Dr. Sarah Mitchell
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4 month sleep regression: A Case Study

A reader contacted me with questions about her daughter’s 4 month sleep regression. This is her second child and she had been working on establishing good sleep habits from the very beginning. Those included putting her baby down awake, soothing with ssshhhing, and focusing on getting her baby down to sleep BEFORE she was really tired.

This resulted in a 3 month old who was sleeping from 7 pm until 3 am and then up at 6 or 7 am. Pretty good overnight sleep for a 3 month old. Obviously mom was pretty happy with one night feed. So when her baby started waking up twice at night, Mom really felt this change and wanted to nip it in the bud.

If you’ve read my other post you know that the 4 month sleep regression can be caused by:
– increased altertness
– more consolidated overnight sleep and less daytime sleep,
– the 4 to 3 nap change.

Her 4 month old was getting 4 naps in per day, resulting in a bed time around 7 or 7:30 pm.

Night wakes at 1 am, 4 am and 6:45 am.

She felt that the 4 am and 6:45 am feed the baby wasn’t taking a full feed as she didn’t seem very hungry.

The plan:

  1. Knock off the 4th nap that existed around 5pm for 45 min. This bumped bedtime up to 5:45 pm. This will depend on when she woke from her last nap – somewhere between 1.45 hr to 2 hr for a 4 mo old. So baby was asleep by 6 pm.
  2. Institute a dreamfeed around 10pm.

I know what you’re thinking… 5:45 pm is way too early to put a baby to bed, and perhaps your partner might not even be home from work yet! Not only that, if you have other children, this can sometimes be right in the middle of dinner time, very inconvenient. However, trust me that it will work.
******It works if you work it.*******

The result:

Baby woke up at 3 am, and then at 7:30 am… happy as a clam. Strategy was successful in getting the baby back down to 1 night feed at 3 am.

Ultimate goal will be that the dreamfeed will become a better feed. When first instituting the dreamfeed, the baby may not eat as much as normal, but once they are used to it, they will. So our goal will be a good dreamfeed at 10 pm and then no night feeds until morning. From 4 months on, this is feasible, if you are comfortable with that. Of course you will listen to your baby’s cues, and assess any unexpected wake ups.

**********Remembering the cardinal rule – if they wake at the same time every night, it is usually out of habit. If the time of the wake up changes, then its hunger.

When your baby’s night time wake up patterns change, give them 3 nights to observing and recording to see if patterns are emerging. We feed hungry babies.

Take away points:

  • Sleep begets sleep. The more well rested, the better they sleep, the more they sleep, and the easier it is to get them to sleep.
  • An earlier bedtime can be an essential key in eliminating night wakings. Don’t be afraid of putting baby down early.
  • Follow your age appropriate wake times, and your baby’s cues.

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