4 month old unsettled at night

[Freckles1981]

Hi there, my LO is 14 weeks old and still continues to be really unsettled during the night. We've pushed his bedtime out to around 20.30 so that we go to bed once he is asleep and we at least get a few hours sleep.

He usually goes to sleep without too much of a fight, and then sleeps for maybe five hours. After this, he wakes up screaming maybe 6 times, and the only thing that settles him is either a feed or the dummy. More recently, the dummy has been settling him well and we've not needed to give him a feed until between 4-6am, though we still have to resettle him a fair few times before this.

We've tried putting him to bed earlier, but this means we have even more awakenings, and always had two night feeds around 1-2am and another at 4-5am.

I don't really want him having a dummy but nothing else will settle him when he wakes (he doesn't have a dummy when he goes to sleep). Should we maybe be reintroducing a night feed when he wakes up, in the hope that will keep him going for another few hours and reduce the awakenings? We've tried reassuring him, patting him etc when he wakes but he gets more upset.

His day routine is a bit all over the place at the moment but I'm trying to get him back to 3.5 to 4 hourly feeds, but sometimes he wants a feed after 2.5hrs. He usually has x4 40 minute naps during the day if we are home, but he won't go any longer than this.

Any help would be appreciated as I'm feeling completely exhausted now and don't really know what to do :-(

[katie80]

Hi and welcome to BW!

So, 14 weeks is really only about 3mo, right?  It sounds like he's sleeping quite normally for a 3mo old, a 5hr stretch is quite average for that age.  It's also very, very normal to still have two night feeds at this age (3 wouldn't be out of the question either).  It sounds to me like he might well be hungry the first time he wakes, if you're having to resettle often after that until you end up feeding him at 4-6am, so I would go ahead and feed him then and see if it helps with some of the other wakes.

It's also very normal for him to still have 3-3.5hr feedings during the day, with some 2.5hr intervals as well.  There's often a growth spurt at both 3 and 4mo, so he could have just been through one and that may be a reason for the shorter feed intervals.

Can you keep track of your EASY for a few days and write it down here for us to take a look at?  Maybe we can find a couple things to work on to try to get longer naps and a more settled night.

[Freckles1981]

Thanks katie80 :-) I think 14 weeks is classed as 3.5 months (he's now just coming up to 15 weeks). Our routine is a bit all over the place as it completely depends on when he's up during the night and when we feed him, but generally its like this:

Feed at around 4/5am (5oz) and wakes for the day at around 7.30am

E: 08.30 (6oz)
A: 09.00
S: 09.30 (40 minutes but we can usually get him to sleep for another 30 minutes after doing a bit more A time in-between)
E: 12.00 (6oz)
A: 12.30
S: 14.30 (40 mins)
E: 15.30 (6oz)
A: 16.00
S: 16.30 (40 mins)
E: 18.30 (4oz)
A: Bath
E: 19.30 (4oz)
S: 20.00 (bedtime)

We were finding that if we fed him after the bath only, that he would only take a small feed and then fall asleep on the bottle, hence the feeding before and after the bath. This means that he goes in his cot awake now and we leave him to settle himself to sleep with minimal fuss.

His feed times are pretty regular now but his activity & sleep times are still pretty fluid. I look out for his sleepy signals before taking him to his cot, but I have a real fight to get him to nap in his cot. He also usually needs a nap after being awake for around 2hours.

Is there a certain point/time in the afternoon that we should stop him from napping so it doesn't mess up his night sleep?

[katie80]

Ok, so let's go with 3.5mo. It looks to me like he's probably going to bed quite overtired as his last short nap ends just after 17:00 and he's not going to bed until 20:00. That means he's been up for almost 3hr by bedtime and is likely crashing. Going to bed OT can be a cause of unsettled NWs. I would try to keep your day no longer than 12hr at this point, especially as he's having lots of CNs.

His A time is definitely on the high side at 2hr. Are you only ever able to get the second half of a nap in the morning?  Are you ever able to resettle naps or use wake-to-sleep to extend them? How do I address habitual wakings? (wake-to-sleep and other methods) He's at a tricky age for napping (lots of LOs do degelopmentally short naps from around 3-6mo), but I think if you could resettle a couple naps during the day that would help you get to BT without so much overtiredness. Does he sleep longer naps in a wrap/sling, stroller, or swing? It might be worth doing an APOPd nap like that once a day to get at least one restorative nap.

He's taking great feeds during the day. I think what you've done with splitting up the bedtime feed is wise. He may still need two NFs, especially as he comes up on the 4mo growth spurt. But, I think solving some of the daytime sleep issues, might help your nights the most.

[Freckles1981]

You are my very own Baby Whisperer katie80 ;-)

So I have tried the wake to sleep method for his naps yesterday and today and I've managed to extend them to around 1hr 45 each, so we are doing two of these naps a day plus a 40 minute catnap in the last afternoon. This has worked for both of his naps yesterday and today so I'm feeling positive on that front, but at what point should I stop and see if he can make it through his first sleep cycle by himself?

On the down side, his last two nights have been more on the bad side even though we've gone with an earlier bedtime so that he's not up for more than 12 hours. Last night he woke 5 times, the night before was every hour from 11pm. I'm so exchaused that I kinda feel like I have a hangover :-(

He still won't fall asleep or show any tired signs until he's been awake for around two hours. If I try and put him down earlier, it's a real fight, but at 2 hours the crying isn't quite as intense.

Since LO was going till about 4/5 am without a feed, I have been reluctant to introduce a dream feed as it means one of us has to get up another time (we go to bed when LO does to try and get a block of sleep), do you think it's worth trying this now? Should we perservere with the NWs a bit longer is the hope that the extended naps and earlier bedtime might work?

I had really thought that the nights might have been easier by 3/4 months, but it just seems to be getting worse and we're really at the end of our tether with it now x

[katie80]

You are my very own Baby Whisperer katie80 ;-)

LOL, don't give me too much credit... I'm only repeating what I've learned on here!

So I have tried the wake to sleep method for his naps yesterday and today and I've managed to extend them to around 1hr 45 each, so we are doing two of these naps a day plus a 40 minute catnap in the last afternoon. This has worked for both of his naps yesterday and today so I'm feeling positive on that front, but at what point should I stop and see if he can make it through his first sleep cycle by himself?

Super!! Tracy recommended to do W2S for 3-7 days and then leave him and see what happens. I'd try it for a week and then leave him. If he wakes, try it for another week and hopefully that will do it.

On the down side, his last two nights have been more on the bad side even though we've gone with an earlier bedtime so that he's not up for more than 12 hours. Last night he woke 5 times, the night before was every hour from 11pm. I'm so exchaused that I kinda feel like I have a hangover :-(

Ugh, I know that feeling. (((Hugs))) I'm thinking it's because he's not crashing and sleeping a decent stretch, but let's give it a couple more days and see what happens, crossing our fingers that he comes around. Can you post what your EASY looks like with the longer naps?

He still won't fall asleep or show any tired signs until he's been awake for around two hours. If I try and put him down earlier, it's a real fight, but at 2 hours the crying isn't quite as intense.

Totally fine... he's just a higher A time kid is what it sounds like.

Since LO was going till about 4/5 am without a feed, I have been reluctant to introduce a dream feed as it means one of us has to get up another time (we go to bed when LO does to try and get a block of sleep), do you think it's worth trying this now? Should we perservere with the NWs a bit longer is the hope that the extended naps and earlier bedtime might work?

No, I don't think you need to try a DF at this point. Get the sleep you can and let's see if he comes around with the better daytime routine.

I had really thought that the nights might have been easier by 3/4 months, but it just seems to be getting worse and we're really at the end of our tether with it now x

More (((hugs))). I think 3-4mo can actually be a tricky time, and some babies are trickier than others. Have your nights always been rough? Does he have any signs of pain from reflux or a food intolerance, possibly? Reflux 101 - General reflux information, Does my LO have food intolerances?

[Freckles1981]

So things are now more like this....

Feed at around 3/4am (5oz) and wakes for the day at around 7.30am. These timings are give/take maybe 15/30 minutes but we are trying to ensure he is down for the night by between 7.30pm latest.

E: 08.00 (5/6oz)
A: 08.30
S: 09.50 (approx 1hr30 to 1hr50 max)
E: 12.00 (6oz)
A: 12.30
S: 13.30 (approx 1hr30)
E: 15.30 (7oz)
A: 16.00
S: 17.15 (40 minutes max)
E: 18.15/30 (3/4oz)
A: Bath
E: 19.15 (3/4oz)
S: 19.30

Last night, as the timings went slightly right, we cut out the feed before the bath as we didn't think he'd been long enough since the last feed to take a substantial amount. He then took 6oz at 19.00 and was in bed by 19.30.

My partner has introduced a dream feed for the last few nights (out of frustration!) at 10.30pm but we can't get LO to take more than 3oz, so I think this may be pointless as he's waking 2.5hrs after this. It's quite an effort for us as we have to put the alarm on to do the dreamfeed as we still go bed early.

LO is now waking at 1am, 2am and/or 3am, 4am & 6am.

A few weeks ago, he was going around 6 hours without waking, and then sometimes not taking a feed for 8 hours (usually 4am).

Is there anything else you can think of, or that looks like it needs tweaking? We are waiting for a local night nanny/sleep trainer to become available but she doesn't have availability for a few weeks yet so we really need to get things improved quite quickly.

[katie80]

Hmm, the EASY looks good... he's still on the lower end of the sleep spectrum, but I don't really think that's an issue. He may just be lower sleep needs.

TBH, I'd stop offering the DF if it's that hard to rouse him and get him to take more than a few oz. I can't remember, but what if you didn't do the DF and then fed him at 1am when he wakes. Would that be more inclined to get rid of the 2/3/4am wakings?

Can you tell me a little bit about what happens at the NWs? Is LO upset right away or just waking and babbling? How do you settle him? Could he be hot/cold? And you don't think he's in any discomfort from reflux or intolerances?

[Freckles1981]

He always wakes up quite upset....certainly no babbling! If we don't respond to him very quickly, he works himself up and becomes even more difficult to settle.

When it comes to settling him during the night (when we're pretty sure it's not hunger), he doesn't respond well to sshh pat or PU/PD. I am maybe too weak for PU/PD but he gets so distressed and it escalates. If we give him a dummy, he settles almost immediately but I'm concerned that he'll get attached and it will become a prop (maybe it already is). He doesn't go to sleep with a dummy, nor does he really have it during the day unless we are out and he becomes really upset, but he does need it for naps.

We've tried different blankets at night to see if this makes him more comfortable but I don't think this is the issue as his chest/back never feels either too hot/cold.

We are still swaddling him (he's now approaching 16 weeks), and sometimes he manages to break free but we re-Swaddle him. Perhaps we are at the point now of seeing if he can sleep without swaddling?

We've been to the Doctors and Health Visitors so many times now with concerns about his sleeping & health (q: potential reflux) but he doesn't show any consistent symptoms. They gave us Gaviscon to try for a week which made him so so constipated and his NW were worse. Tilting the cot & keeping him upright after feeds have made no difference.

Going back maybe two weeks or so, he was some times sleeping through till 5/6am. He was on less formula over a 24hr period at this point & was going to bed later around 20.30 (cluster feeding at 6 & and taking short naps.

Then he started waking at 2am & 3am and we'd settle him with the dummy but still feed at 5/6am, and then it got progressively worse with 2am, 3am & 4am, so we would feed at 4am (this was quite cosistent for a few weeks), then he woke hourly for a few days. Now he's waking earlier at 1am, 2 and/or 3am, 4am & 6am so we usually feed once he's woken maybe twice & if that wake up is close to the previous wake up (and he won't settle with the dummy).

Perhaps we should just feed him when he first wakes now rather than settling him? I was concerned about doing this as we know from the past that he used to go at least until around 4am and I didn't want him to relate waking to being fed and then getting into more bad habits.

[katie80]

Ok, a couple thoughts... there is a often a sleep regression and a growth spurt at 4mo.  So, I'd first try feeding him at the first NW and see if it makes a difference with the others.  Does he seem uncomfortable from trapped air at all?

Second, I'd be mindful of the paci. It's about this age (during the sleep regression) that it can start to become a prop.  You mentioned he doesn't need it to go to sleep, but does need it for naps? Does he use it to go to sleep at naptime, but not bedtime? Do you need to replug during naps or only use W2S? I'm wondering if the NWs are habitual, if it would be worth it to try W2S in the MOTN as well. You certainly don't need to use PUPD at his age, he's quite young.  I'd stick with shh/pat, if possible.

Finally, some LOs do in fact sleep better once they are unswaddled, so if he's starting to break out that may be a sign he's ready to go without.  This may make the paci more of an issue, if he starts knocking it out, or he may find another way to self-soothe, with his hands/fingers.

What do you think?

[Freckles1981]

I apologise for the essay below......

We've now gone with feeding him when he first wakes during the night, which usually falls soon after midnight (so about 4/5 hours after his last feed).

He then wakes up again around 3/4am, and nothing settles him so we feed again. He then starts waking for the day at around 6am but at this point I use the dummy to try & get him back to sleep until 7/7.30am.

At his night feeds, he takes maybe 1 or 2oz less than he'd usually take during the day.

When we start the day at 7/7.30am, he's not really hungry and takes a small feed. Should we move his routine right so that he takes a good feed a bit later in the morning? I've been trying to keep his feeds & naps times as consistent as possible and on occasions, this means waking him up by 7.30am which maybe isn't wise?

He definitely isn't waking from wind, though this did happen a few nights ago after he took a huge feed before bed. We winded him and at this point it was 10pm, so I tried him with a feed and he then skipped the midnight feed at woke at 3.30am and then slept till his usual time. One thing that has crossed my mind is waking him to fed before my partner goes to bed and see if he again drops the midnight feed, what do you think? We tried dream feeding but that didn't work. One night feed would be A.M.A.Z.I.N.G

With regards to the dummy, I only use this during naps and not during the night. I try and fight him to take naps without (!!!) but as soon as the dummy goes in, he starts to drift off. He won't go past 40 minute naps without W2S (though this isn't always successful), and it's variable if I have to replug the dummy. Sometimes it will still be in, other times he's actually woken and I replug it to get him back to sleep, sometimes he doesn't need it.

I have tried unswaddling him on the times that he's really fought it but only during naps, but he will wake after 40 minutes so I'm not sure if he's quite ready yet as he still startles easily. We only swaddle him arms. Is this something that we should perservere with for a minimum of 3 days?

Our routine is now like this......

E: 07.30 (4oz)
A: 08.00
S: 09.15
E: 11.30 (5oz)
A: 12.00
S: 13.30
E: 15.15 (5/6oz)
A: 15.30
S: 16.30
E: 18.00 (3/4oz)
A: Bath
E: 19.00 (5/6oz)
S: 19.30

One of the other difficulties we have is when he does only nap for 40 minutes, his routine goes a bit off. For example today, his morning nap lasted 45 minutes, so until 10am. I still fed him at 11.30am, but he's tired and is now napping from midday. Is this right, or should I keep him up longer so his nap remains at a consistent time?

When he does wake up during the night his eyes are usually closed but he's very upset (no tears though). If we don't respond quickly, he does fully wake himself which was why we were previously using the dummy to settle him quickly rather than feeding him.

[katie80]

Hmm, it's a tough one to figure out, isn't it. The extra feed at the first waking seems to be helping with the hrly waking, but then he isn't as hungry first thing in the morning. It may be worth trying to wake/dream feed him at 10 and see if you can get just the one waking. Was your partner previously trying at 10:30? Maybe that was messing with his sleep cycle and 10 would be better.

Should we move his routine right so that he takes a good feed a bit later in the morning? I've been trying to keep his feeds & naps times as consistent as possible and on occasions, this means waking him up by 7.30am which maybe isn't wise?

I think waking him is just fine and probably sets a good precedent for consistency. You can always wait til part way through the A time to feed and gradually work your way back to first thing throughout the day... that's pretty normal around this age, when you're still doing 2+ NFs.

I do think the paci could be an issue if you're having to use it to extend naps and at NWs. However, I think part of this could be down to needing a bit more A time in your routine. Because you're still getting a 6ish am NW that takes effort to resettle and the morning nap is sometimes only 45min, I think it's time to start pushing that A time to 2hr, as both of those things are signs of needing more A time. I wonder if you start upping the A time and gradually cutting the third nap shorter if that may help your nights. I'd try these things before you start looking closer at the paci. And even then, some parents choose to keep it and continue replugging until LO is able to do it on his own.

As for swaddling, it sounds like it's maybe best to keep it for now. Many LOs are swaddled until they show signs of rolling... until 5/6/7mo, although some do sleep better without it earlier.

For example today, his morning nap lasted 45 minutes, so until 10am. I still fed him at 11.30am, but he's tired and is now napping from midday. Is this right, or should I keep him up longer so his nap remains at a consistent time?

Yes, it's fine to move the second nap earlier if the first one is short. If you keep him up til normal time, he may become OT and then short nap again. Hopefully, a little more A time will help with that.

[Freckles1981]

Just when you think it can't get worse......for the last few nights he's not settling well for bed and waking up another 2/3 times not long after settling 

We had tried dream feeding previously at 10.30 and did this for 5 days, but he was just too sleepy and wouldn't take much more than 3oz and then still woke through the night. We tried changing the DF time slightly by 15 minutes to catch him during a different sleep cycle but this didn't work. I'm thinking that if he's actually awake and registering that he's hungry and feeding, that he will take more though it does go against the grain having to wake a sleeping baby but desperate measure eh 

I pushed him A time out this morning to 1hr55 and he was quite grottya by this point but he settled much easier for his nap and has so far been napping for just over 1hour which is progress.

I tried feeding him when he woke this morning which was three hours after his last NF but he wouldn't take the bottle so I fed him half way through the A time as suggested (so that he'd been 4 hours without a feed at this point). He did take the feed much better but it was still a little short on his normal volume which I'm hoping he'll make up for on his next feed.

Let's see how the next few days ride out with these changes...hopefully something will click into place soon 

[katie80]

Oh (((hugs))), hon. I'm sorry to hear the last few nights have been more difficult. 4mo can really be a sucky time for sleep. Hang in there.