Sleeping FAQ: 4-6 months – Night Waking

My 5.5-month-old son still wakes at night needing a feed

Since stopping breast feeding my son’s weight gain has really slowed down (he has gone from between the 50th and 75th percentile to between the 25th and 50th, prompting the health visitor to recommend weaning onto solids) and his milk intake has dropped; we are lucky to get 5/6 oz into him at each feed, as opposed to the 7/8 he was drinking when we gave him a bottle a month or so ago, and it has become a real struggle – I have tried different teats and sizes, but it does not seem to make a difference, and he often gags and becomes upset if we try to feed him once he thinks he has had enough. He is slow to take to solids compared to my daughter (now 2) and feeding him those is also sometimes a struggle. Despite being a big baby he seems to have lost his appetite, yet he is very happy, alert, healthy looking and rarely cries.
His nights are very variable; he has slept 7 until 6 twice in the past 2 months, but the usual pattern is that he sometimes wakes up once, often twice a night and can wake anywhere between 11pm and 5am, making applying the core night method difficult. We stopped trying to do an 11pm feed as he would never take more than 2oz and it made little difference to how long he would go through the night. If he can get to 3am, that will usually be his only night wakening, but if he wakes before that he will usually wake a second time (it seems as though his 2nd night sleep cycle is a maximum of 4 hours).
His daytime sleep is not bad – he usually has 3 naps and sleeps a total of about 3 hours, but sometimes wakes up in the middle of his midday nap and also sometimes needs a long morning sleep (1.5 hours) rather than a long lunchtime nap, depending upon our toddler’s day. I am trying to reduce his nightly milk intake and only feed him once, even if he wakes up more often. We use a pacifier to settle him but he never falls asleep with it. At night he often falls asleep when feeding and if he wakes a second time he falls asleep in my arms, as usually by then I am just desperate to settle him so I can go back to bed. This is the only time he falls asleep with my help and is capable of settling himself to sleep during the day. My instinct is that he is waking at night the first time because he is hungry and has not taken enough during the day, but why does he wake a second time? What can I do to get him to increase his milk intake during the day again so that he does not need it at night?
My first baby was sleeping through by 10 weeks on the CLB routines and eating well when weaned at 17 weeks.

At present he feeds: 6.30am 5ozs, 2 cubes of fruit puree, 1 tbsp organic baby porridge mixed with 1 oz milk, 11am 5ozs, 2 cubes vegetable puree, 1 cube fruit puree mixed with baby rice and 1oz formula, 2.30pm 5ozs, 5.30pm 2 cubes vegetable puree, 2 cubes fruit puree with baby cereal and 1 oz of formula to mix, 6.30pm 6ozs, somewhere between 11pm and 5am 4ozs formula. he weighs 17lbs.
He naps at 9-9.45am, 12-1.30pm and 4.00-4.45pm.

To use the core night – and begin to eliminate the middle of night feeding – you may well have to put back a small feed at 11pm. Until he is taking slightly more solids and increases his milk intake in the day a little, he will need a fifth feed to see him through the night. Although he is taking over the minimum requirement of 20 ozs, he may well need nearer to 28-30ozs at his weight. Getting your son to take slightly more milk will mean introducing more top ups and split feeds in his day so his overall intake is increased. This will help him not to increase his solid intake too quickly as well, which may further increase his milk consumption. Until he is at least six months he needs to have most of his milk before his solids so he takes only the amount of solids needed to satisfy his hunger but not to the detriment of his milk intake.

Feed him at 6.30am when he wakes, then offer him his breakfast. At 10.30/10.45am give him his feed and follow with his solids. Before he goes down at 12pm offer him a top up feed. This could be about 2ozs. Feed him at 2.30pm, which is often a smaller feed than the others, and then split his 5/6pm feed. Give him 5ozs of milk at 5.30pm followed by his baby rice and fruit. Use rice and fruit at this time of day rather than more vegetables as this will help fill him up for the night. Look in the Contented Little Weaning Guide to see the amounts he should be having at his age. Bath him at 6.30pm, then offer him a further 2ozs of milk after the bath. This should immediately bring up his milk intake. Keep offering his solids and milk at this time in this way until he is going through to 7am on a regular basis. Then you can move his tea back to 5pm; he will increase his solid intake then but without cutting back too much on his bedtime bottle. Wake him at 11pm and offer him a feed. He may only take 2 ozs, but this along with the increase in the day should denote that any night wakings are not caused by hunger but more by habit. When you first begin this plan you may have to offer a very small feed in the night should your son wake, but it will be easier for you to use the “core night” method and gradually decrease the amount of milk you offer him to see him through to 6.30/7am.

When settling him at night try not to use a dummy or holding him too much, as he needs to learn how to settle alone as he does by day. This is not always easy as it may involve some crying down and you may be conscious that he could wake your toddler. It may take a few nights of broken sleep for you all but should result in better sleep for you all in the long term. Try to keep his longest sleep in the middle of the day rather than a long nap in the morning as this can also result in a baby going to sleep exhausted at 7pm and then waking early in the morning.