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4 month old Waking to Nurse

My daughter is 18 weeks yesterday and she is my first child. She has been a great baby from day one. She was not colicky, she can self-soothe...although her method is sucking, but won't take a pacifier just fingers (which used to really confuse me with hunger signs). She goes down for naps without hesitation, especially after 2 hr or 2 hr 15 min. Bedtime has a routine. She takes a bath, reads a book, then a bottle or nurses. Sometimes she falls asleep while eating and other times wakes afterwards, gets right in her crib, and then puts herself to sleep. She used to do the 3-4 45 min naps a day and would go to sleep at night anywhere around 6:30-7:30 and sleep until anywhere from 5-7.

Just recently she has been starting doing two longs naps ranging anywhere from 1 1/5 to 2 1/2 hrs at 9 or 10 and 1 or 2. This has put her on a 4 hour schedule so she is only eating 4 times throughout the day. Now she has started waking in the night anywhere from 3-5. I do not know if this is because she has less to eat during the day or she is just waking then? Sometimes she wakes herself because she has flipped over. I have tried to let her cry it out a little with efforts of going in covering her, rubbing her, changing a diaper, etc. but she gets more upset and I end up nursing her after an hour or so of this and she eats a full feeding and then goes back into bed happy and sometimes falls asleep right away and sometimes not for another 30-45 min.

Since she used to sleep through the night with 5 feedings I am wondering what I should do? With her naps it is hard to get her to eat anymore than 4 now. Will she just adjust to the 4 feedings eventually and should I just keep feeding her whenever she wakes in the middle of the night? I have thought about a 3rd nap so I could get another feed in later, but she is tired at 6 or so and has always fought the 3rd nap.

Please any advice would be so welcomed :)

Overall your daughter is off to a fantastic start and its clear you have put effort into developing good sleep habits. Unfortunately, she has become side tracked and we need to get her back on the right path.

I am worried that she is getting in the habit of needing night feedings. If you continue to feed her at night you are training to wake up and she is becoming calorically dependent on these feedings.

Has there been any recent changes to cause this change? Travel? Visitors? Illness? Is she still growing well? Do you still have a good milk supply?

A feeding schedule with 3 naps and 5 feeding is more consistent with a typical (and our Gordon) 4 month olds. She is going down too early for bed. Most of our 4 month olds went to sleep for the night around 10pm.

My guess is she needs the 5th feeding to get her required calories. The average 4 to 9 month old needs 25 to 35 ounces of breast milk or formula a day. You could try starting solids to see how they affect her nighttime routine.

The nighttime feeding is her 5th feeding and needs to be moved to the daytime. Feeding less or moving the feeding later is progress. The longer she has been waking to eat at night, the longer it will take to correct.

Nighttime waking caused by flipping over is a normal phase. Your job is to place her on her back. If she flips over and wakes up then simply roll her to her back.

There are a lot of options to adding in a third nap and a 5th feeding. You may have success by waking her at 8 or 9 pm for a feeding and bedtime routine. You may need to adjust her nap schedule by putting her down earlier for her first two naps or even shortening her later nap.

By increasing her daytime feedings and naps her good nighttime sleep habits should return.




Written July 2011 by
Dr. Gordon, Orlando Pediatrician


 is intended to help parents understand the needs and behaviors of children. The information presented in the site is the opinion of Gregory Gordon, M.D.and does not reflect the opinion of his partners. This website is owned exclusively by Doctors insights LLC. The advice in this site does not apply to all children. Always consult your healthcare provider for your individual needs.

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