The Four Month Sleep Regression/Nap tips

The four month sleep regression

Ah, the dreaded 4 month sleep regression. I get calls about it all of the time. Noe Valley Pediatrics Dr. Elizabeth doesn’t like to call it a regression and she makes a good point. Think of it as moving into a new phase. Similarly, Parentline founder and clinical psychologist Dhara Meghani says, we tend to encourage parents to think about the 4 month sleep regression as a time of reorganization, rather than a setback. An (imperfect) analogy is to compare it to when you are cleaning and reorganizing your closet or kitchen cabinets. Often times we have to pull everything out, may have to shuffle things around, discard what no longer fits, and even install some new hardware to make the storage more efficient. The brain does exactly this every few months during infancy, and even years into development -- it goes through what we refer to as phases of "synaptic pruning" in the service of increasing efficiency and speed of important neural connections. So while there is all this work occurring underneath the surface, what may temporarily go by the wayside are the infant's developing skills of falling and staying asleep, feeding fully without being distracted, and being consolable when overtired, cranky, hungry, or bored. While your baby's brain is going through this enormous growth spurt, they are more aware of everything around them. You might find that they pop off the breast or bottle more frequently to pay attention to their surroundings. There are lots of developmental changes going on. Babies are trying their best to roll over, but usually can only flop over from tummy to back. Daily tummy time exercises are even more important now so that they can work on mastering the roll in both directions. In the first few months of life there is usually no real set schedule. Babies eat, they snooze, they are awake for a bit, maybe another snack and then some more sleep. Ideally you have made a clear distinction between daytime and nighttime feedings and have encouraged longer stretches at night. But here you are, your baby seemed to be doing pretty well. You were getting a nice enough stretch at night that you couldn’t tell your other friends with young kids without sounding like you were boasting. Now, just when you thought you were about to see the light after this stretch of new parent sleep deprivation, suddenly horrors, your previously good sleeper is back to waking up at night. This phase will vary from baby to baby. Sometimes it is only a night or two, and for the more unfortunate, it can last a few weeks. The not knowing how long it might last adds a degree of frustration. Let’s consider some of the more obvious causes of what could be stopping them from going back to sleep when they have those middle of the night wake ups . Step one is making sure that they have some self soothing skills! The sleep cycles are becoming a bit more like those of an adult, with the light sleep, deep sleep and REM. When babies hit those light cycles they may wake up. It is essential that they have the ability to get themselves back to sleep without relying on you. If you put your baby to sleep with help, nursing and rocking rather than letting them drift off to sleep on their own, then when they become aware of their surroundings and you are no longer present, they are going to object. Shooshing and quiet singing with a hand on their chest may be a nice compromise. Your message is, “you are fed, your are changed, I am right here. You need to sleep.” Right from the beginning (brand new parents, I hope you are paying attention) it is essential that you allow them to do some self soothing. Of course they will fall asleep when they are feeding; that’s fine. But, when you transfer them to their crib and they stir a bit, that’s okay! Don’t return them to the breast; simply give them some little pats, and see if they can settle back down. Every single time that your drowsy baby is able to drift off to sleep on their own it should be considered a win. My mother in law tried to gently give me that wisdom which I soundly rejected. What did she know? My baby wasn’t going to allow me to simply put her down! I nursed and vigorously rocked Lauren to sleep for at least 4 months at which point we (who am I kidding, it was all on my husband!) had to do a phase of tough sleep training to teach her some sleeping skills. Once they are finally asleep, tiptoeing around in utter silence to avoid waking the sleeping baby gets pretty old. Some parents find that turning on a white noise machine for the sleeping period helps. A Hepa filter works well for this and serves a purpose at the same time. Soft music playing is another option. If you have Alexa she can play some nice lullabies for a set period of time. If they can learn to sleep with some background noise you won’t have to worry so much about them waking from a sudden sound. Baby might be hungry. My sleep advice doesn’t get terribly strict until they are getting some extra calories during the day with the addition of some solid food. Until they seem ready for that, I would consider offering a dream feed before you go to sleep. If your superstar was giving you 9-10 hours without a meal before this unwelcome change in their sleep pattern, do not go down the slippery slope of offering extra meals at night aside from that dream feed. If you offer them more frequent nursing, I would imagine they will be happy to accept it. That doesn’t mean they need it. At this age, the body benefits from a break from digesting at night so that it can concentrate on other growing tasks. Is it dark enough? Try to make the sleeping room as dark as possible. Making sure that you have blackout shades or thick curtains can extend your mornings and help out at nap time. Make sure they are not over tired! This is also when you can start establishing a more regular nap schedule. A 4 month old should be getting a total of 13 -16 hours of sleep in a 24 hour period.This ideally includes 3 naps a day. More often than not, 2 of the naps tend to be shorter and there is one longer one. Some babies absolutely don’t seem to need quite as much sleep as others, but if you have a cranky kid on your hand, I am going to suggest you make sure that their sleep schedule is adequate. You might think that a baby who didn’t nap well will catch up with a great night sleep, but you would be wrong. When a baby is overtired you are trapped in a nasty cycle. The first nap is usually about 2 hours after their morning wake up. The second nap is about 2 & 1/2 hours after they wake up from nap number 1. The third nap is 2 & 1/2 hours after nap number 2, but it is essential that the 3rd nap is over before 5 pm or it will interfere with bedtime. If you are lucky you can get into a grove with this for a couple of months. At some point between 6-9 months they usually get rid of the third nap and go down to 2. Naps don’t need to be written in stone. I don’t think you need to be pinned to the house because of a nap schedule. Second babies don’t have that luxury and nap on the go. If you are lucky enough to have a baby who snoozes in a stroller or carrier, that can count as a nap as you go about your day and get some errands done or go for a walk with a friend. I would try to have at least one nap that is in the crib. That nap is great practice for letting them drift off on their own. Make it dark, turn on the Hepa filter, sing a song while you do a little massage and then leave them be. Some babies need to fuss a bit as they go down. If they are absolutely screeching when you leave, go back and soothe them. Starting good habits from the start will make everything much easier. Trust me on this. Sleep begets sleep. If your baby still doesn’t seem to be getting enough sleep, you might need to start your bedtime earlier. I understand that this isn’t always easy to do. Working parents want to have time with their babies for a bit in the evening and it can be a challenge. Have a bedtime routine that signals that the day is winding down. Make sure it is calm, this is not the time for jumping around. Having a special song and massage routine right before bed is also a nice way to wind down. Hands, ears, feet are especially relaxing. Pacifiers. I am fine if they use a pacifier to fall asleep. DO NOT get into the habit of replacing it every time it falls out. That is akin to a dog with a ball, it never stops. Room Temperature/sleep suit options Keep the baby’s room somewhat cool and use a sleep suit when swaddling is no longer an option. Because this is the age when babies are growing out of the swaddle, many of my families have found the Baby Merlin's Magic Sleepsuit will help you out of this transition. Dhara sent a few other links to share that look like they are worth checking out. 2. Zipadee Zip: zipadee-zip 3. Puck-A-Baby: puckababy The Puck-A-Baby has a higher price but can follow your child through their early toddler years and through seasons. Try to be as consistent as you can. Remember, any time that your baby has an extended period of tough nights, it could also be an ear infection or something else going on. It is worth calling about a fussy baby if you aren’t able to get things under control. Dhara reminds you: --Get support. If baby's not sleeping, chances are you aren't either. Can you find a neighbor, family member, or friend to come by and help with the dishes or the laundry? Can they take the baby for 15 minutes so you can get a shower in? If you have a partner to split up the shifts at night that can also reduce the burden on any one person. Don’t forget that Parentline is one more terrific resource for parents who are trying to figure things out. It is a free service hosted by the University of San Francisco. More info down in the bulletin board section 1-844-415-BABY Parentline@usfca.edu Thanks so much to Dhara Meghani from the University of San Francisco Parentline for her valuable input and feedback on this post!