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My four month old baby needs a routine!

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(Parents: I'm including this letter because I often get asked advice about very small babies and I would like to offer a general response to those of you out there. Thanks, Annie)


Hello Annie,

 

I’m having trouble establishing a routine for my 4-month-old son. He does have some semblance of a routine, but it’s very variable. One week he’s fine with it, the other he’s not. His feedings are all over the place (he is bottle-fed); sometimes he’s always hungry, other times he’s not interested (cries when given the bottle) and will only eat at night. He also doesn’t sleep through the night. Although I am OK with this, it seems as though he doesn’t always awaken from hunger. I also find that I’m really not sure HOW to get a routine in place.


I am in desperate need for structure – am I hoping for something that isn’t possible?

 

Thank you,

 

Isabelle

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Hello Isabelle.

Thanks for writing to me. I'm always careful what I tell parents of really little people ie. particularly those under six months because there are so many unknowns, some of which may be medically based. There may be a whole load of issues I'm not aware of and I'm not a nurse or doctor. With a baby this age, I would advise you to check with a pediatrician or child health nurse first.

Having said that, there are some thing you can do to make life easier for your baby and yourself. I understand how tiring it must be for you with his schedule all over the place. It sounds right now as if he's quite a busy little bee at night. I know you said you were OK with that but I think it would be helpful to try to get him to be more settled at night both for your sake and his. We also want to look at changing his eating patterns to make sure the large majority of his nutrition comes during the day. Is he beginning solids? Sometimes that makes a huge difference when it comes children sleeping for a longer period at night.

Here's a couple of things that might help you out. Keep naps as close to the same time every day. Between naps make sure he's up and enjoying the world. Offer good stimulation, chat, play, tickle his tummy and generally keep him awake. Keep bedtime at the same time too every night. Make it a relaxing time. Perhaps a bath, a massage etc. Then at night, be totally boring. Do what you have to do but try to be the very least stimulating you can be. Keep it as dark as possible and talk in hushed tones. When you change him or feed him in the evening be as quiet and boring as you can. You want to give him the idea that this is now sleep time and nobody is much fun at this point of the night.

Depending on whether or not you're dealing with any medical issues, sleep training might be a good thing to consider at this point. At four months, it's the beginning of the period when children will fall in to learning how to sleep on their own quite naturally and it's good to take advantage of that. Don't rush in immediately he stirs and put him to bed sleepy but awake. Try and avoid feeding him to the point he nods off and/or rocking him to sleep etc. Try not to worry about letting him cry for a while. You just need to go in to reassure him at first 5, then 10 and then 15 minutes intervals to let him know you haven't deserted him. Just don't stay in the room too long and do exactly the same in the middle of the night that you do when you put him to bed.

Also, try and minimize how much you feed him at night in comparison with his day time feeds. Putting him on solids during the day may make a huge difference on that front. When you say he may not even be hungry when he wakes, it's possible (and I'm only going on what you've told me) that he may be waking up at night because he's got used to the fact that you're around. Everyone goes through several light sleep cycles a night. Right now, when you wake up, you've learned to go back to sleep without anyone helping you or acting like your sleep soother. Learning to get past those cycles and go back to sleep on your own is a learned skill, which babies need to learn too. It's always a bit stressful to teach babies that skill, but well worth it in the long run.

Best of luck,

Annie

Date Entered: 2007-02-18 09:43:41.0
Date Last Modified: 2007-02-18 09:48:20.0

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