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

Melanie
Melanie Nanit Team
edited July 19 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.

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 **** 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

  • Hi Dr. Barnett,

    My son is 18 weeks old and he’s never been the best sleeper but me and my husband have been struggling to help our son sleep through the night. A week ago he also learned out to roll over so he has been in a sleep sack (arms out) constantly wanting to roll at night which has factored into his and our sleepless nights. He typically goes down between 7-8pm and max will go 5 hours without waking but then usually wakes around 1/2am and then 4/5am. At times he also wakes around 10:30/11 but will go back to sleep with singing or touch, without being taken out of the crib . For the 1/2am wake it seems to occur because he is rolling over, gets frustrated then cries. We attempt to soothe him in his crib and he, possibly out of frustration, poops so then we have to change him and post change he is typically unable to be soothed back to sleep and rooting so we feed him. Then the 4/5am wake up he also gets fed again and this wake up ends up being longer as well due to him waking from rolling, getting frustrated, and crying out. At this age I know he should be able to make it through the night without a feeding but he seems to only calm down with one especially after the lengthy wake ups he has. We have tried a “dream feed” and it doesn’t seem to make a difference. He is breastfeed and eats during the day every 2-3 hours. He gets 4 naps, never exceeding more than 30/40 mins because he wakes. He also seems constantly irritated whenever he is getting put in his sleep sack and we are getting ready for naps or bed no matter how calm our routines are. Any advice on how to set him up for better/longer sleep? Thank you!

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Hello! Its really normal for babies this age to still be feeding overnight, so please dont beat yourself up if hes not sleeping through the night just yet!

    Just so you know, it is safe for a baby to sleep on their tummy if they are able to get there themselves. You will always put him down to sleep on his back but if he's capable of getting onto his tummy its fine for him to stay there. The best way to get him used to that is to practice tummy time during the day as much as possible. I like to suggest even 10 times per day, if you can, right now. At this tricky stage, you want to get him used to the feeling of being on his tummy and know what it feels like and what he should do with his head and arms to get himself comfy. Just do tummy time for as long as he is happy there - that might be 30 seconds or it might be ten minutes. I dont want him in tummy time upset, so if he gets upset, pick him up and try again in another 30 minutes or so.

    The most important thing he can do at this stage though is fall asleep by himself at the beginning of the night. Once he can master that, we see those night feeds start to fall away pretty quickly.

    30-40 minute naps are really normal at this age. They will likely start to lengthen over the next few months but these shorter naps might be a main stay for a while!

    Take a look at the Nanit sleep schedule generator which will give you a nice guide for when to feed him and put him down for naps. You might find that the naps improve slightly with the right timing.

    Good luck!

    Natalie

  • Hali
    Hali Member

    HI Dr. Barnett!

    My 6 month old son has had us on quite the sleep journey :) He has GERD and was born about 3.5 weeks early so he struggled to gain weight and was colicky the first two months, which contributed to poor sleep. Since about 10 weeks, we have had him on a good formula/medicine combo, he has been gaining weight, and sleep has improved TREMENDOUSLY! We also moved him into his crib in his room at that time, which I think helped as well. Recently, our only real struggle is early wakings. For the past month or so, he has been waking up around 5-5:15am. I am okay with early mornings, but would really like 6am to be the earliest if possible. He is currently on a schedule of either 2 or 3 naps a day, totaling about 2-2.5 hours of daytime sleep. He usually goes to bed between 6:30pm and 7:30pm, depending on how much he slept that day and his last nap. We have been finding that the early morning waking of 5am doesn't vary that much whether he goes to sleep at 6:30pm or 7:30pm. We haven't been doing any MOTN feedings since about 4.5 months of age and are really trying to avoid giving him a bottle at 5am with hopes that he goes back to sleep for just another hour. Full disclosure - he usually falls asleep during his bedtime feeding and is placed into the crib either asleep or very close to being asleep. I didn't think this was the source of the issue, however, as he is able to self-soothe back to sleep at other night time wakings (typically hear him stir a bit around 10pm and again around 2am). Thank you so much for your help and insight!

  • Hi Dr. Barnett!

    My wife and I have been experiencing issues with our son sleeping through the night lately. He is a 14 month old boy and previously was an AMAZING sleeper. We had him a very strict routine for both naps and bedtime sleeping. For about the last 6 weeks now he all of a sudden started fighting his afternoon nap. Often screaming and crying to point where you would just have to give up and skip the nap - other days he would accept the nap fine and sleep as usual. Each of his two naps (if he took the afternoon nap) was about 1-1.5 hours each. However the real issue came for bedtime; all of sudden around this same time he would go down for bed just fine and then almost exactly 1-1.5 hours later he wakes up and will not self sooth back to sleep. After some time we go up once its apparent he will not fall back asleep on his own and rock him back to sleep and put him back down. He often then will awake again in the middle of night doing the same thing at around 12am or 1am. The moment his body touches the crib again he instantly cries and wants to be picked back up, often taking 2 or 3 attempts to get him to finally fall asleep and stay in the crib. We have never experienced this before as he was always a great sleeper, barely woke from noise and slept straight through the night, his Nanit sleep score where always in the mid 90 percentile. We are dumbfounded as to what we are doing wrong. His room has blackout shades, we play the same white noise hes always had on since birth, we do the “wind down” period about 30-45 minutes before bed time with reading time and a bath, his diet has been fine, and the doctor at checkups says he is totally normal with no issues, so we truly are puzzled. I would chalk it up to teething but it seems odd that especially his first wake up of the night is always 1-1.5 hours exactly after being put down that it would be pain hitting you daily at nearly the exact same times. Any help or guidance would be a tremendous help!!

  • MeyersLemons
    MeyersLemons Member
    edited July 17

    Hi Dr. Barnett,

    Our 9 month old son is in daycare during the day and we are having a hard time managing his naps. Around the 4 month mark, his naps became 30-45 minutes long and that trend has carried on and we’ve been unable to lengthen them consistently. When he’s at daycare during the week, he will get between 1.5-2 hours of sleep divided between two naps. He wakes around 7am and goes to daycare by 8:30. His first nap isn’t till 10, 10:30am and the second is around 2pm. With the excitement of being around his friends, he usually doesn’t sleep longer than 45mins to 1 hour at a time. When he comes home at 4pm, we don’t put him down for a nap since bedtime is at 7, 7:30pm. He’s an okay night sleeper doing approximately 10-11 hours a night, so on average he gets 13 hours of total sleep in 24 hours.

    My question is, since we can’t control the time or duration of his daycare naps, should we be trying for a third nap at home before or after daycare to increase daily nap hours? We don’t know if we should be prioritizing those nap hours or getting more night sleep.

    Thanks in advance,

    Veronica

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Veronica,

    This is a really common complaint (not be able to control the daycare schedule), but honestly, it sounds pretty great. I would be suggesting two naps at this age at about these times anyhow. Im not worried about shorter naps if he is happy during the day. To your point, since you cant control the day sleep, my preference is that you focus on the night sleep. 'Normal' sleep ranges vary a LOT and the best guide is looking at your son. If he is happy and engaged throughout the day, he is likely getting enough sleep. If he seems tired or grumpy, you might want to focus on trying to lengthen the night sleep. You dont need a 3rd nap when he gets home. Instead, my preference would be to put him to bed earlier in the evening if you think he is tired. This is also a great way to lengthen the night sleep.

  • Natalie_Barnett_PhD
    Natalie_Barnett_PhD Member, Nanit Team, Expert

    Vinny!

    Honestly, I think hes ready to move to one nap. It sounds like he might not be tired enough going to bed at the beginning of the night which might have been the catalyst for your struggles. Take a look my Nanit Sleep Schedule Generator for a guide of when is likely to be the best time to put him down for a nap. He likely needs around 5-6 hours of awake time before going to bed a night.

    I think it should just take a week to get you back on track!

    Since he is used to taking that earlier nap in the day, try to keep him busy at him in the morning (ie, avoid the car or stroller so that he doesnt fall asleep). Then give him an early lunch (this will help lengthen the nap) and then put him down around noon (or even 11.30 if he cant make it to noon). He might then need to go to bed a little earlier in the evening as he gets used to the longer awake time in the afternoon but give this schedule a week and then let me know how it goes!

    For the middle of the night wakings - this very often stems from him not falling asleep by himself at the beginninng of the night. Make sure he is going into the crib awake and getting himself to sleep by himself. Remember - what he needs to get to sleep at the beginning of the night will be what he needs to get himself back to sleep when he wakes. So if that is a breast, bottle, warm body, being rocked or held, it will be frustrating for him not to have those things when he wakes in the night. So I'd suggest focussing on the beginning of the night and then the night wakings should take care of themselves, since it will be far easier for him to get hiself back to sleep.

    Whatever method you choose to implement the changes, just make sure you are consistent. All sleep training methods work! Choose the one that feels best to you and follow though with it for a week.

    Natalie

  • Melanie
    Melanie Nanit Team

    Thank you for participating in our Ask Me Anything with Dr. Natalie Barnett! The AMA is now closed, but be on the lookout for our next Ask Me Anything.

This discussion has been closed.

Join the conversation!

Sign in using your Nanit account or register for an account.