"Dear Dr. Moore,

Thank you so much for writing your book, it has totally changed my parenting experience. I've had Jake on NAPS since he was 7 weeks old, and he is now 6 months. When his little clock runs out, he rubs his eyes a few times, I swoop him up and give him a cuddle and he's out like a light in his crib. My mother can't believe what a happy, contented baby he is, he's very cheerful and giggly. I attribute this to his getting the sleep he needs during the day. He is happy, and I am happy. I can't thank you enough.

Jake usually falls asleep easily and naps 3 times a day (sometimes 4) and up until a few days ago would sleep for 5 hours straight from 7 - 12 every night. Then, just as he turned 6 months I hit a bit of a bump. He's been waking every half hour or so at night, he's not teething, he's not hungry (he gets a huge meal before bed, and a snack), his diaper is clean, but he just gets up. I soothe him and put him down again and as soon as my head hits the pillow he's up. repeat.

What am I doing wrong? I still rock him to sleep and put him down fast asleep at night, and I know I need to stop this, but I'm not sure how to do this. We have a bedtime ritual that is very enjoyable for us both -- a bottle, a bath, a massage (for him), a story, a prayer and bed, this is when I rock him to sleep. How do I put him down without rocking him to sleep? Is he telling me that he needs to learn sleep independence?

Please forgive my typos, I am functioning (or attempting to) on very little sleep. I have never not had sleep problems actually, that's why it was so important for me to teach my son proper sleeping habits, so he isn't insomniac like me. I have chronic insomnia, I slept in my mother's bed until I was 14 and have had on and off bouts since childhood. Even though Jake sleeps relatively well, especially during the day, I get about 3 to 5 hours a day, sometimes less.

Thanks again,"

- Allison, Toronto

Hi, Allison,

Congrats on your happy baby! And thanks for your kind words about the book, but you are doing all of the 'heavy lifting', all the hard work on that. Good for you.

I'm curious about the change in your son's sleep habits. You are probably correct that self-soothing would help Jake to get back to sleep on his own when he wakes in the nighttime.

If you still have a copy of the book, look up 'self-soothing' in the index, there are a couple of times I cover related topics in there. Being well-rested from the get-go will help facilitate this process. It's always MUCH harder when the baby's not getting enough sleep.

Let me know what you think.

Polly.

"I actually started trying out NAPS unofficially before I got the book, just from reading the basics on your website & on line. So far my baby seems to be pretty good, He is 11 weeks old, he eats then plays & right around the 90 min, I swaddle him & lay him in his crib & he goes out on his own. Other times i will go for a walk or do my errands around the 90 minute mark because motion puts him to sleep, even when its not nap time, so I try to do that when it is nap time, although putting him in his crib swaddled seems to allow him to take the most productive naps!

I got the book & read most of it, i skipped round a bit, but my concerns that I haven't come cross an answer to is what takes precedence, feeding schedule or the nap schedule? My baby is in the 75th growth percentile. He usually eats 6am, 9am, 12pm, 3pm, 6pm, 9pm, then 3am. Sometimes the 3am feeding is sooner, as early as 130am, then 430 then 730 (OR) 230am then 530 & so on which brings all the feedings up to an earlier time. Ideally I want to get rid of the middle of the night feeding, but I dont mind dealing with the 3am feeding then starting the day with 6am feeding every 3 hours.

I am going to try comforting him when he wakes in the middle of the night as per the book. My fear is that i will comfort him at 3am, he will go to sleep just for another hour & then wake up again?? Then what do you suggest? If I ultimately end up feeding him it will mess up the feeding times for the next day. & then do you suggest me working the naps to my advantage of getting him to the next feeding time that works for me or do you suggest letting his nap delegate the next feeding time? & Also, I wasn't sure what to do when he is on a good schd & his nap starts going into the next feeding?.... What I am aiming for is to get rid of the 3am feeding, but at the same time, I would like to stay consistent with his feeding times because I am going back to work next week. & if there has to be a midnight feeding, I'd rather keep it at 3am.

THANKS!"

- Nicole

Hi, Nicole,

With regard to which-trumps-which, sleeping or feeding, what works for a lot of moms is feeding really early in the alertness cycle. If you put off feeding until much later, and you come up against the end of that alertness cycle, you may find yourself trying to feed a baby who may be too sleepy to feed to satiety.

Having fed the baby also helps you be more confident about the signs of sleepiness actually being real sleepiness, and not just hunger, if that makes sense.

And regarding your question with regard to whether or not to feed during middle of the night wakings, you've noticed I do go on and on about this issue as well in the book. Without repeating the whole discussion, you are correct, soothing without feeding during those awakenings, rocking the baby back to sleep if needed, when possible, gets greater long-term benefits than does nursing back to sleep during those times.

Polly.

"Hello,

My daughter had a baby boy on April 8, 2008. He doesn't sleep very much. I am worried about him. His eyes are blood shot sometimes. He doesn't take naps and when he does it's only for a few minutes. At night he sleeps about 4 to 6 hours and he doesn't want to go back to sleep. He likes to socialize at 3:00 AM!

I told my daughter about your book and she replied "babies don't develop a good sleep habit until 4 months."

Starting at the end of August my daughter wants me to watch my grandson full time as she returns to work. I told her she better get his sleep habits nipped in the bud before I start taking care of him!

What can I do to help my daughter realize how important it is for her baby to get sleep during the day and at night?

Thank you."

- Linda

Hi, Linda,

If you have bought the book or even noticed the tips on the website, it will be a snap for you to start establishing better sleep habits for your daughter's baby. The results come quickly, actually, once you start following the baby's signs of sleepiness.

Then our next challenge may be for you and I to help your daughter to follow those same good habits the rest of the time, when you're not with him.

(I'm being presumptuous here, but I have come across this issue more than once, in the very way you describe it)

Let me know how things are going, if you're so inclined---

Polly.

"My baby girl is 12weeks old and is a great sleeper during the night. She has her last bottle at 8pm & will wake up at 8am (she does not wake up for night feeds). My problem is that she is a catnapper! She'll go down for her naps about 1 1/2 hrs after waking (she is clearly tired when I put her down), she settles herself to sleep within 5-10mins but ALWAYS wakes up after 30mins!! & finds it hard to soothe herself back to sleep. She is still tired because if I pick her up she's very grumpy & ends up screaming! How do I help my baby sleep longer during the day??"

- Barb

Wow, you got your baby sleeping 12 hours straight at 12 weeks?

Maybe YOU should write a book!

If you have the time, I'd like to take a look at her bedtimes, naptimes, and waketimes over a several day period.

That will help me get a grasp on what's going on.

If she is really only getting such short naps, I would wonder whether or not at some point would her nighttime sleep be affected, and possible become a bit less restful.

Polly.

"Hi.

I have a 5 week old boy who sleeps very well at night & takes great naps during the day. I recently read your book & started tracking his wake-sleep cycles. I have noticed that he will usually sleep for three hours at a time, a few times a day. When he wakes, I nurse him & change his diaper, then I sing to him or talk to him in an attempt to interact with him. However, this only works for about 30 minutes. After 30 minutes or so, he yawns & drifts off to sleep again no matter what I try to do to keep him awake. So I let him go back to sleep, which can last another hour or two. Is this normal? He was a full term baby & is growing at a healthy pace. I don't know how to keep him awake for 90 minutes! He's such a sleepy head. His sleep cycles are indeed in 90 minute increments but his wake cycles are sometimes barely 30-60 minutes.

Any advice?"

- Leyla

Hi, Leyla,

Interesting question. The rare times I've heard this description were in the first few days of following the program.
I attributed it to the baby catching up on lost sleep.

Has this issue resolved in the meantime? If it has persisted, please let me know.

Polly.

"Hello Polly,

I bought your book when my son was 3.5 months old and it was brilliant – he really did follow a 90 minute sleep cycle. I was even able to teach self soothing to him around 4 months (right before that dreaded 4 month sleep regression!), so even though he still wakes up for a feeding at night, he can pretty much get himself to sleep at naps and after his nighttime feed.

However, now that he’s almost 5 months, I’m finding he is not tired at 90 minutes, but he can’t quite make it to 3 hours either. Also, I find I have to feed him twice (for instance when he wakes up in the morning and then right before he goes to bed for a nap, as he can’t go 6:30am to 11am without another feed – not a big deal as I don’t nurse him to sleep, and it does make for an easy process!). I have been putting him down after about 2.25hrs of wakefulness (when he should be at his peak, I know!), but he just gets too fussy if I try to stretch him to 3 hours. Is this just the process of stretching to a longer wakeful period, or is he breaking with the cycle?? He generally takes a long-ish morning nap (1.25-1.75 hrs) and his afternoon naps are 50/50 as to whether I get a longer one out of him. If they are not long, they are 45 minutes on the nose…(I found your book when he was taking 5 45 min naps a day, so I figured your theory must have some merit with him!). He is starting to have longer evening wakeful periods without too much of an issue – it’s more his morning and afternoon ones that are causing my confusion.

Any insight would be greatly appreciated.

Thanks!"

- Pam, Toronto

Hi, Pam,

I'm a little confused by the time intervals involved here. You mention your son couldn't go from 6:30am to 11am without another feeding---does that mean he was awake that entire time? I would have expected signs of sleepiness around 9:30am in that case.

Have things improved for you since you wrote? If the problem has persisted, and you have the time, would you drop me a line with your observations of his bedtimes, naptimes, and waketimes over a couple of days?

Polly.

"Hello-

I have been having many issues with my almost five month old son. He is exclusively breastfed, although we have been including formula 1x a day recently in order to encourage him to have more satiety at night. The addition of the formula has not promoted longer night sleeping, nor has it abolished frequent night waking.

My husband believes that we should be pushing him to a later bedtime, rather than the 7:00 pm time established. This is the time within his 2 hour wakeful period. What are your thoughts on keeping my son up later in order to help him sleep at night? (He will get up to feed once, then wakes multiple other times in which he is not fed)…..He will potentially stay up for 2 hours and struggle with return to sleep.

He is generally a good napper, although at times when I put him down within his 90 minute window and have observed his sleepy signs, he can become very playful, talkative, at which point I take him out, then try again later. Should I leave him in there until he can relax and fall asleep?

Please help, as I am not sure how to proceed from here.

Thank you"

- Era

Hi, Era,

As I'm sure you read in the book, many parents besides you and I have noticed that putting more food into the baby does not always lead to the baby sleeping better.

This is because (I believe) they are not awakening due to hunger. It's easy to be confused by their willingness to take the breast or bottle in the night after an awakening, but remember sucking is calming and focusing for a baby, and they use it for comfort and not nutrition at least some of these times.

Have you tried pushing bedtime later as your husband suggested, and if so was it successful? My prediction would have been that it would not be, but if it was, then by all means, stick with it.

As I describe in the book, my advice is usually not to push bedtime later, nor to keep the baby up during the day. It is folly to think this will lead to deeper sleep at night; for most babies, the opposite seems to be true.

If you're following the 90-minute clock and it's helping you to recognize your son's sleepy signs, that will help him to get MORE sleep during the day. I realize this is counterintuitive, but when babies sleep more during the day, they will awaken less during the night.

Polly.

"Polly,

Hello, I haven’t gotten to read your entire book yet. However, I find it fascinating as I noticed this 90 min. sleep cycle when my 9 month old was 2-3 months. We started out sleeping great, but have created a complex problem that must be solved ( I am pregnant again and need my sleep!). He slept 5-8 hours beginning about 6 weeks and took 2-4 naps a day pretty regularly. The first nap of the day (90 mins after waking) seemed to be the most important. This all fell apart around 5 months. At some time in the previous month or two, we began bringing him into our bed after his first night waking (no longer needed to be fed at night). This backfired around 6 months when he began waking 5-6 times per night. After talking with the doc. and friends, we began supporting him in sleeping in his own bed. We were getting a little more sleep at first, but he seems panicked and unable to return to sleep. (He is teething constantly and this seems to wake him a lot at night). We have resorted to napping in the car a lot because it works. I have a lot of professional experience with behavior and realize that I have created several problems for myself in my efforts to get enough sleep myself. Now my husband and I have a lot of work to do. How do we break the car-nap habit? Why does he go to sleep better and sleep longer with sitters and grandparents than his parents (that he has bonded beautifully with)?

Thanks sooo much for your book and this opportunity."

- Stefanie

Hi, Stefanie,

I'm not sure why he sleeps better with other caregivers, but it may be they have different responses to his cries. (It's hard for me to know unless I'm in your household on questions like these)

The car-nap habit is usually (though not always) a sign that a baby is not getting enough sleep, overall, over the course of a 24-hr day. Needing the motion of a car to fall asleep means he can't soothe himself, and needs the external help.

Have you been able to recognize your son's signs of sleepiness? I hope so, and I hope it has helped you and him to get more sleep. The funny thing is, when he starts getting more sleep, he'll have an easier time getting to sleep and staying asleep.

Let me know what has changed since you first wrote me, if you have time.

Polly.

"Hi!

I just read your book and am already trying to notice the sleep signs of my baby and use the 90 minute method. I have a 7 week old and in the past few weeks I feel he has become very sleep deprived. He's getting about 13-14 hours a day and from 6:00pm until 10:00pm we can't get him to sleep at all. My question is how do I get him back on track? I understand all the premises of the 90-minute plan, but I feel like he's so tired, I can't get him to sleep fast enough in that window. For instance today, he's only had about 3 hours of total nap time and it's almost 7pm! He's wailing right now while my husband tries to get him to sleep (we thought the 90 minutes would be up at 6:45). All day long it's taken me forever to get him to sleep. When he does finally fall asleep, he wakes after an hour. A few times I've soothed him and he's closed his eyes, drifting, only to pop them open after 20 minutes--before I even put him down! I'm extremely frustrated and scared for my poor tired baby! Any additional advice would be helpful.

Thanks"

- Ashley

Hi, Ashley,

The evening fussiness you describe is typical for your baby's age (or the age your baby was when you emailed me, sorry for the delay!). Usually this is outgrown by about week 10 or 12.

When my babies were going through this phase, here's what I did: after 90 minutes of evening fussiness, I would rock them to sleep in a rocking chair, or in a sling, and let them get a bit of an evening nap. It didn't stop the fussiness every evening, they were fussy every single evening anyhow, but at least I wasn't as frustrated by it. I knew that after 90 minutes, they'd stilll be ready to sleep. And I knew they'd eventually pass through this phase.

I regard that fussiness as the baby's difficulty in tuning out stimuli, I believe it's an aspect of the developing brain, and it's certainly a common developmental phase.

I hope this part of the evening is starting to improve. . .it should soon if it hasn't already.

Polly.

"My 14 week old breastfeed exclusively daughter goes down by 8pm and is not consistent with the amount of sleep she gives us.

She sometimes gives me 6 hours in a row, then breast and down another 3. Then the next day, she may be up every 2 hours.

She is a healthy 16lb baby, who did have severe acid reflux up until 10 weeks of age.

Any suggestions?"

- Shannon

HI, Shannon,

Have you tried any of the tips from the website, about following your baby's signs of sleepiness that tend to arise about 90 minutes after awakening?

I can't tell whether or not you've read the book, but it's not necessary to read the book. The website has tips to follow.

Polly.

"Dear Polly,

First please let me tell you I am in love with your book! You described all the problems I had been having with my son and I had not realized that they were due to sleep. I even went to a pediatrician with him who told me he just had a temper and to let him cry it out!... tried it, it didnt work. In turn, all of that lead me to your book. Now, my question for you is my son is doing a lot better now that we are following your advice BUT... he seems to be running on a 120 min clock? is that possible? You are right and he does show his sleepy signs anywhere from 60 to 80 mins into the clock but doesn't usually fall asleep until about the 120 mark no matter how long I try to soothe him. Any other suggestions for me on how to do better?

Another question is his feedings, if I feed him as soon as he gets up then he is awake for 2 hours, if I dont feed him again before I put him back to sleep then he sleeps for 2 hours he is missing his 3 hour feeding. He is 4 months but only taking 3 to 4 ozs at a time right now (he has only been on formula for about 3 weeks now) any suggestions for me about that? I am willing to do anything to make this work!!!

You are my hero!!!

Thanks in advance!!!"

- Shannon

Hi, Shannon,

Good for you to have mastered your son's signs of sleepiness!

I'm certainly curious to know more about his 120 - minute clock, too.

Is there any way you could jot down some notes for me, his sleep times and wake times, across a couple of days?

How are his naps doing now, and is he taking any more formula these days? Has that resolved the problem, by chance?

Polly.

"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.

"Dear Dr. Moore,

My baby boy is a very active 5 month old (20 weeks). I am doing everything I can to help him get all of the sleep that he needs, including almost never going out during his nap times. I have struggled with his reluctance to sleep since day one. As a result, I have read all of the popular sleep books, and your is by far and away the best and most effective. I have been consistently using the N.A.P.S. plan for about a month and his average daily sleep has increased from about 13 hours a day to almost 13.75 hours a day, so I am seeing improvement. I can usually get him down for a nap 90 minutes after he wakes up, but he typically takes 4-5 short naps of 30-50 minutes each per day. I have determined through experimentation that his best bedtime is 8-8:30 p.m. because he goes to sleep most easily and sleeps the longest stretches with this bedtime. He is feeding about every three hours during the day, although he'll feed hourly in the three hours leading up to bedtime after which he wants to eat only once during the night (between 20:00ish and 06:00-07:00ish), although he wakes 2-3 times more per night, at which point he will usually go back to sleep almost immediately if I replace his pacifier. He is typically a happy, focused and engaged baby, and our efforts to help him self soothe are paying off in that he can sometimes now fall asleep at bedtime while laying in his crib with just patting, shushing and his pacifier. He still needs to be more vigorously soothed at nap time.

These are my questions:
1. How will I be able to tell when his wakeful periods are increasing from 90 minutes to 3 hours? Just today he went down for two naps that only lasted 20 minutes, but was up and smiling and cheerful after each. Could it be that he didn't really need a nap at these 90 minute intervals?
2. He sleeps best and longest while swaddled, but he will only tolerate swaddling about half of the time. If he is unswaddled he wakes himself up after a short nap or repeatedly during the night because he rubs his hands on his face or keeps jack-knifing his legs up in the air or turns on his side and pushes with his feet against the crib rails until he's turned around sideways. Is there anything I can do to calm these activities down and help him be more peaceful? As he gets older and more mature will he either start sleeping through these antics or stop being so squirmy?
3. We are going on an unavoidable 4 day/3 night trip at the end of this month. We will be traveling from the central time zone to the mountain time zone. Can you give me some tips to help minimize the negative impact that this will have on his sleep?
4. Does anything in the above description of his sleep habits jump out at you as an area that could use improvement?

I appreciate your time and I hope you can help me help my boy get all the good sleep that he needs.

Yours truly"

- Bethany

Hi, Bethany,

Congratulations on the success you've had with your son's sleep! I'm delighted with the amount of sleep he's getting.

You are correct (and have probably figured this out by now), indeed at 5 months your son could be able to stay awake for 3 hours once or twice during the day.

Usually (though not always) a 3-hour wakeful period will "bookend" the night's sleep. That is, 3 hours just prior to going down for the night, and 3 hours upon awakening in the morning.

This may be related to his need for more soothing at naptimes, and the short naps.

I hear your concern about traveling across timezones, but you seem to have such a good grasp of your son's sleepy signs, I wonder if it will really be an issue. This is usually my advice with traversing fewer than 3 timezones: follow your baby's signs of sleepiness, not the clock. The naps and bedtimes may shift by an hour compared to what you're used to at home, and it may take a day or two of adjustment, I'm thinking he ought to do just fine.

Polly.

"Hi. i've just ordered your book from Kalahari.net, however delivery is only in 10 working days as I live in south Africa.

In the interim, I need your speedy assistance as my lil girl sleep issues are compounding day by day, and I need guidance ahead of the 2 week book wait. Thanking you in advance.

From birth till 4 wk, she had great sleep habits. Good day naps (averaging 2 hrs each) and normal newborn evenings. Btw, shes
exclusively bf.

Anyways I was told due to lil ones green stools to bf on her demand and duration. I did this but became oversensitive to this and always offered breast first. I believe I caused the prob by feeding her when she wanted to sleep. The result being that from 4 wks till 8 wks she had minimal to no daysleep. She was regularly cranky, and would quickly escalate into unconsolable screaming/tantrums. I knew this was related to lack of sleep.

On advice, from week 8 till now (wk 14 starts today), she has been on a sleep/feed routine of feed every 2h30min and sleep max 1hr after start of feed-time, regardless of what time she awoke. The result being that she is now having very short day naps - approx 3-4 ranging betw 20 min & 45min each. She is not as crabby as b4, but still has her regular whining sessions and still escalates to full scale screaming.

Regardless of the above, her night sleep has been unaffected (down at latest 7pm, up max 2 times in night, up for day at 7am). Except in last week she is now waking 4 times at night, and last night has been up every hour betw 6pm and 6am this morning.

In addition, she regularly falls asleep at breast. When getting her to nap in day, she requires rocking (always), sometimes dummy, sometimes breast(when all else fails). She doesn't take a dummy any other time. She has never been able to put herself to sleep, and doest know how to self soothe

I want to restore my babys precious sleep, as it is important and makes a huge difference to her disposition. Plse help.

Plse advise an interim solution to restoring sleep soonest and then a longer term plan, once I have the book. Also, if she starts sleeper longer in day, will she not miss out on feeds, and hence require more at night.If within 90 min awake time, she falls asleep at breast, do I still put her to sleep 90min after her awake time, excl snooze/nap at breast.

Ps: I am not willing to employ cry it out at all. Tx for your understanding"

- Shaadia, Durban, South Africa

Hi, Shaadia,

I'm glad you're enjoying the success of reading your baby's signs of sleepiness, and that she's falling asleep regularly. Have your baby's naps changed in duration in the past few days?

Some moms tell me after a few days, the baby's naps begin to lengthen in duration, while other moms report an immediate lengthening of naps.

If they are still short length naps, check that the interval between naps is consistent at around 90-minutes.

At 14 weeks, I'm not overly concerned about the baby's need to fall asleep while breastfeeding.

She will have time later on to learn self-soothing.

If I were in your shoes at least for the time being breastfeeding is facilitating her sleep.

I suspect your baby is still catching up on lost sleep!

I'm hopeful that the nap duration will lengthen as she continues to catch up on the lost sleep.

Polly.

"Please help I am a desperate mam of a four and half month old boy. Jack just does not sleep - his naps during the day tend to be 3x 20 mins and are usually around the same time every day. At night we have established a good routine and he can drop off easily (with help) but then is awake every hour or less until early morning. He is always rubbing his eyes and banging his head into my body, even only ten mins after waking up and I try to get him to sleep again and he just screams and screams. If left to cry for more than a couple of mins he works up into a rage and starts coughing, chocking, holding breath and it takes a long time to get him back down. He hates his arms swaddled and hates being tied into a chair or sling and has developed feeding problems every other day (getting frustrated at the breast or bottle, arching back etc). I am so tired and just dont know what to do anymore. I am still breastfeeding. Jack has had a few ilness's but has recently been given a clean bill of health - we have started weaning him on the advice of doctors. He is a very alert and active baby and needs to be entertained a lot during day. Please can you offer any advice?"

Best Regards

- Gemma

Hi, Gemma.

You didn't mention whether or not you've got my book, but if you do, immediately and without haste you should begin applying the steps outlined in Chapter 4. If you follow them faithfully and without exception, you will get quick results.

Your baby Jack sounds like a handful of babies I've come across that are just too tired to sleep, to the point they are nearly inconsolable, AND they can't sustain the sleep state on their own. This is not a common response to sleep deprivation, but it's also not unheard of. Jack does need sleep, and right now (and for a little bit longer) he will need your help to get it. I'm sure you are already feeling like nothing will help, but this won't always be the case.

Initially, you will need to do a lot of soothing of Jack yourself, but you will need to do less and less of this as he begins to get all the sleep he needs. Getting more sleep will solve most if not all of the troubles you and Jack are having. As he starts to sleep more, he will get less fussy and less needy.

The book describes exactly what to do and when, in very simple terms. If you don't believe me, you can check out the reviews of my book that are posted on amazon.com. This method truly works, and it CAN work for you and Jack.

Let me know how it goes, if you get a chance---

Polly.

"My 20-month old granddaughter usually does not nap (my daughter always puts her down after lunch for at least a 1-hr quiet time).  She occasionally had night terrors, usually lasting around 30 minutes.  In the last six months, her night terrors  have become more frequent.  Last week she had them two nights in a row. 

Her pediatrician has not been very helpful, just saying that night terrors don't last that long and she will out-grow them.  We haven't found much information either in books or the internet.

Could you give us any guidance?  Do you do telephone consultations?"

- Gloria

Hi, Gloria.  Thanks for your email.
 
We just don't know much about night terrors in general, but one of the most prominent "causes" of them is insufficient sleep.  You don't mention how much sleep your granddaughter gets in a 24-hour period, but you mention that she doesn't nap.  (The other causes are overstimulation or similar extreme "stress.", even when it's happy "stress.")
 
A 20-month-old that does not nap strikes me as concerning.  It would be unusual for a child this young to have "outgrown" the afternoon nap.  For most children, the afternoon nap continues until age 4 or 5 or even 6 years of age.
 
When a 20-month-old is routinely not getting an afternoon nap, it is very likely she is not getting enough sleep, and this situation alone can predispose the child to the occurrence of night terrors. 
 
The lack of nap plus the night terrors tells me it's likely your granddaughter is not getting enough sleep each day and night.
 
I can't tell whether or not you're aware of my book, or whether you've read it, but it is very easy for parents and caregivers to miss the good opportunities for sleep in their little ones.  My book describes a very simple formula you can follow to make sure your granddaughter gets her naps.
 
My book also briefly describes that although the brain of an adult can compensate for or make up for lost sleep, this neurobiological process is not yet present in early life.  This buildup of what the sleep researchers call "sleep pressure" in a child who's had insufficient sleep time to discharge it, leads to a build up during deep slow wave sleep in those first few hours of nighttime sleep, to a kind of a super intense, super deep sleep.  The problem is a child's brain can't process this super deep sleep like an adult's brain can, so it can lead to events like night terrors, and is one of the reasons night terrors are so common in the young, but much rarer in adults.
 
By the way, your pediatrician is correct that your granddaughter will outgrow the night terrors.  The problem is, we don't know exactly when and it could be literally years from now. 
 
To my mind, there IS something you can do to help them become less frequent in the meantime. 
 
I would urge you to help your granddaughter get all the sleep she needs, including ensuring an afternoon nap.  I strongly suspect that when you are successful with this, the night terrors will become much less frequent, and they may in fact disappear altogether.  Even if they don't disappear completely, it's worthwhile to help her get more sleep for these simple reasons:  a) it will not cost you anything, and b) you will not harm your granddaughter at all by doing so.  In fact, by helping her get more sleep you may be benefitting her health in many ways for years to come.
 
Let me know how it goes, if you're so inclined.  
 
Polly.

"Dear Polly,

We have a 19.5 week old and 9 nights ago, we started to implement the Cry it Out method for nights. He cried hard for 93 minutes straight the first night and it decreased by about 10 minutes for hte following two nights. By the 4th night, however, his crying started to increase in length - up to 2 solid hours at night 6! We have followed all the prescribed procedures (no more going into his room, etc) and have a night routine of bath, feed, story, song, and prayer before he's in the crib and the lights are out by 6:45pm. Once he finally sleeps after approximately 90 minutes of crying, he sleeps well (from exhaustion, perhaps?) and is only up for the 11pm and 3am feeds. He generally then wakes up for the day at 6:30am.

As for naps, we are working hard at getting him to nap between 3.5 and 4 hrs of total nap time. We aim it so that he naps every 75-90 minutes or so. We are not as strict with the Cry it Out method during the day (as he may not meet the nap quota otherwise), and will use the stroller and car rides to put him to sleep. His naps are never longer than 30-50 minutes.

We are wondering if you would have any advice on decreasing his crying at night? Any advice? The second question is how do we lengthen his naps?

Thank you!"

- Mimi

Hi, Mimi---

I'm sitting here looking at the keyboard, trying to figure out how to give a quick answer to your post. But if you've got the book handy, refer to the following pages: the section on this specific 'cry it out' question from p 121- 125, especially beginning at the middle of p 123.

As you may already know the NAPS plan (and especially Chapter 4 for your little guy) will help your baby get more daytime sleep, which will help with a lot of the issues you're describing, since lengthening his daytime naps reduces night time crying in the vast majority of cases.

Good luck!

Polly.

"Hi Dr. Moore,

I have a four-week-old son and read your book shortly before giving birth--I'm so glad I read it. I'm noticing his sleep patterns emerging and the knowledge of the 90-minute cycles is very helpful.

I have an older son in school and need to pick him up daily which is disrupting one of the baby's naps. While the baby is sleeping I need to get him out of the crib, get his little coat on, get him in the car seat, into the car, and then the reverse when we get home. He is waking up multiple times during this process. It's my understanding that letting him sleep in his car seat isn't safe or I would put him in his car seat for this particular nap and leave him there to finish his nap (even though the clicking sounds of the car seat and movement of getting him in and out of the car is still disruptive it's mostly getting him in and out of the crib and bundling him up that is waking him). I'm trying to make other car pooling arrangements so I can let him sleep in peace but if that doesn't work out do you have any other suggestions?

Thanks in advance for your time."

- Jessica

Hi, Jessica!

Wow, your four-week-old is sleeping that regularly? Is he asleep every day that you go pick up your other son from school? I'm impressed. He must be sleeping soundly and well, good for you.

Two thoughts.

One, your baby is still fairly young, and won't always be napping at this hour.

Though the 90-minute clock will still be going strong across the first year and beyond and will still be easy to follow, what will change is his ability to stay awake for longer periods of time. This will have the effect of adjusting the start time of his naps, as he grows.

My point is, just when you get the hang of it, he'll change on you, so this too shall pass, as they say.

Two, if your four-week-old sleeps fairly well in the car seat, and it would seem to me like a decent idea to put him to nap in the car seat prior to picking up your son. I say this for several reasons. One, it sounds like your baby is not one to get just a "catnap" in the carseat. Also, your baby does not seem to be dependent on the carseat for naps. If he were, we'd have a different discussion here. The one concern is the safety concern you mention with car seats. I'd like to know your reference on the safety concerns with babies sleeping in car seats. A lot of moms would need to know this! So if you have the chance, please pass that info along.

Good luck and keep up the good sleep work---

Polly.

"Hello.. I have had the pleasure to see you at Marcie Sauders home for your in service presentation. Since then I have been very motivated as a Post Partum Doula to share your information and use the program. I have been with a long term family of twin boys and we have been in a sleep dilemma frenzy. This Mom is breastfeeding tandem. The babies were sleeping from 7 pm to the first night feed at 1-2 am. If they woke before their first feed, I often could rock them back to sleep. However recently they began waking again, sometimes every 2 hours inconsolable. We are all tired and confused, especially mom. Everyone has different opinions on how to handle this. Most say to allow the babies cry it out. Mom and I do not feel comfortable with this. We are also being told to unswaddle and their clearly teething. They are 4 months and weigh 16 plus lbs. I trust and value your opinion and suggestions. Anything suggestions/direction would be greatly appreciated."
Warm Regards,

- Joey

Hi, Joey!

Thanks for your email. You mention that everyone has a different opinion on how to handle this situation, and I'm afraid I'm going to add another one to the list!

First off, I don't think 'crying it out' is necessarily the best route here. My hunch is the twins' are just a little too young for that. Maybe in a month or two this can be revisited, but I'd like mom to investigate something else first.

You mention the twins' bedtime is 7pm, but it's not clear from your email how much sleep they are getting during the day. You are probably not with the twins during the day, but ask if the twins' mom about this. If daytime naps are irregular or short, we may have our best clue: frequent nighttime wakings and the sudden increased need for external soothing during the night are often a consequence of not getting enough daytime naps, especially in babies that have moved beyond the newborn stage.

If you find out that the twins are not sleeping well or regularly during the day, and the mom needs help with that, please refer her to the N.A.P.S. plan. If insufficient daytime sleep is the culprit, and she's able to get the twins to sleep more during the day, you and she should see results within a week or less.

And please let me know how it goes.

Polly.

"Hi Dr Polly-
 
I have been following the 90 minute wake cycle with our five month old baby boy since he was about eight weeks old.  I actually noticed this cycle on my own before finding your book and it only helped to confirm my natural "gut" feelings with him.  He is now five months old and I have allowing him to follow his natural sleep rythm since coming across your book when he was just eight weeks old (despite growing slightly frustrated from living my life in 90 minute increments).  I now have several questions:
1.  Evenings are tough.  Say he wakes up from a nap around 3:00, I will attempt to get him down for catnap at 4:30.  Even though he is tired and ready for sleep, he will fight any nap that happens to fall after 3:00.  Obviously, this makes for a tough evening for he and our family.  On these type of days, I will actually put him down for the night at 6:30pm.  What are your recommendations for getting that difficult evening nap?  Or, is he just the type of baby who may always fight an evening nap?
 
2.  His naps have actually shortened in length over the past 2-3 weeks.  The funny thing is, they will last exactly 45 minutes, sometimes, he will wake up and go back to sleep on his own for another 45minutes, making it an 1.5 hour nap.  He will take 3 naps throughout the day.  At his age, should I be concerned that he still is taking several short naps throughout the day, with 90 minutes of wake time in between?
 
3.  His nights have actually become more difficult than they were say when he was around 2.5-3.5 months old.  At that age he would sleep from 7 pm- 7a.m. with ONE feeding somewhere between 1 a.m. and 3 a.m.  Now, he will get up anywhere between 11p.m. and 3 a.m., and then on a bad night he will wake up several times between 3 a.m. and 7 a.m. and need to be rocked and put back to sleep.  We are only trying to feed him once at night, he was a big baby (9lbs 7 ounces) and is 90th percentile hieght and 70th for weight.  We are just pretty exhausted with his new night pattern.  About twice a week, we will have a good night where he wakes up once, over a twelve hour night.  Again, do you have any suggestions to help improve his nights? We have a bedtime routine, but most evenings he is so tired from not taking an evening nap (sometimes he will be awake from 2:30 until 6:30!!) that he screams himself to sleep while we rock him.  This is getting better (the screaming), but it makes for a tough bed time. 
 
4.  Lastly, I get so much unsolicited advice about his multiple mini naps during the day and the fact that he does not sleep through the night at five months.  Are we doing something wrong?  When he is awake, he is a happy alert baby, and in my opinion, very physically advanced.  He already rolls over both ways and can support himself with his hands to sit up... he has even attempted the "army crawl" several times.  He is engaged and laughs all the time.. until his ninety minutes are up, then we head to his nursery, rock with a pacifier and he is down for a nap.
 
thanks in advance Dr. Polly!"

- Sara

Hi, Sara---
 
You ask a lot of great questions.  I'll do my best here. . .
 
Re your questions about the evening naps, and the multiple naps, and the possibly related issue of the re-emergent nighttime awakenings.  I have a couple questions for YOU.  How does your five-month-old fall asleep, for naps and at night?  Is he ever able to fall asleep on his own?  If so, you may want to think about trying to extend his daytime naps to 3 hours.  (He is just about the right age to try this, especially if he's self-soothing frequently.)
 
It's not too complicated.  When he awakens from a nap (whatever length, 45 minutes, or 90 minutes, etc), you may want to see if he's able to get himself back to sleep.  Don't retrieve him immediately from the crib, but see what happens.
 
My daughter was like this, she had five 90-minute naps across the day, which admittedly was not terribly convenient, but I was just glad she was sleeping better, so I'd kept at it.  One day I just stopped getting her out of the crib upon awakening, and sort of waited (patiently) for 15 minutes and sure enough, she started falling back to sleep on her own and her naps got longer.  And my life got simpler.
 
She was about 5 - 6 months of age at that time, so I know it is possible, even though it might sound like it couldn't work.  But your baby needs to be doing some self-soothing for this to be successful, so let me know if he's at that point yet. 
 
If you are always rocking him to sleep, then you might want to start giving him opportunities to self-soothe, and then when he gets the hang of it, try the above approach.
 
I wonder whether the nighttime awakenings are worse (or better) on the nights in which he really fights the nighttime naps, vs. the nights in which you put him to bed at 6 or 6:30pm.  Have you noticed a pattern? 
 
The other surprising thing for me is how he is screaming himself to sleep.  It sounds like a sign of genuinely intense fatigue for a five-month-old.
 
The issue of fighting the evening nap is a new one for me.  I wonder are you and your family just too darned interesting for him to fall asleep?  Might he be fighting the evening nap because he wants to be with the gang?  I'm not kidding; this is sometimes true for especially sociable babies.  Is your son a sociable one?  
 
There are ways for you to become less interesting (I'm only half kidding here) so that he can get himself to sleep in the evenings.
 
And I know the evening nap is hard, but as you pointed out, when it's skipped, the baby is NOT having a good time.  My babies were quite similar to your son.  Both of them took an evening nap well into their 9th month of age, my son was nearly a year when he (at long last) abandoned the evening nap.  You may notice in my book I do not refer to this as "normal" nor "standard."  Many other babies at this age do not need the evening nap.  I was aware my babies were outliers on this issue.  Yours may be the same.  I don't know what else to say except that babies are not all the same and you well know from experience what your baby is like when he doesn't nap, so of course, you choose to help him nap.  To force him to stay awake is not your parenting style.  You are trying to do the right thing by YOUR baby.  And it's hard now, but he will eventually outgrow it, so hang in there.
 
And I hear you about being the unwilling recipient of unsolicited advice, it can be annoying, even when people have the best of intentions.  All of us moms are just trying to do the best we can by our kids and our families.  It's unfathomable to me how someone could suggest you are doing anything wrong or try to find fault with your parenting if you have a beautiful happy engaged and healthy growing baby.  Hey, moms first thought I was nuts when I told them about the 90-minute rhythm, too.  Then they were amazed to discover this rhythm that in fact had always been present but they'd just never noticed it.  
 
People are funny, aren't they?  And babies aren't all the same.  And we need to do what we think is right by them.  I say, follow your intuition and stick with what you are doing that works.  
 
Polly.  

"I just got your book and haven't finished it yet but I already know that I my daughter seems to follow her cycles very well.  I rock her to sleep at 9, she sleeps in the crib until midnight, I bring her to bed and nurse her and we sleep until 430 or 5.  I feed her again.  And I used to put her in the swing around 615 without waking her, get ready for work, wake her at 730 to nurse one more time then back in the swing and leave her home with my sister.  She would then be awake and looking at the mobile or her feet and then fall asleep around 8 and wake at 11.  According to my sister she would take a nap in the afternoon, for about 90 min, eat at 4 and then nap for 30 min around 6.

I started her in daycare yesterday and she only got 10 hours of sleep yesterday.  She only slept for about an hour during the day and was super cranky.  They think I didn't leave enough food for her and that she is a "mover", liking to go from activity to activity…play mat to bouncer to walker.  I know she was just way overtired and could be kept from screaming by frequent stimulation.  And today they fed her way too early, at 930 and then got her to sleep for 45 minutes.

I am very upset that they used food to get her to sleep and don't seem to know when a baby is tired.  I have told them in every conversation that you have to catch her when she is rubbing her eyes and yawning and then she can be rocked or put in the swing ( I know I need to stop using the swing) and she will go right out. 

I called them 3 times yesterday and twice today and I don't know how to convey this schedule/knowledge to them.  I think they may have an alternative agenda of getting my daughter on their schedule or there are too many babies to be able to pay attention to her cues.  Today there are 11 babies and 3 caregivers.

I need help, I don't want to get off on the wrong foot with the daycare, but I am kind of angry they fed her early when they knew her feeding time, I am very worried that Jenna won't get the sleep she needs.

Please help!!"

- Melinda

Hi, Melinda.

Thanks for your message.

This does sound like a frustrating situation.  I'm so glad to hear of your success with managing Jenna's sleep.  I'm sorry that your daycare situation does not seem to understand your baby's signs of sleepiness as well as you and your sister do.

Do you think it would help if I sent your daycare a free copy of the book?  If you also don't mind giving me their address, I'd be happy to.  However, I also don't want to put you or your daycare in an awkward situation.  So let me know.

I can't imagine how hard it must be to care for 11 babies all day.  Pretty sure I would not do a very good job with that, and that some of those babies might go without all the sleep they would ordinarily get at home.  I hope you don't think I'm being disrespectful of them and I also don't mean to imply that the book will solve all their problems.  But I wonder if it might help.

If you think it might help, let me know.

Polly. 

"Just went to your seminar today at Scripps Mende and LOVED IT! You confirmed so many of my suspicions regarding her fussiness and general unhappiness. My daughter is turning 13 weeks tomorrow and she has been quite the handful! Terribly fussy since day one. Although colic,
reflux, and difficulties with breastfeeding have all been challenges, I generally believe that she is very overtired. I find her to be incredibly sensitive to overstimulation and believe that she has great difficult shutting out the world. Fortunately, we've become more and more attuned to her needs- No easy process! (I so related to your early experience with Maddie- nursing her repeatedly when she in fact was tired. This was so the case for me and my daughter).

At this point she is sleeping beautifully through the night. Generally going down between 7:30-8:00 and either waking at 7:00 or so OR waking briefly for nursing at 4-5 a.m. and then returning to sleep until 8 or 9 a.m. However, getting her to sleep is a battle. We have created the monster ritual of doing squats with her to calm her. Was the only thing that worked in the early days when screaming for extended periods of time ruled our world. Like you said in the seminar, short-term and long-term consequences with every decision right? When in survival mode and trying to maintain sanity, you do anything just to bring sleep on...even at the price of creating a bad habit, I suppose.

In any case, every evening now requires this as she is tremendously upset and uhappy. Even when I believe we are catching her in the window. She bellows and cries inconsolably for upwards of an hour while we do squats and pat and rub and try to hang on until finally sleep takes over. However, we also put her down asleep most nights... She has had some success in fussing herself down once placed in the crib, but never when she is actually "crying". I can't handle the cry it out yet... However, I want her to have the ability to self-soothe.

So- first question: Is this just pure overtiredness rearing its head at the end of the day when she cries and cries in our arms until finally going to sleep? Being a sensory sensitive baby, could she simply need this release in order to calm her nervous system?

Second question: Nap time is frustration time. Still relies heavily on
movement in order to fall asleep- Having her in the sling works best. She'll fall asleep in the car (and sometimes stay down even after we've stopped and moved her inside). I've been trying to put her down during the day but it is a nasty battle. She fusses immediately and escalates quickly. I believe she is a baby that only continues to escalate herself right out of sleep all together. I have tried to let her cry for upwards of 15 minutes and going in every few to comfort her, but this only causes her to be more and more upset with me. The big challenge is that I continue to do this dance - bounce her calm, place her down, screams for me, comfort and bounce her again, place her down, screams and screams, etc- And then before I know it, 45 minutes have passed and I know we are out of the window for sleep until the next cycle comes along. It seems then my whole day has been spent trying to get her to sleep. I know I can get longer naps if I wear her, lay down with her, etc. But I know this is only a temporary solution. Just today I saw my windows open up every 90 minutes. However, after fighting it for so long, I guess I have to just wait until the next cycle and try again?

Again, THANK YOU warmly for today. Already reading your book. You validated so much and I am already feeling much more confident and positive about being able to read her cues and respond to her needs."

Warmly,

- Brie, San Diego

Hi, Brie!
I'm so glad your daughter is sleeping so well at night!
Usually when I hear about babies like your daughter (and I have heard this description more than once!), sleeping well at night is NOT part of the picture.
So you can count yourself lucky on that score.
It's hard for me to know whether or not she's truly getting enough sleep during the day.
She may indeed be overtired due to not getting enough daytime naps, as you suspect.
Have you tried filling out a sleep diary?
My first bit of advice is to dedicate yourself to seeing how much naptime you get for her.
Even if that means wearing your baby for three straight days, if that's the only way she gets a good 2-hr nap (or more) at each naptime, do that.
At least, this is what I would do if she were my daughter.
Next, I wouldn't worry about training on self-soothing just yet.
For one thing, you've got some time, she's still pretty young.
For another, as she's a sensitive-to-overstimulation baby, attempts at crying it out in an overtired easily-overstimulated baby might backfire.
You will want to be very confident about when she's going to be sleepy before you trying crying it out, for your sake and for hers.
If you get a chance, let me know how it goes---
Polly

"I have a 20 month old that have not slept through the night since she was 2 days old. She still wakes up a minimum of 3 times a night and once we hit the 3:00am mark it is every hour upon the hour until 6:30am. She is an exclusively breast fed baby and still very attached to it. Will your book work for us? I honestly don't know what to do other than letting her cry herself to sleep. An approach that I strongly disagree with but seems to be my only option at this point. Please help.

p.s. Since my husband is not a reader, is there a 90minute video tape/DVD out there?"

- Nada, San Diego

What you describe sounds like a baby that does not get enough sleep, and by that I mean, she sounds extremely sleep deprived. My guess is she's so reliant on or attached to breast feeding because she is so sleep deprived, and thus she's unable to soothe herself, and she "knows" she needs external sources of soothing to get the sleep she "knows" she needs. (I put the word "know" in quotes because I mean on some level, she knows it, or her body knows it, even if she doesn't know it consciously, if you know what I mean.)

You don't mention daytime naps but I'm willing to bet they are irregular or don't occur at all.

Honestly I don't know whether or not the book will work for you, but I also know that crying it out is not likely to work, and very likely to backfire in your daughter's case. She is clearly unable to soothe herself at this time. This is why she seems so attached to breastfeeding.

But I believe you should still try to focus your efforts on getting her to nap during the day, and I believe that doing so will bring you other successes with her sleep. At your daughter's age, she should be having at least one afternoon nap of two hours or more, and possibly also a morning nap. Look for signs of sleepiness about 3 hours after she awakens, or at about 4.5 hours after awakening. Getting a nap or two will help her sleep a little better at night, and she should start to have fewer awakenings then. After that point, you can address the remaining night wakings with other strategies, possibly to including crying it out, though this is certainly not the only option.

I don't have a DVD yet, I'm sorry to say. There is one out there, though it is not "authorized" by me, and I don't recommend it. Since you are San Diego based, I can refer you to my colleague Dr Brad Schnierow, who has an excellent track record with toddlers' sleep problems. I believe his office number is 858 623 3266.

Good luck and I'd like to know how things go if you have the opportunity to do so---

"I’ve read your book and have been trying to follow the NAPS plan for a little over a week now with my 5 ∏ month old son.  He has pretty standard cues – yawning, rubbing eyes and fussiness – which he sometimes exhibits as early as 20 minutes into the cycle.  Could use your advice on a couple issues:

a/ I will start to soothe him when he exhibits his sleep cues, but sometimes even 10-15 minutes after the 90 minute mark, he will still be awake.  I rock, sway, shush/sing (and sometimes end up nursing if he is hungry), but he won’t fall asleep.  In prep for sleep training, I’ve also been trying to put him into the crib when he is half asleep and not fully asleep, but sometimes I can’t even get him to that droopy eyelid stage.   Is he consolidating cycles even though he is showing signs of being tired?  At what point, should I give up trying to get him to sleep, and when I give up, should I wait for the next cycle?  On some days, I feel like I spend all day trying to get him to sleep!

b/ He wakes up for the day at a different time every morning (anywhere from 6:30 a.m. to 9:30 a.m.!), and as a result, ends up feeding / napping / going to bed at different times each day.  His nap lengths are also all over the place – some days, it is 45 minutes, other times it is 1.5 hours.  The intervals between naps range anywhere from 90 minutes to 4 ∏ hours, but are never the same from day to day (e.g., on Monday, he will have a 90 minute interval b/n waking up and his first nap and on Tuesday, he will have a 3 hour interval).  He is also erratic with night sleeping – on a good night, he’ll sleep from 8 – 4:30, babble to himself before and then cry to be fed around 5; on a bad night, he’ll be up every 3 hours.  Is there anything I can do to encourage him to be a bit more consistent? Thanks!"

- Tina, New York

It sounds like your son is indeed a sleepy guy, and in fact I have heard descriptions like yours from a few other moms. Does he also take quite a bit of time to calm down? It sounds to me like he may be a baby that just has a harder time tuning out the world, so that he can fall asleep. It can be really hard for parents to read his signs of sleepiness because he is so distracted by all the interesting things to see in the world. So to my mind you are ahead of the game on that score.

Every once in a while, these moms with similar situations do try sleep training their babies. I would not necessarily recommend it for your little one because of his "distractibility" (for lack of a better word, and there probably is a better word for it, I just don't know what it is, "sensitive to visual sensations", perhaps?) These babies already have a hard time tuning things out, and need a lot of help with that, so giving them a crash course in doing it on their own just seems to be unlikely to succeed.

If he indeed is a baby that needs extra assistance in tuning out the world, the best approach is to make things as monotonous as possible for him at naptime. I would do this to help him fall asleep at naptime until he starts to sleep in a little bit longer stretches. Something really boring like rocking, something his eyes can't keep up with, that then disengages him enough so he can drop off to sleep.

After some number of days with this (wish I could be more specific), you should find he will not need so much help falling asleep.

But it's a process that takes a bit of time, I'm afraid. Do feel free to give me an update if you have time. I'd like to know what things you've tried in the meantime and what has worked for you.

"My 3 month old definitely follows the 90 min. sleep cycle. Lately, he has been taking 2-3 very long naps (3 – 3 ∏  hours). Should I ever wake him from these long naps? Will these naps cause him to stay awake at night more. It seems that he has awakened more the last couple of nights (not b/c he’s hungry). The other thing that I have done differently the last couple of nights is wake him before I go to bed for a bottle. Is this the cause of him waking in the night more or is it the long naps???"

- Velvet & Jon

As I discuss in the book, I don't recommend interrupting naps or shortening naps for the illusory purposes of helping the baby sleep better at night.  Disrupting naps generally does not lead to better nighttime sleep.   

I take the longer naps as a sign that your baby is now sleeping better, a good sign.  He may be catching up on lost sleep.  That's a very good thing.  That's also possibly an indication that you are really reading and responding to all of his sleepy signals, right on cue.  Good for you! 

If that's the case, then usually the naps may be longer than usual for a few days, but will usually revert back.  

And I consider a 3-hr nap a decent nap,  I don't consider it "too long."  Not at all!  Not at your baby's tender age.  To my mind it's more likely that it reflects a temporary adjustment for his lost sleep.

It is also possible that he was waking up not because of the naps but because of the additional feeding. 

"I have read other sleep books, my favorite was Healthy Sleep Habits by Weissbluth (maybe you've heard of it, ha) and with my first son, now a toddler, it didn't work. Only time worked (10 months or so) to get him to start napping. Now I have another son almost 6 months (next week) and he doesn't nap either! I think it may be genetic? Anyway, I came across your book, bought it online and read it the same night.

All of the other sleep books state as a baby gets older, their awake window increases. Example, for a 6 month old it is 2.5 hrs. However, since my baby only takes 20 to 30 minute naps, and only two of these a day, I tried your method. I can get him asleep or close to it every 90 minutes for the most part. However, he still only sleeps 20 to 30 minutes. I have at times left him alone to see if he will fall asleep again and he won't (up to an hour per "other" books). Then before the next 90 minutes he is sometimes fussy way before this time, sometimes right after the very short nap. I also put him down awake sometimes for naps as he can put himself to sleep when he wants to. However it takes over an hour if he does it. If I rock him until his eyes just close, I put him down and he wakes up immediately. So I am within the 90 minutes but he gets more awake in the crib! And he was drowsy! So this is where I am confused. I have to rock my guy until he is totally asleep for him not to wake up when I put him down, but either way, he is up in 20-30 min.

Any suggestions?

*He also wakes for the day at 5-5:30 a.m. and not to eat. His room is dark also. I have tried putting him down to bed for the night as early as 5:30 pm. however it usually takes him 60 to 90 minutes to put himself to sleep. Usually not much crying, if there is I pick him up and put him down. He is usually goofing around in there!

Thanks in advance for any help you can provide. If you are ever in the Phoenix area and want to do a sleep study on my little guy, that would be great :) Maybe he is the worst sleeper you will ever encounter."

- Susan, Phoenix

I'm hearing more stories like these since I wrote the book. It's hard for me to know for certain, of course, but what I suspect is that there has been a fair amount of sleep loss that the baby now is having a hard time overcoming.

It leads to an oversensitivity to stimulation and possibly to some challenges in regulating his own body temperature, among other things. These factors conspire to wake him up in the shallow stages of sleep!

I can give the advice I often give, but I recently gave it on this website, and it appeared not to be successful for that mom and baby.

So for what it's worth, here it is.

I notice you mention that a six month old is able to stay awake for 2.5 hours. In my book, I describe this as a 3-hour clock, not a 2.5 hour one. This may sound like hair-splitting details, but to me it's not. It could be that these thirty minutes make the difference between initiating a nap in phase with your son's natural sleep tendencies, or out of phase with them.

The first thing I would do is see whether using a 3-hr timing makes a difference. If you stick with it over a few days you should start to see longer naps. At his age he should be napping for longer durations.

I also don't think your boy is the worst sleeper I will ever encounter ---- I've definitely heard worse!

"I have not yet read your book, but plan on picking up a copy asap! I heard you on 104.7 The Fish Atlanta this morning! I have a 26 month old who does not take naps unless it is on his schedule. He goes down great, if I tell him it is time,he tells me he is ready to go to bed at his normal bed time and has no problem napping on his own. When I put him down however he will lay in his bed for up to 3 hours and sing and talk and play with his hands and feet, he does not fuss or cry! What would you suggest in this situation? Does he need those naps, or should I like you say follow his natural rhythm? Or is this just him being to excited at the time to nap, since he will go down on his own when he is tired?"

- Crystal, Atlanta

Ah, . . . .you must be referring to my NEXT book.

The one I haven't written yet.

Just kidding! There are probably other books out there that have advice like mine, which I'll summarize my advice quickly here, and is touched upon in my book.

And actually this came up in a chatroom discussion I had last month at centraljerseymoms.com

It might be accessible still from that website.

Strategies are a little different with toddlers and naps. Your son is right on schedule---around two and a half years is when a little one comes to realize that s/he can exert some will over whether or not they sleep during naptime.

And I do remember when my own kids went through this! Those were tough days! My toddlers could stay awake, all right, but for the rest of the day, they were just a mess: temperamental, klutzy, moody, or of short attention span. From these signs, it was pretty clear that in fact the naps were still needed. (It's great that you recognize this also, that when your toddler's able to maintain wakefulness during naptime does NOT mean the toddler's outgrown the nap. People make this mistake often, in my opinion.)

Do you know what a sticker board is? A calendar posted somewhere your son can reach, with a place on each day to put a sticker? Using one of these, telling your son why it's still important for him to nap in the afternoons, and having him put a sticker on the board each time he gets up from a nap is usually extremely effective. He should get something special as a reward after a week or so of consistent naps (which doesn't necessarily have to be expensive or high in calories). The trick is to motivate him to want to nap.

"I just finished reading your book and I have loved it! I wish I had gotten it when my baby was born. It confirmed what I had always thought about my babies’ sleep, but everyone always made me feel bad for putting my babies to bed so quickly and not keeping them up longer. I listened to the others and ended up with problems. I got your book when my little guy had just turned 6 months old. I have read it thoroughly. My problem is trying to start out cold turkey at 6 months. I’m having a hard time figuring out when to put him down after 90 minutes or when he is ready for longer awake times. I try to watch him for cues, but he has been such an erratic little guy since he was born, that he’s hard to read. I was wondering if you had any general advice for getting started at 6 months."

- Keri

It sounds like the book affirmed what you suspected all along. I'm glad about that

I think if I were you, I wouldn't be doing anything differently from what it sounds like you're doing: looking for signs of sleepiness, and responding asap by providing an opportunity to sleep.

Be guided by your observations. See which sleep opportunities at 90 minutes were followed by sleep and which ones weren't.

My guess is it will take a few days or a week or so to sort it all out.

As a broad guideline, many (but not all) six-month-olds have a 3-hour stretch in the morning once they're up for the day, and another before they go down for the night.

There might be other 3-hr stretches in between his daytime naps. You might not see this yet if he hasn't been getting his full allotment of sleep for some time.

Once your little guy starts getting more regular naps and hopefully longer naps, you'll know which are the real alertness intervals to follow up with a nap.

Make sense?

If it doesn't, can you try to describe for me what cues you're going by? That might help me be more specific.

"Our almost 16 week-old baby seems to want to be held or be resting next to me while he sleeps. If I try to put him down or leave his side, he wakes up. Even if we hold him while he's sleeping, he still wakes up at about 25 to 35 minutes into sleeping, and has to be helped back to sleep again by rocking or nursing. I would love to be able to put him down and have him sleep for even just an hour. It seemed like we were able to do so weeks ago and I'm not sure why this is happening. He does sleep well at night, waking every 2 to 4.5 hours to nurse, falling back to sleep again nursing, between about 7-8 p.m. and 7-8 a.m. Am I expecting too much at this age for his napping? He also startles very easily and wakes from small noises in the house -- the cats, a dish clinking, a paper rustling. Should I be making it louder to "condition" him to sleep through noise, or putting him somewhere even quieter? Thank you!"

- Jenna, Berkeley

Depending on the amount of sleep your baby is getting, which isn't entirely clear from your post, he may indeed be a bit sleep deprived.  Requiring being held, awakening frequently, needing contact with you in order to stay asleep are often associated with inadequate sleep.
 
Of course, needing contact to fall asleep isn't unusual, but when babies can only remain asleep when they are being held, that's a possible sign they're not getting enough sleep. 
 
In addition, the being very sensitive to noises may also be a sign of inadequate sleep.  This usually though not always gets better once your baby starts getting enough sleep.  My advice is not to focus your attention on modifying the baby's sleep environment.  My advice would be to focus on his inner rhythms as described in the book. 
 
Did you receive the book yet, did reading the book offer any possible solutions or new strategies for you?  If so, have you given them a try?   Let me know when you can.

“Do I wait until 90 minutes are up to start trying to get my baby to sleep? Or should I start trying to soothe her before the 90 minutes are up so that she'll fall asleep at about 90 minutes? What sort of window of time do I have before another wakeful period starts? 5 minutes? 10? 1/2 an hour?”
- Pamela - sleep deprived parent. :)

Excellent question. Here's my advice.

#1. I wouldn't wait until the 90 minutes are up to start trying to get the baby to sleep. Your baby's signs of sleepiness should be your guide. When you see the signs (or hear the signs, as the case may be!), that's your cue that the sleepiness window is "open" and that you should try to respond as soon as you reasonably can.

Which leads us to . . .

#2. How long is the window open, you ask? I only wish I knew the exact answer to this question. It seems to me that babies are not all the same, that this may vary from one baby to the next. Some babies seem to have a 5-minute window, others may have 10 or 15 minutes. Your own experiences will be a more useful guide for you than any number I would come up with.

"What if my son doesn't stay awake for the full 90 minutes?"
- Matthew, Evanston, IL

My advice is to follow your son's signs of sleepiness: if he is sleepy in less than 90 minutes, follow his signs of sleepiness, not the clock.

Following the signs of sleepiness is your cue, and it's what will help the baby fall asleep easier and quicker.

"I've been devouring your book for the past two days and I started observing my 9 week old son for the 90 minute cycle and couldn't believe my eyes when he would dose off like a switch went off! He's not 100% consistent but I did see the pattern a few times even the 1st day. My son has been eating pretty consistently on a two hour schedule day and night, sometimes stretching to 3 hours at night. Part of the reason I think is the hypoallergenic formula he is on which is very thin and easy for him to digest. His feeding schedule is keeping him from staying asleep for very long. Any advise you could give would be appreciated. I am trying to give a larger amount of formula but he doesn't accept it most of the time and due to reflux issues, I don't want to overfeed. Thank you very much. P.S. I'm not sure it matters but Conner was born 3 weeks before his due date."

- Jamie, West Orange, NJ

Hi, Jamie!

Is Conner doing any better now?

Stick with your pediatrician's advice regarding formula and feedings. In Connor's case, his atypical feeding needs will trump any suggestions I have about sleep. Connor is still pretty new, but I think you will observe that as he grows, he will be able to ingest more with each feeding, and then the intervals between feedings will also lengthen.

When you and he are able to stretch out the interval between feedings to 3 or 4 hours (work with your pediatrician on this), you should see his sleep periods start to lengthen. I know it is hard to be patient, but you and he will be sleeping more soon.

I hope you will check back in with me and let me know how it's going.

"We are definitely in crisis mode, our baby will be 8 months old next week, and she is a cat-napper, only napping at times 45 minutes a day, and is up probably on average 8 times a night. We try to do everything right, get her back to nap about 2 hours after she wakes up, get her to sleep early in the evening, but she just doesn't stay asleep. We need to rock her, hold her, and put her in her swing in order for her to sleep, she will not sleep in her crib, and occasionally ends up in our bed which we do not want to do. If we try to let her cry it out and soothe herself back to sleep she becomes quite hysterical and quickly vomits everything up in her stomach (very large amounts). We are at our wits end here and I am going to try your book for some advice, but am wondering how we should go about trying to get her to sleep in her crib since she is getting bigger and will be reaching the limits of her swing soon. Do you have any suggestions for us? Our pediatrician has been absolutely no help. Please, we are desperate!"
- Jessica

Your baby does sound like she is very sleep deprived. I've worked with other families in your situation and I know you can handle this. Here's what I advise.

Your daughter is probably too sleep deprived for the 'cry it out' method to be successful. This is best attempted in a fairly well rested baby.

At this time I advise you to focus on daytime naps. You mention that you put her to sleep about two hours after she wakes up. Attempting naps is good, I applaud you for that, but I advise you try a different timing: try starting naps either at 90 minutes after she wakes up or 3 hours after.

Try to be looking for her signs of sleepiness at those times, too, at 90 minutes or 3 hours after she wakes up. This probably sounds bizarre if you haven't read my book, but just trust me on this.

Before you re-attempt the 'cry it out' you want to have a very good sense of your baby's nap schedule and her signs of sleepiness. In your situation it is probably very difficult to pick out her signs of sleepiness, because she is so tired, almost all the time, and so are you! Both of you are doing your best, so please don't blame yourself. It's not your fault.

Most 8 month olds have a fairly predictable nap schedule, so your daughter should have a morning nap, an afternoon nap, and depending on her bedtime, possibly an evening nap. Once you are confident in the nap schedule and in her signs of sleepiness, then you can re-attempt the cry it out approach--- or you can try one of the other self-soothing approaches.

Please check back in with me and let me know how things are going.

"My husband and i just started the NAPS plan a little over a week ago and it has helped tremendously however, I have a few questions. I can get the baby to fall asleep for her daytime naps but she does not stay asleep longer than 30 or 40 minutes. She doesn't wake up crying and I've tried putting her back to sleep but it doesn't work. How do I extend her naps. Also she is 5 months old and does not go to bed until 10:30 or so. How do I get her to go to bed early or will she adjust herself if we stick to the plan? Please help. Thank you.
   I have a few more concerns. I'm really frustrated. I have been using the naps plan for over two weeks now and the baby seems like she's sleeping less. She doesnt take long naps and is waking up several times at night. She seems so exhausted but I don't know what else to do. I would appreciate your advice and help. Thanks again."
- Monica

Sounds like we have a couple of concerns here, and I think I need a little more information before I know what to advise. You are right, most five-month-olds are able to nap for longer than 30 or 40 minutes at a time. When naps are that short it signals to me that the baby might (still) be sleep deprived, on some level.

When families describe a pattern like this to me, sometimes I ask them to fill out a sleep diary for their baby. It's because I need see whether or not they are truly being faithful to the 90 minute clock. It is easy to miss nap opportunities and not know it.

I do have specific advice in the book about how to get babies to "consolidate" their naps, and at five or six months of age is the perfect age to start it, it's when I did so with my daughter. I do also have specific advice for using the 90 minute clock to adjust your baby's sleep time earlier in the evening. Hope you don't mind that I refer you to the book, but I don't have space here to get into all those details.

Let me know how it goes, if you would.

"My 6 month olds sleep pattern is very scattered. Some days she will nap for an hour or more, but most days she only takes 45 minute or less naps. Her night time sleep is very sporatic, on a good night she will go down at 8 or 9 and wake at 1am and 4 am, and then wake for the day at 7 am. But usually she is waking up every 2 hours still, and some nights it is every hour. She does us a pacifier so I usually just give her pacy back and only feed her at 1 and 4. I think that she is just used to me being with her as I did let her sleep with me a lot in early months while breast feeding."
- Brandi

Have you been following the NAPS plan as outlined in my book? I can't tell from your post.

"....as to where to go next. My baby will be eight months old on Monday. I’ve tried different methods to get her to sleep since she was born, and although she sleeps ok at night (except for waking up at least once), I have been unsuccessful to get her to be a good napper during the day. I stumbled upon your book the other day and basically read it cover to cover in one day. It makes perfect sense to me and I’m eager to put it into practice, but don’t know how to start at this point.

Some days it seems she only wants to be up 90 minutes in the morning and other days a three hour wake period works for her. It just doesn’t make sense to me that she should be so inconsistent from day to day. Her morning nap is the only reliable nap I can get her to take. I’ve tried different times in the afternoon (prior to reading your book) and have been successful about 50% of the time to get her to take a good nap (one hour +). Her bedtime routine has been working well for the past several months with a bath at 6:45 and lights out between 7:00 and 7:30. The only problem is that she has yet to sleep through the night and continues to wake up between 5:30 and 6:00. To compound the situation, I have a three year old daughter who doesn’t understand, or care to understand, the meaning of being quiet while her sister is napping. I do believe the noise in the house is affecting the babies ability to sleep, but don’t see a way around it.

What has lead me to ask my question is the total disaster of last night. I was out and about more than normal yesterday, and while my baby did nap in the car and stroller quite a bit, by 6:00 pm last night she was almost falling asleep in the high chair. I decided to put her down earlier than normal to see if that would help her sleep better during the night. I started the bedtime routine 30 minutes early and had her asleep by 6:55. I thought it would be a great night of rest and sleep for my husband and I. Unfortunately, the baby woke up three times more than normal during the night and was up for good at 5:30! I don’t understand why that would happen and hope you could shed some light on the situation. I was able to put her back down at 7:00 am and she slept for an hour. I tried to put her back down at 9:30 because she was yawning and rubbing her eyes, but she’s still babbling in her crib. I’m going to try again at 11:00, but until then I remain utterly confused as to where to go from here.

My main question is how should I start the NAPS program for an eight month old baby? How do I get her to be a good sleeper at this point when I feel I’ve already taught her some bad sleeping habits? Should I focus on the daytime sleep first, or the night time sleep? Please help!"

- Robyne

From your post, I gather that your daughter is awake for either 90-minutes or 3-hours, and that this seems inconsistent to you.

It doesn't seem inconsistent at all to me. So I must apologize for having been unclear. Since 3-hours is two 90-minute periods put together, it makes perfect sense to me.

It also sounds like you are right on target and I commend you for your keen observations about her signs of sleepiness. That is half the battle right there.

Responding to the signs of sleepiness is the next part of the battle.

I say this because your description of what happens when you keep the baby awake much of the day (your described "total disaster of last night") is also classic (and described in my book). This is why in my book I emphasize the importance of protecting time for naps during the day. Good solid regular naps during the day are what will help your baby sleep through the night. Keeping the baby awake during the day does not lead to deeper sleep at night. In fact for most babies it does the opposite: the overtiredness leads to more awakenings at night.

I advise you to continue to follow her signs of sleepiness during the day and see if that helps with the nights.

"I wish I had come across your book sooner! I was one of the parents experiencing "mystery fussiness" with my baby. She was always so cranky and impossible to get to stay asleep during the day although she has always slept well at night. I have a question regarding the length of naps. I just started implementing the N.A.P.S. program and I definately see an improvement however I'm concerned about the fact my 3 1/2 month old baby is currently taking a nap that has been going on 4 hours already and it's only 1:30pm. She took a 4 hour nap yesterday as well. Is a nap ever too long? I know the book states to let them sleep but her naps seem a little excessive and last night she was still extremely irritable and hard to settle even after such a long daytime snooze. Thanks!! I can't wait to see how following this plan will help get my daughter to nap well."

- Christa

In fact, your description is just what would be predicted by sleep research.

It indeed sounds like your baby had not been getting enough sleep. Once you start correcting this situation, it's a good sign when in those first few days you see some long-ish naps.

That is most likely part of something sleep researchers call the "sleep recovery process" and a very good sign that she's making up for lost sleep.

This probably continued for a day or two, and then her naps shortened back up. Am I right?

Also, just as an aside, this sort of temporary lengthening of sleep bouts (naps and/or nighttime sleep) can also be observed in children or toddlers whose snoring has recently been corrected by tonsillectomy.

"How does a baby's feeding schedule relate to the 90 minute sleep schedule that you describe in your book? My baby did get tired at 90 minutes, and fell asleep. The only problem was that he woke up 30 minutes later with hunger. He tends to eat every two hours, so he didn't get much sleep in before he was hungry again for a feeding. Hunger seems to disrupt this 90 minute cycle. Can you provide some help to me?
Thank you!"

- Elizabeth, Massachusetts

I can't tell from your post the age of your baby, and my advice will be different depending on his age. When they are newborns, as you know, babies will require pretty frequent feedings, so this phenomenon you describe might be due to his young tender age, and he may outgrow it with time.

Its also true that in the very young babies especially it can be hard to tease apart which are the signs of hunger and which are the signs of sleepiness. It is easy to be tricked. Very tired babies are often eager to nurse or feed. The process of sucking is very focusing for them and helps them fall asleep. Sometimes if you make sure the baby's fed early on in the 90-minute alertness cycle, then you will be able to pick out the difference later which is which, hunger vs sleepy.

"I just read your book and want to try the program tomorrow. I was just wondering what to do when my baby wants to fall right to sleep after feeding. He does this at night and that is fine, but during the day sometimes he falls asleep right after feeding. Should I let him? He is 5 weeks old. Also, should the baby be on a feeding schedule with this program? Hope to hear back from you! I can't wait to try the program!"

- Jodi

There have been a couple of other posts about the relationship between hunger and sleep, and as you know the book does go into this as well. Do you think you have a grasp on which of his signals relate to hunger and which relate to sleepiness? It's usually pretty confusing before about two or three months of age.

“Hi, I have a question. I notice from your sleep chart that my baby should be sleeping 15 hours a day. My baby doesn’t get that much sleep and I think she doesn’t need as much sleep as you say she does.”
- Amy, Ventura County

It’s funny . . . some babies don’t read the sleep charts! Although most babies will sleep a predictable number of hours in the day, some need more than the average and some need less. All babies, however, will follow their natural inner rhythms in an age-appropriate way. (These rhythms and how they change over the first year of life are described in the book.)

Before concluding that your baby needs less sleep than others do, make sure you are adhering to the N.A.P.S. plan, and that you are watching for and responding with alacrity to her signs of sleepiness. Don’t expect the baby to conform to an adult’s schedule, especially when it comes to daytime activities and bedtime. Do not cut off naps by taking the baby with you on too many errands and appointments, and try putting her to bed early to increase the number of hours she sleeps at night. You may be surprised at how much your baby can sleep when she is given the opportunity to follow her own body rhythms.

"My baby used to be a good sleeper, but now he wakes up at night."
- Jane, Lincoln

It can be crushing when a baby who was sleeping well suddenly starts to wake up again. You’ve had a taste of good sleep, and now you feel ripped off!

Unfortunately, there are almost always some blips in the sleep process—times when your baby wakes up even though he is not sick or hasn’t been thrust out of sleep by an unusual event, such as a loud thunderstorm. These blips can occur during developmental milestones, when the baby is learning to roll over, sit up, or stand up. He’s excited and may want to share his happiness with you! Wakings may also occur during teething (although teething is overrated as a cause of serial wakings) or when a baby suffers from jet lag. Sometimes babies start waking up for reasons that no one fully understands.

Of course, if your baby is waking up because he is sick or in pain—you can probably tell by the cry, which tends to be much more insistent or higher-pitched than usual—go to him and help him. If you have ruled out these causes and the baby is younger than six months, you may also need to attend to the baby. He’s still very little and profoundly dependent on you. If he’s already proven that he doesn’t need to eat at night, try not to rely on food as a soothing method. Instead, comfort him with as little fuss as possible. In a few nights, he may resume his good sleeping habits. As a last resort, you can try letting the baby fuss for five or ten minutes before responding to him, especially if the cry sounds sleepy—he may settle down on his own. If that doesn’t work, you may need to wait until he is old enough to learn self-soothing techniques (see chapter 4).

If the baby is six months or older, you have a slightly different set of tools in your kit. Try giving the baby a few minutes to return to sleep before going in. Then respond as neutrally as possible. Try patting the baby without picking him up, or talking to him in soothing tones. If the baby has pulled himself to a standing position and is unable to get down (it really happens), or if he has a foot caught between the crib slats, assist him and then try to leave the room. I recommend doing this in as matter-of-fact a manner as possible. Try not to speak, don’t smile, avoid making eye contact, and don’t linger, because you don’t want your baby to get the idea that it’s time to play. If the baby is still waking up after a few nights, you may choose to teach him self-soothing techniques. If you have already gone through a self-soothing routine before, there’s some good news: it should proceed more quickly this time.

“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.

“Help! My baby is three weeks old and I’m having trouble putting him into his crib without waking him up. Even more frustrating is sometimes even when I’m successful at this, within a few minutes he’s awake and crying. What am I doing wrong?”
- Karyn from Orange County

Hang in there, Karyn! This is not your fault. Let me explain a few things to you, okay?

Very young babies enter sleep directly into the REM sleep stage, which is lighter and more active than non-REM sleep. Because it’s easy to awaken from REM, a young baby who has just fallen asleep on your shoulder may wake up shortly after being put down in the bassinet. While in REM, a baby also has difficulty regulating his temperature. After getting warm and snuggly in your arms or while nursing, a baby may cool quickly when you put him down. The temperature change can also cause a premature waking. This can be frustrating for parents, but it helps to know that sleeping babies who don’t transfer easily into a crib are perfectly normal.

There are a few ways to help your baby make the transition from your arms into a crib. While soothing the baby, you can place a blanket between your body and the baby’s, so that it will grow warm from your body heat. Then, when you place the baby in the crib, leave the toasty blanket in with him. (Make sure that you are using a small, light blanket, such as a receiving blanket, that is safe for babies.) Maintain as much body contact with the sleeping baby as you can as you ease him into the crib. Leave your hands on him for a few moments to make the transition less abrupt. A fitted knit or flannel sheet and a blanket sleeper may also help keep him warm; newborns will probably like to be swaddled. Another trick I used in the very early months was to nurse my daughter while I was lying down, having spread out the baby’s blanket underneath her before we began. Once she fell asleep, I picked up the edges of the blanket, hammock-style, and was able to gently put her into her bassinet without jostling her floppy neck or other tiny body parts, and awakening her in the process. This method is particularly useful if your wrists are aching from holding the baby.