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.