[Emma H]

Hi Julia,

It’s so nice to have you join us! And you’re definitely not alone!

It sounds like you’re all doing everything you can to settle your little one to sleep and get some sleep yourself.

It’s so nice to hear that you have already made some changes to your routine and implemented a lot of the strategies outlined in the course – that is honestly very impressive. It’s nice to see you have noticed some slight improvements as well.

From what you have written I just have a few more questions – so when you have time can you please answer them – sorry for all the questions!

1. Does your little one have a consistent wake-up time, that occurs within the same 30-minute window? If so what time is it?
2. When you swaddle her are her arms up by her head or down by her side?
3. Is there the option to swaddle her on hot days in the UK – so maybe turn on an air conditioner?
4. When you say she doesn’t sleep for most of the day and night – do you notice if she is falling asleep while breastfeeding?
5. When she won’t sleep overnight – do you keep the lights off or dimmed and distractions minimal (so no tv on in the background)?
6. When she woke today at 4:40am and you fed her did you follow the wake, feed, sleep routine or are you still needing to change her diaper? Also during this feed did you keep the lights off/dimmed?
7. From what you recorded in regard to her naps it looked like this:

• 6:30am – Wake
• 8am – Nap (asleep for 4 hours and 45 minutes)
• 12:45pm – Wake
• 4:40pm – Nap (asleep for 3 hours)
• 7:45pm – Wake
• 9.05pm – Nap (asleep for 40 minutes)
• 9:45pm – Wake
• 12:30am – Bedtime

Do you feel like this represents a normal day? Or are the naps generally shorter than this?

8. How long do breastfeeds typically take during the day and where do you feed her?

Sorry again for all the questions,

Emma

[Emma H]

Hi Jacelyn,

It sounds like you’re already on the right track by consistently following the wake-feed-play-sleep routine and establishing clear nap and bedtime routines – great job!

That said, I completely understand how tiring it must be carrying around an 8kg bub to help him settle for sleep.

From your description, it seems he’s waking regularly overnight, particularly more frequently in the early morning hours. At his age, it’s quite common for breastfed babies to wake at least once for a feed overnight. The wakes where you find you can’t resettle him without feeding are likely genuine hunger cues, so you’re responding perfectly there. However, the wakes where you can settle him back to sleep by walking him around suggest he may be waking due to a sleep association – needing your help to recreate the feeling of being held to transition between sleep cycles.

To help reduce these overnight wakings, we need to help him learn how to fall asleep in the crib independently. To help you achieve that I just have a few more questions:

1. What time does he typically wake in the morning? Does this stay consistent within about 30 minutes each day?

2. You mentioned he generally has 3 naps a day—could you share roughly what times these naps typically occur?

3. Does he use a pacifier at all for sleep?

4. You mentioned you give him 140ml of breastmilk per feed, and you’re not sure if he should be having more. Do you know if he is following his weight curve? So tracking well in regards to weight gain?

Sorry for the questions,

Emma

[Emma H]

Hi Carola,

Firstly, congratulations on the arrival of your little one! It’s wonderful that you’ve already started following the advice from the course.

Regarding your baby’s behaviour before sleep, it’s possible she might not be quite tired enough, which could explain why she’s protesting. When you notice her starting to stare into the distance, losing interest, or fussing, try changing the activity—maybe walk into another room, step outside briefly, or introduce a new toy. If she stops fussing after the change, it’s likely she was bored. But if the fussing continues and she’s been awake for more than 45 minutes, it’s probably a sign of tiredness.

If tiredness is the issue, something that can help reduce the protesting is swaddling her out in the living space and then holding her in your arms while you walk around the living space a few times until she calms back down. If she really wants to be looking out into the room instead of into your body, what you can do is hold her on her stomach or side while she’s in a horizontal position (I show this position in the Period Of PURPLE Crying video when I demonstrate Dr Harvey Karp’s 5 S’s position). This position is still soothing so likely to help her get sleepy and also fits her desire to see everything.

The other thing that might be worth trying is swaddling her in the living space but then walking into a dark bedroom and shutting the bedroom door. Often babies can become overwhelmed with all the new things to look at and a dark space where they can’t see anything can make it easier for them to ‘switch off’ and fall asleep. She might protest when you first walk into the dark room but just give it a few moments with you bouncing up and down while holding her and see if she calms down.

In regards to naps when you’re out and about. Ideally, you would still complete your little one’s nap routine to tell her that it’s sleep time and then you would just help her fall asleep, whether this is in a baby carrier, in your arms or in the pram. If you are using a pram and it’s a bassinet-type pram it can be helpful to swaddle her as part of her nap routine (so like you would do at home). Something to remember though, is it might take your little one a little while to fall asleep, because of all the sudden noises and movement, but eventually they will fall asleep. Also, it’s still important when you’re out and about to follow your little one’s cue and offer sleep when they are showing you that they are tired.

Let me know if any of the suggestions above help. If they don’t then I will just need to ask some more questions to truly understand what is happening and tweaks that we can make.

Emma

[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 Catherin,

I hope the vaccinations went smoothly and haven’t disrupted your little one’s sleep too much!

During the vaccination appointment, were you able to ask the paediatrician or nurse about whether you still need to hold her upright for 20 minutes after a feed? Skipping this step, if it’s no longer necessary, would make applying the settling pyramid at bedtime easier, as she’ll still be awake.

Overnight Wakes

Something I wanted to mention is that it’s perfectly normal for babies to wake once or twice overnight for feeding at this age. It sounds like your little one may already be settling back into waking just once, which is great progress. Once she consistently falls asleep independently at bedtime, she’ll likely drop the overnight feed naturally and start sleeping through.

What To Do When She Wakes Early

If she wakes earlier than usual, you can adjust her morning routine and naps accordingly. For example, if she wakes at 7 am (which is quite reasonable for babies), consider shifting her first nap earlier by half an hour to 9:30 am instead of 10 am. If she appears very tired earlier, you can move the whole schedule forward like this:

• 7 am: Wake

• 9 am: Nap (wake by 10:30 am)

• 1 pm: Nap (wake by 2:30 pm)

• 5 pm: Short nap (maximum 45 minutes)

• 8 pm: Bedtime

Adopting this schedule consistently might naturally shift her bedtime to around 8 pm.

If you prefer maintaining her current wake-up and bedtime, when she wakes at 7 am, you could feed her and then gently lay her back in her crib to continue sleeping until her usual 8 am wake-up. Offer another feed at 8 am, though she may not be hungry immediately and might prefer feeding slightly later, around 8:30 am.

Regarding the recent frequent wakes, it’s unlikely that the bath caused this. More likely, the later bedtime was the culprit. Additionally, since it’s summer and you mentioned not having blackout curtains, early sunlight may cause earlier wakes. Adding blackout curtains could help extend her morning sleep.

Naps With Your Husband

It sounds like rocking your little one to sleep for naps may currently be a bit challenging for your husband. It might help if he focuses initially on consistently following the 3-nap schedule, as this will help bedtime and make future transitions easier. When her nap schedule becomes predictable, she’ll naturally feel tired at these times, making it easier to introduce rocking later without much resistance.

If your husband continues feeding her to sleep, sitting upright will be safer and make swallowing easier compared to lying down.

Naps With You

For naps where you’re settling her, you mentioned you usually feed her while you’re sitting in your rocking chair. Instead of feeding her to sleep, would you be happy to tweak her nap routine slightly to look like this:

• Go to her room

• Pop in the pacifier

• Close the blinds

• Turn on the white noise machine

• Sing her a lullaby while rocking her gently in your arms (this will become a sleep cue)

After finishing the lullaby, you have three options:

1. Lay her down in her crib and use the settling pyramid.

2. Continue standing and gently rocking and shushing her, gradually stopping the rocking, then reducing shushing, allowing her to fall asleep without movement or sound before laying her down in the crib (this method helps her gradually adjust to falling asleep without movement which will make it easier to transition to the settling pyramid when you’re both ready).

3. Gradually stop rocking while sitting in your chair, allowing her to fall asleep without movement. Then you can either let her nap on you or transfer her to the crib.

Does this feel achievable?

Emma

[Emma H]

Hi Justin,

Thank you so much for answering all those questions – I really appreciate it!

It’s fantastic that you’ve already purchased some swaddles. Newborns often sleep much better when swaddled, so I’m curious to hear how it’s been going. Have you tried swaddling yet, and if so, have you noticed if she’s able to stay asleep when laid down, or is she still primarily sleeping on you? Also, when you swaddle her, do her arms naturally rest up by her head or down at her sides?

At four weeks old, it’s completely normal for your little one not to have a structured nap schedule yet. Typically, babies wake when they’re hungry, uncomfortable, or no longer sleepy, and there usually isn’t much awake time between feeding and diaper changes.

However, as you have noticed she is starting to stay awake briefly following some feeds. You mentioned that when she does stay awake following the feed it typically looks like this: wake, feed, diaper change, feed, brief play/interaction then feeding her again when she becomes fussy – at which point she falls asleep. Instead of offering her that 3rd feed when she begins to fuss, could you try swaddling her, then rocking her in your arms while you sing her a lullaby or a song? If she’s calmer in your living area, it’s fine to stay there initially. Then once she’s calm, could you try:

• Placing her gently into the pram. If she starts to fuss when you lay her down, start pushing the pram back and forth (gently) and shush her until she settles and falls asleep.

• Or lay her in the cot and try the settling pyramid. Again if she becomes upset as soon as you lay her down on the mattress, immediately start patting her and shushing and then if she starts to calm down move back down the pyramid.

If she becomes too unsettled when attempting this, just pick her back up and soothe her to sleep in your arms.

Does this sound manageable?

Emma

[Emma H]

The things that help in the maturation of her circadian rhythm is having a consistent wake up time and exposing her to light (sunlight if possible) when she wakes, and turning the lights down at nighttime to signal to her that it is bedtime and promote the release of melatonin the sleepy hormone.

Letting her sleep in a cool, dark, quiet room for naps, is fine – in fact it could make it easier for her to fall asleep (as the room is dark and there are no distractions) and stay asleep for longer (as it is quieter).

So if you feel comfortable I would let her sleep in the same room for naps and nighttime.

[Emma H]

Hi Robin,

Thanks so much for the update!

It’s tricky to pinpoint exactly why his naps have regressed, but developmental milestones could definitely play a role. Has he recently learned any new motor skills or started doing something new physically? Another possibility is that his wake windows might have extended, meaning he’s not quite tired enough at nap times. Do you think this could be the case?

I’m glad you spoke with your pediatrician and received approval for Maxi to sleep on his tummy during daytime naps when supervised. I’ll be interested to hear how this goes.

Regarding your trip to the Netherlands, could you please let me know if the time difference will be two hours earlier or later compared to your current time? That way, I can give you some specific advice on how to help Maxi adjust.

Emma

[Emma H]

Hi Livia,

It’s wonderful that Emilia has settled into a consistent bedtime routine!

However, I’m sorry to hear the nights have been challenging lately. Has this continued?

Given this is a new behaviour, it’s possible she might be feeling unwell. I doubt the change is related to having one arm free, especially if that arm was out for a few days before this behaviour began—is that correct? Similarly, the nursing strike may not fully explain it, as you mentioned she continued to fuss and wave her arm even after a full 20-minute feed. I’d love to hear how the past few nights have been going.

Regarding the nursing strike, you’ve already done a great job by reducing distractions during feeds. If you suspect strong milk flow might be the issue, feeding her in a slightly reclined position can help slow down the milk flow and make feeding more comfortable. Additionally, babies naturally become more efficient at feeding as they get older, so it’s possible Emilia might now be getting enough milk in a shorter time. If she’s feeding briefly but still gaining weight consistently, that might be what’s happening.

As for your question about the pacifier impacting naps, during daytime naps babies spend a lot of time in lighter REM sleep, making it easier for them to wake up if the pacifier falls out. Also, since sleep pressure is the driving force for naps, if the pacifier falls out while she is sleeping it could cause her to stir fully between sleep cycles and lead to shorter naps.

If Emilia continues to have short naps, you might try removing the pacifier just before she falls asleep during naps (you can still use it during the routine). If this doesn’t help lengthen her naps, it’s okay to accept these shorter naps and start her to the next awake window. You could attempt to resettle her briefly, but keep in mind that lower sleep pressure after a short nap makes it trickier for her to fall back asleep. So I would only try to do this for 10 -15 minutes and if she doesn’t fall back to sleep, then simply pick her up and start the next wake window.

Emma

[Emma H]

Hi Giedre,

I’m thrilled to hear that the new routine is working so well and that your little one is falling asleep independently again.

Good luck with the night wakings. I am sure she will be sleeping for longer stretches in no time!

Wishing you and your family all the very best. Take care!

Emma

[Emma H]

Hi Rita,

If you feel like these sleep changes started around the time she began solids and she continues to experience bowel difficulties and general discomfort, contacting your paediatric department is absolutely the right next step. They can help determine if there’s an underlying cause and suggest appropriate interventions or dietary changes.

I really hope you get some answers and relief soon.

Please keep me updated!
Emma

[Emma H]

Hi Julia,

I know that nap sleeps in her bed might feel impossible at the moment but it is definitely achievable.

That’s fantastic news that the construction has moved further down the road and reduced the noise! Hopefully, this means you can start consistently using the bedroom for naps again. If the noise returns, using the pack and play in the hallway might still be helpful. I understand the depth of the pack and play could make the settling pyramid a bit tricky, but it’s definitely doable.

It’s great to hear she slept until 3 am for that first feed. Has this continued?

Regarding tummy sleeping, once babies learn to roll over, it’s virtually impossible and impractical to prevent them from rolling onto their tummy. Given she’s already commando crawling, this indicates good arm strength to lift her head if needed. It’s reassuring that she has rolled from tummy to back at least once already. I completely understand that tummy sleeping can feel concerning, so it might be helpful to talk it through with your doctor or pediatrician for added peace of mind. Typically, babies learn to roll confidently onto their backs by around 7 months, so she’s likely close to mastering this.

To improve her daytime naps, here are some suggestions:

1. Keep the morning consistent: It’s wonderful you have a regular wake-up time of 7 – 7:30 am. Keeping this consistent will really help.

2. Return to the wake, feed, play, sleep routine: I noticed you mentioned that feeding her to sleep has become easier lately, switching from your previous wake-feed-play-sleep routine. Feeding to sleep can make transitioning to settling in the crib more challenging. Would you feel comfortable returning to the wake-feed-play-sleep routine during the day? If that feels too difficult at the moment, maybe just try this approach for the first nap of the day, so we can gently introduce the settling pyramid.

3. Try the settling pyramid at bedtime and first nap of the day: Bedtime seems to be going well, aside from needing to hold her hands. Has this improved to the point where you can just pat or shush her? If bedtime is now smoother, and with the reduced construction noise, this might be the ideal time to try settling her for the first nap in her crib, since it’s usually the easiest nap to manage.

When you notice she’s getting tired, you could:

• Walk her into the bedroom

• Curtains down

• White noise on

• Lamp on

• Sleeping bag on

• Optionally read a short book

• Carry upright while softly singing one lullaby

If she’s calm after the lullaby:

• Lay her down in the crib and start the settling pyramid

If she’s not calm:

• Walk around gently patting her bottom and shushing

• Gradually reduce movement, stopping walking first, then patting, then shushing, allowing her to fall asleep without movement or noise before placing her in the crib

If she wakes shortly after laying down:

• Pause briefly to see if she settles herself

• If her crying continues without breaks, attempt crib settling for about 5 minutes

• If she doesn’t settle, use the carrier, gradually reducing movement as before

Remember, even short naps in the crib are a success because they help her build the skill of settling independently.

Naps in the carrier: If trying the crib for all naps feels overwhelming, it’s completely fine to continue using the carrier for the other two naps, with slight adjustments to the routine:

• Walk into the bedroom

• Curtains down

• White noise on

• Lamp on

• Optionally read a short book

• Pop her into the carrier and gently walk around while singing a lullaby

• Gradually reduce movement and noise, as outlined above, until she falls asleep calmly

Does this approach feel doable for you?

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 2 months, 3 weeks 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