Dr. Sarah Mitchell
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The 4 Month Old Sleep Regression: A Case Study

4 month old sleep regression – urban legend or developmental change or something else?

The 4 month old sleep regression; fact or fiction?

We often hear mom’s say their child is going through a 4 month sleep regression. Is this an actual entity or an urban legend. My little one just turned 4 months and there have been a few changes in her that I’ve noticed.

  1. Increased awareness and attention – at this stage of development, your LO (loved one) is becoming more and more aware of the world around her. This is a lovely parenting stage as the smiles come easily and the giggles are heart melting. “This is the best stage”, I would hear myself exclaim, on a high from her connectedness. This increased awareness of surroundings is one of the reasons that I believe it is important to lay down good sleeping habits before 4 months. A lot of authors out there say no sleep training before 4 months. The nuance here is “sleep training”. There is such a variation on what sleep training is that I find this sweeping statement to be too vague, and a disservice to many parents.There are lots of things you can implement before 4 months. This involve creating opportunity and expectations, without creating any stress or anxiety for you or your little one.
    For example, if I rock my child to sleep every time its bedtime, that will become one of her expectations associated with sleep. However, if I lay my child down awake at each sleep time, this provides her with the opportunity to learn how to soothe herself to sleep, and it creates the expectation that I will not be rocking, nursing or holding her to sleep. She is responsible and able to put herself to sleep. Of course, there will be times that she needs help. However, without giving her the opportunity to soothe herself, she will ALWAYS need that sleep crutch. If you have been nursing, rocking, holding your child to sleep, at 4 months you will notice an increase in night time wakes. This is due to increased awareness of her surroundings. She wakes up and wants Mom, or someone, to put her back to sleep with rocking, nursing etc because she knows no other way.
  2. Consolidated Night Sleep – at this stage, your LO will start to develop a regular wake up time. Usually sometime between 6 and 7 am, where previously it could have been between 7 – 9 am. This earlier wake up time can seem like a big jump for Mom and Dad.  Bedtime will shift from 9 pm up to 7 pm.
  3. Naps transition from 4 to 3. Somewhere around 4 -5 months, your child may start to move from 4 naps down to 3 naps, and their bedtime becomes earlier, between 6:00 and 7:30 pm. During any nap transitions, parents and baby are working on adapting their schedule and the opportunity for overtiredness, due to not reading her signs accurately, can occur. Night wakings are a huge sign of overtiredness. Not getting enough daytime naps in, or having a bedtime that is too late. Many new parents reason that if you keep a baby up later, they will sleep more soundly or sleep in later in the morning. This is actually the opposite. Rarely will a child’s wake up change due the time they are put to sleep. Keeping them up past the “window of opportunity” to go down easily, will make them overtired. This results in night wake ups, not to mention a long process of getting them to go to sleep in the first place.

The 4 month sleep regression probably does exist due to the factors mentioned above. It will vary from household to household based on the baby’s aptitude to be able to soothe themselves to sleep.

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 mo sleep regression can be caused by:
– increased alertness
– 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:

  • 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.
  • Institute a dreamfeed around 10pm.

I know what you’re thinking… 5:45 pm is way too early to put a baby to bed. 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.
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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