Baby Flora – 4 weeks old
Baby Flora was 4 weeks old when her mum phoned us. She was napping beautifully in the day but waking every 2 hours at night. Mum was sure she was not hungry as she was gaining 200 grams+ each week and wasn’t even interested in a feed after 2 hours of sleep, she just needed to be re-settled.
Mum was a previous client so had great settling skills and was able to settle Flora back to sleep easily, but understandably this was exhausting and mum was contemplating a hammock over night. Whilst hammoks can be great, this mum was thinking she would rock the hammock all night for a quick re-settle. After chatting for a while, mum didn’t really want to get into a rocking to sleep association when Flora was actually easy to settle already and was even self settling for lots of her naps.
Flora was awake around 90 minutes between her naps and having 1.5 hours in the morning, then 2.5 hours from 11.30-2.00pm and another 1.5 hours from 3.30-5pm. She wasn’t interested in cluster feeding and was asleep by 6.30pm.
I felt even with 90 minutes awake time Flora was showing signs of getting too much day sleep, particularly in the late afternoon. We pushed her middle nap out by 15 minutes as mum felt she wasn’t even upset at 11.30am and this would be easy. We capped her afternoon sleep at 1 hour, essentially trimming 45 minute off her day naps!
That night Flora slept from 6.30-10.30pm. Mum was trying a 10.30pm feed to establish a long stretch of sleep from 10.30pm onwards. Flora was falling asleep in mums arms and very difficult to convince to eat. While a long awake feed at this time can help some babies consolidate their night sleep, in Flora’s case I don’t think it was, and I think it was then encouraging the extra wake ups after midnight.
Night two of less day sleep, we didn’t do the 10.30pm feed and Flora slept until midnight! She then was easy to feed and took a nice big feed and was easy to re-settle, back in bed asleep by 12.45am.
She then woke at 4.30am for another quick feed and up for the day around 6.40am.
A huge improvement from a few day time tweaks!
No cry sleep training baby Hugo
Baby Hugo was 9 months old and had always been fed to sleep, he was sleeping in his cot side cared by mums bed. He would wake 6-8 times a night to feed to sleep, spending a lot of the night from midnight onwards in mums bed.
This is a common story we hear, usually the trigger point for the phone call to us, is the naps start to fall apart and the rocking/bouncing holding gets harder and harder. This is usually due to developmentally the baby has outgrown the settling method and they are becoming over tired from the accumulative affect of the frequent night wake ups. The fragmented night sleep is not as restorative as consolidated chunks of sleep.
I always recommend a gentle approah when feeding to sleep is the association. Hugo’s mum was on board as she was a big advocate of no cry sleep training.
I explained how she would use her voice and touch and even nursing to help Hugo calm down, but we wouldn’t assist him to sleep. I explained the hierarchy of our settling approach to Hugo’s mum and how to back off when Hugo was ready. We discussed the way Hugo was communicating with his cries, and that it was ok for mum to listen then react to his cries, and not always be able to “stop” the crying immediately.
I gave mum the option of delaying nap training and work on nights for a week, she said she would play it by air and we would obviously stay in contact. The first night Hugo needed to be nursed 3 times before he self settled. Pretty good in my books!
By night 2 it was 1 nursing session and by night 3, none!!! Not even any touch! Hugo was nailing the evening settling. Mum was loving lying next Hugo on her bed and being there for him, but giving him the space to wind himself down.
We often get frustrated as parents when our children don’t fall to sleep immediately. But the reality is 20-40 minutes to settle to sleep (not crying) is really normal.
Hugo’s night sleep consolidated easily into a big 6 hour chunk and then 2-3 hour bits until morning, this was a work on progress.
While mum was going to wait to nap train Hugo, she felt on day 2 he was ready. Boy was Hugo ready! He settled with no nursing, just mums voice and touch, and slept for 1.5 hours, and repeated this later in the day!
The other big change for Hugo was his 4.45am start to the day moved to 7am! He was being fed around 5am and settled back to sleep, but this did mean he was getting much more night sleep, and not waking up so over tired.
It took another 2 weeks of gentle changes to consolidate Hugo’s night sleep into a 12 hour block and for his naps to be a consistent 1-1.5 hours each. But the moral of this story is even with gentle sleep training the changes are rapid when everything is looked at from an holistic point of view and the sleep training method does NOT compromise mums parenting style.
Baby Oliver – the cat napper!
Oliver was 4 month old who had not been swaddled since birth, his mother had incorrectly been told that swaddling would damage him and subsequently she had never tried it.
By 4 months he was a healthy 7kg and still exclusively breastfed, he was clearly thriving in all aspects of his life, except sleep.
Oliver was a serial cat napper (45 min sleeps), these short sleeps hadn’t bothered Mum so much when he was younger as she knew that he was neurologically immature and possibly not ready to link his sleep cycles together. However now after 4 months of 45 minutes his naps where becoming progressively shorter and sometimes 25-35 minutes was al that Oliver would nap for every 3 hours or so.
These short naps were beginning to stress mum out, as Oliver was also waking more frequently at night, his 4-7 hour stretch of sleep he was doing from 8.30pm had reduced to 1-2 hour’s, and often 45 minutes was all he would do until 11pm!
Because Oliver had never been a great sleeper mum was now in the habit of rocking Oliver, but this was taking longer and longer at each nap, and becoming more difficult as he got bigger.
He was struggling to settle at his usual 8.30pm bed time, and thus mum and dad where not eating dinner until after 9pm at night, and they felt their relationship was being strained and their older daughter Eve (4) was suffering with two very tired parents.
It became apparent to me that Oliver had a severe case over tiredness, and this sleep debt from being over tired was accumulating day in and day out, and this was making his sleep cycles become shorter and his bed time move later.
His little body would have been pumped full of stress hormones and these prevent babies from easily drifting into a deep sleep.
We discussed Oliver’s cat napping and lack of swaddle, mum was reluctant to swaddle since she never had. But after seeing for herself how much Oliver was startling himself still at 4 months when we tried to settle him she agreed to try the 0.5 tog ergo cocoon swaddle I had in my kit.
I didn’t think a tight swaddle would suit Oliver’s temperament as he was already showing signs he wanted his hands in his mouth, and he had never been swaddled. So I find at this late stage the best option is a swaddle like the ergo cocoon. Dad was never any good at swaddling their older daughter Eve when she was a baby, so he was impressed at how easy the cocoon was to use, and the fact that Oliver could easily be weaned off it by removing one arm in a months’ time.
We looked at Oliver’s sleep environment, and hung some black out blinds for the day to see if a darker room would mean less distraction for Oliver and help him to produce some of his own melatonin and feel drowsy enough to self-settle and sleep for longer than 35/45 minutes.
Mum and Dad discussed the logistics of no cry sleep training, and as is often home with Eve and Oliver they decided mum would need to be able to readily leave the room to check on Eve while teaching Oliver to sleep without being rocked.
We also decided to use some white noise as Eve had a distinct shriek which Oliver clearly new was his big sister and this would wake him frequently from his sleeps. White noise also helps trigger babies calming reflex and this helps them self-settle. (As does swaddling!)
We set up a nice pre nap ritual, Oliver into his room, black out curtains shut, white noise on and ergo cocoon on for a cuddle with mum singing her favourite nursery rhyme to Oliver.
Oliver quickly (in 8 days) adjusted to his new nap routine, he was self-settling for 2 out of 3 sleeps, the third nap was often in the car on the way home from the shops or pre-school. Mum was surprised at how little Oliver cried even though she was prepared for 3 tough days, he settled really quickly. Mum had tried a similar technique a month before but claimed Oliver only became hysterical when she left him. I felt this was due to being too young and not ready, and then not having any swaddle or white noise, and the bright room which was not sleep conducive. We also looked at the timing of Oliver’s naps and ensured they fell within his age appropriate biological sleep windows. This always means crying is minimal.
Mum is now able to spend more time with Eve, and Dad is even confident he can settle Oliver as the changes where simple and the swaddle uncomplicated.