Nothing truly prepares us for the sleepless nights that we endure when we first bring home our babies. The one thought that I would always hold onto was that nothing was forever. When my first-born turned one and she was still waking at night for a feed, I started to wonder whether it maybe was forever! With my second [and third!] babies, now armed with much more knowledge about sleep, I vowed to do things differently. I knew it was possible for babies to sleep through the night much earlier than 15 months of age. Below you will find a step-by-step guide to getting that glorious full night of sleep [at least most nights!] The below instructions assume that your baby is healthy and you’ve discussed nightweaning with your doctor. The steps should be followed in order as by tackling one step, it may mean that you don’t even need to move onto the next step! Let’s do this!
Step 1: Look at the schedule
There are two main factors that play a part in babies sleeping well at night: sleep associations and schedule. An independent sleeper who is overtired won’t likely sleep through the night and a well-rested baby that requires help to fall asleep likely won’t either. So we first want to look at baby’s schedule, and mainly, we want to make sure that baby is not overtired. Following age-appropriate awake times is crucial and most importantly, we want to ensure that baby is not awake too long before bed. A baby that is overtired at the on-set of nighttime sleep is much more likely to fight bedtime, experience nightwakings, and wake early the next day. We might confuse some of these overtired wakings for wakings for hunger, so ensuring baby is well-rested first and foremost is key in ensuring we see a reduction in wakings that are not hunger-related.
We’ve made sure baby is not overtired, but now we need to make sure baby isn’t undertired [huh?] Baby sleep is all about finding that balance between enough sleep and not too much sleep. Enough awake time but not too much awake time. A baby that is undertired [by not getting enough awake time in during the day or by napping too much] may try to make up for that lack of daytime awake time by….you guessed it! Being awake at night. If your baby is waking at night and you suspect maybe too much daytime sleep/not enough awake time is the issue, try to adhere to the following rules:
4 months of age: aim for a minimum of 7.5 hours of daytime awake time and no more than 4.5 hours in naps
5 months of age: aim for a minimum of 7.75 hours of daytime awake time and no more than 4 hours in naps
6 months of age: aim for a minimum of 8.25 hours of daytime awake time and no more than 3.5 hours in naps
7 months of age: aim for a minimum of 9.25 hours of daytime awake time and no more than 3.25 hours in naps
8 months of age: aim for a minimum of 9.75 hours of daytime awake time and no more than 3.25 hours in naps
9 months until 1 nap: aim for a minimum of 9.75 hours of daytime awake time and no more than 3 hours in naps
Baby on 1 nap: aim for a minimum of 10.25 hours of daytime awake time and no more than a 3 hour nap
**when a baby first drops a nap, it is normal that daytime awake time will be lower and this is okay. It should only be temporary though and you should work to slowly increase awake times to reach the above goals.
Step 2: Look at the routine
As mentioned above, the two main factors that contribute to a good night of sleep are schedule and sleep associations. Now that we know your baby is rested, we need to work on eliminating any unhelpful sleep associations. An unhelpful sleep association is anything that your baby cannot recreate on his own throughout the nighttime [I’m looking at you, pacifier!] If your baby is reliant on nursing to fall asleep, a bottle, rocking, pacifier, holding, etc. they will wake requiring these same associations to help them back to sleep. Some form of sleep training will be required in order to reinforce healthy sleep habits. This is the hard part but it’s crucial in order to ensure we have good, lasting, healthy sleep habits. Your baby can do this, believe in him!
When we sleep train, we want to make sure that baby is going down fully awake [not drowsy!] and that we’ve separated food from sleep. Putting baby down too drowsy or still feeding them to close to sleep will reinforce that unhelpful sleep association [i.e. baby is still reliant on you/food to prepare their body for sleep]. If your baby is 16 weeks of age or older, you want to be laying them down ‘wide awake but calm’ or ‘awake, minus the drowsy’ and the last feed of the night should occur at the very beginning of the bedtime routine [before the bath if it’s a bath night or before diaper change and jammies if it’s not]. As a note, it is not important that baby is kept awake during middle of the night feeds [or is woken up at the end of the middle of the night feed]. As long as baby is falling asleep on his own at bedtime, it won’t create an association if baby falls asleep eating in the middle of the night.
Step 3: Look at the age
Alright, so we now have a super well-rested baby that is sleeping totally independently! Woo hoo! But baby is still waking at night to eat. Boo hoo! Are you doing something wrong? Not necessarily! Sleep training does not [and sometimes, should not] equate to total nightweaning. Having a well-rested independent sleeper should drastically reduce the number of times baby is waking at night, but it won’t stop them from waking if they are truly hungry [or if they have a sticky habit, more about that below]. It is very normal for babies to wake at night to eat in their first year of life, often multiple times/night. When we are thinking about nightweaning, we want to make sure we aren’t expecting too much out of baby. What would be expecting too much?
4/5 months of age: expecting baby to eat less than twice per night unless they have dropped feeds on their own
6-9 months of age: expecting baby to eat less than once per night unless they have dropped feeds on their own
**when I say ‘dropped feeds on their own’ this means that baby has started to sleep through feeds without us actively trying to wean them and your doctor has okay’d this
Some babies will naturally consolidate their nighttime sleep earlier than others and may only need 1 feed/night at 4 months of age or no feeds at night by 6 months of age but I wouldn’t recommend trying to actively nightwean a baby down to less than the above.
Now, while we don’t want to expect too much out of baby, we also don’t want to expect too little. While sleep training often greatly reduces the number of times baby is waking at night as it eliminates the sleep association problem, if a baby is used to being fed at a certain time or after a certain amount of hours of sleep, we may now have a habit on our hands. These habitual wakings can be a bit trickier to eliminate and would require us to use our sleep training method to encourage baby to either a) fall back asleep on their own or b) lengthen out their stretch of sleep to something more age-appropriate. What is age-appropriate?
4 months of age: an initial stretch of 5 hours, followed by another stretch of 3.5 hours
5 months of age: an initial stretch of 6 hours, followed by another stretch of 3.5 hours
6 months of age: an initial stretch of 7 hours, followed by another stretch of 4 hours
7-9 months of age: an initial stretch of 7 hours, no second feed
10+ months of age: 11-12 hours of consolidated sleep
**stretches are counted from the beginning of the last feed, not from the time baby falls asleep
If your baby’s stretches of sleep are much shorter, you want to encourage them to wait longer in between feeds to ensure we aren’t feeding the habit. Whichever method you used initially to help baby to learn to fall asleep is how you want to respond if they were to wake before these times. You would continue with your chosen method until baby a) falls back asleep or b) you reach these above times. While it may seem like you are ‘rewarding’ baby by now feeding them after he woke early, you’re still setting the expectation and feeding baby when he is likely hungry [and he may have built up an appetite in that time and if so, it would be very difficult for him to fall back asleep without the feed].
If your baby is hitting these above stretches but still having a lot of extra nightwakings, try to really pay attention when they eat at night. Do they seem hungry? These stretches above are just an average and won’t be suitable for every baby. If your baby is capable of sleeping longer stretches but we’re feeding them too early, we are feeding the habit and that will encourage extra wakings. If you think this is the case, try increasing the time before you feed baby by 15 minutes every few nights to see if it helps.
Once you’ve reached the 7 hour stretch and baby is 6+ months of age, it can be wise to increase the stretch by 15 minutes every week to start working towards that full night of sleep by 10 months of age. So at 6.5 months of age, you might be at 7.5 hours. At 7 months of age, you might want to use an 8 hour cut-off, and so on.
Step 4: Look at daytime consumption
When a baby has been used to being fed at night [or multiple times per night] their body becomes accustomed to those nighttime calories. If a baby is getting the bulk of their calories at night, we call this ‘reverse cycling’. This is especially common with babies who require food to fall asleep. While this can happen very quickly and easily, luckily it can also be undone [by following the above and below steps!] One of these important steps is to try and increase consumption during the daytime. This might mean adding in an extra feed for a breastfed baby [not right before sleep times though! Make sure any milk feeds are separated from naps by at least 30 minutes + some sort of activity] or increasing ounces in baby’s bottles. Also, try to ensure that baby’s feeds are distraction-free. Try feeding baby right upon waking from sleep with the lights still off, white noise still on, sleepsack on, etc. If baby is bottlefed, make sure the nipple size is appropriate - oftentimes if baby starts to eat less or slower, it can mean you need to increase the nipple size. If your baby is eating solids, try incorporating some high-fat/high calorie foods such as avocado, heavy cream, butter, olive oil, fatty fish, beans, whole-fat yogurt, full-fat coconut milk, eggs, bananas, etc.
If you have any questions or concerns about how much your baby should be eating, please speak to your pediatrician.
Step 5: Look at how you respond
Perhaps one of the most important steps you can take to working on increasing those stretches of sleep at night is waiting it out. Babies are noisy sleepers, especially those new to independent sleep. They wake up, cry a bit, fall back asleep. For babies just new to independent sleep, this can occur after every single sleep cycle at the beginning of the night, as their transition is ‘sloppy’ and unrefined. This gets better with practice! We often mistake partial arousals as cries for hunger and in we go to offer a meal. Despite not really being hungry, baby likely obliges by eating - and a habit is born. While sometimes it’s not easy, especially in the middle of the night, establishing a wait time before entering baby’s room can be a game changer for nighttime sleep. I would start with whatever number you are comfortable with, even if it’s just 1 minute at first, and try to increase the wait time by 1 minute every night or every few nights until you are waiting 10 minutes. I would be waiting even if it is technically time to feed, as you always want to give baby a chance to self-settle before you intervene. Also, if we are rewarding every waking with instant gratification [food] we are really reinforcing that wakefulness and it’s more likely that baby will continue to wake at night even once he’s not hungry! Your baby might really surprise you if you give him that chance!
Step 6: Look at nighttime consumption
You’ve followed steps 1 through 5 but baby is still eating more at night than we’d like [come on baby!] which means we move to the final 2 steps which are the more ‘active’ nightweaning steps. The first step is the slow wean, which means that we will be slowly reducing the amount of calories baby is eating at the nightfeed(s) that we are trying to eliminate.
If you are nursing, time the nighttime feeds for 2 nights and take the average. On the 3rd night, reduce the minutes you are nursing by 3 minutes. Every 3rd night, reduce the feed(s) by another 3 minutes until you are only nursing for around 5 minutes.
If you are bottlefeeding, you will want to reduce the number of ounces in the bottle(s) by half an ounce every 3rd night until you are only offering 2 ounces.
If your baby is 9 months or under and you’re keeping 1-2 feeds/night, you can feed baby as much as he wants at the remaining feed(s).
You should plan to reduce the earliest feedings first. For example, if your baby is 5 months old and eating at 10:30pm, 1:30am, and 5:00am, plan to cut out the 10:30pm feeding. That first stretch of sleep is the most important stretch of the night as not only does it set the tone for the rest of the night [i.e. if we feed too early at the first waking, the rest of the night is likely to be fragmented] but it also contains the deepest, most restorative sleep and is when growth hormones are secreted, memories are formed, and baby’s learning ability and overall alertness for the next day is affected.
Once you are down to 5 minutes of nursing/2 ounces in the bottles, we can move onto the next step:
Step 7: The final step
We made it! If you’re at this step, that means that your baby has an age-appropriate daytime schedule and bedtime. He falls asleep 100% independently without any props and you feed at the beginning of the bedtime routine. He eats well during the day and you have been waiting him out at night [if your baby is 6-9 months of age, I would try increasing the wait time to 15 minutes before this final step to see if that encourages him to skip the feed. If your baby is 10+ months of age, I would try waiting 20 minutes]. You’ve reduced ounces/minutes at night but he’s STILL waking. The last step is to eliminate the feed entirely which is possible now that you’ve really set the stage. You would use your chosen sleep training method [or if you’re a lucky duck and haven’t had to sleep train, read up and find a method that you are comfortable with] and when baby wakes at night and is still awake after your 10 minutes, you’d encourage him to fall back asleep on his own [perhaps by using timed checks, sitting next to the crib, or leaving him to settle on his own]. If you’ve followed all of the above steps, it should not take more than 3-5 nights until baby is sleeping through that waking. If baby is really protesting and you’re losing your resolve, try rocking your baby to sleep instead of feeding [obviously best case scenario is baby falls back asleep on his own but rocking to sleep is better than feeding to sleep!]
If your baby, in this process, has dropped all nighttime feeds and maintains that full night of sleep for 7 nights in a row, your baby has now learned how to sleep through the night successfully and if he were to wake at night, I would not be offering a feed anymore [checking in on him or comforting him is okay of course, but a feed would not be offered]. Once a baby learns to sleep all the way through, sleep generally overrides hunger, which means that hunger isn’t likely to wake him out of a deep sleep and wakings at night are more likely attributed to something else [overtiredness, teething, illness, milestones, etc.]
Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, now based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!