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.
Room-sharing is one of the most common practical constraints families face when working on infant sleep. It complicates extinction because the parent is present — close enough to hear every sound, close enough for the baby to smell — and because there is nowhere to retreat. Megan’s consultation shows how to work within that constraint, and what happens when the bedtime is finally moved early enough to let everything else fall into place.
“Hello Dr. Weissbluth. I have a 7-month-old who naps very well, however, he still wakes up frequently throughout the night. He is breastfed and has been on solids for the last month. He usually goes down for night sleep anywhere between 6 and 7pm depending on his last nap. He will self-soothe and doesn’t have long crying spells when falling asleep for naps or night sleep. His first wake-up is usually around 11–11:30pm. I used to go to him at this time and feed him, however, for the last week and a half I have let him cry it out at this time to cut back on night feedings. His crying during this time has gotten shorter and shorter, and there was one night where he slept from 6:30pm to 1:30am, although that has happened only once and he still is waking around 11–11:30pm, 1–2am, and sometimes around 4–5am. I have been only feeding him when he wakes between 1–2am and then around the 5am mark. On top of this, we share a room because of limited space in the home. I am reaching out to see what I can do to maximize his night sleep.”
MW: Please describe his mood and behavior when alone with toys during the hour preceding his bedtime. Please describe a common nap schedule.
“He has a wonderful mood and temperament all day, every day. He started crawling a week ago so he has been much more active. His nap times are typically: Nap 1 between 8:30–9am, anywhere from 50 minutes to 2.5 hours. Nap 2 between 12–1:30pm, sometimes 45 minutes to 2 hours. If he wakes up at 2pm or later, I will not put him down for a third nap and will make his bedtime between 5:30–6:30pm. If he wakes before 2pm, I play it by ear for a third nap depending on how cranky or tired he seems.”
MW: If he is truly hungry at night, please feed him. Because he might not be truly hungry at night, would you like to try extinction? Because you share a room, it might be a little complicated for 3–4 nights. Let me know and I’ll advise you.
“So I have been trying extinction for when I hear him at 11pm. The first night he cried for an hour and a half. The second night about 45 minutes. Several nights after that about 30 minutes. There was a night where he made a little noise and immediately went back to sleep. But for the last few nights he is crying between 15–30 minutes. He will go back to sleep and then wakes again around 1–2am, at which time I change and feed him. Then he is up again anywhere between 4 and 5:30am. If it is close to 4am, I attempt extinction again and sometimes he goes back to sleep and sometimes not. I am open to anything at this point.”
MW: Please try to be certain that he is hungry at night by offering a test bottle and observe how quickly and how much he takes, or pay close attention to his sucking strength and rapidity compared to swallows. If truly hungry it will be suck/swallow repeatedly; if not, it will be suck/suck/suck/swallow. Consider camping out in your living room for only 3–4 nights, do extinction, feed him only if you think he truly is hungry, and after a few nights go back to your bedroom.
“Yes, thank you so much!”
“One more question — if he goes to sleep between 6–7pm and I am doing extinction, at what time should I go to him?”
MW: Please read carefully the blog posts on drowsy signs and base your bedtime on drowsy signs — 7pm is too late. The failure to have an early bedtime will cause extinction to fail.
“Lately he is in bed between 6–6:20pm. I have been consistent with extinction and last night he slept from 6:15pm to 3:55am. When he woke at that time, he was gently vocalizing for about 10 minutes until it started getting progressively louder. At that point I went in, changed his diaper, breastfed him, and he was back to sleep by 4:30am and woke for the day around 6:20am. If he continues to wake around 4am, do you recommend I continue extinction until a later wake-up time like 6am, or is it okay to go in around 4am, change and feed him, and allow him to go back to sleep? I am unsure if I should drop the 4am feeding.”
MW: Please continue to feed him and change him when he is hungry around 4am. Because about 80% of breast milk is consumed in about 10 minutes, I gently suggest that you try to shorten the time you are with him — perhaps 15–20 minutes instead of 35. I think you are on the right track for success.
“I have been trying extinction for over a week and a half now and my son is still continuing to wake up around 11pm, 1–2am, 4am, then around 6am for the day. I was doing extinction for the 11pm and 2am wake-ups but he is persistent at waking at these times and at 11pm he has been crying for at least an hour. I myself am so sleep deprived and all nightly duties are on me because my partner works third shift. I don’t know if I should abandon extinction temporarily or if I should continue.”
MW: Here is my suggestion for the next 3–4 nights only, then re-evaluate: A strict 5:30pm bedtime — you have bathed, changed, fed, and soothed him and are leaving the room when he is drowsy but awake at 5:30pm. Do not go to him before 5:00am unless you are absolutely certain he is hungry; if so, make the feeding and changing very brief. Do not wake him in the morning. Nap times based on drowsy signs mid-morning and mid-day. No third nap.
“I am willing to try anything. Thank you!”
“Dr. Weissbluth — just an update. Last Monday I started your most recent suggestion and by night four, he slept from 5:30pm to 4:40am without waking at all. I then got him, changed and fed him, and he slept from about 5am to 7am. This has been occurring for the last four nights. Thank you so so much! It worked!!”
What Resolved This
The consultation unfolded across several weeks and several adjustments, each one addressing a real variable. But the turning point was the strict 5:30pm bedtime.
For weeks, bedtime had been floating between 6:00 and 7:00pm — a range that sounds reasonable but contains within it the possibility of a bedtime late enough to trigger pre-sleep arousal and set the night’s pattern. Extinction at 11pm was producing some improvement but not enough. The 11pm waking persisted. The crying at that waking was not shortening further. The process was stalling.
When the bedtime moved to a firm 5:30pm — with everything completed and the room left at that moment — the biology finally cooperated. By night four: 5:30pm to 4:40am without waking. Then a brief feed, then 5am to 7am. Eleven or more hours of consolidated sleep, with one brief, appropriate early-morning feeding.
The room-sharing constraint, which had seemed like a major obstacle, turned out to be manageable with a specific and temporary solution: camping in the living room for three to four nights to remove the mother’s physical proximity from the equation. Once the extinction had taken hold and the bedtime was correctly placed, the room-sharing ceased to be an obstacle.
The Lone Parent Problem
One detail in this account deserves direct acknowledgment. Megan was doing all of this alone. Her partner worked third shift. Every nighttime waking, every feeding, every hour of lying awake listening to crying — she managed it without the relief of another adult who could take a turn or simply be present. Sleep deprivation accumulated. Her resolve wavered. She asked, honestly, whether she should abandon the process.
The answer was not to abandon it but to change the strategy — specifically, to move the bedtime earlier than it had been and hold it firmly. The earlier bedtime did what weeks of late-night extinction had not been able to accomplish on its own.
Single parents and parents whose partners are absent at night face a specific and underappreciated version of this challenge. The process is harder without support. It is not impossible. What Megan’s account shows is that the biology responds to the right conditions regardless of who else is in the room — or whether anyone else is in the room at all.
— Marc Weissbluth, M.D.
It’s amazing how the accounts and comments from other parents shed light on our own day-to-day challenges; even when we’re already applying your teachings, it’s common to run into difficulties from time to time. In our case—with a 3½-month-old whose naps had improved—we shifted bedtime to 6:00 PM (after more than a month of going down at 5:30 PM), and suddenly we started having issues with wake-ups at 11:00 PM and 4:00 AM, ready to start the day. There was crying, too—something that hadn’t happened in a long while. Thank you for your work, Doctor.
Thank you for this — and you are right that other parents’ accounts have a way of clarifying what we already know but sometimes need to hear again.
What you discovered at 6:00 p.m. is the minutes-matter lesson playing out in your own home. Thirty minutes looks small on a clock. In a 3½-month-old whose sleep is still consolidating, it was enough to tip the balance — the 11:00 p.m. waking, the 4:00 a.m. early start, the return of crying that had been absent for weeks. That is not a coincidence. That is pre-sleep arousal telling you the bedtime had drifted past the drowsy period.
The good news is that you recognized it, and I suspect you already know what to do.
I would love to hear what happened when you returned to 5:30 p.m. How quickly did things resolve? Did the 11:00 p.m. and 4:00 a.m. wakings disappear, and if so, after how many nights? And did the crying stop as quickly as it had appeared?
Your experience — including how fast the correction worked — is exactly the kind of account that helps other families trust the process.
— Marc Weissbluth, M.D.
After just one night of going to sleep at 5:30 PM, the baby slept for 11 hours straight; he woke up at 4:30 AM to feed, went back to sleep, and woke up again around 6:30 AM. There was no crying this time. In the morning, he took a 3-hour nap with very little crying (we are still working on independent napping). In the afternoon, he took another nap—this one lasting 35 minutes—with more crying, though I believe I got the timing wrong. I had suspected that 6:00 PM was too late, and my husband and I had already returned to our usual routine. Your blog post came right after that successful stretch, and it felt as though you had written it specifically for us, confirming what we had observed (but viewed through the lens of your expertise).
Thank you so much, Beth — one night. That is all it took. Eleven hours of uninterrupted sleep, no crying, a three-hour morning nap, and a baby who woke up ready for the day. The contrast with what had been happening at 6:00 p.m. could not have been more stark.
Your experience beautifully illustrates something that is both simple and profound: thirty minutes of bedtime timing, in the wrong direction, was enough to unravel weeks of good sleep — and thirty minutes in the right direction restored it overnight.
I want to share a thought about the science behind what you observed. Many pediatric sleep researchers, aware of the many variables that influence children’s sleep, would look at your experience and note — correctly — that it is anecdotal evidence. They would say that when you moved the bedtime later and a sleep problem developed, and then moved it earlier and the problem resolved, those changes were “correlated” rather than “causal,” because other variables were not experimentally controlled. That is a fair scientific point.
And yet — there are five experimental studies demonstrating that differences of just minutes in bedtime or sleep duration produce major, measurable effects on children’s sleep and daytime functioning. The experimental evidence exists. Your lived experience is entirely consistent with it. You and your husband, and many parents like you, know in your bones what the data confirm.
What I would love, if you are willing, is for you to write a narrative account of your experience — what you observed when the bedtime shifted later, what happened when you returned to 5:30 p.m., and what that one night told you. I would post it as a Blog Post to encourage other parents who are struggling to appreciate why thirty minutes matters so much.
Your story could be the thing that convinces another family to make the change.
— Marc Weissbluth, M.D.
Our son is three and a half months old. Since he was six weeks old, we have been following Dr. Marc’s guidance for nighttime sleep. I have read the book twice, along with much of the blog’s content (a shout-out to the middle-of-the-night feedings for making all that reading possible). For over a month, his bedtime had been 5:30 p.m., and things were going well: he no longer cried at bedtime, he had only one night waking, and he would fall back asleep without crying — on his own, in his crib. We felt we had found our rhythm.
Because everything was going so well, and his naps seemed to be improving, we made what seemed like a small, harmless adjustment: we moved bedtime to 6:00 p.m. Thirty minutes. On a clock, it looks like nothing.
Almost immediately, things began to fall apart. First, there was one night when he cried at bedtime. On another, he woke at 7:00 p.m. crying as well, and we applied extinction. Up to that point, we thought it might be because we were sleeping at our house in the countryside. Then he started waking at 11:00 p.m. Then came the 4:00 a.m. wakings — not to feed and drift back to sleep, but wide awake, ready to start the day. And the crying returned, something we hadn’t seen in a long while. It was disorienting: we hadn’t changed anything about our routine except those thirty minutes, and yet weeks of good sleep seemed to be unraveling before our eyes.
My husband and I suspected the later bedtime was the culprit, and we decided to return to 5:30 p.m.
It took exactly one night.
That first night back at 5:30, our son slept eleven hours straight. He woke at 4:30 a.m. to feed, went right back to sleep, and woke for the day around 6:30 a.m. There was no crying. In the morning, he took a three-hour nap with very little fussing (we are still working on independent napping). His afternoon nap was shorter — about 35 minutes, with more crying — but I believe I simply got the timing wrong that day. The night itself, and the baby who woke from it, were transformed.
The contrast was stark. Thirty minutes in the wrong direction had been enough to produce night wakings, early morning starts, and crying. Thirty minutes back in the right direction restored everything — literally overnight.
Shortly after, Dr. Weissbluth published a post about how minutes matter in bedtime timing, and it felt as though it had been written specifically for us. We had observed it in our own home before we read the explanation.
To other parents who are hesitating over whether such a small change could really matter: it does. We lived it, in both directions. If your baby’s sleep has recently deteriorated and the only thing that changed was a slightly later bedtime, try moving it back. For us, one night was all it took to know.
On another subject, Dr., I would love your guidance regarding naps. I feel I can’t manage to improve them — with respect to the crying. I also feel I don’t know how to read his drowsy signs. Sometimes I get wonderful naps, where he sleeps well and falls asleep with very little crying, but I can’t identify a pattern I can reproduce. And sometimes, by the very next nap, there is a lot of crying.
It seems that night sleep is “easier” not only because, as you explain, night sleep consolidates first, but also because we have a fixed time for it — 5:30 p.m. With naps, I have a lot of doubt about how to make it all the way to 9:00 a.m. for the nap drill, and I also feel so insecure about leaving him to cry alone, given that sometimes he sleeps 30 minutes at most. His sleeping independently for naps has become a necessity, because I have returned to work (even though I work from home). And just to clarify: despite my insecurity, I am putting him in the crib and letting him cry.
Today, for example, he woke at 5:48 a.m. I left him in the crib to see if he would return to sleep on his own (he was only fussing quietly), and we picked him up at 6:00. At 7:10, when I sensed he had become irritable (perhaps it should have been earlier, since irritability is already a late sign?), I took him to the dark room, with white noise, put him in his sleep sack — and he cried for more than 20 minutes and slept only 35 minutes.
Let me just add one point. His pediatrician said that he is now at an age when babies can already get bored, so I sometimes have a hard time telling whether he is getting sleepy or is simply bored when he is on his play mat and starts fussing. Sometimes I interact with him, but he continues to fuss anyway.
Thank you, Beth — your narrative account is a gift to every parent who will read it. You observed something important, documented it honestly, and shared it generously. That matters.
Now to your questions about naps.
What you are experiencing is entirely normal for a three-and-a-half-month-old. Regular nap rhythms do not reliably develop until around six months of age. Before that, naps can be unpredictable in their timing, duration, and ease of entry — not because anything is wrong, but because the circadian system that governs daytime sleep is still maturing. The three-hour morning nap and the 35-minute afternoon nap you described in the same day are both perfectly consistent with where your son is developmentally.
The best strategy right now is not the clock — it is your son. Keep the intervals of wakefulness short and watch him carefully for subtle drowsy signs. This is harder than it sounds, because drowsy signs at this age can be easy to miss or misread.
Here is something I want to share that may help. I have a four-month-old grandson, and like his father before him, he is a thinker and a looker — always alert and calm, quietly taking in the novelty of his world, never appearing bored. Parents of babies like this sometimes miss drowsiness entirely because the child never seems tired. But there is a difference between engaged looking and unfocused looking. When his gaze loses its sharpness — when he is staring off rather than staring at something — that is drowsiness, not boredom. That is the wave to catch.
For much more on recognizing drowsy signs and understanding what you are looking for, please read Blog Posts 9, 83, 115X, 232C, 232AX, 232BX, and 232D. Together they give you a full picture — descriptions, videos, and the science behind what drowsiness looks like in a young infant.
You are doing beautifully. Watch him, not the clock.
— Marc Weissbluth, M.D.
Hi Mark, it’s me again!
Our nights are still going well. We have been having only one wake-up, usually sometime between 2:00 and 4:00 a.m. We change his diaper, feed him, and he goes back to sleep. He has then been waking for the day at around 6:40 a.m.
I have now finished reading the 4–12 month chapter of your book. I had previously read the whole book except for some of the age-specific chapters that did not yet apply to my baby. Since yesterday, I have been trying to look at the clock a little more and aim for naps around 9:00 a.m. and noon.
Sleep latency, both for naps and at bedtime, has actually been very short, with very little crying. The main problem I am having is nap duration.
Here is what the last couple of days have looked like:
Sunday: bedtime at 5:48 p.m.
Monday:
Wake-up: 6:38 a.m.
First nap: started at 8:50 a.m. He woke after about 35 minutes, cried briefly, and then fell back asleep for another 11 minutes, for a total of about 46 minutes of actual sleep.
Second nap: 12:19–1:30 p.m. (1h11)
Third nap: 3:03–3:47 p.m. (44 minutes)
Bedtime: 5:47 p.m.
Today:
Wake-up: 6:40 a.m.
First nap: 8:47–9:23 a.m. (about 35 minutes). He did not fall back asleep during the remainder of the hour.
Second nap: started at 11:39 a.m. He initially slept for about 25 minutes, then woke and cried for approximately 33 minutes. He eventually fell back asleep for another 10 minutes and then woke again. So he had only about 36 minutes of actual sleep despite being given the opportunity to return to sleep.
I saw the section in your book where you recommend leaving the baby in the room for at least an hour. Monday was encouraging because, after waking early from the first nap, he did manage to fall back asleep and add another 11 minutes. Today, however, he was unable to do that after his first nap. During the second nap, he eventually fell back asleep after 33 minutes of crying, but only slept for another 10 minutes.
This is where I feel a little lost. How should I handle the rest of a day like this so that I do not jeopardize the night? From what we have observed over the past few weeks, he still seems quite sensitive to insufficient or disrupted daytime sleep.
On a day when the first two naps have been this short, should I try to “save” the day by offering an additional late-afternoon nap? And, if so, how should I actually do that nap? Should I still put him down in the crib and follow the same nap-drill approach, or is this the kind of nap that can be assisted — for example, in the stroller, carrier, or contact napping — simply to make sure he gets some additional sleep?
I am trying to understand whether the priority on a difficult nap day should still be practicing independent sleep in the crib, or whether the priority should shift to getting enough daytime sleep to protect bedtime and nighttime sleep.
I also wanted to clarify something because I may be misunderstanding the book. I noticed what seemed to me like different guidance regarding late-afternoon naps. In the nap-drill section, I understood that there should be no naps after 3:00 p.m. However, in the 4–12 month chapter, I found passages that seem to suggest that, in some circumstances, a baby may start a nap sometime between 3:00 and 4:00 p.m.
Am I reading this correctly? Particularly on a day like today, when the main naps have been so short, how late would you allow that “rescue” nap to start, and would you limit its duration?
I am also unsure how to handle the interval after a very short or failed nap. For example, if he sleeps only 25–35 minutes and then spends the remainder of the hour awake and crying, should I calculate the next sleep opportunity from when he actually woke up, or should I still try to preserve the clock-based schedule and aim for the next nap at the usual clock time?
That is probably the part I am struggling with the most right now: balancing the clock-based schedule with the fact that some naps are still very short, without letting the whole day unravel or affecting the night.
I read all the blog posts you indicated. Thank you again for your patience.
Just to add: he is now 4 months and 4 days old.
Just to add another information —as it happens, he just fell asleep at 2:38 PM. Once again, the latency was a minute or two at most, with just a tiny bit of fussing. I think we’ve really managed to work on his self-soothing skills. I’ve been trying to stay consistent with the routine, using your suggestions for the morning (taking him out for a walk, then coming back and doing a longer soothing session).
Please deliberately shorten the duration of wakefulness before his first nap by about 20 minutes for 3-4 consecutive mornings. Observe latency to sleep onset. If he easily falls asleep, then you will know, after the fact, that your observations regarding naps were caused by a little pre-sleep arousal in the mornings. Based on nap durations, shorten the intervals of wakefulness before all other naps by about 15-20 minutes and observe latency to sleep onset and nap durations. Keep a written record and get back to me. Naps are well established by about 6 months of age and after that age when they become disrupted, the ‘Nap Drill’ is used to re-establish them. But not at 4 months of age.
How does this sound?
That sounds great—I’ll keep you posted. I already tried it for the third nap of the day after your reply: a 1-hour-27-minute wake window, 2-minute latency, and a 40-minute nap (which is already longer than 30 minutes). I think we’re on the right track. Tomorrow, I’ll start with the first nap of the day! Thanks so much for the feedback.
Dear Dr. Weissbluth,
Thank you again for your guidance. As promised, I am following up with five consecutive days of nap and latency data. My son is 4 months and 14 days old. All naps are taken in the crib unless noted, drowsy but awake, and I leave the room.
AUGUST 3 — woke 6:14 AM, asleep 5:25 PM
Naps: 8:15-8:49 (35 min, left room 7:55, cried until asleep) | 9:40-10:23 (43 min, crib 9:23, cried a lot) | 10:37-11:05 (20 min) | 12:23-1:08 PM (45 min, no crying, asleep almost immediately)
Total daytime sleep: 2h23. No nap after 2:46 PM.
AUGUST 4 — woke 5:27 AM, asleep 5:43 PM
Naps: 7:06-7:40 (34 min, latency approx. 6 min, light crying) | 8:50-9:27 (37 min, crib 8:48) | 11:07-11:38 (31 min, left room 10:54, latency 13 min) | 1:16-1:52 PM (36 min, left room 12:55, latency 21 min) | 3:03-3:12 PM (8 min, left room 2:55)
Total daytime sleep: 2h26.
AUGUST 5 — woke 5:17 AM, asleep 5:30 PM
Naps: 7:00-7:37 (38 min, left room 6:55) | 8:15-8:54 (39 min, left room 8:10, short interval, he was yawning) | 10:27-11:12 (44 min, left room 10:22) | 12:42-1:32 PM (50 min) | 2:35-3:05 PM (30 min)
Total daytime sleep: 3h22 — the best day of the five.
AUGUST 6 — woke 6:35 AM, asleep 5:32 PM
Naps: 8:10-8:41 (31 min, left room 8:01) | 9:51-10:33 (42 min, left room 9:20, cried a lot) | 12:12-12:45 (33 min) | 2:28-2:55 PM (25 min, crib 2:22, only fussing)
Total daytime sleep: 2h11.
AUGUST 7 — woke 6:10 AM
Naps: 7:33-8:14 (40 min, left room 7:20, fussed then cried) | 10:58-12:10 (1h12 — I put him in the crib at 9:20, he cried hard for about 25 minutes and would not settle, so we had to take him out and leave the house. He then fell asleep IN THE CAR while it was moving, but I parked and stayed stationary until he woke on his own) | 1:28-1:58 PM (30 min, left room 1:25)
Total daytime sleep: 2h22. I mention the car nap explicitly so this figure is not read as a crib result — in the crib he is still capping at 30-45 minutes.
OBSERVATIONS
1. No crib nap in five days has exceeded 45 minutes. The single nap over one hour was the car nap.
2. The second nap of the morning is consistently the hardest — hard crying on three consecutive days, 25 minutes on August 7.
3. The unusually long wakeful intervals in this data are not intervals I chose. They are the result of failed crib attempts: I put him down on drowsy signs, he cried hard and did not settle, and we had to take him out. The interval that appears as 2h44 on August 7 is of this kind.
4. The last nap of the day often ends early — 3:12 PM on August 4, 2:55 PM on August 6, 1:58 PM on August 7 — and I am frequently unable to get another nap after it. He either will not settle, or the hour is already too late to start one. This leaves more than two hours of wakefulness before bedtime: 2h31 on August 4 and 2h37 on August 6.
5. Night sleep appears to track the previous day’s naps. After August 5 (3h22 of naps) he slept 11h55 and woke at 6:35 AM, his best morning. After the days with 2h23 and 2h26 of naps he woke at 5:27 and 5:17 AM.
NIGHT SLEEP
I leave the room at 5:30 PM and he falls asleep on his own within 10-15 minutes. He has been falling asleep independently at bedtime for over a month.
This week he has been waking twice: once around 2:00-2:30 AM (49-60 minutes each time, with a feeding), and on three of the five nights a second waking between 4:41 and 5:22 AM. After that second waking he wakes for the day between 5:15 and 6:10 AM. Before this week he was giving 10-11 hour stretches. I know how much you value a short nighttime awakening. I’ve been doing my best, but after I put him in the crib, he continues talking for quite a while, but falls asleep without crying. I also want to eliminate at least one feeding (because he was only having one and it was lasting 11/10 hours). I’m thinking about letting him cry at 2 am. I would schedule myself to feed him between 3 and 4 am (and 5 am if he happens to be sleeping for 12 hours). My impression is that he’s hungry at 2 am, but not as hungry as he used to be at 4 am.
Thank you very much for your time.
Best regards.
Currently is he bottle or breast fed. If breast fed, will he take a bottle? Describe in detail what you do around 2-2:30am and the duration. If he is well fed at 2-2:30am, he should not be hungry around 4-5am, so I am confused.
Please describe his general mood and behavior during the day.
Thank you once again for the fast reply.
He is exclusively breastfed, and we have never tried giving him a bottle. Last night, for example, he woke around 2:05 a.m. We waited about 10 minutes, until he started crying. Then we went in and changed his diaper for approximately 5 minutes (he almost always has a bowel movement). During the diaper change, he usually starts crying quite intensely. I then breastfed him for about 10 minutes on one side and 8 minutes on the other. I took him off as soon as his sucking pattern changed and he paused. My husband then held him upright to burp for another 5–10 minutes, since he still spits up quite a bit. We put him back in the crib and left the room, and he fell back asleep at 2:58 a.m.
When he wakes again around 4–5 a.m., I usually do not think he is truly hungry, but I end up breastfeeding him because it helps him go back to sleep. He also almost always has another bowel movement. He still tends to poop after almost every feeding. We do not think the dirty diaper itself bothers him very much: I apply a thick layer of diaper cream, and since this has been his pattern since birth, it has never been unusual for him to fall asleep even after having pooped.
His temperament is not particularly easy, and I identify quite a bit with your descriptions of a more difficult temperament. Of course, he smiles and laughs, and when he is well rested he can happily play by himself on his activity mat. But I feel that his mood changes very quickly. He has also not been waking from naps in a particularly good mood. I am trying to be as consistent as possible with the routine before naps and bedtime.
Coincidentally, last night he woke at 2:05 a.m. and then again at 6:00 a.m. I still do not think 6:00 a.m. is his biological wake-up time, because when his only night feeding happens between 3:00 and 4:00 a.m., he usually wakes for the day around 6:30–6:40 a.m. Still, this was already better than having the second wake-up around 5:00 a.m.
“When he wakes again around 4–5 a.m., I usually do not think he is truly hungry, but I end up breastfeeding him because it helps him go back to sleep.” I understand why you are doing this and I am not criticizing you or wanting to add any more stress to your life, but you are denying him the opportunity to learn self-soothing back to sleep unassisted.
Let’s look at the big picture. Write a brief narrative account starting from where we began and where we are today, include changes that you attempted, even if they have failed. Correct me if I am wrong but it appears that none of my suggestions have helped so far. Describe what is the most pressing sleep problem that you would like to address.
Just to add one more detail: after he woke at 6:00 a.m. this morning, we put him down for his first nap and left the room at 7:20 a.m. It took him about 30 minutes to fall asleep, and he cried very intensely during that time. He then slept for only about 30 minutes and has just woken up.
We based the timing on the previous day’s schedule. Also, while we were going through our soothing routine before putting him down, he started yawning, so I did not think the timing was wrong. But after seeing how long it took him to fall asleep and how short the nap was, I am now questioning whether we got the timing right.
Dear Dr. Weissbluth,
First, I owe you an apology: I mixed two different problems in my messages — the night wakings and the naps — and I also left out an important piece of context.
The night wakings I described were happening while we were staying at my mother’s house during our move. We kept his routine there, and we did let him cry to fall asleep, but at the middle-of-the-night waking it was very hard to do the same in someone else’s home. I knew at the time that what we were doing was not right.
Yesterday was our first night in our new home, and the night went well. He went back to his own pattern: falling asleep around 5:30 p.m., a single night waking at which he is clearly very hungry, and then up for the day after 6 a.m.
I also don’t think I made clear how much you have already helped us — that is undeniable. He has been falling asleep on his own at bedtime for over a month now. What I failed to explain is that my real problem is the naps.
Where we are today: he has not had a nap longer than 40 minutes in a long time; 30 to 35 minutes is the norm. On the baby monitor I can see him trying — at around 30–35 minutes he starts moving, tries to close his eyes again, tries to get his finger to his mouth and cannot, and then he starts to cry. I wait: I let him cry, I go drink a glass of water before going in, but he almost never falls back asleep. He wakes up already tired and a little cranky, which makes the rest of the day harder, because the intervals become even shorter.
There is one contrast that I think may be relevant: when he naps in my arms, he does connect the sleep cycles; in the crib he does not. But this only happens during the day. At night he sleeps in the crib, falls asleep on his own and connects his cycles there without any help from us. It is only the daytime naps that he cannot extend.
I also want to be clear that all four or five of his naps are taken in the crib. I am consistent about this — and that is precisely what makes the day so draining: it means four or five rounds of crying, of short naps, and of a baby who wakes up tired. He cries for at least a few minutes before every one of them.
What I have tried, in order: first stretching the interval closer to two hours; then, following your suggestion, shortening it, taking into account the previous period, how long the last nap was, and how long it took him to fall asleep. But I am not simply watching the clock — the interval is only a reference for me. What I actually follow are his drowsy signs, and I have been extremely attentive to them. I have read all the posts on your blog.
We also let him play on his own quite a lot, instead of constantly entertaining him, exactly so that his signs appear clearly and I can see them.
And I believe I am getting the timing right: we take him to the room following a pre-established routine, and while we are doing it, before we put him down awake in the crib, he yawns. Even so, he cries and does not extend the nap.
I understand what you often say about immaturity, and I am not expecting a miracle. I only want to be sure that I am doing the right things, because I am a little lost at this point.
The most pressing problem I would like to address is extending his naps in the crib — and, eventually, having him go down for those naps without crying.
Thank you very much.
Congratulations, you are doing everything correctly. How old is he now?
He is now 4 months and 17 days. Thank you again for the fast response.
My clinical and some research observations show that naps are becoming more regular between 4-6 months of age. That is why I began my nap study at 6 months of age. Exact data on what happens between 4-6 months is lacking. My impression is that a regular mid-morning nap develops before a regular mid-day nap in most children and because of the general variability of nap duration and nap timing and the number of naps, the best strategy is watch for drowsy signs (and ignore charts of “wake windows”) and keep the intervals of wakefulness brief and focus on an early bedtime. Does this help?
Yes, that helps. I’ll stay the course and manage my expectations! I’ll come back to give you an update when he is six months—hopefully a positive one. Thanks again for all your support, materials, and quick responses.
Hi Dr. Weissbluth, it’s me again! I’ve been getting ahead on reading and learning about introducing solid foods to my son, and I was wondering whether you have any books on the subject that you would recommend — ideally something you consider particularly reliable or in line with the evidence-based approach of your own work.
A little off topic from sleep, I know, and of course please don’t feel any obligation to respond if this is outside the scope of what you usually answer here. I just thought I would ask in case you happen to have a favorite resource.
Thank you again!
‘Caring For Your Baby and Young Child’ should have a good section on this subject.
Thank you!