4 Week Old Won't Nap

[Machir]

Hi everyone

I have a four week old who won't nap during the day at all. She has never been a great napper, but typically sleeps well during the night (usually up for a feed every 3-4 hours). She's combi fed at the minute and used to nap after being at the breast, but she now won't settle after that. I am having to use nipple shields while we wait for an appointment for a tongue tie assessment. She hates the nipple shields so I suspect this is why I can't sooth her this way anymore, but my nipples are unfortunately in tatters!

The last few days she's screamed at us for hours from mid afternoon until 8-9pm. We have resorted to a dummy and it soothes her for a while but she will soon spit it out and scream again. Taking her out for a walk usually puts her to sleep eventually (she screams initially) but typically only for 30 minutes or so at a time. If I do manage to get her to sleep, she must sleep on me, as soon as I put her in her moses basket the eyes ping open almost immediately.

She does usually get approx 14-15 hours within 24, majority of these being at night. The past few days we are maybe 12-13 hours in 24. It just seems that during the day she is constantly screaming and I just can't figure out why. I'm a first time mum with no support from family due to covid restrictions and a husband who is now back at work. I'm really concerned I'm doing something wrong and I'm hindering her development.

From reading things online, I've removed all dairy from my diet and have removed caffeine (was only have one cuppa a day anyway) for the past 5 days. I don't drink at all so alcohol isn't a factor either.

I'm at my wits end here!

Is she your first? Was she born early? Mine only slept on me for naps for about 3 months. Totally normal. Just hunker down on the sofa with snacks and TV and go with it! Read up about 4th trimester basically she hasn't adjusted to being away from you yet and needs your comfort to sleep.

Yes, she's my first. I'm constantly holding her trying to get her to nap. Changing positions, patting her back/bum, walking around the house, all the while singing, talking softly, white noise etc. Usually ends in her screaming. She often gets distracted and stares at a light source - lamp, tv, window. I had read to keep daytime somewhat bright and noisy, but this doesn't seem to work for her at all.

@Machir mine still will only nap on me or in the pram at 4 months old 😅 he sleeps when put down at night but if I put him down during the day he wakes almost immediately and is so upset. Doesn’t matter what I try, nothing seems to work! He does 3 naps a day so I hold him for his morning one and later afternoon one and I try to spend his lunchtime one in the pram out walking.
Have you tried just keeping it simple and cuddling her in bed or on the sofa? Skin to skin if possible. Hopefully that will settle her. Honestly, at 4 weeks I wouldn’t worry at all about trying to get her to settle in a Moses basket etc, I would just cuddle up and try to settle her that way. The more over tired she gets the harder it will be to get her off to sleep.

Totally normal don't worry! My LO was the same at that age. I used to use a sling a lot. About 3/4 months he started napping in a swing chair til about 7 months which was amazing. I just wanted to mention the dairy free - are you doing this under medical supervision? I'm breastfeeding and dairy and soya free as my little one is allergic ( had diagnosis from GP) you ought to be taking calcium
(500mg twice a day) and vitamin D supplements if you are . Cutting out dairy is quite a major diet change and you don't want to be doing that unless its really necessary! Also I wouldn't think having one cup caffeine is causing anything I also have one a day and some days it's my lifeline after a bad night!! Hang in there. If you are concerned about milk allergy speak to your GP though.

I just can't get her to sleep in the first place! It's as if she isn't tired but gets bored. Any sling recommendations? I've got the sling from the baby box but she keeps slipping down when I wear that, although that's likely my fault too!

Yesterday she had 3 hours sleep during the day then slept basically all night only waking up once between 8.30pm and 7am. We usually set alarms to feed her just in case she sleeps through (she doesn't often) but last night we just let her sleep until she woke us. She's up now and crying after being fed, burped and changed. The constant crying worries me, she cried so much yesterday evening she made herself sick. And no amount of singing or cuddling etc helps, it seems to make it worse.

I've just got one of the fabric tie ones off Amazon I think it's called cuddle bug , There's loads of them on there but all the same really just a long piece of fabric. That's pretty good sleep wise I would say. Crying in the evening is very common until 12 weeks I think . Does she cry a lot throughout the day or mainly evenings? Just keep trying lots of different ways to calm her down and try each one for 10 minutes if it doesn't work move on. Eg walking around in sling, lying on floor and dangle toys, stroke her face with something soft, strip her down to vest and tickle her toes elbows etc. Lay her face down on your fore arm and carry her around. Baby sensory on youtube. These probably won't work but worth a shot. When they are worked up it's even harder to get them to sleep so in those instances just try to distract and calm first ? Honestly tho it is normal and you are not doing anything wrong and she will grow out of it !

You mentioned the tongue tie OP. If she does have this, not only does it hurt you when she's feeding, but it will prevent her removing milk from your breast effectively. Could the constant crying indicate hunger? You mention she is combi fed... Are you feeding on demand and offering formula top ups after a breastfeed? It might be worth expressing breast milk after a feed too, that you could also offer her and to keep your supply up until she is assessed.

P. S. You also mentioned she sleeps well at night. Do you tend to breastfeed more during the day and use formula milk before bed and during the night? If this is the case, it could reinforce the possibility of hunger throughout the daytime, with the crying and no napping. It just reminded me of my situation when my baby was very new. He has a tongue tie and before it was diagnosed he cried all the time and wouldn't sleep. He also slept better at night. He is and was exclusively breastfed, but I'd express for my husband to offer a bottle at night, after which he slept better. He was definitely hungry. I started expressing and the crying stopped immediately and he napped too during the day. The tongue tie was snipped and now he's back feeding at the breast again. Although it did take 2/3 weeks for him to learn how to use his tongue. This is normal.

@Somethingsnappy Thanks for this. She is combi because of the pain when she breastfeeds and she just wasn't getting enough. She slips on and off constantly, I've had blisters and deep cuts. I am expressing and using nipple shields at the minute, and topping up breastfeeding afterwards. Although hunger may be right - I just gave her 5oz of formula an hour ago, and she's polished off 4oz of breastmilk now. And yes she does tend to get formula in the evenings these days because we both struggle with nipple shields in the dark.

I tend to struggle to express after breastfeeding because she doesn't settle, and I'm left holding a crying baby until the next time I'm due a feed, so I'm definitely worried about my supply. I can express easily overnight though using my hand pump while my husband feeds her.

I definitely understand this... Impossible to express while holding a crying baby! Definitely better to express while your husband is able to help. So, just to make sure I undersrand properly, are you giving a bottle first for a feed and then offering the breast as a top up or breastfeeding first and offering a bottle as a top up? If it's the former, you could then offer some more bottle after the breast sgsin, to make sure she is getting plenty at the feed. It is so hard for them to extract the quantities of milk they need, with a tongue tie. How are your baby's nappies and weight gain so far?

She sounds overtired and overstimulated.

Babies need help falling asleep. 60 minutes after wakeup, you need to be helping her start winding down for the next sleep, with movement or sucking or a calm environment. The more tired they get the harder it is for them to drop off. Some babies do need quiet and dim light to sleep. Let the baby sleep on you. When she becomes tired, take her somewhere very quiet and dim and play loud monotonous white noise - a hairdryer, hoover sound or radio static all work well. Try a swaddle - when overtired my baby would fight the swaddle madly for about a minute and be asleep in under 5.