What to do when all nothing else works to put baby to sleep

Question

Our daughter is 4 months old, and over the past month she's been giving us hell with every single nap, and her night sleep is getting worse and worse.

With every day that passes, it seems that every single trick that used to work is now starting to fail: swing, pick up / put down, stroller, going for a drive, rocked on a chair, held upright and rocked while being held... all of those no longer work. Her room is blacked out, and we have a white noise and shusher going at all time.

Two things remain that still work, but are slowly staring to upset her as well: bouncing on a yoga ball, and going for a walk outside in a carrier. For both of those activities, she seems OK for most of the time, but then before she falls asleep she ends up screaming for 5-10 minutes or so.

Out of desperation, we tried Ferber for one day, but after 20 minutes of ridiculous screams, we broke and nursed to sleep. Our pediatrician recommended waiting until 5 months to sleep train, but we might not make it til then...

Have any of you been in this position? What did you do? Have any of you tried Ferber and decided it's not for your baby? What were the signs / indications?

Answer 1

Ferber recommends trying the method for much longer than a single night for 20 minutes. The method is usually successful if parents adhere to the routine for the entire night for 3-4 consecutive nights (Ferber, 2006). It is expected that the first night or two will be difficult. They were in our experience. But I am glad in retrospect that we stuck to the method.

Make sure that you are not forming incorrect sleep associations - the goal is for the child to learn to self-soothe. See also this answer for more details.

Other things that you have not mentioned and are worth trying to improve sleep are:

• Multi-step Ferber's method, rather than single-step method most commonly used (Ferber, 2006), see below. Also see the book, Chapter 4 "Sleep Associations: A Key Problem" for more details.
• Good daytime routine. See also this answer.
• Lights must not be too bright before sleep.
• White noise during sleep. See also this answer, and Karp and Spencer (2004), as well as Harvey Karp's videos that can be found on YouTube or on DVD.

REFERENCES:

By the third or fourth day your child will most likely be sleeping very well. If further work is still necessary after that, continue following the chart down to day 7; if at that point the problem is improving but is still not fully resolved, continue to add a few minutes to each interval on successive days. But if things are not improving or are getting worse, you may have to rethink your approach...

(Ferber (2006), p. 156, boldface here and below mine)

I told them to expect the first night or two to be difficult — though only rarely will a child cry for several hours — but by the third or fourth night things should be going fairly well. I also told them that if things were not improving markedly over the first few days, or at any time that they decided that the amount of crying was more than they were willing or able to accept, that we would consider shifting to an even more gradual multistep approach...

(Ferber (2006), p. 167)

Most families choose to correct their children’s sleep associations in a single step. However, you can choose to teach your child new associations in two steps or even more if you think it will be better or easier for you or for him. But bear in mind that at each stage you will have to start the learning process over again. How long that takes depends on how many steps are involved. It might sound easier for your child to learn new sleep habits in a few small steps rather than in one big one, but that is only occasionally the case.

(Ferber (2006), p. 173)

Don’t start too young. Parents frequently ask at what age they should start a progressive-waiting approach. It is difficult to give a precise answer to this question, but there are some guidelines. Most children start to sleep through the night on their own within three or four months after birth. (Note that all figures here are based on the due date, so they will be later for children born prematurely.) Newborns do not sleep through the night, and you should not try to make them. ... By the time a child is around three months old, significant developmental changes have taken place. Now most sleep should be occurring at night, and the pattern of sleep stage cycling should be fairly mature (see Chapter 2). A baby’s sleep patterns often improve markedly around this time, so unless you are having unusually severe problems, it is a good idea to wait until your child is three or four months old before you institute major changes.

(Ferber (2006), pp. 194-195)

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Ferber, Richard. (2006) "Solve Your Child's Sleep Problems: New, Revised, and Expanded Edition" New York, NY: Fireside: https://www.amazon.com/dp/0743201639/

Karp, H., & Spencer, P. (2004). The happiest baby on the block: the new way to calm crying and help your baby sleep longer. Bantam Books. https://www.amazon.com/Happiest-Baby-Block-Harvey-Karp/dp/0553381466

Answer 2

I see that you have already accepted an answer but I wanted to provide a different perspective if you (or another parent who happen on this question) decide that sleep training or a cry-it-out method is not working for you.

As a first thing, as you probably already know, 4 months is a specific landmark in development where the sleep pattern of a baby change and become more adult-like:

3-4 months. Baby sleep patterns are becoming more adult-like. Infants no longer plunge directly into REM after falling asleep, and their sleep cycles begin to include longer stretches of slow-wave, "deep" sleep (Schechtman et al 1994).

(from https://www.parentingscience.com/baby-sleep-patterns.html) This usually means that the baby will cycle through stages of lighter and deeper sleep, thus increasing night wakings, but it may also mean that the baby will have a harder time falling asleep, just like you are experiencing.

We went through the very same experience as you, around the 4 months mark all the things that used to work didn't work anymore (an the yoga ball was a last resort for us too!) We didn't try Ferber or another cry-it-out (CIO) methods because my husband and I agreed that it was not for us. I will offer our experience with the caveats that

• non-CIO methods like we used are probably less effective than Ferber et al.
• they require lots of time and patience

Overall in the end we are happy with how things went, now my son is 1yo and putting him to sleep in the evening is generally a painless affair dealt with in 10 to 30mins. He usually falls asleep on his own, laying down quietly with me or his dad by his side.

What we did after the 4 month sleep regression hit was introducing a schedule and a bedtime routine.

Schedule

Trying to have a regular schedule during the day is important for two reasons:

1. Regularity, consistency and knowing what is going to happen helps babies keep calm
2. You want to make sure that your baby sleeps enough and does not arrive at naptime or bedtime too tired, because then she will have a hard time calming down enough to fall asleep

Bedtime routine

Again, there are two reasons why this is important:

1. Same as 1 above: once the routine is established the baby learns that this particular succession of things leads to sleep and this will help her arrive at the sleep moment more calm and relaxed
2. The routine itself should contain elements that you know are effective in soothing your baby. You mention that the old tricks don't work anymore but as your baby grows you can try new ones :) for example, there has always been a music moment in our routine but the kind of music changed over the months from hits of the nineties to Mozart

The most important thing

What I think is the most important thing you can do is to try to understand your child and the trouble she's having. I know it's hard! I fought a lot with my husband at the time and I couldn't help being angry at the child too sometimes.

But really your baby needs sleep, she wants to sleep and she cries because she feels she's too winded up and can't get to sleep. That's the simple truth. So if you can help her calm down and settle she will sleep.

Good luck!

Answer 3

Hang in there, is my advice. At such a very young age, your child is constantly changing. It is to be expected that what worked one week won't work the next.

Keep coming back to options you've tried before and deemed ineffective. Things may have changed. I'm willing to bet you'll be trying out different techniques until the problem has eventually gone away, without you ever knowing what helped and what didn't.

Take turns getting some sleep yourself. Enlist outside help, if available and if need be. If you can't get your baby to sleep, the only thing you can do is be there for her through her upset. I'll prefer a baby screaming in my arms over a baby screaming alone in her crib any day (well, night).

Being awake at night with a screaming infant is, while there are those who are spared, completely normal. It isn't necessarily helpful to view it as a problem with the child that has to be solved, unless there is indeed an underlying medical condition here, and a medical intervention might be called for. As long as you're there for your child and caring for her, you're doing what you can. Don't think you're failing in your parenting because your child isn't content at night, that's how children are. With the knowledge, then, that you're doing fine as parents, you can turn your attention to how you're doing for yourselves. Sleep deprivation, on the other hand, is not a normal part of adulthood that should just be endured - that is what you should try to manage. Things being what they are with your child right now, consider what other parts of your life that can change to accommodate her, because she doesn't need fixing. If taking turns sleeping during the night doesn't get you enough sleep, you'll need to look into how you can reduce other daytime activities to free up time for catching up on lost sleep.

Answer 4

Do you use a pacifier? Do you swaddle still? (If she cant roll over yet. Sleep sacks if she can) These are some of the 5S techniques that help soothe a baby. (Suck, Swaddle, Sideways, Shush, Swing)

Based on your comment about connecting sleep cycles etc, it does seen to me like she's able to self soothe IF she's relaxed and sleepy already. May be that's the gap. You can try experimenting with shorter/longer awake periods to make sure she's tired enough but not over tired. And keep putting her down sleepy but awake. She will fuss. There are a few options for what you can do about the fussing :

• The cry it out (needs rock-hard resolve!)
• Fading method (comfort her and leave for increasing periods of time till she falls asleep)
• Any combination of any sleep training that you find effective

But try always putting her down sleepy but awake. Chances are, she'll eventually fall asleep on her own, with minimal fussing that she wont even need you for. Various sleep training articles on the web claim to achieve this in 15 days, 20 days, etc. But each baby is different, there isn't really a timeline set in stone.

For relaxing her, do you do a bed time routine? Try incorporating relaxing activities like a massage, walking around the house saying good night to things in hushed tones, anything else that relaxes her. (My son finds the hum of the vacuum relaxing - that we get time to clean the house is a bonus!)