The 4 to 6 months sleep milestone:
Throughout their development, babies and toddlers go through "sleep regression".
Why sleep regression?
(note to sleep physiologists, I have simplified the physiology of sleep in this article to make is accessible to all).
Until 4 (sometimes 2) to 6 months, babies' circadian cycle is made of 2 main phases: REM sleep (dream sleep) and a phases of deeper sleep.
As the baby hits the 4 to 6-month mark, the circadian cycle starts maturing into the sleep cycles we experience as adults (4 phases).
This transition is a big change for babies and can lead to many night wakings and parasomnia (crying in sleep but not waking). As the baby's brain goes through the various phases of sleep, the baby experiences those cycles and wakes (please note, some babies are totally oblivious to this!) very frequently. This phase is often occurring in conjunction with acquiring new motor skills such as rolling/ grasping, and the baby will often try and practice at night.
Different needs: during this phase, which can last anything from 1 to 6 weeks, the baby will also experience significant growth leading to more feeding. It isn't unusual for a baby who was a good sleeper and only needed once a night feed to start waking a couple of times a night.
The calorie requirement needs to be met, so it's ok to feed more.
Behaviour: The behaviour of the baby might also change. She might be more irritable, cranky, wants lots of cuddles & one to one interactions.
Tips to get through this phase: This is when the routine becomes important. Whatever is implemented now will have its benefits/repercussions later.
- Daytime naps should not be skipped & bringing bath time/bedtime earlier might be necessary at this age.
- By the late afternoon, the baby is so tired that her cortisol (stress hormones) levels creep up, which inhibits melatonin production (sleep hormone).
- Using blackout blinds might be necessary to ensure the maximum production of melatonin. Any light, even dimmed, can inhibit its production.
- Avoiding all sorts of blue light, including "baby projectors," as they inhibit melatonin production.
- Exposing the baby to 12h of daylight per day, including naps in a room that is not blacked out and 12h of darkness to condition the baby's circadian rhythm.
- At this age, babies are most susceptible to noise and waking easily. It is worth continuing using pink noise to block out unwanted noises.
- If the baby starts rolling, it is time to get out of the swaddle and into a sleeping bag to prevent suffocation.
- When the baby is waking up (unless it needs a feed), patting off the nappy and using a "shhh" sound can help get back to sleep without being picked up. A good technique is to roll the baby on her side and pat her bottom then, once calm, place her back on his back.
- Remember! Babies should never sleep on their side/stomach due to risks of SIDS. You may have to push day feeds a little, but it is never guaranteed to stop night feeds.
- Get plenty of tummy times, too, so she can practice rolling as much as possible in the day and hopefully not so much at night!
- Sleep associations: if a baby has been used to falling asleep using any sleeping aids (breast, bottle, dummy, etc.), the baby expects those to be available when she wakes up and needs them to be able to go back to sleep. Breastfeeding to sleep and during the night is wonderful, and I would never discourage it. However, some mothers struggle when the waking occurs frequently, and the only way the baby can go back to sleep is by suckling at the breast. I am all pro-attachment parenting, but I understand it is not for everyone.
- One must understand that it is hard for a baby to be used to a specific way to fall asleep than to have that way taken away.
- If a mother wants to avoid sleep association, the best way is to avoid using the sleeping aid to put the baby to sleep.
- In the baby who feeds to sleep, feed before the bath, top-up after the bath but do not allow the baby to fall asleep while feeding. Replace the feed with a cuddle, so the touch remains.
- As the baby gets used to this (there might be tears, but if the baby is reassured by touch or a gentle "shhh," she will not experience stress (unlike the baby left to cry out). Then slowly move the baby to the crib, leaving a reassuring hand on the tummy until the baby is fast asleep. This creates a new imprint on the baby's brain; with repetition, she will consolidate this new way of falling asleep.
- Introducing solids: many mums are be told to introduce solid to their baby, hoping it will "stuff her up," and she will sleep through. This is a myth that science has now backed up. Moving onto solid doesn't reduce night waking. If anything, vegetable or fruit purees have so little calories that they take volume in the baby's tummy while offering fewer calories than milk!
A great read to understand the introduction of solid in babies: "Why solids matter" by Professor Amy Brown.
- Finally: patience & persistence are key! It is exhausting but implementing good habits early on has long-term benefits not only on the baby but also on the parents and siblings. Babies and children grow and learn in their sleep; there is a huge brain activity going on! It will pass: it is exhausting, but it does eventually passes!
Holistic Babies London Gentle Sleep Coach
Steph & Charmaine
To book a Gentle Sleep Coaching Session or discuss further, please contact firstname.lastname@example.org