“Why does my baby wake up during the night?”
- LuAnn, Indianapolis

Until your baby is around six weeks old, expect frequent night wakings. These rounds of waking and sleeping may actually help the baby’s brain calibrate the sleep mechanisms he’ll use for the rest of his life.

After the first few months, there are some babies who will continue to wake up frequently, even when they are not ill. Parents often attribute these wakings to teething, gas pain, or emotional distress, but in my opinion these so-called causes are dubious.

There are three common patterns to frequent wakings: waking up every hour or two; waking up and eating voraciously; and waking up and falling asleep immediately after feeding has begun. In all cases, you should first make sure that the baby’s sleeping environment is comfortable, and especially that it is warm without being too hot. Then you can try a few strategies that address your baby’s specific pattern.

Waking up every hour or two. I’ve seen families in which the babies take just a few twenty-minute naps during the day, are up nearly every hour at night, and require nearly continuous holding and soothing. These are families for whom sleep deprivation has reached crisis proportions. The babies are unhappy, and the parents are zombies who are more than a little depressed and clearly unsafe to drive.

Because you may not have much control over nighttime sleep yet, focus on giving the baby better naps during the day. When he is better rested from good naps, his nights will improve. So follow the N.A.P.S. plan strictly, watching your baby like a hawk for signs of sleepiness. Even if you can’t see any sleepy signals (and they may be hard to detect if he is crying a lot anyway), start the soothing process just before [approximately how many minutes before?] the 90-minute alertness cycle is over. Your baby may be harder to soothe than others, so consider yourself an exception and don’t feel guilty if you have to rely on swings or constant use of a sling for a period of time, say a few days or a week. You can wean the baby from these external devices later. (Just don’t depend on car rides if you’re too tired to get behind the wheel.) Finally, take a look at the advice on page 120 (“My Baby Takes Short Naps”) if the catnaps persist and appear to leave your baby unrefreshed.

Waking up frequently--and eating voraciously. “My baby eats so much at night... he must be starving!” one mother said to me. This little boy was past the newborn period, in the 95th weight percentile, and clearly not suffering from weight-gain problems. I suggested that she consider another cause of the wakings: she had trained his digestive system to expect food by offering a bottle at each waking. He’d become dependent on the food to help him get back to sleep every time he awakened.

To reduce this dependence, you can cautiously use your instincts and good sense about offering comfort instead of food during night wakings. When the baby stops expecting constant snacks during the night, he may reduce the number of nighttime arousals. (Before following this advice, check with your pediatrician to be sure that your baby is at an appropriate age and does not have a problem gaining weight.) For more information about night feedings and their connection to problematic wakings, see page 82.

Waking frequently, but falling asleep immediately after feeding has begun. The baby wakes up; you offer a bottle or the breast, and within seconds the baby is asleep again. When this happens, you have a valuable set of clues. These clues point to the possibility that your baby isn’t really hungry; he may just want some comfort to help him back into sleep. By feeding an older baby [Please define.] frequently throughout the night, you may be creating a connection between food and sleep, or of needing an external source of comfort to fall asleep, and this perpetuates the night wakings. (Newborn babies, on the other hand, have a genuine need to eat often in the night.) By offering an alternative form of comfort, you can ease your baby off this habit, and the baby may start to sleep for longer periods on his own.