Sleeping FAQ: 0-8 weeks – Early Morning Waking

Will my 7-week-old daughter settling at 6.40pm cause early-morning wakings?

The routines are working well so far. The only thing is that – as the routine suggests – I give her the 6.15pm feed (which she is well ready for!) but as I am bottle feeding, she will take a 6oz bottle and fall asleep at 6.40pm rather than 7pm and I am worried that she may start to wake earlier than 7am. At the moment I have to wake her and would like to keep it that way. Do I need to keep her awake so she goes down at 7pm or is it ok to let her settle earlier?

Your daughter seems to be doing exceptionally well for 7 weeks, settling for the night after her 10.30pm feed and being woken at 7am. Be guided by her needs as well as following the routines. If she needs to settle to sleep at 6.40pm and this has no effect like her waking earlier than 10pm or in the morning leave things as they are.

If she does begin to wake earlier in the morning, be aware that she does need to be fully awake for at least 45 minutes at 10.30pm. Sometimes this waking time needs to be extended with a split feed starting at 10pm and finishing around 11.30pm. This has the effect of helping a baby sleep on in the early hours of the morning if they have begun to wake earlier.

Sleeping FAQ: 0-8 weeks – Early Morning Waking

At 7 weeks old my son is waking at 6am and wants his morning nap by 8.30am

My son is 7 weeks old and following the routine generally quite well. He usually wakes up in the night at around 3.30/4am for a feed [I normally give 3 oz], he then generally wakes at 6/6.30am and will not settle until I feed him. What do I do about his morning nap which is now meant to be 45min? He doesn’t make it until 9am and is very overtired by that time. Do I put him to sleep at 8.30am and allow him to sleep until 10am? What else do you suggest?

At present he feeds at 6.30am 5oz, 10.30am breast with formula top up 5oz, 2.30pm breast with formula top up 5oz, 6.15pm 5oz, 10.30pm 5oz, 3.30am 3oz. He weighs 3.9kg

He naps at 8.30-9.45am, 12-2.30pm and 4.15-5pm. He settles well at 7pm.

It is quite normal for a baby of your son’s age to wake about 6/6.30am. Feed him when he wakes, but treat the feed as you would in the night. Keep the room dark and eye contact to the minimum so he is likely to settle back to sleep again. Only change him if it is absolutely necessary. Wake him at 7.30am and offer him a small top up of 2-3 ozs which will get him to his next feed. Once he settles after his 6am feed he should be able to stay up after 7.30am to nearer 9am. Many babies of this age need more sleep at the morning nap, you must be guided by your own baby’s needs as well as following the routines. These are a guide to work towards. Rather than trying to keep him up until 9am straight away, work towards it by keeping him up 5 minutes more every three to four days. This will help him get used to the lesser amount of sleep gradually and avoid him becoming overtired and unable to settle. He may still need slightly more sleep than 45mins but once he is settling back to sleep at 6/6.30am you should find it easier to give him a shorter morning nap.

Sleeping FAQ: 0-8 weeks – Night Waking

My 4-week-old baby is unsettled and uncomfortable from 4am

My 4-week-old son is nearly on the CLB routine all the way through. The main problem is the period from 2.30am-7am.
He feeds well before and after his bath at 6pm and wakes at 10pm for a expressed/formula feed of 120mls. He settles until 2.30am. When he wakes I give him a short breast feed (25mins one side) and settles until 4am. He then wakes and spends until 7am in “pain” (due to wind?). At this time he is generally uncomfortable and does not sleep. He gets sleepy after each explosion but only for a short while as the next one follows fairly quickly.
By day he is very windy which also disrupts his daytime sleep and he requires immediate comforting after each “movement”, otherwise he gets very upset and takes a long time to settle again. He was on Infacol to alleviate this problem, but we have stopped giving it as he appears to be getting worse; it was given for 2 weeks. Vomiting does not appear to be a problem although he does posset a lot.

At present he feeds at: 7am breast, 10am breast, 2pm breast, 5pm breast, 6.15pm breast. 10pm 80-100mls expressed and 20mls SMA. His problems with wind started before this was introduced. 2.30am breast, short 20-25min feed, 4.30am one breast if woken up or is awake and hungry. He currently weighs 3.87kg (8.8lbs).
He sleeps from 9-10am, 12-2.00pm and 4-5pm.

The problem that your son is having with being uncomfortable in the early hours of the morning is not uncommon. Often a small babies digestive system does not always develop at the same rate as his appetite and gets rather “overloaded” at times. Whilst some babies are able to cope with this and sleep on, others are not.

Try elevating his cot or crib at the head end by placing telephone directories or a decent pile of books under each leg. Being in a slightly sloping position as opposed to lying flat, can help a baby eliminate wind and bowel movements slightly easier.

Dr Spock believed that the reason for fussing and fretting is that the stools of a very young baby are so soft, they do not put enough pressure on the anus, making them more difficult to eliminate; it is something he will grow out of as his systems mature. Once he is taking solid foods things may well improve a lot.

Keep a food diary of what you eat and see if these episodes are worse after dairy (in excess), citrus fruits -drink apple rather than orange juice- mushrooms and tomatoes. These four items may be the cause of excessive wind in babies. It takes 12-16 hours after you have eaten something to cause a bout of windy crying in a baby if they are being affected by it. Also watch your caffeine intake; drinking too much coffee, tea and chocolate can sometimes cause irritability in babies. If you feel there is a pattern to his behaviour with your diet, try cutting out the particular food for several days. If you notice an improvement then keep off it for a further week before gradually reintroducing it. If you are concerned that your diet is having an effect on your son, then discuss your concerns with a health visitor or doctor.
Are you happy with his position at the breast? Incorrect positions can lead to a breast-fed baby being more bothered by wind. Keep him tummy to tummy using two pillows if necessary for support. Holding him at the angle used for bottle feeding may cause him to take in more air than necessary as his latch is not so good. Ask a local NCT counsellor to check this out if you are concerned.
As you have already tried Infacol without success it may be worth considering Colief. This is available from Boots and is more expensive than Infacol. It breaks down the lactose in milk which some babies have trouble digesting. It can be given with both breast and formula milk. This could be worth considering, once you have been through all of the above.

Finally check that your son is really well tucked in the night. Use a sheet over his swaddle or sleeping bag, and secure it well with two rolled up towels down the sides of the cot spars.

Development FAQ: 0-6 months – Smile?

When can I expect my 5 week old baby to smile at us? When can I expect my 5 week old baby to smile at us? I am sure he does smile but my mother dismisses it as wind. At times I feel he does look at me knowing who I am but no smile shows so maybe he is not really sure who we are yet.

You are probably right in thinking that he does already look at you with recognition in his eyes, as many babies do this before they learn how to control their facial muscles to form a smile. The kind of smiles your mother dismisses as “wind” probably are as they will involve just his mouth rather than his whole face.

From birth, you will have been looking at your son’s face whilst you feed him. Whether at the breast or having a bottle, his face will be close to yours and at each feed time he will be staring intently at your face and will sense when you are smiling at him. You will know when he does smile properly, as his eyes will light up and he will smile while watching your face. This normally happens around the sixth week, although it might be earlier or later than this; you may be asked if he is smiling at his 6-8 week check, as it is considered a developmental milestone. Some babies do smile more than others; personality and character are factors in this, but it does help if a baby sees lots of smiling faces.

Feeding FAQ: 0-8 weeks – Worried about milk supply

Question – Worried about milk supply

My second baby is due any day and I am fretting over breast-feeding as I failed miserably with my first for various reasons, and ended up with bleeding nipples and a very poor milk supply. Having read some other people’s suggestions about increasing milk supply, I’m a bit confused, so would love some clarification.

The advice seems to involve fenugreek, fennel, Weleda mother’s milk tea and blessed thistle. I can’t seem to find a UK company that makes Weleda’s tea. Should fenugreek and fennel be taken together?

Answer:

I’m sorry to hear you had such a hard time breast-feeding with your last baby and wish you the best of luck this time around. I’m impressed that you’re so keen to succeed. Firstly, do be reassured that having trouble feeding one baby doesn’t always mean you have difficulties the second time around. Part of breast-feeding success is the teamwork between mother and baby, and some babies do just seem to take to it better than others, making it easier or more difficult for their mothers and changing the likelihood of bleeding nipples and other problems.

You’ve obviously been spending some time researching ways to increase milk supply. I would suggest that you try to establish a good milk supply by feeding and expressing frequently (as outlined in The Contented Little Baby Book) before trying special teas or herbal remedies. You could also contact specialist breast-feeding consultants through groups such as the UK’s National Childbirth Trust or the La Leche League, who have branches across the world.

While many people take herbal remedies such as fenugreek without any obvious adverse effects, and feel that it does increase their milk supply, it’s important to remember that we are taking them as a drug. Even though they are herbs and should be safe (apart from possible allergic reactions) in the amounts used to flavour food, as herbal remedies they are being taken in larger amounts for the effects of the chemicals they contain, just as we would take medications from the chemist. Anytime we do this, we need to be aware of possible side effects. For example, fenugreek, while generally considered to be safe, contains substances that may thin the blood and may reduce blood sugar levels. It can also have effects on the digestive system, such as diarrhoea, and some asthma-sufferers have reported that their asthma worsened when they took fenugreek. It’s also possible that people allergic to peanuts, soybeans, chickpeas or regular garden peas may find they react to fenugreek. Do note that this herbal remedy should not be taken while pregnant – it has been traditionally used to bring on labour, though its safety and effectiveness in this area isn’t known, and could increase the risk of miscarriage or early labour.

Another issue to remember is that any drug or herbal remedy carries the possibility of interactions with other drugs or herbal remedies you may be taking. So fenugreek could potentially increase the effect of blood thinning medications (which you might be put on in a medical emergency, without a chance to discuss any herbal remedies you are taking) and of diabetes treatments, with dangerous consequences. For all these reasons, I recommend that you discuss any herbal remedies with your GP before taking them. This should also mean they are listed on your medical record, just in case you were taken into hospital in an emergency. This includes herbal teas, as again they are being drunk for the medicinal effect of the herbs they contain.

One last point: remember that anything we take into our body while breast-feeding may end up in our baby’s body via our breast milk. Their little bodies can be more sensitive than ours. It’s definitely a time for extra caution and checking first with a medical expert.

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.