I probably get asked more questions about the 4 month sleep regression than any other questions. Just what is this anyway? In this blog post, I break this down for you with some strategies for dealing with this and maybe even avoiding the sleepless nights by putting some good habits in place from the start.
You can read this detailed version or watch the shorter version in video below.
Newborn sleep is governed by two things - being tired and hungry. It is pretty simple. They sleep when they are tired and they wake up when they are hungry. But as babies get older - somewhere around 4 months they begin to develop a more mature sleep pattern which is regulated by the sleep hormones of cortisol - which wakes us up in the morning and melatonin which makes up sleepy at night.
Our daytime schedule and dark and night play a big role in baby sleep as well (all tied in with these hormones).
As your baby's natural circadium rhythms start to get regulated, their schedules can get really out of sorts. The experts call this The 4 month Sleep Regression. But, it is really your baby growing up and progressing into a more mature sleep pattern. When they get there, they are easier to get on a routine. But, it is the getting there that is the difficult part!!
Babies who were sleeping really well now start to wake every few hours. And, cry at night and want to be fed. What is going on? You thought you had this figured out!
Babies at 4 months of age are starting to develop routines and habits are really easy to develop and sometimes those get in the way of developing those mature sleep patterns.
If you can help your baby to develop good sleep habits, moving through the 4 month sleep regression is a lot easier.
Make sure that your baby's room is dark. As the sleep hormones are starting to get established in your baby's body, help your baby know the difference in day and night. Use your black out shades to signal that it is time to sleep. (use these for naptime too!)
Make sure you get plenty of sunlight during the day. Go out and enjoy the fresh air. Open the windows and enjoy the sun. Open the blinds or curtains when you get the baby up. Make a distinction between day and night.
Block out all of the distracting household or outside noises that will wake your baby by using white noise. This will help your baby calm down and relax and settle his brain. Lullaby and other types of noises do not do the same thing as white noise because they have a pattern that the brain can focus on. Use real white noise.
Keep the crib - and room - free of distracting toys. The baby's room should be restful. Mobiles and crib toys will signal to the baby it is time to play. If the baby wakes, you want him to go back to sleep -not be entertained and stimulated! Musical toys and lights will wake your baby.
Even though your baby will take several months to get into a sleep routine, as early as you can, start to put routines in place. Your baby will begin to learn "What Comes Next". This is helpful in all parts of childhood. Children thrive on knowing this. Even when your child is breastfeeding every 2 hours, you have a predictability in your routine.
Start with setting a bedtime. Begin to develop a bedtime routine with the same order every night. Feed, Bath, Book, Bed... Whatever you choose to put into your routine. This will signal to baby it is time to settle down and get ready for sleep.
Even if you know baby will wake in 2-3 hours for another feeding, it is still bedtime. Eventually baby will sleep longer and your bedtime is already set. And baby will know this already and you will not have to establish this later.
Write down your baby's feedings and sleep and wake times. You will use this for determining your baby's ideal schedule.
How many naps should your baby be taking? A 4 month old should be taking about 3 naps per day and the first two should last about 90 minutes. The last one is often shorter. This will be a total of about 3-4 hours of daytime sleep.
But it is not uncommon for babies to still be taking short naps, called cat naps.
Because baby sleep cycles are so short - babies will often wake up before they are really ready to be awake - before their nap is really over. Day sleep is hard because it is so light outside and you don't have the effect of melatonin helping your baby to be as sleepy.
If you can catch your baby as they are just waking up, you can help them to fall back asleep. Try to ease them back into another sleep cycle - either with patting, or rocking or shushing - just don't do what your usual habit is.
How do you know if your baby needs a feeding if she is waking up at night?
This is a tough one. Some babies still need a feeding in the night at 4 months - some don't. Some still need a feeding at 6 -7 months. Check with your health care provider to see if your child should be able to sleep longer.
But, if your child has been sleeping longer and then is now waking, you have a better idea that your child is not waking because of hunger.
Looking at your daily log helps you to know if your child is taking in enough feedings in the day. This will help reassure you. The other thing your log tells you is how much sleep your child is getting and how long they can go without a feeding at night.
Here is a guage.
Look at your daytime log.
If your baby is sleeping long stretches of day sleep - 3-4 hours in the day, then your baby will probably not need as much night sleep. (remember your baby probably needs about 12-15 hours of total sleep in a day) So if your baby needs 10 hours of sleep at night, then your baby may be able to go all night with only one feeding.
But if your baby is just cat napping during the day, and not getting his 3-4 hours of sleep, then your baby will need longer sleep during the night - maybe 11-12 hours. If your baby needs that much sleep, your baby will probably not be able to last that long without a feeding or two or even more.
So, don't assume that your baby is waking hungry until you look at your baby's schedule. You may be training your baby to wake to feed, by offering a feeding every time they wake, when they really are not needing to be fed,
But, if your child is not getting enough sleep during the day, your child may not be able to go all night long without a feeding. Work on your daytime sleep, so that your child is getting enough sleep during the day.
Sleep associations are things that baby begins to associate with how he falls asleep. These can be positive or negative. These are things that help your baby fall asleep. Helping a baby fall asleep can't be bad right? Well, only if he relies on someone else to do it for him.
A positive association is something that helps a baby fall asleep that doesn't require someone else to do it for the baby - like sucking his thumb.
A negative association is something that someone else has to do for the baby so that he will fall asleep - like rocking him all the way to sleep. Now, rocking a baby is a beautiful thing. What is so wrong about that? It works. So how can that be negative?
The negative part is that a baby requires you to do this when he wakes up to get him BACK to sleep!
See, when a baby GOES to sleep, he doesn't STAY asleep. Baby sleep cycles are VERY short - 30 minutes or so in the beginning.
So, what happens when his sleep cycle is over and he wakes up? He needs someone to come back and do whatever they did before to put him back to sleep.
Let's look at some of these:
Sucking her thumb
Rubbing, holding, biting a lovey
Humming or singing
Rocking back and forth
Twirling her hair
Sucking a pacifier (can be positive or negative if they can get it themselves)
Wiggling their legs
Rocking to sleep
Nursing or Feeding to sleep
Laying down with the baby/child
Bouncing/ walking child to sleep
Driving in the car
Think about falling asleep in someone's warm cuddly arms and then waking up later somewhere completely different. You are still sleepy but you don't know how to get back to sleep. You have to cry out and get that person to come and do that same thing again so you can fall asleep again.
During the 4 month sleep regression, habits become very ingrained. It is really important to help your baby learn to fall asleep on his own. That does NOT mean you cannot rock, or feed or cuddle - that is the beautiful part of being a parent and babies need that. You just need to make sure that your baby goes into his bed awake and falls asleep on his own.
All of these tips will help your baby settle into a good routine that will help your child progress into a more mature sleep schedule. Often people try to fix just night sleep and I find that almost never works.
I hope that you have found this helpful.
You may find this other blog post I wrote on sleep associations helpful too. You can read it here : Sleep Associations: How They May be Causing You Sleepless Nights.
And make sure you sign up for the FREE Dream Baby Playground below - which has other sleep information inside.
Let me know how these resources help you. I want to make sure that you are getting the rest that you need so that you can actually enjoy this baby you have dreamed of.
LuAnn Marlow has been a Pediatric Nurse Practitioner for over 25 years. She is also the mom of 4 grown boys. She has practiced in many areas of pediatrics from newborn care, childhood cancer, child abuse and more. She loves taking the frustration out of parenthood so that moms and dads can spend more time enjoying those babies they dreamed of.
The information you read here is for informational purposes only. It is not intended to be a substitute for the advice of your own healthcare provider. Do not use the information in this site to diagnose or treat a health problem or disease. Do not disregard the advice of your own healthcare provider because of something you read or hear here. This information does not create a patient-provider relationship. See full disclaimer on the website.