Jennifer Hamilton, a Mothercraft nurse and Karitane enrolled nurse for 20 years and a mum, provides tips and ideas for helping your babies to have a good sleep routine. This is a great opportunity to ask someone with both personal and professional experience your questions.
Jennifer has been overwhelmed with questions. For more information review the sleep articles on the Huggies website or visit Jennifer’s website, Maternity Matters.
At this age babies get used to sleep associations to get to sleep and to be resettled. It is a good idea to encourage your baby to sleep without things such as patting rocking, feeding or dummies. Try and use these things as a last resort when settling, after 30 mins or so and after a while he will learn to settle himself and when he can achieve this he will not rely on intervention from you when he is in a light sleep (after 45 mins) to help him back into a deep sleep. He will then naturally sleep better. It can take a few days for him to get used to. Be consistent and he will learn to sleep without association.
At 4 months solids is just to familiarise your baby with different tastes and textures. He will be getting most of his calories through her milk feeds. Try starting with rice cereal and then when she is happy with that mix a little pear or apple with it. As she becomes more familiar with solids she will have more filling foods. This is when she is 6 months or over.
Try and encourage her to settle without the bottle. Have a bedtime routine and talk to her telling her that she is going to bed and don’t mention the bottle. If she asks for it distract her with maybe a book or a teddy and a story. At this age you need to make the decision and get rid of the bottles altogether. She is too old to wean her off them. Be consistent with the cup with meals and maybe a little milk from a cup before bedtime. She may ask for the bottle to begin with but through consistency she will forget about the bottle and get better with a cup. Tell her what a big girl she is and try to ignore her demands for the bottle. It will get better. When you are ready you will be surprised that it really is not that difficult. When i disposed of my daughters bottle at 17months she did not even ask for it. I bought her a big girls cup!
If you are ready to make the change you have to be consistent. You cannot give in. if you don’t like the idea of controlled crying then sit by his bed with your back facing him but do not talk to him. Tell him it is bed time and time to go to sleep. This can be hard but you need to ignore him and if he gets out of bed put him straight back into bed without talking to him. Each time he gets up at night walk him back to bed without talking. Sit by his bed until he falls asleep but don’t interact. This can be a long process but will work if you are consistent. As he gets better at falling asleep move further away from his bed until you are sitting at the door way. At this age he understands what you are doing but he will try and get your attention. You need to be consistent. He knows you are there and you love him but he needs to learn that THER IS NIL INTERACTION AT BED TIME OR THROUGH THE NIGHT. The other alternative is controlled crying.
You do not need to completely wean. You need to encourage him to settle and sleep without association. Sleeping in the parental bed is an association and he finds it hard to fall asleep any other way. Offer the breast feeds only at breakfast, lunch and dinner. Do not feed directly before bed or upon waking. Teach him to feed for nutrition and not for comfort (which is what he is doing over night.) you can offer milk in a cup with lunch to start off with but you need to remain consistent. If he does not take to it straight away this is normal. Be consistent and he will become familiar. If he is eating well then the two other breastfeeds is enough whilst he is getting used to the cup. It is a catch twenty 2. if you keep feeding over night then this will interfere with how well he is eating in the day. It is really about his sleeping and he would benefit with learning how to sleep through the night. He does not need to feed overnight.
My daughter did this to me often. Very frustrating. If she is older and crawling it is hard to prevent. Just make sure ther is nothing in the cot and put her down in a sleeping bag. She will find her own comfy position. If she is younger and unable to sleep on her tummy safely then settle her on her back, perhaps wrapped or at least with a cotton sheet tucked very firmly over the top of her so she finds it harder to move around.
She does need to get some sleep during the day. Also as she gets older it is quite common for babies who don’t sleep well to start night waking. This can happen at around 6 months and you don’t really want this to happen. It is better to encourage and to teach her to sleep well both day and night to prevent later problems. You need to be consistent with settling techniques during the day. Even is she does not go to sleep you need to encourage her to for a good hour or so. This will have a knock on effect and she may have a sleep the next time you try. Sleep induces sleep in babies so don’t get her up just because she protests a little. Be consistent and persistent. Teach her how to sleep. She needs it.
Why not wait until around 6 months. You can then introduce a cup with perhaps a little formula. Be consistent offering the cup with perhaps a meal in her high chair and she will get used to it and it will not interfere with your breastfeeding. Some babies never take a bottle so don’t be too hard on yourself
You are doing a great job and at 7 months if she is a good eater which you say she is she will get all the nutrients she needs. Offer her a cup with her lunch time feed (solids) and then offer the am and pm breastfeeds. This is all she needs and she will be adequately getting everything she needs. The cup you offer can be breast milk or formula and in a little while you can change this to cows milk. If she is having cows milk with her cereal and has been ok then cows milk in a cup is more than fine. Don’t stress she is doing great!
Give her something in replacement of your hair. Such as a blanket or teddy. Tell her she cannot play with mummy’s hair to go off to sleep anymore. At 2 she understands what you are telling her. Sit by her bed with your back towards her but do not interact with her. Ignore her demands and if she gets out put her straight back to bed and sit facing away again. Continue this until she falls asleep. The trick is to let her know you are not abandoning her but you want her to go to sleep on her own. If you ignore her she will be cranky at first but will soon learn there is no point in staying awake because she is getting nil attention. As she gets better move further away from her, this should take approx a week or so. Soon you be sitting at the door and she will not need you to be there. Rewarding her good behaviour is also good so each time she goes to sleep by herself without too much fuss reward her in some way the next day.
A lot of babies by this age refuse to take a bottle. Offer a cup at the same time each day, preferably with a solid meal. Be consistent, it can take a few days for him to get used to it. The cup can be breast milk or formula. When you go back to work he will only need 3 milk feeds a day so he can still breastfeed am and pm and have a cup with lunch. I hope this helps.
You need to be consistent. Once you have decided to make a change and teach your son to sleep in his own bed you need to stick with a consistent set of rules and techniques until he achieves it. At this age he will protest quite strongly but if you remain strong he will have no choice but to sleep in his own bed. Just like he has learnt through consistency to sleep with you he can learn to sleep on his own. Start gently by sitting next to his cot but with your back facing him. No matter how hard it is you need to be strong and to ignore his demands. Sit there until he falls asleep and each night move further and further away from him until you are at the door and then not even in his room. Each time he wakes overnight sit in his room but do not give in and put him in your bed. Once you do you will have to start again. He will get used to sleeping in his cot because he will have no choice. He won’t feel abandoned because he will know you are close. He will also know he is getting no attention.
Your other option is controlled crying where you actually leave him to learn to settle on his own. The first option is the gentler approach but can take some time and a lot of patience. Both ways will work if you are consistent. You have to teach him how to sleep on his own, unfortunately at this age he is not going to just do it out of the blue! Expect this to take 1-2 weeks.
Babies wake many times a night as we do. It becomes a problem when we attend to them and give them attention. They get used to it and will remain awake until they get some attention. In your case it is a feed which I can understand why you give. Sleep is precious! The rule of thumb that I use when working with night wakers is if they are not crying in a loud and distressed fashion Leave them alone. They n need to be given the opportunity to resettle themselves. If she is not crying then don’t go in. If she does cry then don’t reward her with a feed. If you have to give her something then make it water. It is not as yummy as breast milk. She does not need that feed at night it is just a habit. Also give her a dream feed at 10pm. You wake her for this feed and you know then for certain that she is not waking from hunger. You can then confidently encourage her to settle without a feed. Only attend to her when she really needs it. If she is just making noise ignore it.
Parents tend to let their babies sleep for long periods without a feed in the first half of the night and then feed them whenever they wake in the second half of the night. I encourage parents to wake their baby at 10pm for a quick dream feed. They are then more confident with resettling without a feed through the rest of the night. The 10pm feed works well for a couple of reasons. It teaches your baby to feed and wake during the night only when they are woken. It tops baby up and gives them the right amount of calories that they require. It also puts you in charge of a parent directed routine compared to a baby directed routine. The 10pm feed can be a bit daunting at first but through consistency it works best for encouraging baby to sleep through the night. My definition of sleeping through the night for your baby’s age is bed at 6-7pm, dream feed at 10pm and sleeping until5-6am. This is very possible at this stage for your baby. You can find more information about an appropriate and realistic routine for your baby as well as a step by step guide for the 10pm dream feed in my parent craft manual which is available through my web site.
I had the same experience with my 2 children. My son was sleeping well at night by the time he was 8 weeks and my daughter hardly slept, no matter what I did until she was 4 months. I did exactly the same thing with both of them. NATURE VERSES NURTURE! Even though they responded differently I tried to remain as consistent as possible. Babies can change in their behaviour so dramatically from week to week. It does not take long to then start trying different things. Especially when you are desperate for sleep and when you have other children and things to do. You need to start again being consistent from whatever stage you are at. Try not to compare babies or look back at the differences. Be consistent again with the 10pm feeds coupled with settling techniques and he may start responding. All of the techniques and guidelines we used and encouraged with your daughter are in my manual. It may help you to remain a little more consistent with making the changes and will remind you of what you did with your other baby. Take a look at my web site, Maternal Matters, if you want a copy.
Tell your ever helpful mother in law that he is not vomiting. It is called positing and it is very common in babies. It is an overflow of milk that comes up before, during and after feeds. Some babies do it more than others. There is a little flap that sits at the top of the oesophagus. This flap lets food in and keeps it in. in babies this flap is very immature and can also let food out until it gets stronger and works more effectively. If your baby is not terribly upset by this, is having wet and dirty nappies and appears to be healthy and putting on wait then there is no problem. My son was a chucker and I found it nothing but inconvenient as I was continually washing and I always smelt like vomit! He will grow out of it. One thing I would suggest is that you do try to keep him on the first side for lo9nger so that he does not constantly get such huge volumes of milk from both sides. The first part of a feed is high in volume but lower in fat. The second half is lower in volume but higher in fat. If you keep changing sides and only giving short feeds he will always receive the large volumes. I know you were given the short but frequent feed advice but when I am working with babies with the same problem I find the less they are feeding and the more they are resting the less positing they are doing. Babies also grow when they are sleeping so if you are feeding him too often he is not getting a chance to rest his gut.
This is very common. Babies are often unsettled at this time. In answer to your question, yes they can grow out of it but usually need to be encouraged to sleep better. It is through encouragement and consistency that they will start to settle down and by 10 weeks if he is getting more up time during the day he should be starting to settle down. When they are newborns they tend to respond favourably to comfort settling (up in arms etc?) but as they get a little older they can become effected by overtiredness and then find it harder to switch off and settle. You need to become a little more consistent now and encourage him to settle at this time of day. Keeping in mind that at the end of the day babies find it harder to settle using a consistent set of settling techniques can gently direct and teach your baby to settle. He has gotten used to you picking him up and therefore demands it because he finds it hard to settle in his cot. Try wrapping him firmly, put some music on in his room, hold him until he is calm and then put him down. When he is unsettled try to encourage him to settle without picking him up. Turn him over, try patting him to calm, use a dummy and only pick him up as a last resort after approx40 mins of settling him in his cot. The more often you do this the more familiar he will become with settling in his bed at this time of day. This settling information is available in a step by step fashion in my parent craft manual. It contains appropriate and very effective settling techniques for your baby.
This is one of my most passionate topics. I really feel there is too much pressure on women breastfeeding today to not introduce bottles. Women are told that it will encourage the baby to wean. I totally disagree with this. I feel that a bottle introduced the right way and with the notion not to wean in mind is a very healthy option for mum,bub and the whole family. I believe that as a mum you need time out and a lot of mums, out of necessity, have to return to work. So many new mums ring me asking for help when their baby is 4 months old, they have to go back to work but their baby won’t take a bottle. This is a very stressful situation and one that can be totally avoided if given the right advice in the beginning. Most babies by the time they are 4 months old will not take a bottle if they have not had one offered as part of their routine. The sucking technique is totally different for baby in breast and bottle feeding so if they are unfamiliar they basically have no idea how to do it. I really encourage you to offer a bottle now before your baby gets too much older and if you only give one bottle every couple of days (at least every 3 days) and all other feeds are breast then I don’t see how that could negatively affect your breast feeding. My motto is Happy mum, Happy baby! I think time out for mothers is extremely important and I think one bottle every couple of days (bottle can be expressed breast milk) is a far healthier scenario than a mother feeling exhausted and a little trapped when she cannot leave baby’s side. There is a lot of practical information on this topic in my parent craft manual. Good Luck!
For more information see Episode 5 Baby care or Parenting .