Healthy Sleep Habits, Happy Child
83
Drowsy Signs Revisited (An Alternative Plan)
June 13, 2022

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Healthy Sleep Habits, Happy Child

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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 83Drowsy Signs Revisited (An Alternative Plan)

Here is a description of Drowsy Signs and an Alternative Plan for parents who have difficulty observing Drowsy Signs.

HOW TO KNOW WHEN TO PUT YOUR BABY TO SLEEP

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.  Healthy sleep occurs when the sleep period is in synchrony with the occurrence of the brain’s output for sleep during the day and the night.  The drowsy state is an in-between state: not fully awake and not fully asleep; it is similar to twilight (not fully day and not fully night).  Like twilight, drowsiness is a transition with a beginning and an end (Blog Post 8).

When you soothe your well-rested baby to sleep at the beginning of the drowsy period, because the baby’s brain is naturally drifting into a sleep state:

            ·  It is easier for your baby to fall asleep and stay asleep.

            ·  No crying occurs before your child naturally falls asleep.

If your baby is over-tired because of a too late bedtime or naps not occurring in synch with daytime brain outputs for sleep:

            ·  It is difficult for your baby to fall asleep and stay asleep through the night.

            ·  Crying occurs before your child falls asleep.

Often, starting the soothing process to sleep at the beginning of the drowsy period will prevent sleep problems in the first place and solve sleep problems if they are present.  Also, a sleep solution might include moving the bedtime earlier because just a few extra minutes of nighttime sleep makes a big impact (Blog Posts 6 through 8).

DROWSY SIGNS

As your young child enters the drowsy period, your child begins to move away from an alert, engaging, calm, and relaxed state. 

Early, as the drowsy period appears, your drowsy signs are:

                        ·  Appears less animated.

                        ·  Becomes quieter.

                        ·  Appears less interested in toys or people.

                        ·  Sucking strength is weaker or slower.

                        ·  Yawning.

These behaviors are most noticeable when your child is in a quiet and relaxed environment, for example, when being read to.  These behaviors might be absent when you anticipate a sleep time from past experiences and soothe your baby to sleep at a clock time that is in synch with the brains sleep output. These behaviors might be present but not be noticed if you are distracted by looking at a digital screen or on a phone call.  These behaviors might be “masked” if your child becomes hyperalert in a stimulating environment as a busy mall or when placed in front of a television or screen-based media device.  

Try to begin soothing to sleep early, before you notice changes in the eyes which occur later in the drowsy period:

                        ·  The eyes become less focused on the surroundings.

                        ·  The eyes appear glazed over, staring, not as sparkling.

                        ·  Your child seems to look “through you”, not at you.

                        ·  Drooping eyelids.

                        ·  Long or slow blinks.

FATIGUE SIGNS

Fatigue signs occur when your child is over-tired or short on sleep.  For example, the bedtime is too late. Or the duration of the soothing to sleep was too long and the prolonged soothing efforts interfered with the rising sleep wave and prevented an easy transition to sleep.  Fatigue signs occur as your child is becoming overtired, moving toward an irritable or tense state:

                        ·  Rubbing the eyes.

                        ·  Less able to entertain himself.

                        ·  Less cooperative.

                        ·  Drooping of the head.

                        ·  Slightly “wired”.

                        ·  Pulling the ears.

                        ·  Mild fussiness, irritability, moodiness, whining, crying, cranky, clingy, peevish.

                        ·  Easily upset, frustrated, short-fused, rough around the edges.

Older children might be oppositional, defiant, uncooperative, angry, aggressive, or complain of headache or stomachache. 

Adults might complain of depressed mood, mental fog, inability to concentrate, lack of motivation, or a sensation of just going through the motions, like a robot, without much feeling or sense of vitality.

Sometimes a child appears to have no drowsy signs and instead, immediately “crashes” into fatigue signs.  This is most likely to occur in an infant with colic under four months of age or a baby or child who is very short on sleep at any age.  The sleep solution is to first record the usual interval of wakefulness that usually occurs between an awakening from a sleep period and the appearance of fatigue signs.  Next, watch the clock and plan ahead to begin your soothing to sleep 10-20 minutes sooner than that usual time interval, even though no drowsy signs are apparent.  Even this slightly shorter interval between naps and before night sleep can produce a major benefit (Blog Posts 6 through 8).

MOST COMMON MISTAKE
MISTAKING FATIGUE SIGNS WHICH COME LATE
FOR DROWSY SIGNS WHICH COME EARLY

Beginning soothing to sleep as drowsy signs appear make the transition to sleep easy, without your child crying.

Beginning soothing to sleep as fatigue signs appear make the transition to sleep difficult; your child may cry before falling asleep.

SUGGESTION AND INVITATION

The suggestion is to video your baby or child making the transition from an alert-awake state to a drowsy state to a sleep state.  Then, you might be able to see more clearly the development of specific drowsy signs in your own child to get a better handle on when to begin soothing to sleep.  Perhaps this would be a week-end project as it probably would involve two people.

The invitation is to post your video online and include a link in the Comments section for this Blog.  Any observations or comments from you would also be welcome.  There is only one video online showing this transition! See ‘Drowsy Max at 18 months. Sharing your video online offers the opportunity for other parents to sharpen their focus on their own child’s drowsy signs.  Also, perhaps, I will notice items that might be helpful to share with viewers.

AN ALTERNATIVE PLAN: AVOID CRYING

In general, I recommend watching your child more than watching the clock, but some parents have difficulty observing drowsy signs or subtle fatigue signs in their child.  Although suggested above, here’s another way to think about this. The alternative plan is to focus on crying instead of drowsy signs:

Always try to begin soothing followed by putting your child down to sleep before there is any crying!

Estimate, or keep a record of, the interval of time between when your child awakens in the morning or awakens from a nap and the onset of crying.  This interval of wakefulness will vary a little day-by-day based on the duration of the preceding sleep period and how your child is interacting with people and activities.  Now, shorten, a little, the usual interval of wakefulness, by watching the clock or using the interval timer on your smart phone or watch. So, you are now beginning soothing to sleep a little earlier.  If crying still usually occurs before sleep, then shorten the interval a little more.  

When your child is drowsy, she is at a low level of arousal; falling asleep is easy.

When your child is crying from being kept up too long, she is at a high level of arousal; falling asleep is difficult.

Because:

Past drowsy, your child is uncomfortable (crying) from being over-tired, and her body is producing stimulating chemicals (high arousal) to fight the fatigue.

High neurological arousal interferes with easily falling asleep and staying asleep.

Comments

  1. Hi Dr Weissbluth,

    My 14-week old fights me at nearly every nap. I put her down as soon as I see drowsy signs but is it possible she cries because she is undertired? Her signs are not entirely clear. She only starts crying once I swaddle and she knows it’s nap time.

    For example, I swaddled (arms out) for first nap after only being awake for 1 hour and she cried and wriggled for 5-10 minutes before being calm, at which point I put her in bassinet. However she then fussed for close to 25 minutes and then only napped for about 35 minutes.

    She also only takes short naps of 45 minutes, four times a day, and fights me nearly every time! It is exhausting having to calm her every time, so I’m wondering if she is in fact under tired not overtired?

    Thanks

    1. Please describe your soothing to sleep routine for naps in addition to swaddling.
      Please describe a common night: Bedtime, bedtime routine, night feedings, night awakenings, morning wake-up time.
      Please describe the role of the father for naps and night sleep.

  2. Naps: white noise, dark room, nappy change, swaddle (arms out now she’s older) and then rock / sway to calm state or til eyes droopy then down in the bassinet. It is usually me although my partner does also do this but not as often due to him working full time. I watch the clock with one eye and her with the other, I’ve experimented with different wake windows from 1-1.75hrs. She always fights the last nap of the day the most. The first nap is usually the easiest.

    Bedtime: warm bath (dad always does the bath), clean nappy, pyjamas, swaddle in dark room with white noise and then breastfeed. She usually falls asleep at the breast but not always – sometimes I put her to bed awake, as I do for naps. We have been experimenting with different bedtimes for weeks – between 6;30pm and 8pm but we easy always get false starts regardless of the time we put her down. Ie she falls asleep fine, then wakes up after one sleep cycle and then needs rocking or nursing back to sleep – this can often happen three or four times but after that first sleep cycle the subsequent wakings will be in quick succession, not full sleep cycles, then she’s down for a long stretch, anywhere from 4 to 6 hours, sometimes 7 or 8 and she even did 11 hours straight last week. After one feed after the long stretch she has no trouble going straight back to sleep until morning – it’s just these false starts at the start of the night, which only started at 8 weeks. Dad goes in to soothe but usually if she’s really worked up it’s always me who ends up nursing her and then she’s down.

    1. Naps are difficult to start and they are brief; naps become more regular and longer starting around 3-4 months of age and a clear pattern is present by 6 months of age or earlier.
      Night sleep becomes more regular and longer starting around 6 weeks of age.
      Your daughter is 3-4 months of age, so for now, focus on night sleep first.
      You describe a variable bedtime. Please describe her behavior and mood in the hour or so before the bedtime.
      How often does she fall asleep at the breast versus being put down drowsy but awake for bedtime?

  3. Ok so sounds like not much to be done to improve naps at the moment, I’ll persist.

    Well I keep an eye on the clock and try to start the bedtime routine before she starts to get restless / get irritable, I usually put her to bed around 1.5 to 2 hours after she wakes up from her last nap, which will be 7;30 to 8 most nights but I’ve also tried 6:30 bedtimes after shorter wake windows. She is generally calm in evenings but sometimes wants to cluster feed, she would do this most nights when she was younger and would be super frantic at the breast then just pass out for a long sleep, I now can see she was probably overtired too.

    She falls asleep at the breast most nights, but I have also tried putting her to bed awake and the false starts still happened. She always has a full feed and doesn’t just suck for a few minutes only to fall asleep.

    1. Please see my latest Instagram Post explaining why so-called ‘Wake Windows’ are fake. Please review “Drowsy Signs’ and currently put her to sleep much earlier at night. I would suggest no nap opportunity after 3-4pm and a super early bedtime around 5:30pm temporarily. Please attempt a more consistent approach to putting her down drowsy but awake at bedtime. If she gets more sleep in the early evening, she will wake up better rested in the morning and be able to nap better. Let me know how it goes.
      Sweet Dreams
      DrW

  4. Ok will try, thank you. As she always seems to fall asleep so content at the breast, do you suggest I actively wake her up before putting her down? I’ve tried just doing this a bit so she opens her eyes and sees she is in the bassinet before she then goes to sleep.

    Also last night we let her cry it out after trying to put her down multiple times after her false starts as she was fed, I had attempted soothing multiple times and she kept crying. After 20 minutes she was asleep, she then woke up after a few minutes, cried again for 7 minutes then fell asleep for six hours. Do you advise I continue this over the next few nights while trying trying other changes suggested or only try once change at a time?

    1. Shorten the total duration of nursing plus soothing. Currently, what is the usual total duration that she is at your breast at bedtime? If she has a strong ‘suck-swallow-suck-swallow’ pattern, she is hungry, so nurse her. As soon as she slows down and has a ‘suck-suck-suck-swallow’ pattern or sucks with less energy, kiss her and put her down to sleep for the night, hopefully, drowsy but awake. If she has drifted into a deep slumber, just put her down, but the next night, nurse for a shorter duration. Trying for a much earlier bedtime now is your single goal. Doing more than one thing at a time might lead to inconsistency and confusion.

  5. Hi Dr Weissbluth,

    We put our daughter down at 5:30pm last night. She did seem tired. Her last nap had ended at 3:45pm ( four naps of 43 minutes during day). I nursed her but not to sleep, then attempted to put her down but she ended up crying for 20 minutes before falling asleep ( I went In once to soothe in that time but it didn’t help).

    She woke up after one sleep cycle as usual but this time wasn’t hysterical and went back to sleep. However the rest of the night she woke up every 3 hours, which is unheard of for her as she usualLy has a long stretch after her initial wakings of the night, 6 hours on average so I’m only up once a night overnight to feed.

    I fed her at these wakings because she usually only wakes to feed them goes right back to sleep, however being 3 hourly seems excessive. She did take proper feeds though. I don’t think she would have gone back to sleep otherwise anyway.

    Overall with the night wakings I think she only get an hour extra sleep. She slept through to 7:30am.

    Would we be better off aiming for 7pm bedtime, or is that too long to be awake if she wakes from her last nap at 4? Do we just alter bedtime each night to be when we see her drowsy signs rather than at a set time like 5:30? Also, if she wakes after the first sleep cycle should we just let her cry given we had to do so with the early bedtime last night anyway?

    1. Please read, and have your husband read, Blog Posts 19 and 24-26 and/or Chapter 5 in the 5th edition of my book regarding sleep solutions. Also, both read Blog Posts 49 and 67 regarding when to start sleep solutions. Finally, both read Parents’ Reports section 2 (Bedtimes) and 7 (sleep solutions). There are many variables so it is important for you to make a plan that you are both comfortable with. Share it with me so that I may further advise you.

  6. We are ok with our daughter crying it out. We have done so the past few nights at bedtime because as you suggested I stopped nursing her before she fell into deep sleep. So therefore I’m not sure if the crying was due to that or the earlier bedtime (5:40 night one and 6pm night 2), or both. Regardless she went to sleep after a period of crying, and we didn’t have the waking after 45 mins / one hour. Again, not sure if that’s because I put her down awake or the earlier bedtime. We also noticed she was very irritable (tired) at 5pm even though she had only woken up from a nap at 4:20.

    She then woke up after 3 hours (I fed her as it had been four hours since a feed) and then four-hourly after that, so 2am and 6am. I put her back to bed after the 6am feed and she fussed but then slept until 8am so overall she slept roughly 6:45pm to 8am.

    I own your book and have read all the posts. We will keep monitoring her 4-5pm to determine when to put her to bed, and let her cry it out at bedtime if need be, however is it normal that with this earlier bedtime she is only doing four-hour stretches? As I mentioned, after her false starts she would go 6-11 hours straight so I’m keen to get back to that!

    1. Thank you for the detailed information. Here are my suggestions:
      During the next 5 days and nights, keep a detailed record of day and night sleep duration and timing.
      Consistently provide nap opportunities at home in a dark and quiet room based on drowsy signs.
      At 4pm, if she is asleep. let her sleep but do not start a new nap after 4pm to protect early bedtimes.
      Because of variable naps, bedtimes will vary and bedtimes are based on drowsy signs.
      Have a brief bedtime routine, leave the room after putting her down drowsy but awake at naps and bedtime.
      At night, choose graduated extinction (father responds) or extinction.
      During the day, when available (weekends?), have dad put her down for naps.
      Feed her when she is hungry (no more than twice at night after the bedtime) but do not use the breast for soothing when she is not hungry.
      Begin this plan only when you see that you can consistently do this for a 5 day stretch.
      After 5 days, report back regarding day sleep and night sleep and we will make modifications based on your data.

  7. Ok will do.

    A few questions:

    1) if she cries / fights naps even when we catch her drowsy signs (our current situation – she only starts crying once we are in the nap routine), what do you suggest? Let her cry for a certain period? Or abandon ship and try again 20 mins later?
    2) if she cries more than twice during night, do you mean we do not respond to the third / non-hungry cry?
    3) if she wakes up at 5 or 6,, should that mark the start of the day or should I try and nurse and put her back down / just soothe her back to sleep? Its still dark at 6am currently.
    4) how many hours of overall nighttime sleep are we aiming for?

    Thanks

    1. 1. Follow your heart depending on the intensity of her fussiness/crying, time of day, your certainty that it is nap time.
      2. It depends on whether you are doing extinction or graduated extinction.
      3. The earlier she awakens in the morning, the more you should attempt to return her to sleep. This might vary from morning to morning.
      4. Your goal is a well-rested child. Watch your child, not the clock.

  8. Hi Dr Weissbluth,

    We did extinction for our daughter’s false starts / non-feeding night wakings. The false starts have stopped since we have permanently brought her bedtime earlier, however she is still waking up upset at least once before her first feed time (before midnight) every night, and it’s been nearly 2 months. She is now nearly 5 months.

    Not going to her and letting her cry it out does not seem to be stopping her from waking.

    Lately she has also been waking at almost the exact same time, 9:50pm (bed at 6-6:30) and cries for at least 10 minutes, sometimes on and off for 30 minutes.

    Prior to 3 months old she would go minimum 6 hours without feeding, often 7 or 8 overnight, now she Won’t go more than 4 without waking and crying. I try not to feed her before 5 hours have lapsed since bedtime so if she cries at 9:50 I don’t go to her until the next waking.

    We are feeling very disheartened because we have been very consistent with extinction and it has not stopped his waking/s.

    Any advice?

    I do not nurse her to sleep at bedtime, she falls asleep independently every night.

    Thanks

    1. I am sorry that sleep is not going well. Let’s take a fresh look because sleep patterns can shift a lot during the first several months of age. Please describe the current most common:
      Times when the naps begin and their durations.
      The time of the last feeding for the day, the time when you begin a ‘bedtime routine’, and the the time when you leave the room.
      How does she look during the 1-2 hours before you begin a bedtime routine.
      How dark and quiet is the room; do you use a white noise machine?
      We last communicated about 5 weeks ago; would it be possible to stay closer in touch to better monitor progress or the lack thereof?

  9. Hi Dr Weissbluth,

    Sorry for taking up so much room on this page! Happy to discuss elsewhere if better.

    1. Times when the naps begin and their durations:

    Time is still fluctuating a lot due to different nap lengths and lots of short naps still. I try to aim for 9am, the earliest the first nap will be is 8:15am – I stretch her to reach that if she wakes early (6am). The following naps depend on how long that first one is and her drowsy signs, but roughly start about 1h40-1h50 after last nap wake. She has only jsut started taking longer naps of 1 hour plus, the past week (one per day, sometimes two), prior to that she took four short naps (30-50mins) per day and nothing would lengthen them no matter what I tried. The longer naps now are probably due to the fact that she has just started sleeping on her tummy in the past ten days, I assume. If she gets one or two long naps she ends up taking 3 naps a day, not four.

    2. The time of the last feeding for the day, the time when you begin a ‘bedtime routine’, and the the time when you leave the room.

    Bedtime floats between 6pm and 7pm, with 6:15-6:30 the most common time depending on when she last wakes for the day. Bedtime routine starts about 25 minutes prior to bed, beginning with a bath with Dad. I feed her during her bedtime routine as the second last step (book is the last step), and it usually works out that I have also fed her an hour or so prior to that as part of her regular feedings. After the book I hold her for a minute while a lullaby plays, then put her straight down in the cot wide awake and leave the room. She rarely makes a fuss and falls asleep quickly, even if she fusses I don’t go to her and she settles as I find my presence does the opposite of calm her down!

    3. How does she look during the 1-2 hours before you begin a bedtime routine.

    Depends on how her naps went. if she has had less than 3 hours of nap time that day, which has been the case until recently, she fades quickly and is irritable and we have to put her to bed as soon as possible, ie. 6pm. If she has had 3+ hours of sleep that day she is fine before bed.

    4. How dark and quiet is the room; do you use a white noise machine?
    Room is pitch black, with white / pink / brown noise machine playing.

    5. We last communicated about 5 weeks ago; would it be possible to stay closer in touch to better monitor progress or the lack thereof?

    NB: Her night sleep is now more disrupted than usual due to having just started sleeping on her tummy, but it seems to be helping her naps ( I assume this phase is short-lived). She is waking 1-3 times in addition to her 2 feed wakings (when I go to her), and fussing / crying. We did CIO at the start of August, bedtime is great but it has not helped the other waking/s.

    I am also hoping to drop a night feed as she is 5 months old tomorrow and still feeds every 2.5hrs during the day.
    Yes happy to

  10. She is nearly 23 weeks from due date. She rarely takes 3 naps, it’s only happened a few times if she has taken really long naps so there is not enough time to squeeze in the fourth one. Especially as she fights any naps after 4:30 so we just put her to bed early instead. It’s usually 4 naps.

    1. She is almost 6 months old. Naps fluctuate and develop over the first 6 months and are more predictable and longer (duration is independent of supine or prone position). At 6 months of age, 84% of children take 2 naps and 16% take 3 naps. Here is a rigid suggestion to consider implementing now or in a few weeks because she is not quite 6 months old.
      1. Impose on your daughter an age-appropriate nap schedule so that her naps occur in phase with her biological nap rhythm. Nap #1 begins at about 9am and nap #2 around 12-1pm based on the duration of nap #1. Nap #3 is optional based on the durations of the previous naps and begins no later than 3pm. The competing goals are to keep her up and comfortable with extra soothing to reach her nap times versus making her so overtired that she had difficulty falling asleep and staying asleep. Do not let her fall asleep at other times such as in a car or swing; use gentle stimulation to keep her up and calm en between the scheduled naps. If 9am is impossible, try to get as close to 9am as you can.
      2. Feed her when she awakens in the morning and at the first 2 naps and upon soothing to sleep at night (4 times during the day) and feed her only once overnight whenever you wish. During the night, if she awakens and cries out at other times, do extinction or graduated extinction.
      3. Her bedtime will vary because of the variability of naps (number and duration) but it might be as early as 5:30pm. Her wake-up time will vary because the bedtime will vary. Do not go to her to start the day before 5:30-6am or she will never be able to get to a 9am 1st nap.
      4.Keep a detailed record of the timing of all these events for 5 days and report back to me what happens.
      What are your thoughts about this plan?

  11. Thanks Dr Weissbluth.

    I have actually tried implementing the biological schedule before, perhaps two weeks ago, but her naps were so short and inconsistent (ie. sometimes her first nap of the day was only 25 or 30 minutes) she was beyond overtired and very irritable by midday and the days were very long and challenging, so I just went back to observing her drowsy signs instead which usually meant extra naps (all of which were short). I will try this again, going back to a biological schedule. What do you suggest if she continues to have very short naps at the 9, 12pm etc.? If she is overtired is it ok to give her a fourth nap?

    Can you please clarify, are you suggesting I cut down her day feeds? And only feed her four times during the day (as I currently feed her every 2.5 hours). In addition, if I feed her upon waking from each nap, because her naps are often short this could mean feeding in an even shorter period, ie once every 2 hours potentially or very irregularly due to nap length. Please can you clarify?

    Because she is used to feeding twice a night and has a third waking, I was going to start weaning her off the second feed first, and then work on the first – are you suggesting going cold turkey on the second night feed?

    Understood re early bedtimes, however if her naps are still short and irregular during the day, this may mean a 5:30 bedtime every day – will this shift her biological clock to be that early permanently?

    Thanks,
    Madeline

    1. Are you only breast-feeding? If so, do you use expressed breast milk in bottles/
      Are you only formula feeding?
      Are you feeding breast milk and formula?

    1. Here is a suggested feeding schedule. Do it only if you feel comfortable and are confident that your breast milk supply is ample. Otherwise, chat with your child’s caregiver, lactqtion consultant or both.
      Feed her when she wakes up to start the day and at bedtime.
      Feed her mid-morning and mid-afternoon: either before or after a nap. Don’t feed her at other times.
      Feed her once at night (between 12am-3am) or twice (10pm-12am and 3-4am) and this decision might, or might not, be based on the time of her bedtime feed. No 3rd night feeding.
      Remember that sleep comes from the brain and not the stomach. The fact that some naps are now longer suggests that more success might occur now or in a few weeks than occurred two weeks ago.
      Please: No fourth nap. Instead, a super-early bedtime is better.
      A super-early bedtime is always temporary. As she matures, her bedtime will be later.
      Does this help?

  12. Thanks for your advice. I’m curious: are you suggesting having more daytime feeds (ie six vs four) can disrupt nighttime sleep? And do you still suggest stretching her to the biological nap times as far as I can, even if she is having short naps (she will be very overtired)?

    And I currently wait for her to wake to feed her, are you suggesting I wake to feed in those windows? Ie last night she had a good night and woke at 1 (I fed) and again at 4 ( fed), and woke at 7 for the day.

    Thank you

  13. Hi Dr. Weissbluth – This is Alexis (was chatting with you on Instagram this morning), and am just reading through some of the relevant blog posts as discussed. A quick question about your back and forth with Michelle as we try out a few things, including earlier bedtime and feeding only when waking over the next week or so:

    – If the baby wakes up before 6AM (it has been 4am, 4:45am, 5am, etc. the past few nights) and continues to cry loudly until we get them out of the crib at 6, should we try soothing them back to sleep in the old way or continue with extinction? We’ve tried both feeding and not feeding at wake up and the baby doesn’t go back to sleep. We are hoping to resolve the early waking by troubleshooting but I’m just wondering if in the meantime, should dad go in and soothe the baby back to sleep as we would have done before sleep training or should we just continue to let the baby cry every morning until we figure this out?

    I will get back to you with a more detailed question/summary once we’ve given our new plan from your book and blog a week or so trial. Thanks again,

    Alexis

    1. There is not a simple answer to the question: If the baby wakes up before 6AM (it has been 4am, 4:45am, 5am, etc. the past few nights) and continues to cry loudly until we get them out of the crib at 6, should we try soothing them back to sleep in the old way or continue with extinction?
      If your baby awakens at 3-4am and you observe that promptly responding with a feeding (and you are sure your baby is hungry) and diaper change (if needed) and minimal soothing allows your baby to return to sleep, then that is your course of action.
      If you are sure your baby is not hungry then but needs a change, then do not feed but change your baby, and ignore any subsequent crying until as close to 6 as you can manage.
      If you are unsure about whether your baby is hungry, and you are nursing, and you know you have ample milk supply, than you might try 3-4 nights of extinction then to see what happens.
      If your baby awakens at 5-6am, it is more likely that your baby is hungry/wet/soiled and needs your care. You might experiment with 3-4 days of being quick, quiet, and then leaving him alone for 10-20 minutes to see if he will return to sleep to determine whether you can extend sleep or not. It’s not likely to work at this time.
      If your baby awakens between 4-5am, choose which ever path your heart tells you to do for 3-4 days and then judge whether you should change your tack.
      Does this help?

  14. Thanks, Marc! Yes this helps, we will experiment a bit and see where we get. So if baby awakes between 5-6am and despite our experiments he can’t get himself back to sleep in 20 minutes, get him up and start the day? Does this go for the 4-5am window too or if despite our experiments he can’t get himself back to sleep in 20 minutes (say by 4:30) should we get him up then too or leave him to cry until a certain time? This morning we fed and changed him at 4am and left him to cry till 5:30 when we got him up for the day but it was clear he was not going back to sleep after half and hour. Not sure if getting him up early will create a habit or will he just sleep longer when he’s ready and all the elements are in place as per your other posts?

    1. “I will get back to you with a more detailed question/summary..” This might help me better answer your question, perhaps you could send it now.

  15. Sure thing:
    Baby is 5 months old this week, and we are on night 7 of sleep training.

    He has had a consistent bedtime routine and bedtime since 2 months old (bath, massage, feed, bed between 6:30-7:30).
    He was sleeping in the snoo until last week. He has never slept later than 6am. He has always been bounced to sleep and placed in the snoo sound asleep – we never let him cry (we just got your book on the weekend!).
    He was sleeping one 4-6 hour stretch then 2-3 hour stretches before he turned 3 months, and then for the past 2 months he was up every 30 minutes to an hour needing to be bounced back to sleep or held.
    He was very fussy and potentially colicky until he was 2 months old but has been less fussy, especially since 4.5 months.
    He still seems like he may be overtired though, he is generally happy but has a short fuse, hates the car seat and stroller, likes constant stimulation. It does seem like he yawns and rubs his eyes even when he has just woken from a nap. This is despite all our best efforts to get him 3-4 hours of naps per day.

    He is exclusively breast fed and does not take a bottle but my husband does put him down for every bedtime and one nap a day, and soothed at night when we were doing that.

    Before sleep training, he’d be up at 5:30-6:00, first nap at 8:00-8:30, second nap at 10:30-12:30, third nap at 3-4, bed at 7. Now that he’s out of the snoo, he can’t nap longer than 30 minutes on his own and we haven’t started nap training so we hold him for his “long 2 hour nap” in the middle of the day. It’s the only one where we can usually get him back to sleep once he wakes at the 30 minute mark.

    We started sleep training before getting your book so what we had been doing is a bit of a modified extinction: normal bedtime routine, put down drowsy but awake, wake up to feed at 10:30 or 11, and again at 2:30 if needed, ignore all other wake ups and leave in the crib until 11 hour mark.

    Night 1: 15 mins to fall asleep, 3 short wake-ups with less than 15 minutes of crying, but after we woke him up to feed him at 2:30 he never fell back asleep and cried for 3 hours.
    Night 2: 20 minutes to fall asleep, 6 short wake-ups with less than 15 minutes of crying each, did not feed at 2:30 so just at 11, up for the day at 5:30 am and quiet in crib till 6
    Night 3: 30 minutes to fall asleep, 2 short wake-ups with less than 15 minutes of crying each, did not feed at 2:30 so just at 11, up for the day at 5:40 and crying in the crib till 6
    Night 4: 10 minutes to fall asleep, 3 short wakeups with less than 20 minutes of crying each, same feed schedule, up for the day at 5 crying, got him at 5:35
    Night 5: 7 minutes to fall asleep, 2 short wakeups, same feed schedule, up for the day at 4:40 crying, got him at 5:40
    Night 6: 45 minutes to fall asleep, 1 wake up, same feed schedule, but up for the day at 4am and I decided to try feeding him and laying him back down since I now have your book and he cried till I got him at 5:30.

    I am thinking I want to stop waking him up for feeds and just go based on when he wakes but am worried that my inconsistency will put us right back at square one. (These types of dream feeds are recommended by Taking Cara Babies who says that feeding when the baby wakes up and cries reinforces crying and so to never feed when the baby wakes up themselves but I now see why that might not work thanks to you book so not sure where to go from here!). It is very tough listening to the baby cry in the morning for an hour +

  16. Baby is 5 months old this week, and we are on night 7 of sleep training.

    He has had a consistent bedtime routine and bedtime since 2 months old (bath, massage, feed, bed between 6:30-7:30).
    He was sleeping in the snoo until last week. He has never slept later than 6am. He has always been bounced to sleep and placed in the snoo sound asleep – we never let him cry (we just got your book on the weekend!).
    He was sleeping one 4-6 hour stretch then 2-3 hour stretches before he turned 3 months, and then for the past 2 months he was up every 30 minutes to an hour needing to be bounced back to sleep or held.
    He was very fussy and potentially colicky until he was 2 months old but has been less fussy, especially since 4.5 months.
    He still seems like he may be overtired though, he is generally happy but has a short fuse, hates the car seat and stroller, likes constant stimulation. It does seem like he yawns and rubs his eyes even when he has just woken from a nap. This is despite all our best efforts to get him 3-4 hours of naps per day.

    He is exclusively breast fed and does not take a bottle but my husband does put him down for every bedtime and one nap a day, and soothed at night when we were doing that.

    Before sleep training, he’d be up at 5:30-6:00, first nap at 8:00-8:30, second nap at 10:30-12:30, third nap at 3-4, bed at 7. Now that he’s out of the snoo, he can’t nap longer than 30 minutes on his own and we haven’t started nap training so we hold him for his “long 2 hour nap” in the middle of the day. It’s the only one where we can usually get him back to sleep once he wakes at the 30 minute mark.

    We started sleep training before getting your book so what we had been doing is a bit of a modified extinction: normal bedtime routine, put down drowsy but awake, wake up to feed at 10:30 or 11, and again at 2:30 if needed, ignore all other wake ups and leave in the crib until 11 hour mark.

    Night 1: 15 mins to fall asleep, 3 short wake-ups with less than 15 minutes of crying, but after we woke him up to feed him at 2:30 he never fell back asleep and cried for 3 hours.
    Night 2: 20 minutes to fall asleep, 6 short wake-ups with less than 15 minutes of crying each, did not feed at 2:30 so just at 11, up for the day at 5:30 am and quiet in crib till 6
    Night 3: 30 minutes to fall asleep, 2 short wake-ups with less than 15 minutes of crying each, did not feed at 2:30 so just at 11, up for the day at 5:40 and crying in the crib till 6
    Night 4: 10 minutes to fall asleep, 3 short wakeups with less than 20 minutes of crying each, same feed schedule, up for the day at 5 crying, got him at 5:35
    Night 5: 7 minutes to fall asleep, 2 short wakeups, same feed schedule, up for the day at 4:40 crying, got him at 5:40
    Night 6: 45 minutes to fall asleep, 1 wake up, same feed schedule, but up for the day at 4am and I decided to try feeding him and laying him back down since I now have your book and he cried till I got him at 5:30.

    I am thinking I want to stop waking him up for feeds and just go based on when he wakes but am worried that my inconsistency will put us right back at square one. (These types of dream feeds are recommended by Taking Cara Babies who says that feeding when the baby wakes up and cries reinforces crying and so to never feed when the baby wakes up themselves but I now see why that might not work thanks to you book so not sure where to go from here!). It is very tough listening to the baby cry in the morning for an hour +

    1. Because of colic, your son had difficulty easily falling asleep and staying asleep. Perhaps read the section regarding colic and post-colic sleep problems. Your intense soothing and the snoo kept him fairly well-rested. But now he lacks self-soothing skills and is mildly sleep deprived (He still seems like he may be overtired though, he is generally happy but has a short fuse). Because an early bedtime develops in all babies around 6 weeks of age, you want to focus on an early bedtime (5:30-6:30pm) based on drowsy signs which will vary in time because of variability in naps. Graduated extinction or extinction should be attempted at bedtime and in the middle of the night when you determine he does not need to be feed. Most babies his age are fed once before midnight and again around 4-5am or just once around 1-3am. These times are only approximations. As we discussed, it is sometimes not clear what to do early in the morning.
      Naps in colicky infants seem to develop more slowly than non-colicky infants so while most infants have well defined and long naps around 6 months of age, post-colicky infants might be this way closer to 9 months of age. One strategy is to focus only on night sleep (to encourage self-soothing skills) and do whatever you can to maximize day sleep without concern for schedules or habits for another few months. A second strategy is to focus on the morning nap because he is most rested at this time from overnight sleep. Here, you keep the interval of wakefulness very brief, maybe only 1 hour, soothe him, put him down drowsy but awake, and leave him even if he cries up to but not longer than 1 hour to see if he can develop some self soothing skills for this nap. Within 4-5 days, you will know that is helping and thus continue the effort or that it is not working, and abandon the effort. Choose either strategy. As night sleep improves, you will be more successful with the morning nap. Then, you can put forth effort to help your son learn self-soothing for subsequent naps. This sequential approach make sense for post-colicky babies. After naps have become regular and long (this may take weeks or months), the bedtime might be comfortably move a bit later. How do you feel about all of this?

  17. Sounds good, Marc – we will keep using extinction for all wake ups except the ones we feed on and will stick to an early bedtime, 6:30 at the latest. Then we’ll work on naps.

    My only other question for now – as we are working on trying to get his morning wake up later, what should we do when he is not going back to sleep in the mornings after we’ve fed/changed or left him? Let him cry till 5 or 6 or get him up for the day after some cap on crying snd try again the next day? I’m assuming then his first nap could be very early to bridge him to a normal first nap time.

    Thanks again,
    Alexis

    1. The early mornings are always a bit uncertain at this age. In general, I agree with you that you should not ‘start the day’ until 5-6am.

  18. (Perhaps I’m too sleep-deprived but) I’m having trouble understanding the paragraph after the bold text “Always try to begin soothing followed by putting your child down to sleep before there is any crying!”

    Could you rephrase it?

    1. Always try to begin soothing followed by putting your child down to sleep before there is any crying!

      Estimate, or keep a record of the interval of time between when your child awakens in the morning or awakens from a nap and the onset of crying. This interval of wakefulness will vary a little day-by-day based on the duration of the preceding sleep period and how your child is interacting with people and activities. Now, shorten, a little, the usual interval of wakefulness, by watching the clock or using the interval timer on your smart phone or watch. So, you are now beginning soothing to sleep a little earlier. If crying still usually occurs before sleep, then shorten the interval a little more.

      When we are sleep-deprived, we are in a mental fog. So write down when your child awakens in the morning. When you begin the soothing for the first nap, if crying occurs, write down the time that you began the soothing process and/or the time when crying occurs. Let’s say that the interval between awakening and beginning the soothing or the onset of crying was 95 minutes. Well, the next morning, begin to sooth your child after a wakeful period of less than 95 minutes, say 80 or 85 minutes. If crying still occurs, perhaps the next day you would begin the soothing process after a wakeful period of 70-75 minutes, and so on. The idea is to shorten the duration of wakefulness to prevent a second wind (see my IG reels; #marcweissbluth) that causes the crying.

      The same concept applies to the interval of wakefulness between naps and the interval of wakefulness between the last nap and the bedtime.
      Does this help?

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