Sleeping FAQ: 0-8 weeks – Night Waking

My 3.5-week-old daughter is difficult to settle after her night feed

My daughter sleeps well from 6.30/7pm until I wake her at 10pm. She then feeds well from one breast, but dozes off on the second side and I rouse her twice by winding her. She settles easily until 3.30/4.15am. She then feeds well from one breast and, appearing to be sleepy, begins to nod off in my arms. Unfortunately, after ten minutes in her cot, she starts to kick her legs, make grunting noises and finally scream. I check she is swaddled and tucked in and try to settle her by rocking the cot and making gentle noises. This doesn’t work or, if it does, she dozes off only to wake screaming again within 15-30 minutes. After another unsuccessful attempt at settling I then get her up and find she is wide awake. My daughter is then irritable until fed again at 6.30/7am. After a good feed at this time, she is sleepy and it is difficult to keep her awake until her 9am nap. She is also sleepy after her next feed and it is difficult to keep her awake until her lunchtime sleep. By 11.30am she is dozing in my arms. I settle her and she sleeps really well until I wake her two hours later. She is then fairly alert for the afternoon, but it is an effort to keep her awake until 4pm, at which time she nods off as soon as the pram starts moving.

Could her problem of not settling after her early morning feed be due to an insufficient feed at 10.30/11pm? Or is it more likely due to her getting only half a feed at 4am? Is she then over-tired at 9am and unable to settle herself? She settles easily at 4pm when we go out in the pram, but it is a very light sleep and bright lights or sudden noise easily wakens her. At present she is exclusively breast-fed. She feeds at 7am for 30 minutes, 7.45am for 20 minutes, 9.30am for 20minutes, 10.30am for 15minutes, 2pm for 20 minutes, 2.45pm for 15 minutes, 5pm for 20 minutes, 6.15pm for 20 minutes, 10pm for 25minutes, 10.45pm for 15 minutes and 4am for 15-20minutes. My daughter weighs 9lb 2oz. She naps at 8.30-9.15am, 11.30-2pm and 4-5pm.

There could be two reasons why your daughter is restless and awake after her middle of the night feed. The first is that she is still hungry, which is the most common reason in a young baby, and the second is that she is not awake enough at the 10pm feed. Until the age of about four months, most babies need to have a waking spell between the hours of 7pm and 7am. Making sure your daughter stays fully awake at 10pm for at least an hour could help the problem.

To do this, begin to wake her at 9.45pm. It can take a while for a baby of this age to wake up naturally at this time. Go into the room and turn on the lights. Undo any swaddle or coverings so your daughter is able to move and begin to wake. Busy yourself in her room, tidying away clothes or preparing for the night feed, and occasionally give her some strokes on her forearm and hands if she takes a while to stir. Let her come round fully before you feed her. Check that she does not get too warm and snuggly when feeding at this time. Undo her sleepsuit and take her legs out so she is aware of the air on them. The room should be well lit and there should be some background noise, all of which will help to keep her awake. Once you have given her one side and winded her, allow her some kicking time on the floor, again making sure she does not get too warm. You need to keep her awake until 11.15pm. Some time on her changing mat could help if she begins to get sleepy before then. Most babies like being on their mats, and if you prop a simple book alongside, she will have something to focus on while you change her and give her another opportunity to kick without a nappy. At 11.15pm return to her room and lower the lights. Swaddle her before you offer the second side. Because she has only received half a feed and is still awake, she should take a good feed before settling quickly once winded.

All of this should help her sleep until 3.30/4am, possibly even longer, before waking for her feed. This feed is usually quite short and the baby can be sleepy, but to ensure she does take enough to satisfy herself, feed her while sitting in a chair rather than the warmth of a bed. Once you feel she has finished, wind then settle her. Hold her until you feel her heavy and relaxed, but put her down before she is fully asleep. If she then begins to stir again, leave her several minutes to see if she will resettle, but as soon as you sense the crying is increasing rather than decreasing, pick her up and offer her the breast she last fed from. She is still very young and her sleepiness may mean she does not take enough milk to fully satisfy her. If you try splitting the 10pm feed, and always consider hunger in the night as a possibility for being unsettled, you may see an improvement. Look in The Complete Sleep Guide p 72 or Contented Baby to Confident Child p 48 for a case study; Sophia 4 weeks shows how splitting this feed can help. There is also a question and answer on the bottom of p 86 in The Contented Little Baby Book, which explains about splitting this feed.

The knock-on effect that this wakefulness is having on her morning routine is apparent. Once she learns to take a proper feed in the night and is awake for long enough at 10/11pm, you may find her mornings improve. A young baby needs to be awake for short spells after feeds, and some are able to stay awake for up to two hours, but the majority will need to sleep after one and a half hours. Use the timings in the routine as a guide. Your baby may not be ready to stay up until 8.45am for another few weeks. If you feed her at 6.30/7am, she will probably be tired by about 8/8.15am. Changing her at this time, and perhaps topping and tailing her, will help her through to nearer 8.30am, at which time you need to wind her down ready for sleep. Once swaddled and calm, she should be more willing to settle around this time. If she is only able to sleep for 45 minutes, waking again at 9.15am, you could let her have a catnap for 20 minutes after her next feed around 10.45. Your daughter will then be able to get nearer to midday before settling for her lunchtime nap. See CLB book p 136 for this suggestion.

The nap in the afternoon is never so deep as the others, especially if your daughter sleeps well at lunchtime. Provided she is able to get through her feed, bath and bedtime feed without showing signs of extreme tiredness, she is getting enough sleep in the afternoon. As she gets older she may take two catnaps in her pram in the afternoon, which will be enough to see her through until 7pm.