HELP! MY BABY WON’T SLEEP!!!
You’re not alone. I know someone else who said that a few years back… ME.
Our first little one arrived 2 weeks early. But he fed well. He gained terrific weight. He hit all his milestones. There’s just one thing he didn’t do. LO did. not. sleep.
We tried everything (or rather, we thought we tried everything!) We rocked him in our laps for what seemed like days at a time. We walked the floor with him at 2 AM night after night. We tried leaving him to cry (against all recommendations). We used pacifiers, white noise machines, bouncy seats and baby swings. Everything worked… for about 10 minutes.
We asked friends with babies for advice. We even borrowed a copy of Ferber (and read it!)
Reading Ferber for me was the proverbial light at the end of the tunnel. In this book I first encountered the concept of “sleep associations“. It was a kind of epiphany for me. And my journey began. I started reading more about sleep and infant development. Then it all fell into place. I had planted the germ of and idea that was to evolve into my sleep coaching business.
I discovered that a powerful potential for normal sleep resides in every human being. The trick is to unlock it. There are no ‘sleep problems’ per se. There are only barriers that stand in the way of a baby or child and a restful night’s sleep!
Over the years, I’ve heard the cries of “Help! My baby won’t sleep!” hundreds, maybe thousands of times. Each story is unique. Each child and family has their own set of issues that contributes to a sleep problem.
But very often, each of these unique cases can be classified in its own group. I’ve made a catalog to share with you here. I’ll explain the broad sleep issue, then explain the elements of the fix. The key thing to remember is that each child is unique, so your story may be different, as will the remedy. The underlying elements, however, are the same.
Why Your Baby Won’t Sleep
1. She’s Not Tired
It’s 9:00 PM. You’ve been up since 4 AM with your 2-month old. You’ve fed and changed her what feels like a dozen times. You’ve gone shopping. You’ve done four loads of laundry. Oh yeah, and you cooked dinner for your husband, who strolls in at 6 PM looking fresh as a daisy. You look like you’ve been in a fight gone bad. You can barely keep your eyes open. So why is it the baby won’t sleep?
It could be that she’s already slept 16 hours in the last 24, and she just got up from a 3 hour nap at 7:00 PM! She’s just not tired enough to go to sleep yet!
Babies develop sleep-wake cycles just like we do. When they are very young, their stomachs usually set the clock. After a few weeks, they begin to respond to the structure imposed by the sun. That is, they learn that day is light and night is dark! They also respond to the structure imposed on the day by their parents: the day tends to start at the same time. She eats at the same time. She plays at the same time. And she naps at the same time.
For a baby like this, I first make sure she’s healthy and getting enough to eat. Then we talk about her sleep patterns. We talk about a typical day for her. In this case, when she’s just had a huge nap in the afternoon, I recommend some tinkering with the nap schedule. It may involve moving the afternoon nap earlier in small steps, say 15 minutes at a time. Again, the fix when the baby won’t sleep because of the recent long nap is only an example. There are always little tweaks that I recommend for families.
2. She’s Overstimulated
Overstimulation is a real thing. It really can rev a baby’s motor so high that she cannot calm down enough to go to sleep. Maybe there’s been too much activity. There was a party in the morning. You listened to a rock station on the radio on the way home. You played all afternoon when she wasn’t napping. By the end of the day the poor baby is wired up!
Newborns and some young babies are able to protect themselves from overstimulation. They do this by ‘shutting it down’, and going to sleep. I call this “The Tilt Function“. As they develop, babies lose the Tilt Function and expose themselves to the risk of overstimulation on those really busy days. Some babies can handle a lot of stimulation, but some cannot!
Sometimes the baby becomes overstimulated because she has lost one of her naps that she really needs. Sometimes this happens ‘accidentally’ and sometimes it happens by design – at day care.
The best way to fix overstimulation is to avoid it to begin with! If the baby’s day is too much for her senses, try cutting back on activities. If she needs that third nap and isn’t taking it, I can teach you some tricks to get that nap back!
On the day that the baby won’t sleep because she really is overstimulated, you may need to bend a few rules. That means, you may need to sit or rock with her for a while. Do this in a dark, calm place. You can run a white noise machine or hum quietly to her. It may be a bad night. But you’ll know how to avoid such nights in the future!
3. She’s Hungry
This one is more common than I thought it would be. Babies are growing faster in their first year of life than they will ever grow later. They need a lot of calories. Some exclusively breastfeeding moms worry that their babies aren’t eating enough. This is natural because it’s hard to know how much the baby is eating if you can’t measure it! But sometimes a baby won’t sleep who is exclusively bottle fed! Rarely, a baby who has started taking solids is still not getting enough calories during the day.
In all these cases, the baby won’t sleep because her stomach keeps her awake. It’s a good thing, in a way. A baby needs to grow!
The first step is to consult the pediatrician. You want to know if they baby is getting enough calories for her weight during the day. You want to know if she is gaining weight along her growth curve appropriately. If she is not getting enough calories, work with your pediatrician, or perhaps a nutritionist, to figure out ways to feed her up. A baby who eats well, sleeps well (and vice versa!)
4. She’s Over-Fed
This is the opposite of #3. Sometimes a baby won’t sleep at night because she’s eaten too much, not too little. Their stomachs are working double time to try and digest all the formula (and solids?). These babies are gassy and colicky. Often they are constipated. In that case, the baby won’t sleep because she needs to poop and cannot. Or sometimes she poops to much, and her full diaper won’t let her rest.
I see this a lot in babies who drink “spiked bottles”. These are bottles of formula or pumped breast milk that you’ve added cereal to. There is no reason to spike bottles, people (see below).
Just as in #3, the first step is to consult the pediatrician. You want to know if the baby has a good weight for her age. You want to count up the calories she’s eating per 24 hours. This number varies, but she should get around 50 calories per pound of body weight per day. If she’s eating substantially more than this, this could be the reason baby won’t sleep. You should discuss it with your pediatrician. He/She will probably recommend that you cut back on calories. One thing is pretty certain, however. The pediatrician will recommend you stop spiking the bottle if that is what you are doing! Formula or breast milk are perfect by themselves!
5. She’s Got Bad Sleep Associations
This is a major cause of “baby won’t sleep”. It may be the major reason. Sleep associations are, very simply, those things that your baby associates with going to sleep. Some typical ones are darkness, swaddling, sucking on a pacifier, being rocked.
What’s the difference between a “good” sleep association and a “bad” one? A good sleep association is something that will stay with the baby all night. Baby sleep cycles from shallow to deep, just like ours does. A bad sleep association is something that disappears, or is taken away, after we fall asleep. When we get to shallow sleep, we ‘take an inventory’ of all the things around us (our sleep associations), make sure they are all there, then we roll over and fall back asleep. We don’t even remember these partial awakenings.
A baby does this too. What if one of her sleep associations is being held by you? Unless you plan to hold her all night, she’s going to awaken partially at midnight and wonder where you went! That’s why being held is a bad sleep association.
Very often, the baby won’t sleep because the binky (pacifier) has become a bad sleep association for her. When the binky falls out of her mouth, as it surely will, she’ll ‘look around’ for it in the dark. Then she’ll get ticked off and become fully-awake. Then you have a crying baby!
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Pay close attention to the events that surround the moment of sleep. Is she surrounded by all the things that will be there in 90-120 minutes when she partially wakes up? Do you hold her or rock her until she falls asleep? If so, she may associate holding and rocking with being asleep. No holding? No rocking? Baby won’t sleep!
Each case is different, but in general parents and I work on ways to put some time between the bad sleep association and the moment of sleep. First a few minutes, then more minutes. It’s essential to dis-associate these things in order to allow the baby to master her natural self-soothing technique.
6. She’s Got Colic
I call this the “C” word. I hate colic. Everybody hates colic. By definition, no one knows what colic really is. The incessant crying for hours at a time, every night, at the same time, is enough to drive any parent nuts! I’m talking about babies who eat well and nap perfectly throughout the day. Then they turn into little devil-babies at night. It begins at 3 weeks of age and continues until 12 weeks.
Colic is a “diagnosis of exclusion”. That means, once you exclude all the other reasons why baby won’t sleep, you can call it colic. Some of these reasons are reflux (see below), over-feeding (see above), or under-feeding (also above).
Parents hate this answer. You have to wait it out. If you and your pediatrician figure out that there’s no other reason why baby won’t sleep, then you have to wait. At 12 weeks of age, it will stop. These may be the longest 8 weeks of your life. But you will survive it. We all did.
7. She’s Got an Inconsistent Schedule
Again, this reason why baby won’t sleep turns out to be a lot more common than I imagined. It turns out that some (many?) babies are creatures of habit. They like having a regular day. They like things predictable. They don’t like change. They don’t like inconsistency. Having said all that, there are many babies who don’t mind chaos at all! But if the baby won’t sleep because she needs consistency and her day is chaos, you may have a difficult problem on your hands!
Sometimes the schedule is fairly consistent except for one part of the day. I’ve had many clients who believe the baby won’t sleep because Dad comes home late and the baby wants to play with him! They’re right! She probably does want to play with him. The problem is her regular sleep-wake cycle wants her to be going to sleep at 9 PM, not to be playing with Dad.
Easier said than done. For many families, chaos is more or less a way of life. It would be great if every day were more or less the same, but the reality is that this just doesn’t happen for some families. But in every family, there are some ways that the day can be made as regular and as predictable as possible. For example, there may be a four-hour stretch at the beginning of the day when mom and baby are alone together. This is a good time to try and establish a routine of eating, playing, and sleeping. If you can succeed in introducing order in one part of the day, then you can work on other parts of the day as well.
8. She’s Got Reflux
Sometimes the baby won’t sleep because food comes up instead of going down. That’s reflux in a nutshell. Milk or food that is supposed to pass into the baby’s intestines comes back up toward her mouth instead. Sometimes acid from the stomach irritates the baby’s esophagus. These babies seem to be in pain. They make funny faces. Many, but not all, of these babies also spit up. Not every baby who spits up has the painful symptoms of reflux.
Some parents tell me that the baby won’t sleep unless she’s being held upright. Or she won’t sleep unless she’s in the bouncy chair. This is a clue. Other parents tell me that the baby always seems fussiest right after eating, especially if they put her down right away.
The first step, once again, is to discuss the possibility of reflux with your baby’s doctor. While you are doing this, there are some things you can try. I call these “anti-gravity methods”. The point here is to let gravity be the baby’s friend, not her enemy. If food is supposed to travel down, let gravity help it go down. I recommend keeping these babies up on an angle virtually all the time, except when changing their diapers. An angle of 30 degrees is possible, but you may have to buy more than one wedge at the baby store. When I say “angle” I mean the entire body, not just one part of it. You don’t want the baby to do an “abdominal crunch’; this might only make the reflux worse. You wan’t her entire body ‘planked’ up at an angle of 30 degrees.
Sometimes doing smaller feeds more frequently can cut down on reflux. If anti-gravity alone doesn’t work, I sometimes recommend adding this technique.
If neither trick works, your pediatrician and you can try some other methods. There may be dietary changes she can make. Sometimes medications can help. The good news is that practically every baby with symptomatic reflux gets better by her first birthday.
9. She’s Sick
Sometimes the baby won’t sleep because there’s something wrong. She’s coming down with something. Or she’s already caught something. Usually you can tell this reason from the other reasons because the baby won’t be right throughout the day, not only at sleep times. She may or may not have a fever. Sometimes, the best way to tell if a baby is sick or not is to ask how well she is feeding. A baby who is feeding well may be sick, but she’s not SICK, if you know what I mean. I worry a whole lot less about about when a baby won’t sleep but continues to eat well, than I do about a baby who won’t sleep and won’t eat!
If you have any concerns or question at all that the baby may have an illness, consult your pediatrician. The overwhelming majority of the time, when the medical problem is fixed, the baby will go back to sleeping well again!
10. She is Hypersensitive
Finally, the baby might be more sensitive to the sensations of her world than other babies. For example, the baby won’t sleep because she hears every toilet flush in the house and it wakes her up. Or if you go in her room to check on her and you ever-so-slightly jostle the crib and it wakes her up! Or the baby won’t sleep if there is too much light in the room.
These are real example from families I’ve helped. On further questioning, I often learn that one or both the parents were “just like this” when they were babies. Grandparents can be a helpful resource when trying to figure out why the baby won’t sleep.
Create a “sensory deprivation space” in the baby’s room. Install black-out shades and carpeting to muffle footsteps. The exception may be a white noise machine. Sometimes, but not always, these devices can help filter out noises from around the house that might wake the baby. It sounds gross, but sometimes I recommend that the parents wait until the baby is awake to flush the toilets. I’ve actually seen this work at least once.
Sleep, Baby! is Here for You
If these ideas don’t work for you, or if the reason your baby won’t sleep doesn’t appear on the list, contact me. I can help!