Sleeping FAQ: 4-6 months – Night Waking

My five-month-old baby who is formula fed, has started crying constantly during the day, particularly when I try to settle him for his daytime naps. He also wakes several times in the night and only settles when fed. He has never gone to bed before 9pm and I am not sure how to implement your routines, as I am starting later than the book recommends.

At four months he did start to sleep from his last feed; from 11.00pm until 6.30am. He done this for over two weeks, but then he started wake up again during the night. I introduced solids in the hope that this would help him sleep better, but he still continues to wake at around midnight, 2am and 5am, refusing to settle unless fed.

I also have problems settling him for his daytime naps. When I put him down in the morning and at lunchtime he constantly cries, and usually ends up having two 20-30 minute naps during the day and perhaps an hour at 5-6pm.

He weighs around 14lb 3oz feeding times and sleeping details are as follows:

• 12 midnight – 4oz

• 3am – 4oz

• 5.30am 3oz

• 8am – 4oz formula

• 10.30am 20/30 minute nap

• 1am- 2tsp baby rice

• 12noon – 5/6oz formula

• 1.30pm – 20/30 minute nap

• 3.30pm – 4/5oz formula

• 5pm – 1 hour nap

• 6pm – 2/3 tsp baby rice

• 7pm – 6/7oz formula

• 8.30/9pm – settles well to sleep

• 10.30pm – 4oz

It is recommended that solids are not introduced until a baby is six months of age, and certainly never before four months of age. If you have been advised to introduce solids before six months it is important that you structure his milk feeds properly. At this stage, solids are intended as a taster and filler, rather than a replacement for his main nutritional needs, which is still milk. During the early stages of weaning milk should always be offered first before solids to ensure that the amount of milk a baby takes is not reduced too quickly. As you are giving solids to your son an hour prior to his milk feed, this is affecting the amount of milk that he is taking and is probably contributing to his night-time waking. Once your son is taking four to five full formula feeds between 6/7am and 11pm, he should manage to sleep a longer spell in the night. We would strongly advise that you do not offer your baby solids until you have established full milk feeds during the day. This can be done by restructuring his feeding and sleeping times.

At the present, your son is having his longest nap of the day in the late afternoon, which could also be a factor to him not sleeping so well at night. We would recommend that you begin to move the timings of your babies feeds and naps forward until you are beginning your day at 7am. Do this by waking him 10mins earlier every few days until you are beginning your day at 7am Once he has had his first feed, encourage him to have some kicking time on the floor before his first nap of the day – exercise is important at this age .

Until he is sleeping better at night we would suggest that you take him to his room at 8.45am, and spend some time ‘winding down’ by holding him quietly. If he has taken less than 7oz of formula at the 7am feed, we would recommend that you offer him a small top-up milk feed so that you rule out hunger as a reason for him not settling. At the moment he is taking only 4oz of milk at 8am, and you are trying to settle him two and a half hours after he woke, so the the cause of him not settling well for his first nap of the day is probably a combination of hunger and over-tiredness. We would advise that he should have no more than 45mins sleep at 9am, so that he will be ready to settle for his next nap by 11.30/11.45am. It can take time to establish the lunchtime nap, but there is a good article about it on the website: Solving the lunchtime nap. which gives different options on how to establish a longer sleep at lunchtime. Whichever method you choose it is important that you are consistent and that you eliminate hunger as a possible reason for your baby not settling. As your son is having baby rice at 1pm followed by 5/6oz milk feed at 12 noon,we would recommend that you give your baby his milk feed at around 10.30/11am in the morning, followed by a top-up feed prior to his lunchtime nap. As mentioned earlier we would not advise that you give your son solids until he is established on full milk feeds of around 8oz of formula.

Some babies of this age still need a very short late afternoon nap, especially if they are not managing two hours at lunchtime. But make sure your son is well awake by 5pm. At his age, providing his daytime sleep (between 7am and 7pm) does nor exceed three hours, he should be ready to settle by 7pm. Establishing a bedtime of 7pm, with a split milk feed at 5pm/6.15pm should mean that he increases his late feed. We would suggest that you also make the late feed a split feed at 10/11.15pm as having him awake at this time for a short while as well as allowing him a bigger feed will also help him sleep a longer spell in the night.

It may be that, despite increasing his daytime feeds, he continues to wake up before 2.30am, out of habit. If this happens we would suggest that you implement the core-night method. The time after his late feed and before the next is his ‘core night’. You can help him extend this to being the longest stretch he sleeps, by using the core-night method, explained here:
If he should wake before 2.30am try to settle him back to sleep without feeding him. If he fed well at 10.30pm he should be able to go four hours at least. You may need to offer him some cool boiled water and a cuddle. Some mothers may offer a dummy, but the idea is to get him to sleep again without needing a feed to do so. If he settles for another hour and then wakes, you will have already extended his ‘core night’ to nearer five hours, and he should then be fed. When using this method it is important to eliminate one feed at a time, gradually encouraging your son to begin to stretch out the time he is able to go without needing a feed. If you continue to structure his day, as suggested, he will eventually not need to feed in the night as his nutritional needs are being met in the day between the hours of 7am and 11pm. Look in The Contented Little Baby Book for an explanation on how the core night works. The Complete Sleep Guide also discusses this method in some detail. A case study in this book about a five month baby called Jack may be helpful to read as it explains how the problem of breastfeeding several times a night was resolved.

Once you have established full milk feeds, you can then start to introduce solids again. However, it is important that milk still remains his main source of nutrition for quite a while yet. If you follow the weaning plan set out in the Weaning Book this will ensure that his milk feeds are not reduced too rapidly and once you have established the right balance of milk and solids, his need for night time feeds should naturally decline.