"Dear Dr. Moore,

We are writing because we having been using your 90-Minute Baby Sleep Program for the last couple of months but have hit a major snag. Our daughter is now almost 5 months old. She has always been a challenging child in terms of sleep and fussiness - for the first 8 weeks she showed colicky signs - difficult to console, would only sleep when we were holding her, etc. Around 8 weeks she started to settle down and we were able to get her sleeping in her bassinet, although she has always needed to be swaddled and usually needs to fall asleep in our arms. As time has gone on, we have focused on giving her more structure, following the NAPS program as your book suggests - tracking her her hours to make sure she gets enough, watching for sleepy signals and looking for the 90 minute cycle. We've tried unswaddling her but she tends to jerk a lot and wake herself up so we've given that up for now.

For awhile we saw great progress - for example, she tends to wake up a couple times in the middle of the night after 3-4 hours - when it happens, we feed her, change her, re-swaddle her and then just place her in her bassinet with her pacifier and she puts herself to sleep. For a couple of days, this pattern even worked for her naps! But getting her to sleep for the first time at night remained a challenge. Her naps are just okay - usually 4 naps/day lasting 45 minutes each and we try to extend a couple for another 45 minutes.

About two weeks ago, things took a major turn for the worse. She became much more difficult to get to sleep at all times - day, night and middle of the night. Although the first time at night is far and away the worst. For the last couple of weeks, it has taken a minimum of 1 hour to get her to go down at night and sometimes much more (tonight is up to two hours!). It doesn't matter if we start at 1 hr, 1hr 20 min, 1hr 30 min or 2 hrs of wakefulness. It also doesn't matter if she gets 14 hours the day before or 11 hours. It doesn't matter if she has a good day or bad day in terms of naps or activity. And her naps have often shortened to 30 minutes (which sometimes we can extend).

We've tried everything - feeding her, unswaddling her, creating a ritual, holding her, letting her fuss (but not cry it out for more than a couple of minutes). She cries most of the time although at times she will stop crying and fall asleep, but she inevitably wakes up within 15 minutes and we have to start the whole cycle over again.

Any suggestions on what we can do??

Thank you!"

- Allison and Josh

Hi, there, Allison and Josh.

You describe sudden changes in your daughter's sleep, but it's a little hard for me to tell whether or not something else is going on that has coincided with the changes in her sleep.

You report that she needs much more comforting to get to sleep at nighttime in particular. What comforting/soothing strategies tend to work best for her? Is it one consistent thing, or a bunch of different things?

It would also help me (though I realize it is a lot to ask) if you could provide me with a snapshot or list of your daughter's sleep and wake times for a couple of days.

Polly.