Getting Baby to Sleep

The secrets from those books you don't have time to read.

 

 

Introduction


The majority of this information is from the following book:

Healthy Sleep Habits, Happy Child

(4th Ed., 2015)

Dr. Marc Weissbluth, M.D.

*Other sources include the “Sleep Sense” program by Dana Obleman and the “Happiest Baby” materials from Harvey Karp, M.D. 


The book “Healthy Sleep Habits” is over 600 pages long. It is dry, repetitive, disorganized, self-contradictory, and at times just plain offensive (especially when you are sleep-deprived). 


But for us, and the multiple sets of parents who recommended it to us, the method actually worked. The general principles are not particularly unique; this just happens to be the book someone gave us in our time of need. In the past I have recommended the book to friends based on the ideas and methods, which are helpful, but who has time to read all that when they have a newborn? So I tried to break it down to the basic points and organize it in a way that makes some sort of sense.


Parts of the book I left out:

  • Any recommendations which go against basic American Academy of Pediatrics SIDS recommendations (such as co-sleeping). These are never his first-choice strategies, anyway.
  • Theories that do not seem to have any useful application for solving sleep problems (for example, why financial problems or marital discord can cause fussiness in babies)
  • Several “special situations” (such as dealing with twins) which we did not experience
  • Detailed sleep strategies for older children and adolescents
  • Any details regarding Weissbluth’s 40ish pages of references to scientific literature backing his theories.

 

Baby sleeping peacefully in star-patterned onesie on white bedding.

 

Contents


Part I: General Concepts

  • Philosophy
  • Sleep Strategies
  • No Cry/Maybe Cry Methods
  • Let Cry Methods
  • Common Problems and Special Situations
  • Colicky Babies

Part II: Sleep by Age

  • 0-1 month
  • 1-2 months
  • 2-4 months
  • The Nap Drill
  • 4 months-1 year
  • 1 year-7 years


 

 

PART I: General Concepts

 

 

Philosophy


Sleep is important. Think of sleep like food. You would not deprive your child of food, do not deprive him of sleep. A constant small sleep deficit can add up to a big problem. Healthy sleep early on leads to better sleep at an older age.

The process of falling asleep is a natural, learned skill that children will learn on their own if parents do not interfere. Think of it like walking -- children will learn to do it but things like walkers provided by parents can hinder the natural development of those skills

  • Letting your baby cry is not “doing nothing.” You are encouraging him to develop independence, providing the opportunity to learn how to fall asleep alone, and respecting his ability to do so successfully.
  • It is normal to awaken naturally throughout the night. The process of falling back asleep requires the same self-soothing skills as falling asleep at bedtime.

Parents can force wakefulness but not sleep. Parents can only provide the opportunity for optimal sleep. Whatever the maximum amount of sleep that occurs, that was their child’s actual need for sleep.

  • If parents run in to soothe the child at every night awakening, they deprive the child of the opportunity to learn self-soothing and they fragment both their own and the child’s sleep.
  • Risk factors for sleep issues (i.e. ways parents might force wakefulness):
  • Attending to child every time he vocalizes
  • Parents staying in the bedroom until the child falls asleep
  • Bed sharing

Well-rested parents are better parents. Parents’ sleep is important for their baby’s health, too.

Sleep begets sleep. It seems illogical but it’s true. Well-rested children sleep better.

  • Depriving a child of sleep to make him sleep later in the morning or more at other times does not usually work. 

Sleep and food/hunger are usually unrelated and often tied too closely together in parents’ heads. 

  • Arousals from sleep do not always mean hunger.
  • Feeding does not directly cause sleep. One reason we know this is that babies on continuous tube feeds have the same sleep/wake cycles as other babies.  
  • Formula versus breast milk (when you eliminate the confounding factors associated with nursing) does not affect sleep duration or quality, nor does early introduction of solids. Babies who are breastfed wake up more frequently from 6-12 months because they like Mom’s company, not because they are hungrier.

Crying at bedtime is not due to separation anxiety. Sleep patterns improve rapidly with reduced parental attention. There is plenty of evidence that ignoring bedtime “protest crying” will NOT cause any long-term emotional problems.

Sometimes babies cry for NO GOOD REASON. Crying as a signal system is not perfect. “No reason” is actually the second most common “cause” of crying, after hunger. Not all crying signifies pain.

There are different “types” of sleep

  • Naps and nighttime sleep are often unrelated. 
  • Children do not always “make-up” for missed naps by sleeping more at night. 
  • Night and nap sleep are not equivalent or interchangeable. They restore the body and brain in different ways.
  • Naps and nighttime rhythms can be out of sync. In other words, a child might “night-sleep” into the time they were supposed to start their morning nap or “evening-nap” right up past bedtime.
  • Night sleep comes easier. When treating sleep problems, improvement will be seen in night sleep first (then the morning nap, then the other naps)
  • Not all naps are created equally: morning naps might involve different phases of sleep than afternoon naps and serve a different purpose
  • Early night sleep (before midnight) is more deep and restorative than morning sleep. That’s why “earlier bedtime” is frequently the solution to a sleep problem.

“Watch the child, not the clock.” The perfect amount of sleep is not a set time. Children can be short or long sleepers by nature.The overall number of hours is not the only factor. What is important is that they aren’t acting tired (cranky, groggy, hyperactive). 

“Wired” often really means “tired.” Signs of sleepiness in children are not the same as signs in adults. Adults get slow and yawn, kids get excitable and hyper. Because of this, parents often miss signs that their child is sleep-deprived.

Don’t compare your child to others for what is “normal.” Bedtime hours have shifted later and average total sleep by age has decreased over the years. Today’s children are probably getting too little sleep. 

Don’t be judgmental of other parents. Babies and families are all different.

Never wake a sleeping baby. (*except in very specific circumstances as described below, to preserve the sleep schedule)

Don’t change too much at once. If you make a change, wait four or five days before making another.

Consistency is key. Avoid “intermittent positive reinforcement” of any unwanted behavior. For example, going to soothe a crying child sometimes, but not other times, will teach him to cry louder and longer. 

 

 

Sleep Strategies


The ultimate goal here is to get Baby to fall asleep on his own without you there, consistently, for naps, bedtime, and when he wakes up throughout the night (if he doesn’t actually need anything)


These are broken down into three basic categories: “No Cry,” “Maybe Cry,” and “Let Cry” methods. 


“No Cry” and “Maybe Cry” methods (there is a lot of overlap between them so I have lumped them together into one list) are things everyone should be doing from the very start. These are strategies that will lay the foundation for Baby to learn self-soothing and do not require you to leave him to “Cry it Out.” For many babies, the “No Cry” and “Maybe Cry” methods will be all you ever need. If you consistently use these strategies, Baby will slowly but surely learn to self-soothe and become an independent sleeper.


In some situations, the “No Cry”/”Maybe Cry” methods are not enough. This is particularly common in colicky babies. In that case, you eventually need to move on to the “Let Cry” methods to help your baby learn to self-soothe and ultimately get him the sleep he needs. These are similar to the methods known as “Cry it Out,” or “Ferberizing.”

 

 

Sleep Training Steps


Here is the Step-by-Step overview of how to “Sleep Train” Baby. More details on timing by age will be included below when you get into the “Part II: Sleep by Age” section.

  1. Start “No Cry” or “Maybe Cry” methods to teach self-soothing right away
  2. Keep a sleep log starting around 6 weeks
  3. Use “Let Cry” methods for teaching self-soothing if sleep problems persist 


 

 

Step 1: Starting Right Away

 

 

No Cry/Maybe Cry Methods


  • “Catch the Wave.” The overall “trick” to giving your child the opportunity to sleep is timing. The goal is to “catch the wave,” meaning to put the child down when he is sleepy but not overtired. If you wait too long, the child can have a “second wind,” a rush of stress hormones, where he will seem hyper or wired, and this will make falling asleep harder. Generally, if the child appears “tired,” you have already missed the window.
  • “Magic moment” (signs of drowsiness, time to “catch the wave”): 
  • Slight quieting, less animated
  • Lull in being busy, less interest in toys or people
  • Slight staring off 
  • Hint of calmness
  • Sucking becomes weaker or slower
  • Yawning
  • Eyelids drooping
  • Pulling ears
  • Signs of entering the danger zone (overtired):
  • Fussiness, irritability, cranky
  • Rubbing eyes
  • Put Baby down “Drowsy but Awake”
  • To teach self soothing: start the soothing process, then place the drowsy child in the crib before he is fully asleep (usually after about 10 to 20 minutes), and allow him to fall asleep on his own
  • It’s okay if at first Baby still usually falls asleep in someone’s arms -- the point is to give him an opportunity to learn self-soothing at least sometimes. 
  • When you try to have him self-sooth, it might only work 10% of the time at first, but keep at it. 
  • Don’t deliberately wake a baby to put him down “drowsy but awake” (are you crazy?)
  • Try to figure out how long Baby is usually awake before showing signs of fatigue and start the soothing process 20 minutes before that. 
  • A good time to try this is within one hour of morning wake up (when he’s well-rested from overnight sleep)
  • “Many hands.” Use help from others
  • Falling asleep under different conditions promotes self-soothing skills
  • Moms: consider passing off the child to someone else sometimes (like after breastfeeding) for the soothing process so he becomes more flexible
  • Dads can send Mom away for an extended period (like overnight), because even smelling Mom can make Baby resist self-soothing.
  • If Baby is being breastfed, you might be more likely to get Baby back to sleep if someone other than Mom responds to wakeups (Baby will be less stimulated).
  • A caregiver who is less sleep-deprived and has more breaks from Baby (for example, anyone who is not breastfeeding) may have more success soothing Baby because s/he has more reserve and is less likely to become frustrated.
  • Provide the opportunity for many naps (do not force wakefulness)
  • Feed at night only when hungry
  •  It’s important to distinguish sucking for comfort versus hunger. Signs that it’s hunger, not just comfort-sucking:
  • A swallow follows every suck
  • Baby will readily take a bottle right after breastfeeding (*does not apply to colicky babies, who will take a bottle for comfort then spit up)
  • Will take a bottle from Dad instead of breastfeeding
  • Allow for self-soothing to happen. There is a difference between “soft” and “hard” crying. It’s okay to wait through low-level fussing and whimpering for a child to soothe himself to sleep. You can also try soothing without picking up as a midway point.
  • *It’s also important to let Baby “self-soothe” during the day in moments of frustration. Don’t always run to his aid right away.
  • Institute a Bedtime Routine
  • Use some combination of these things in an order that makes sense for you. Try to do the same thing in the same order every time. This acts as a “yellow traffic light” to signal to the child that bedtime is coming
  • Reduce stimulation
  • Create a quiet, dark bedroom that is comfortable temperature (68-72 degrees)
  • Bathe
  • PJs on
  • Swaddle (if it helps)
  • Sing
  • Rock
  • Cuddle
  • Feed
  • Read books
  • Quiet play
  • Brush teeth
  • Beware of “Sleep Crutches.” Baby will ultimately need to be able to self-soothe in different environments (like Grammy’s house, and someday his college dorm) and when awakening alone in the middle of the night. You do not want him to rely on conditions that are difficult to replicate or anything that requires your constant presence. Common examples include running vacuum cleaners or hair-dryers, driving in the car, bouncing, nursing, and stroking his back.
  • Aim for Motionless Sleep
  • If Baby falls asleep in a swing or car, stop the movement.
  • BUT don’t take Baby out of a carseat or do anything else to disturb him while he’s sleeping. 
  • Create a good Sleep Atmosphere 
  • Room-darkening shades.
  • Motion and loud noises can help babies fall asleep, but continuing these things during sleep can lead to poor sleep quality.
  • Avoid sleeping outside.
  • Sound machines are okay on the lowest setting, far away from Baby.
  • Keep screens and media out of the child’s bedroom.
  • Bed/crib should not be used for anything but sleep. Foster a strong association between being physically in the crib and sleeping.
  • Follow the American Academy of Pediatrics Recommendations for preventing SIDS (these will not help him sleep, but maybe you’ll sleep better knowing you are doing what you can to keep him safe): 
  • Put Baby down on his back on a firm sleep surface without soft objects or loose bedding for 1st year
  • Give paci at naptime and bedtime for the first year
  • Don’t smoke (or let anyone else who takes care of him smoke)
  • Don’t let him get too hot (use breathable PJs/swaddles/sleep sacks, keep temperature around 68-72 degrees)


 

 

Step 2: Start A Sleep Log

 

 

What's Sleep Log?


  • A graphical way to chart sleep trends over time to see what is working and what isn’t and what his natural rhythms seem to be.
  • Helps maintain consistency, foster communication, and build confidence among different caregivers.
  • There are popular apps for this including “Feed Baby” and “Baby Tracker.”
  • You can also use paper or a computer/tablet that stays with Baby.

 

Sleep Log Example Daymark Photography
Sleep Log Example Daymark Photography

 

Here is the sleep log we used - a spreadsheet kept on an old laptop that we always had around Dylan. We color coded naps vs night sleep, which days grandparents were helping, #oz of food or new foods introduced, and let the computer do the math for us so we knew all the totals for 24 hours. You can be as basic or involved as you want, but overall we found the information very useful.

 

 

Step 3: Moving on to "Let Cry" Methods

 

 

Let Cry Methods

for teaching self-soothing if sleep problems persist or emerge after trying “No-Cry/Maybe-Cry” solutions (if above strategies work well, you may never need these. Colicky babies usually ultimately need these).

 

 

Extinction (or "Unmodified Extinction")

The method of allowing an overtired baby to sleep by refraining from further stimulating him with your presence.

  • This is the most effective method
  • Do not use before 6 weeks
  • Less crying involved if you do it before 4 months
  • Put baby down (usually between 6-8pm), and don’t go back to him no matter how much he cries unless it is to feed him
  • Wait at least 4 hours between feeds in healthy children
  • May need feeds 2-3x per night up to 4 months
  • 1-2x per night after 4 months
  • No feeds after 9 months
  • Feed in the dark, without lots of socializing, and put back down without prolonged soothing
  • End feeding when he slows down sucking (don’t count ounces or try to “top him off”)
  • *If you think Baby is ill or in danger, obviously go to him. If he smiles at you when you rush in (“gotcha!”), turn around and leave without saying a word.
  • In a baby with good habits in place, healthy and younger than 4 months, pattern is usually:
  • Night 1: 30-45 minutes of crying
  • Night 2: 10-30 minutes of crying
  • Night 3: 0-10 minutes
  • Night 4: No crying
  • In a baby with good habits in place, healthy and older than 4 months, pattern is usually:
  • Night 1: 45-55 minutes of crying
  • Night 2: slightly longer than Night 1 (trying harder to get your attention)
  • Night 3: 20-40 minutes
  • Nights 4-5: No crying
  • Days or weeks after sleep training, you will get a “response burst” of crying or calling out as Baby tries to see if he can revert to the old ways.
  • Pros:
  • It works - strongest empirical support
  • Fastest way
  • Easy to redo if there is a regression (a move, an illness, etc.)
  • Total amount of crying is less than any other method because success comes earlier (tolerating an extended period of crying upfront prevents much more crying overall). 
  • Cons:
  • It’s hard to listen to your baby cry.


Extinction With Cap:

  • Pick a time limit that you will let Baby cry (don’t go to him before that)
  • *needs to be at least 45 minutes or Baby will probably learn to just cry to the limit
  • Pros:
  • Feels a little less harsh (you can soothe yourself believing there is an “end” to the crying in sight)
  • Most kids won’t cry until the cap consistently anyway - so it ends up being no different than the “Unmodified Extinction” method.
  • Cons:
  • It's hard to listen to your baby cry.


Extinction With Parental Presence:

  • Let Baby cry while you are in the room 
  • Can include “fading out,” for example sitting in a chair moved further toward the door each night, or changing from milk to juice to diluted juice to water
  • Cons
  • This strategy is based on false assumption that bedtime crying is related to separation anxiety
  • Usually takes at least 7 nights
  • Hard to re-do later because it is more time-consuming


Graduated Extinction:

  • Let Baby cry for 5 minutes, then go to him and soothe him
  • Next time, let him cry for 10 minutes, then 15 minutes, etc. 
  • Usually works better with Dad
  • Takes 4-9 nights to work in perfect conditions
  • Cons:
  • Can be hard to keep to the schedule, especially if sleep-deprived

 

 

Common Problems and Special Situations


Signs of sleepiness (long-term sleep debt): 

  • Falls asleep in the stroller/car
  • Wakes up crying or grumpy
  • Due to “sleep inertia” which many adults experience -- general discomfort when waking up from a nap. This can be a sign of overall sleep debt.
  • “Witching hour” (crankiness, hyperactivity, fussiness) strikes in the afternoon/evening
  • 4-5pm for kids under 3
  • 5-7pm kids 3 and older
  • This is a form of “second wind”
  • Don’t assume witching hour is “natural” -- it’s a sign of poor sleep

An extra-early bedtime can compensate for poor napping during the day

  • To make bigger changes in bedtimes: when you are trying to keep your child up later, do it gradually. When you are moving bedtime earlier, do it abruptly.

To transition from swing to crib (when Baby only sleeps in the swing):

  • Avoid swing altogether if baby is less than 6 weeks and not colicky -- give him an hour in the crib in the morning when he’s well rested and allow for some low-level fussing/crying
  • If child is 6 weeks or older, skip the swing and go straight to the crib at bedtime
  • Turn off swing after baby falls asleep
  • Transition deep sleeping baby from swing to crib
  • Start baby in crib to begin with

Baby waking up too early:

  • If he is well-rested, you can try slowly moving back bedtime, but keeping Baby up later rarely works (you probably just have a natural early riser on your hands)
  • If he is overtired, set bedtime EARLIER (for example, 5:30pm) temporarily until sleep debt is repaid.
  • When you go to get him in the morning, be quiet and non-stimulating so he does not begin to fight morning sleep for the excitement of your company.

Inappropriate/frequent night wakings (“disturbed sleep”)

Losing the paci, swaddle, or getting stuck after rolling over. You may go in to replace a pacifier once or twice if it is going to get everyone more sleep. Don’t do it all night (if this is necessary, you may need to teach Baby to sleep without it). Consider stacking the crib with multiple pacifiers or using an alligator clip. Same goes for re-swaddling or helping Baby change sleep positions.

Head banging

  • 5-10% of children bang or roll their heads side to side from around 8 months up to 4 years as they fall asleep
  • This is not a sign of behavioral or emotional problems
  • If it bothers you, you can try to cushion the areas where they bang to prevent the noise to decrease the appeal of using it to get parental attention

Daylight Savings Time

  • Continue to use clock time to put your child to sleep
  • Social cues within the family (when you eat dinner, etc.) will help regulate the change

Mother returning to work

  • If you are planning to return to work consider starting a bottle (expressed milk or formula) at least once a day at about 2 weeks old (child will be more likely to accept it if you don’t wait too long)
  • Write down instructions for sleep routines so other caregivers can keep things consistent
  • Have other caregivers contribute to the sleep log
  • Try to bring some sleep cues to the different places where Baby might sleep, such as daycare, to build a familiar environment 
  • stuffed animal
  • blanket 
  • music box/sound machine
  • perfume spray

Two working parents/daycare

  • Often children are kept up too late because parents want time with them after work
  • Children have to be woken up in the morning for daycare which can disrupt sleep schedules
  • Naps at daycare might not be good-quality
  • Parents might try to do “too much” on weekends to make up for lost time during the week. Don’t try to skip naps too often on the weekends.

Overweight baby

  • Overweight babies are almost always overtired babies whose parents have mistakenly attributed their crying to hunger instead of fatigue

 

 

Colicky Babies

  • Some (~20%) babies are considered “colicky” or have “extreme fussiness” (really, it’s on a spectrum). They require some special considerations.
  • It’s just luck of the draw whether you get one or not.
  • This starts to show itself after the first week (if born on time)
  • Criteria (one example of many): 
  • >3 hours a day spent soothing to stop him from crying (can also be >3 hours of “fussing” if parents are using heroic efforts to prevent true crying)
  • >3 days per week
  • for >3 weeks
  • Baby may suck for soothing, eat more than they need to, then spit up
  • Breastfeeding: feeding is irregular, long, and frequent. Lots of non-nutritive sucking. Often leads to painful feeding for the mother. Methods of soothing other than breastfeeding often do not work.
  • Colic often leads mothers to worry something is wrong with breastmilk (her diet, milk supply).
  • Parents may worry the formula they are using is causing the problem.
  • Often parents end up breast-feeding while co-sleeping as the only successful method of getting Baby to sleep.
  • Colic has no proven link to food hypersensitivity or reflux or any other GI problem although these are often blamed
  • Treatments like probiotics, manipulative (chiropractic/osteopathic) therapies, simethicone, and GERD drugs have never been shown to help.
  • Frequently these treatments are started around week 6 (peak fussiness) which may cause a bias that they work because that’s when fussiness tends to improve anyway
  • Baby may not be able to sleep in a crib instead of a swing until about 4 months
  • Do not worry about sleep problems developing before this because of “bad habits.” When dealing with colic, the first 4 months are just about survival. Do what you can to maximize sleep, whatever it takes.
  • There are two main soothing strategies, both are fine if you are consistent (including grandparents and other caregivers). Be consistent with naps and consistent with bedtime even if you use a different method for each.
  • Method A: Always put your baby down after a brief soothing period whether or not he is asleep. Pros: creates independence, teaches self-soothing.
  • Method B: Sooth Baby until he is asleep regardless how long it takes. Pros: provides more security, may feel more “natural”. The problem is it’s much harder to be consistent with Method B.
  • If you have a colicky baby, you may need to start with Method B and transition to Method A.
  • You should still try to help develop self-soothing skills by using the same methods as recommended for non-colicky babies (“No-Cry/Maybe-Cry Strategies”), but with the understanding that a colicky baby may just not be as responsive. 
  • Tends to improve by 2 months (50% of colicky babies) or 3 months (80% of babies)
  • Should be ready to learn self-soothing around 4 months. But, by this point they often need a “Let Cry” method.

 

A peacefully sleeping newborn swaddled in soft pink fabric rests on white textured bedding.

 

Part II: Sleep By Age

(*“Age” in weeks is based on DUE date, not actual birth date)

 

 

0-1 Month (weeks 1-4): CHAOS REIGNS


GOOD NEWS! During the first 6 weeks you can usually assume your baby is getting enough sleep. If they want to sleep, they can fall asleep basically anywhere. This is your grace period.

  • Light, noise, burping, changing, and feeding styles do not seem to impact sleep patterns
  • Don’t worry about spoiling Baby, you can’t right now. If teaching self-soothing isn’t working, prioritize maximizing sleep (Baby’s and yours) instead. 
  • Do not try to allow a newborn to “cry it out,” it’s too soon

They have no established sleep rhythms whatsoever, no circadian rhythms. Ignore the clock altogether, watch for drowsy signs instead

Nap when Baby naps (if you can)

Start to teach self-soothing early: If you prevent sleep problems from the start, you may be able to sleep train with little to no crying. Treating sleep problems later on usually involves some crying. Early strategies for teaching self-soothing are called “No Cry” or “Maybe Cry” solutions for this reason.

  • “Many hands” (have Dad and others help with soothing)
  • At 2-3 weeks, breastfeeding moms should give a bottle of expressed milk once every 24 hours (allows others to participate, gives mom a break, keeps baby used to bottles, helps prepare everyone for Mom’s return to work, if that's the plan)
  • Put baby down drowsy but awake (at least some of the time)
  • Brief intervals of wakefulness (goal to never have Baby awake more than two hours)
  • Start a bedtime routine
  • Avoid unnecessary interventions and feedings at night
  • At 3 weeks old (if healthy and gaining weight appropriately) start to dissociate food when Baby wakes at night -- delay feeding using diaper changes or handling first.

Soothing styles and tips:

  • Methods of soothing: experiment, try the same things again, what failed before might work later, things might inconsistently help
  • Appeal to one sense at a time (too many at once can be stimulating)
  • Be somewhat consistent to give Baby cues that it’s sleep time 
  • Each caregiver can have different methods
  • Common Methods - (“recreate the sensations of the womb”):
  • “Happiest Baby on the Block” Methods (known as the “5 S’s”)
  • Swaddling: Even if you feel as if you're putting your baby in a straightjacket, that cozy cocoon will prevent his limbs from twitching and help him nod off. 
  • Side Lying: Before birth, your baby spent most of his time on his side in the fetal position. Carry him the same way now, and use the football hold as you nurse (clutch him with one arm, your hand supporting his head and his legs under your armpit).
  • Shushing: A "shhh" sound is soothing to a newborn because it mimics the whooshing noise that surrounded him in the womb. Make the sound yourself or use a radio tuned to static, an iPhone app (try White Noise or Ambiance 2.0), or white noise machine. Make sure the sound is louder than your baby's cries; he won't hear it otherwise.
  • Swinging: Fast, rhythmic movements like swinging, rocking, or jiggling might remind your little screamer of those carefree days he spent bouncing around inside you. The more agitated your baby, the more vigorous the motion should be.
  • Sucking: For a baby, sucking on a finger or pacifier can be what lying on a warm beach is for us: total relaxation. It works best after you've calmed him with the other S's.
  • Bodily contact
  • Gentle rhythmic motions (swing, stroller, car)
  • Massage
  • Gentle sounds: lullabies, singing, humming
  • Warm-water bottle on abdomen
  • Remove stimulating toys, bright night-lights

 

 

What To Expect


  • The clock starts at Baby’s due date, not actual birth date.
  • Accordingly, pre-term babies will sleep more than full-term, post-term will sleep less
  • Week 1 (term babies) is the “honeymoon period” (baby will sleep a lot and fuss relatively little). This “honeymoon period” will be longer than a week if born early, shorter or nonexistent if born late.
  • From newborn to 6 weeks babies become increasingly alert, gassy, and fussy. This is often misinterpreted as a milk-related problem even though it is a normal phase of development that will pass.
  • Fussiness gets worse every week until a peak at 6 weeks post-due date. This should get better by ~2-4 months. If other caregivers are scheduling time off work or trips to come help, you can use this tendency to predict when you are most going to need “all hands on deck”
  • Longest sleep period will be 3-4 hours
  • Total sleep about 16-17 hours per day, longest single sleep period 4-5 hours
  • Babies start out eating little and usually lose some weight.

 

 

COMMON ISSUES


Crying

  • All babies cry. Average daily duration of crying is two hours (three hours at the six-week peak). This is normal in babies regardless of how perfectly you are doing as a parent.
  • Over one third of crying spells are caused by no identifiable reason. “Unknown cause” (determined by experts) is second only to hunger as the most common cause of crying.
  • Crying spells start to happen around the same time each day in many babies: typically between 7pm and 9pm.
  • Take breaks from Baby (go for a walk, or to a movie)
  • There is a difference between “hard” and “soft” crying. Try to ignore quiet vocalizations during sleep, these are not a sign of distress or hunger. Babies are noisy sleepers.

If Baby always falls asleep while feeding, shorten the duration of feeding (as long as weight gain is fine). Occasionally falling asleep while feeding is fine.

 

 

1-2 Months (weeks 4-8): ALL ABOUT INTERVALS


Goal: encourage the development of self-soothing skills. Keep using the “No Cry” or “Maybe Cry” strategies from weeks 1-4.

  • Intervals. Aim for no more than two hours of wakefulness. This is the maximum babies can tolerate before becoming overtired. That means start soothing and putting down to sleep before two hours, not at the two-hour mark
  • In the morning try putting Baby down “drowsy but awake” within one hour of wakeup time
  • It is normal for babies to protest-cry before sleep. Consider letting him cry for a few minutes (avoid unnecessary interventions).

 

 

What to expect


4-6 weeks: Bedtimes are irregular and may occur late, between 9-11pm

6 weeks:

  • Time to start your sleep log
  • Night sleep rhythms emerge
  • Height of fussiness, may give up napping altogether
  • Longest single sleep period is 4-6 hours
  • Begins to occur regularly in evening hours, usually before midnight
  • Time to start moving bedtime earlier (6 to 8pm)
  • Last “nap” is whatever started between 4 and 5pm. When he wakes up from nap, bedtime is 30-90 minutes later
  • Social smiles and increased social awareness emerge
  • Noises, voices, lights, vibrations will increasingly start to disrupt sleep
  • This is when babies (non-colicky) may start responding to sleep-training techniques.
  • “No-cry” and “maybe-cry” sleep solutions may work quickly at this age. 
  • Can also start trying “Let Cry” methods if needed

 

 

common issues


Crying/Fussiness

  • Same stuff from the first 4 weeks applies; crying is normal. 
  • Under 3 months, sleep cycles and wake cycles can actually be out of sync so children are getting opposing messages from different parts of the brain which causes fussiness. Six weeks is usually the peak of fussiness.
  • Use soothing techniques
  • Optimize opportunities for sleep
  • Take breaks, enlist help
  • Remember that it will get better

 

 

2-4 Months: SENSING A (NAP) PATTERN


Goal: Encourage the development of self-soothing skills for night sleep and develop the “morning nap.”

“Protect naps” starting around 3-4 months

  • Don’t expect your baby to be able to sleep "anywhere" anymore
  • Provide a good “sleep atmosphere”

Try to teach self-soothing for the morning nap and then do whatever it takes (help soothe Baby if needed) to maximize sleep for the rest of the day.

  • How to “teach self soothing” for naps: Try to allow 5 to 20 minutes of crying before picking Baby up after putting him down 
  • This will give him the opportunity to develop self-soothing skills and the opportunity to sleep. 
  • Crying is a sign of being overtired, so hugging, rocking, etc. could interfere with sleep and make the problem worse.

Keep trying to “catch the wave” (synchronize your attempts to soothe Baby to sleep with his internal sleep timing). If your timing is perfect there will be no crying.

Keep watching those intervals. Continue to put a 2-hour cap on time awake.

Nap rhythms may start to mature and you may start to transition from watching wakefulness intervals (the 2-hour rule) to watching clock time (planning around morning and midday naps)

  • Do not try to force a schedule on a baby less than 3-4 months. They are variable and unpredictable by nature.

*Bonus material: Lucie’s List article “Put Your Baby on a Schedule?”. This does not 100% match up to Weissbluth’s timing but it’s pretty close and may give you a more concrete sense of what to expect/shoot for particularly if you are…”Control-Oriented.” https://www.lucieslist.com/postpartum-week-8-put-baby-schedule-yes/

 

 

what to expect


Child becomes less “portable”. 

  • This can be socially limiting but overall will be liberating when you have a happy, well-rested baby.

A pattern of three naps starts to develop: Morning, Midday, and Evening.

The midday nap (somewhere between 12pm and 2pm) evolves after the midmorning nap.

The evening nap is usually the shortest and does not always happen.

Total sleep goes from 16.5 to 15 hours

Longest sleep period goes from 4 to 9 hours and is usually at night 

 

 

common issues


Children can begin to accumulate a sleep debt around 3 months of age if good sleep habits haven’t been established. 

  • They will start waking at night or crying more 
  • Parents often mistake this for hunger from a “growth spurt.”

How do I “make” my baby nap?! Your goal is to provide the opportunity for naps at the appropriate times. Use the “Nap Drill” algorithm to do this.

 

 

Nap Drill


  • Day “starts” at 5:30-6:30am (for a reference point)
  • *focus on establishing the morning nap before working on the midday nap until after 6 months old
  • Third nap of the day (evening nap) doesn’t always happen. If he starts crying, just pick him up and don’t try to extend or ignore.
  • If a child misses a nap, try to keep them up until the next nap or bedtime (even if you have to put them down a little early to avoid getting into the overtired state) to preserve the overall sleep rhythm. (Don’t let your child sleep at times other than the nap schedule to avoid throwing them off the schedule)

 

How to Get Baby to Nap Daymark Photography

 

4 Months - 1 Year: GET BABY ON A SCHEDULE


Watch Baby and the clock, transitioning to using clock time instead of intervals. 

You create the nap schedule, even if Baby does not cooperate by falling asleep.

Age-appropriate schedule: 

  • Wake up 6-8am, 
  • 1st nap (“morning nap”) 9 am 
  • (1-2 hours) 
  • disappears between 9-12 months
  • 2nd nap (“midday nap”) 12-2pm 
  • (1-2 hours, never starting after 3pm) 
  • disappears around 3-4 years
  • +/- 3rd nap (“evening nap”) 3-4pm
  • (variable time, often 30-40mins) 
  • disappears around 9 months
  • Bedtime 6-8pm. 
  • If child skips midday and 3rd nap, plan early (5:30pm) bedtime.
  • Once a child is down to 1 nap a day, bedtime needs to be moved earlier by 20-30 minutes.
  • Once a schedule begins to emerge, vary bedtime a little (~30-60 mins) based on Baby's behavior and how his daytime sleep went, but not by more than that. 
  • First night waking: 4-6 hours after last feed due to hunger (not all children), 
  • plus partial awakenings every 1-2 hours which should be ignored. 
  • Second night waking: 4-5am. Usually wet, soiled, or hungry. Respond but keep it quiet and dark.
  • Feedings usually are scheduled around sleep - 
  • once on morning awakening, 
  • once either before or after each nap, 
  • once around bedtime
  • once or twice at night before 9 months old.

Nap timing is important: if the midday nap is too early (way before noon), they may be overtired by bedtime or take a 3rd nap which interferes with bedtime. If it’s too late (lasts past 3pm), it may interfere with bedtime.

Avoid long excursions in the car between naps -- mini-naps can throw off the schedule (OR designate someone to sit in the back seat near Baby and keep him awake).

*once you have a well-rested baby and a solid schedule in place, occasional breaks in routine like later bedtimes for special occasions are fine (1-2 times/month)

 

 

what to expect


Night feeding: from 4 to 9 months old, expect to feed 4-6 hours after his last evening bottle and again around 4-5am. Feeding more than twice a night can create a night-waking problem.

Partial awakenings at night are normal and occur every 1-2 hours. Don’t go to him every time this happens or you will create a problem. If he is hungry, go to him. If he wants to play, ignore him. When you feed him, keep the room dark and quiet. Don’t go in more than 1-2 times per night.

4 months:

  • Naps grow to about 1-2 hours long.
  • Naps less than 30 minutes are not helpful.

5 months:

  • Over half of babies are “sleeping through the night.” (Many definitions exist)
  • Before 5-6 months some babies still have not established a schedule of regular long naps, especially post-colic.

6 months:

  • 16% of children are still taking 3 naps at this age.
  • Parents are more likely to be responsible for sleep problems than anything intrinsic to Baby (for example, by attending too often to nighttime wakings).
  • Baby develops “self-agency” - will express likes and dislikes with greater persistence.

9 months:

  • Night waking for feeding stops. Healthy children 9 months and older do not need night feedings. Children who are napping well and have an early bedtime should be sleeping through the night by now
  • 90% of children this age will take two naps per day
  • Baby needs an earlier bedtime because the 3rd nap is gone and he is more active. 


 

 

common issues


Losing the paci and getting stuck. You can help Baby if he rolls over and gets stuck or loses his pacifier once or twice (for the sake of getting everyone some sleep), but not all night long.

Daycare: Kids in daycare often have poor-quality naps so they need earlier bedtimes.

  • If sleep debt accumulates during the week for any reason, protect early bedtimes on weekends.

Loud crying during partial awakenings is a sign of an overtired baby. Only respond if it’s been 4-6 hours since last feeding.

  • Remember, if you establish an earlier bedtime, Baby might need a middle of the night feeding that he didn’t previously need, because he used to be fed later (if under 9 months).
  • Another consideration is that baby is awakening because of an uncomfortably full diaper now that he is sleeping longer stretches. Consider switching to "overnight" diapers that will absorb more.

Late napping. To establish an early bedtime (which is the answer to many sleep issues), you may need to awaken Baby to prevent sleeping past 4pm. *This is one of the only times it is acceptable to wake a sleeping baby.

Temporary disruptions in the schedule or mild variations may not be worth changing unless they are causing Baby to develop sleep debt.

Early riser. Don’t go to your child before 6am even if he’s crying, this could cause him to keep getting up earlier each morning.

Transitioning from 2 to 1 nap (dropping the morning nap):

  • Keep him up for the first nap; early morning fussiness is easier to deal with than a fussy child in the late afternoon
  • Can start the “midday nap” closer to morning and move it later slowly over time


 

 

1 Year - 7 Years


Children in this age group can start understanding “stimulus control”

  • Example: use a clock with a corresponding picture to say “look, it’s 7 o’clock, that’s bedtime!” 

Sharing your plans with an older toddler is more likely to lead to cooperation

Settling/soothing tips for toddlers:

  • Slowdown activity
  • Close physical contact
  • Gentle massage or stretching
  • Cuddle in a chair or nestle in bed
  • Quiet voices
  • Talk about a fun event
  • Tell a story
  • Read a book
  • Sing or hum a song
  • Chat about the day
  • Talk about family
  • Say goodnight to everything in the room
  • Play a favorite tape, like grandparents singing or nature sounds
  • Comfortable room
  • Photos of family and pets
  • Favorite stuffed animals and dolls
  • Nightlight or flashlight
  • Dream catcher or guardian angel for protection

 

 

What to expect


12 - 21 months: midmorning nap goes away (down to 1 nap per day). 

  • This might mean an earlier bedtime is necessary. 
  • Usually occurs around 18 months. 

3 - 4 years: napping in general becomes less common. Midday nap disappears around age 3.

3-6 year olds typically go to sleep between 7 and 9 and awaken between 6:30 and 8. These bedtimes are probably too late for many children.

 

 

common issues


Super long naps 

  • Can be a result of poor sleep (like breathing issues) or a too-late bedtime. 
  • Remember that long naps do not make up for a too-late bedtime (not all sleep is created equal). 
  • Long sleep durations are also associated with higher intelligence, so it could just be that you have a smart kid!

Transitioning from 2 to 1 naps:

  • If Baby is taking a long morning nap and fighting the midday nap, you might want to start by shortening the morning nap (keep it to 1-1.5 hours) so they are tired again by midday. *Another rare time it might be okay to wake a sleeping baby.
  • OR start moving the morning nap back a little at a time until it becomes the midday nap. You will need an ultra-early bedtime if you do this because it will be a long stretch between naptime and bedtime at first.
  • OR have some one-nap days and some two-nap days.

Not napping at all:: 

  • If Baby is much less than 3, try to keep the midday nap. Leave him alone in his crib at naptime (up to an hour), even if he cries, to give him a chance to nap (keep up your “Nap Drill”). 
  • Try a super-early bedtime (5 or 5:30) so he is well-rested enough to take a good nap (“sleep begets sleep”). If this causes an early wake up, ignore him until 6am. 
  • Aim for intense stimulation in the morning and an extra long soothing period before naptime. 
  • If older than 3, he may just be done with naps. 

Children who slip in and out of good sleeping patterns are often always going to bed a little too late.

Fears. Around 4 years old: fear of darkness, death, and monsters are natural. 

  • Try reassurance, open doors, and a longer bedtime routine. *Night lights may help but may also make it harder for the child to sleep. 
  • BUT maintain consistent resolve - bedtime is still bedtime. 
  • Learning to cope with anxiety, like self-soothing, is a healthy process children must go through.
  • You can provide extra attention without it being “open-ended” or limitless. 
  • Control the amount of extra soothing time (For example, use “stimulus control” like setting an alarm for soothing time, and leaving when it goes off)

Getting out of the crib (or out of their room): 

  • Consider a crib tent. 
  • You can also put a lock on the door - make sure the child sees you do it. Keep it unlocked until they get out once, then show them that you are locking it. They will probably not try again the next night because they do not want you to lock it again.
  • “Silent return to sleep”: Every single time, you silently pick him up and put him back in his bed, no negative or positive attention, and be 100% consistent and unrelenting until he gives up. Should eliminate the problem in 3-4 days.
  • “Sleep Rules” can be set for older children >2.5 years. Reward him for compliance and restrict privileges for noncompliance. Have him help you make a poster:
  • Stay in bed
  • Be quiet
  • Keep your eyes closed
  • Try to sleep
  • Pass system (older kids): Give them a card exchangeable for one visit/room departure after bedtime

Transitioning to a big bed: Wait as long as you can. At least until around 3 years old. Wait for the child to ask for a toddler bed. There is no rush on this. A child who is used to a crib and fits in a crib is going to sleep better in a crib.

Getting up too early: 

  • If they seem well-rested, it could be just how your kid is (a 5-6am waker). 
  • Can also be caused by a too-late bedtime. 
  • Sometimes giving him a bottle when he wakes up will help him fall back asleep (but don’t let him sleep with milk or juice as this can cause tooth decay). 
  • Some parents have their kids watch videos first thing in the morning to get themselves more sleep, but kids might start getting up earlier and earlier because they are excited to watch the videos. 
  • Use stimulus control - a clock with a picture next to it that shows when wake up time is, or one with a soft alarm or light. Don’t respond to cries before the scheduled wake up time, then go in exactly at the time you picked for wake-up.

Bedtime battles are normal in this age group. 

  • What’s “normal”? Most children (ages 1-5) 
  • have a bedtime routine of less than 30 minutes, 
  • go to sleep with the lights off
  • fall asleep within about 30 minutes of lights out. 
  • Night waking happens about once a week. 
  • More “self-agency” can lead to battles over bedtime. 
  • To reinforce good sleep habits, praise specific behavior: “Thank you for staying in bed” instead of “thank you for being a good boy!” 
  • Let your behavior/actions do the talking; try not to waste energy explaining, negotiating, or threatening when it comes to sleep times.

Difficulty falling asleep (in children who do not resist bedtime), is a separate problem from “bedtime battles.” This may require evaluation by a mental health professional for issues like anxiety disorders.