Sleep regression

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Advice for babies and toddlers who sleep regress.

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Advice at different ages and stages:

4 months

Toddler

Resources

 

4 month sleep regression

 

As the original poster writes:

"[My child] had progressed to waking max 3 times a night, usually 2.
Now, he’s up every hour, or every hour and a half. He wakes up starving. I feed him and he goes back down fairly easily. Initially I thought it was a growth spurt, but it’s continued past the one week mark.
I have him on a rigid feed-wake-sleep schedule during the day, and a pretty consistent bath-books bedtime routine. But, I haven’t tried cry-it-out yet, or any genuine sleep training. I’ve tried putting him down drowsy and waiting 10 mins but he always ends up screaming the entire time and I cave around the 6 minute mark. I’m not sure how many more sleepless nights we can do.
Any suggestions/tips? I’m open to anything. I’d love to hear, in particular, strategies that have led to consistent and prolonged sleep (over 6 hours) and any insight into what comes after the sleep regression."

 

Replies:

 

"We experienced something similar around 3 months...up every hour (or more) wanting to nurse, etc.  I was so sleep deprived and just looking for any sort of relief.  It was clear that he wasn't really hungry because even after drinking a 4oz bottle, he would still wake up an hour later.  He was comfort eating.  Our pediatrician confirmed that [my child] didn't need to eat every hour (and conceivable could go all night without eating at his then age and weight).  She suggested that we feed him twice during the night - once after 1am and another time after 4am - and then let him cry it out at all other times.  Alternatively, if you don't want to do cry it out, you can go in and comfort (rock, hold, paci, etc.), but still don't feed except once after 1am and once after 4am.  If you're going to do the comfort option, perhaps someone other than yourself can do it (because being comforted by the person who usually has the milk may be confusing!).
We did this with relative success.  We let [my child] cry at all time except for the two feedings.  The first few nights were rough (I let my husband handle it because I could not stand to hear him cry), but we definitely saw progress after a few nights and by the end of the week, he was only waking once or twice to eat and settling himself back to sleep much better after feedings.  We also used our judgement in terms of when to feed.  For example, there were a few nights where the crying ramped up around midnight so rather than waiting until 1am we may have fed at 12:30...but only feeding twice a night and not feeding every time he cried and letting him cry it out a bit, helped break the crazy waking every hour cycle.
In full disclosure, we did have a brief regression after the initial success but that was due to sickness/sleep issues with older brother/husband traveling, etc.  Once back on track, we settled into a groove and while he still wakes up to eat even now at 5 months it's only 1-2 times per night and he settles right back to sleep after he eats (now if only his older brother would sleep so well!).  We just started solids and I'm hoping that as Liam eats more during the day, we can start to give up the night feedings with relative ease (fingers crossed!).
Whatever route you choose, I will echo what my pediatrician and other moms have advised...make a plan with your partner in the light of day, make sure you are both on board and committed and give it at least 3 days/nights!"

 

"Couple of things:
1. He may be going through a growth spurt. Lots of things change at 4m. And/or early teething - movement of teeth inside the gums before they start showing.
2. He may need more awake time during the day - stimulation, playing and looking around etc that would make him tired at the end of the day.
3. Make sure he has solid naps during the day - around this age it's usually 2-3 naps: morning, afternoon and sometimes late afternoon/early evening. This also helps with night sleep. 
You can also at this point try to "stretch" the time between the night feedings with a help of a paci - he may not be hungry but just looking for comfort, and with the paci he'll be able to skip one night feeding and be hungry enough at the next feeding to eat well so he doesn't wake too quickly for the following one.
Hang in there! Next big thing is teeth!!!!"

 

“Our [child] just turned 4 months yesterday so we're not in the thick of it yet, but when we asked our pediatrician at today's checkup how to prepare ourselves, she heavily suggested not increasing night feedings because that could strengthen the eating=sleeping association, making it harder to fall asleep without nursing. She said to just comfort with cuddles and rocking and all that. In our case she mentioned that since we were dealing with bottle refusal for a while when I returned to work, allowing her to eat all night could bring back bottle refusal during the day. I don't know if her advice will work for us, but I figured we'd share what we heard.”

 

"We bedshare and it's amazing for getting sleep (she's 6.5 months now) - she sleeps great cuddled next to me and I honestly couldn't tell you how many times she wakes during the night because neither of us really fully wakes up. Basically with bedsharing all those frequent wakings don't turn into crying/getting up because when baby realizes they're right next to you they just go back to sleep or dream feed a bit and fall asleep. I usually get into bed with [my child] between 8:30-10:30pm (depending on what time she falls asleep nursing), and once she's pretty deeply asleep in my arms/on the boob, I lay her down in the bed next to me (we have an attached co-sleeper so if she rolls she'll just roll into that and not off the bed), usually at that point if I want to get back up to brush my teeth or do something she'll tend to stay asleep by herself in the bed for anywhere from 30 minutes to 3 hours (with me closely checking in with our bedroom door open and nowhere to fall from and no loose pillows or blankets). Other nights I just go right to sleep with her. She pretty consistently sleeps in until about 8:30am (sometimes as late as 9am) so I am able to get as much as 8-10 hours pretty solid sleep cuddled next to her. I'm only really aware of her "waking" and finding the breast maybe once or twice at most during the night (and I put "waking" in quotes because she doesn't even open her eyes or cry more than a tiny little grunt, just wiggles to find the breast and I only wake to the extent of half asleep barely opening an eye, maybe adjusting my shirt/boob and then dozing back off - I don't think I'm awake more than 10 minutes in the night, if that).
Anyway, that's just us - bedsharing isn't for everyone but I think it is an underutilized arrangement in the US (its the norm through much of the world outside of the US/Canada and Western Europe). If the idea piques your interest there is good info for safety and practicalities of bedsharing in the book Sweet Sleep by La Leche League as well as Dr James McKenna's website for his mother-infant sleep lab at the University of Notre Dame.
Also an alternative view of the 4 month 'sleep regression.'"

and:

"I'll second the co-sleeping option. It's been a lifesaver with both our kids and we definitely all get more sleep than if we had to go comfort a crying baby in another room. Babies are designed to both wake and eat at night and co-sleeping had made that easier for us. Totally personal preference but it's one option.”

 

“Sorry you're going through this frustrating time! [My child] is almost 6mo old, so I remember when he regressed, and thinking that my husband and I would never make it alive...
[My child] was co-sleeping in a pack n play right next to my side of the bed, and generally waking 2x/night. He would go down easy at the start of the night, but staying asleep was the issue. I would nurse him, thinking he was hungry, and he would go right back down. But then we started noticing a pattern and realized that he was getting used to the nursing to soothe himself back to sleep! Plus, he is about 20lbs, so he is definitely not needing to eat that much throughout the night!
We recently moved him to his own room and that same night we decided to cry it out. It was heartbreaking! But it WORKED! (for us) The 1st night, he cried for 1hr 45mins and I almost threw the towel in (and cried myself). But we looked it up and read that the 1st night is the worst and that babies can cry for around 2hrs - so 1hr 45mins seemed like a win! We have now gone backwards, since Henry got his 2nd cold and then we traveled for the holidays. But I am actually looking forward to getting back home to Brooklyn tonight to start this all again! And it'll break my heart a little less this time, since I know that he can do this successfully. And we all feel better and more human with more sleep.
I also read this book.
It's a bit difficult to read and focus on the subject of sleep when you yourself are sleep deprived, but it was very informative and I like the way she writes. I'm even going through it a 2nd time to take some notes.
You can get through this! I do recommend making a plan with your partner and sticking with it for at least 3 nights to see if it truly works for you and your family.”

 

 “With both of my kids, we took the four month sleep regression as our cue to sleep train (or sleep “teach”).  Each family has their own approach of course — but if you are planning on sleep training, then 4-6 months is really the ideal time to do it (things get harder once they acquire object permanence).  Both of my kids had been great sleepers but then went back to waking up twice per night around 14/15 weeks of age, so we sleep trained at about 16 weeks.  We used the over the phone services of a fabulous sleep consultant and within a couple days we had handled both nights (7pm-7am) and naps.  Particularly with my second kid we were very relaxed with our approach prior to sleep training — so he was literally swaddled, in rock n play, using pacifier at 14 weeks.  A week later and he was sleeping 12 hours overnight in the crib.  Plus, he’s a much happier baby now that he’s so well rested and on a predictable schedule.  And some weird digestion issues have also resolved now that he’s not eating overnight — it’s much better for him overall.”
View PSP member reviews of sleep consultant recommendations here >

 

"We've been though the mill, and we're heading back. [My child] extended his own sleep, without any training or support from 5 to 7 to 9+ hours weeks 11 - 14. Then: regression. It was so bad we got a sleep consultant, who was great! Literally all of her instructions worked. Here's the routine:
-keep the room pitch black. We already have black out curtains, but we added construction-duty garbage bags to the top of the window where light seeped in. It's behind the curtains, so you can't see it taped up there.
- wake: between 7 and 7:30am
- follow eat, play, sleep routine.
- extend wake times by 15 - 30 min during the day (example: first nap after being awake 1 hour 45 min; second nap after awake 2 hours; 3rd nap, awake for 2 hours 15 min. We also adapt a bit based on Louie's mood and apparent need for play/sleep).
- rigid sleep routine for all sleeps (change diaper, read book, sleep sack, {we add sing short song here}, into the crib, noise machine on, "key phrase" (she has us say the same thing every time, like "rest well, I love you") lights out, leave the room.
- don't respond to mid-nap cries for 10 min (we were already doing 15, so we stuck w that; then we went to 20). If needed, do a "reset," wherein we calm Louie and get him resettled into his nap. After about a wk and a half, he stopped his nap interruptions.
- don't respond to overnight cries for 10 min. Louie stopped eating overnight almost immediately. He was ready for the change, and had already shown us that from his independent sleep-lengthening from the month prior***  I don't recommend going cold turkey on this change in feeding/pumping for milk supply purposes. If anyone has questions, email me separately. It's a whole other long piece of info. I had to spend 2-3 days power pumping to get my supply back up after Louie immediately dropped night feedings two nights in a row.
Bedtime wind-down routine (this is how we've implemented it, although "by the book" was slightly different, as we are less efficient in practice):
- wake from nap #3 no later than 5:50pm
- feed then play
- 6:45 - 7pm: "top off bottle": per the sleep consultant, we give Louie an extra feeding to prep for sleeping through the night. We are still working out the magic # of ounces which work for us. I think... 3?
- bath. It's "warm soak" for us, as we only use soap once/week. Louie loves it! It's much easier than I anticipated. The water immersion experience is such a different experience from anything he did that day, so it's a good cue to expect sleep. 
- PJs
- feed - This was supposed to be the top off bottle, and the other was supposed to be nursing. However, I switched the two bc I didn't have much milk so close to the feed following nap #3. This allowed me to "refill" a bit. I have to be careful not to overfeed Louie with the top-off, or else he won't eat much from me this last feeding, and I end up pumping to both keep up supply, and not be too full/uncomfortable over night
- diaper change
- sleep sack
- song
- crib
- key phrase
- sound machine
- lights out
- leave room
The whole wind-down routine, starting with bath, should take 20 - 30 min, but takes us 45 -50. Bed is supposed to be btwn 7 - 7:45, but Louie often gets in at 8pm. This all worked like magic for about 10 days. Now, [my child] rolls onto his stomach, gets stuck like a beached whale, and screams until we help him. He can keep it up endlessly, too. I'm going to post this recent dilemma to the Advice board to see if people have suggestions."

 

"I will fourth (fifth? sixth?) taking the sleep regression as the time to sleep train (if you're planning to). [My child] went from waking once a night to feed to waking every 45 minutes starting at 4am. When he started doing that, we tried rocking, singing, soothing and then nursing but he'd fall asleep immediately with my boob in his mouth so it clearly wasn't hunger so we just had to hold him to get him to fall back asleep.
Plus he wouldn't go to sleep until 10/10:30pm at night and it was draining us (because of course we wanted some time to ourselves but that meant we weren't getting in bed until midnight). And I could only get him to fall asleep nursing. And he was a terrible napper, so we hoped that once his nighttime sleep was better, his naps would get better. So lots of different sleep issues. We had already stopped swaddling at that point, and he was sleeping in his crib in his room
We got the okay from his doctor at his 4 month checkup that we could drop his one nighttime feeding since he was a hefty 18 pounds and she recommended the full cry it out (or gradual if we couldn't handle the full). So after a week of steeling my nerves and getting lots of encouragement from other moms who had done it, we went for it at 4.5 months. I nurse him, do a bedtime routine (take off his clothes, fresh diaper, massage, pajamas, book, and song - takes about 15 minutes), and then put him down awake.
Night 1
Put down at 7:30pm. Cried 55 minutes.
Woke at 1:48am and cried until 2:03am.
Woke at 5:46am and cried until 5:58am.
We went in at 7am and he was starting to wake up and was very smiley and in a good mood (we were expecting glaring and thoughts of "you bastards!" on his face!)
Night 2
Put down at 7:35pm. Cried for 30 minutes, then quiet for 10 minutes, then kind of whiny crying (not the full throated crying) for 7 minutes.
Woke at 7:11am!!!
Night 3
Put down at 8:15pm (this was my fault!). Cried for 10 minutes and then quiet for 10 minutes before falling asleep.
Woke at 7:11am!!
Now he goes to bed awake and falls asleep within 10 minutes or so. Sometimes he squawks a little, and while we were away for Christmas, it took him a night to get used to a new environment but was still able to sleep. He occasionally wakes around 4:30am and makes some noises but then goes back to sleep on his own. Now when we go in at 7am to get him, he's often awake and we can tell from our baby monitor that he's been awake for awhile but just hanging out quietly in his crib.
Naps are still a struggle but are getting better. Not letting him nap too late in the day is pretty important too. We don't let Nathan nap past 4pm and he goes down at 8pm. We're more or less following the 2-3-4 schedule - first nap 2 hours after waking up, second (longer) nap 3 hours after the first nap, then 4 hours later and he goes to sleep, which is pretty close to what his daycare will be doing when he starts in a month.
The road is very bumpy - we had lots of regressions and roadblocks, but we are all much happier after sleep training. My husband and I get to eat dinner together instead of taking turns and we can even watch (half) a movie in the evening!"

 

"The "top off" bottle of breast milk has been a nice opportunity for my husband to feed the baby - we do about 2.5 oz after the bath. Silas knows what to do when he sees the bottle now, so it's nice to know he'll take one when I leave him as he's otherwise breastfed.
I pump before I go to bed, which recently has been later than I would like at around 11:00 or 11:30pm. I get maybe 3.5 oz average, so that gives me enough for the top off bottle for the next day, plus I have been gradually building a little mini stash in the freezer.
In terms of method, the consultant basically recommended the Sleep Lady Shuffle, where you sit by the crib for the first few nights and gradually move farther away, although she put her own twist on it. We started at 14 weeks. I'm sure every baby is different - Silas seemed ready for independent sleep, and from the first night did not do much crying with this method. At least not at night/bedtime. He will still sometimes cry for a couple of minutes going down for a nap. (See Maria's email for a rough outline of scheduling/routine.) He'll be 5 months old on Monday and is consistently sleeping 11+ hours at night now, and taking two 1.5-hour naps per day, plus a catnap. At Silas's 4-month visit, his pediatrician told us to keep doing what we're doing. We're going to transition to 2 naps at around 6 or 7 months.
We have a video monitor, and since the 4 month sleep regression - or whatever you want to call it when their sleep cycles change - we can clearly see him waking up or rearranging himself multiple times throughout the night. (And often once or twice during a long nap.) The idea is that once they know how to settle themselves into sleep at the beginning of the night/nap, they can do it in the middle when they wake up.
[My child] did well over the Thanksgiving and Christmas holidays while we were staying with family. We're really happy with the outcome of this process, as he wakes up happy and seemingly well-rested, and it has saved my sanity because my husband and I are also able to get sleep. I also appreciate the predictability of his naps because I can get some things done around the house. I was really nervous to try sleep training, though, because I didn't know what to do, which is why I worked with a consultant. I've said this before to the August babies group, but if you don't know what to do or where to start, feel free to reach out."

 

“On the sleeping we did actually do some sleep training before 4 months but it was just to get him to go to sleep when we first put him down for the night. At 4 months his naps fell apart and his night sleep went from decent (1-2 wake ups a night) to terrible (waking every 2-3 hours). We were so tired we resorted to CIO. He cried for an hour but slept for 11 hours the next night and the next. We have had nights here and there where he wakes but he has been sleeping through most nights for the past 2 months ( he is 6.5 months old) and it just took us that one night of letting him cry. On naps from 4-6 months we could only get him to nap in the carrier or stroller. However with the help of our nanny he now is having 1-2 hour crib naps a couple of times a day. She told us there was crying but she only let it go for about 15 minutes. If he cried longer than that she soothed him and if he still wouldnt rest she gave up on the crib nap and used the carrier or stroller then tried the crib nap another time.
That's what worked for us and every baby is different so it may not work for you but I hope knowing our experience is helpful.”

 

"We are having sleep regression too!  In our case, I think it might be teething."

 

"We dealt with this with [my child].  We never quite figured out what caused all the waking - teething?  move to a new home?  new crib? just her age? etc, etc.  We tried a bunch of things (Tylenol before bed) but nothing worked.  She got to the point of waking up almost every hour.  When my husband would comfort her, she'd go back to sleep in about 30 seconds - it definitely wasn't a hunger issue. She was totally exhausted during the day, as were we. After a few weeks on and off of this, when we were so bleary-eyed we couldn't function (!), we ended up letting her cry one night.  It was pretty awful, but I had started to feel like we were making things worse by going in to comfort her.  In any case, after the first night which was very tough, she started sleeping MUCH better - and has slept as long as 9-10 hours at a time.  I'm just hoping it continues as this is all a work in progress!"

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Toddler

 

Here is a similar thread about a toddler suddenly waking up at night. As the original poster writes:

"Our 2.5 year old suddenly started waking up several times a night, occasionally just standing and shouting for us with random demands but mostly crying, usually about nothing or an inability to find a stuffed animal right next to her. She doesn't articulate being scared but we are trying to figure out what's going on- and mostly if this is a temporary phase and we should keep going in and soothing her or whether we need to do some cry it out ignore her. Help!"

 

Replies:

 

“We experienced exact same thing at exact same age. I want my teddy. I want water. Etc etc. finally did cry it out and after a few nights he gave up.
I had this as well and it went on for months! she is in a toddler bed so she would walk out about 5 times a night i was exhausted. I kept thinking its a phase it will end and it went on for months. Then someone suggested a gate in her room and it worked like magic. She cried at the gate for 10 min first night and then started sleeping."

 

“Just wanted to chime in and say that we're experiencing the exact same thing!  We've enjoyed a blissful year of flawless sleep and just in the last few weeks our daughter has started waking at night and giving us a hard time at bedtime. It's thrown us for a loop. Some nights are better than others...two nights ago she woke at 1am and refused to go back to sleep until 4am! And last night she slept through with no problems. Glad to know we're not alone. Must be developmental. Hoping this will pass soon!”

 

“My 2.5 year old is doing the same as well right now.  He's being potty trained as well, but his wake up demands are limited to more Q & A.  We do our best to calm him down and walk him back to his room.  I have a nightlight in his room so I dont think it's related to any fear of the dark.  Friends of mine mentioned it was normal and just to be consistent and patient  - walk him always back to him, dont stay around too long in his room and eventually he will train himself to get back to bed on his own.”

 

“My daughter hit this stage a few months ago right after a trip to CA. This trip included a lot of cartoon watching, and I don't think it's a coincidence that she started waking up more frequently at this point. (She mentioned a "big, scary puffer fish" multiple times at night, which was something that made appearance in an Octonauts episode she watched with her big brother. Oops!) Knowing she was waking due to nightmares, we tried to comfort her by allowing her to come into our room at night and sleep in a cot set up at the foot of our bed. She doesn't come in every night anymore but I know she appreciates the option. Things have settled down considerably but it was a def few brutal months of waking up.

 

"As for nightlights, both of my kids love these turtle lights, which make soothing (and cool) constellations on the ceiling. They aren't that bright and can be set to shut."

 

“We really love these nightlights - like a friend and a nightlight in one! And you can put it on the floor right by her bed (or wherever she demands you put it!).

 

Useful resources and reading:

 

precious-little-sleep

Precious Little Sleep: The Complete Baby Sleep Guide for Modern Parents

12weeks-cover

12 hours' sleep by 12 months old
“The schedule in the book that [PSP member] recommended above, Twelve Hours Sleep by Twelve Weeks, really worked for us and our daughter. We started this schedule right after her 4 month sleep regression/fussy phase and now she is sleeping through the night. As long as she eats at least 24 ounces during the day, sleeps only three hours a day, and is up for 3-4 hours before bedtime, she can make it through the night without waking up. Thanks for the recommendation.”

bedtiming-cover

Bedtiming
“The one thing I'd offer is a great book called Bedtiming that is basically about when to sleep train and the big insight is that 4-5.5 months their development is all about the interpersonal and so it's a really tough time to sleep train but that after that there's a window 5.5-7 months.”

 

Related PSP articles on sleep:

 

Cry It Out vs. No Cry Sleep Solutions

Establishing Schedules and Sleeping Through the Night

More sleep book recommendations and resources recommended by PSP members