Sleep-fighting 4.5 month old: help please!

[ACatCalledFang]

I'd really welcome any suggestions for how to gently encourage my 4.5 month old to sleep. He wasn't too bad until 12 weeks - would feed to sleep around 2200 after much cluster feeding, wake after 4-5 hrs, then again after 2-3 hrs. Since then, we've hit the so-called 4 month sleep regression hard and everything has gone to pot.

Our main issue is his frequent night waking. Sometimes the issue is getting to sleep, other times staying asleep. A good night at the moment means he wakes after 3 hours, then again 2 hourly. A bad night means it can take 3 hours to get him down in his crib for more than 20 minutes, and results in hourly wake-ups. Unfortunately, his preferred way to get to sleep at home is to breastfeed to sleep and he gets very upset when I try to resettle him through any other means. 9 times out of 10, he goes ballistic when DP tries and I can't take the screaming (it's not low-level grumbling, but full on choking-on-own-saliva...).

Positives: he does know the difference between night and day, and sleeps around 11 hours overnight and usually around 3-3.5 hours in the day, broken into 3 naps (shorter morning and late afternoon/early evening naps, a longer early afternoon nap most days). He usually starts the night in his co-sleeper crib but ends up co-sleeping with me. He has a bedtime routine, and we follow the same steps for daytime naps minus the bath and massage. He's very flexible about where he sleeps (pushchair, car seat, sling, our bed, etc, all acceptable, stealth transfer to crib sometimes works).

I think the very frequent wake-ups/problems settling in the first place are related to wind/tummy trouble, but if he won't burp, he won't burp. Then he wakes crying, I lift him out, he burps, and then wails at any attempt to settle him other than feeding, which ultimately makes it worse. It's maddening.

So:

1. Should I be trying to break the feeding-to-sleep association at this age and, if so, how? It's currently the only way to get him to nap at home.

2. How often should he go between feeds at night? He goes 2-3 hours in the daytime. I'd like us to get to the point where he goes 3-4 hours at night.

3. Is there anything I can do about the wind? Gripe water makes little difference. Infacol makes no difference. He isn't allergic to dairy (he has been mix fed previously).

4. Is he too old to swaddle? He sometimes wakes himself thrashing around but am not sure if swaddling at this age for the first time is wise.

We're riding through this stage by breastfeeding on demand, co-sleeping and DP banishing himself to the sofa bed, but I'm a bit concerned we might be creating bad habits....

If you read through all that, thank you! All suggestions welcome!

Oh, and we've tried dummies, repeatedly, two different kinds, from day 3. Straight in, stealth swap with nipple, etc. It works maybe one time in ten, though he sometimes wakes when the dummy falls out. I want to work on the "stealth swap with nipple" thing at home more.

Argh, poor you. My DS did things like this at four months. I ended up setting up a pop up travel cot in his room and made sure there was a duvet in there for me and we also co slept half the night like that. Don't worry too much about bad habits as things will probably get better and saving your sanity is vital.Now my DS is 6 months , on a good night he wakes twice, I no longer have to co sleep.

Have you tried feeding to sleep until drowsy, transfer and then a bit of shhing, patting, or a firm hand on his chest and legs to limit jolts or wriggling. White noise may also help keep him calm and can be put on while feeding etc..I think with my DS the biggest part of trying other methods of training other than feed to sleep was my own confidence and determination. He would always protest for the first week but I was there with him, even if he cried. After a week it gets easier. I still feed to sleep often though and he doesn't self settle all the time( he is going through a bad patch :)).

Could you up his feeding in the day? Hopefully someone will be about to help you more. .good luck x hope tonight is better x

Oh and meant to say. I have and had the same wind issues when feeding to sleep. I made putting him on my shoulder and patting his back ( with white noise on )part of the nap/ bedtime routine. Also burping half way through a feed if I was really struggling and genuinely needed him to feed to fully asleep.

Thanks so much for posting, it's great to know this isn't unusual as he seems to be worse than most of our baby group friends! What you say about confidence really rings true: I have very little faith in anything other than the pushchair and feeding at this stage, as other methods work perhaps once in ten times, with so much crying on the other nine occasions it's a bit off-putting to even try...

I'm being a bit obsessive about winding at bedtime so we now have the lamp on for the first half of the feed, before he's burped (I will wake him at this point if I have to!), then do the rest of the feed in the dark.

Tonight was typical in that he fed to sleep but was awake within ten minutes of going in his crib. Took ten minutes to get a burp out of him, then managed to get him to accept a dummy (holding it gently in place) - and he's still down 45 minutes later.

The shushing and patting has never worked! Have had occasional success with "baby straitjacket", i.e. I snuggle up next to him in his co-sleeper crib and gently hold his arms still to stop the flailing. Might try the "drowsy transfer" during the day when it feels like it matters less.

I feed around every 2 hours in the day, though sometimes he's very distracted (e.g. when we're out) so I'm trying to offer more frequently either side of outings.

Thanks again for your thoughts, it's a relief to know it's not just us!

I think nearly everyone has been in a similar predicament to you. Unless they lie, have amazing and rare babies or perhaps even left them to cry from day one.

Shhh pat can be too stimulating for a 4.5 month old I guess. I did a shhh stroke version while holding his legs at that age. Don't get me wrong it takes ages and I think DS was always crying, he would then calm turn his head to sleep and then get really frustrated to not be asleep and then it went on, repeat, repeat, repeat. Took ages to get him to sleep sometimes. But then I think I have always been pretty bad at timing and sleep cues. I was quite hard really . I told myself, ' right, this is going to work' and didn't give in. My whole day was spent putting him to sleep. Horrible. My house was a right state :)

You can do something called pick up put down( you probably know and have tried this) from 4 months. My DS screamed frantically though as if to say, ' put me down'. So, despite my tough attitude of not giving up I did with this. It isn't for every baby.

Keep going, it won't be forever( mind you saying that I have just rocked my OT DS to sleepfor his morning nap, sometimes he will SS and sometimes he just doesn't want to.)

Ps just for the record it sounds like you are doing a great job and are surely feeding him enough in the day to cover that ground. How long does he feed for?

..and have you tried white noise...even a detuned radio can work. I know it sounds desperate but actually quite common.

Also, just to say, daytime sleep matters the most. It directly effects nighttime sleep. I know this because my DS is not a great napper and as result wakes up in the night. He wakes less when he has had a good day of naps.

1) Should I be trying to break the feeding-to-sleep association at this age and, if so, how? It's currently the only way to get him to nap at home.

Keep going with the dummy, it will be your saviour! The dummy falling out and needing to be re-inserted thing is just a phase that he will grow out of when he can re-insert his own dummy. But as a means to get baby to sleep (and extend naps), you cant beat a dummy for simplicity and no-tears.

Also try settling in the cot, rather than in your arms and then trying to put a sleeping baby down (which hardly ever works even for the most experienced mum). Shush patting is often too stimulating. A firm hand on chest/shoulders may work. Also helps stilling a wriggly baby. Occassional dummy-reinsertion as required. Then just your presence, lying on your bed eye to eye, right next to baby in the co-sleeper. Great way to start teaching independent sleeping/

2) How often should he go between feeds at night? He goes 2-3 hours in the daytime. I'd like us to get to the point where he goes 3-4 hours at night.

The more you feed during the day, the less feeds will be needed during the night. I used to feed every 2-2.5h through the daytime (7am-11pm), which means 8 or so full feeds per day.

3) Is there anything I can do about the wind? Gripe water makes little difference. Infacol makes no difference. He isn't allergic to dairy (he has been mix fed previously).

I'm reading your post and in all honesty wondering is this is more about your worrying than an actual physical issue. You can ask your GP for reflux medication though.

4) Is he too old to swaddle? He sometimes wakes himself thrashing around but am not sure if swaddling at this age for the first time is wise.

The Lullaby Trust do research on SIDS risk to inform NHS guidelines. The Lullaby Trust recommend that if a bay is to be swaddled, swaddling should start before 3 months old. A baby used to being swaddled when newborn can then continue to be swaddled longer-term. However current recommendations advise not to start swaddling a baby after 3 months.

That said, parenting is about risk management, not achieving zero risk. So it is up to you how you manage SIDS risk.

My youngest was very wriggly - like your baby she also really liked being held still, almost pinned down. It kind of helped her stay calm and still, to sleep. We did swaddle, but there are other options. Have you tried a tightly tucked in blanket to in baby down?

We used a cot sheet but had it width-ways across the cot - not the lengthways it should be. This gives loads of extra material to tuck under the mattress really tightly. I used to use a tightly tucked in blanket over the top of DD in her sleeping bag - just reducing her clothing by a layer accordingly.

Thanks again for your suggestions, there are some great ideas here. In no particular order:

• We use white noise as a sleep cue, for every nap at home and bedtime.

• The wind is a definite physical issue (although I'm the first to concede I'm a worrywart ). He wakes crying and appears to be in pain and, after being held upright, he burps. Mainly a problem with bedtime feeds.

He's been seen by a GP, who did not think he had reflux, as he's generally a happy little soul and the symptoms didn't add up. Babies in my family are windy, it's just frustrating because I know what will happen when I put him down at night (less of an issue for daytime naps).

• FifiFerusha, thank you - health visitor made me feel I was doing everything wrong. Though I take their advice with a pinch of salt after one of them told me to put him to sleep on his front. What you say about daytime sleep is very true - I've been keeping a diary for the past week and we have noticeably better nights when he has a minimum of 3 hours worth of daytime naps, so I'm trying to be vigilant about naps.

I'm also keeping a note of feed times and trying to keep an eye on which night time feeds are longest. If there is a pattern to him waking for comfort/resettling rather than food, I'll feel more confident about persisting with a dummy at night. We had weight issues in the early weeks which means I have a tendency to assume crying = hunger, which I know isn't always the case.

If there are distractions during the day, like if we're out, he tends to snack feed - a really decent full feed can take 20-30 minutes, though 10-15 is more the norm. He's gaining weight consistently, though.

FATEdestiny, thanks for your very detailed post, especially the information on swaddling. I have held off introducing swaddling in view of his age and the fact that we use baby sleeping bags. I did try it this afternoon (on the grounds that I'd be present and awake), using a very large muslin, but he was having none of it! I may try again for daytime naps, though, and hadn't thought of tucking it round him blanket-style, that's a great idea.

How persistent do you have to be with techniques like shushing, and how much crying is normal? I have a reasonable tolerance for low-level grizzling at naptime but can't "ride out" proper crying/screaming given his age, it just feels cruel apart from for getting him into his pushchair or we'd never leave the house.

how much crying is normal?

See, I've got zero tolerance for crying. So I would say none. Any level of any grumpiness at any point day or night would result in me alternating between feeding baby or plugging a dummy in and getting baby to sleep (the dummy was only given for sleep time - to make it a clear association).

So if last time DD grumbled she was fed, next time she grumbled she was dummy-plugged and bounced to sleep (in bouncy chair in the daytime) or swaddled/cuddled to sleep (in bedside cot at night time - not in my arms).

I work on the assumption that baby should always be happy, content, alert and easy-going when awake whenever that is not the case then the problem will be solved by either sleep or milk or both. I wonder of more frequent naps and feeds through the daytime would help you calorie load and avoid over-tiredness at night time?

My 4.5 mo has been waking once or twice a night since Christmas despite sleeping 9 hours a night before this, and for the past week has been up every hour or so breastfeeding back to sleep. It feels like torture operating on 3-5 hours of broken sleep a night! I feel like I will just stop functioning!

Beaky, could you sleep during the day? Co-sleep for naps on your bed maybe?

I sympathise. My DC2 is the same age and we are struggling with both day time naps and night time sleeping (I have to move him for the school run/classes and he invariably wakes and doesn't go to sleep).

You are doing all the right stuff and the 4 month regression is a bastard.

The only thing I would suggest is that when babies over feed or cluster feed for comfort, they can end up with too much lactose from your milk, which produces gas when it breaks down. I suspect that's the cause of my DC2's legs up crying and waking.

In essence, they wake because they are in pain, are soothed by nursing, then about 20 minutes later the gas builds up and they wake in pain, want to nurse, etc.

The best solution I have found is to block feed, so only feed from one breast within a 3 hour period. I think the idea is that they get the fattier hind milk, which has less lactose.

I recommend doing this through they day but especially at night. If you can comfort any other way (dummy, rocking, your DH), then even better.

Other than that, just ride it out - it does get better; it's just a leap, and it won't especially create bad habits. They just need a lot of comfort at this stage.

FATEdestiny, in terms of "how much crying is normal", I meant more in terms of "what should my tolerance level be when trying to settle to sleep using methods other than feeding?", rather than whether it's normal for a baby to be unhappy during the day. I'm never sure whether I should ride through grizzling when trying to settle using other methods but, when I have tried to persevere, it usually leads to real tears and upset, which I wouldn't ignore.

If he's grizzling and has been up for an hour or more, I usually conclude DS is tired or hungry and try to facilitate a feed and a snooze - he's generally a happy baby unless hungry or tired. He rarely goes more than 2 hours without a feed in the day.

You're absolutely right about frequent naps - I've kept an eye on this and have noticed we have vastly better nights when DS has had a minimum of 3 hours daytime sleep (and more is better), usually including a morning nap, one long or two short afternoon naps, and an early evening power snooze.

What worked well last night apart from having my DM stay so I could experiment in the knowledge that I could go back to bed this morning was picking him up, swaying with him to get the wind up/out, and resettling. I decided I was going to try to hold off feeding for at least 2 hours but that I would offer if nothing else worked.

Lying next to him and stroking/cuddling made him more upset but picking him up did work. Perhaps not ideal but, at the moment, my goal is to resettle him as quickly as possible without boob, before moving on to resettling him without getting him out of the crib

Got him in his crib at 2050, resettled at 2145 and 2300, he fed properly and winded at 0100 and went back in crib again until 0400! A vast improvement on 9 wake-ups in 11 hours...

BeakyAndBun, I hear you, it's exhausting, isn't it? Not much to offer bar a solidarity fist bump, but know that you're not alone!

ShootTheMoon, have just seen your post - thank you! I finally have a scientific explanation for what I'm seeing.

Last night went a bit tits up in every sense as I was struggling to sleep myself so had had 20 minutes sleep by 0200 and co-sleeping/shoving nipple in as required was path of least resistance. Managed to catch up on sleep a little this morning thanks to DP, so will persevere again tonight and try block feeding as well as alternative methods of settling. Rocking has worked very quickly when I've tried it this week. Dummy less so.

I prefer not to get DP to help at night unless I'm on my knees - partly because he isn't a good sleeper himself and is easily disturbed (he's currently on the sofa bed), partly because bedtime are usually less fraught when I do them by myself. DS won't always accept DP when he's tired and this can lead to lots of screaming which is only resolved by boob, despite them having a great relationship during the day and DP being very hands on. Having bedtime (and the bedroom) to ourselves means I feel freer to experiment with different settling methods without worrying about disturbing anyone else.

Oh I know the feeling! My husband is in a job that requires a lot of precision and concentration, with funny hours, and it can be so stressful trying to keep the baby quiet when he is in with us. If he is really knackered, he sleeps elsewhere.

Do read up on the lactose thing because I am a bit hazy on the details, but that's the gist.

Wishing you a much better night :)

This sounds so similar to my baby who is the same age, so thanks everyone for the advice!

I agree with the comments about rocking and shushing sometimes being too stimulating. Also I have noticed that my deep breathing and quiet singing can help calm her sometimes as I think it can affect their own breathing and calmness.

I'm still feeding to sleep/cosleeping if she is going frantic as at the moment I don't think anything else will work. But I'm hoping every time we succeed in a nap/settling at night that is calmer and doesn't involve holding and feeding, it will start to get her used to doing it more.

I don't think it will ever be a linear process. Two steps forward, one step back.

PS I had to have her in bed with me all night last night as my husband was trying to get her to sleep and she was crying a lot. I told him to get me if he can't settle her, but instead he left her wailing and went to sleep in the spare room. I was so mad when I went in to get her.

Going to have to have a (calm and not patronising) conversation about leaving her to cry!

4 month sleep regression is the absolute pits. But it is a regression, not the new normal, and you will come out the other side. So I think 'riding it out' is an option, rather than feeling it a problem that needs a solving. Do what works for now and if you need to work on better sleep habits you can do it once you are through the regression.

On crying - my DS nearly always has a bit of a cry when falling asleep and when waking up, it's just his style, no amount of comforting changes it (in fact if anything he cries more when he has more comforting). I just don't think he likes the transition from waking to sleeping. The 4 month regression was particularly bad for him absolutely howling, I pitied my neighbours!