Healthy Sleep Habits, Happy Child
56
Naps (4 of 4)
December 6, 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 56Naps (4 of 4)

Naps

(Continued.)

Development of Naps in your Baby’s and Child’s Sleep Schedule

Immediately after your baby is born, you will see what people mean when they say “sleeping like a baby.” For a few days, babies sleep almost all the time. They barely suck and normally lose weight during this time. A few days later, babies begin to wake up more. This increased wakefulness reflects the normal maturation of your baby’s nervous system. The baby looks around more with wider eyes and is able to suck with more strength and for longer periods. Within days, the weight loss stops and a dramatic growth in weight, height, and head circumference begins. Also, slightly longer periods of wakefulness begin to appear after a few days. Although your baby is intently interested in you and is quickly able to recognize your face and voice, she is not yet curious about objects such as toys or mobiles. She does not appear to care about the general buzz or noises, colors, or other activities surrounding her, and therefore she falls asleep almost anywhere. All babies gradually seem to become more aware of action, motion, voices, noises, vibrations, lights, wind, and so forth as they become more curious. At that point they often do not “sleep like a baby.”

Brief intervals of wakefulness between naps prevents your baby from becoming overtired. Experiment with the first morning nap beginning after only one hour of wakefulness from night sleep. This will prevent a second wind. Brief intervals of wakefulness and brief nap durations will result in many naps each day. Parents have told me to emphasize the point that babies need many naps because it is not intuitively obvious. Babies need to return to sleep within one to two hours after waking from a nap.

Watch your baby closely for drowsy signs (Blog Post 9). If you soothe her during the beginning of drowsiness, most likely she will easily fall asleep. The exception is the colicky baby, who might not fall asleep easily; these babies need longer and more complex soothing efforts to help them fall asleep.

What happens if you miss this window of drowsiness? Your baby will become overtired if she cannot fall asleep because the duration of wakefulness preceding the attempted nap is too long or there is too much stimulation around her. When you or your baby becomes overtired, the body is stressed. Chemical changes then occur to fight the fatigue, and this interferes with the ability to easily fall asleep and stay asleep—that is, the baby gets a second wind. Babies vary in their ability to self-soothe and deal with this stress, and parents vary in their ability to soothe their babies. Not all babies go bonkers if they are kept up a little too long. But you will have a more peaceful and better-sleeping baby if you respect her need to sleep again within one to two hours after waking.

Some young babies will need dark and quiet environments to sleep well, and others will appear to be less sensitive to what is going on around them. Respect your baby’s individuality and do not try to force her to meet your lifestyle. I like the analogy with feeding: We do not withhold food when our baby is hungry. We try to anticipate when she will be hungry, so that we will be somewhere calm where we can feed her. We do not feed her on the run. The same applies for napping.  If your newborn does not fall asleep, continue trying to soothe. Do not let her cry or ignore her.

Nap rhythms begin to emerge around 3–4 months of age. As your baby becomes more aware of her environment, she is less likely to sleep well in brightly lit or noisy places in the stroller. A goal is to use her emerging nap rhythms as an aid to obtain long periods of deep day sleep. Now parents better have the opportunity to “catch the wave” of developing drowsiness and synchronize their soothing to a drowsy-but-awake state with the nap wave before it crashes into a second wind. The midmorning nap becomes more regular before the midday nap. Typically, the approximate times are around 9:00 A.M. and between 12:00 and 2:00 P.M. An additional nap or naps occur in the late afternoon or early evening. The midmorning and midday naps may be brief at first, but between 4 and 6 months of age they become more predictable and longer, so that eventually, each nap is 1 to 2 hours long. Often there is one late-afternoon nap,  but it may not occur every day and it is usually briefer than the midmorning and midday naps.

After 3–6 months of age, it is possible to inadvertently put your baby to sleep for a nap before or past the time of her biological drowsiness, with the unwanted consequence of accumulating a sleep deficit from no naps or poor-quality naps. Please remember that good-quality naps are those that occur during the biological rhythm of daytime drowsiness, and naps while you are outside and in motion might be less restorative than motionless naps at home or in a quiet park.

Regular sleep schedules in general help anchor healthy sleep. But don’t be a slave to a sleep schedule. Exceptions to your sleep plan, such as skipping naps or staying up late for holidays or special occasions, are fine once or twice a month, but not much more often. Well-rested children tolerate these events and recover quickly. Early bedtimes or naps at home are socially limiting. But it is liberating to be out with a well-rested child who never fusses, and it is liberating for a couple to have relaxed private time in the evening when their child easily falls asleep early at night.

As nap rhythms mature, the naps will become more predictable and longer if and only if they are in sync with biological nap cycles. Although they will not occur at exactly the same clock time every day, you will be able to watch the clock a little more. If you have good timing, you might not see drowsy signs, because you are perfectly catching the sleep wave. Because drowsy signs might be absent and because the naps are now getting longer, you want to move away from the notion of brief intervals of wakefulness and focus more on the clock-time window when your child takes her nap best.

By 6 months of age, 80% of children are taking 2 naps a day and 20% are taking 3 naps a day.  The range of total amount of daytime sleep time is wide and the average is 3.5 hours.

Comments

  1. I’ve been reading your book and it has helped me so much. My son turns 4 months this weekend and suddenly his naps and nighttime sleep have gone haywire. We were getting long stretches at night ( waking twice to nurse) and 2 long 3 hour naps. Do you have any advice about this sleep regression? Last night he woke every 2 hours.

    1. Please read Blog Posts 36 & 37 to understand why ‘sleep regression’ is a myth. Focus on early bedtimes (Blog Post 7) and drowsy signs (Blog Post 9) to help your child sleep better.
      Sweet Dreams,
      DrW

  2. I’ve been scouring your book (4th edition) and cannot find a direct answer to this question. I’ve been using extinction with my 7wk old for night time, but read that because naps are not organized at this age, I should not use extinction for naps. What am I supposed to do when she refuses to nap during the day (even when I’m watching for drowsy signs and putting her down before 1-2 hours after attempting to soothe)? How long do I let her cry to learn to self-soothe? What do I do if she misses a nap because of this? You say that I shouldn’t use extinction at night “if naps are not going well”, so how can I get napping to go better?

    1. What was her gestational age at birth?
      What is the most common bedtime at night? Describe how night sleep is going.
      How do you attempt to nap her: in arms, in swing, in crib, etc.? Describe a common attempt and outcome for naps.
      How does she behave and appear around 4-5pm?

      1. She was born 38+4 and is 7wks and 2 days today.

        Bedtime is around 6pm, but I haven’t been comfortable setting a time because naps by evening time are usually not happening at all.

        Night sleep had been going very well for a few days with a 6-7 hour period after falling asleep after extinction and then one or two more wake-ups with 2-3 hours between. Last night, though, she woke up at 11 after falling asleep at 8pm after crying for 45 minutes.

        I try to put her in her bassinet for naps after changing, swaddling, nursing, and soothing. I have a 2.5 year old though who can’t be left alone for the full 20 minutes 10x a day that it takes to get her to fall asleep (for only a short period, half hour if I’m lucky).

        4-5pm is tricky because I can’t tell if I should call it her bedtime because she’s overtired and thus use extinction then, or if I should just try one more nap and then put her to bed with extinction after she wakes up from that (if she falls asleep at all). Does that make sense?

        1. Please clarify: She falls asleep around 6pm, sleeps for 6-7 hours, then has 1-2 awakenings, and in general, how much crying occurs at sleep onset and when she awakens at night?
          Have you tried to maximize day sleep with swings or cloth carriers?
          Are week-end naps different from week-day naps?
          Your answers might mean that the following suggestion is inappropriate, but here it is:
          Do your best to maximize sleep during the day and minimize crying during the day but there will be no nap schedule or long naps until 3-4 months of age or even later.
          Try soothing her to sleep for the night, temporarily, around 5:00-5:30pm for 4-5 days and see if you get more night sleep. This might backfire because she might just get up much earlier in the morning. On the other hand, she might get more night sleep, wake up in the morning better rested, and thus, nap better. If so, as weeks or months go by, better naps will allow you to make the bedtime later.
          Please let me know how it goes.
          Sweet dreams, DrW

          1. Having started extinction fairly recently, the last several nights it’s been about 45 minutes. A couple times, she’s cried for 20 minutes, fallen asleep, and then woken back up 10 minutes later to cry for another half hour (I am confident she’s well fed). Tonight, her crying was delayed about 5 minutes but is starting up now.

            When she wakes up at night, she goes right back to sleep but she’s really refluxy so I keep her upright and burp her for at least 15 minutes, so she is essentially going down in a deep sleep.

            Does that change your suggestion? I can get her to sleep in the car or in a wrap, but I was under the impression that was inadvisable unless your baby was extremely colicky.

            I will see how it goes! Thank you!!

          2. Please read Blog Post 43 to determine if she fits the diagnostic criteria for colic. Let me know. If you think that she might have colic, then ignore my suggestion and we will take a different approach.

          3. I don’t believe she has colic as she is never inconsolable, but she does need to be held most of the time.

          4. First, your attempt to help your child sleep better has not, in any way, harmed your child. But you are an experienced mother and having a child that needs to be held most of the time to prevent fussing or crying suggests that your child has colic, or alternatively, she is going through her period of peak fussiness. My book, ‘Your Fussy Baby’ might help. Either way, I would do whatever works to maximize sleep and minimize crying during the day and night for 1-2 weeks to regroup. Because of her age, focus on a super-early bedtime. In 1-2 weeks, try extinction again for 3-4 nights only because if she has colic, 50% of children outgrow it by about 2 months of age. Let me know your thoughts and how this does or does not work.

  3. Olá tudo bem? Sou brasileira, e acompanho seu blogue sempre. Gostaria de saber como ajudar a minha filha a ter autonomia nos cochilos. No sono noturno apliquei choro controlado e já dorme bem. Durante o dia tem tido cochilos muito curtos, embalo bastante tempo, e quando vou colocar no berço ela acorda. Como seria a abordagem? Ela já tem 9 meses.

    1. I understand that you have a question about naps in your 9-month-old. Would it be possible to be more specific regarding your question and please describe a typical nap and night sleep schedule. TranslatING into English before posting your reply would be helpful..

  4. Hi Dr. Weissbluth, we have a 14-week old (16 weeks gestational age), our first child, who has been a terrible sleeper since we brought him home. We fell into the attachment style of parenting in an attempt to minimize crying and it culminated in co-sleeping with wakings to comfort nurse every 30 minutes to 2 hours, and his complete refusal to sleep (at night or during naps) anywhere but on our bodies. The sleep deprivation was too much for me, and he was becoming increasingly irritable and unable to sleep- even in our arms- without 20-30 minutes of hysterical crying.

    We finally implemented a gentle sleep training approach (“pick up/put down”) and saw immediate progress at night (we got him into his bassinet!), and heartbreakingly, we saw his exhausted state unmasked after just one night of less fragmented sleep. After a few nights, we’ve gained the confidence to try the extinction method but don’t know how to approach naps, which still aren’t going well.

    1. Since he’s at 4 months of age, can we proceed with the extinction method even though naps aren’t going well?
    2. Since starting sleep training, he’s so exhausted during the day that wake windows before drowsy signs appear are usually 30 minutes to an hour; then when we put him down to nap, he struggles to fall asleep and naps for only 30 mins. Should we do the nap drills (we’re opting to monitor him remotely for 30 mins after wake up) for every nap?
    3. Should we try to maximize day sleep by letting him nap on us or in a carrier or will that amount to intermittent reinforcement since he’s 4 months old?

    Thank you!

    1. I will give you general advice now, but please read the section on colic in my book and let me know if you think he had colic so I can then give you more specific advice. Blog Post 95 will help you organize your thoughts. Based on his age, you have two choices, for now.
      1. Do what ever you can to maximize sleep and minimize crying during the day (without worrying about habit formation) and focus on an early bedtime and consolidated night sleep.
      2. Do above except for this modification: After he wakes up to start the day (this is your determination), quickly change, feed, and soothe him so the duration of wakefulness is 30-60 minutes. Put him down drowsy but awake for this first nap and do the nap drill for this nap and only for this nap. You are encouraging the development of self-soothing for this nap and because he is most rested from night sleep and the interval of wakefulness is ultra short, you might be successful.
      How do you feel about this?

  5. I think we can do that!

    Regarding #1, since we’re doing whatever we can to maximize sleep during the day, it’s okay to let him sleep on us during the day, even if we’re putting him in the bassinet at night?

    Regarding #2, thanks for the correction that we should only do the nap drill for this first nap, we will try that.

    After reviewing the description of colic in your book, my husband and I agree that he had (has?) colic. We had suspected it and hoped that he would mellow out as he approached three months but now at nearly four months, we’re not noticing a decrease in fussiness. If anything, he seems more tired and even fussier. We will use the extinction method to help him consolidate night sleep, and then try to extend his first nap of the day using the nap drills. After that, we’ll focus on consoling him and maximizing day sleep however possible.

    Thank you so much for your response and support!

    1. Regarding #1, since we’re doing whatever we can to maximize sleep during the day, it’s okay to let him sleep on us during the day, even if we’re putting him in the bassinet at night?–Yes

      Colic dissipates over 2-4 months in all children but post-colic sleep deprivation (causing fussing/crying) from a continuation of intense parental soothing and lack of self-soothing in the child creates the illusion that that the ‘colicky’ fussing/crying goes on and on past 4 months of age. However, it may be that post-colicky infants have a slower development of their circadian nap sleep rhythms such that instead of having predictable and long naps by about 6 months of age (as is the case in non-colicky infants), it might be around 9 months of age for post-colic infants.

      But he has a strong night sleep rhythm so your focus is on early bedtimes and consolidated night sleep. Your expectation is that night sleep will improve first, than morning naps, and then mid-day naps. The improvement will be sequential, not simultaneous.

      If you have a consistent and unified approach (is your husband on board with this plan?), definitely be optimistic!

      Please send me a progress report in a few days.

  6. Hi Dr. Weissbluth, thank you so much for your advice and support- we really appreciate it! Yes my husband is on board and we’re working together on this. He’s been doing night bottles and we’ve found that our son returns to sleep much more quickly and easily vs. when I go in to breastfeed.

    We’ve been focusing on consolidating night sleep and letting our son nap on us for now since our attempts at putting him down for naps were failing and resulting in over-tiredness. We’ve been trying an earlier bedtime and for the last two nights we’ve gotten him down between 5-5:30, one hour and fifteen minutes to an hour and a half after he’s woken from his last nap. The night before those two, he napped from 2-5pm resulting in a 6:30pm bedtime. We think this nap may have thrown us off kilter because our night sleep hasn’t been great for the past few days…

    Here are the issues we’re running into so far:

    1. Once he’s down in the bassinet for night sleep, even though he seems drowsy (though to be honest, we struggle to read his cues), he takes an hour+ of crying to fall asleep. He’ll then wake up on and off for another hour or two. Throughout the night, he’s also been waking pretty frequently. He’s been going down quickly after his two feeds but we don’t know what to do when he wakes up between 4-5:30am and has a harder time falling back asleep.
    *He’s content during the day and isn’t hungry when we put him down, nor does he have a fever or any other issues that we know of.
    -Do you think we should aim for a two hour wake window before putting him down?
    -Any other tips on how to troubleshoot his long time to fall asleep and frequent night wakings?

    2. Morning wake times have been all over the place, between 5am and 7:30am.
    -What can we do to make wake times more regular?
    -If he does sleep in until 7 or 7:30, should we let him sleep or wake him at a time that we think might emerge as a consistent wake time (6:30am)?
    -If he wakes around 4-5:30am, do you recommend we start the day or give him a chance to go back to sleep? When we do start the day, he’s tired and doesn’t seem ready to wake up; he just can’t get back to sleep on his own.
    -In the above case, he can’t usually stay up for more than an hour; how should we treat that nap so it doesn’t disrupt the mid-morning nap too much?

    3. We’ve had two successful mid-morning naps two days in a row! Both have started between 8:30-9am and have lasted about two hours.
    -If he can continue sleeping, do you see a downside to letting this nap extend beyond two hours?

    Here’s last night’s sleep log which is pretty typical of what’s been happening:

    ————12/4————-
    5am awake and start the day at 5:30am
    7-7:30am short nap in glider
    8:30-10:30am nap in glider
    11:30-12pm asleep in carrier while on a walk
    1:30-3:45pm nap in glider
    5pm down in bassinet for night sleep (asleep at 6:10pm)
    7-8:30pm waking, crying, falling back to sleep on and off
    11:30pm 4oz feed
    ————12/5————-
    3:00am 5.5oz feed
    4:00am awake crying but was able to go back to sleep
    7am wake up
    9-11am mid-morning nap
    1:20-2pm short midday nap 🙁

    Thank you again, so much!

    -Leo C. and family

    1. Congratulations! You have accomplished a lot in a short time. I will respond to your specific questions, but first, you wrote:
      “We’ve had two successful mid-morning naps two days in a row!..and have lasted two hours! When did he last do this? Ever? Is this new behavior? If so, what do you think caused it to occur?

  7. My husband and I both agree that this is a new behavior. Before this, he’d been regularly taking two short morning naps of twenty to forty minutes each.

    My husband thinks that this two hour morning nap has started coming together due to developmental changes- he can sleep longer now. I think it has mostly to do with 1. how incredibly overtired he’d been before we started sleep training, and 2. after a failed bassinet attempt we used to wear him in the carrier for this nap (and all others) in the living room or wherever we were. Since reading your book, we’ve committed to being human mattresses for all day naps (until night sleep consolidates and we start training naps), and sit in his darkened nursery with the sound machine on. We saw positive changes in our son’s night sleep and naps and daytime alertness immediately.

    1. “We’ve been trying an earlier bedtime and for the last two nights we’ve gotten him down between 5-5:30..” If this early bedtime is new, then the fact that you “had successful mid-morning naps two days in a row…lasted about two hours” shows that sleep begets sleep. The earlier bedtime produces more and better quality sleep so he wakes up in the morning better rested and is at a lower level of neurological arousal and this allows him to take a longer mid-morning nap. Do you agree?

      Your plan now is to promote self soothing skills, either gradually because he had colic or quickly because you and your husband are totally sleep-deprived.

      1. Because night sleep rhythms develops before day sleep rhythms, consider focusing on continuing the early bedtime and for the bedtime only, use drowsy but awake and extinction or graduated extinction (but perhaps not in the middle of the night or for naps).
      And/Or
      2. Because he is most well-rested in the morning after night sleep, focus only on the morning nap. If the glider is in motion throughout the nap, perhaps turn it off after a short while. Perhaps put him in the glider more awake than drowsy. Perhaps attempt to not use the glider. Consider the nap drill for the morning nap in a bassinet.

      For now, for all other naps and any night wakings, try to maximize sleep and minimize crying.
      How do you feel about this?

      Your specific questions:

      Forget wake windows, watch for drowsy cues.
      Don’t wake him in the morning.
      If he wakes around 4-5:30am, respond promptly, attend to his needs quickly, try to get him back to sleep. Try to protect the mid-morning nap.

      As naps develop, the bedtime will become later. A common mistake is for parents to make this happen to soon and/or make it too late.

  8. Hi Dr. Weissbluth, thank you again SO MUCH. Yes, we forgot about the role of the earlier bedtime and we do agree with you that it’s likely leading to the longer, higher quality midmorning naps. We had previously been following other sleep guidance (from Taking Cara Babies) that recommended a 7-8pm bedtime and a late cat nap to get our baby to that late bedtime hour. We were noticing that our son was very tired for the late nap and we’d always have to wake him up from that nap in order to give him awake time before his 7-8pm bedtime. The earlier bedtime is much better for him and while his sleep is still a work in progress, we’re seeing definite improvements especially less overtiredness/increased neurological arousal.

    We have been going in to soothe him for middle of the night awakenings and this is hard to admit but we’re realizing that he may just be hungry. He’s falls asleep very quickly after a feed.

    We’re also trying to minimize daytime crying while maximizing daytime sleep, and limiting motion sleep as much as possible.

    We’ll hang tough for the 4-5:30am mornings and wait for sleep to improve and for the bedtime to get later.

    Thank you!!

  9. Hi I’m really looking forward to reading your book, I have just ordered it today! It has been recommended to me. I don’t know if our situation is common or not. Our little girl is 9.5 weeks and naps very rarely during the day, it’s worrying me but an osteopath has told me that some babies need less sleep than others, as little as 9 hours in a 24 hour period and she probably is in that category, what do you think?

    She does nap buy mainly in the carrier or the car or very briefly on us and if she goes down at all in her crib during the day it doesn’t last for very long. She sleeps in her crib for 4-5 hours a night and then has a feed but will only sleep in the bed after that in the very early morning with me. She has had painful, recurring nappy rash which is only beginning to clear in the last 2 weeks and doesn’t have colic exactly but is crying and uncomfortable with gas in the evening time. You mentioned that there is alot to read in your book, I wonder could you point me in the right direction of what chapters to begin with. Thank you

    1. Page xv: How to Use This Book
      Chapter 1: Step-by-Step Program
      Chapter 6: 1st month
      Chapter 7: 2nd month

      Have your husband read above and also, Chapters 2-4 to help understand better what is going on.

  10. Our daughter, Anna, will be four months old at the end of the week. The good news is that once she falls asleep for good during the night, she sleeps for long stretches in her crib and only wakes up once or twice to nurse (always at 4am, sometimes also around midnight or 1am). We are pretty good at not responding to every whimper and letting her stay asleep. But we have three problems: (1) the only way we can get her to sleep is to nurse. I have not been able to put her into her crib drowsy but awake because she falls asleep when nursing. (2) Naps are a mess – she will only nap in my arms. Sometimes, she will nurse through the nap, sometimes I am able to release her suck. I try to put her into the crib but she wakes up when I do. She no longer falls asleep in a swing or the stroller, either. (3) We have several false starts at night. She nurses to sleep, I wait for several minutes to make sure she is deeply asleep, then transfer her to the crib. In the past, she would then sleep well, but recently, she has started waking up 30 to 45 minutes later. We try to let her cry and put herself back to sleep, but her cries get increasingly gut-wrenching. So, I go in to nurse her and she falls back asleep, then I transfer her to the crib. This used to happen once and she would be down for the night, but recently we have been having more and more false starts and wake-ups like this. I am scared to try the extinction method because all four elements are not in place: I haven’t been putting her down drowsy but awake and her naps are a mess. She usually wakes up between 7-8am, first nap around 9am-10 am (about an hour and a half after waking, napping for about 30-45 minutes), second nap around 12-2pm (about an hour and a half to two hours after waking, napping for about 1-2 hours), third nap from 4pm-4:30 (I wake her up at 4:30) to preserve bedtime. We aim for a 6:30pm bedtime, and start our routine at 6pm, but she usually falls asleep (for the first time) around 7pm. After reading your book, we have been trying to pay attention to drowsy cues and try for earlier naps and earlier bedtimes (for example, starting our routine at 5:30)but we haven’t yet seen a difference.

    1. Previously, at night, when did you start the soothing bedtime routine? What was the duration of the bedtime routine excluding the actual time nursing? What was the duration of nursing before putting her down in the crib?

      Currently, at night, when do you start the soothing bedtime routine? What is the duration of the bedtime routine excluding the actual time nursing? What is the duration of nursing before putting her down in the crib?

      Previously how did she look/behave around 5pm-6pm? Currently, how does she look/behave around 5-6pm?

      Please read Blog Posts 84-86 and the section in the book on cumulative sleepiness. This explains why ” recently, she has started waking up 30 to 45 minutes later.”

  11. Thank you so much for your reply and for all of your great information in your book and your blog! Yes, I do believe Anna is suffering from cumulative sleep debt – before we had read your book, we did not recognize her drowsy signals and mistook fatigue signals for drowsy signals. We were also not appreciative of the power of small changes. I meant well, but I’m afraid that I missed many signals and often delayed 10-15 minutes too long, perhaps missing good sleep windows. Plus, as your book notes, she doesn’t nap as well in my arms as in the crib – I thought I was helping her but I was moving in completely the wrong direction.

    I’m not sure how to undo the negative habits and get her back on track. From your questions, is it correct that you would advise us to focus first on getting her bedtime earlier more consistently and seeing if that helps reduce the false starts and makes the napping easier? Do you think we should hold off on trying the extinction technique until she may have regained from some of her sleep debt or do you think we should couple our earlier bedtime routine with putting her in her crib before she is deeply asleep and practice the extinction technique off the bat?

    To answer your questions:
    – previously we started the soothing bedtime routine around 6pm – 6:15pm. The bedtime routine involves playing a song, saying goodnight to Daddy, changing diaper, changing into bedtime clothes, singing a couple lullabies while we change, and nursing. The routine other than nursing takes about 10-15 mins.
    – the duration of nursing varies from 10 minutes to 20 or more.
    – I can now see how I’m a pretty bad judge of timing, so even though I thought I was targeting a 6:30 bedtime, she really wasn’t usually falling asleep until 7pm or even later.
    – we have now started soothing and bedtime routine around 5:30/5:45.
    – I have not noticed whether there is a change in the length of the soothing or the nursing. I will pay attention to that.
    – Previously, between 5-6pm she was growing increasingly fussy. I have also noticed her scratching her head, which I think is a fatigue and stress sign.
    – Currently, we are more focused on trying to notice the drowsy signs, which she has started exhibiting between 5pm and 5:30. At the start of the hour, when not sleepy, she is very good at playing by herself but she starts to get more fussy and starts to make vocalizations that sound more frustrated and whiny and wants to be picked up. We are now recognizing those as drowsy signals and trying to start our bedtime routine then. It seems so early, so we are probably still too hesitant and so still catching the sleep wave a little too late.
    – I should also mention that we’re not sure if she is hungry. She was born full term (two days before due date) but only in the 8th percentile for weight. At her two month check-up, her height was incorrectly measured making it look on paper as though she had a very low BMI, even though she has consistently been gaining between 1/2 to 1 ounce a day. Trying to make sure that she was not hungry and trying to maintain my breastmilk supply was top of mind and drove some of the sleep-related choices. I feel fearful of having her be hungry but we are now better at seeing hunger cues and more confident in her weight, so I think we need to prioritize sleep.
    Any additional advice you have would be greatly appreciated.

    1. Thank you for the detailed description. Based on her age and behavior, here are my suggestions:
      1 Based on her mid-morning nap and her mid-day nap, you might try for a third nap but the third nap starts before 3pm. No nap opportunities after 3pm. This means she might need extra soothing and distraction in the late afternoon (after 3pm but no third nap) but do not do that which might put her to sleep such as a car or stroller ride or swings.
      2. TEMPORARILY: Plan about a 10 minute soothing routine plus about 10 minutes of nursing and lights out at 5:30pm as you are leaving the room. She may be in a deep sleep then or drowsy but awake, but either way, leave the room at 5:30pm. If she cries hard then or shortly thereafter (“false starts” about 30-45 minutes later), promptly go to her and do whatever you can to soothe her back to sleep including nursing. Do not leave her to cry. If she is very quietly fussing or crying, consider delaying your response, but follow your heart. If you know that quiet fussing or crying will always escalate into intense hard crying, then do not delay your response. On the other hand, with this super early bedtime, she might be able to return to sleep unassisted after a little low level fussing or crying.
      3. Keep a written record of times asleep day and night, duration of crying, number and duration of night wakings.
      4. Do the above if, and only if, you can commit to 3-4 nights.
      6. Send me a detailed progress report in 3-4 days.
      How do you feel about this? Will your husband support this plan?

  12. Hi Dr. Weissbluth, we wanted to check in since we think it’s been about a week since we last wrote to you.

    We’ve been following your advice to
    1) continue with the early bedtime, using drowsy-but-awake and graduated extinction (but perhaps not in the middle of the night or for naps), and
    2) focusing on the nap drill only for the first morning nap.

    For most of this week, he’s been sleeping well for the first stretch of night sleep. Hs night sleep looks like this:
    4:45pm bedtime, will fall asleep after 5-15 minutes of crying
    -about 5 solid hours of sleep
    10:00pm first feeding, after which he’ll quickly fall back asleep
    2-3:00am second feeding, after which he’ll quickly fall back asleep
    4:00-5:30 awake, we’ll try to put him back to bed, but it usually doesn’t work and the day begins.

    If he wakes up before 6, he’ll stay awake for about an hour before going to sleep for about an hour. This seems like a continuation of night sleep.

    Apart from that, his naps have been lasting no more than 30-40 minutes, whether we swaddle him and put him in the bassinet asleep, wear him in the carrier (which used to be his favorite way to nap), or hold him for the duration of a nap while he’s swaddled. And starting last night, he would cry for about an hour before falling back to sleep each time he woke up at night. We’ve been trying to maximize sleep and minimize crying, which we’ve interpreted to mean helping with more parental soothing. Likewise, we haven’t been using extinction for naps or for night wakings.

    We’re wondering:
    a) It seems like his lack of napping is pushing his bedtime too early; he seems sleepy as early as 4pm. Should we try to keep him awake at least until 5pm?
    b) How long should we continue to maximize sleep and minimize crying during the day and during night wakings? Are we interfering with his ability to learn self soothing, or should we continue with this approach at least until night sleep and the morning nap are firmly established?
    c) He’s on the verge of being able to roll over, do you recommend we unswaddle him so he can start to use his hands to self-soothe?

    Thank you!

    1. It is my impression that you have accomplished a lot for your post-colic son in two weeks. Is this correct? Please give me a narrative report describing how he has or has not improved?

      a) Naps usually begin to lengthen and become more regular between 4-6 months but perhaps later in a post-colic child, if, and only if, ample night sleep is present. When naps improve, then yes, delaying the bedtime to have a later wake-up time and trying to get the first nap at around 9am makes sense (Please read ‘The 5:30 p.m. Bedtime Rut’ in my book, page 303). Exactly when to try this and how gradually or quickly you proceed will involve trial and error.
      b) How much of the 5-15 minutes of crying at sleep onset intense or mild? At the 2 night feedings, “he quickly falls back asleep”; this suggests that he is developing self-soothing skills at night and, if true, will soon allow him sleep better during the day. Just to be clear, at the two night feedings, is he being put down after the feeding drowsy but awake?
      c) Try unswaddling him for 2-3 nights to see if this helps or not.

  13. He definitely has improved a lot! His 5.5 hr block of night sleep is amazing.

    a) His night sleep is much improved, but I’m not sure if it’s good enough for his naps to lengthen yet. We will read that section of the book.
    b) Over the course of 2 weeks, the 5-15 minutes of crying has gone from very intense to mild, though occasionally he’ll still have an intense 30 minute crying period before falling asleep, during which time we’ll do graduated extinction. At the two night feedings, he is being put down drowsy but awake after the feedings. When he’s falling asleep after the feedings, it really does look like he’s developing self-soothing skills! We can hear him cooing and see him shaking his head and sucking on the side of his bassinet.
    c) We’ll try this. He wriggled an arm out last night and after a long period of quiet-but-awake, he fell asleep for an hour with one arm unswaddled.

    Thank you so much for all your help!

    1. a) Congratulations. Please be patient. The morning nap will improve before the mid-day nap.
      b) Congratulations, again. Self-soothing skills are learned behavior and over time and practice, skills improve.

      Do you remember what it was like only 14 days ago? Please consider sending me a detailed narrative report of your journey and I would post it anonymously as a blog post.

      Expect criticism regarding the early bedtime and think about how consistent or flexible you want to be over the coming holidays.
      Sweet Dreams,
      DrW.

  14. Hi Dr. W, reporting back. Thank you so much for your help.

    We’ve had a bit of a rough go. The good news is that when Anna does finally get to sleep for the night, she stays asleep and is able to put herself back to sleep when she wakes up. Unfortunately, getting her to sleep for the night (and for naps) continues to be a challenge.

    We haven’t been able to effectively implement your advice yet, but we are still trying. Anna usually falls asleep while nursing during the bedtime routine and wakes up when I transfer her to the crib. I shut the lights off and leave the room, but she cries before I even get out the door. I try to nurse her back to sleep and wait until she is deeply asleep, but she usually wakes up again when transferring to the crib. We try several times. Eventually, I run low on milk, which frustrates her and nursing doesn’t comfort her at that point. We spend many hours every night trying everything we can think of to put her to sleep (both my husband and I try) — nursing, swaying, rocking, singing, reading stories, telling stories more nursing and, letting her cry. A couple of times, she has cycled through crying herself to sleep, then waking up a few minutes later to cry more, then falling asleep, then crying, etc., until we come back in. Ours is a stubborn one! What works one night won’t work the next.

    We’ve also had some bad luck – the day we got your advice, she received vaccine shots, so that night was a mess and she didn’t sleep for more than an hour until 2am. The next day, she woke up super late, so her internal clock was way off. That night and a couple others, she seems to have treated the early bedtime like a nap, waking up about an hour later fully alert and wanting to play.

    Our initial bedtime routine is consistent, but it is completely overshadowed by the several inconsistent hours that follow. I know I should be consistent but, I don’t know how to be consistent in our response. I think we may be at the point where we have to put her in her crib after the bedtime routine and not go back to comfort her (unless she is cycling through crying herself to sleep and waking up for more crying ). That may be the only way to give her a clear message and a consistent routine. But I’m afraid the false starts will continue and she will wake after a short while. It’s hard to see a path forward. Any further advice you have would be greatly appreciated.

    1. Congratulations on the good news! This is a major accomplishment over just a few days and you should be proud of your Anna’s quick learning.
      Here are some suggestions to consider going forward.
      1. For about 4-5 nights, consistently briefly nurse her, but not to a deep sleep state (‘drowsy but awake’), pass her to dad, you leave the room, dad does 5-10 minutes soothing (or more if there is crying then), he puts her in the crib. If upon transferring to the crib or anytime thereafter, only dad responds quickly and only dad does soothing.Read ‘Check and Console’ section in my book. She knows that dad cannot breast feed and she will cry less and less.
      2. Alternatively, commit to 3-4 nights of ‘Extinction’ or 4-7 nights of ‘Graduated Extinction’ as described in my book.
      Perhaps my suggestions above make sense to do now when dad is off for the holidays or maybe after the holidays when things are more routine.
      3. Experiment with a bedtime that is 10-20 minutes earlier. If she appears to be falling asleep at this earlier time, then you will know that the current bedtime is a little too late. What is the current time that you begin your bedtime routine. What is the current duration of nursing at bedtime. What time are you attempting to transfer her to her crib?
      How do you feel about these suggestions?

  15. Hi Dr W – thank you for your continued advice and support! The night we received your advice, we weren’t sure which alternative would be best for Anna. But, we heard something a little different in her cry. It sounded like she was close to sleep, actually, so we decided to give her a little time. That night, she only cried 16 minutes and fell asleep! So, we decided to commit to the extinction method. Unfortunately, the next night, she cried longer (for 53 minutes) before falling asleep. Then subsequent nights: 27 minutes, 20 minutes and 17 minutes. So, we’re not free of crying yet but we seem to be moving in a good direction. It’s also worth nothing that once she falls asleep, she is able to sleep for long stretches and put herself back to sleep if she wakes up. That means that even though hearing her cry is painful, she gets to sleep sooner and sleeps more than she had with our previous consoling techniques and interventions. And, she wakes up in the morning cheerful and more well rested. We are committed to a couple more nights to see what happens and hope that she will soon put herself to sleep without crying. (That’s reasonable to hope for, right?). We are also committed to an early bedtime. We had been trying to start bedtime at 5pm but we just weren’t having much luck – even though Anna was drowsy then, she just seemed to be fighting sleep. We seem to get better results when we start the bedtime routine at 6pm. We do think she is suffering from cumulative sleepiness and hope that once she learns to put herself to sleep without nursing, we can experiment more with earlier bedtimes to try to get her more, restorative sleep.

    We are also still struggling with naps. In order to focus on bedtime, we have left things status quo with naps – meaning that Anna falls asleep nursing and stays latched on, continuing to nurse while napping. I haven’t fought this because we are focused on bedtime and want to make sure she gets enough sleep during the day so that she won’t be overtired at bedtime. We are hopeful that once she learns to put herself to sleep at bedtime without crying, we might have more luck with naps and perhaps try the nap drill then. What do you think?

    Thank you for your all your advice and support! We will report back!

    1. Congratulations! You have accomplished a lot in a short time. How old is she now? I understand that naps may vary a lot, but please describe a typical daytime (nap) routine with clock times of nap onset and nap duration.

  16. Thank you! Anna is four and a half months old (19 weeks). Her current schedule looks like this:

    – Anna usually wakes up between 7 and 8am.
    – Her first, morning nap is usually 30-45 minutes, usually around 8/8:30 to about 9/9:30. (We look for drowsy signs, which we usually see about an hour to an hour and a half after she wakes up.)
    – Her next, midday nap is usually about an hour and a half to two hours, usually around 11/11:30 to about 1/1:30 or so.
    – We give her a third nap around 3pm/3:30, and keep it to about 30 mins. We wake her up at 4pm.
    -Bedtime routine starts at 6pm, with lights out at 6:30 and she has been falling asleep by 7pm.

    I like the schedule and it seems to suit her, but I can’t get her into to crib. She only naps while nursing. I used to be able to get het into the crib at least for the shorter naps, but not anymore. She used to take a pacifier, but now she spits them out. She starts to fuss if I break her latch and the fussing escalates to hard crying. We are currently working with the extinction method at bedtime. (She is stubborn, and our habit of nursing to sleep is quite engrained. We are on night 7. We have seen less crying each night but we are still at about 15 minutes of crying.) We thought that we would try the nap drill you describe in your book once we can get her to bed at night without crying. What do you think?

    Thank you!

    1. At 6 months. of age, about 84% of children are taking 2 naps and 16% are taking 3 naps per day. So the expectation is that her 3rd nap will soon disappear naturally. However, it is possible that her sleeping would improve (no more crying at night) if you did the following (maybe consider just a 3-4 day trial to see if it works):
      Although she is drowsy around 3ish, instead of napping her for 30 minutes then, keep her up with gentle stimulation and extra soothing to keep her contented, and do not allow a situation to occur that might cause her to nap such as a car ride or swing. Then, TEMPORARILY around 5pm, begin a soothing, bedtime routine, and feeding so that you are leaving the room at 5:30pm. By falling asleep earlier, her total night sleep will be longer (even if she wakes up a little earlier in the morning). Longer night sleep duration will cause the morning nap first and the mid-day nap second to become longer. This process might take a few weeks but it will allow for a later bedtime when naps have improved.
      Being better rested during the day might allow her to more easily transition to a crib for naps.
      Please remind me, does she ever take a bottle?

      How does this sound to you?
      There is a thread with ‘Vicky’ in Blog Post 109 that might be of interest to you.

  17. Hiya,

    Thanks for you info, you recommended what sections of your book to read a few weeks ago. Out little girl is 13 weeks old now and things are settling for us a bit more now after Christmas and after recovering from head colds. We haven’t been strictly implementing all the methods in your book yet other than testing out the drowsy but awake method and it seems to be working. My partner is taking two weeks off and we have been planning to establish a routine but in the meantime things have surprisingly settled a bit more for us. I’m surprised that she has started going down for me roughly every 2 hours ish during the day. It’s a great change for us, I’m really delighted. The nappy rash and gas previously was a definite interference as was the length that a breastfeed would take in the early days, thankfully these things have calmed down and we’re getting a bit of harmony.

    It’s interesting that we’re getting her down during the day without having to feed her to sleep (most of the time) but at night she feeds to go to sleep . I’m not strictly noting the times during the day, it’s just roughly every 2 hours. I was noting times with breastfeeding in the early days but it stressed me out so I’m just checking the time roughly, the day is from about 8am to 10pm at night. She goes down for me for about 30 mins during the day now and sometimes wakes and with a cuddle, soother or short feed will go back down again in 5 mins. I’m so delighted with this in comparison to last month. I know there’s a bit of reliance there on feeding, soother whatever but it’s such a change to being so sleep deprived last month that I don’t mind. My partner seems to get her down and she’ll stay asleep for over an hour in the evening, whereas it’s just the 30 mins when I do it. The soother is involved 50% of the time during the day so I know we need to work on that in the long run. There’s been no crying or anything, she’s just going in the crib.

    Any tips for evening time would be great as it’s harder to get her down for the evening time naps, my partner has more luck, is this overtiredness / overstimulation? We start the night feed at about 10pm and it takes a while and then we get a 4/5 hour sleep with her in the crib (this went out the window tho when she had a headcold but things are returning to the way they were, we got 4 hours again last night). Then there’s a feed and back to sleep but it’s cosleeping in the bed til the morning. I don’t mind the cosleep for the moment but in the longrun know I need to cut it out. In the last two evenings she has gone down for a while in the evening so we’re hoping the sleeps will start to become longer and her bedtime will become earlier, there is no early evening bedtime for her at the moment.

    I’m happy enough with the daytime for the moment considering it’s only been one week but I do have a question, my friend who recommended your book says we’ll be at home for quite a while implementing a new routine but that won’t be great for me really. We’re 30 mins from the places we like to go and I like getting out for walks or coffee, it’s important for my head space. Our routine during the day goes a bit like sleep, feed, nappy, play and back to sleep. What’s the best point in the routine or day to get out for an hour or two? Our little one does tend to sleep when we’re out for coffee or in the car, I know you’ve mentioned it’s not the same kind of rest but this is something I want to continue with for a couple of days a week. If all this info is in the book, happy to read the relevant sections. Thanks so much for all of your info in advance.

    Cheers,
    Michelle

    1. I am happy for her improvement! What is a ‘soother’?
      What is the usual time of the start of the bedtime routine, how long does it last, is she awake, drowsy or asleep when it ends, and when do you leave the room?

  18. A soother also called a dodie, that babies suck on.
    Lol, maybe we’re doing it all wrong based on your questions.
    We try to start our pre bedtime feed at 10 or 10.30pm, mainly because before last week we weren’t really getting any naptimes during the evening time at all so the thought of a bedtime around 7pm just seems so unlikely. So the pre bedtime feed is part of our routine I suppose, then it’s her falling asleep after a feed on me, there’s no rocking or anything like that, it’s always quiet and then we put her into her crib beside the bed so we’re not leaving the room as we’re already in bed and sleeping after that.
    I suppose we should really be doing the same routine for day and night

  19. Hello – My 5.5 month old is really struggling with sleep. One night feeding but up with intermittent cries multiple times a night (maybe a dozen times during two separate periods). The nap training isn’t working – up like clockwork every 30 minutes and cries for 30 minutes or so till I get her. I have no idea what to do to help her learn and cry less. Goes to bed at 5:30 pm and sleeps till about 5 am. Your thoughts are appreciated. Thank you.

    1. Please describe in detail a usual night pattern of when and for how long she is up at night and what you are doing when she is up at night.

  20. Hi – For the last week she’s been going down around 5:30-6:30 PM after showing sleepy signs (rubbing eyes, yawning, starting to fuss) and doing a bedtime routine. Room dark with white noise. Tuesday she went down at 5:57, woke at 10:31 and cried or fussed till 10:38, slept till 11:40, cried and fussed till 11:46, slept till 1:19, cried or fussed till 1:21, slept till 4:30. Then I went and nursed her (usually I feed her during a wake up between 1:30 and 3). Put her back in crib at 5 and she’s awake with minimal noise until 5:30, sleeps till 6:22. The times vary but the waking up frequently and briefly is typical. I dont go in unless she’s really crying for 10+ minutes or it’s after 1:30 AM, then I feed her. Thank you!

    1. Please read Blog Post 9: You are putting her to sleep when she is fatigued, past drowsy. An earlier bedtime should help a lot.
      Your thoughts?

  21. Hi Dr. Weissbluth,
    I love your book and your methods worked great for my now 3-year-old. She is still a fantastic sleeper.

    My son just turned 5 months. He goes to bed at 6:15 and sleeps well until around 3:30/4 am when he is restless. We leave him to self-soothe until at least 6 am. Your book states that I shouldn’t let my child stay awake longer than 2 hours to prevent being over-tired. However, I am unsure how to accomplish naps at 9 am and 12-2 windows is he taking short naps? He ends up taking 4-5 naps throughout the day. Here is an example of how our day might go:

    Awake at 6am
    Shows signs of being tired at 7:30. 7:30-8:00 short nap,
    8:00-10:00 awake
    10:00-10:35 short nap
    10:35-12:15 Awake
    12:15- 12:50 Nap
    12:50-2:50 Awake
    2:50-3:20 Sleep
    3:20-5:00 Awake
    5-5:15 cat nap
    5:15-6:15 Awake
    6:15 Bedtime

    Thank you in advance for your help!

    1. Please describe her mood and behavior between 5-6pm when your child is alone, not in front of a screen or being soothed by you, or interacting with an adult.
      When does she actually fall asleep at night?

  22. Thank you for the response!!! My son (5 months old) is the one who is having difficulty. He has a pretty calm happy demeanor from 5-6. We do not use screens with him. However, he is probably with an adult during that time. Someone is probably holding him or he is in a chair near an adult as we cook dinner. He falls asleep by 6:30.

  23. Hi again – We’ve been putting her down at 5-5:15 every night since but the pattern holds: she sleeps for several hours then wakes up every hour till I nurse her, then repeats the second half of the night. She’s up very briefly, maybe 10-15 minutes, and cries out before putting herself back to sleep. She doesn’t give drowsy cues but we’ve been trying to catch her before fatigue at naps too, but they’re still quite short. I’m not sure what else to do but this sleep can’t be restorative for any of us… Thank you

    1. Please describe a typical day of naps with onset times and durations. Please read the section on the ‘Nap Drill’ in my book; perhaps this will help with daytime sleep.
      Please describe in more detail a typical night with when and for how long she is crying, the quality of her crying (mild, moderate, intense) and your responses.

  24. The naps are wildly inconsistent. She takes 2-3 a day, but often refuses 1 (hence the days with 2 rather than 3). They tend to be 39-45 minutes. She goes down about every two hours, except when she refuses a nap and then we have a 2-4 hour wake window. She tends to take one around 7:39, 11:30, and 1:30 on a decent day. At night, she cries a few hours after we put her down at 5 or so, around 9 or 10 pm, and for anywhere from a minute to 10 or so minutes, pretty mild, sometimes moderate, we don’t respond unless it’s around 1 or so and then I nurse her and put her back down. She wakes up every hour or two and repeats this, with some 2-3 hour stretches of quiet. It’s really all over the place and not predictable.

    1. Understood.For about how many days has she had the super-early bedtime?
      Do you think a white noise machine and making the room pitch black might help with naps?
      When does she usually get up to start the day?
      A general problem is that her major mid-morning nap rhythm starts around 9am so a much earlier nap throws off her nap schedule and this makes the naps too short and more irregular and causes her to be super sleepy very early in the evening. This often lead to the ‘5:30 rut’ described in my book (page 303). I think the section on ‘Nap Drill’ (page 289) will help.

  25. Thank you, will re-read those sections. Started the super early bedtime 5 days ago, before that was doing about 6 pm or so. We started waking her to start the day at about 6 the past two mornings because we worried if she slept too much at night it would impede napping. Otherwise she’ll sleep to between 6:30-7:30.

    1. Please do not wake her in the morning. By getting more sleep in the morning, she’ll be more able to take naps around 9am and 12-2pm in synch with her nap rhythms. Thus, these naps will become more restorative and longer and eventually this will result in her being able to fall asleep a little later at night.

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Blog 9
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Drowsy Signs

The brains in babies and young children produce drowsy periods followed by sleep during the day and in the evening. Watch for drowsy signs before your child falls asleep. Drowsy signs are your signals to start soothing your child to sleep for a nap or for the night. Begin to soothe your baby to sleep as soon as your baby starts to become drowsy.
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