My baby Jamie is four months old. It seems like he is only happy when he's being held (or nursed), and I'm so exhausted I'm getting desperate. Every time I put him down he screams, even if he's just fallen asleep in my arms. He never sleeps more than ten minutes during the day, unless we're driving in the car or taking a walk. What can I do?
Jamie sounds like a tired, cranky little one who has learned to doze in your arms just enough to make it through the day but not enough to keep him happy. Let me describe the typical day of an overtired baby, and you decide if it sounds like your child.
Your baby wakes up in the morning, alert and hungry, and you feed him. After his first feeding he's cheerful and alert and happier than he is at any other time of day. After about twenty to thirty minutes, he starts to fuss. You play with him, change him, and he seems happy, but after another ten to fifteen minutes he's fussing again. You do your best to distract or play with him, but after five minutes he's still unhappy. Now you wonder if he might be hungry, so you nurse him. The feeding calms him down, and he may even doze for a few minutes. Unfortunately, if you try to move him, he wakes up and now, instead of being alert and happy, he's alert and a bit fussy. For the rest of the day, he gets fussier and crabbier, only dozing briefly. You might find that if you take him out for a drive or walk he’ll sleep for a while as long as you keep moving. If you keep him in motion until he wakes up naturally he might sleep for an hour or more. Then, after that nice nap, he's cheerful again, just like he was in the morning, perhaps for an hour or more.
If this sounds like Jamie’s day, the problem is that he is both overtired and over stimulated. Although he's learned to comfort himself briefly by feeding, (kind of like having a candy bar when you’re tired) he can’t get enough rest just dozing in your arms. It's only when he has the constant, even motion of the car or walk that he can relax enough to have a restful sleep. That's why he's cheerful after a long ride - he's not overtired any more.
There are two solutions to your problem. It would be a good idea to choose one of them because being the constantly exhausted mother of a constantly fussy baby isn't good for either of you.
The first solution is not ideal, but is also not unusual, even though most parents admit that it’s what they’re doing. Plan your day so that you go out for a ride or walk at least three times every day, starting each walk or ride after Jamie has been awake for about two hours since his last nap. Keep moving long enough for Jamie to get an uninterrupted nap. You'll be able to tell if he's getting enough sleep because he'll be much more cheerful (remember that all little babies fuss and cry some, especially in the evening). You can begin with this solution just get a feeling for how much sleep your baby needs and what he's like when he's not tired. Then you can start to plan a more regular nap schedule for him.
Of course, even though some parents do plan outings every day to get their babies to sleep, after a while this approach can get pretty tiresome, especially if the weather is bad.
The next solution is harder to implement, but it works if you are willing to stick with it for a week or two while Jamie adapts.
After Jamie has his long alert period in the morning and doesn’t seem cheerful any longer, instead of feeding him again, put him in his crib. Since he's not used to this, he'll probably begin to fuss, complain or cry. This will be very hard on you! You can stay with him and sing or softly pat him back. But let him fuss until he falls asleep.
If Jamie is really mad about your doing this, he may start to cry hard. But he’s not crying because he want to be held--if that were the case, he’d come daown and be cheerful when you pick him up. He's crying this way because he is exhausted! Instead of picking him up to soothe him, try to use your voice or just pat him. After he’s gotten as upset as he needs to get, he’ll peak out and then he'll fall asleep.
Some parents feel that this approach is cruel to the baby and would rather not try it. However, it's worth considering that it’s not very kind to keep a baby in a constantly fatigued and cranky state. An exhausted baby is often labeled as "colicky" or "difficult" and those labels can affect the way parents feel about him. If a baby is fussy and unhappy much of the time, the whole family is under stress and the psychological consequences can be worse than the short term stress of crying at nap or bedtime. The best way to tell if what you are doing is working is to look at your baby and see how he acts when he has had a chance to sleep.
Meg Zweiback, R.N., CPNP, is an infant sleep consultant in Oakland, California