually lasts 45 minutes to an hour. We’re slowly trying to teach her the skill of falling asleep on her own and getting back to sleep, so this is mostly practiced on the first nap. Third nap is solely contact nap to ensure she gets the remaining daytime sleep she needs.
    Night waking response varies. I nurse her if it’s been 3 or more hours since her last feed, then bounce her and put her down asleep. Otherwise, I first try to soothe her by giving her the pacifier and placing my hand on her chest. If that fails, I bounce her back to sleep and put her down. Before going down at night, I bounce her to sleep and hold her for 30 minutes before putting her down. She responds very well to the bouncing and usually falls to sleep in minutes.
    She was born at 40 weeks and I am breastfeeding exclusively.
    She is showing progress with putting herself to sleep and back to sleep when she wakes up. However, she’s waking very frequently at night. She also seemed to no longer want to sleep in the bassinet next to the bed, so we are now bed sharing which is not what we want.

    1. 1. Around 6 weeks of age, your baby’s brain wanted an earlier bedtime and because the bedtime was too late, cumulative sleepiness developed and by 9 weeks the sleep debt was so large that sleep issues appeared.
      2. The too late bedtime harm was partially mitigated by your heroic efforts to maintain long day sleep duration, but a byproduct was that your baby has not developed strong self-soothing skills and those efforts are not sustainable.
      Specific family circumstances prevent me from giving you detailed advice on how to correct your situation, but here are some general pointers:
      Nap sleep rhythms begin to develop around 3-4 months and are well established by 6 months. So the time when you should work hard to fix naps might be now or later.
      Night sleep rhythms begin to develop around 6 weeks so you should work hard to fix night sleep now.
      Your general plan is to have no nap start after 3pm and move the bedtime earlier. There is not one way to do this for all families and details are presented in my book that explain the pros and cons of different approaches. I am sorry that I am unable to give you highly specific advice but I hope this helps a little.

  13. Thank you for your advice. We will try the new schedule you suggest. My last question is about night time sleep training. You discuss different methods in your book, including extinction. Do you think she is too young to try one of the methods discussed in your book to help fix night time sleep? Should we be waiting until 4 months? Her self soothing seems to be getting stronger. The last two nights, she woke frequently but each time was able to put herself back to sleep once she was given the pacifier. I’m wondering if using a CIO method at night to encourage stronger self soothing in combination with an earlier bedtime might be helpful?

    1. “I’m wondering if using a CIO method at night to encourage stronger self soothing in combination with an earlier bedtime might be helpful?” YES
      “Do you think she is too young to try one of the methods discussed in your book to help fix night time sleep? Should we be waiting until 4 months” NO to both. Read Blog Posts 105-107

  14. Hello Dr. Weissbluth!! Our 5 month old son has been sleeping great since we implemented your recommendations!! He goes down between 6-6:15pm and usually wakes between 4-5am to eat and then will go back for another couple hours. We are really struggling with naps though! He wakes up after 25-30 min no matter the wake window. We watch sleepy cues and even if he falls asleep right away, he is up 25-30 min later on the dot! Any advice for lengthening naps? Thanks so much!

  15. Hi Dr. Weissbluth,
    I just wanted to thank you for your advice! We’ve shifted to an earlier bedtime of between 6:00-6:30 and our daughter is now sleeping in her own room in the crib for 12-12.5 hours a night. The very first night we implemented an early bedtime, she slept 12.5 hours with two feedings and no crying. We’re now doing graduated extinction when she does wake up, and it’s going well. Thank you so much for your advice. Once we get nighttime sleep occurring consistently like this, I’d like to start working on naps and I have the same question as Lisa’s comment above. How can naps be lengthened? Can I do a CIO method for naps? And how can this be done while also preventing over tiredness?

    1. Sorry, this thread is a bit confusing. Please tell me your child’s age and her common current nap schedule.

      1. Thank you. How is her usual mood and behavior when alone (no screens or parental interaction) around 5-6pm?

  16. My daughter is 12 weeks old. She Has 3 naps per day. Schedule has shifted a bit now that nighttime sleep is becoming established. Nap 1 is about 2.5-3 hours long from around 8:15-10:45/11, second nap about 2 hours from about 12:30-2:30, third nap about 45 minutes from about 3:45-4:30 and bedtime between 6-6:30. I start naps one and two in the crib but they only last 30-40 minutes. I then finish the naps as a contract nap. Her room is very dark, we use white noise and she does have self soothing skills but struggles to put herself back to sleep when she wakes up during a nap.

  17. Hello Dr. Weissbluth!! Our 5 month old son has been sleeping great since we implemented your recommendations!! He goes down between 6-6:15pm and usually wakes between 4-5am to eat and then will go back for another couple hours. We are really struggling with naps though! He wakes up after 25-30 min no matter the wake window. We watch sleepy cues and even if he falls asleep right away, he is up 25-30 min later on the dot! Any advice for lengthening naps? Thanks so much!!

    1. For the next 3 days only, do everything that you currently do but start the soothing to sleep process 20 minutes earlier and monitor latency to sleep onset, night wakings, and naps. Let me know how it goes.

  18. I would say her mood between 5-6 pm while alone is a bit fussy. She will play with toys but becomes fussy without interaction. We don’t usually use a pacifier during the day during waking hours except for before bedtime. We tend to do our best to distract her before bed and keep her calm.

    1. This is a description of ‘presleep arousal’: “I would say her mood between 5-6 pm while alone is a bit fussy. She will play with toys but becomes fussy without interaction. We don’t usually use a pacifier during the day during waking hours except for before bedtime. We tend to do our best to distract her before bed and keep her calm.”

      It indicates that she is past drowsy and is entering a state of heightened neurological arousal because the bedtime is too late. For 3 nights only, begin your bedtime bathing, feeding and soothing to sleep so that it ends at 5:30pm and you are leaving the room(the expected falling asleep time). Keep a sleep record and report back to me after 3 nights. This super-early bedtime will allow naps to lengthen. As naps get longer over the next 4-8 weeks, the bedtime might become later. Watch the video Blog Post 115X and read Blog Post 9.

  19. Hi Dr. Weissbluth, we are still really struggling with naps. He only takes 25-30 min naps. He takes 3-4 a day. He is cranky a lot of the day because we think he is tired. We have tried every combination of wake windows from 60-180 min. We put him down in the crib in picture dark, his sleep sack, binki and white noise. He goes to bed between 6-6:15pm, sleeps until 4-5am to eat and then will sleep another 2 hours. These short naps have been going on for over 2 weeks now.

  20. Dr. Weissbluth,

    Love your book! It’s already made a difference.

    We think are considering implementing the nap drill for seven seven-month-old old, but are unsure if he’s too old for this intervention. 
    He won’t self-soothe for naps. He’s dependent on mom to sleep for naps (dad was once nap king before his parental leave ended).

    When he gets his naps his night sleep is fantastic. When he doesn’t well…
    start the bedtime routine at 6pm and finish at 6:30 pm. He actually falls asleep at 7pm. We’d like him to fall asleep at 6p because we think he needs the earlier bedtime.

    1. At 7 months, I suggest that on Friday, start with super-early bedtime (5:30pm), do extinction or graduated extinction for night sleep, and do the nap drill (with your husband available for week-end support). Let me now on Monday how it went.

  21. Dr. Weissbluth!
    I thought I’d give the report. My son’s sleep has SIGNIFICANTLY improved. He’s been logging an extra 3 to 4 hours of sleep in a day. Thank you! Here’s what my husband and I did:

    We decided to do extinction with a 45-minute cap because our son has always been Mr. Sir Poops-A-Lot. We wanted to be able to check his diapers, and we thought that graduated extinction was too much to keep track of. 

    We also moved his bedtime up by 30 minutes and agreed on a nursing schedule (baby can eat every four hours at night if he chooses.) Only Dad goes in for diaper and hunger checks.  Mom goes in for a feed if the baby is really hungry.

    100% of the time since Friday we have put the boy down drowsy but awake and left the room for him to soothe himself to sleep.
    Here’s what happened:

    Day 1, Friday
    Otis cries for 45 minutes. My husband goes in and does a diaper check. It’s the dreaded code brown. Husband changes the diaper and reports back to me. He’s ready to call it quits on day one because he doesn’t want our son to get a massive diaper rash. As he’s talking, Baby Otis falls asleep and proceeds to sleep for 8 hours straight for the first time in his life. Husband recommits! 
    I give him one feed (Baby is definitely EATING not comfort eating). I put him down awake and leave the room. He cries for 15 minutes and then sleeps another 4 hours. 

    Day 2, Saturday 
    Nap 1: Baby cries for 20 minutes then sleeps for 30 minutes. Woke up from a bowel movement. Rotten luck for the kid. 
    Nap 2: Baby cries for 20 minutes then sleeps for 2 hours!
    Nap 3: Cries for 15 minutes then sleeps for 30 minutes

    Night sleep: Baby cries for 40 minutes then sleeps until 2am. I give him one feed (Baby is definitely EATING not comfort eating). I put him down awake and left the room. Baby wakes at 4am then falls back asleep after 15 minutes of crying. Sleeps until 6:30am 

    Day 3, Sunday
    Nap 1: Cries whole hour. No nap
    Nap 2: Cries 30 minutes then falls asleep for an hour.
    Nap 3: Cries 15 minutes and sleeps 45 minutes. 
    Night: Cries 20 minutes then falls asleep until 2 a.m. I give him one feed. I put him down awake and left the room. Baby wakes at 4 am and cries for 30 minutes and falls back asleep.
    Mom gets eight hours of sleep for the first time in 7 months.
    Day 4 (today) Baby Otis is napping. Peacefully. On his own. 

    My son is in the 96 percentile for height. His favorite way to sleep is for MOM (his short mom) to carry him around the room until he passes out. He’s now too big to carry. We needed a sleep solution. This book’s advice improved my son’s sleep and saved my back! 

    1. Congratulations!
      The key to your success is an early bedtime, based on drowsy signs. Please congratulate your husband for not giving up! Some fathers mess up infant sleep. Naps will vary; so the bedtime will vary. Please resist the temptation to keep him up past his time of subtle drowsy signs. Be confident that as naps improve over the next few weeks, his bedtime will often then be a little bit later.
      Spread the word.

  22. Hi – wondering if we should cap our 11 wk old’s naps at 2 hrs. He is otherwise an excellent mapper, self soother. His bedtime is 7 pm but he is still waking at 11 pm and 3 am to feed, even with consistent q3-hr feeds during the day.
    Thank you!!

  23. Our first kiddo slept 6 p-6a following your book guidelines at 11 wks of age! But this kiddo isn’t sleeping longer stretches and we have a night nanny who told us to cap all daytime sleep at 2 hrs. We were curious your thoughts.

  24. I should add that we previously had him going to bed earlier – about 6:15 pm – without longer stretches

    1. A common issue with child #2 is that child#1 distracts parents in the evening and child #1 is put to sleep at night too late. Focus on drowsy signs on your infant and maybe an earlier bedtime will erase the night wakings. Because sleep begets sleep, the nanny is wrong.

  25. Thanks so much. Will try letting him nap as long as he wants today. Appreciate your input! I recommend your book to everyone.

  26. Hi Dr. W,

    Coming back for some more advice.
    Our son is 13 weeks old and not sleeping very long stretches at night. With our first, we followed your book to a T and she slept 6p-6a starting at 11 weeks of age (and continues to be an excellent sleeper at 4 yrs). We would love for him to do the same!
    This time, as I mentioned above, we hired night help 5x/week. We are getting conflicting advice and he also has reflux which complicates things.

    Things that are going well: he absolutely falls asleep drowsy but awake, and we are adamant about putting him down asap with sleepy signs (yawn, staring into space, red eyebrows). We feel we are on top of this. He has a sound machine, room is dark, he is swaddled, and we leave after putting him down. He fusses maybe 30 sec and then self-soothes asleep.

    Here is an example of a recent day:
    6 am – either wakes on his own or is woken by night nanny for feed
    7-8:30 am – nap
    9 am – feed
    10:15-11:15 am – nap
    11:45 am – feed
    12:45-2:35 pm – nap
    3 pm – feed
    4:30-5:30 nap – woke him at 5:30 to feed, with goal bedtime of 6-6:15 pm
    **he is sleepy at this time when we wake him but feel like we need to get that last feed of the day in before bed, then hold him upright for 30 mins given reflux issues (he’s on famotidine, starting omep soon)
    6:15 pm bedtime
    11:34 pm starts to stir, gave paci
    11:55 pm Stirring, let cry a few mins and gave paci
    12:30 am stirring, gave paci
    1 am – feed, help upright for 30 mins afterward d/t reflux, put down awake, was asleep within 5 min
    2 am – woke choking due to large vomit – changed everything, did not re-feed, put down again at 2:15
    5:45 – up crying, gave paci x2, fell back asleep
    6:38 am – woke him up for the day and fed

    Our questions:
    1. He is gaining weight very well. Should we still wake him to feed q3 hrs during the day? We have heard that giving those full feeds during the day every 3 hrs will allow him to get calories during the day instead of at night, and that’s the only reason we are interrupting his sleep. If not, how do we ensure he’s getting a full feed before bed in order to do that first long stretch? We are aware sleep begets sleep so this is tricky…

    2. Is it okay to let him cry it out at this point when he starts to fuss at 11-12 pm? We never needed to do this with first kiddo. The fact that he vomited a feed at 1 am and then wasn’t re-fed until morning suggests he can go a long stretch without a night feeding.

    3. Does having the night nanny in the same room ruin his ability to put himself back to sleep? Can kids at this young of age (13 wks) figure out that if they stir, someone will give them the paci? Nanny says she can’t sleep train until 4 mos of age…

    Greatly appreciate your contributions to the sleep world and any insight you have!

    1. 1. Because his weight gain is fine, I suggest you stop waking him for a feed in the morning and at night.
      2. For 3-5 days/night, no nap is to start after 3pm. If he is asleep then from an earlier nap, do not awaken him. Impose a strict 5:30pm falling asleep time (he has been bathed, fed, soothed, lights out, you are leaving the room at 5:30 pm). Over night, because you are experienced, feed him if you think, and only if you think, he is hungry. If he calls out at other times, follow your heart for a sleep solution (no cry, maybe cry, or let cry)
      3. Nanny is wrong, see the relevant ‘Parents’ Reports’ on this subject. Get her out of the room and during this 3-5 night trial, do not allow her to soothe or feed him. Take charge and I think you will see success quickly. Once you have determined his best nighttime feeding schedule, than the nanny can follow your exact instructions or find another job.
      How does this sound?

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