Sleeping FAQ: 0-8 weeks – Night Waking

My 5.5-week-old baby is unable to settle herself to sleep and is still waking at night

My daughter is 5.5 weeks old and was born 6.9lbs and now weighs a healthy 9.2 lbs. I have been trying to follow the routine from 2 weeks and have also resisted creating any bad sleep associations as I did with my eldest daughter.

The problems are still the same. She is unable to settle herself to sleep. I have tried “crying down” but the cries escalate and do not subside; when they do she goes quiet for about 5-10 minutes and then she starts up again ; this can go on despite reassurance for brief moments every 10-15 minutes. I have resorted a few times to using a dummy but find that ,although this sends her off, it does not keep her asleep. I am still refusing to rock her to sleep and am also reluctant to nurse her back to sleep. What am I doing wrong? I catch the first yawn, or else make sure she has not been up for more than 1.5 hrs. I cannot make her room totally pitch black but do shield her eyes when initially settling her. I then put some lullaby music on and then let her get on with it. I have also tried topping her up to make sure she is not hungry.

There is also another issue where she is still waking up 2am and 5am for feeds and from then onwards seems unable to stay asleep and grunts and wriggles and whines. This has the knock-on effect of her not feeding brilliantly first thing and also needing a much earlier morning nap.

What are the exact steps for teaching her to settle? I am prepared to let her cry as I know how important it is and also it is really causing me and my toddler so much stress whenever it is her naptime. I really cannot stay with her for, however long it may take to get to sleep, by patting etc as my toddler needs attention too. What do I do if she misses her naps? She also used to sleep during lunchtime but over the last 2 days does not and wakes after 45 minutes or so!

She did used to settle (at around 2-3 weeks) after allowing her to cry for 15 minutes or so, but has not since. I know that it is also because she is becoming more alert, but what can I do?

Her naps have been very irregular so it is hard to plot the times; she was doing 5.5-6 hrs during the day but now it is more like 3.5-4 hrs and during the night she wakes every 3 hours for a feed but during the day; she used to have to be woken. Over the last 2 days she is not napping well and wakes well before her awakening time – if she settles at all!

At this age your daughter is probably in the middle of her six-week growth spurt and so waking through hunger. This could also be the reason for her not settling so well. As you are totally breast feeding and have another small child as well your supply may just not be meeting her demand at present. It is never easy to rest during the day with two small children. Use expressing to help boost your supply and if possible consider offering one feed [10pm?] as a bottle of expressed milk, which could perhaps be given by someone else so you are able to express and go to bed early to help you cope through the night. See how much you express at 9pm and also first thing in the morning to see how good your supply is. By the end of the day it may well be low and your daughter should always be offered a top up at 6.15pm to help her settle for the evening. At her weight she should be taking about 3-3.5oz feeds.

Teaching a young baby to settle to sleep can take both consistency and persistence. She may be fighting sleep through overtiredness so begin having a wind-down period before each nap 15 minutes earlier than you think she can manage to stay awake i.e. 1 hr 15 minutes after waking. Take both children to her room and settle your toddler with a special toy or “busy bag” near the door which is kept ajar. This bag is kept for the times when you need to spend time with the baby. Fill it with a variety of small toys and surprises and change them regularly so there is always something to interest the toddler. Swaddle your daughter so she is less likely to jerk herself awake with her Moro reflex whilst settling and hold her close but with no eye contact. This is best done by holding her over your shoulder. She may need holding like this for 10 minutes or more but you are teaching her how to calm herself so she can settle to sleep. She needs to learn how to go from being awake and alert, to falling asleep and it can take time for a baby to learn. If she is overtired she will just continue to fight sleep. You will also get up any wind which may bother her once lying down. Once you feel that she is relaxed, and has become “heavy” on you although not totally asleep put her in her cot. To begin with, put her down when her eyes are really heavy with sleep and gradually work towards putting her down more awake. Secure her with a cotton sheet placed lengthways across her and tucked well in on both sides with rolled up towels pushed down the sides of the cot spars. Leave her for 5-10 minutes to settle herself. If she becomes more upset ,rather than beginning to “cry down”, then pick her up to reassure her, calm her and offer her more to eat as hunger is one of the main causes of a young baby being unable to settle. Re-settle and leave her again for 5-10 minutes; if she continues to cry then you must repeat the procedure. For a few days it may take several times of doing this – not feeding to sleep, before she learns how to settle alone. The time you take over this now and the small amount of crying you may have to cope with will pay off as she will learn to settle herself with a small amount of fussing in a few weeks. Many babies do fuss and cry for 5-10 minutes before going to sleep. Escalating in crying is more likely caused by either hunger or wind so both are checked for when you pick her up to reassure her. Having a toddler with you will not make this always easy to carry out but it is worth trying as much as you can at every naptime and in the evening.

It is not unusual for a totally breast-fed baby to need a feed at 2am and another between 5/6am. The fact that she is uncomfortable between these times points to her again not being totally full and also possibly suffering from wind. Once you are sure that your supply is enough for her, then look at wind. Often babies are sleepy at these night feeds and may not latch on so well, thus taking in more wind. Because of their sleepiness they may find it harder to burp after finishing. If she is really unsettled pick her up and see if wind is a problem. You may find it helpful to elevate the head end of her cot by placing two thick telephone directories or books underneath the legs so she is not sleeping totally horizontally , which can be uncomfortable for some babies. Again, check that she is totally swaddled and well tucked in.

In the day, until she learns to settle herself better, adjust her nap times by putting her down 15 minutes earlier at the next one so she does not become overtired. As she learns to settle and sleep better you will be able to move these on, until she is nearer to following the times laid out for her age.