Four and a half month old baby doesn't know how to self soothe
(San Francisco, CA)
Question: My daughter is four and a half months old, she has been 100% breastfed since birth. I have read quite a few sleep books, including the book by the Sleep Lady, Baby Whisperer and Dr. Weisbluth.
We haven't really been able to follow any of the advice from the books. My daughter is just not able to self soothe when she's put in the crib drowsy but awake. She seemed to be getting better around 2 to 3 months old, where I could get her drowsy and she would take a pacifier in the crib and fall asleep.
However around 4 months, she started sleeping in shorter spurts again, and has been near impossible to get down for naps. She'll sleep for 10-45 mins at a time. We've tried the cry it out method, she cried at the top of her lungs for two hours, and there is just no way she could self soothe when she is crying like that.
We have a consistent bedtime routine for her, but the bedtime is a little hard to pin down since her nap durations are so inconsistent. The last step of the bedtime routine is nursing, at which time she falls asleep. She'll wake up 10-30 mins later screaming wanting to be nursed or rocked again. After going through this process for about 1-2 hours, she'll finally go to sleep for 4 hours.
What is the best way to teach her how to self soothe and put her on a schedule? She will play in the crib by herself when she's awake, but the minute she starts getting tired she starts crying.
Thank you for reading. Your website is so helpful and realistic. It helps to know that you went through much of what we are going through, and that you aren't just a book that assumes all babies are the same.
Heidi's Answer: Dear Dora, first of all don't worry, self soothing is a tricky skill and many babies struggle to get it. Especially at 4-5 months old. It usually becomes much easier towards 7-8 months old.
You can actually choose between two options right now:
1. Let it be for now and keep nursing/rocking her to sleep whenever necessary (and start working on self soothing only in a couple of weeks, or more).
When nursing to sleep, do make sure you keep her awake long enough to get a full feed and also don't skip burping her (even if this means holding her upright or placing her over your shoulder swiftly). Because both not having had enough or not having burped may cause her to wake up 10-30 minutes later.
While doing this (keep nursing/rocking to sleep) do work on a regular schedule. Don't expect a very strict very regular schedule yet, but aim for one.
That means you look at her closely and figure out a good schedule for her, based on early sleepy signals (staring, losing interest in her environment, a first yawn). Any later signals are past bedtime.
Maybe note these times down for a couple of days until you see some consistency. If you see none, follow her lead for a few more weeks until you see more consistency.
Also you may want to have a look at the Baby Sling Trick to help you set the schedule.
2. Do all the schedule work as above but also work on self soothing. That means you avoid her falling asleep at the breast. Use the gentle unlatch technique for this:
When she's nursed enough and is dozing off: release the vacuum by gently squeezing your finger in between her mouth and your breast. Very quickly (at the same time really) tip up her chin: this avoids her reaction to reach for it again and wake up.
You'll have to experiment and practice a bit.
At first this will only work when she's well and deeply asleep. Very gradually, do it a bit earlier, when she's not so deeply asleep. After that you still hold her a while before putting down.
By doing the move a bit earlier each time/night/day, you want to arrive at the point where she's awake when finished nursing (and awake for burping or sitting upright for a while). After that you rock/hold her to sleep.
So this way you'll have moved from nursing to sleep to holding to sleep. Once this is working well, start encouraging the self soothing further with the gentle self soothing method I describe here.
For dedicated guidance, follow the 3 essential steps to lasting self soothing skills in No-Tears Self Soothing.
Of course it will also aim at putting down drowsy/awake but the strength of the method is in going very gradually. This gives baby, and her body, the time to learn the so important skill to self settle.
Take your time, you have been doing very well so far with gently guiding her, and with a bit of patience, you will also get this phase nailed.
O and a final note: congratulations on the successful breastfeeding, this is so good for the both of you!
And a small extra tip just in case: don't be in a hurry to start solids. Many of us are getting a bit impatient in that 5th month to get it started, but all too often results in digestive issues (and therefore sleep issues). Six months old is still the safest and most recommended (also by the WHO) age to start.