4-Month Sleep Regression

What Is the 4-Month Sleep Regression?

At around 4 months, a baby’s brain and body are developing rapidly , and the process of forming and linking different areas of the brain and nervous system may create instability in sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , referred to as a sleep regression.

A newborn needs between 16 and 18 hours of sleep per day Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source , which typically comes in one to three hour segments Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source throughout the day.

This starts to change by around 3 to 4 months of age when a baby’s sleep starts to consolidate, meaning that they begin to sleep for longer periods at a time. While multiple naps are still the norm, they may have longer nighttime sleep sessions and sleep fewer total hours.

Do All Babies Have a 4-Month Sleep Regression?

Not all babies have a 4-month sleep regression. Research has shown that there’s a considerable amount of individual variation in infant sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Some babies may have no detectable sleep regression at 4 months, while others may have difficulty sleeping at this age or a few months earlier or later.

What Causes a 4-Month Sleep Regression?

A 4-month sleep regression can occur because babies are in the midst of a major transition away from a newborn sleep pattern. That transition isn’t always smooth and may have plateaus or setbacks like sleep regressions. There is typically no single cause for a 4-month sleep regression, but some contributing factors may include: 

• Separation anxiety
• A greater awareness of their surroundings, which can result in overstimulation
• An uneven transition into consolidated sleep
• Disturbances in the infant’s sleep environment

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What Are Signs of the 4-Month Sleep Regression?

At about 4 months old, some babies show signs of worsening sleep. Your baby may display some sleep-related symptoms that can indicate a sleep regression. 

• Difficulty falling asleep: It may take longer for your infant to initially fall asleep. They may also appear restless around the time they normally settle down for bed.
• Frequent nighttime awakenings: After putting your infant to bed, they may wake up during the night more often. These nighttime awakenings may be accompanied by crying or fussiness. 
• Irritability upon waking: Disrupted sleep during a 4-month sleep regression may cause irritability or crying when the infant wakes up. 
• Reduced total sleep time: You may notice that your baby is sleeping less overall, both at night and during the day. It is also common for feeding schedules to be disrupted during a 4-month sleep regression due to this shift in sleeping patterns. 

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What Can Caregivers Do About the 4-Month Sleep Regression?

There’s no single solution to a 4-month sleep regression. Instead, caregivers are encouraged to cultivate healthy sleep routines and habits for their baby. These tips can help in the short-term and also create a framework for healthier sleep as your baby grows.

Adhere to Safe Sleep Guidelines

As you consider making changes to your baby’s sleep habits, make sure to review guidance for safe sleep Trusted Source National Institutes of Health (NIH) The NIH, a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency — making important discoveries that improve health and save lives. View Source and reducing the risk of sudden infant death syndrome (SIDS). Some risk reduction techniques for SIDS include removing soft items from the baby’s sleep space and putting the infant to bed on their back, according to the American Academy of Pediatrics (AAP). 

Create a Sleep-Wake Routine 

Establishing distinct routines during both waking and sleeping hours can help adjust your baby’s internal clock and encourage nighttime sleep. During the day, keep your baby active with playtime and provide access to natural light. 

At night, allow your child to experience falling asleep in bed, as opposed to falling asleep somewhere else and then being put in bed. This can help them associate their bed with sleep and get them accustomed to falling asleep in bed on their own, which can help with self-soothing during nighttime awakenings. Feeding your baby shortly before bed can ensure they can stay asleep longer before their next feeding. 

Your baby’s bedroom should be dark, quiet, and calm so that there are fewer sources of stimulation, distraction, or disturbance.

Help Your Baby Get Sleepy

Relaxing activities like cuddling or rocking can promote sleepiness. Try to identify signs like fussiness or eye rubbing that can indicate that your baby is tired. This can be a cue to start your bedtime routine so that you can put them in bed while drowsy.

Gently Encourage Your Baby Back to Sleep

If your infant wakes up during the night, it’s important to gently encourage a return to sleep.  You may want to wait a minute before comforting them to see if they are able to self-soothe and fall back asleep. If you need to feed your baby during the night, try to do so as quickly as possible while keeping the room dark and quiet. As soon as they are fed, avoid playing with them or stimulating them and put them back to bed to return to sleep.

If your baby cries from separation anxiety when you put them in bed, resist the urge to pull them back out of their crib. Try being comforting and reassuring, lightly rubbing their head while talking in a soft, soothing voice until they calm down, at which point you can quietly walk away and let them fall asleep.

Self-Care for Caregivers

Self-care is an important part of parenting, and that includes recognizing that nighttime awakenings or sleep regressions are common in babies.

Caregivers should set realistic expectations and remember that it takes time for babies to develop stable sleep patterns. Many babies do not sleep through the night even at 12 months Trusted Source Pediatrics View Source , so caregivers should avoid blaming themselves if their infant wakes up in the night. Self-care also includes considering tips to help parents get the sleep they need to feel more rested despite their baby’s sleep schedule.

When Should You Talk to Your Pediatrician?

Talk to your doctor if you have concerns about your baby’s sleep or increased nighttime awakenings. It is important to consult with your pediatrician Trusted Source American Academy of Pediatrics (AAP) The AAP and its member pediatricians dedicate their efforts and resources to the health, safety and well-being of infants, children, adolescents and young adults. View Source if you also notice:

• Lack of growth or weight gain
• A reduced number of feedings
• Changes, especially reduction, in urination or bowel movements

Parents should also discuss any abnormal breathing during sleep with their pediatrician.

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