Sleep clinic: Help! Our baby won't sleep
A reader wrote in to Gurgle magazine asking for help as her 28 week old baby isn't sleeping well. We enlisted the help of Rebecca Welton, mum of 2 and child sleep practitioner and consultant.
Hi Gurgle team,
We are first time parents and our son is 28 weeks old and is sleeping worse than he ever has; from birth until around 3 months there was a glimmer of hope as he was sleeping through for around 7-8 hours uninterrupted for his longest stretch but since then there has been a steady decline and I can't understand why!
I have trawled through the Internet and looked at every 'Sleep Solution' section that I can find but I believe we are doing everything suggested and cannot see a solution for our particular issue. I surely cant be the only one out there with these problems...can I?
Here are the details of the issue.
1. Night-time Sleeping
He has a bedtime routine of a bath followed by a bottle in his room (with dim lights and no talking) and then we put him in his cot and let him fall to sleep by himself. This happens at around 6.30-7pm each night. However, he has started waking up between every 30mins to 2 hours. We leave him for a minute or so to see if he settles himself but nine times out of ten we have to go up to him. Up until around 2am - 4.30am, when he feeds, he just seems to want his dummy again and drifts back of by himself. We don't pick him up when we go into him (unless for feeding of course). He has also started waking up completely sometimes between 4am and 5am! Every night is different despite his bedtime being the same and this problem has peaked over the last month. He has slept for a stretch of 9.5hrs for a total of four times since he was born...but then the night after this he will go back consistent wakings. There are also black out blinds in his room.
2. Daytime Sleeping
His daytime sleeping has never really improved from when he was one month old or so. He only sleeps for around 30-45 minutes for each nap...but very shortly after waking from his nap he is rubbing his eyes as he is tired again. I am sure he needs longer naps but unless we are holding him (which is not very often as I do not want this to become a habit) or if we very quickly put his dummy in when he stirs he just will not sleep longer than this. He sleeps in the same place, on our sofa, for his naps. He generally wants a nap every 1.5 to 2hrs.
Other information that may be relevant...
Our baby started weaning at around 20 weeks, he is on stage 2 food now and is enjoying trying lots of new flavours. His feeding cycle is around ever 2.5 to 3 hrs though. We have to give him his bottle before having his solid food or he will just refuse his bottle completely. I have been told that his milk should still be his main source of nutrition. He has on average 35oz over a 24hrs period plus 3 small solid meals.
We have always tries to limit the use of his dummy in the daytime but he does seem to have developed a bit of an obsession with it over the past few weeks. He will often whinge, for what seems like no reason until he has it. He likes to play with it/turn it around in his hands etc...I fear that he has grown dependent on it for sleeping but I don't know how to rectify that. I can't imagine him being able to sleep without it and would cry hysterically if we just took it away.
He has the odd bout of what I think is him teething...I give him some pain relief and he is generally ok.
Please, please could you offer us some advice...it's very difficult being a happy, playful mummy everyday on 4-5 hrs of broken sleep. I do the weekday shifts as my husband works and then he takes the weekend shifts so I can try and catch up on some sleep. My husband and I are even sleeping in separate rooms at the moment as he drives a lot for work so it's important that he gets his rest. So, as you can imagine this is putting a bit of a strain on our relationship too as we don't really get any time together.
I return to work in March and I am really conscious that I need to get him into a good routine as soon as possible.
He is overall a healthy, happy baby but I'm worried that he too isn't getting the rest he needs for his development.
Rebecca Welton is a qualified child sleep practitioner and author of Baby Sleeping Trust Techniques – Alternatives to Controlled Crying. She runs drop-in sleep clinics for parents, and blogs about sleep issues.
Here is Rebecca's suggestions to help our reader.
It sounds like you guys are really going through it - four to five hours of broken sleep each night, with you all sleeping in different rooms would be extremely difficult for anyone to cope with.
It does sound like he has a sleep association with his dummy. Everyone has sleep associations - as adults we have our own bedtime routines, for example, having a bath or reading a book. We then switch off the light, get into bed, and lie down with our pillow. These bedtime routines send the right messages to our brain so that we can fall asleep.
It is normal for babies, children and adults to wake several times a night. As adults, we might look at the clock, or go to the loo. Yet if you woke to find your pillow on the floor, you would pick it up before you could fall back to sleep.
Babies and children also have sleep associations. At the moment, he has a sleep association with his dummy. So when he wakes in the night (which is perfectly normal) and it has fallen out - just as you would fetch your pillow, he needs you to put his dummy back in before he can fall asleep again.
Try one of the following
1. If you don't want to get rid of the dummy, use a comforter toy that can attach to the cot and hold hold dummies. he can then learn where to find a dummy at night and can get them himself rather than calling for you.
2. The best long-term solution, though, is to be dummy-free. Teach him how to fall asleep, without a dummy, by using a settling technique (the Waiting Game or Peekaboo Baby) consistently: so every nap time and every bedtime. Do make sure he has a special toy during the day, and in his cot at night, so he has another comforter.
Have a nap time routine – this should be similar to your bedtime routine, but not as long (between 5 and 10 minutes is about right). Put him down to sleep in his cot, rather than on the sofa – this way, when he wakes between sleep cycles he will either find a dummy with comforter toy or will be able to settle himself back to sleep without a dummy.
Once his sleep association with his dummy has gone, you will find that his sleep is much less disturbed and as he becomes less sleep deprived, he should start to sleep later in the morning too.
The Waiting Game
This technique can be used from five months.
• Follow your usual nap or bedtime routine, but end it with you gently placing your baby in his cot.
• Stay next to the cot, but try to avoid eye contact. If he cries, rub his tummy or stroke him, but do not pick him up. Stay with him until he falls asleep.
• Once he is used to this new routine (it may take a few days), try to move a bit further away from his cot as soon as you have placed him down. Don't touch him but do stay with him until he falls asleep.
• Once he is happy falling asleep in this way, try to move further towards the door every few days.
• Eventually he'll be happy to be placed in his cot and for you to leave the room.
This technique can be used from six months.
• Follow your normal nap or bedtime routine, then gently place your baby in his cot.
• Leave the room.
• As soon as he starts to cry, or if he continues to cry, go back to him. Briefly reassure him and then leave the room again.
• Don't touch him or pick him up.
• Remain in the room only long enough for you to reassure him that you will keep coming back if he needs you.
• Don't stay away for long – if he is crying, you should go to him immediately.
• If at any time your baby's cries spill over into distress, cuddle, stroke, or pat him in his cot (try not to get him out of the cot) until he calms down, then start again.
Initially, you will probably spend most of your evening doing Peekaboo Baby, but it is rare for it to take more than a week before your baby will happily settle by himself.