My 7 week old sleeps all day and is up all night

by Amber - Answer by Heidi Holvoet, PhD
(Florida)

Question: My 7 week old boy (2 weeks premature) sleeps all day and wakes up for food or to be changed but wakes up at night and stays up for several hours. I try to wake him up during the day but he stays sleeping. Is there any tips to wake and keep him up?

Heidi’s Answer: Hi Amber!

It's not unusual for such a young baby to have a reversed day/night rhythm (on average it takes about 12 weeks before a true day/night rhythm establishes, a bit longer for premature babies), but very hard on you of course, unfortunately. So let’s see what we can do to improve as much as possible.

Waking up a very deeply sleeping baby can be very hard indeed. In fact it’s even better not to, giving his baby sleep patterns the chance to develop naturally.

But when he wakes up during the day, you can try to keep him awake as long as possible: feed him as soon as he wakes up. OR, if he is not too hungry, wait a bit and keep him busy (you may already gain 15 minutes like this). But don't stretch and feed him when he really needs it of course.

Then change him (or change him in between if he falls asleep before finishing his feeding completely, and then do a ‘fake’ diaper change at the end of the feeding, just to wake him up).

Or, instead of changing, give him a bath right after feeding. Even if many people believe it calms a baby down and helps them sleep, many babies actually get excited by it (either because it is fun or because they do not like it) and it may leave him fit and refreshed.

You cannot give him a bath after each feeding of course, but you can take him to the bathroom, wash his face with a lukewarm cloth, …

Also try to have some ‘play’ time after the feeding/changing/bath, walk him around the house, pointing at toys, singing lively nursery rhymes, … He may not react too much just yet, but he will soon!

Try all of this, but don’t push it, let him sleep when he really can’t stay awake anymore.

All the while, you keep working on instilling the day/night difference:

1) Make the nights dim and dull, and the days light and fun.

This is very simple but the most effective way to teach the difference between day and night. You may already be doing this, but then you may need make it even more obvious.

So during the day, you make sure there is a lot of light, even switch on the lights on a darker day. When he naps, do not darken his room.

Also make sure the days are active: have lively music on, a lively baby TV show, talk to him a lot, take him to a busy playground, go shopping, … and keep it lively, also when he naps.

I know he may sleep through all of this right now since you say he sleeps all day and it’s hard to wake him up. But it is important to keep giving these cues. Even when asleep, the fact that the house is lively and light will impact his sleep patterns!

The nights then are always very dim, do not switch on the light when you go to him. If he needs a diaper change, try to do this in very dim light too. Do not leave the bedroom with him. And do not interact more than necessary. Don’t answer his smiles (as cute as the may be :) …), no funny faces, …

2) Then there is this approach where you use his night time rhythm and copy it to the day by adapting the daytime schedule to his night time schedule.

This is how to do it: note the times when he usually wants to feed and is awake at night (as an example let's say that is at 11pm 1am 3am 5am and 7am). Those will most probably not be quite fixed times and rather vary quite a bit each night. But if you write it down for a couple of nights you may see some sort of schedule, and take the typical/average times.

Then you want to use those times as a feeding schedule during the day. So, with the example times of above, you would then want him to feed at 7am 11am 1pm 3pm 5pm 7pm.

However, you do want to avoid waking him too briskly from his deep sleep (as I mentioned, letting his sleep patterns develop is very important). So try gently at the picked times but don't insist if he's really far off. Or, if he does wake at about 10.30am, and the set feeding time is 11am, do try to stretch it till then. Stay relaxed though, if it does not work, or you only fit a few of these times, that is already good.

It will take some patience, but with all the above you should see improvement within a week or two.

Let's see how you get on with this to start, good luck!