Sleeping FAQ: 8-12 weeks – Settling/Sleep Associations

My eight-week-old is unable to settle himself to sleep without prolonged crying

Oscar has always been difficult to settle to sleep at 7pm. For the last three weeks we have tried controlled crying, but he is still crying wildly every night for at least an hour. He only falls asleep when totally exhausted. I follow a strict routine between 5pm and 7pm and put him down in his Moses basket not fully asleep.
He is given a full feed at 11pm, but takes this in his sleep. He then wakes about 3.30-4.30am taking between a half to a full feed and settles again until around 6am.
Oscar followed the routines from about 2 weeks. He was put to sleep in his nursery which has full black out blinds and curtains. He has all his nappy changes there. During most days I took him out either in the car or buggy, at times which coincided with his nap times. Lately he has been waking at the lunchtime nap after 30-45 minutes and not re-settling. I decided to give him his naps at home in his room, as I felt he had developed wrong sleep associations with always being out at these times. I have tried controlled crying at these times for 3 days but Oscar is getting hardly any sleep as he cries hysterically when out sleeping in his moses basket.
Despite such little daytime sleep he is still hysterical at 7pm, and now is beginning to wake really early [6am]. This makes it difficult to stay on the routine during the day. He is feeding at about the right times but not getting nearly enough daytime sleep.
Oscar weighs 12lbs 8ozs and is taking between 29-36ozs of formula milk every 24hrs. His feeds are roughly 06.30 6ozs, 10.00 5 1/2 ozs, 14.00 51/2ozs, 17.00 2ozs, 18.00 4ozs, 23.00 6 ozs, 03.45am between 2 and 6 ozs. He takes about 1oz of water at 3.30pm. His sleeping and feeding are beginning to vary a lot each day.
He has been fed Nutramigen since 6 weeks after he appeared to develop colic at 4 weeks and cried all day. I gave up breast feeding entirely at 5 weeks as it was suggested this was the cause of the colic. Before this, he had top ups of formula as I found he was taking two hours to feed.

Oscar sleeps 08.30-09.30,12.00-12.30, 16.30-17.00 in the day.

It would appear that Oscar has not learned to settle to sleep alone. He becomes tired and fights sleep and this has become a vicious circle. The more overtired he becomes, the more he fights sleep. His sleep cycles have changed from the newborn pattern into a more adult one. He is surfacing from a light sleep about every 45 minutes. As he does not know how to put himself back to sleep, he is waking fully. Getting him to learn how to fall asleep alone by day is important, so this problem does not begin to happen in the night.
To get him better at settling by himself, watch him carefully for signs of tiredness, taking him to his room at least 20 minutes before you think he will be asleep. Not all babies of this age are capable of staying awake a full two hours. Many are ready to go down after an hour and a half. This means getting him to his room before he is too tired and fights being settled.
Once there, change him and draw the curtains. When you put him down at the lunchtime nap offer him a small top up, as Oscar has his mid-morning feed at 10am. If he wakes after 30-45 minutes when coming into his light sleep, you will then be certain that hunger is not the cause preventing him from getting back to sleep. Begin to leave him 10-15minutes, so he learns how to settle back to sleep again. If the lunchtime nap still is a problem, read Gina’ s article on ways to cope with it.
Once the room is dark, sit with Oscar, who may still need to be swaddled for a few weeks, if he is disturbing himself with jerking whilst falling asleep. It can take a baby 15-20 minutes to be calm and relaxed enough to be put down. Oscar has to learn how to fall asleep after being wide awake. It can take a sensitive baby a while to learn how to do this without the aid of a car or buggy ride. Try to remain calm yourself as you hold him. A small baby will quickly pick up on a mother’s tension. Once Oscar feels “heavy” on you and you sense he is sleepy, put him down and tuck him in well. Even in a moses basket you need two rolled towels to secure the sheet or light blanket used across him. At Oscar’s current weight, it is time to think about moving him into a cot. He may well be disturbing himself by knocking against the sides of the moses basket.
Once down, leave Oscar for ten minutes to allow him to learn how to settle. If he was really sleepy when you put him down and he is securely tucked in, he should be able to learn how to carry on drifting off. Although it is best to put babies down when more awake than asleep, in Oscar’s case you need to treat him as a younger baby whilst he is learning how to settle alone. Gradually as he becomes more used to falling asleep in his basket or cot, you can lessen the time you hold him before putting him down, so he is more awake.
If, after ten minutes his crying is escalating rather than beginning to lessen, go in and reassure him with a quiet voice and gentle soothing, but keep this reassurance to only 1-2 minutes. Then leave him again and wait another ten minutes before repeating. This “crying down” can take up to half an hour but provided Oscar is not over tired when first put down he should begin to learn how to fall asleep alone.
If Oscar’s daytime sleep improves, he should be less tired at 7pm and begin to settle better then. Keep giving him a split feed at 5/6pm but possibly offer him 5ozs at 6pm rather than 4ozs. Again this is to make sure he is not still hungry when being put down. If you think he is tired by 5.30pm, begin his bath early and put him down before 7pm. If Oscar is over-tired he will fight sleep. As he is only getting 11/2hrs sleep in the daytime at present, he will be ready for bed before 7pm. This could help him be less sleepy at 23.00. Until 3-4 months of age, babies do need to be awake for a good 45mins to an hour at the fifth feed of the day. This helps them cut back and drop the middle of the night feed. It should also help Oscar to sleep nearer to 7am. A very tired baby will fall into a deep sleep at the beginning of the night and often begin to wake earlier in the morning as a result.