4 month old waking hourly in the night

[katiescarlett]

Hi, new to the forum, really hoping someone can help me. I'll try to keep it brief, not least because dd is currently asleep in my arms which isn't making typing too easy!

She is exclusively breastfed, never had any problems, other than frequent night waking. We've had a good bedtime routine of bath, boob, bed for about 2 months now. The night wakings were manageable until we hit the 4 month sleep regression about 3 weeks ago at which point she went from sleeping in 4 and 2 hour blocks to 2 and 1 hour blocks. She's been waking every hour for most of the night for about 3 weeks now and I just can't take it any more. She's in a bedside crib with me, daddy is in the spare room.  As soon as she stirs, I pick her up, give her boob which gets her straight back to sleep. Since I nurse her to sleep at bedtime too, obviously I have created a strong sleep association with boob which I need to break. Most of the time she just suckles for a few minutes and falls asleep again. I've been trying the Pantley pull out method but sometimes she's asleep before I even get the chance!

So we've changed the bedtime routine so I feed her after bath in a different room and I'm going to try leave a few minutes between that and putting her to bed. I'm also introducing a comforter but that obviously takes time to build the association. She won't take dummies.

During the day I've always got her to nap in the pram either walking around or pushing up and down in the kitchen. Or out and about in the car. If daddy is at home he rocks her to sleep in his arms and she generally stays there. She very rarely naps for more than 45 minutes and usually 4 times a day. Again, more unhelpful sleep associations I can now see. So today I tried to get her to sleep in her cot. After 1.5 hours of pick up put down I had to concede defeat because she was actually screaming and was too wound up to sleep on her own. She's been asleep in my arms for a few minutes now and is still doing that hiccuping thing you do when you've been crying really hard. So now I feel really cruel, I probably should have given up sooner.

If anyone can please offer any advice I'd be really grateful. I'm at my wit's end. I don't mind feeding her every hour in the day if that's what she wants but it's completely unsustainable to wake up every hour all night, and it's not good for her sleep either. If I leave her in the night to settle herself she just cries louder and louder until I pick her up. I know she can settle herself sometimes because she's not always asleep when I put her down at bedtime and she did get herself to sleep last night after 30 minutes or so and 3 trips upstairs to settle her down. Last night was the first time we changed the bedtime routine slightly by feeding her in another room then carrying her through.  Sorry if I've babbled, I'm exhausted and a bit delirious! She's 20 weeks old this week.

[Layla]

Hi and welcome to the BW ,

If she is relying on props to get to sleep during the day and night, some sleep training is probably required so that she can learn how to self settle. Dd2 was around 4 months old too when I had to stop all the props (holding, rocking, boob, dummy/paci, sling) and start doing naps in the cot and settle at night without the boob or dummy!

What I did was create a set nap and bedtime routine and put her down drowsy but awake. Mine was also fed to sleep almost always and so I had to bring back the feeds. I would put her in the cot and leave. If she started crying right away, I would come back and do shh/pat. Even though the BW recommends pu/pd from 4 months, I found shh/pat better than the pu/pd technique and I would pick her up if she was really distressed, give her a cuddle and then back in the cot. I put a limit on the shh/pat though and my limit was 20mins. If she wasn't asleep by that time, I would get her out of the cot and out of the room, give her more A time and watch for tired signs. As soon as I saw a tired sign, I would get her back in the cot and start shh/pat if she needed help. If E was due then I would feed and afterwards try S. If she was falling asleep by the breast, I would gently end the feed and try for S. You will have your E's and S's all over the place but try to stick to at least 3hrs E's if you can so that she's taking a good feed. If mine woke early from nap (say 45mins into the nap), I tried for another 15mins to resettle (so up to an hour from when she'd fall asleep) and if she wouldn't resettle, I would forget resettling and get her out of the room. I didn't swaddle my girls and so I would lay her on her side (your dd may/may not like this) and away from me. I used to put my arms through the cot bars and shh/pat until she would settle down and then slowly stop shh/patting. You will notice there will be a peak in the crying and then she will start to settle down. At that point, I would slow down the shh/patting until she was close to being asleep. For the first couple of times you can shh/pat until she's very close to being asleep but be careful doing it every time as she may expect to be patted to sleep. Dd3 liked her head/forehead being stroked... you'll find what works for your lo and use that to help her settle. If during shh/pat, she's mantra crying, you leave her as this is her way of learning self soothing. You only help her if she's crying the "I need you" cry...

It will not be easy and there will be lots of tears but I promise you, if you are consistent with the approach, she will learn how to fall asleep on her own (whether it is rubbing her ear, her hair, sucking her thumb, or whatever) and it will get better. It took us 2 weeks of shh/pat before I could put my daughter down awake and leave the room without any crying. Her naps were still short and short naps can be developmental at this age too but it was amazing not having to worry about her needing anything to get to sleep. Mine started sucking on a corner of a blanket that I would put her down with.

With dd3, I did the same thing (although I started much earlier than 4 months) but I did the 3rd and 4th nap in the sling rather than the cot so that I could get things done with dd1 and 2. A lot of other mums do that too.... you can AP the catnap because the late afternoon nap is often the harder one for babies to settle for... maybe it has something to do with them being overstimulated by the end of the day. So, you could perhaps keep one nap in the pram but try the morning and afternoon nap in the cot.

Make sure the room is nice and dark. If you have a white noise machine, use it so that she doesn't get easily woken up by noises and try to have a set nap time routine so she knows what's coming up.

She probably doesn't need to be fed every hour (day or night). It would be good to space out her daytime feeds too so that she takes in a good amount (I always offered both sides) and not snacking, which can also contribute to short naps.

At night, my rule of thumb was to follow the same E's as during the day... so if she woke anywhere from 4+hrs, I would feed and if less, I would try and resettle. In your case, you could start with 3+hrs and so if she wakes before 3hrs from last feed, you try and resettle and if its more you feed and back in the cot. No lights, no nappy changing (unless soiled and/or leaked)...

I moved dd2 (the one I had created all the sleep props with) out of our room at night too when I committed to sleep training because my moving around in bed and my dh's snoring was waking her up and she was waking me up. I was responding to her too early too and not letting her resettle. Our nights got better almost right away and daytime sleep followed.

The other thing that helped me was to send DH in to resettle. He didn't help as much with dd2 but with dd3, I got him on board and she would settle a lot quicker than when I tried it...might have had something to do with her knowing I had the goods and he didn't

It will also help her if she's not overtired by bedtime. Could you please post what your day looks like (or the last 3 days have looked like)? When a baby is kept awake for too long before bedtime, that often leads to restless sleep and the baby will find it harder to resettle. How long is she awake for before you attempt naps?

Sorry for the ridiculously long reply ...what do you think?

[katiescarlett]

Hi Layla, thanks very much for the reply. 

I've never tried shush pat, at least not properly as per the instructions. When I'm holding her and settling her that way, I often pat her back in a heartbeat rhythm and shush which works well. The one thing I don't get about shush pat is that babies are meant to sleep on their backs right? So are you meant to leave them on their side or roll them back onto their backs? If so, at what point do you do that?

Our room is very dark once the curtains are drawn. Just about light enough that you can walk around, if you know what you're doing(!), but nowhere near light enough to read or find stuff really.  I do have a white noise app on my phone though haven't used it since the bad old days of the evening meltdown / witching hour. Tbh once I read the Baby Whisperer and realised the problem there was overtiredness, that doesn't really happen any more. We went through a phase of taking her out in the car every night for nearly a fortnight to get her to settle. I once went out at 2am on my own with her I was so desperate, it was an awful time. Anyway, those days are behind us now thankfully.  I watch carefully for her tired signs and try to get her down as soon as I can. Though weirdly recently she hasn't been making them, or I've been missing them, so I've been keeping an eye on the time and I try not to let her be awake for more than 2 hours at a time during the day.  This isn't always possible though when we're out and about. Partly logistically but partly cos she just loves being the centre of attention when we go visiting people. And those people just love her and it's really hard getting her off them to get her down to sleep! Even when I do prise her away from them, she's usually too worked up to sleep then and there often isn't anywhere other than the car seat or pram to put her in.  Sometimes I have to leave earlier than intended just so she can finally get to sleep in the car or pram. 

She's always been a very fast feeder. I'm not sure how much is that she's a very efficient feeder and I have super fast let down (it sprays like mad if she comes off too soon!) and how much is that she is a bit of a snacker. She definitely feeds for longer if it's been a long time between feeds.  So I should aim for around 3 hours between feeds, at least to start with?

So if she wakes in the night and it's been less than 3 hours since she last fed I should try and settle her in other ways? Is it ok to use stuff I know works like walking, rocking etc until I've got the hang of shush pat? How long do I stick to it if it's not working?  I've got to admit the prospect of getting up and doing this at 3am is very unappealing but I know you're right that it needs doing. She woke up a few times as usual last night and she does always feed for a bit, particularly in the first 2 wakings. I've been trying to do the pantley pull off as soon as it seems she's falling asleep again, though last night she really cried when I did that so I had to let her fall asleep on boob.

I have a bedside light on very low all night, it's one of those sad light things. I don't turn it up when I feed her and she very rarely needs changing before morning. 

I'm not ready to put her in her own room yet if I'm honest and don't really want to until she's 6 months. I have to go back to work when she's around 7 months so I'm hoping that month will be enough to get things settled.

So she generally wakes up around 7.30am. I feed her in bed then get a shower while she plays on the bed, nowhere near the edge obviously! We tend to potter around in the bedroom for an hour or two until it's time to go out. We have an activity most mornings, play groups, baby massage etc. Depending on timing I try to get her to sleep in the car seat before we go out so she'll get a long enough nap as most activities are quite close and she usually wakes up once we get there. I usually feed her when we get there, or after in the case of baby massage. Then we usually come home again, she often falls asleep on the way back.

We either potter around at home in the afternoon and we often go for a walk in the pram, she usually sleeps for more of this and I try to be out for at least 45 minutes.  Otherwise we go see people in the afternoons, either go to my office (I run my own business so have to pop in and do stuff while the staff fight over who gets to play with her!) or I go to my mum's work when again she's the centre of attention and I get to put my feet up for a bit.  We've just started swimming lessons this afternoon which she absolutely loved, she's completely fearless and just loves water.

Daddy gets home around 4.30pm and takes over then. He plays with her, sings to her, takes her out in the sling etc until bathtime at 6pm sharp, by which point she's pretty tired. She perks up for that though, I think it's her favourite activity of all. That generally takes around half an hour at which point we dress her for bed and I feed her. I used to feed her to sleep in bed, we've got a bedside crib so I feed her where I sleep sat up in bed then literally just reach over and put her down. But for the last 3 nights I've fed her in the spare room until she's falling asleep then daddy puts her down.  She goes down with absolutely no problems then, we haven't heard a peep from her last night or tonight. She usually wakes up around 2 hours later which is when I go to bed. Then again 2 hours later. Then after that I can't say for sure because my brain is so fogged that it's hard to keep track. On bad nights it's every hour. Last night was a bit better I think. Before the 4 month regression she used to go 4, even 5 hours sometimes between bedtime and her first waking. It was wonderful!

Think that's it. Oh and I've introduced a comforter. I have it there when I'm feeding her and encourage her to hold and play with that instead of my top or bra as she usually does. And I'm leaving it in the cot with her and with her whenever she's asleep in the car seat.

We've never swaddled, partly due to worries about hip dysplasia and also because she absolutely hates it. She's a thrasher and hates being constrained at all. The moses basket didn't last long at all for that reason, I realised she was waking herself up by hitting her arms on the sides as she thrashed herself to sleep!  She had a cold a while ago and is still a bit snotty sometimes. I regularly put a bit of saline water up and suck any big bogies out if needed.  She seems to find farting a bit painful sometimes but not excessively I don't think. We've just recently started giving her a tiny bit of food, just a couple of weaning spoons of porridge or mushed up banana, if that. She hasn't really got the hang of it yet but we thought it was worth a try!

I think that's it. Thanks so much for your help and advice  Sorry for the epic reply!

[katiescarlett]

Sorry one more question, how soon after sleep should baby eat? Does it matter? thanks

[Momoq75]

I have the same problem, my dd wakes up every 45-60 mins if sleeping on her back.  She had severe gas pains from birth to 2 months old from my oversupply of milk.  So I noticed that she passed gas easier if she was sleeping on her side.  So, now if she's put down at bedtime on her side she'll sleep for 4-5 hours but now I want to sleep train and when I put her on her back she falls asleep in about 20 mins but wakes up every 45-60 mins. 

My sleep consultant told me she's used to sleeping on her side and it can take 3-5 days to break that habit.  She said I should prepare myself to work the nightshift.

[Layla]

I've never tried shush pat, at least not properly as per the instructions. When I'm holding her and settling her that way, I often pat her back in a heartbeat rhythm and shush which works well. The one thing I don't get about shush pat is that babies are meant to sleep on their backs right? So are you meant to leave them on their side or roll them back onto their backs? If so, at what point do you do that?

Could you gently roll her on her back before you leave?

With tired signs... sometime around 5 months, we lost our tired signs and went by the clock (even earlier than that) and I started offering her naps at around the same time. Our "by the clock" naps were more or less in line with the av A times though (with the exception of the morning nap, which was sometimes over the av A time if she had an early waking). I tried not to get out of the house at nap times so that she would have a good sleep in the cot (as pram/car seat naps would almost always mean short naps). If I had to go out, it was a local trip and back in time for a nap. Or if I had to go out, I would wait until her evening nap was due so that she could have a sleep in the car as the 3rd nap is often a short nap anyway...

You don't have to move her out of the room, especially if you're not comfortable doing that! I did find dd's night sleep improved when she was in her own room but it was probably because I wasn't responding to every single moan/stir , etc... and gave her a chance to resettle.

She's always been a very fast feeder. I'm not sure how much is that she's a very efficient feeder and I have super fast let down (it sprays like mad if she comes off too soon!) and how much is that she is a bit of a snacker. She definitely feeds for longer if it's been a long time between feeds.  So I should aim for around 3 hours between feeds, at least to start with?

So if she wakes in the night and it's been less than 3 hours since she last fed I should try and settle her in other ways? Is it ok to use stuff I know works like walking, rocking etc until I've got the hang of shush pat? How long do I stick to it if it's not working?  I've got to admit the prospect of getting up and doing this at 3am is very unappealing but I know you're right that it needs doing. She woke up a few times as usual last night and she does always feed for a bit, particularly in the first 2 wakings. I've been trying to do the pantley pull off as soon as it seems she's falling asleep again, though last night she really cried when I did that so I had to let her fall asleep on boob.

Yes, I would try and stretch her to 3hrs and apply the same to night wakings. Personally I wouldn't be introducing new props or walking, rocking, etc.. if you're committed to sleep training... I would just do shh/pat. Some babies past 3-4 months don't respond well to shh/pat so ppl use the pu/pd method but I've always had great success with shh/pat and dd3 responded really well to it past that age. I know of the Pantley method (I have her book too) but I found it easier to just stop all the props... If you prefer the gentle removal plan... here's a link you might find useful Gentle Removal Plan

It's interesting that before 4 months, the props weren't an issue and a lot of others (myself included) notice that they often aren't and then something happens (maybe it has something to with baby's brain development and being more aware) and the baby will need those things to get back to sleep at every awakening, if you know what I mean!

Sorry one more question, how soon after sleep should baby eat? Does it matter? thanks

I fed almost right after wake up time/nap times.... but if the nap was short, I would wait a bit and tried to feed closer to the 3.5hr mark. In the evenings, we cluster fed so it wasn't every 3.5hrs, sometimes it was only 2hrs from last feed but we did one side only and then I would give her the other side right before bedtime.

Be careful with introducing solids too early... milk is much more important than solids as it has more calories and you could get into a situation where solids are interfering with her milk intake.

Oh and for the snotty nose.... breast milk is absolutely amazing for that!!! Dd3 had a cold when she was just 8 weeks old and I read up on it and expressed some breast milk into a cup and used that instead of saline drops. Her snots cleared up within days! 

[katiescarlett]

Thanks for your reply.  Well we tried shush pat just now for her first morning nap and it didn't work at all.  The first problem was that she really didn't want to be laid on her side. We've never done that and I imagine it felt weird for her. She just rolled over yesterday for the first time, front to back by the way!  So I tried patting her chest and shushing. She got really annoyed really quickly and cried really loudly. So I picked her up and shush patted on my shoulder until she was calmer, put her down and tried again. I did this 3 or 4 times but each time she was getting more and more worked up so I conceded defeat and put her in the car seat where she went to sleep in 5 minutes flat.  I'm not sure if I should have given up so quickly but I felt like she was just getting more and more worked up and continuing was making it worse not better. 

I'm going to give it another go when she wakes in the night and see how that goes. Is it ok to pat their chest if they won't go on their side? I've read that it makes some babies worse, is that true? if so should we try pu/pd instead?

According to the BW she's textbook but I would also say she's a very determined baby, she's definitely got her parents' stubborn streak! I'm wondering if we've left it too late? Thing is, I don't mind her sleeping in the pram in the day or whatever it takes but it's just the frequent night wakings I can't take any more. I'm so tired I'm having frequent dizzy spells, my eye is twitching and I'm starting to feel quite low. She's started to go a bit longer in the night now, 3 hours to start with then 2 then 1. But last night she was awake at like 3am for over an hour. Not crying thankfully, just lying there talking to herself (quite loudly!) and thrashing around! I didn't pick her up or anything and eventually she got herself back to sleep but I couldn't sleep at all with the noise.

Incidentally bedtime is going better than ever. Last night she didn't even get sleepy on boob so we put her down once she'd had a good feed and we didn't hear a peep out of her again! Maybe after a few more nights of that she'll get better at self settling during the night?  She obviously can self settle because she's doing it at bedtime,even when she's wide awake at bedtime like last night. When she wakes in the night, I should ignore her until she actually cries right?

I am trying to extend the time between daytime feeds but it doesn't always work. Like yesterday I went to see my mum and was putting my feet up for a bit. She'd just had a good sleep so I knew she wasn't tired and had eaten 2 hours before. She was screaming absolute blue bloody murder so eventually I fed her and she fed for ages.

Yes I think this bad phase all started right around the 4 month mark, right when the Wonder Weeks said it would. According to which we've still got a week to go... She's definitely learned loads in this time, grasping, putting things in her mouth, being more vocal, rolling, moving etc. From that perspective it's been a wonderful time, if I could only sleep for a bit longer things would be golden!

Re solids, we're just trying literally a tiny weaning spoon of porridge or banana every now and again, not even always every day. I know they can't really have solids until 26 weeks but we were told it was ok to start introducing a little bit at this point to get them used to it. I'm so worried about the fact I have to go back to work when she's 7 months old, particularly as she won't take milk from anywhere except my boobs! That was the other thing, we've been trying to get her to take a bit of formula from either a bottle or a sippy cup with no luck so far. I'm starting to think she doesn't like formula, or maybe certain brands of formula? Next step is to see if she'll take EBM from a cup or bottle. I know once I'm back at work I can feed her before I leave and when I get back but that's not ideal for her and it also makes night feedings more likely, the thought of which makes me weep if I have to work too. It's hard enough now but being woken up all the time when I have to work too is a truly awful prospect. Also it would be nice to be able to leave her for an afternoon to go get my hair done or sleep or whatever. And we have a few social events this summer, a wedding, hen do and a concert, none of which are going to happen if I can't leave her for more than 3 hours. I suppose part of our rationale for starting her on solids now is that she'll hopefully take to them really easily once she is old enough and at least then if she's still refusing bottles or cups, she'll be eating plenty when I'm at work.  Anyway, that's a whole other problem!

I've read that too about breast milk and snotty noses. How did you get it up her nose?!!

Thanks again for your time and replies :-)