Question: My son is almost 5 months old and fully breastfed. He does not nap very long during the day but I do put him down at 9, 12 and 4 because these are the times he is tired, he usually sleeps for 1 hour each nap. He gets a feed ever 3.5-4h and his last one would be at 7pm but he is very often too tired for the 7pm feed and falls asleep but whether he takes the feed or not he usually wakes at 10.30/11pm again for a feed. Then sleeps till ca 2/2.30am for the next feed. From 2.30 he wakes at 4am and 5.30 am and that’s it. I did feed him at 4am to see if he would sleep till 7am but whether I do feed him or not he wakes at those times. I usually pat his tummy or rock him for 2min and he would fall asleep again easily but waking up after 1.5h again. This has been going on for 4 weeks now and I don’t know why he is waking at 4am and 5.30am every night. He would eat if I put him on but only for a few minutes. He is on medication for reflux and got winds. I also tried giving him the bottle at nights but this did not make a change either. I haven’t been feeling well lately and I was wondering if it could be that he doesn’t get enough calories during the day as he is not feeding for long during the day and thats why he does not make it through the night. Heidi, Thank you for your help. Lin
Heidi's Answer: Dear Lin, I am sorry to hear you have not been feeling well and it is absolutely understandable that you are having a difficult time. Sleep deprivation can be so tough. You hope you will find some comfort through this page on sleep deprivation effects and you can email me about it too.
I know this is not what you are waiting to hear but I do have to say that how your baby son is sleeping, is still thought normal. A maximum of 4 hours in a row is the most many babies can do at this age. Yes of course, there are also babies who do sleep longer stretches but they are far from the majority.
I'm mentioning this only to help you relax about it, just realising that it is still normal, but it's not to say there is nothing we can do to improve your nights.
An important part of the answer is in what you write in your question: "he is very often too tired for the 7pm feed" and "he is not feeding for long during the day" ... So the first step will be to help him feed more during the day. Over-feeding right before bedtime is not a good idea (it will not improve his sleep and it's not healthy), but we can work to increase his intake, spread over the whole day.
Very good of you to put him down at those regular times during the day, well timed to have them when he is tired. There I will suggest an experiment to make those naps longer, and slightly rearrange the schedule to optimise his sleep overall.
We will also make the most of his ability to easily go back to sleep again when he wakes - with your patting his tummy or rocking for just 2 minutes.
So the plan I want to suggest is this:
- Keep the 9am nap, but put shift the two other ones to slightly earlier: not much, just 10-15 minutes or so. The idea is to put him down when just a bit less tired.
- To extend the naps: about 5-10 minutes before he usually wakes from a nap (so about 50 minutes into a nap): go to him very quietly so as not to wake him but put your hand on his tummy (or something else you know comforts him. This way many moms manage to take baby to the next sleep cycle as it helps him stay asleep. I wouldn't make you do this at nights right now, the practice during the day will help him at night too.
- Feed him immediately or very soon after waking from the naps. This will have him most awake and able to eat the most. Make sure he 'empties' the first breast completely before moving to the second one (the hind milk has the bulk of the calories so you do not want to miss that). Do not offer the second breast otherwise, he might drink a bit there (because the fore milk comes with less effort for him) but not get the calories he needs.
- Squeeze in one or two extra feedings during the day, when convenient.
- Shift the 7pm feeding to a bit earlier, say 6.30pm to have him more awake and feeding more. Don't worry too much about shifting his whole night to earlier, it's all about finding a good schedule, and suitable feeding.
- Between that feed and the 10-11pm feed: try to get some sleep for yourself. It may feel awkward to go to bed that early, but if you can get about 2 hours before the night starts, that can make such a huge difference.
- At night and the early morning wakes, for now, mostly do as you have been doing so far. When he wakes though, and fusses a bit but does not really cry or is upset, wait a few moments before going to him. He may be able to settle by himself. If not, do go to him and help him to sleep asap again, with as little light and interaction as possible.
- For the early morning awakenings, it can also be worth checking a few things that might wake him (especially since 4 weeks when it started?): does it get colder in his room around that time, noises on the street or next door, does he always have a wet diaper, ...? Sometimes it's a little things like this that mess up the nights.
Other than this, he is nearing 6 months old now, an age where sleep very often settles down. So keep up the good habits like the regular and well-adapted schedule, a simple bedtime routine, no-fuss going down and then you will naturally move towards better nights.
For yourself, please do not hesitate to reach out for help. If your partner, or a family member, friend or baby sitter, can take over for even just an hour from time to time, so you get some time for yourself, that can help wonders. Sleeping is also good, but just relaxing a bit, going for a walk, reading a book or any activity you like (not what others say is good for you, but really, something YOU like) is good to do.
Good luck, take care, Heidi
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