4 Week Old Needs Lots of Help to Sleep

The baby sleep problem

We have a 4 1/2 week old baby girl who is having sleep issues.

Daytime: she is having self-settling problems - will sleep for 30 - 35 mins at a time and won't settle herself when she wakes. She also needs a lot of attention to get her to sleep initially - holding, rocking, ssshhhhing, patting on the back, etc - doing this repeatedly for anything up to an hour before she will go to sleep for the short time that she does. (Her sleep is often quite light and there is a lot of grunting and stirring.) By the time all this has happened it is 2 hours since her last feed and she won't resettle easily and I often end up feeding her again and starting the feed, play, sleep routine all over again. She is well wrapped.

She used to sleep well in the day then we went away for a few days and things were unsettled so she was napping and snacking during this time away and has carried on with it at home for a week now.

Consequently I feel as if I am spending my whole day trying to get her to sleep or worrying that she is going to wake up any minute (which invariably she does). Quite stressful.

Evening: she will often spend a good 3 hours or more crying inconsolably in the evenings. We are trying to have a regular routine to the evening - bath around 6pm then feed and settle in her bedroom - but she won't settle at all. She is obviously very tired but will cry constantly. Last night she didn't sleep from 4.30pm until 11.30pm. She spent the majority of that time crying - not just grizzling, but really crying. There was nothing wrong as far as we could work out. I fed her repeatedly (knowing that she could be going through a growth spurt about this stage). I wonder is she is having a bit of reflux as she often shows symptoms of this, however this is not all the time.

Nightime: I will give her the last feed around 10.30 - 11.00pm (which I wake her up for if she has gone to sleep but she sometimes has only been asleep for a short time and I don't know if this is the right thing to do or not.) Then she normally settles really well to sleep (although last night she needed a bit of settling) and will sleep through until about 3 am, then settles again nicely until about 6 or 7am. The fact that she can sleep well at night and not need any settling or feeding from me like she does in the daytime makes me wonder why she can't manage to do this in the day.

Another question: I realise that swaddling is important and I am doing this. However it is fairly hot these days and she is a reasonably hot baby - she doesn't need as many layers as others - and she often seems to overheat when swaddled. I am using a muslin wrap when it is hot, but this even seems too much sometimes (and also doesn't wrap as firmly as some of the other cotton wraps I use). Any advice?

Our recommended baby sleep solution

It sounds to me like your baby is over-tired during the day, which gets progressively worse as the evening wears on. Given you’ve been away, she’s probably been spending more time than usual in the car and your feed/play/sleep has been all over the place, these things can all really upset a baby too.

There are some things that will make a real difference to her sleeping during the day, and also make things much easier for you in the evening.

The things I recommend you look at are

1. Settling techniques

2. Tired signs

3. Newborn routine

4. Swaddling

5. White Noise

6. Movement

7. Dummy

Settling techniques

The best information you can possibly get on settling newborn babies is The Happiest Baby, by Dr Harvey Karp. This wonder DVD will teach you simple and incredibly effective techniques get your baby to sleep and help her sleep longer. Using Dr Karp’s techniques, you should be able to settle herr in minutes. Some of these are things you are currently doing, but there are easier options you can take, such as an electric swing rather than rocking her to sleep.

Tired Signs

Have you seen the Plunket ‘Sleepytime’ video on tired signs? It sounds like she is probably over-tired from early in the day, and gets worse through the afternoon. Many of the tired signs are onlyobvious when you know what to look for, such as glazed eyes or jerky legs. Yawning & eye rubbing are late tired signs, and babies show these when they are just about to lose the plot from being over-tired. Click here for more info on tired signs. The Secrets of the Baby Whisperer is a great book for helping you learn the difference between tired and hungry signs, and also following a simple routine will also ensure you don’t get them mixed up. I lend copies of Sleepytime if you can’t see it at Plunket.

Routine

It’s great to see you are using Feed, Play, Sleep. Using this combined with swaddling, white noise and an electric swing, you should see her sleeps lengthen and her not be over-tired. Ensure you use your Feed/Play/Sleep consistently and plan any outings around it.

Feed – feed baby when she wakes up. Do a full feed on both sides, until she stops feeding. Once she is nibbling or comfort sucking, pop in her dummy.

Play – this is her awake time, and will be no more than about 15-30 minutes. Awake time includes nappy change, a very short tummy time and cuddles. At 4 weeks there is very little actual ‘play’!!!!

Sleep – as soon as you see any tired sign, wrap her and put her into bed. You will know she is not hungry, as you only finished feeding her 30 mins ago. She should be back to bed in less than an hour from when she woke up.

At this age, I would do whatever you need to do to get her to sleep quickly, such as using a dummy, swaddling and white noise. Just work on getting her into the feed/play/sleep routine and out of the feeding constantly. It is easy to wean a baby off any of these techniques later, just do it gradually.

You can also wrap her and put her in the pushchair, and go for a walk (a gravel path works wonders) and the fresh air is great for both of you too.

Also regards your routine, aim to have her down for a sleep (pushchair/electric swing or bed) at about 4pm. Then she is less likely to be grumpy in the evening and overtired at bedtime.