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Does your 4-month-old suddenly wake up around the clock? These 8 tips can help them, and you, sleep soundly

Oct 18, 2022, 20:45 IST
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You can promote your baby's rapid development by helping them practice new skills with tummy time.Westend61 / Getty Images
  • Many babies experience sleep disruptions around 4 months due to rapid growth and brain development.
  • They might have trouble falling asleep and wake up often, leaving you exhausted, too.
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Just when you thought your baby's sleep had settled into a predictable routine — maybe they even started sleeping through the night — they suddenly seem to reverse all progress. Now they wake up almost every hour, and you're feeling frustrated and so, so tired.

This 4-month sleep regression, as it's commonly called, happens due to a combination of rapid physical growth and brain development that occurs somewhere around 4 months of age.

Note: Research on the causes and signs of the 4-month sleep regression remains limited, but that doesn't mean this phenomenon doesn't exist. Many parents report a disruption in their baby's sleep patterns around the 4-month mark.

Signs your baby has entered the 4-month sleep regression include:

  • More difficulty falling asleep
  • Waking up more often at night
  • Fussiness
  • Fewer hours of sleep at night and during naps
  • Fidgeting, turning, and increased activity during sleep

You might notice these changes in your baby as early as 3 months, or closer to their fifth month — and this sleep regression can last up to six weeks, according to some parents.

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If you're already sleep deprived, six weeks may feel like an eternity. Read on for eight strategies that can help make this phase easier on you and your baby, as well as when to contact your pediatrician about sleep-related concerns.

1. Provide activity during the day

During this time of rapid development, your baby works hard to reach milestones like rolling, grabbing, and making new sounds.

You can promote your baby's development by helping them practice new skills with tummy time — at least 60 to 90 minutes daily — and talking to them throughout the day about what's happening around them.

Making sure they have time to play and experience new sights and sensations can also help wear them out if you're having trouble getting them to sleep. You can also help stimulate your baby's fast-developing brain with activities like:

  • Taking them for walks
  • Playing with colorful toys
  • Singing songs and playing music

2. Make sure your baby gets enough naptime

Alternatively, too little sleep can also cause your baby to become overtired, making it harder for them to sleep at night. Babies 3 to 6 months old tend to sleep around 15 hours per day — about 9-10 hours at night, and the other four to five hours during naps.

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"A 4-month-old baby should be given the opportunity to nap every 1.5 to 2 hours," says Dr. Charissa Chamorro, a private practice sleep consultant and clinical psychologist.

A baby who gets enough sleep during the day is more likely to sleep soundly at night, she says.

Some babies are harder to put to sleep than others. If your baby routinely fights sleep, try:

  • Taking them for a walk or drive: The movement may help lull them to sleep.
  • Contact napping: Letting your baby sleep in your lap while you catch up on a good book or podcast (with headphones) can help your baby get some sleep and give you a break, too. Admittedly, this may prove tricky if you don't have much downtime during the day.
  • Bouncing and rocking: Sometimes the movement of bouncing or rocking a baby can get them to sleep deeply enough that they'll let you set them down in a crib or bassinet to finish their nap.

3. Increase daytime feedings

The 4-month sleep regression can happen alongside a growth spurt — and of course, growing can make your baby hungrier than ever, which can lead to more nighttime wakings.

Feeding your baby as often as possible during the day may help cut down on hunger at night. Just keep in mind your baby likely isn't ready to drop night feeds altogether: At 4 months old, a baby typically needs about four to six ounces of milk every three to five hours.

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Still, you may be able to minimize night feeds by feeding every three hours during the day and aiming for a four- or five-hour gap between feedings at night. This tactic may prove especially helpful if your baby still wants to eat every two hours.

4. Create an evening routine

Before 4 months of age, babies aren't ready for a bedtime routine because they need to eat and sleep around the clock. But at around 4 months old, you can start establishing a clear and consistent nighttime routine that ends with something like a kiss or goodnight phrase rather than feeding, Chamorro says.

"This will become your baby's cue for sleep," she says — and establishing a positive nighttime routine could help reduce nighttime wakings.

Quick tip: Keep other family members in mind when building a bedtime routine for your baby. If your household leans toward a later bedtime of 11:00 pm, there's no need to put baby to bed at 7:00 pm if they aren't tired and it inconveniences everyone else. Aligning everyone's sleep schedules could make a difference.

Dr. Victoria Regan, a pediatrician at Children's Memorial Hermann Hospital in Houston, Texas, suggests your routine could include:

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  • Dimming the lights
  • Bathing your baby
  • Using a softer tone when speaking to your baby
  • Reading age-appropriate books, like a soft textured book or board book
  • Playing soft music

5. Try soothing without feeding at night

Around the time of the 4-month sleep regression, you can move feedings to the beginning of your baby's bedtime routine. This can help them fall asleep more easily — and stay asleep longer — since they won't associate feeding with sleep, Chamorro says.

If baby wakes up after an hour or two, you may be able to soothe them back to sleep without feeding by:

  • Giving them a pacifier to help them settle
  • Patting or rubbing their back
  • Placing a hand on their belly until they fall asleep
  • Using a white noise machine or making shushing sounds

Soothing without feeding can help weaken the association between nighttime wakings and feeding, which may eventually help your baby sleep more soundly.

6. Adjust your strategy to meet their needs

Some parents swear by sleep training, while others find that safe co-sleeping helps everyone in the family get more rest.

Note: The American Academy of Pediatrics does recommend against co-sleeping, but it's a common practice and possible to do safely. If your baby struggles to sleep well alone, safe co-sleeping could help both baby and parents get some much-needed rest.

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If one sleep situation doesn't seem to work you can always reevaluate your options:

  • According to some sleep consultants and coaches, sleep training may help babies learn to self-soothe. Finding a program your family feels comfortable with could help your baby get longer blocks of sleep at night.
  • Switching your baby's sleep location to a crib, bassinet, sleep sack, or even floor bed could provide a different set of conditions that helps them sleep more soundly.
  • Blackout shades can help create an environment that makes it easier for your baby to fall asleep in the evening if it's still light outside, as well as prevent early morning wakings, Chamorro says.

7. Sleep when you can

It might go without saying, but it's not always possible to "sleep when the baby sleeps." Still, snatching extra windows of time to sleep where you can may help take the edge off of your exhaustion.

Some ideas for getting extra ZZZs:

  • Adjust your sleep schedule: Because babies tend to get their longest stretch of sleep at the beginning of the night, going to bed at the same time as they do can help you get a longer stretch of sleep as well, Chamorro says.
  • Establish a schedule with your partner: For households with more than one adult, consider alternating who wakes up with the baby, Regan says.
  • Call in support: It's a good idea to enlist as much help as possible during this time. Consider inviting grandparents or finding a babysitter to give one or both parents a chance to nap, Chamorro says.

8. Practice self-care

The 4-month sleep regression can lead to serious sleep deprivation, especially when it doesn't resolve in a couple weeks. Chronic sleep loss can cause emotional and physical health concerns, including:

Practicing good self-care can help reduce the impact of sleep loss until your baby's sleep evens out. Eating well, spending time with friends, and engaging in mindful movement each day can all make a difference, Chamorro says.

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If you experience persistent sadness or anxiety, Chamorro also recommends connecting with a therapist. "A trained mental health professional can help you develop more coping strategies and can also provide you with a place to process all of the challenges and joys that come with parenthood," she says.

Recognizing postpartum depression

Postpartum depression most often starts in the first few weeks after childbirth, but it can show up anytime within the first year after the baby arrives. Symptoms can include:

  • Deep feelings of sadness, anger, guilt, or hopelessness

  • Loss of interest in activities you previously enjoyed

  • Changes in weight or eating habits

  • Difficulty bonding with your baby

  • Thoughts of self-harm or suicide

If you notice any of these symptoms, connect with your regular doctor or a therapist as soon as possible. They can offer more guidance and information about your options for treatment.

To get free, confidential support for thoughts of suicide, you can call 988 to reach the Suicide and Crisis Lifeline or text "HOME" to 741741 to reach the Crisis Text Line.

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When to connect with your pediatrician

It's natural for babies to experience many changes in their sleep patterns during their first year of life. In addition to sleep regressions, teething, growth spurts, and schedule changes can all disrupt your infant's sleep.

You'll probably discuss sleep at each well-child visit with your pediatrician, Regan says.

"Don't be afraid to address your concerns in detail at these visits," she says, adding that you may want to check in with your pediatrician if you notice the following changes:

  • Your baby wakes more often than usual.
  • They seem much harder to console.
  • They begin breathing more rapidly or seem to have difficulty breathing.
  • They have a fever.

Your pediatrician can help pinpoint potential causes of sleep issues, including teething, sleep apnea, or illness. They may also recommend working with a sleep consultant who can help you tackle difficult-to-solve sleep issues brought on by the 4-month sleep regression.

Insider's takeaway

The 4-month sleep regression can pose a significant challenge to any parent, and it's natural to feel overwhelmed during this time.

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"It can feel so difficult in the moment, but remind yourself that it is normal and temporary. The most important thing you can do is to connect with others so you are not going through it alone," Chamorro says.

Even through these seemingly sleepless nights, your baby is likely getting plenty of rest and doing plenty of growing, too. Try taking as many opportunities to sleep as you can and remember that eventually, both of you will eventually sleep through the night again.

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