Why is my 3 month old waking up 10+ times a night?

Question

My 3 month old went from starting on a good sleep trajectory (a five hour and 3 hour stretch at 8 weeks regularly) to waking between every 15 minutes and every 2 hours. What I'm trying to figure out is what causes the frequent night wakings. She was fighting her arms out of her swaddle and getting the fabric over her face in the process, so for her safety we taught her to sleep without it. Plus she started sleep crying for gas pain or some other cause in the very early morning nearly every morning that we rushed to comfort. With all that her sleep habits deteriorated. They have been getting worse and worse since 9 weeks and at 14 weeks I am at my wits end with the double digit number of night wakings. Reading that some people consider 4 bad was hardly comforting.

I've seen Marc Weissbluth's theory that the frequent waking issue is from some form of overtiredness in Healthy Sleep Habits, Happy Child. I've tried his solution, too, which is invariably to move bedtime earlier. Well Her bedtime has consistently been earlier than 6:30 for well over a week with no changes. I'm sure the completely fragmented sleep is making her overtired, but earlier bedtimes are doing nothing to help. Her naps are not yet organized (I'm despairing that they ever will be at this rate) and so she takes 4 to 5 30-45 minute naps - if she'll take them - that I offer whenever she starts yawning, looking glazed-eyed, or rubbing her eyes.

This question's accepted answer suggests hunger as one possible cause. My little girl is skyrocketing up the growth chart and eats every 1-2 hours during the day on demand. I feed her 2-3 times at night, but not at every waking. I sincerely doubt she's hungry, but I'm open to being wrong.

Baby does have a pacifier, and popping it back in often soothes her back to sleep. Would trying to wean her off of it at this early age perhaps help her learn to self-soothe, or would it just make sleep worse? I am totally fine if she wants to suck on her fingers or thumb and get us all a little sleep, but so far every time she finds her thumb it does nothing to help her go back to sleep. She's not really coordinated enough to keep it in her mouth.

Could it be the 4 month sleep regression come to call early? An early start of Wonder Week 19? Is there any solution other than to soldier through? Is there an age-appropriate form of sleep training worth trying?

Answer 1

I had a bedtime routine and followed a 3 hour cycle for my infant (at the time newborn). He slept a good 5 hour stretch, would nurse, and continue sleeping for another 2-3 hours. We did hit a road block around 8 weeks. We had stopped swaddling him for the same reasons you listed above. I know the importance of swaddling for the developing neurological system, however, I could not sleep thinking he would cover his face and not breathe.

By week 10, things were not improving. I think they got worse. I used a bassinet that was slightly inclined and when you place your newborn/infant in it they "sink" (for lack of a better word) and are swaddled in a "fetal position". That allowed him to have longer naps during the day (not the 30 minute power naps he was having) and helped instantly his night time sleep. He went back to his old schedule and quickly began 8-10 hour stretches.

I think he became overtired. But looking back, in my experience, the starting problem was the lack of swaddling.

As an occupational therapist, I know that the nervous system is immature those first 12 weeks and one of the ways it does mature is through the deep input a newborn gets with swaddling. (Like you said, I preferred to eliminate the risk of suffocating) but I found that that particular bassinet provided the same kind of input swaddling in a blanket would provide.

Hope this helps. I can't stress enough that giving him that input helped instantly with night time and day time naps.

Good luck.

Answer 2

Is there an age-appropriate form of sleep training worth trying?

Reading your question, the first thing that came to my mind was that it might help to introduce a stricter rhythm to the day - in the hope that it might help your nights as well:

You mention that she feeds every 1-2 hours on demand. You might want to try switching from demand to supply. It worked wonders on our then-infant when we introduced a rather fixed 3-hour schedule of sleep→eat→awake *)

The baby was a lot happier when awake, and the sleep phases (day and night) got better - some of those 3-hour cycles just merged into one 6-hour cycle at night.

Update:

You normally can't postpone the baby just because the schedule says so. But flip it around: if the schedule says it's feeding time, then offer it and it will very likely be accepted. When it's sleeping time, go through your sleep ritual and perhaps she will accept the bedtime as well (otherwise you've at least trained it, and repetition brings success eventually). If her rhythm is set on 45 minutes then start your schedule on that rhythm, and add some minutes every day until the rhythm is longer.

_{*) Or was it sleep→eat→awake? I tried searching for older answers but didn't find an obvious hit. I'm told this is the better sequence, but go with whatever floats your boat.}

Answer 3

Is it possible that you gave up swaddling too early? Or, that you jumped from full swaddling to no swaddling too quickly? We swaddled both our kids to about 5 months. I recall it being difficult to keep their arms from getting loose as they grew older---it required a large cloth and very snug folds. Also, have you tried swaddling one arm and body or just the lower body?

Answer 4

We abandoned swaddling at 4 weeks because our son would scream and thrash when being swaddled. We tried every type including miracle blanket. He was still waking 3-5 times a night and not napping well unless being held or laid next to. We adopted the cosleeper bassinet unit from summer infant and this worked wonders for a while until he would wake up if you even shifted a tiny bit. We went to the crib using swaddle sacks and waking again 3-5 times a night with horrible napping patterns. Finally one exhausted day I broke down and swaddled him for a nap. He took a three hour nap the first time and one hour the second. Then I swaddled him that night at his 9pm bed time ( he won't wind down until around 8:30 so we start the bedtime ritual at 7:30) and he slept from 9 to 4. Then up for a bottle and back down till 8:30 am. I've found that the more strict I am with naps and routines the better he responds. He's 12 weeks now and going through a leap so it's a little off but I just stick to the routines he's helped work himself into. Eat play nap. Usually this is about a three hour stretch. For a long time we went through the eating every hour cycle. It was exhausting. I hope it gets better for you soon! Also my son suffers from severe reflux and milk and soy intolerance. Check with your dr it took us three visits to get it figured out and several medication changes to get a hold on it.

Answer 5

Since this post was written a little over a year ago I've continued to search for answers to my daughter's terrible sleep at the time. While I can't go back and conclusively prove any of these factors contributed, I believe that they all did.

1. I believe we had to drop the swaddle before my daughter was ready for it. I believe she still had a Moro reflex. Stomach sleep would have solved this problem, but is not an option for us due to the correlation between back sleeping and a decline in the SIDS rate. Viable options would have been products such as the Swaddle Strap that provide a swaddle that does not have a risk of fabric over the face or products designed for the transition out of the swaddle such as the Zipadee-Zip or Baby Merlin's Magic Sleep Suit.
2. Because of her Moro reflex I wish we had tried an incline sleeper such as a Fiscer Price Rock 'n' Play for at least naptime sleep to promote longer naps. By 3 months she was consistently taking only single-sleep cycle naps and I believe this led to overtiredness that could not be fixed by any nighttime helps.
3. Starting around 2 months I was keeping her intervals of wakefulness too short, around 45 minutes when I believe she needed longer. This led to an undertired-overtired loop. She was not tired enough to take a long nap, and then from a too-short nap was overtired during the next wakeful period. This caused both naptime and nighttime problems. It is possible that stretching her slowly between feedings to train her metabolism onto a 3 hour schedule at a younger age may have been helpful as well, but I believe the major contributing factor was the undertired-overtired loop.
4. I believe that rushing to soothe her cries that may have been gas pains led to an attachment to her pacifier which developed into a full-blown sleep association around 3.5 months. Again stomach sleep may have soothed the gas pains but was not an option. Modifying my diet also may have soothed the gas pains, but I did not have a chance to try an elimination diet before her digestive system matured and the gas pains disappeared. What I wish I would have tried is waiting a couple of minutes to see if her sleep cries were really pain or just crying in sleep. If just crying in sleep I wish I had let her resettle with my presence, but without a pacifier.
5. That said, because she had developed a poor sleep association with the pacifier and also with being held to sleep some form of sleep training, at an age where it was suggested by her doctor, was required to teach her proper sleep associations. Bedsharing would have also been a solution, but it was not viable for us because I am a deep and active sleeper.
6. I discovered around 5.5 months that it is definitely possible to have a too-early bedtime. Given the exact same intervals of wakefulness my daughter would have a good night with a bedtime of 6:30 to 7 but a bad night with a bedtime before 6:30 or after 7. Finding her bedtime sweet spot made a major difference.

For those babies who are challenging sleepers from an early age it can be hard to hit on the appropriate combination of a feeding schedule, sleep routine, and good sleep habits to promote the best sleep your child is capable of at any age. However it can be done.

Answer 6

Completely unrelated to my other answer: When you don't swaddle anymore, what is she wearing at night?

When swaddling doesn't work, I recommend trying a baby sleeping bag. My son never let himself be swaddled, right from day 1. So we started out with a sleeping bag and he used it for more than 2 years.

The big advantage of a baby sleeping bag is that it's a cover, like a blanket, but one that stays on the child and away from the face at the same time.

You can get pretty wide baby sleeping bags, or pretty narrow ones, depending on how much wiggle room she likes best. You have to shop around.

Answer 7

We used the Magic Sleepsuit as a transition from the swaddle and it really helped us get back to a good sleeping routine. We were up every hour or two and a friend recommended it to us. It helped muffle her startles so she would fall back to sleep on her own. We had the Fleece one and it kept her warm and cozy. It is one of our favorite baby products!