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Baby Not Sleeping at Night

baby not sleeping at night

At around 2 months, our son would wake up once to nurse in the night and would go back down without any problems.  I had always rocked him to sleep- naps, bedtime, and back to sleep in the night.

A week before he was 4 months old, he began to wake up every 2-3 hours in the night.  Coincidently this is when I went back to work and he went to daycare.  My husband and I decided to let him cry it out until he fell asleep.  When I put him down for bed, I rocked him until he was almost asleep and put him in his crib a little awake.  For the first few nights, he woke up only once to eat.  After about a week of it, he began waking up a few times throughout the night again.  I do go in and comfort him (briefly rock him, change him, or nurse him depending on the last time he ate) but again, try to put him back to bed awake. We have been battling this for a couple weeks now.

I am at a loss for what to do.  It is exhausting to wake up often, but it breaks my heart to hear him cry and cry.  I don't know if I should give him his pacifier, give him the option to nurse, or change him (he will not sleep in a soiled diaper).  I don't want to necessarily give in to him and teach him to cry, but I am trying to make sure I am meeting his needs appropriately.  I also do worry about the affects of letting him cry himself to sleep and not ruining trust.  I also do not know if I should let him cry himself to sleep for naps.  Please help me understand how to effectively do this- especially for what to do when he wakes up in the night.

 

At 4 months healthy, well grown children should consistently sleep a 6 to 8 hour stretch every night. It sounds like you have many of the right ideas, but need to know where to focus your efforts.

Lets get back to the basics (aka sleep 101 according to me)

1.) First establish a good “sleep routine”:
- an active, bright and stimulating day (I’m sure daycare will do)
- a dark and boring night (I’m sure two tired, working parents will do)
- a strict bedtime routine - see link

Once you have established a good “sleep routine” work on his feedings.

2.) Stretch out his feedings to 3.5 to 4 hours.
Gradually, increase the spacing of his feedings (both night and day). Feeding are standardly measured from the start of one feed to the start of the next. What is his closest feeding interval? If he currently feeds every 2 to 3 hours. Work with 2 hours. During the first week, do not feed him any sooner than 2 hour and fifteen minutes. As he adjusts to one interval, slowing increase your minimum interval.

I’m ok with you letting him fussy a little to settle himself down, but I do not recommend a full “cry it out” until children are at least 6 months old.

3.) Minimize your night time interactions
Do as little as possible in the middle of the night.

At 4 months, nursing in the middle of the night is a trap. Night time feedings will get him to calm down and go back to sleep. However, long term these feedings train children to wake up as they learn to depend on these feedings.

Quickly decrease and eliminate his night time nursings. Decreasing the number of feedings and even the time he feeds is slow progress. We need to get a 6 to 8 hour stretch of no feedings.

After he is no longer nursing at night then minimize the picking up and rocking. If he poops at night you do need to change him. Fortunately, this typically ends after the night feedings end.

If you are worried your son may have an ear infection or other health issue take him to his doctor.

 

Written September 2012 by
Dr. Gordon, Orlando Pediatrician

 

 

 

 

 

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