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Baby Sleep Questions Answered

The Sleep Survival Zone

By Amalah

Dear Amy,

This first time mom needs help undoing some bad sleep habits that I admittedly let my four month old son develop.

My son had all sorts of stomach issues when he was born. We finally got a diagnosis of bad reflux and lactose sensitivity, but it was a lot if trial and error to get there. He is now on Zantac and special formula and gaining weight like a champ. He also is now (mostly) sleeping through the night. But prior to figuring out what was wrong, he was up every one and a half to two hours at night and would only do 15-20 minute catnaps during the day.

I have a very fast paced, demanding career which I love, but the office doesn’t fall under FMLA requirements and I only got 6 weeks of unpaid maternity leave. And my husband left with the military the day before I went back to work. So starting at 6 weeks, and dealing with all these stomach issues, I was doing it by myself while working and was willing to do ANYTHING to get this kid to sleep more than 60 minutes at a time.

So now, at 4 months, he is very dependent on a bottle to fall asleep (but refuses every pacifier ever created), and won’t sleep anywhere except in my arms or in the rock and play with the vibration on. And has a hard time staying asleep unless I keep pushing the button to keep the vibration on. I’m trying to transition him into the pack and play but it’s been awful. I’ve inclined the mattress, I’ve stuck a vibration thingy on the side of the mattress, I’ve given him the bottle while laying in the pack and play, I’ve set him in there after he’s asleep (never stays asleep longer than 20 minutes). I’ve tried being in his sight, out of his sight, white noise, nightlights, total darkness, swaddling…..Nothing works. I’ve also tried cry it out (which I hate), but after 15 minutes and him working himself up to heart wrenching wails, I just can’t do it. He just can’t self soothe.

He’s about to outgrow the rock and play and I’m about to put him into daycare two days a week because of current relative babysitting issues (which is a different can of worms entirely). I have to get this munchkin to sleep! Help!

Desperate FTM

Okay, here’s what I want you to do:

RELAX.

I doubt there’s a four month old out there who isn’t still reliant on some kind of sleep association/crutch (or two, or four). I always think of the first three months with a newborn are a solid “do whatever it takes” survival zone. Baby only wants to be held, co-sleep, sleep in a swing or carseat, nurse/bottle-feed to sleep, use your knuckle as a pacifier all night, FINE. DO IT.

(Within reason, of course. I don’t care how much better some newborns sleep on their tummies or nestled among a sea of pillows or on the couch…that’s all patently, hugely unsafe. We’re talking common-sense concessions here.)

And then yes, around 12 weeks old I think you can start getting serious about creating more of a nap/sleep schedule and consistent routine. But understand that for most babies, it’s NOT going to be an overnight transition where they’re just like, “okay cool, a crib, I guess I sleep here now zzzz.” And that it’s NOT a sign that you’re doing all the things wrong and/or have irrevocably ruined your child’s chance at healthy sleep habits.

There’s ALSO this little thing called the four-month sleep regression, where any good habits you maybe managed to establish in the earlier weeks tend to go completely out the window. Which is why I personally don’t recommend (or see much point to) trying to formally sleep train before six months. Ride out the regression at around three/four months, focus on mapping out a good daytime sleep schedule (the 2/3/4 schedule works well at this age), and more or less keep doing whatever you need to do to ensure maximum sleep at night.

Since your son has reflux, he’s going to be super-resistant to lying on his back in a crib, even at an incline. It’s going to more uncomfortable for him that the “average” infant (who will still put up a good fight about it as well), which is another reason I suggest tabling your concerns for a couple more months. At six months (around the time when he’ll be ready for solids), his esophagus will be better developed so you’ll likely see a marked improvement in the tummy/reflux department. Which means you’ll see a marked improvement in his ability to tolerate a different sleeping arrangement. Not necessarily his WILLINGNESS, but he’ll at least be physically ready, and you can embark on a GENTLE sleep training regimen. (I DO NOT recommend straight-up CIO. A gradual “fuss it out” extinction method like Ferber will get the job done without thoroughly traumatizing everybody involved.) But know that some reflux babies really can’t sleep on their backs until 7/8 months, so keep your expectations reasonable.

As the Rock-n-Play will pose a serious safety concern for him, I definitely can’t recommend that you use it past the age/weight guidelines. Which means you might end up having to hold him or co-cleep (SAFELY) until his reflux issues improve a bit more and you are ready to give sleep-training (again, NOT CIO) a try. And cut yourself some slack about it. Reflux babies have different sleep needs than what all the baby books describe. It is what it is, you do whatever you have to do.

(As an aside, I haven’t examined a recent/new model Pack-n-Play, but on the one I had, the standard mattress was admittedly pretty uncomfortable. I’d use it in a pinch for naps or travel but I don’t think I could’ve expected my babies to be happy sleeping there full-time without a serious mattress upgrade. If you’ve already bought a better mattress for it, great! Ignore me.)

As for the daycare concerns…honestly daycare was a damn Christmas MIRACLE when it came to my oldest son’s sleep habits. He was 12 weeks old and had been (mostly) sleeping through the night for about a month, but his nap schedule was a hot mess and as time went on I could see our awesome nights of sleep going increasingly AWOL because he was so overtired. Daycare got him on the 2/3/4 nap schedule so freaking fast I couldn’t believe it. I followed their lead the first weekend at home and it was like…oh. Wow. Look at that. NAPS ARE A THING THAT CAN HAPPEN.

So again: Relax. Relax relax relax. Your baby isn’t broken, he’s just still really tiny. Enjoy him.

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Comments

  • Myriam

    4 months! IMHO, there are no “bad habits” at 4 months. We are not takling about a 4 yo. At that age, the brain is not mature enough to “desire” something, they just know what they need. Try to accomodate what he needs, safely, and go with it. And don’t believe for a minute that most babies sleep through the night at that age. Some do, but most don’t. My children, who didn’t have health issues, also followed that pattern of night time and nap sleep (up every 2h and catnaps during the day).

    And trust me, all kids learn to fall asleep on their own eventually. When and how is really cultural, and varies from family to family. Sleep is just not a linear process. Good luck.

  • bookworm81

    Can he roll over and/or lift his head? When our first was constantly spitting up our pediatrician told us that the best sleeping position for babies with reflux was on their stomachs on an incline and since he was strong enough to lift his head it was fine. As a first time mom I was still nervous but the incline didn’t work because he’d just slide to the bottom of the crib and get upset. Then at 2 months he started rolling from back to front as soon as you set him down so we no longer had any control over sleeping position anyway. You might ask your pediatrician what they think.

  • Dan

    Oh sweet honey child. I know your pain. Our child was a desperate horror show until we figured out he had silent reflux and milk issues. Then, less so but still maddening.

    Two things: get his meds checked. He might need more or different meds to help him be comfortable enough on his back. The other thing that really worked for us was putting him to sleep slightly on his left side. The left side helps close the stomach valve. I’m talking like a 45 degree angle so he’d really need to work to roll onto his front, with the crib inclined upwards too. The Chicco Next 2 Me crib was really useful for this. We also used a long towel rolled up in a u shape around the top end of him (this was what we laid him against for the side angle) but far away from his face. This helps with a feeling of being in a small place rather than a big crib. We had to hold him to sleep for at least the first three months, then we started trying putting him down about 5 minutes before each nap with a hand on his belly and read to him. If he really got in a fuss (more than a little noise) then we’d pick him up and cuddle him and put him back once or twice and then give up. Don’t leave till he is asleep. He now goes to sleep on his own from about 6 months.

    The bottle is probably helping him sleep for usual comfort but also because it helps keep the milk moving downward rather than back up. Don’t stress about “habits” at this age, it’s too early to sleep train.

    Find someone (a night nanny, a grandparent) and throw that person under the bus for a night. Warn them but then get the hell out and go sleep.

    And the no more than 20 minutes thing is because that’s how long a sleep cycle lasts, roughly. At the end of each he wakes up lightly and realises it’s not how he went to sleep then wakes himself up.

  • Rachel

    A 4-month-old is way too young for a 2-3-4 schedule. They can only stay happily awake for about 2 hours at this age. Most 4-month-olds still take 4 naps! 2-3-4 would be better after 6 or 7 months old.

  • Ali

    Completely agree with this. Neither of my kids could handle more than 2 hours of wake time until at least six months, and at four months were probably only up to 90 minutes or so of awake time at a time. I also think four months is too early for bad habits…just do whatever it takes at that point. I could only tell that my kids feel into habits more around 8-9 months…that is when I realized sleep crutches were a becoming an issue. Coincidentally maybe, but that is also right around the age we tried to cry it out…..both kids only took 1-2 nights of 10-15 minutes of crying to resolve any issues they had falling asleep. I know some people think CIO is torture, but for our family, it really was best for everyone. I highly recommend reading the Weissbluth book on sleep. It is my sleep bible!

  • Lindsay

    Hi, Desperate FTM checking in! Baby boy is almost 7 months! We double checked his reflux meds, which were fine. I spent the past three months pretty much holding him 2/3rds of the night. I was finally able to get him out of the rock n play and into the crib, lying on a slight incline and on his stomach (cleared by pediatrician at 6 months). He hit the 4 month sleep regression hard shortly after I wrote the submission, and I didn’t sleep for about a month after. I tried co-sleeping a couple times, but it terrified me so much I just couldn’t do it (I know it can be done safely, but it was a huge fear for me and stressed me out too much, so I wasn’t getting any more sleep). At this point we’ve got a great daytime nap schedule, but nights are still a hot mess. I can almost never get him to fall asleep in the crib, even with a gentle sleep training regime (didn’t do straight CIO), and after trying every lovey/lullaby/crib projector, ect. He’s still falling asleep on me most nights after a long struggle, then I can put him down in the crib and occasionally he sleeps through the night, but more often I’m up 3-6 times a night.

    I’m at a point where I’ve just accepted that it’s going to take a long time for him to develop into a better sleeper. But I’ve also started seeing a doctor for PPD/PPA, so that has greatly reduced the stress level surrounding the sleep issue. And every other aspect of raising a kid. I didn’t know it wasn’t normal to be as frantically stressed out and scared 24/7 about every single part of this process.

    • Alpha Mom (TM)

      Thank you for checking in. Even though you are still having a tough time at night, I’m relieved to hear that you are taking care of yourself for PPD/PPA. Be gentle with yourself. Many hugs.