Sleeping FAQ: 0-8 weeks – Settling/Sleep Associations

How can I get my 6 week old to settle to sleep without being held?

Harvey is 6.5 weeks old. He was breast fed for 10 days and is now on formula. Whilst in hospital he was difficult to settle; even the nurses had a problem. He would fall asleep whilst feeding and then only be put down when deeply asleep.

Once on the bottle he seemed to settle into a routine, having several naps a day and going down about 9pm. He would then wake at 4am for a feed. But he still needed to be cuddled to sleep. At 4am he would never properly settle, so I began to take him downstairs and sleep with him until 7-8am.

I began to follow the CLB routines about a week ago hoping it would help him to settle better and drop the 4am feed. Now he will still only settle in the day when he is being held, but has also begun to startle himself awake as soon as he is in his pram or cot. Settling in the evening is just as bad.

He was moved into his own room at night over a week ago, but despite introducing an additional feed at 10.30/11pm once on the CLB routine, he is still waking at 4am and not settling back unless I am cuddling him. Before starting the routine he was settling at 9pm and going through to 4am.
He regularly wakes himself with the Moro(startle) reflex; I have tried to swaddle him but he just hates it; getting more upset.

During the day I have tried to put him down much earlier than the routine suggests, so he can try to settle himself. He is happy to go into his cot and amuse himself for 20 minutes but then cries gently before getting hysterical. I have tried to leave him for an hour at a time, returning and trying to settle him, but to no avail. However, it did work this morning but he woke after 15 minutes with a startle reflex and was unable to settle himself back again.

Harvey was 7lbs 15ozs at birth and is now 14lbs. I have had conflicting advice about this from doctors and medical professionals, some saying it was alright, others warning I should watch his weight as it could lead to trouble.
Harvey has not really had a dummy but I had started to give him one to help him settle. Having read the section about dummies in the CLB book, I don’t want him to become dependent on this.

As Harvey has only been following the routines for about a week, look back to the ones laid out for younger babies. It explains about “winding down” ready for sleep. This is something which Harvey needs to learn how to do with your help at first, before he will be able to settle alone. He has learnt to associate falling asleep with being held. Winding down helps him relax enough to be sleepy. In the early weeks a baby may need to be more asleep than awake before going in his cot, but gradually he will get used to going down more and more awake, as he has learnt how to fall asleep alone.

Try this with Harvey. Seeming as he fights swaddling, dress him in a lightweight (0.5 tog) sleeping bag. Take him to his room, change him and then darken it before he is really tired. Now sit with him, holding him against you but with no eye contact. This is a time when a dummy can be useful as it can soothe him and make him sleepy. Wait until he is really heavy and sleepy but not soundly asleep before putting him down. Remove the dummy now so he doesn’t associate falling asleep with it. Put him down and tuck him in securely with either a cotton sheet and/or cotton cellular blanket depending on the temperature. Use this lengthways across him and secure with two rolled up towels pushed down the cot spars. This will secure Harvey and help him not to be so startled by his Moro reflex. He may protest at first. If he is still crying intensely after 10-15mins, you may have to resettle him by holding him again until sleepy. In the beginning let him be really sleepy before going down. Then begin to put him down slightly less asleep. This won’t happen overnight as Harvey has to “unlearn” his associations. But keep at it every day in the same way at each nap and sleep, and he will come to learn how to settle alone.

Harvey’s intake of milk is fine for his weight now, but he has put on weight very quickly. If he is a fast feeder, as boys who have a good appetite often are, let him have some “sucking time” mid feed. Give him half his feed, then sit him in his chair and let him suck on a dummy for 15-20 minutes. This allows him to satisfy his sucking need without taking in too much milk. It also lets his stomach begin to register how full it is. Offer him the second half of his feed, and you may find he is a little more satisfied. This will help you not having to increase his feeds too often as a 6-8 oz increase each week is far healthier.

Getting Harvey to drop his 4am feed will happen gradually. At his age he needs to be awake properly at his 10pm feed. Many mothers find keeping their babies up for longer at this feed helps them go through further in the night. Wake him at 10pm, make sure he is really wide awake before feeding him about 1/2 his feed. Then let him have a kick for about 1/2 hour. Keep the lights quite low and don’t stimulate him too much as he needs to know that this is night time. Change him and feed him the rest of the feed before settling him about 11.15pm. This should help him go through a little longer in the night. Although big, Harvey is quite young to drop his middle of night feed. If he begins to lose interest in his 7am feed, then you will know he is ready to begin to have less in the night, and you can begin to cut it back a little.