Dear Dr. Gwenn:

I have a 5 month old, that sleeps roughly 11 hours at night and usually only wakes up once in the middle of the night. He is exclusively breast fed and has started rice cereal. He goes to bed easily at 7-8pm sleeps until 3am then wakes up for a feeding and sleeps until 6 or 7 am. He was a full term baby of 8 pounds and was 17 pounds 10 ounces at 4 months. Does he need to be eating at 3 am or can I wean him of this with a pacifier and/or crying it out a bit?

During the day, he does a 30 min morning nap about 2 hrs after waking. I am trying to get him to nap in his crib in the afternoon (while his brother is napping). I try putting him in and am lucky if I can get a half hour, he seems like he can go 6 daytime hours with no sleep. How do I establish a solid afternoon nap?

Thank you,
JR, Mother of 2, Wayland, MA


Dear JR:

Your questions raise some of the most common sleep concerns with infants. You have a number of options that you can try to help your son sleep better but first let me give you some facts.

Babies at this age have cumulative sleep over the course of the day and many babies do not need a long nap even at very young ages. So, if a baby this age typically needs 12 hours of sleep, he is getting that just mostly at night. The nighttime waking could be habit but he is going down early and may very well be waking up hungry.

Here’s what I’d suggest. For napping, you may have to cut your losses given how much sleep he gets at night. His body will tell you what he needs and from what you describe he doesn’t really need to nap.

To help you determine if the middle of the night wake up is habit or hunger, try offerring him a pacifyer first. If he settles down he may very well be using you as a human pacifyer. Another way to increase calories is to add more rice cereal before bedtime and consider adding more solids during the day. Another strategy is to wake him before you turn in at 11/12am and give him a quick feed. Or,have dad give him breast milk in a bottle to give you a break. As you add more calories, you’ll quickly find he does not need that 3am meal.

Your son’s body and behavior are telling you what he needs. The nap issue is tricky because he may not need a long nap. Many babies are cat-nappers, particularly if they sleep as long as your son does overnight. If having a nap is important to you due for the flow of your family, you may need to consider keeping him up a bit longer at night.

As for adding more solids, you will eventually go to 3 meals and breast milk scattered about the day and he will get more active. All these things will impact his sleep – hopefully in a good way. Until then, go with the flow and don’t worry about the naps. Just rejoice that he is such a good sleeper at night.

Finally, if you need the break while your 2 year old is napping, consider putting your 5month old in a playpen near you or a swing. Just because he is awake does not mean he needs to be attached to you during that entire time. Don't feel at all guilty about this. You have needs and a house to keep in order - and he needs a bit of time away from you, too!

Best,
Dr. Gwenn