[Emma H]

Hi Justin!

Firstly, a huge congratulations on the arrival of your little one!

It sounds like you both have been doing an incredible job ensuring she’s getting plenty of sleep. However, holding her 24/7 is understandably exhausting, so I’m not surprised you’re both feeling so tired!

Thank you so much for providing all that information. I have just a few more questions to better understand your situation. Whenever you have a moment, could you please answer the following?

1. Does your little one have a consistent wake-up time in the morning? If so, what time is that?

2. At 4 weeks old, it’s quite normal for babies to wake, feed, and then fall asleep during feeding. But typically, around this age, babies start staying awake a little after that first feed of the day before drifting back to sleep. This doesn’t have to happen at every daytime feed, but you might notice it occasionally. Have you observed this yet?

3. Does she wake up on her own for feeds, or do you need to wake her?

4. When she wakes for a feed, do you typically feed her, then change her diaper and feed her again (with her falling asleep during that second feed)? Or do you feed her, change her diaper, have some quiet playtime or interaction, and then feed her again until she falls asleep?

5. You mentioned that she happily lies on her back during the day for play. I am assuming based on this comment she is generally a happy bub or she has moments during the day that she is content – so she isn’t crying or unsettled all of the time?

6. How long do her breastfeeding sessions typically last?

7. Is she sleeping in a swaddle? If so, are her hands positioned up near her face or down by her sides?

8. What time is her usual bedtime?

9. Do you have a consistent bedtime routine? If yes, could you please describe it?

10. How often is she feeding throughout the day and night?

11. Is there enough space in your living room and bedroom to gently move the pram back and forth?

12. Would you consider using the flat-bed pram in the bedroom for her daytime naps, if we can successfully encourage her to nap there?

Thanks so much – I look forward to your answers!

Emma

[Emma H]

Hi Cindy,

I just want to say that your daughter is not broken and you’re honestly doing a fantastic job.

Also, I want to reassure you that holding her at this point isn’t spoiling her; however, I completely understand how exhausting it can be when your hands are rarely free.

At 5 weeks, babies can sleep a lot! However, if they sleep too much during the day, it can affect their overnight sleep. This is simply because they only need a certain amount of sleep in 24 hours. If they reach that sleep quota during the day, they might not sleep as much at night or wake more frequently.

You mentioned that in the evenings she might be awake for 3+ hours with nothing soothing her. If this happens around the same time every night (like clockwork) and she’s difficult to soothe, this could be the Period of PURPLE Crying. At 5 weeks old, her crying could be reaching its peak if this is what’s happening. Have you been able to watch the video I have on the Period of PURPLE Crying in Peaceful Dreams?

Another reason she could be protesting so much at bedtime is that bedtime itself might be too early.

To help me pinpoint exactly what’s going on and give tailored advice, I have a few more questions. I know life with a 5-week-old is incredibly busy, so please only answer these when you have the time:

1. Have you started waking her at a consistent time each morning? If so, what time?
2. Is she starting to stay awake after some feeds during the day? You’re right in that for the first few weeks newborns tend to wake up, feed and then fall asleep while feeding. But what you should see is that instead of falling asleep while feeding she occasionally stays awake for a short period.
3. If she is staying awake after feeds, have you been able to follow the wake, feed, play, sleep routine during those wake windows?
4. How many naps is she having, and how long are they?
5. You mentioned she only naps on you. How do you get her to fall asleep on you or your partner? (Feeding to sleep, rocking, wearing her, etc.)
6. When she naps on you, do you hold her for the entire nap or lay her down in the bassinet once she’s asleep?
7. Does she use a pacifier?
8. Is she breastfed, formula-fed, or having mixed feeds?
9. When you wake her for feeds during the day, where do you feed her? Do you change her nappy mid-feed or at the end?
10. What time is bedtime, and what time does she fall asleep and stay asleep at night?
11. Have you been able to start a bedtime routine? If so, could you describe it?
12. Do you swaddle her for naps and overnight? If you do are her arms up by her face or down by her side?
13. When she wakes overnight, do you follow the wake, feed, sleep routine, or is she still pooping overnight and needing diaper changes?
14. When she wakes overnight, do you keep the lights low and feed her in the bedroom, or do you go into the living space or turn on the lights?

I’m sorry for all the questions, but your answers will really help me understand what’s happening and how I can best help you.

Emma

[Emma H]

Hi Catherin,

In the video you’re referring to I recommend the Tommee Tippee Portable Blackout Blind. These blinds have suction caps which stick onto the glass window. They won’t stick onto any fly screens though.

Recently I have also discovered blackout film with sticks directly onto the glass window. The one we have is the Ergopouch Window Blockout Blind White. These take a while to put up – as you literally cut the film to size but are really good at blocking out the light and also give you the option to open a window and let in some air which isn’t something that you can do easily with Tommee Tippee Portable Blackout Blind.

I hope that helps!

Emma

[Emma H]

Hi Julia!

It’s wonderful to hear that you enjoyed Peaceful Dreams, and thank you so much for providing all of that detailed information.

It sounds like your little one is learning lots of new skills, which can certainly impact sleep patterns. The good news is that there are definitely strategies we can implement to help get her sleep back on track.

Before I can offer you specific guidance, I’d love to gather a bit more information about her current routine. When you have a moment, could you please answer these questions:

1. What time does she typically wake in the morning, and does this stay fairly consistent within a 30-minute window?
2. Could you share the timing and general duration of her naps throughout the day?
3. You mentioned she becomes quite upset when rolling onto her tummy during sleep. Have you tried gently patting her bottom or placing a hand on her back whilst rocking her side to side when she’s in this position? Often once babies master rolling to their tummy, they actually prefer sleeping this way.
4. Since she’s army crawling, I’m assuming she’s comfortable on her tummy during awake time?
5. Do you have a specific nap routine that you follow? If so, could you describe it?
6. For naps in the carrier, am I right in thinking you pop her in and continue bouncing on the exercise ball until she falls asleep?
7. When you are settling her to sleep in the carrier what room is this usually in and is the room cool, dark, and quiet?
8. Once she’s asleep in the carrier, do you continue wearing her whilst moving about, or do you sit down?
9. Does she use a pacifier?
10. When she wakes overnight, do you follow the wake-feed-sleep routine whilst keeping the lights off or dimmed?
11. What times is she typically waking overnight?
12. Is she breastfed, formula-fed, or combination fed?
13. Have you noticed whether some overnight feeds are shorter or smaller than others?

Regarding your trip to Austria: A different time zone can present some challenges, but since you’re there for three weeks, you could consider shifting her schedule by just 3 or 4 hours if that works with your family commitments. If it doesn’t then when you arrive you would just need to wake her up in the morning at the same time (keeping it within the same 30 minute window), open the blinds and maybe even take her outside into the sunlight if possible. This will help reset her circadian rhythm and slowly adjust to the new time zone. It will most likely take her a week to adjust to the new time zone. And then she will need an adjustment time when she comes back.

Does that make sense?

Emma

[Emma H]

Hi Cindy,

Thanks so much for taking the time to answer all those questions.

I was just trying to see if your little one was unsettled all the time and if there might have been an underlying intolerance or something causing discomfort for her. It’s just a little unusual that she is constantly crying and staying awake for hours at night after most overnight feeds. But it doesn’t sound like your paediatrician has noticed anything unusual and it’s also promising that she is having some moments in the day (particularly in the morning) where she is content at times.

In regards to improving your little one’s sleep there are a few things that you can try:

Consistent Wake Up Time

You mentioned that she tends to wake at 9am. To encourage her bedtime to become consistent and help in the maturation of her circadian rhythm continue to keep this wake up time consistent. So if she isn’t awake by 9:30am go in and wake her up and start the day.

Breastfeeds during the day
You mentioned that she is an efficient eater which is great. Instead of letting her stay on the breast and suck for 20 minutes, I was wondering is if you would be happy to:

• Start the breastfeed
• When her sucking slows down, as well as her swallowing, pause the feed,
• Change her diaper to wake her back up
• Then swap sides and finish the feed
• Stop the feed again when her sucking slows down and she isn’t swallowing as much (as this indicates that she is falling asleep).

This will ensure that she has longer, fuller feed but doesn’t necessarily fall asleep every time she has a feed during the day.

Wake, Feed, Play, Sleep

When she wakes at 9am and your husband has her, you mentioned that she is generally happy at this time and stays awake after her morning feed. Since she is now staying after that initial feed, would your husband be able to try and follow the wake, feed, play, sleep routine? To do this, all he would need to do is instead of feeding her when she starts to get fussy after being awake for a little while (which indicates she is getting tired), he would a do nap time routine and settle her to sleep either in the bassinet or his arms. So the nap routine could look like this:

• Put on the swaddle
• Walk to the bedroom (or even the special nighttime room if you are sleeping)
• Turn off the lights and close the blinds
• Turn on the white noise machine
• Sing her a lullaby while he rock her in his arms
• If she is calm, lay her down in the bassinet if it is available and try the settling pyramid.
• If she is upset, continue to rock and walk around the room and as she calms down slowly reduce the movement.

• Stop walking and just rock while patting her bottom and shushing
• Stop rocking and just continue patting her bottom and shushing
• Stop patting and just continue shushing
• Stop shushing so that she falls asleep without movement and noise. Getting her comfortable falling asleep without constant movement will make it easier to transition to the settling pyramid when you’re ready.

Cap Her Naps

Currently, holding her during day sleeps likely means you’re unconsciously responding to every small movement, potentially extending her naps. Would you be comfortable waking her from daytime naps after two hours? This encourages more active time and feeding during the day, which should promote longer night-time sleep with fewer feeds.

Whilst she’s too young for rigid scheduling, with a consistent 9am wake-up, her pattern might naturally develop like this:

• 9:00am – Wake and feed
• 9:30am – Play time
• 9:45-10:30am – First nap
• 11:45am-12:30pm – Wake and feed
• 12:30-12:40pm – Play time

Bedtime Routine Tweak

Given that you are spending over 2 hours trying to settle her to sleep at bedtime, I was wondering if you would be happy to tweak the bedtime routine slightly to increase the chances that she will fall asleep while feeding so you can all get to bed quicker? I know this prevents you from being able to try the settling pyramid at bedtime, but that is something we can work on later. So the new bedtime routine would look like this:

• Diaper change
• Swaddle her
• Turn on the white noise,
• Turn off the lights and close the blinds
• Feed her while you are in the dark bedroom
• Lay her in bassinet

Does this sound doable?

Emma

• This reply was modified 1 year, 2 months ago by  Emma H.

[Emma H]

Hi Cindy,

Thanks so much for getting back to me quickly with those details! I have just a few more questions to help clarify your situation – sorry to ask again!

1. You mentioned her wake windows aren’t typically long, but also said she’s awake from about 9 am until 1 pm. Could you clarify what happens during this time? For example, do you feed her around 9 am and then spend the next 4 hours trying to soothe her to sleep while she cries? Or does she initially fall asleep feeding, wake shortly after in your arms, and then repeat this pattern until she’s extremely tired around 1 pm, at which point you can lay her down and she will sleep for around 3 hours?

2. When she is sleeping, does she generally seem settled and comfortable, or is she squirming, grunting, or otherwise appearing uncomfortable?

3. How long does a breastfeed typically last?

4. When she’s awake, are there periods where she’s content and calm, or is she consistently fussy and upset?

5. Have you noticed any mucus or blood in her stools?

6. Overnight, when you feed her, do you typically find she falls asleep while feeding and you can lay her down to continue sleeping or does she feed, then cry and fuss for an hour or two before falling back to sleep?

7. Lastly, it sounds like the inconsolable crying is happening all day – not just in the afternoon or evening. Is this right?

Again sorry for all the questions,

Emma

[Emma H]

Hi Julia,

Thanks so much for responding quickly and providing all those details!

It’s great to hear you’ve already tried settling her while she’s lying on her tummy, and it worked.

The AAP recommends placing babies on their backs initially, but once they roll independently, it’s safe to let them sleep in the position they choose (so if they roll over onto their tummy after you lay them down in the crib it’s okay) – as long as the sleep space remains safe (firm mattress, no loose bedding, toys, or bumpers). If you’re comfortable with it, I’d encourage you to keep settling her this way, especially at bedtime and over the weekend. You can also try it when you’re in Austria, assuming there’s a quiet space available. If this continues to go well, you can complete your bedtime routine, lay her down awake, let her roll onto her tummy, and use the settling pyramid if she needs additional soothing. Does this approach sound okay to you?

Before I give you more advice, I just want to check- is there space in your kitchen or another quieter room, away from construction, to set up a pack-and-play or bassinet for daytime naps instead of using the carrier?

Thanks again!

Emma

[Emma H]

No worries at all!

[Emma H]

Hi Giedre,

It’s so good to see that the two nap schedule seems to be working for her and that she is starting to fall asleep on her own again.

Now that she’s self-settling, you should see a gradual decrease in her nighttime wake-ups. Typically, the initial stretch of sleep before her first overnight feed will become longer, as this part of the night dominated by deep sleep, and the early morning feeds will gradually move later. If, after two weeks of consistent self-settling, you aren’t noticing this improvement, you can gently help her reduce overnight wakes by using the settling pyramid for any wake-ups before midnight and offering a feed only for wake-ups between midnight and her morning wake time.

If you have an early morning appointment, it’s fine to offer her an earlier first nap, around 8:45–9:00 am. Keep in mind that if she wakes earlier from this nap, her second nap might also shift slightly earlier, possibly requiring an earlier bedtime as well. However, some babies handle occasional longer wake windows just fine, so you may find that her second nap can remain at its usual time. It may take some trial and error to see what suits her best.

Regarding the crankiness after her naps, I don’t think this is something to be concerned about, as she is back to her usual self 30 minutes later. You mentioned that when you let her have a longer first nap (so 1 1/2 hours instead of 1 hour) she was a lot happier when she woke. You could see if continuing to let her have a longer 1st nap (max of 1 1/2 hours) helps improve her mood. But I do expect that as she gets used to the new routine and more consistent with self-settling this crankiness will resolve on its own.

Emma

[Emma H]

Hi Leonor,

Wow, 2 naps in the crib – that’s fantastic! Well done!

Also happy 4 months! Time really does go so fast. Hopefully, she starts giving you those gorgeous giggles soon.

Your strategy of calling it quits after 15-20 minutes of trying is a great plan. Something to keep track of is the time she falls asleep for that first nap. Her wake windows might have expanded, so we may need to adjust that first wake window to ensure she’s actually tired when you try to settle her for her first nap.

Regarding wake windows at 4 months, babies can usually tolerate staying awake anywhere from 2 to 2½ hours. However, it’s always best to combine this with her tired cues to truly determine when she’s ready for a nap.

Emma

[Emma H]

Hi Catherin,

It’s wonderful that the later bedtime initially worked well, though it’s definitely tough that she had that rough night waking every 2 – 2.5 hours. Has her sleep settled back into longer stretches again?

Great job establishing a consistent 8-8:30am wake-up; consistency is so beneficial for sleep patterns.

Regarding your concern about spitting up and choking: Generally, by 6 months, babies spit up less frequently. Additionally, sleeping on her back significantly reduces choking risk because the milk is likely to flow back down the food pipe rather than entering the airways. However, because your little one has reflux, I’d recommend checking with your paediatrician about whether it’s safe to lay her down immediately after feeds overnight, possibly removing the need to hold her upright.

For total overnight sleep at 7 months, typically babies need 10 – 12 hours, so a 9pm bedtime with an 8am wake-up is perfectly suitable.

Here are a few suggestions to improve your little one’s sleep:

Adjust Her Nap Schedule: I reviewed your sleep data and noticed the timing of her naps and the length of her wake windows varied quite a bit. At her age, a structured nap schedule usually works best, with wake windows around 2-2.5 hours. It sounds like she has gone back to having 3 naps a day. If she has then would you be happy to follow a more structured nap routine? So it could look like this based on her consistent wake-up:

• 8am: Wake

• 10am: Nap (wake by 11:30am if she’s still asleep)

• 2pm: Nap (wake by 3:30pm if she’s still asleep)

• 6pm: Short nap (45 minutes max)

• 9pm: Bedtime

Tweak Her Bedtime Routine: You might adjust her bedtime routine slightly to help keep her awake after feeding, enabling you to use the settling pyramid effectively:

• Feed her in a brighter, stimulating room.

• Pause feeding when she slows down, put her in pajamas to help her become alert again.

• Finish feeding and move to the bedroom.

• Place her in her sleeping bag, dim the lights, close the blinds, and sing a lullaby.

• Then, lay her down awake but calm, and use the settling pyramid if needed.

Discuss Pain Relief for Teething with the Paediatrician: Since she’s rejecting Tylenol, it might help to explore different flavoured options. My own children tolerated orange-flavoured medicines far better than strawberry ones.

Finally, I have a few more questions to clarify:

1. How do you typically settle her for naps in the crib—feeding, rocking, or something else?

2. Do you have a specific nap routine? If so, what’s involved?

3. Is she breastfed, formula-fed, or mixed-fed?

4. When she falls asleep in the pram, is your husband pushing it continuously outside, or rocking it indoors?

5. Is the pram a bassinet style (lying down) or an upright seat?

6. What time do you leave and return from work? (This helps me understand which naps your husband is managing.)

7. When she wakes overnight, do you feed her each time? Does she have a big feed or are they quick?

8. Are diaper changes overnight due to bowel movements?

9. Do you keep the lights off or very dim during night wakes?

10. Does she sleep on her back or tummy?

11. Is she sleeping in a crib overnight, and is it in your bedroom or elsewhere? Can you describe her sleep space – so is it cool, dark and quiet?

Sorry for the questions.

Emma

[Emma H]

Hi Catherine,

I’m sorry to hear that her older brother is sick. Hopefully, she doesn’t get it – but siblings love to share their germs!

It’s a great idea to wait until everyone in the house is feeling well again before trying to settle her in the crib.

Hopefully it’s a quick illness!

Emma

[Emma H]

Hi Giedre,

Please let me know how it goes!

Emma

[Emma H]

Hi Livia,

It sounds like a lot was happening the past week, and it impacted her sleep a little, but it’s great to hear things have settled down again.

In regards to your questions I have answered them below:

Early Wake-ups (5am local time 6am at home)

Starting your day at this early wake time is actually exactly what I would recommend if it suits your family routine. However, if you prefer a later start to the morning, you can try keeping the room dark at the 5am wake-up, offering her a feed, and seeing if she’ll go back to sleep. If she does return to sleep, limit this extra sleep to no later than 7am local time /8am at home to maintain her usual wake up time.

Transitioning Out of the Swaddle

Given she seems quite uncomfortable with the swaddle and is approaching the stage where babies typically transition out of it, you can begin gradually by freeing one arm (as demonstrated in the video “How to Dress Your Baby For Better Sleep”). However, if freeing one arm doesn’t help her settle, you might consider transitioning directly to a sleep sack, completely removing the swaddle. Initially, she may need extra support like more patting and shushing while lying in the crib, but most babies adjust well within two weeks. Bedtime is usually the easiest sleep session to start this transition because her circadian rhythm and sleep pressure will naturally encourage sleep.

Pacifier Use

If the pacifier falling out is waking her, removing it could help her achieve longer stretches of sleep. You have two options here:

• Option 1: Use the pacifier during your nap and bedtime routine but remove it just before she falls asleep. To do this you would just place your little finger between the pacifier and her mouth to gently break the suction and pop it out just before she falls asleep. If she continues to fall asleep, great! But if this causes her to fully wake up, you may need to move to Option 2.

• Option 2: Completely remove the pacifier for all naps and overnight sleep. You can still use it during the day to soothe her when she’s fussy or in the car, but for sleep times, avoid it entirely. She’ll likely need more initial support from you using the settling pyramid as she adjusts.

4-Month Sleep Regression

Regarding your concern about the 4-month sleep regression: If your little one learns to fall asleep independently in the crib she’ll develop the essential skill of linking sleep cycles. This means she will be less likely to experience frequent waking every hour or two. Instead, she’ll likely continue having longer, more restful sleep stretches overnight, and the time between her overnight feeds will naturally lengthen.

I hope this helps!

Emma

[Emma H]

Hi Leonor,

It’s fantastic that you’ve started using the settling pyramid for your baby’s first nap of the day! Here are a few suggestions to help increase your chances of success:

• Make the Room Very Dark: Can you make the room completely dark, so dark that you wouldn’t be able to see your hand if you held it up in front of your face? This helps minimize distractions and clearly signals to your baby that it’s sleep time. You might need to partially close the bedroom door to achieve this.

• Adjust Wake Time: You’ve mentioned she’s happy and cooing in the crib initially. I’m wondering if she might benefit from a slightly longer awake period in the morning to ensure she’s truly tired when you put her down.

• Allow Time to Self-Settle: If she is calm and content, try giving her space to fall asleep independently. Babies often need up to 20 minutes to drift off, so if she’s comfortable and happy, let her be.

• Instant Comfort to Avoid Escalation: You’ve noted she escalates quickly to screaming when upset. To prevent this, try providing immediate comfort by patting her gently or placing your hand firmly on her chest and gently rocking her body side-to-side while she remains lying in the crib. Starting comfort immediately may help avoid escalation to intense crying.

• Settling Her in Your Arms: If she continues crying after being picked up, it’s completely fine to soothe her to sleep in your arms. However, try reducing any movement gradually so she learns to fall asleep without motion, which will eventually make transitioning to the crib easier.

• Handling Short Naps and Waking on Transfer: If she wakes shortly after being placed in the crib from your arms, settling her back to sleep in the crib might be difficult because her sleep pressure has reduced. In this scenario, you have two options:

  1. Pick her up again and settle her back to sleep in your arms or a carrier.

  2. Start her next wake window immediately, but know it will be shorter, and she will likely need an earlier nap.

Does this sound okay?

Emma