[Joyce Chang]

Dear Emma,

Thanks for all of your thoughts on how to help us. The daycare staff tend to rock her to sleep for naps though occasionally she’ll fall asleep on her own in a bouncer or boppy and then they transfer her. She also falls asleep on the bottle sometimes. She is generally still happy during wake times – I notice that she gets more clingy and tolerates floor time less in the evening if she only takes short naps all day, so perhaps that’s another signal that overtiredness is playing into it. I have never noticed her feet jumping at bedtime.

Fortunately her nap length and wake windows are both starting to lengthen – now naps average 35-45 minutes at a time and her last wake window seems closer to 145-150 minutes when she has better naps during the day, so it will be easier for us to drop the last nap and try the earlier bedtime.

Thanks so much!

Joyce

[Joyce Chang]

Hi Emma,

We tracked sleep data all last week when she had no signs of any illness. I have taken your advice to do her last feed before bedtime in the living room and have also started to feed her in an upright sitting position now that her head control is good so that she’s less likely to fall asleep.

Just by chance there were two days that her fourth nap ended around 5:20pm-5:30pm and I wasn’t able to feed her to sleep at 6pm, so we were forced to try Option 2 – unfortunately I think we messed it up because between feeding, bathing, changing and the whole bedtime routine, we weren’t able to get her down until 8-8:10pm. I’m guessing she got overtired – fussed on and off 8:30-9:20, slept one sleep cycle, then had to be shushed and patted every 2-5 minutes until finally picked her up at 11pm and held to deep sleep before transferring to crib, after which she slept and was able to put herself back to sleep between sleep cycles the rest of the night except for her overnight feed. After that we reverted back to Option 1.

As for the other days:

1. Last daycare nap 2:35-3:20pm, fed to sleep 6:04-6:25pm (3 hrs total nap), bedtime 8:16pm, needed to be picked up after each of first 2 sleep cycles, then patted at 10:40, 11, 11:20 until finally settled for rest of night until feed at 5:30am

2. Last home nap 5:05-5:44pm, fed to sleep 6:07-6:19pm (2.5 hrs total nap), bedtime 8:18pm, patted back to sleep after first sleep cycle, woke again 11:30pm and 12:30am patted back to sleep each time, slept until morning without a feed

3. Last home nap 5:16-5:50pm, fell asleep at breast 6:13-6:17pm (2.8 hrs total nap), bedtime 8:18pm, patted back to sleep after first sleep cycle but had to be picked up 10 minutes later, picked up again 10:44pm put down in deep sleep 11:12pm, picked up again 12:14am put down in deep sleep and slept until morning without a feed

4. Last daycare nap 3:10-4:30pm, fed to sleep 6:17-6:30 (4.5 hr total nap), bedtime 8:48pm, woke after 4 minutes had to be picked up and put back down, needed to be picked up again at 9:40pm, put down in deep sleep and slept until morning without a feed.

5. Last daycare nap 3:05-3:40pm but fell asleep on floor 5:25-5:35pm before pickup, didn’t feed to sleep at 6pm but then fell asleep for ~10 minutes in grandma’s arms 6:50pm-7:10pm (3.75 hr total nap) while I was prepping her bath, bedtime 8:40pm, amazingly slept right through until 4am feed (some kind of fluke??)

6. Last day care nap 3:04pm-3:40pm, fed to sleep 6:13-6:34pm (2.75 hrs total nap), bedtime 9:03pm, woke 10pm and had to be held to deep sleep, after which slept until 5am feed

She just got sick again and had to be held all night so I didn’t include the last two days. Not sure if you can make any sense of this data (I certainly can’t!), but let me know if you have any suggestions.

Thanks,

Joyce

[Joyce Chang]

Yes, her first nap is always around 9am plus or minus 10 minutes. At home, the first nap is almost always 27 minutes long, but at school they most often document 40 minutes (ranging anywhere between 20 to 90 minutes). Occasionally she falls asleep on her 10am bottle and then they have to put her down for another nap because they’re not allowed to wake them once they’re asleep.

• How many naps she’s currently taking—has she dropped from 5 to 4? She mostly still takes 5 naps; about once a week she takes only 4 when there is a longer nap at daycare.
• What time her last nap at childcare usually starts and ends? Despite recording all of them I can’t find a good pattern – ideally the last nap starts around 3:15-30pm and ends shortly after 4pm in time for her 3rd bottle feed, but some days that nap ends later and she doesn’t get fed until 5pm, and other days she has a nap that ends around 3pm and then has fallen asleep again by 5ish right before I pick her up.
• What time you typically pick her up from childcare and get home? I usually pick her up by 5:30pm and get home by 5:50pm. On the days her last nap at daycare ends around 3:30, she falls asleep for 5-10 minutes in the car but always manages to fall asleep again at the breast after I feed her when we get home.

Her bedtime routine is still just as you described. She seems to have more trouble settling at night on non-childcare days despite us having a little more control over the schedule…

• How many naps she has on non-childcare days: Always 5 short naps now that we no longer extend them unless she wakes up less than 20 minutes in
• What time her final nap starts and ends: 6:15-6:35pm plus or minus 5-10 minutes in either direction – regardless we cap it at 20 minutes total just as we do during the week
• What time bedtime usually is: 8:30-8:45pm depending on how tired she seems

Tonight she had her last nap at daycare from 3:30-4:10pm and then fell asleep at the breast between 6:10-6:30pm for a total of 3 hours of naps. We put her down at 8:40pm after her movements started to get fidgety and she sucked her thumb to sleep but then woke up crying again after only 5 minutes!

My only concern with doing a much earlier bedtime (like 7pm) is that we don’t get to spend a lot of time with her during the week while she is in child care and so the evening before bed is our cuddle and play time.

Thanks for attempting to analyze this crazy schedule!

Joyce

[Joyce Chang]

Thanks Emma,

I think you might be right about sickness impacting her sleep – come to think of it she did need to be held upright (I didn’t think much of it at the time because she has always preferred to be held upright since birth) and the last few nights have been much better with her nose being fully clear. I just assumed she was always going to have a bit of a runny nose being in daycare.

To answer your questions, she wakes up between 7-7:15am and bedtime has very recently shifted earlier 8:20-8:30 (as of last week still 8:30-9). Her naps are all over the place – never the same from one day to the next. I let her fall asleep at the breast for 10-15 minutes between 6ish to 6:30 after we get home just to get her by until bedtime. They moved her crib to the quieter corner and she naps much longer now at daycare – average 3 hours total. There were two days she napped 5.5 hours and those nights were horrible – she was super awake at bedtime and wouldn’t let us put her down until 1am. On the best nights, she goes down at 8:30 without a problem and always wakes after 35-45 minutes. Once or twice she put herself back to sleep for the night and the rest of the time I have to pick her up and put her back to sleep in my arms. On the worst nights she has to be held until midnight and then sleeps through the rest of the night.

Joyce

[Joyce Chang]

Dear Emma,

We started daycare this week which I knew was going to throw off her schedule, so I waited to see how she would do.

At home, we usually do wake up at 7-7:30 at the latest, first nap in the crib (lasts 25-35 minutes max), second and third naps start in the crib and then we extend them by picking her up to ~1.5 hours each to maintain the wake eat play sleep schedule, and then fourth nap is 30-45 minutes until 6:30-6:45. Total naps averaged 4.5 hours. She was still frequently waking in the earlier part of the night.

Since starting daycare, she only does 20-30 minute naps and I can’t imagine they are that restorative – it’s loud and bright all the time. She basically takes 5 cat naps at day care and then we do a 6th one at home which has been from 6:15-6:45pm because she is usually so exhausted when we pick her up. Even after that last she seems so tired and it has been difficult to stretch the last wake window to get her last 2 feeds in. Total naps now falling 2.5-3 hours max and she falls right asleep after being put straight into the crib at 8:45pm. Once she managed to sleep straight through and I actually had to wake her up at 4am to feed her (she often refuses the bottle at daycare so I have to keep nursing her overnight). The other nights she woke completely after 9 minutes or after a full cycle at 45 minutes but was tired enough that I watched her fuss a little for a few minutes and go back to sleep for the remainder of the night until her 3-4am feed. I am of course happy she can sleep well overnight, but she just seems so tired in the evening – all she wants to do is cuddle and won’t play on the mat or anything like that. I wonder if at home on the weekends we should just be letting her do the numerous cat naps and forego the wake eat play sleep schedule or keep extending 1-2 naps but maybe cap her total naps to 3-3.5 hours? Can she still consolidate memory/learning if she only sleeps for 25 minutes at a time during the day?

Thanks,

Joyce

[Joyce Chang]

Dear Emma,

My baby is now 3 months old – about 2 weeks ago we had gotten her bedtime to 8:30pm for 3 days and she could sleep a long stretch until 12-1am, but then she started to roll and we had to transition her out of the swaddle. We did one arm out for 7 days and then put her in the halo transitional sack which she has been in for over a week now. It seems to work well for her in the later part of the night (1am -7am) but we’re having a lot of trouble in the beginning of the night even though that is supposed to be when deep sleep predominates. We can get her settled and down in the crib initially but she always wakes up before 45 minutes have passed (sometimes even within 16 minutes) and then is impossible to settle back down again with the pyramid without being held – she repeatedly wakes up between the hours of 9-12. We were trying to keep the 8:30 bedtime but it’s hard to always cap her last nap at 6:30pm because sometimes she doesn’t go down for her last nap until 6:15pm depending on how the rest of the day goes, and the time that she skipped the last nap because her previous one ended at 5:30pm was really horrible with overtiredness. I have tried adjusting her last wake window between an hour and 45 minutes to 2 hours and 20 minutes to see if maybe she is under or overtired but neither seems to make a difference. I’m wondering if she’s either not ready for an earlier bedtime or maybe it’s now too late for her based on her current age? Or perhaps she needs more time to adjust to being unswaddled though I’m not sure why that only impacts her in the beginning of the night?

Thanks,

Joyce

[Joyce Chang]

Hi Emma,

I’m happy to report that with practicing peeling back the movement in a stepwise fashion before she falls asleep, I was finally able to put her down in the crib for her morning nap without her screaming and use the settling pyramid. The first time she continued to fuss and whine intermittently so I left the room and observed on the video monitor – after about 10 minutes as I was about to go back in she fell asleep!! The second time it took 5 minutes. She only napped for 20-30 minutes each time but the amazing thing is that ever since then, she has been able to sleep 2-3 hour stretches between feeds from midnight until wake up time and put herself back to sleep between sleep cycles. We then started practicing at bedtime at the later 9pm you suggested and she is also now going down for bedtime in the crib. Initially still only staying asleep for 30-45 minutes before needing to be held, but last night was the first time she lasted 2.5 hours! We are so grateful for your advice!

I’m not going to mess with what’s working right now, but at what point do you suggest starting to move bedtime back earlier?

Thanks,

Joyce

[Joyce Chang]

1. Sleep Routine:

   Hi Emma,

   Thanks for the reply – my answers to your questions below:

   She doesn’t like it when we make it suddenly dark (as if she knows what’s coming) so our nap routine is peaceful piano music for a minute or so, close the blinds, then gradually dim the lights, swaddle, change to white noise, sing lullaby while moving around the room and rocking+patting if just fussing a little, otherwise rock+bounce+pat+shush if really angry about the swaddle. In the latter case often goes straight from fussing/crying to suddenly asleep. Bedtime routine is same except we throw in a feed and a book before making it dark.

2. Daytime Mood: as long as her naps are good she’s generally content – only fusses sometimes with big spit ups (growing fine) or if wake window gets stretched a little long

3. Feeding:
   Breastfed – will occasionally offer expressed milk in a bottle for practice

4. Wake-Up Routine:
   Generally follow wake feed play sleep pattern unless she needed a little snooze button feed around 6am and isn’t that hungry right away in which case we will do a little play first

5. Wake Windows:
   Most commonly 85 minutes at this point but can range 75-105 minutes

6. Bedtime Behavior:
   With her bedtime around 8:30 p.m. if we place her in the crib fully asleep in deep sleep she can occasionally go 1-2 hours if she doesn’t wake up in the first 15 minutes. If no crib attempt is made, the person holding her can pretty much stop rocking, patting, or shushing as soon as she is asleep for the first 2 hours or so after bedtime – I think during this time she can occasionally connect sleep cycles on her own, but my husband and mother often start patting her again when she looks like she’s waking up between cycles

7. Overnight Routine:
   I primarily hold her to help her fall back asleep unless it has been at least 2.5-3 hours since the last feed and she doesn’t settle right away in which case I assume she’s hungry

8. Sleeping Environment:
   Her crib is in a separate room – we use a video monitor with a sound and motion detector

Thanks,

Joyce

[Joyce Chang]

Hi Emma,

It has taken me a while to reply because it has been a bit of a roller coaster ride between a string of day care illnesses and what I think might be her 4 month sleep regression as she is now 16 weeks old.

Since my last message, she started napping better at day care and isn’t a complete puddle anymore when I take her home at the end of the day, so that’s a piece of good news. She continued to have some false starts and/or waking after the first sleep cycle with an ~8:30pm bedtime. I thought maybe she started her 4 month sleep regression because there was one night she woke up basically every 45 minutes and except for once or twice was able to put herself back to sleep. But more recently we’ve taken a huge step backwards as she had a couple rough nights where she just couldn’t settle in her crib at bedtime no matter what we did and just screamed at the top of her lungs until we picked her up. we couldn’t get her back sleeping in the crib until 1am. I even tried feeding her to sleep at midnight which didn’t work (normally I don’t nurse her overnight until 4-5am). These rough nights happened regardless of whether we kept the last cat nap around 6-6:30pm 2 hours before bedtime as we were doing before or dropped the last nap altogether, in which case her last wake window ended up being ~3 hours. She still puts herself to sleep in the crib for most of her naps so I know she CAN self-soothe, but for whatever reason she has been getting so worked up at night I’m not sure what to do. She falls asleep the minute we pick her up so I know it’s not just some physical discomfort we’re missing. The first time I know it was because we all had a nasty stomach bug and my mother-in-law ended up holding her all night, but she was able to sleep in the crib the rest of that week, so I don’t know if just that one time would have ruined all of the sleep habits we have been working hard to build?

We have already stopped extending her naps and let her take short naps all day just like she does at day care (totaling 2.5 hours per day) to minimize that sleep association with being held.

Joyce