Help with PUPD / 5.5 month old sleep

[Josi2015]

I'd be really grateful for some help with getting our lo's sleep/routine sorted out. She is 5 and a half months. Up until a few weeks ago she was sleeping pretty well but now we're all over the place and need some help to get back on track.

I know people often post their EASY routine but we're so off track at the moment I don't really have a typical day to post. However, in general we aim for a 7:30am to 7:30pm day, although this sometimes gets pushed either end depending on what time she wakes in the morning/what time the last nap of the day happens.  Our LO is exclusively breastfed and feeds approximately every 3hrs15 (we have just started trying solids this week but she is only taking tiny taster amounts at the moment). I know Tracy says to get babies onto a 4 hour routine after 4 months but our LO doesn't seem to be able to last this long between feeds.

Apart from the first morning nap, we've always struggled to get her to nap for any decent length of time which has made it difficult to follow an EAS pattern. However, I think the key things we've taken from the baby whisperer are not to feed her to sleep and to watch her awake times (we've been following the guidelines on this site as well as watching her tired cues).

Although I don't feed her to sleep, we have always rocked her to sleep and most attempts to get her to settle in the cot have been unsuccessful (although we have never tried any proper sleep training). We always knew we'd have to tackle this at some point but until recently it wasn't a problem - we could rock her to sleep in about 5 minutes and she was sleeping most of the night with just one feed at about 4-5am. Even though naps were inconsistent she seemed like she was getting enough sleep during the day. That has all changed recently though, probably as a result of a 4 month sleep regression. Now it takes closer to 20 mins for her to fall asleep on us and recently she has been waking when I try to put her down. This has resulted in quite a few very short (20 minutes or so) naps as I've not been able to get her back to sleep again. She's also now waking several times at night. She is still only feeding once but that feed is often more like 2 or 3am rather than the 4-5am it was.

We've realised that the time has come to work on putting her in the cot awake and settling herself to sleep and are thinking of trying PUPD in a couple of weekends once my husband is back from a trip abroad. We'd be really grateful for some advice on when would be the best time to do PUPD and any changes we should be making to her "routine" before we attempt it.

In particular we've thought of the following questions:

1. Are there any changes we can/should make to her routine before trying PUPD and how long should we try them for before doing PUPD? I know we need to work on getting longer naps but I'm not sure how we can do that without addressing the rocking to sleep issue.

2. What should we do with awake time when she has had a really bad nap? We are aiming for nearly 2.5 hours awake time now and it seems quite hard to get her to sleep again any time earlier than about 2 hours even when she has only had a very short nap.

3. Does it matter that feeds are not 4 hours apart?

4. We are looking to move our LO to her own room shortly. Is it a good idea to do this before or after trying PUPD? We're nervous about making too many changes at once but also don't want to end up having to redo PUPD when we move her.

5. I've read that babies often develop separation anxiety at around 7 months. Is it best to do PUPD before this happens or are we likely to have a regression once separation anxiety sets in?

6. When we start PUPD, do we do it for night wakings too? What about the feed (when I think she is genuinely hungry as she takes a full feed and wakes at different times every night)?

We'd really appreciate some advice from people who've been there as we're completely off track at the moment. Thank you.

[becj86]

1. Are there any changes we can/should make to her routine before trying PUPD and how long should we try them for before doing PUPD? I know we need to work on getting longer naps but I'm not sure how we can do that without addressing the rocking to sleep issue.

Yes, it sounds like she not tired enough, hence taking a long time to get to sleep - a suitable routine for her age will help with this and probably the nap length too. PUPD is a last-resort method and should not be used until you've got the routine right and you've tried some other method of sleep training consistently for at least 2 weeks with NO improvement.

2. What should we do with awake time when she has had a really bad nap? We are aiming for nearly 2.5 hours awake time now and it seems quite hard to get her to sleep again any time earlier than about 2 hours even when she has only had a very short nap.

A time at this age, nearly 6 months, can be more like 2:45 and even after a short nap, 2:20 or so is generally manageable.

3. Does it matter that feeds are not 4 hours apart?

Not particularly, you can do a topup feed to ensure she's not waking due to hunger by doing something like this:
7 - WU, eat
8 - topup feed
9:45 - nap
11:15 - WU, eat
12:15 - topup feed
2 - nap
etc...
This gives her the A time she likely needs to take long naps and keeps feeds after naps.

4. We are looking to move our LO to her own room shortly. Is it a good idea to do this before or after trying PUPD? We're nervous about making too many changes at once but also don't want to end up having to redo PUPD when we move her.

I would suggest doing this gradually, perhaps as part of your gentle sleep training attempt rather than with PUPD. Try first off introducing her to the cot during A time to create some happy associations, then once you've got her sleeping a bit more reliably, you can try putting her down drowsy but awake into the cot and see how she goes.

5. I've read that babies often develop separation anxiety at around 7 months. Is it best to do PUPD before this happens or are we likely to have a regression once separation anxiety sets in?

We see SA more around 9 months, generally but either way, SA is best dealt with by reassuring LO hat you will be there when she needs you.

6. When we start PUPD, do we do it for night wakings too? What about the feed (when I think she is genuinely hungry as she takes a full feed and wakes at different times every night)?

Is she waking at night other than when hungry? If not, no need to do any sleep training at all for night.

[Josi2015]

Thanks so much for your quick reply. I will definitely try extending her A time - I'd been so focused on making sure she wasn't overtired I'd overlooked this as a possibility but it makes sense.

Just one question - when you say PUPD should not be used until you've used another sleep training  method for 2 weeks with no improvement, what are our options to try to teach her to self settle before trying PUPD? Whenever we try putting her in the cot awake she fusses and eventually cries so we resort to picking her up and rocking her to sleep in the end. She has started to wake at night when not hungry and I'm thinking that teaching her to settle independently might help with this.

Thank you again.

[becj86]

She has started to wake at night when not hungry and I'm thinking that teaching her to settle independently might help with this.

So will getting the routine right I find about 80% or so of these issues with  extra wakings at night and resisting nap or short naps are fixed with routines appropriate to the baby rather than sleep training.

Whenever we try putting her in the cot awake she fusses and eventually cries so we resort to picking her up and rocking her to sleep in the end.

Ok, so if you put her down when she's tired, you'll have better luck. Also, you can hold her til drowsy, maybe while singing or saying your sleepy phrase, then pop her into bed and keep singing and keep a hand on her. Same principle as shush/pat but slightly more acceptable to an older baby. Just gradually put her down less drowsy and eventually you'll be able to put her down awake and the sleep cue will be the wind down and being in her cot rather than rocking.

[Josi2015]

Thank you for another quick reply - really appreciate your help

It would be great if we can avoid sleep training by making changes to the routine. Will start tomorrow and see how it goes!

[Josi2015]

Hello, I'd be really grateful for some more help after my post last week.

We've extended DD's A time to 2hr45 and there has been a definite improvement in her naps - we've had a lot more naps of over an hour and she has been taking much less time to settle. However, the night wakings have suddenly got a lot worse.

For example, Monday was as follows:

WU 6:30
E 7:00, top up 8:30
A 6:30 - 9:15 (2hrs45)
S 9:15 - 10:25 (1hr10)
E 11:20, top up 12:55
A 10:25 - 13:12 (2hrs47)
S 13:12 - 13:35 (23mins)
A 13:35 - 15:28 (1hr53 -short but very fussy and showing all her tired signs)
E 15:00
S 15:28 - 17:00 (1hr20 total but woke and needed settling twice)
E 18:15, top up 19:10
A 17:00 - 19:32 (2hr32)
Bedtime 19:32

NW 20:05, 20:40, 21:40 (fed - didn't take much), 22:05 (fed again at 22:30), 23:00, 00:00, 01:00, 04:00 (fed at 4:30), 05:35 (kept falling asleep on my husband but waking up again a few minutes after being put down until 6:30).

WU 8:00am

Yesterday was similar although with slightly fewer night wakings.

She seems to have fallen into a pattern of waking at least a couple of times in the hour or two after going to bed and is obviously in a very light sleep as the slightest noise wakes her. Is this typical of being either overtired or undertired? Or could it be the result of having been rocked to sleep and waking up in her cot? (we are still rocking her to sleep at the moment as we wanted her to make sure we were getting the A time right before trying to teach her to settle independently).

She also seems to be developing a pattern of waking at around 4:30am and being wide awake for at least an hour. Again, is this typical of being either overtired or undertired? We are not putting the lights on or talking but she seems to want to be awake and up.

To what extent should the A time be reduced after a bad night's sleep where we know she has been awake a lot and is obviously tired the next day as a result?

In an ideal world we would have a 7:30am to 7:30pm day. If she has woken early and won't go back to sleep, should bedtime be brought forward so that it is still a 12 hour day (eg should we have had a 6:30pm bedtime on Monday)? Or is it important to have a consistent bedtime so that she gets used to sleeping at that time?

Finally, should we be aiming for the same A time before bedtime or can this period be a bit shorter so that bedtime is around the right time?

Sorry for so many questions - I'd just really like to figure out what's going on so we can put it right. Thank you

[becj86]

Ok, here goes:

She seems to have fallen into a pattern of waking at least a couple of times in the hour or two after going to bed and is obviously in a very light sleep as the slightest noise wakes her. Is this typical of being either overtired or undertired? Or could it be the result of having been rocked to sleep and waking up in her cot? (we are still rocking her to sleep at the moment as we wanted her to make sure we were getting the A time right before trying to teach her to settle independently).

Yes, this can be OT or UT and can definitely be the lack of independent sleep.

She also seems to be developing a pattern of waking at around 4:30am and being wide awake for at least an hour. Again, is this typical of being either overtired or undertired? We are not putting the lights on or talking but she seems to want to be awake and up.

This here is the first thing I'd tackle - this behaviour, together with the short(ish) 1:10 nap first up in the morning tells us she needs more A time in the morning. Once that's sorted, the disruptions in the early evening may settle, as they can also be related to her shifting her day when her first nap is too close to WU. Maybe increase the first A time to 3hr and see how she goes over the next few days.

To what extent should the A time be reduced after a bad night's sleep where we know she has been awake a lot and is obviously tired the next day as a result?

Ideally, not changed at all - if you keep the routine the same, her body has a chance to take the sleep she needs when its offered and she can listen a bit more to her body clock. If you keep changing, she doesn't know where she stands and cannot self-regulate.

In an ideal world we would have a 7:30am to 7:30pm day. If she has woken early and won't go back to sleep, should bedtime be brought forward so that it is still a 12 hour day (eg should we have had a 6:30pm bedtime on Monday)? Or is it important to have a consistent bedtime so that she gets used to sleeping at that time?

This depends a little on you - I would probably stick with a similar BT - a 13hr day here and there is fine. There is the possibility of her waking progressively earlier as she transitions from 3 naps to 2 naps. All about the 3-2 transition- 5/6 months

If you can get that first A time right and she can take a full restorative nap (around 1.5hr+) then she's less likely to take that OT 2nd nap and you may be able to just jump to 2 naps. You're doing really well - this is about what we'd expected to see at this stage, just need to increase those A times a smidge more

[Josi2015]

Thanks so much.

Just to make sure I've understood correctly, am I right in thinking we should aim for the first A time to be 3 hours and the second to still be 2hr45?

On days when we have a catnap, what should we be aiming for as the last A time of the day? As you've said, we're nearing the 3:2 transition, and there's not enough hours in the day to fit in 3 full A times plus a catnap. Last night we had 2 hours A time between a 15 minute catnap and bedtime at 7:30pm and that seemed right in her being tired enough for bed but we still had several evening wakings (although from what you've said it sounds like the first A time of the day may be more important to tackle this). 

Should we try to cut the A time before the catnap short as well/instead of having a shorter A time after the catnap before bedtime?

Alternatively, if we try to drop the catnap, what would be the maximum amount of A time it would be wise to have before bedtime?

If it would be better to post these questions in the nap forum, let me know and I'll repost. Thanks again for all your help 

[becj86]

If you get a good nap off 3hr, I would do 3hr for the 2nd A time as well (otherwise, stick with 2:45) effectively dropping you to 2 naps and leaving you with 2:45-3hr before BT which is probably plenty.

You're doing well with picking up on the patterns, they're the things that will help you keep things on an even keel in future

[Josi2015]

Thank you! We ended up having 3 3hr A times today and had 2 great naps - 1.5hrs and 2hrs - I can't remember the last time we had such good naps! Based on today it looks like 3 hours is the right A time for her so no wonder she was resisting naps at 2hrs30!

Will keep at it the next few days and see what the nights have in store...

Thank you so much for your help 😃

[becj86]

Awesome Keep an eye out for shrinking naps and increase her A time little by little and you should be golden for a while. How is it going with independent sleep? Is she going down awake and going to sleep herself?

[Josi2015]

No, independent sleep isn't happening yet. - we are still rocking her to sleep. We wanted to make sure the A time was right first to give ourselves the best chance of success with starting to put her down awake - I guess we can't put it off any longer now 😬

I have had a lot more luck than previously settling her in the cot when she wakes overnight though, so it seems that she is learning how to go to sleep in the cot. We just need to work on getting her to go to sleep that way in the first place.

[becj86]

Yeah, just gradually putting her down less drowsy and settling her in the cot will help - basically a baby version of gradual withdrawal is the way I'd go

[Josi2015]

Yep, I've been reading about gradual withdrawal and it does sound like it's the way to go.

So last night she was slightly less wide awake in the early hours than previous nights but we still had a crazy number of night wakings. Is it the case that it will take a few days of the right A time/good naps for it to make a difference to her night patterns? Or do you think we won't see a real difference until she can self settle?

[becj86]

It can take a little while to see a difference in her night wakings, even if the daytime routine is working well. Part of the equation likely will be self-settling too - there's a developmental leap at this age that means that when she wakes and something's different from how it was when she fell asleep, she'll wake.