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Thursday, November 02, 2006
Sleep Advice From Dr. Marc Weissbluth

Dr. Marc WeissbluthDr. Marc Weissbluth is well known to new parents for his expert guidance on helping babies sleep soundly. His book, Healthy Sleep Habits, Happy Child, sits on the nightstands of sleep-deprived parents everywhere. He’ll be here next Tuesday and Wednesday to discuss healthy sleep habits for babies and he’ll have three local couples on stage with him Tuesday.

These parents are members of our Parenting Center and subscribers to our Parenting Activities email list. They responded to our call for participants and have been in consultation with Dr. Weissbluth for the past month via email. After the jump, we offer excerpts from these three sets of email exchanges in the hope they might be of use for other parents of young children with sleeping problems. 


Parent 1: As far as letting baby learn to soothe himself, I am prepared to do this in moderation if his doctor determines today that he is in good health. I am not sure I could let him cry in the evenings right now because 1) emotionally, I think I need my husband to be here with him and let me leave the apartment while he cries or I won’t be strong enough and 2) I often have to get back online and work for an hour or two as soon as possible after baby goes to sleep, so I need to use the path of least resistance most of the time. I can start with the daytime naps. I also worry that it will be a battle with baby because he has quite a bit of determination for an infant. (Just ask my nanny!) I also worry about how one determines that a baby is ready to self-soothe. Are all babies equipped to learn this at 4.5 months? If he is not, am I harming him or breaking his trust?

Dr. Marc Weissbluth: Continue to breast feed baby at night but no more than twice at night.  If you think he is hungry, nurse him anytime after 9:30 pm and again anytime early in the morning. Absolutely do not sleep with him in your bedroom and do not spend time otherwise soothing him at night. Before 9:30, after the first night feeding, and after the second night feeding it is dad’s responsibility to do ‘check and console’ whenever baby needs attention. Ignore very quiet sounds at night and dad is to respond promptly to loud fussy sounds or crying. Dad will soothe him until he is calm, drowsy but wake and leave the room.  Dad will do this as often as necessary up to about 6am when you start the day.  Do not start the day before about 6am. This plan is not for forever.

Parent 2: He goes to bed every night between 6:30 and 8pm, usually just before 7, and rarely after 7:30pm depending on the day. Most often, the first part of the night is when we get the longest stretch of sleep—only once a week or so will he wake before 11pm, and usually he wont wake until 12am-ish for a feeding. Then, i’d say half the week he goes back down until sometime between 3-5am, and then doesnt wake again until 6:30am ish when he usually plays quietly for at least 30mn. The other half of the week he wakes frequently after the midnight-ish feeding, and unless I am really exhausted or desperate, I do not feed him more than one more time—we just let him cry. He usually only cried for a few minutes, but then wakes frequently to do that.

Dr. Marc Weissbluth: Is he calm, attentive, alert, pleasant (well rested) or rough around the edges, easily frustrated, demanding, or clingy (not well rested)? Is he in your bedroom or in his own room?  How dark and quiet is the room during the day and at night?

Parent 3: We followed your instructions last night and Sam did not get out of bed or call out before he went to sleep. Actually, he was smiling as he thought about getting chocolate and TV in the morning.  At 6am, however, he came into our room and needed a diaper change.  He may have also heard his sister as she was up early. We also noticed that his bed was wet so we put him in the bed next to his and told him that he had to go back to sleep until it was light out for the reward. At 6:30 he came downstairs to the playroom where I was with his sister. It wasn’t quite light but it was an improvement. I gave him the reward. Do you think I should have withheld as it was not 7am? He really never slept or stayed in bed until 7am before. I tried to use the alarm clock but he plays with it so much that it gets messed up and ends up not working. I thought to use the “when it is light” outside rule. Any thoughts?

Dr. Marc Weissbluth: Thank you for the information. It appears that if you compare the past few weeks with past few years there has been much improvement for him. Unfortunately, I do not think the present improvement will persist or get better unless you make further changes. The reason I say this is because you are sending him mixed messages. You recite the Sleep Rules but he still gets a reward even though he violates them. This will cause him eventually to ignore the rules completely as he habituates to the reward. That is, the reward will eventually lose the power to motivate him to change his behavior because he gets it anyway. How do you feel about this interpretation?

My strong recommendation is to explain to him that tonight he is rewarded in the morning only for complete cooperation with the Sleep Rules.

[Dr. Marc Weissbluth: Sleep Smarts: 11/07/06]
[Dr. Marc Weissbluth’s Twin Talk: 11/08/06]




Comments Comments (84) | Posted in Family at 8:41am | Email this item to a friend. Email This to a Friend | | Back to Main


Comments Reader Comments

What was Dr. Weissbluth’s final solution for Parent 2 where the baby slept the first half of the evening but awoke between 3-5am?

By Sue at November 21, 2006, 4:58pm

I am so engrossed in your book Healthy Sleep Habits, Happy Child. I find myself highlighting sections and rereading them every day as if I am preparing for an exam. I am in the process of teaching my postcolic 3.5 month old to nap in her crib. Prior she would only nap in someones arms or her swing.  I also have transitioned her from my bed to the crib. Which was easy compared to naps. I get three 40 minute naps a day and have moved her bed time to 5:30/6pm. My problem is she seems to be tired most of the day and fussy shortly after the naps.  And by 4pm she is crying as if the colic were back.  How can I help her lengthen her naps-or is this just something that will happen over time?

By julie at November 25, 2006, 8:59pm

I have a 10 week old, who was born 4 weeks early and I am a single parent and will soon go back to work.  I have read Healthy Sleep Habits, Happy Child over and over again.  I am having trouble with him waking up fussy and crying after he goes down for his naps, after i get him he tends to sleep in my arm.  He will sleep for 30-45 minutes then will cry and is very angry and fussy.  He eats before he naps, so he can’t be hungry. Should I let him cry?
Also, he goes down at night around 7pm and wakes up crying every 3-3.5 hours, so I feed him.  Is it too early to skip any of the night feedings? If not how do I go about it?  HELP!

By sara at November 30, 2006, 12:44pm

I’m Sally Tannen, director of the Parenting Center, and I am responding to Sara’s post.

Sara, you are asking many good questions.Your baby is still young enough so that if he is waking up to feed, then he is hungry and you should feed him. Talk to your pediatrician about when you can drop one of the night feedings. It will depend on how much he weighs now, but young babies have small stomachs and can only take in so much at once so it may be to soon.

Babies can be very fussy in the first few months.The only way he can communicate with you right now is to cry. I’m wondering how long he cries when he wakes up after a short time. If you left him alone for a few minutes, does he calm down, or does he get more upset?Some babies go from 0-60 in seconds, and others just make some crying sounds, but then can get back to sleep. If he gets more wound up, then you should definitely pick him up and help him at this point because he’s too young to be able to soothe himself back to sleep on his own.

Do you know about our New Parent Get Togethers on Wednesday mornings? If you are in NYC, you should come. They are every Wednesday at 10:30, and every week is a different topic. Next week is Your Baby’s Temperament, and the week after is SLEEP!

I hope to see you at the Y! Good luck.

Sally Tannen

By Sally Tannen at December 01, 2006, 5:22pm

Thank you Sally.  I did like you suggested and left him alone once he started to cry for several minutes, sometimes longer than others, but never more than 5 minutes. (it seemed like hours!) You were right, he just went right back to sleep.  He will cry a couple of small bouts now during his 2hour!! nap and i just wait and see.  Yes he now will usually nap 2 hours!!!!! I just was not letting him before!!

Thanks.

By sara at December 03, 2006, 11:21am

My daughter has never slept through the night.  She is twenty-one months and wakes every 2-2 1/2 hrs.  I have tried earlier bed time, consitent naps, bed time routine,cry it out method ect, nothing is working.  She was diagnosed with slient refux at two weeks old and it has been a stuggle since.  She does however fall asleep without a problem for naps and bedtime. The night wakings are taking a terrible toll.  I generally end up crying next to her crib at night wishing she would just go back to sleep.  The only way we get peace is if I nurse her to sleep but that lasts only for a couple of hours.
My husband and I are at the end of our rope. I cannot get through the day without a break down. I don’t know what else to do?

By laura at December 10, 2006, 6:17pm

my 9 month of goes to bed between 6:30 and 7pm, I have tried to put him to bed later but he so ready for bed at this time.  He wakes every morning by 5am.  I think this too early and I have tried putting him to bed later but he still wakes up at 5am.  Can you please offer me some advice.

By helen tansey at December 22, 2006, 5:27am

My daughter does not sleep through the night and she is 20 minths old. She shares a room with her older sister, and is causing trouble for her as well. She has reflux, allergies, and asthma, but they are all treated and seem to be under control. I just dont know how to get her to sleep through the entire night. She doesnt generally cry when made to lie down for naps or bedtime, we still have the ocassional cry myself to sleep which can last from 30 minutes to two hours! Im at my limit, it is not only effecting her, it is effecting the entire family. And with her sharing a room, letting her cry at night is hard to do, sister has school the next day!

By Kelly at December 27, 2006, 2:28pm

Is 4 months too young to self soothe to sleep?

By Carol Murphy at December 29, 2006, 12:09am

My 5 1/2 month old will go to bed at night between 6:30-8:00. Then get up for the morning between 5:30-7:00.  He will wake up 2-4 times in the middle of the night for feedings or comfort.  But when I nurse him at night he falls asleep in my arms and when I put him in his crib he always immdediately wakes up crying and won’t go to sleep.  So I do the process all over again.  After an hour and a half and 5-7 times of picking up and soothing him he’ll finally sleep in his crib.  I have to do this two or three times every night!!  I get up for work at 4:30 in the morning and I don’t want to let him cry it out.  What should I do?

By MARY at December 29, 2006, 3:55pm

Dear Laura, and everyone:

Sally Tannen and other 92nd Street Y experts are now answering your parenting questions in a new section of our blog: Ask the Parenting Center. Email your questions to us and we’ll see if our experts can help you.

By Sean Flannagan at January 10, 2007, 1:45pm

I have a 7 month old daughter who sleeps pretty well at night.  We put her down between 6:15 and 6:45pm.  She usually wakes up once at midnight for a bottle and goes right back to sleep.  She was even started to sleep through the night a couple of times.  She then wakes up between 6am and 7am.  My problem is with daytime naps.  She had gotten into a schedule of down at 8:30am slepping for 45-60n minutes and then again at 12:30 spleeping for 1 or even 2 hours.  Recently though, about one hour after waking up, she is sleepy again, but if I try to put her down before 8:30am, she WAKES UP!!!  She only sleeps for 45minutes at the most, sometimes only 30minutes.  She then gets sleepy again at 11am.  Again, if I try to put her down before 12:30, she wakes up!!!...although she is crabby until 12:30.  She has also started to only sleep for 30 minutes. When she wakes up too early from a nap. should I let her cry back to sleep?  I tried once and had a wailing child!!! I have tried the late afternoon nap, but that is impossible..it was fine at 5 months, but no longer wants it.  I also find that if she does take even a 30minute third nap, it intereferes with an easy bedtime. THanks!

By Cristiane at January 25, 2007, 9:15pm

We have a 10 month old who sleeps thru the night (7:30 to 6:30 am). We have followed Dr. Weisbluth’s book since she was 4 months old.  Our problem is with naps.  She only sleeps for 30-45 min (around 9:00 and 1:00).  We have to put her down fully asleep or she cries for almost an hour before sleeping for 30 min.  What can we do to improve naps?

Thanks

Brian

By Brian Mess at January 29, 2007, 5:41pm

A friend recently gave me Dr. Marc Weissbluth’s book Healthy Sleep Habits, Happy Child and I’m finding it very helpful for my 4-week old daughter Colette (who was born at 34 weeks and 3 days).  I’m finding that his suggested methods work very well for my daughter, but there are occasional times when she inexplicably will not go to sleep.  For example, last night, she awoke from a three hour nap at 7:30, nursed, “played,” and then began exhibiting her sleepy signs at 8:30.  I changed her, nursed her to “top her off,” and put her down in her bassinet by 9:00.  She cried for five minutes, I comforted her; she cried for ten minutes; I comforted her; she cried for fifteen minutes, I changed her, tried nursing--which she acted like she wanted, but wasn’t really interested in because she was so overly tired.  This continued until midnight.  This happened the day before from about 3:00 pm until 6:00 pm.  My husband and I are pretty good about letting her cry for a set period of time before we go to her, but, boy, it is hard.  Last night, I knew that I was doing everything that I could do for her; but I have this fear in the back of my mind that there’s something earlier in the evening/day that I’m doing that is causing this.  She doesn’t seem to be gassy (last night at one point, I even tried Mylicon drops), although she has been spitting up a little bit more than usual.  Her bowel movements and wet diapers seem to be normal.  And at other times during the day (when she wakes, plays) she is a perfectly happy baby.  Any suggestions?

Mary Sheiko

By MarySheiko at January 30, 2007, 3:15pm

I am sleep training my second child(4 months).  The sleep training went well for both for the nighttime, however, naps are a nightmare.  My first cried thru every nap and never fell asleep until 1 year of age.  Now my second is doing the same.  I have tried nursing to sleep and laying him down awake, but drowsy.  How do I get him to nap?

By Jane at January 30, 2007, 3:33pm

I have rocked my 13 month old daughter to sleep at 6:30 or 7:oo every night since she was an infant. After letting her cry it out four weeks ago she usually fall asleep without a fuss now. However, she wakes at 5am every morning and will not take naps without crying for over 40 minutes each time. Even after crying for 40 minutes, she still only naps for about 30 minutes. I know she is exhausted, and fear that if I do not establish good habits now, she will suffer.

What advice can you give me on her early rising and poor napping?

Thank you

By Paige at February 10, 2007, 6:34am

I have 4 1/2 month old baby and his naps are just getting worse. His naps are exactly 30 minutes long and his wake period is 45 min - an hour.  Right around 4 month, his morning nap were getting longer to 1-2 hours then I went back to work, and it’s back to 30 minutes. He usually has four 30 minute naps before I put him to bed at 6-6:30pm. Recently, his afternoon naps became more difficult. He cries and fights it all the time.  I’m afraid my baby will be chronically tired although so far he seems to be happy and healthy. Any suggestion is appreciated.

By Amy Cliett at February 18, 2007, 3:24pm

My baby boy is almost 5 months old and STILL will not sleep.  I have tried several methods suggested by Babywise, Healthy Sleep Habits, etc. and feel as though I am losing my mind!  Our kiddo had colic for the first 3-4 months of his life, so I did not even attempt to follow any sort of sleep schedule until recently.  When we put him to sleep at night, he wakes up after an hour and a half or so and the pattern basically continues throughout the night.  The longest stretches of sleep are no longer than 3 hours.  I know that he doesn’t need to eat that frequently, but I can’t figure out what is waking him up.  Same thing for naps - he wakes up 30-45 minutes into his nap and is obviously still exhausted.  We’ve tried mylicon drops, different sleep positions, white noise, etc.  Am I really just supposed to let him CIO every hour throughout the night? Help!

By Angela at February 21, 2007, 3:31pm

I have a 3 ½ month old.  I have followed much of your advice in regards to my son’s sleep.  He goes to bed between 5:30 and 6:30 p.m. – depending on when he is tired.  Overall he is a good sleeper overnight.

My problem is naps.  After much work, it has become very easy to put him down for naps.  I just soothe him, put him in his crib and give him a kiss.  He then ‘plays’ until he falls asleep.  The problem is that he will only sleep for 40 minutes.  This would not be a problem, however, he is still tired following his nap.  If I nurse him (after the initial nap) he – many times- will fall back asleep on my lap.  If I let him sleep here, he will sleep for several more hours!  He is clearly still tired after the 40 min nap!!  I have tried not going to him immediately following his nap.  I wait until he cries (instead of just fussing) and then I go into his room.  When I walk in, he greets me with a smile.  The smiles make me think that he is refreshed and done with his nap.  When I pick him up, he starts crying, rubbing his face on my chest and acting tired.

How do I know when the nap is over?

By Kristen at February 22, 2007, 11:32am

My 5 month old daughter has recently started waking up at night and staying awake.  She used to wake up once or twice during the night to nurse, but she ALWAYS went right back to sleep.  She doesn’t cry when she wakes up, but she’ll talk to herself for up to 2 hours sometimes when she does this...it’s happened about 3 times in the last 3 weeks.  She naps pretty well during the day, so I’m not too sure what’s causing this.  I make sure to not interact with her when I go in to nurse her, but when she’s up, shes UP.  Any suggestions?

By Bridget at February 26, 2007, 12:05pm

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