Sleep Problem from Feeding Until Asleep
How do I know my baby is a trained night feeder?
The definition of a baby who develops a sleep problem from being fed until they are asleep is:
- A baby over 4 months old who can't sleep through the night (at least 7 straight hours)
- Wakes up and cries one or more times a night to be fed
- Can only return to sleep if you hold and feed him
- Sometimes called a trained night feeder
What causes a trained night feeder?
- The main cause is being breast-fed or bottle-fed until asleep at bedtime and for naps.
- If the last memory before sleep is sucking the breast or bottle, the child does not learn to comfort himself and fall asleep without the breast or bottle.
- Therefore, when the baby normally wakes up at night, even though he's not hungry, he is not able to go back to sleep without feeding as a pacifier.
- Age limits how long a baby can fast. As babies become older, they can normally sleep longer without a feed.
- By 4 months of age, most bottle-fed babies can sleep more than 7 hours without a feeding.
- By 5 or 6 months, most breast-fed babies can sleep 7 hours at night without a feeding.
- Normal children of this age do not need calories during the night to stay healthy.
How can I help my child sleep through the night?
- Separate feeding from falling asleep:
- Feed your baby as the first step in the bedtime ritual, rather than the last step.
- Also, feed him in a different room with the lights on.
- Your baby's last waking memory needs to be of the crib and mattress, not of the breast or bottle.
- Feed, play, sleep is an even better sequence.
- Put your baby in the crib drowsy but awake:
- At naptime and bedtime, place your baby in the crib drowsy but awake.
- This is when you need to re-train your child to be a good sleeper.
- Start with a pleasant bedtime ritual. But when your baby starts to look drowsy, place him in the crib.
- Your child's last waking memory needs to be of the crib and mattress, not of you.
- If your baby is very fussy, rock him until he settles down or is calm, but stop before he's fully asleep.
- He needs to learn to put himself to sleep. Your baby needs to develop this self-comforting skill so he can put himself back to sleep when he normally wakes up at night.
- Visit your baby for crying:
- If your baby is crying, visit him as often as needed until asleep. This is part of sleep training.
- Make the visits loving, but brief.
- Don't stay in your child's room longer than 1 minute.
- Act sleepy. Whisper, "Shhh, everyone's sleeping." Add something positive, such as "You're a wonderful baby," or "You're almost asleep."
- Do all of this in a loving way with a calm, soft voice.
- Try not to show any normal anger or frustration during these visits.
- Return every 5 - 15 minutes. Gradually lengthen the time between your visits.
- Once placed in the crib, do not take out again:
- Naptime and bedtime are the best times for sleep training.
- Do not give in. Do not play with your baby or bring him to your bed.
- Even with your visits, most young babies cry 30 to 90 minutes before they fall asleep.
- For crying during the middle of the night, temporarily hold your baby until asleep:
- Until your child learns how to put herself to sleep at naps and bedtime, make the middle-of-the night awakenings as easy as possible for everyone.
- If he fusses for more than 5 or 10 minutes, go in briefly and reassure him.
- If he cries longer, take your child out of the crib and hold him until asleep. You don't have to do sleep training in the middle of the night.
- But don't take him out of the room, entertain him or talk to him very much.
- Provide a nighttime feeding only if last fed 5 or more hours ago:
- Any healthy 4 month old baby can fast that long.
- Make this nighttime feeding boring and brief (no longer than 20 minutes).
- Stop it before your child falls asleep, and replace it with holding until asleep.
- Stop giving your baby any bottle in bed. If you feed your child at bedtime, don't let him hold the bottle.
- Gradually lengthen the time between daytime feedings to 3 or 4 hours:
- You can't lengthen the time between nighttime feedings if the time between daytime feedings is short.
- If a baby is used to frequent feedings during the day, he will get hungry during the night.
- Phase out any comfort feeding or grazing.
- Last step - phase out the nighttime feeding:
- Phase out the nighttime feeding only after your child can put herself to sleep without feeding.
- Grazing must also be gone and the time between daytime feedings must be more than 3 hours.
- Gradually phase out the last nighttime feeding over 2 weeks by gradually reducing the amount.
- What to expect:
- Be consistent and you will see improvement within a week.
- Expect some crying during the transition.
When should I call my child's healthcare provider?
- Your child is not gaining enough weight
- Crying becomes worse after 4 nights of this program
- Your child is not sleeping longer after you try this program for 2 weeks
- You have other questions or concerns
Learn more about the Sleep Center at Children's Hospital Colorado.
Written by Barton D. Schmitt, MD, pediatrician at Children's Hospital Colorado.
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Pediatrics, Pulmonology - Pediatric, Critical Care - Pediatric