Sleeping FAQ: 3-4 Months – Daytime Sleep

How can adjust my 15 week daughter’s daytime nap times so she sleeps longer in the middle of the day?

My 15 week daughter is very small for her age and more sleepy than most. She gets very angry if I try to shorten her morning nap as she likes to have her two and a half hour sleep in the morning. She suffers food allergies and eczema so never really gets a good nights sleep. She wants to feed up to 3 times in the night for comfort due to the itching. Due to her allergies we won’t start her on solids until as late as possible and we’re worried she will react to formula. Lots of pressure for me to breast feed! She dislikes being swaddled and scratchmits don’t help. She still sleeps three times a day: 8.50-11.20am, 12.20-1.30pm and 4-4.45pm. She goes to bed at 7pm. And often wakes at 5am. How shall I regulate her naps without upsetting her? Or should I just leave her alone because she is so small and uncomfy?

Until now she has been fully breast fed, although we have just introduced goat’s milk formula as top-ups, and will continue providing there is no reaction. I have started to give her 60mls top ups after each feed, but I am not sure if I should only do this before the lunchtime nap and at night. Obviously I want to protect my milk supply.

If she has not slept well in the day I will leave her until 10.30/11pm before waking her. Once she has fed then she will settle in 30minutes and then wakes at 12.30am, 2.30am, 3.30/4am and 6am. I often feed her one or both sides at these times to settle her back to sleep. She is sleepy at these feeds but seems to manage to empty my breasts most of the time. Due to her unsettled nights she sleeps in her pram bag in my bed. During the day and at 7pm she sleeps in her pram bag in her cot, which is in out room.

She usually settles well at night using a dummy. At 4am she doesn’t settle and it can take her 45minutes of her lying next to me loudly complaining. Sometimes I resort to her Baby Mozart CD which works quite fast as I use in the evening for her bedtime association since she cannot be bathed every day, due to her skin.

Often if she wakes at 6am she won’t settle again. If she does I do make the effort to start the day at 7am but it can be difficult due to both of us having sleep deprivation.

During the day my daughter feeds are 7am for 5mins on each side, emptying both breasts. At 11.30am, 2.30pm and 5pm she takes a 10minute feed. She has 5-10mins at 6.45pm to settle her for the evening. She weighs 10lbs 4ozs.

Dealing with a baby who is uncomfortable and itchy a lot of the time is never easy. You have done really well to breast feed her for this length of time as you must be exhausted yourself. Providing the formula does not produce any sort of reaction it would be a good idea to begin to use it for a full feed at 10pm and possibly at 6.45pm. If you offered her both breasts at 5pm and express both sides at 9.30pm your supply should not be too affected. As you are presently offering top ups at every feed it would appear that your supply is a little low. This is hardly surprising with having to feed several times in the night as well as through the day. If you follow Gina’s plan for increasing your milk supply, on page 52 of The Contented Little Baby Book, it should really help you even if you do need to use formula some of the time.

As your daughter is restless and waking often at night it is not really surprising that she is sleepy in the mornings. The reason the longest nap of the day should be slightly later than she takes hers is that it coincides with a baby’s natural dip in alertness. As she gets bigger and does not need so much daytime sleep she may well drop her afternoon nap but, if she is still waking from her lunchtime nap at 1.30pm, she may become exhausted by bedtime

To move these two naps around will take some time but, if you do it gradually, it should avoid your daughter becoming too distressed and unsettled.

You could begin to shorten the morning nap by waking her 10-15 minutes earlier every four or five days until she has cut down the sleeping time to an hour. At the same time she should begin to increase her lunchtime nap. One way to ensure this happens would be to offer her a small top up of formula or expressed milk before going down at 12.15pm. As she begins to cut back on her morning nap move her feed time towards 10.45am, so she should be willing to take a small top up at 12.15pm.

Once you have begun to sort her daytime sleep, and your milk supply, it would be a good idea to see if you could make the nights easier for you both.

A baby with eczema may well need a dummy, especially if she has irritations on her thumbs and fingers which may become infected if she started sucking those to comfort herself. A dummy will help her remain calm and so settle to sleep without getting too upset. Crying a lot will only cause her to get hot which will start up the itching and irritation, making it impossible for her to sleep.

Although you are both tired in the evening, trying to start the late feed at 10pm and keeping her awake until 11.15pm could really help with the night time waking around 4am and her unwillingness to settle afterwards. If you look at page 138 of The Contented Little Baby Book there is an explanation of how to split this feed. It means she would take a slightly larger amount, which should also help her to settle as well as being awake for over an hour. There is also a Question and Answer on page 86 of the same book which deals with the same split feed.

Once you are aware that she is more settled at night you can begin to put your daughter into her cot for night time as well. With her skin condition, getting too warm will only intensify the itching, which could occur if she is sleeping in with you. Obviously she is in some distress with her skin and does use the night time feeds to comfort herself but, once you have managed to get the condition under control with the right moisturizers and skin creams as well as re-structuring her daytime sleeps, she should become more settled at night. If you find she settles well when you use her Baby Mozart CD why not use that in the night so you both sleep better? She may begin to need it to sleep, but it is probably a better sleep association to develop than constantly feeding from you.

Caring for a baby with the problems that your daughter has is stressful and exhausting for you. You need to take as much rest as you can, and accept any offers of help you get. Making sure you eat well every day, and that you drink plenty of fluids, will all help you maintain your breast milk supply. Although you may not manage to feed her 100%, which is difficult with the present circumstances, using a small amount of formula at times should help you manage to keep feeding her for as long as you are able. It is better to do this than have to give up breast feeding entirely, through exhaustion.