Sleeping FAQ: 4-6 Months – Night Waking

My 4.5mth daughter is still waking several times in the night, needing her dummy to settle. How can I improve her sleeping?

My daughter of 4.5mths is waking constantly at night. Her daytime naps are also a bit weird (wakes at lunch, won’t resettle), I guess the problem is one and the same, but it’s the night we really can’t cope with!
She goes down well at 7-7.30pm and I wake her at 10-10.30pm. She’s hard to keep awake at first so I feed her a little sleepy then she wakes up afterwards, usually going down at 11.15/11.30pm quite well. She drinks an 8 oz at the 10pm feed, more than any other feed. Then it starts. Last night she woke at 1.30pm, always whiney at first but builds up until I get up and calm her. This involves giving her a dummy! I’d like to get out of that habit as soon as I am able to. She settled back then woke at 2.30-3am, I offered some herb tea, she didn’t want it, turned her head and went back to sleep. Then woke at 4am, where I fed her both breasts, no top up. She went back to sleep, only to wake at 5.20am, 6am, 6.30, eventually going back to sleep at 7 until 7.25 when she woke happy. At 5.20am she was cooing and gurgling not only moaning. Each time I get up, probably too quickly, and stroke her, give a dummy and stand there for a minute until she sleeps again. These kinds of nights have been for the past 4-5 days. At 7am-ish, she’s not that hungry. This morning at 6 and 6.30am, I left her 10 minutes before going, she didn’t settle herself, just gets worked up. It is the same at lunchtime where I leave her a whole 20mins before going in. She’s always waiting for the dummy I guess. Shall I just leave her completely? We sleep in the same room which doesn’t help anyone. Her skin is good so I wouldn’t say it is the irritation from eczema waking her. She has had wind lately and I feel that with the cot blanket pulled across, she can’t wriggle her legs and get the air out. Not sure, I guess she’d kick around too much without but wouldn’t she get used to that? How shall I deal with this, I’m going a little bit mad?
Also I feel like I do split feeds all day! Should I start giving her solids now even with her sensitivities?
My daughter has a mixture of breast and formula [goats’ milk] feeds.

She feeds at 7.30am, breast, 10.45am breast, 11.50am formula top up 60-90mls. 2.30pm breast and top up of 60-90mls, 5.30pm breast, 6.15pm formula 120mls, 10pm 240mls, 4am breast. She weighs 12-13lbs.

She naps from 9.15-10am, 12-2.15pm and 4.30-5pm.

Due to the problems your daughter has had in the past with skin irritations and wind she has become used to using her dummy to settle herself. If you feel that the time has come to get rid of it then the best method is to go “cold turkey”. As she is using the dummy as a prop to get herself to sleep she will continue to fuss and fret when she wakes until she is able to find the dummy for herself. Getting rid of it and letting her learn to settle without it may result in several days of disrupted sleep.

Look at the case history of Harry in the Complete Sleep Guide, page 82, to see how this can be done.

Try to find a way to place her cot, or yourselves, in a separate room for the main part of the night. This may necessitate moving her cot into a hallway or bathroom once she has had her 10pm feed. This should help you not get up to her straight away when you hear her stirring. Just as you hear her in the night she may well be disturbed by you. Just moving her to outside your bedroom could help you all.

The feed she is having at 10pm is very big. It is worth looking at her daytime feeding to see if she could take more between 7am and 7pm. Until she is sleeping from 11pm to nearer 7am continue to split the feed at 5pm/6pm. By offering her the breast at 5pm, rather than 5.30pm, and then a formula feed at 6.15pm you may find she will take more then 120mls. This should help her begin to cut back on the 10pm feed. Since your daughter has had problems with wind in the past, having a large feed at 10pm and then being laid flat for the night could well make her uncomfortable. Elevating the head of the cot can help sometimes. A baby who is in a slanted position, as opposed to horizontal, may find it easier to pass wind simply due to gravity.

Your daughter’s weight would indicate that each feed needs to be around 180mls [6ozs]. If you are unable to have her weight checked by your doctor or health visitor you can get a rough idea by using your bathroom scales. Stand on them alone and then again whilst holding her to get some idea of her weight.

Make sure your daughter is properly awake at 10pm before feeding her. This may mean beginning to stir her around 9.45pm as babies can be in quite a deep sleep after 10pm. Open her covers and turn on the lights, so she can come around naturally. This may mean waiting 20 minutes or so before feeding her but she then will have a proper length of time awake. As your daughter is still not really sleeping through the night, although she is over four months, she does need to be fully awake for at least an hour around her 10pm feed.

Look at the suggestions for splitting this feed on page 138 of The Contented Little Baby Book. There is also a question and answer on page 86 [bottom] which shows how it is important to have your baby really awake at this time to help her settle better in the night.

Once you have fed your daughter at 4am you can be sure that the waking after this is not through hunger. Since your daughter is not that hungry at 7am begin to very slowly cut back on the feed in the night. Look at page 149 in The Contented Little Baby Book which explains this. You will need to do this by watching a clock as you feed her and cutting the feed down by a few minutes every other night. If you do this slowly your daughter should begin to increase her daytime feeds, especially at 7 am.

If your daughter continues to be restless at 5am/6am this is the one time that Gina advocates you should do whatever you can to encourage her back to sleep to nearer 7am. Offer her a drink of water or cuddle her so she is sleepy again and will settle back. Gina does have a theory that some early morning waking can occur if you do not let your baby wake naturally in the daytime. By this age you should let them wake slowly in their cots, providing they are content, before picking them up and beginning to feed. Look at page 75 and the question on page 85 in The Contented Little Baby Book which explains how the way you deal with your baby in the day can help how they cope in the early morning. Keeping her awake at 10pm/11.15pm may also help this early morning waking.

As you are already giving your daughter a top up before she goes down for her lunchtime nap her daytime waking is probably due to her light sleep cycle and needing her dummy to resettle. Until you have decided when to stop using her dummy you should go in and check her after 15 – 20 minutes of her waking if she shows no signs of resettling herself. Take a look at the Lunchtime Nap article by Gina on the site which will help you see how best to cope with the disturbed sleep.

If you feel that your daughter is uncomfortable being tucked in securely with a sheet then consider putting her into a sleeping bag, if you have not already done so. Using a warmer tog rating would allow you to try to settle her with no coverings. Trying this at the daytime naps first would allow you to see how your daughter copes. You may find she is too young yet to sleep with no covers as her Moro reflex could still be quite strong. This could disturb her when she is in a light sleep cycle around 45 minutes after falling asleep.

Since your daughter has had sensitivities in the past you should ask your doctor or health visitor before beginning to wean her. You should also check that she is showing most of the signs that she is ready to wean. [Page 2 of The Complete Weaning Guide or p190 of Contented Little Baby] One of the most important ones is that your daughter must be taking full milk feeds four or five times a day. A full feed is 240mls [8ozs] or emptying both breasts at a feed. Another sign would be her not being content after a full feed or showing signs of hunger long before the next feed is due.

Getting your daughter to learn how to resettle herself will take persistence and consistency especially if you decide to take her dummy away. She will need to learn how to settle to sleep alone, but should not be left to cry for any length of time before you check her. Reassure her with your voice and stroke her head so she knows you are there. If you feel that wind is causing some of her distress you can sit her up in her cot and wind her there rather than picking her up. This will make it easier for you to continue with helping her to settle alone.