Sleeping FAQ: 4-6 months – Lunchtime Nap

My 4.5 mth son has a short lunchtime sleep and wakes several times at night

My baby boy, age four and a half months and weighing fifteen and a half pounds, has never slept well at lunchtime. He settles at noon, but wakes after 45 minutes, when I have to re-settle him using his dummy. Recently, he has also started to wake two or three times a night between 1am and 6am. I have tried settling him with a dummy, but he rarely sleeps for long. I even resorted to controlled crying, checking him every ten to fifteen minutes, but he cried on and off until 6am.
He is taking 7/8oz at most feeds, and I am still doing a split feed at 5pm/6.45pm. He settles well at 7pm and sleeps until 10pm, when I wake him and give 5/6oz. I also offer one cube of vegetables at 11am, and two teaspoonfuls of baby rice with a cube of pear at 5.15pm. I can’t believe with the amount of milk he is taking, together with his solids, that the waking is caused by hunger. How do I deal with this wakefulness? Should I just leave him to cry until he goes back to sleep?

There are four main reasons why a baby of this age would wake two or three times in the night and not settle back. The first reason is hunger, the second is the wrong sleep association, the third is kicking the covers off and the final reason is sleeping too much during the day. Although you are using a dummy to settle your baby at the midday nap, I do not think that the problem is association, as he settles well at other sleep times. Neither is he sleeping too much during the day, so that reason can also be eliminated. You do not say whether he has kicked off his covers when you go to him in the night, but this could be a possible cause. Some babies under seven months still have a very strong Moro reflex and need to be tucked in securely (see page 5 of the New Contented Little Baby Book). If you are using a sleeping bag, it should be the lightest tog weight so that you can still use a sheet to tuck him in, as the book describes. Once you have eliminated this possible cause, we are left with the possibility of hunger, which I believe could be the problem.

Your baby is a good weight for his age and, if he were fed exclusively on milk, as is now recommended until the age of six months, he would need around 38-40oz of formula a day to satisfy him. As he is only taking 30oz, plus a very small amount of solids, I believe that his disturbed sleep is probably being caused by hunger. When deciding how much your baby needs to eat, you must be guided not only by age but also by weight. I would suggest that, for a few nights, you feed him the first time he wakes, and if he sleeps right through to 7am then you know that the problem is hunger. You will then have to decide whether you want to keep giving him a milk feed in the night or increase his solids more rapidly during the day. If you choose to increase his solids, so long as you continue to give him most of his milk first, you will not risk the problem of the solids reducing his milk intake, which is still very important at this age. As a rough guide, if you choose to go down the route of increasing solids rather than milk, you should aim to increase the amounts every two to three days, provided of course that he is finishing the amounts you are giving him. If you have any further doubts about weaning, please refer to my message on the site about the new guidelines :
It is also important that you discuss any concerns over your baby’s eating or sleeping with your health visitor