My 6 month old baby wakes up more than 20 times a night

by Sarah Jones
(Southend)

Question: My 6 month old son has always been a terrible sleeper but now its getting worse. I had tried everything possible to get him to sleep more than 20min at a time. We have an established bedtime routine, dinner (usually babyrice and fruit), bath, baby massage, last feed, story in a dimly lit room then bed. If i put him down when he is drowsey the second he is in the cot he screams blue murder. Attempted the cry in out method, by going in every 2, 5 then 15 min, patting belly & comforting but after 5 hours this was not working at all, tried it for 3 nights but my son was getting so distressed that by the fourth night even after the first 5 min he started smashing his head against the cot and screaming till he made himself sick.

I can get him to sleep in my arms by rocking him but even then, after he has been in his cot for 10-20min he is wide awake. Have tried staying in his room next to the cot for the first 1-2hours after putting him down to settle him (rub his belly, sing, stroke his head etc) but he still wakes up.

I am happy to co-sleep but he still wakes up, when co-sleeping he sleeps a little longer, about 45 min then screams and moans in his sleep every 10 min or so until he wakes up. We have tried white noise, lullabys playing on loop, hot water bottles in the bed before putting him down, swaddling, offering a soother but nothing works.

He sleeps the longest when held in your arms so that the second he starts fussing he can be settled, even then he will only sleep for an hour.

He is exactly the same in the day, screams with overtirdness and will only settle for a nap (norm 20min 3-4 times a day) when rocked.

My son is a very good eater, eats 3 meals a day with 3 portions of veg and 2 of fruit. When he awakes in the night he always refuses his bottle.

Need help as i am exhausted and meant to be returning to work in the next two months, can't possible function with the amount of sleep i am getting.

Heidi's Answer: Dear Sarah,

That lack of sleep is tough as it is, and I know how daunting the idea of going back to work like this feels. So let's see how we can improve things for you and your son as much as possible.

You have tried all the right things: the bedtime routine, putting down drowsy and/or staying with him for the first hours of sleep, tried co-sleeping, tried feeding but ensure sufficient feeding during the day, ...

The cry it out clearly didn't work out and it sounds like it has been quite violent ... at least you've tried and now you know it wasn't what you needed.

His short-stretch sleep pattern has settled quite strongly and any improvement will have to come from changing those patterns by helping his body physically adapt to different ones.

First of all though, we have to be sure that there is no underlying physical cause. There may be a digestive issue or an allergy playing. Consult your doctor with this specifically. You can also experiment with leaving out dairy food and/or typical allergens like nuts, citrus, tomatoes, strawberries, nuts, from his food or your own if you breastfeed.

A typical cause of what you describe can also be a stuck nerve or bone in his spine or skull. This happens to quite some babies during birth. This can cause serious discomfort when lying down, making it difficult (painful) to sleep for longer stretches. You may consult your doctor or more specifically an osteopath who is specialized in these matters. The cranial osteopathy therapy checklist may help you decide.

As you know, osteopathy is regarded as alternative medicine. I know of many good experiences with it, but naturally only recommend it if you are 100% supportive of it yourself. And above all, make sure you consult a certified and specialized person.

Once you have ruled out any underlying cause, we can work to change your son's sleep patterns both by helping him sleep longer stretches and by changing his schedule.

From what you write, for helping him sleep longer stretches, a baby carrier seems like the way to go. Schedule 3 naps, at regular times.

Ideally you set those times at moments when he is readily tired (all but truly tired) and long before he is over-tired. Since currently he may be 'constantly over-tired', it may be a good idea for you to set the times yourself: choose a mid-morning, early afternoon and late afternoon nap time.

At those nap times, put your son in the sling to help him settle. Go about the house or out for a walk, for as long as you can, ideally about 1,5 hour.

If it is practically impossible for you to do that 3 times a day, do as many as you can.

Your movements should keep him asleep. If he wakes up before the 1,5 hour, don't worry but keep him in the sling and keep moving for the additional half hour. This helps build the routine of longer naps (even if he does not sleep the full nap time).

Doing this with naps has a second goal: reducing his over-tiredness as much as possible. Before you can move towards more independent sleep (which is what we want in the end), you need him well-rested and content. Only then will he be ready to learn self soothing skills.

Daytime naps are a good way to start with this.

Also during the night you can help him sleep as much as possible.

I suppose you have tried it but anyway: if putting down drowsy does not work (i.e. he wakes up soon after) hold him for longer until he's deeply asleep before putting him down. Wait until he breathes slowly and deeply, and his body is fully relaxed (this may take up to 30 minutes from first dozing off).

This also to increase his sleep hour as much as possible.

Whenever he wakes up, help him settle again. Don't wait too long, keep the awakenings as short as possible, with of course dim lights, low voices, minimal interaction and don't leave the bedroom with him.

Once you found some rest like this, in the sense that he sleeps more in total, you will then be able to start working on self soothing. But don't rush, take the time to really improve the sleep stretches during the day and reduce his over-tiredness. I know this will still be very hard on you at first, but you should see improvement eventually.

The other thing is an altered sleep schedule. You will do that by fixing the nap times. Then for night time bedtime, you don't mention it explicitly but if it is on the late side do not hesitate to make it much earlier. A drastic change can have a surprising positive effect. So if you're having bedtime at 8pm now, you can go to 7pm or even 6-6.30pm.

Finally, have you tried changing his lying position a bit by lifting the head side of his mattress?

Summarizing, lengthen his naps by carrying him at fixed regular times. Help him with settling and sleeping deeply before putting down and help him sleep as much and with as short interruptions as possible. Once his over-tiredness improves, work with my gentle self soothing method to increase his sleep independence.

Good luck, I would love to hear how you progress,
Kindly,
Heidi