Sleeping FAQ: 4-6 Months – Daytime Sleep

My 4.5mth daughter has always needed more sleep than recommended but now is unsettled at naptimes and is waking early for her late feed

My daughter has been on the CLB routines since her 7th week of life and taken quite well to them.
However, one area of concern has always been her sleep, she always seemed to need more sleep than the routines suggested. Even now at 4 months and 3 weeks old I do not seem to be able to keep her awake for more than 2 hrs at the time. She settles well at all nap times and after the 9:45pm feed provided she has her dummy, during the night she will occasionally even settle herself without the dummy. She does not cry, just moans and grunts a little. She will go to bed in the evening at 6:30pm and we still have to wake her at 7am, I am confident she would sleep near 8am if we left her. At bedtime at 6:30pm, settling is a bit harder even though she is nearly falling asleep on us or in her chair. She will cry on and off until 7:30/8pm. Once she has fallen asleep for good we have to wake her for her feed at 9:45pm after which she falls straight back asleep. Nap times are about half of the time taken in her pram since we are out, when we are at home she sleeps in her cot in a dark room and this mixture has never posed a problem.
Feeding has after initial problems gone very well in the past even though I feel that the amount of time she spends on the breast is rather short. Up to now she seemed to get enough though, putting on 5-6oz a week with exception of the past two weeks where she only put on 3oz each week, but still being a very happy and contented baby for the first week at least.

Over the past week, everything seems to be going pear shaped. She will not settle well at nap times, even the 9am nap which was never a problem, is a struggle. During the lunchtime nap she will wake up several times, wide awake and ready to play, most of the time I manage to settle her back to sleep but other times not. The afternoon nap I understand some babies cut out and she has done that twice but as a result feeds even less at 5:45pm (which should really be 6pm but I do not dare make her wait that long because she is too tired by then, I tried it before, even with a split feed at 5pm and 6pm she would not be any better). In an effort to make her have the afternoon nap I settle her and let her sleep in my arms for 10-20 mins which I do not really want her to get used to. The 11:00 am feed I had to bring forward to 10:45am most days this week because she was very restless. The 2:30pm feed is as usual provided she sleeps ok. The 5:45pm feed seems to be always the shortest feed of the day, I think due to tiredness (or maybe a low milk supply?). I leave her on the breast until she has finished. Once she is done, she will let go, look at me, then go back on it for just a quick suck, let go again, look at me again, go back on it, this goes on for a little while until she will be looking to the other side or at her dad when I then take her up to burp her. I have tried topping her up with expressed milk at this 5:45pm feed but this has made no difference to the fact that in the evenings, when we before always had to wake her for her late feed, she will now wake anytime between 8:30pm and 9:30pm. We have given her the late feed bottle as early as 8:30pm and she did go straight back to sleep at 8:50pm and did sleep through to 7am when again we had to wake her. Is she maybe ready to drop this feed but rather than having less and less milk at 9:45pm she demands it earlier and earlier to eventually coincide with the 6pm feed?
I have not started weaning her yet since I really want to make sure that she is ready. I had planned to maybe start when she is 5 months in order to avoid her becoming a fussy eater but not any earlier if she did not show any signs. She has been sucking and chewing her hands since she was 2.5 months old, and she does not show any interest in our food. Therefore I thought she might not be ready yet. However, if hunger is causing all those disruptions, maybe I should start weaning her? However, the top up of expressed milk at 5:45pm did not make any difference, in fact that day she woke up earlier than ever for the late night feed, so is it hunger or could it be something else? She has 9oz with the late night feed and is incredibly excited when she sees the bottle which she empties in 5 minutes flat. If you try and take it away to give her a little rest and a burp, she starts screaming hysterically and will try and reach for it to put it back in her mouth. I have a feeling that she would have more if we gave her more. Yesterday evening and this lunchtime I literally fed her to sleep, something I never had to do before, because she would scream the minute her back touched the mattress. I realize that this has only been going on for a week now but since last night the situation seems to escalate and I would be grateful if you could give me your opinion on how best to continue before the whole routine gets out of hand.

My daughter feeds at 7am form both sides taking 15minutes in total, 11am both breasts, feeding time 10minutes, 2.30pm feeding time 8-10minutes, 4pm occasionally 1.5ozs water, 5.45pm both breasts feeding time 8minutes, 9.45pm 9ozs emptied in 5minutes.

My daughter weighs 14lbs.

She naps at 8.50-9.45am, 11.50-2.15pm and 4.30-5pm. She settles at 6.30pm

Some babies do need more sleep than others. As they grow these needs may change a little and you will need to adapt things to accommodate this.

Although your daughter seems tired at 6.30pm she is not settling properly for another hour or so in the evening and then taking a very large feed. Recently she has not settled well to her daytime naps. This all points to hunger being a possible reason for her unsettled behaviour over the past week.

By this age many babies will take short breast feeds. They have become efficient feeders and can empty a breast in 10 minutes or less. Your supply may be slightly decreased, possibly due to doing too much, not drinking or eating enough throughout the day, and you cannot keep up with your daughter’s growing demands. Her slightly lower weight gain over the past two weeks could also be an indication of this, although breast fed babies do often gain weight more erratically than formula fed babies.

As well as trying the suggestions below follow Gina’s plan for increasing your supply, on page 52 of The Contented Little Baby Book.

If your daughter seems tired yet unable to settle to her morning nap, offer her a top up of milk before putting her down. You will then know that hunger is causing her restlessness. Also, try putting her down for her morning nap 10 minutes later and wake her after 30 minutes. Put your daughter down a few minutes later every few days if you feel she will become overtired through staying awake for another 10-15 minutes in the morning.

By having a shorter morning nap your daughter may settle better at lunchtime. To make sure that hunger is not causing her frequent waking during the lunchtime nap, bring her 11am feed to the earlier time of 10.30/10.45am and then offer her a top up of expressed milk before she goes down at 11.50am/12midday.

The afternoon nap often stays in place but does not need to be very long or deep. Some babies will happily cat nap in their chairs or whilst out for a walk in the pram. Keeping it in place will help your daughter enjoy her bath and bedtime routine later and then to settle well once in her cot.

Making sure your daughter is well fed at this time should also help her to settle better. Offer her both breasts at 5.00pm then a top up of expressed milk at 6.15pm after her bath. A low milk supply at this time of day is a common problem. Make sure you have a drink and snack around 4.30pm to help you though to suppertime. With having a split feed over a longer period of time you should be able to get her to take a larger top up, possibly 3-4ozs, which will make it more likely she will get to nearer 10pm for her last feed.

Dropping the 10pm feed is not recommended before weaning takes place. Although you feel that by having the 10pm feed earlier and earlier your daughter may be ready to drop it, she may go through another growth spurt before being weaned fully and so begin to wake in the night or early morning due to hunger.

9ozs is a large feed. Don’t be tempted to give her any more than this at one time. A baby can easily aspirate milk into her lungs if fed too much at one feed. If she continues to want this amount of milk at the late feed, despite making the above changes, consider giving her feed of formula at 6.15pm, rather than expressed milk, which will help her cut back a little on the late feed.

It may take a few days to help you daughter become a little more settled by day:
tweaking her daytime sleep a little, especially in the morning, and making sure her milk needs are being met by offering top up feeds whilst you boost your own supply.