Night Wakening Troubleshooting

Appropriate schedule

  • Time to make a nap transition?

  • Putting down 10-15 minutes prior to the end of wake time?

  • Set desired wake time, set 1st nap time?

  • Set Schedule?

  • How is the child handling the wake times?

  • Excessive napping during the day?

Quality of Wake time:

  • Sunlight exposure

  • Adequate time for Physical Activity

  • Outside playtime

  • Not dozing, snoozing, etc at all during wake time

  • Assess mood during wake times.

  • How is mood as nap time/bedtime approaches?

Eating:

  • Milk- drinking enough overall? Is baby hungry?
    • Eat, Play, Sleep Routine
    • No drowsiness or falling asleep while eating

  • Good quality feeds

  • Would Eat, Play, Eat, Play Sleep Benefit baby?

  • Solids
    • Is child eating enough healthy fats?
    • Is child eating enough solids?
    • Is child overeating solids, not enough milk?

Sleep Environment:

  • Dark

  • Cool

  • Is Child at an appropriate temperature? Does he need a sleep sack for warmth? Are they to hot? Adjust clothes under sleep sack.

  • White noise on all night, with a constant sound, not songs.

  • No external disturbances

  • No distractions in bed (toy, book, etc)

Sleep Props:

  • No Sleep props at any sleep period- Rocking, shushing, patting, bouncing, pacifier, etc.

  • No drowsiness going into bed.

Nap Routine:

  • 5 Min nap consistent routine

  • Abbreviated Bedtime routine. Does this resemble bedtime enough to be a good cue?

  • No Drowsiness, no rocking, cuddling, etc that may be leading to drowsiness

  • Going into bed wide awake

  • Is nap routine too short, does a step need to be added?

Bedtime Routine:

  • 30-45 minute routine.

  • Feeding must be at the beginning of the routine- he MUST stay awake

    • Feeding must end 20-30 minutes before getting into bed.

  • Feed, bath, books, pjs, kiss, into bed wide awake

  • No sleep props, no drowsiness, no “calming” before getting into bed.

  • Lights on during bedtime routine.

Falling asleep at bedtime:

  • Avoid too much intervention in your sleep method

  • Avoid Sleep Props or assistance to sleep

  • Allow him to settle to sleep on his own

Night Waking’s:

  • What’s happening at night waking’s

  • Too much assistance or intervention?

  • For older children- is child waiting for parent to tuck in?

  • Is there confusion- handling NW differently each night?

  • Any confusion with night feedings?

  • Should night feeds be pulled if ongoing?

Caregiver consistency:

  • Are parents doing the exact same thing? Responding in the exact same way?

  • Are there other caregivers that may be slowing down the progress?

Pooping:

  • Adjust timing of feeds in relation to sleep

  • For a toddler nap pooping, have more time between lunch and nap time

  • Solids- give “dinner foods” for breakfast, and breakfast foods for dinner.

  • Solids- Give foods that encourage child to “go” in the morning- prunes, pears, plums, etc, and more binding food in the evening- banana, oatmeal, etc.

  • It may just be a matter of time and consistency for the digestive tract to get used to the new schedule.

Health:

  • Teething, ears, cold?

  • Reflux- meds need adjusting?

  • Weight gain appropriate?

  • Low Iron? Low Vit D? Low Magnesium?

Skills:

  • Are they working on a new skill at the moment?

  • Are they in a wonder week?

Split night?

  • Some babies will wake up during the night and stay awake for an hour or two. This is called Split Night wakening.

  • Split nights mean not enough sleep pressure, may need longer wake times, shorter naps. Make sure child is not “sleeping in” in the morning. Make sure bedtime isn’t too early.