Four-month sleep regression results in a sudden change in sleep patterns that may cause worry in new parents. It is a condition where four-month-olds, who had previously been sleeping well, suddenly begin waking up at night and have trouble falling back asleep.
Sleep regressions are characterized by unexplained disruptions in the baby’s sleep patterns. They are frequently reported but rarely studied. Usually, these regressions coincide with the age for major developmental brain changes. While there is no staunch medical evidence for its occurrence, sleep regressions do occur according to anecdotal evidence.
The sleep regression phase can be difficult for parents and caretakers. It may last for a few days to a couple of weeks. However, it is a normal developmental phase.
Read this article to learn the signs of regression and how to handle your baby during this phase.
Why Do Some Babies Go Through Sleep Regression?
Sleep regression can occur at any age, but it is most common at 4, 6, 8, 12, and 18 months. Not all babies experience sleep regression in their fourth month. Research states that there is a significant variation in the individual sleep patterns in newborns (1). Some babies may experience sleep regression due to the following reasons.
- Changing sleep patterns
The sleep patterns in newborns vary according to their age. Newborns tend to sleep for 14–16 hours a day in short intervals. By the age of four to 11 months, babies generally sleep for 12–15 hours a day (2). This change in sleep patterns during the fourth month might result in sleep regression in some babies, as the total time spent sleeping per day is reduced.
- Rapid brain growth and physical growth
Sleep plays a vital role in a newborn’s brain development. During sleep, their brain releases growth hormones, helping in growth and tissue repair. In some babies, sleep regression may be caused by the rapid growth of the brain, a physical growth spurt, or a developmental milestone, such as rolling over, grasping objects, or kicking their legs. The physical growth spurt could lead to frequent awakenings for feeding at night (3) (4).
- Awareness of their surroundings
During the fourth month, your baby becomes more aware of their surroundings and may make sounds such as “coos” and “ah-goos” (4) (5). They also start adjusting to daylight, artificial light, and feeding. Such developments may also result in sleep regression. As they become more aware of the surroundings, they might wake up in between to check if the environment around them is safe. When something doesn’t feel right, they may not drift back to sleep and start crying.
What Are The Signs Of Four-Month Sleep Regression?
Some babies may not show any signs of sleep regression, while others may have difficulty falling asleep at four months or later.
Here are a few signs of sleep regression to help you identify it (6).
- Frequent night waking
- Difficulty in falling asleep
- Fussiness and frequent crying
- Reduced total sleep in a day
A four-month sleep regression could occur suddenly and out of the blue, causing worry to parents. It could also be hard on the parents as it leaves them sleep-deprived. But remember that sleep regressions are normal and are seen in healthy babies.
When Does The Four-Month Sleep Regression End?
Although it may feel perpetual, sleep regression does end in a few weeks. However, it depends on how well you manage it and help your baby get back to sleeping peacefully (6).
Read the next section to learn how to manage the four-month sleep regression in your baby.
How To Manage Four-Month Sleep Regression In Babies?
Sleep regression can be hard to handle because it is a sudden development in an otherwise peaceful sleeping baby. It is important to help your baby fall back to sleep and try to develop a set sleep pattern.
There is no sure-fire way to reduce the four-month sleep regression in babies. However, parents may try the following steps to help develop healthy sleeping patterns in babies.
1. Look for sleep cues.
During the period of four-month sleep regression, it is imperative that your baby catches up on some sleep. Try to identify sleep cues such as yawning, rubbing of eyes, fussiness, quietness, not wanting to play, crying, and clenched fists and settle your baby to sleep (7).
2. Give them time to explore new skills.
At four months, your baby starts to learn new skills, such as reaching out to hold things and rolling over. It is best to give them time to explore and practice these new skills during the day so that they do not try to practice them when you lay them down to sleep at night.
3. Stick to a routine.
This step could be difficult when your baby is going through the four-month sleep regression. Nevertheless, try to stick to their regular bedtime routine. This might help them get back to a normal sleep cycle once the sleep regression ends.
4. Attend to their needs quickly.
Your baby might wake up during the night due to hunger or a wet diaper irrespective of sleep regression. If your baby is crying because of these, make sure you attend to their needs as quickly as possible.
Make nighttime feedings and diaper changes quick, and avoid talking or playing with your baby when they wake up at night. Do not use a bright light or a mobile screen as it can stimulate the baby.
5. Create an optimal atmosphere.
Try to maintain a quiet and dark environment in the nursery. Make sure your baby feels safe in their crib such that even if they wake up in the middle of the night, they can learn to self-soothe back to sleep.
You could also give them a warm bath, massage them, play soothing music, minimize stimulation, and dim the lights at least an hour before sleep to help them fall asleep.
6. Help them self-soothe.
Some babies can soothe themselves back to sleep after waking up at night, whereas others need the caregiver’s help to soothe them. During the four-month sleep regression period, your baby might wake up multiple times during the night. If you rush to take them in your arms, your baby may get accustomed to it. Instead, help them self-soothe.
Do not lift your baby as soon as they cry. Sit by their side, try to hush them by gently patting them, and reassure them that everything is alright. If this does not work, you may pick them up and soothe them to sleep.
7. Feed them adequately.
Ensure your baby is adequately fed before you put them to bed, so they do not wake up at night due to hunger. At four months of age, your baby may not need frequent nighttime feeds, so stick to a strict feeding schedule. Do not use feeding to get them to sleep during the night awakenings, as it might become a habit.
Also, as your baby starts to pay attention to the world around them, it is easy to get distracted and stop feeding midway. Try eliminating distractions while feeding, and make sure they have a full tummy every time.
8. Be gentle with them.
It can be quite challenging to deal with the four-month sleep regression, but remember, it is a part of your child’s developmental process. Do not show anger or frustration towards your baby; instead, shower them with hugs, cuddles, and kisses to comfort them.
9. Seek help from family and friends.
Dealing with sleep regression takes a lot of patience and perseverance, and it is fine to feel overwhelmed at times. Whenever you think you cannot take it anymore, ask your family members or friends to take over while you get some alone time to reboot.
10. Identify the changes in sleep patterns.
During sleep regression, parents often worry if their baby is getting enough sleep. Now that your baby is four months old, they will sleep for 14–15 hours and take three to four naps a day, unlike the 16–17 hours of sleep when they were newborns (2). So, keep track of their sleep timings to avoid unnecessary worrying.
When To Call A Doctor?
Although four-month sleep regression is common, sometimes, there could be underlying medical conditions, such as colic and gastroesophageal reflux, which could lead to sleep disturbances in babies.
Contact your pediatrician if your baby:
- Cries continuously, and no amount of soothing works.
- Has abnormal breathing, such as gasping for air during sleep.
- Is too lethargic and does not wake up for feeds.
- Is not gaining weight.
- Has not developed expected milestones for their age or has lost milestones that they had previously attained.
- Shows major behavioral changes.
Frequently Asked Questions
1. Do babies sleep better after 4-month sleep regression?
Babies may sleep better only if good sleep habits and a sleep routine are practiced.
2. Do I let my baby cry it out during sleep regression?
You may try the cry-it-out method to put your baby to sleep. However, you should continue checking on them and feed them if required (8).
3. How can I tell the difference between a growth spurt and a sleep regression?
Four-month sleep regression causes unexplained disturbance in the sleeping patterns of the baby. Progressive developmental changes and reduced sleep requirements with age may cause frequent night awakenings and difficulty falling asleep. Maintain a proper sleep routine and do not stimulate the baby by talking or keeping bright lights on when you identify their sleeping cues. Feed them properly before sleeping but avoid breastfeeding to help them fall asleep during the night awakenings, as it might develop into a habit. Take time off if you feel frustrated and seek help from family members as it may take some time to set things right.
- Rapid brain growth and development and sleep patterns can cause sleep regressions in babies in the 4th month.
- Problems with falling asleep, fussiness, and reduced total sleep time are some common signs of sleep regression.
- Looking for sleep cues, setting bedtime routines, and letting them explore their new skill may help manage this condition in infants.
2. Elaine KH Tham, Nora Schneider, and Birit FP Broekman; Infant sleep and its relation with cognition and growth: a narrative review; Nature and Science of Sleep (2017).
3. Macall Gordon; From Safe Sleep to Healthy Sleep: A Systemic Perspective on Sleep In the First Year; University of Washington – School of Public Health (2018).
4. Your baby’s sleep at 3-6 months; Wirral Community Health and Care – NHS Foundation Trust
5. 3-4 months: baby development; Raising Children Network
6. 4-Month Sleep Regression; SleepFoundation
7. Sleep 0 – 3 months; Department of Health – Government of Western Australia
8. The 4-Month Sleep Regression; What Parents Need to Know; Cleveland Clinic9. Cluster Feeding and Growth Spurts; WIC Breastfeeding Support
10. 4-Month Sleep Regression; Sleep Foundation
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Dr. Pooja Parikh(MBBS, DCH, DNB)
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