"Ask Me Anything" about Getting your Baby on a Sleep Schedule with Dr. Natalie Barnett - Extended!

NanitMelanie
NanitMelanie Nanit Team
edited April 28 in Sleep Training

Ask Dr. Natalie Barnett Anything about getting your baby on a sleep schedule!

Post your questions below July 12th through July 16th at 11:59 pm ET.

Dr. Natalie Barnett serves as Director of Clinical Research at Nanit. In her role, Natalie oversees collaborations with researchers at hospitals and universities around the world which use the Nanit camera to better understand pediatric sleep. Prior to joining Nanit, Natalie was Assistant Professor in the Neurogenetics Unit at NYU and holds a Postgraduate Certificate in Pediatric Sleep Science from the University of Western Australia and a Ph.D. in Genetics from the University of New England in Australia. She is able to apply her scientific knowledge to everyday sleep problems and enjoys nothing more than giving families the gift of sleep.


The AMA is now closed - post your questions on this thread and Dr. Natalie Barnett will respond by July 19th at 11:59 pm ET.

*Dr. Barnett will attempt to answer as many questions as possible, but may not be able to answer all due to volume.

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Comments

  • FTM33
    FTM33 Member

    Hi Dr. Barnett! I'm a FTM of an adorable little boy who just turned 2 months. He's now about 12lbs and we've been on a ~12/4/8 o'clock feeding schedule of 6 times per day. I breastfeed him during the day (4 of 6 feeds) and bottle feed at night (for the 12am and 4am feeds, ~4oz each). For the past 2 days, he's refused to take the 4am bottle, and once even skipped the 12am feed too. My interpretation is he may be ready to drop a night feeding, although we didn't increase his daytime feeds/frequency.

    I have a few questions hope you can help:

    Despite not taking the bottle, he still wakes up quite often throughout the night, sometimes crying. If he's not hungry, what can I do to help him sleep better and wake up fewer times at night?

    He hates daytime naps. We watch closely for drowsy cues and always put him down promptly and follow a similar sleep routine as night (swaddled, held/rocked slightly, lay in crib awake, etc). He would continue yawning but refuses to sleep/gets very agitated. On average he only gets 2-4hr of daytime naps total. Should I be worries and how to get him to nap better?

    Finally, could we better plan his nap schedule to improve night time sleep? For example, if he's night time sleep starts ~10pm when should his last nap ideally end?

    Thank you!

  • Kqin2
    Kqin2 Member

    Our 13 month old is waking up around 12:30am every night and wants to come into our room. We cannot calm him down in anyway except for bringing him in. Then he wants to nurse, crawl around and eventually will fall asleep typically an 1-1.5 hours after waking up. Then sleeps straight through until 7:30/8am. I dread bedtime because I am the one up with him as my husband works. He falls asleep on his own most nights and still is taking 2 naps a day no longer than 3 hours total.

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Congratulations on your little one! It sound slike you are doing an amazing job, truly! This is all so new and I understand how frustrating it can be to go from having a very ordered life to having far less order and predictability! Quite honestly, it can be really hard to expect your baby to be on a regular schedule at this age. He might actually need to feed a little more often during the day that he's currently feeding. I'd love you to try feeding him every 2.5-3 hours during the day but he might also want to cluster feed in the early evening (which can be hard to deal with but is totally normal).


    In terms overnight feeds, when your pediatrician says that its ok, you can start to leave him to wake naturally for feeds at night without having to wake him to feed. He will likely still need to feed overnight for the next couple of months at least (maybe longer) but honestly, I really LOVE that you are giving him a bottle for the overnight feeds for several reasons. 1) It means that your partner is able to offer a feed overnight so that you can get a nice stretch of sleep, 2) It means your partner or someone else can also enjoy the gorgeous bonding experience of feeding your baby and 3) It means you can see how much hes eating during teh night so that you can gradually start to cut down those night oz when he is ready.


    For the overnight wakings, my general rule of thumb at this age is that he is likely able to go at least as long between feeds at night as he can during the day. So, for example, if he's consistently doing a 3 hour stretch between feeds during the day, I dont want him doing consistent 1.5 hour stretches at night (the odd 1.5 hr stretch is JUST FINE!). So if he is waking and crying during the night, Id first try to feed him but if hes not hungry, feel free to try to help him back to sleep. I dont want you to worry too much about creating 'bad' habits at this stage. He may not be able to self-soothe and you need to be the one soothing him!


    For naps, dont worry too much about them at this stage. He napping is likely to still be inconsistent for a while. If you can watch for his tired signs and try to get him to take a nap fairly regularly during the day (likely after 1-1.5 hours of being awake), that would be great! We might start to see the last stretch of the day start to lengthen a bit and be closer to 2 hours of awake time before bed.


    In a couple of months you will likely see more consistenty to his day and nights and we can work on a more regular schedule at that point, but right now, we may need to continue to 'go with the flow' a little and not have super high expectations of a regular day and night schedule just yet.

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Hello! We need to remember that what your baby needs to fall asleep at the beginning of the night will be what they need to fall back to sleep when they wake during the night. It can be frustrating for them to need something that they cant get for themselves (eg, breast/bottle/warm body!). Id love you to be consistent about having your baby fall asleep by themselves at the beginning of the night.


    Watch the timing of the second nap. Your baby will likely need around 5 hours of awake time before going to sleep for the night, so if the second nap is too late it might make bedtime a little harder. Ensuring that your baby is tired at the beginning of the night will help them fall asleep more easily at the beginning of the night.


    Most babies really dont need to eat overnight at this age so, in terms of the middle of the night wakings, you have lots of options- 1) you could leave them to get themselves back to sleep unassisted. You will likely hear some frustration from your baby which you will likely only hear for a couple of days if you are consistent about giving them the opportunity to get themselves back to sleep. If you take this route, I like to recommend doing 'check-in visits' if you are worried that something is wrong (you cant smell that poop from the Nanit!). 2) you could go in to reassure them at successively longer intervals (eg, 2 minutes, 5 minutes, 10 minutes) to quietly reassure them that you are close by. 3) you can camp out on the floor of their room while they get themselves back to sleep. You can choose to touch them or not depending on your preference. Whatever method you choose, the most important thing is that you are consistent! Consistency is key when babies are learning a new habit! Good luck!

  • YYZmom
    YYZmom Member

    Dear Dr.,

    Our 9 month old is usually a great sleeper but has been unable to self soothe for the last couple of weeks. We went out west so the time change messed her up and we cuddle her to sleep more on vacation. We’ve been back for about a week now and while she gets tired at her norma Bedtime she is more fussy than usual. We are trying to put her down sleepy but awake but fine we have to get her to almost asleep to avoid tears. She has been waking up around 2 AM in able to self soothe, and while we have tried going in to reassure her nothing works. We end up cuddling her back to sleep to save our sleep. Any tips or is this all part of the 9 month regression?


    thank you!!

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert


    Oh this is so tough, expecially when she was sleeping so well before the vacation! Its really normal for sleep to be disrupted when you travel! BUT - now you are back home, its time to get back on track!

    THE most important thing is that she is able to fall asleep by herself at the beginning of the night. Once she has mastered that, it is just so much easier for her to fall back to sleep when she wakes.

    To give her the best chance of falling asleep unassisted, try to set her up for success! At this age, Id like her awake for around 4 hours before bedtime. Make sure her room is VERY dark and is also cool and I always love to add a white noise machine (our research has shown that babies sleep one hour longer on average when they are using a white noise machine!).

    I like to recommend that the last feed of the day is in the living room with the lights on so that she is really awake when going into the crib.

    Then when she goes into the crib you have many options, depending on your level of comfort. You can leave her to get herself to sleep unassisted (extinction), you can go in and regularly check on her and soothe her until she falls asleep (modified extinction) or you can stay with her in the room and soothe her (verbally or physically) until she has fallen asleep. In my experience, unmodified extinction is the fastest method of getting babies to sleep and research has shown very positive results from sleep training. Research has also shown that there are no long term negative effects of sleep training, if you were worried about that! You can read this really nice article by one of our research collaborators, Prof Michael Gradisar, explaining it better than I can! Prof Gradisar showed in his work that there are only positive impacts of sleep training long term and no negative impacts.

  • Hello!

    My daughter is about 4.5 months and, for the most part, is a great little sleeper. She does about 4 30-45 minute naps a day (which to my understanding is developmentally appropriate) and generally sleeps through the night- minus a few hiccups here and there.

    At home, we have her room completely black, she naps in her crib with her sleep sack and white noise machine. When she was younger, she didn’t mind naps on the go, but now the only place she will sleep is in her crib- I know that this is a good thing. However, without her naps, she is miserable so I find myself nap trapped at home. Any tips for naps on the go when needed without ruining the foundation we have going? Should I be working towards trying to extend her naps so I can drop one of the short naps throughout the day to give me a bit more freedom to actually go somewhere?

  • Hello! FTM here and my baby is 4 weeks old today. I am exclusively breastfeeding. She was born 3 weeks early. Baby girl currently wakes up every 2/3 hours to feed typically including throughout the night. About a week ago she started becoming much fussier. She cries more (didn’t for first few weeks). She does have some slight nasal congestion this week. She is still breast feeding okay and has wet diapers. When it’s time for bed it is almost impossible to get her to go down at night, she fights her swaddle most of the time and then is wide awake. When she wakes in the night she is generally up for a few hours before she will go back down. I change her, rock her in my arms, try sound machine etc. Last night she cries like she’s hungry but then fights me when trying to feed. She will latch then let go and cry more until she latches again. Do you think this is because of her stuffy nose? Is this normal for her age? It’s hard to know if she’s getting enough to be full when breastfeeding. I want to try to get a routine in place but she just doesn’t seem to like anything. She wants to sleep all day but not at night. Any recommendations for getting a routine in place early on for a 4 week old? These parents are tired! :/

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Sam, nothing makes me happier than hearing what an amazing job you have done in setting your baby up for sleep success! Amazing!

    Take a look at the Nanit Sleep Schedule Generator - that will give you a nice guide for a schedule at this age. I'll tell you what I love to recommend at this stage - I suggest doing the first two naps at home and the third nap out and about. The first two are the more important naps and the third is really a cat nap to get her through until bedtime. So if she only takes a short nap or doesnt nap at all, it doesnt throw off the whole day, you might just get her to bed for the night a bit earlier. With practice, she will get used to taking a nap on the go, particularly if you time it correctly.

    I know it can feel very confining with a three (or four) nap schedule when your baby really likes to sleep in her crib but I like to look at it this way - after the lunchtime nap, you can be out and about for the whole afternoon without messing up her sleep schedule. So if she takes a 10 or 15 minute nap in the stroller or car seat, that should be enough to get her through happily until bedtime.

    I actually love to suggest a stroller nap for that third nap on the go, if possible. Its a great chance to get out and about for some exercise and fresh air for all of you and gives you the opportunity to meet up with friends for a walk, grab a coffee, get some errands done, browse some shops (or whatever you are able to do where you live) and feel like you are back in the land of the living again! It can be really isolating when you are at home and feeling tied to the crib and nap schedule and having that scheduled time outside can do wonders. It might take her a little while to get used to stroller (or car seat) naps, but again, since its just the third cat nap, if she doesnt end up falling asleep for it here or there, it shouldn't throw her off too much.

    Good luck!

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Heather,

    Hang in there! Its really normal for babies to 'wake up' and become fussier at this age. Please know that you cant make any 'sleep mistakes' at this stage, so please do whatever you can to keep her calm and happy - so if you need to rock, pat, shush, feed, hold her - do whatever you need to do to get through! Most babies are not able to self-soothe at this age, so you need to be the one soothing her!

    If you are worried, please talk to your pediatrician but it sounds like shes doing great!

    I know it can be hard when you are breastfeeding to know how much she is getting, but if you are changing wet diapers regularly and she is waking every 2-3 hours to feed, it sounds like you are doing great!

    If you can your partner can take shifts at night for who is going to be soothing her back to sleep, it would be great.

    You are doing an awesome job! It WILL get easier soon, I promise! You re dealing with a lot right now and its all so new and unknown.

    Natalie

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