The Four Month Sleep Regression
What Is It?
Many parents will come to me raving that their 3 month old has been sleeping through the night for a month, and mostly it's been smooth sailing when it comes to sleep, for now. Part of me wants to celebrate that victory with them and the other part of me wants to give them a sympathetic hug because I know it's only a matter of time until it all falls apart. The four month sleep regression typically makes its appearance between 14-19 weeks for a healthy term baby. This sleep regression coincides with a very important developmental leap, in fact, it is the largest transitional period they will go through since birth. You may have noticed some other fussy developmental stages prior to now which typically occur as a newborn, at three weeks old, and around six to eight weeks old. Around the four month sleep regression, sleep takes such a big hit during this developmental period, hence the name behind it.
A regression is often an indication that your baby is about to go through a developmental milestone. Brazelton Institute refers to these as touchpoints, or "predictable periods of regression and disorganization that occur before bursts in a child's development." The four month sleep regression happens as a result of an extremely large developmental burst occuring in baby's brain. They're working super hard to master so many skills. Each of their senses are engaged and they studying the world around them using all of their senses. Significant changes are happening as baby is becoming more cognitively aware, and working to conquer new skills.
What Is My Baby Learning?
Your baby may be learning to roll over at this point. Perhaps they were only rolling one way before and now they are rolling both ways. Continue practicing tummy time and you may start to notice your little one pushing up with their elbows or holding their head up with more strength. Your baby has probably already discovered their hands, but now their feet are a whole new level of fun for them. This time can be so exciting because they begin to be more vocal with babbling, coo's, and little giggles. Motor development is a big one this month as they are working at bringing things to their mouth, and grasping for objects. You may think they are teething, and they could be, but chewing on hands, toys, and objects is a natural part of gross motor development.
With all this newness can come some anxieties and uncertainty about the world around them. You've probably noticed your baby has become more clingy and fussy, possibly even preferring one parent over the other. Strangers may have them second guessing, and feeling a bit unsure. Don't be too alarmed if it seems your baby is happy and then crying the next as they might be cycling through moods quickly. It's very common for your baby to become very distracted during the day while eating. Whether it's older siblings, a door shutting, or someone walking into the room, your baby may stop eating and look around. Your once undistracted eater is now trying to keep up with what's happening all around which can make for less efficient feedings. Try moving to a place that is quiet if possible and encourage a solid feeding. It's still beneficial to get as many full efficient feedings in during the day time as this could help to extend the time between those feedings in the middle of the night.
What Can We Expect?
When you brought baby home you were likely not getting much sleep. Baby's have small tummies about the size of a marble. They need to eat frequently to make sure they are gaining weight. As baby grows so does their stomach, but it takes time for time between feeds to lengthen. You may have noticed you were starting to get some longer stretches of sleep at the beginning of the night. Once baby woke to eat, he most likely went back down without much of a struggle. Now, you may find it more difficult with night wakings to get the little one back to sleep. Between two and four months it's possible you were getting those longer stretches and now you're back to waking every couple of hours again all night long, you may be asking yourself what is happening? This my friend is likely the dreaded four month sleep regression making it's not so welcomed appearance.
Sleep disturbances are a result of everything going on in your little ones busy brain. They will likely be resistant to sleep, waking more frequently which in turn may result in you feeding more often, because let's face it you're not sure what else to do and you've tried it all. They may be more difficult to settle upon waking in the middle of the night, and they also may be awake for longer stretches, they really don't care if it's 3:30 in the morning, but you might!
This regression is a tough one, there's no doubt about that. If you've had a little one that sailed through it with minimal sleep disruptions, consider yourself one of the lucky few. Many times parents will say "my baby has been sleeping through the night since 8 weeks old". This is so great and should be celebrated because that means much needed rest was had by all, but it's usually short lived. Once the sleep regression shows up at your cribside, it's usually there to stay for a week or several. This is challenging so do not feel guilty or alone if you're overwhelmed or frustrated with this new shift in behavior as well as sleep. It may feel like the newborn stage all over again, just as you thought you were coming out of that funk.
Try Not to Stress
A common concern for many parents especially nursing mothers is that the new regression in sleep is due to a low milk supply, or a food allergy, possible hunger or an aversion to their crib, or even being scared. Many parents question if there is an underlying issue such as reflux, illness, teething, or baby just doesn't feel well. Always check with your pediatrician or medical provider if you are concerned about any issues with your baby and rule out anything that might help put your mind at ease. All of these fears and concerns are normal. Babies can't tell us what they need or communicate very well with us at this age. They communicate through cries, touch, and body language. Try to read your baby best you can but understand that much of what is going on inside their quickly growing brains is affecting them in a tremendous way. It's a normal reaction to feel at a loss of how to help them when it comes to sleep.
It is common for parents to feel like their routine is basically non existent, and any sort of schedule you may have had going just isn't working anymore. It is normal for baby to be resistant to sleep. It doesn't mean that sleep shouldn't still be a priority, just do your best to offer naps and stick to as much of a routine as possible. Pay attention to your baby's awake windows and their sleepy cues. Try to keep your baby from becoming overstimulated or overtired as this will make them even more agitated and resistant to sleep. Remember, the more day sleep that can happen will usually result in a less stressful bedtime and fewer middle of the night wakings. It's going to take some time to get baby back on track so don't stress yourself out if things seem to be all over the place right now. I'm here to tell you you're right where you should be at this point in time. You are doing nothing wrong. Your baby is working super hard to master so many new and exciting skills. Their brain is developing and your job is to help them through this transitional period.
Babies will need some assistance from you while they master these skills. Now that you know what is happening you may find it fascinating to watch them and discover they are really trying hard to do all these things. The sleep is temporary and it will pass. There is no magic way to go around the four month sleep regression, you just have to get through it. Try keeping your baby on a routine as much as you can. Regardless if they are fighting sleep, continue to offer enough naps (three, possibly even four, naps a day at this point). The brain repairs itself and does so much growing during sleep cycles. During this developmental leap, sleep is so important. I know you're thinking "okay, now tell my baby that". Try getting naps in however you can if they are not in the crib try offering them in ways you know they will sleep such as a car ride, a carrier, or a stroller walk. At night you may find yourself up a lot more, which is normal. This isn't the time to let them figure it out, they aren't cognitively able to self soothe until after this developmental milestone. Instead, offer reassurance and comfort. Try and encourage them to sleep with as little assistance as possible with patting, shushing, and a reassuring hug. Stay at their bedside as they fall asleep helping them to feel secure.
When Can We Start Sleep Coaching?
Once your baby is five months old they could potentially be ready for sleep training. Not all babies hit their developmental milestones at exactly the same time. Five months is the earliest I will coach a child for full sleep coaching because getting them through this large developmental leap is important. They will be ready to learn new skills, and cognitively able to self soothe. The organization of sleep cycles begins to fall in place, sleep becomes more adult like with more non-REM sleep, and self regulation skills emerge. There are many reasons waiting to do full sleep coaching is beneficial after the four month sleep regression, when a baby is at an ideal developmental stage to do so. I don't recommend nap coaching prior to 6 months of age because day sleep is still unorganized until the end of five months. Day sleep is still unpredictable, but once nights fall into place naps may soon follow without needing too much assistance. Night sleep is the first to organize, and once it does it can often help naps to work themselves out.
There is plenty that can be done prior to five months to establish healthy sleep habits, optimize longer stretches of sleep at night, working on putting baby down drowsy but awake, and get baby on a more predictable eating and sleeping pattern. Educating parents about wakeful windows, sleepy cues, and many other factors that affect sleep are an important part of sleep coaching in the early months. If baby is colicky, many times seeking a sleep professional can help you relieve some of these symptoms as an overtired baby can mimic a colicky baby.
Hang In There
You may have thought this article was going to give you tips and tricks of how to bypass the four month sleep regression. Sorry to say, no can do. Setting realistic expectations for your baby's sleep during this transitional period is helpful. Remind yourself it's not forever, it will pass. It makes it a little easier knowing that your baby isn't just a bad sleeper, in fact, they're right on track developmentally and they are working harder than they have to master lots of fun new skills they're excited and ready to show you. We can't go around these developmental stages, but likely with them will come a regression of sorts. Helping them get through it is all you can do, and trying to keep a flexible routine will help them to get back on track once they come out on the other side.
If your baby is still struggling with sleep contact firstname.lastname@example.org to schedule a free phone call to discuss if sleep coaching is right for your family so you can all have sweet dreams once again.