Frequent Waking in 4-Month-Old Baby

My daughter didnt have much sleeping problem but here is my suggestion you may try...I think why she might not be sleeping well is because of her mattress...its like the same we cant sleep...we bought my daughter a serta and seemed to do very well...she is now 2 1/2 sleeping in a toddler bed on the same mattress and does quite well...maybe insted of the incline sleeper just try proping up her mattress from the under neath instead of under the sheet it might feel slightly different for her...hopefully my suggestiion my help a little...also doctors say just let them cry it out too...they might have just had a bad dream.

Here is an article on Sleeping Through the Night/Middle of the Night Feeding:

Getting Baby to Sleep Through the Night: All babies will fall asleep eventually. Some just need a little more help than others.
By Barbara Solomon

Pulling Baby out of the Crib
Up to the time he was 10 months old, my son David had always been a good sleeper. Then my family moved into a new house, and all of a sudden, all bets were off. He began waking two, sometimes three times a night. I was sure he was just unsettled by the change and would return to his old ways soon. But after we tried every trick in the book only to suffer more sleepless nights, we caved in. One night when he called out, I scooped him up and brought him into our bed. We all slept soundly, and I was feeling pretty good -- until I spoke with a friend later that morning.

"Don't you know that you've opened a can of worms?" she scolded. "Now you'll never get him back into his crib!"

Picturing endless sleepless nights ahead, I panicked, and it's no wonder. Getting a baby to sleep consistently through the night can seem like the ultimate unattainable goal. But after I spent just a few nights leaving my son in his crib when he cried for me and gently encouraging him -- "You're okay, David, just go back to sleep!" -- from the hallway, he quickly resumed his old sleep habits. And experts say that with some patience and effort, most parents will be able to solve their child's sleeping problems, too.

The Impossible Dream
During the first weeks of life, you can't expect a baby to sleep through the night. In fact, there is no typical sleeping pattern for newborns; the only thing you can count on is that they sleep around the clock for varying periods, ranging from a few minutes to a few hours. So why can't they sleep consistently for long periods? Blame it all on biology. An immature brain is the primary reason.

"People have a genetic timing mechanism in their brain that controls sleep, and it takes time for that mechanism to develop," explains Marc Weissbluth, MD, professor of clinical pediatrics at Northwestern University's Feinberg School of Medicine, in Chicago, and author of Healthy Sleep Habits, Happy Child (Ballantine, 1999). "Think of it like eye color: Babies are born with a genetic predisposition to a certain eye color, but it takes time for that color to be expressed."

A need to feed is another factor. Many experts believe that newborn babies have to eat frequently, particularly breastfed babies: There's no way to tell how much a breastfed baby is eating at each feeding, so breastfeeding mothers may be more likely to fully awaken a stirring baby to feed.

Bottlefed babies, on the other hand, may sleep for longer periods because formula takes longer to digest and leaves baby feeling fuller longer. "But babies who have birth defects and are fed continuously by tube for the first several weeks of life show the same process of sleep maturation as other babies," notes Dr. Weissbluth. He believes that ultimately, "Sleep comes from the brain, not the stomach."

Regardless of studies and experts, until she is at least 6 weeks old, a newborn baby will undoubtedly wake several times during the night. Around the 6-week mark, many babies show subtle signs of organizing their sleep. They may get drowsy at 6 or 7 p.m. and may sleep at night for consecutive blocks of four hours or more.

At about 3 months, most can adhere to a sleep schedule that includes a morning nap, an afternoon nap, and two or more longer blocks of sleep at night. According to a poll of primary caregivers by the National Sleep Foundation (NSF), a nonprofit organization, by 9 months some 70 to 80 percent of babies are sleeping a straight 9 to 12 hours every night.

That's great news -- unless yours is one of the 20 to 30 percent of babies who don't sleep so well. "My son was a horrible sleeper!" recalls Lisa Henahan of Peachtree City, Georgia. "Until he was 15 months, he would sleep for an hour and a half and then wake for an hour -- all night long!"

If your nights sound similar, rest assured, these tips can help parents solve a range of stubborn sleep problems.

Sleep Tight, Baby
To exhausted parents it seems that there are as many sleep issues as there are children. But most babies fall into the following categories:

"My 2-month-old son sleeps all day and is up all night."
A common phenomenon during the early weeks of life, day-night reversals often clear up with a little time and a lot of daylight. Try exposing your baby to bright light or sunshine in the morning hours and keep the lights dim in the evening. It also helps to move your baby to a busy part of the house throughout the day, play with him during the daytime, and wake him for daytime feedings.

Then, keep your interactions with him quiet and subdued at night. As babies approach the age of 6 weeks, they begin to respond more to environmental cues, so it helps to have a bedtime routine such as a bath and a song. It may take several weeks, and a baby this young still probably won't sleep through the night, but he may consolidate his sleep into two large blocks at night.

"My 7-month-old daughter won't sleep through the night. Why?"
From around 6 months on, a baby should be able to make it through the night without a middle-of-the-night feeding and without waking his parents. But that doesn't mean he's sleeping all those hours. The term "sleeping through the night" is misleading, points out Lawrence Balter, PhD, professor of applied psychology at New York University, in New York, and editor of Parenthood in America: An Encyclopedia (ABC-CLIO, 2000). "All people -- including babies -- wake and put themselves back to sleep several times a night without realizing it," he says. "That's something babies need to learn to do."

Some kids learn on their own; others need a little help. There are several ways to teach your baby to soothe himself to sleep. Most of them involve listening to some crying. So how do you stay focused amid the tears? Remember that crying isn't going to harm your baby. And the reward -- a good night's sleep for all -- is worth a few teary nights.

The Ferber Method
"My neighbor has recommended the Ferber method to help my 6-month-old sleep through the night. What is it?"
This method was developed by pediatric sleep expert Richard Ferber, MD, author of Solve Your Child's Sleep Problems (Simon & Schuster, 1986). He advises parents to check periodically on their baby when she awakens at night. Here's a sketch of how it works: On the first night, when you hear your baby cry, you go in, give her a reassuring pat, and then leave. If she's crying 5 minutes later, you repeat the process, but this time you wait 10 minutes before going in, increasing the time in five-minute increments. The second night, you start at 10 minutes. Dr. Ferber's system has worked for many families.

"We're trying the Ferber method for my 7-month-old, but I can't stand the crying. Is there another, less drastic way to sleep-train my baby?"
There are also ways of making gradual changes within the routine you already have, notes Jodi Mindell, PhD, associate director of the Sleep Disorders Center at The Children's Hospital of Philadelphia and author of Sleeping Through the Night (HarperCollins, 1997). If you've been putting your baby to sleep by rocking her in a chair, for example, start by just sitting in the chair together. "Then choose the next step -- putting your baby in his crib and holding his hand.

"A few days later, you can sit three feet away from your child's bed," Mindell says. Within a few weeks, you should be able to work yourself out of the bedroom.

"We've tried the Ferber method. My 6-month-old becomes enraged every time we go in to soothe him. Any suggestions?"
Some children respond better to a cold-turkey approach. If your baby cries, you don't go in her room (some parents call reassuringly from the hall). This is not for the faint of heart, and, as Balter points out, is better for younger babies. An 8-month-old may be able to sit or stand in her crib, which makes it hard for her to settle down if her calls aren't answered.

More Sleep Issues
"My 9-month-old insists on a 3 a.m. feeding. How can I get her to give it up?"
For many parents, a final obstacle to an uninterrupted night is that middle-of-the-night feeding. If your baby no longer needs to be fed at night (check with your pediatrician to be sure), simply stop giving him the bottle or breast when he calls for it. Alternatively, you can use a sequence of progressive steps, which might include offering him diluted formula or breast milk for a few nights and then gradually replacing it with water. He may not find it as appealing as milk, and, subsequently, won't cry for it.

"My 10-month-old son used to sleep through the night, but lately he's been waking up all the time."
Chances are, there's been some change, however subtle, in your child's routine. Everything from a vacation to an illness to an overnight guest can disrupt a young child's sleep schedule and cause her to awaken and need comforting. Some parents report that developmental milestones, such as learning to walk or use the potty, can also upset sleep patterns.

"When a child takes a developmental leap forward, neurons are firing and there are probably connections being made in the brain," says Mindell. "It's no wonder their sleep is disrupted." Most babies are also keen on practicing their new skills; when they wake in the night, sleep takes second place to getting up on all fours or babbling.

At times like this, you may need to repeat old steps, such as sitting in your baby's room for a few nights and gradually working your way back out. But don't despair; experts say children with established good sleep patterns will return to them pretty quickly.

"How can I get my 8-month-old to go to sleep at the same time every night?"
If your baby isn't sleepy at the same time every night, her daytime sleep routine may need tweaking. "Make sure to wake her at the same time each morning, keep naptimes consistent, and avoid letting baby nap after 4 p.m. A reasonable bedtime for a baby this age is around 7 or 7:30 p.m. If she wakes from a nap at 5:30, she's not going to be sleepy enough to go to bed then," says Mindell.

One strategy to avoid, however, is shortening her naps in the hope that this will make her sleepier at night. The fact is, overtired children have a hard time falling asleep. And evidence shows that babies aren't getting enough sleep as it is. Many experts recommend that infants ages 3 to 11 months get 14 to 15 hours of sleep daily, but according to the NSF poll, most babies get fewer than 13 hours.

Even if you've succeeded in creating a great sleeper, remember that every child occasionally has wakeful periods. When this happens, reassure yourself that you're not going to be sleepless forever. Says Peggy Nona, a Rochester, Minnesota, mother with two school-age girls, "I used to worry about getting them to bed at night; now I worry about getting them out in the morning!"

Barbara Solomon is a mother of three and a writer in Scarsdale, New York.

Originally published in American Baby magazine, July 2004.

In addition to that....

A local parenting coach wrote this:

I know that Dr. Ferber is less strict than he used to be about getting kids to sleep. However, his techniques are still very useful for kids that have actually taught themselves to stay up and/or to demand/expect a parent to be with them until they actually fall asleep. Also watch one of the Nanny TV shows for examples of being firm yet loving with setting limits.

Briefly, the basic idea is that you (1) stop paying any attention to your child after their bedtime--no hugs, kisses, stories and no yelling either. Just make believe they are little critters that you are putting back where they belong. and then, if necessary (2) let them cry themselves to sleep. Also, and actually first, develop a bedtime routine and STICK TO IT! Letting them cry is very hard, and against some people's principles. What we did when my daughter was little (she is now 21) was put her to bed with the musical mobile playing. If she was still crying when the music stopped (less than 5 minutes) we would go in to her. This happened very rarely. I felt that a short period of crying was not a trauma and having her go to sleep on her own was a learned response. It worked and we had very few bedtime hassles.

Good luck,

Marion
Coach and parent
Marion C. Bloch, Psy. D.
____@____.com
www.mayaresources.com

Don't torcher yourself. Keep swaddling her! I swaddled my son with the Miracle Blanket (loved that thing) until he was too big for it (about 7 months old). He had started to roll over by then, so we got the go ahead to put him on his stomach without the blanket (not all people agree with stomach sleeping before a year). Then he was sleeping fine. He never slept all the way through with the blanket, like your daughter, but waking once or twice a night was better than 4 times. Hope this helps.

Hi, I have a now 2 1/2 year old son. He loved the swaddling until he was about 5 months. I chose to take the comfort things away when he was ready. The pacifier just went at age 2! He is a happy,healthy boy.

I would say that if the swaddling works then stick with it. I don't think that it will hurt to continue the usage of it. Try not to focus on to much of what you read, there are so many books and magazine articles out there telling you what is right and wrong. You know your child better than anyone and if you feel that the swaddling works than continue using it. The only thing I suggest is that if your child is very squirmy and may put herself in danger with this thing then maybe you shouldn't continue the usage.
My son never used a swaddler, but I did notice a change in sleep habits around the four month period. Up until then I thought I was golden with the sleep schedule but things changed quickly. I asked advice and was suggested to take two receiving blankets and roll them up and place one on each side of the child as to lock him in place and make him feel secure. I was a little skeptical of this and worried it may become a hazard. I was reluctant to try anything so I gave it a whirl but I placed the receiving blankets on each side starting from a little above the hips down. This actually helped! I think this made him feel secure and not left in the wide open vulnerable. Now Im not sure if your child is sleeping in a crib or bassinet! My son was still in a bassinet at this age and the smaller space made it easier to lock him in place. With a crib on the other hand i'm not so sure this would work.

As for the incline poitioner, well maybe this is why she is waking up to begin with. You said it sometimes seeme like she cant get comfortable. I would eliminate that and go from there.

I understand the sleep deprivation thing all to well as do most mothers. Just know that it will not last like this for to long and that better nights are coming!! Good luck to you!
M.

I would say Yes, she is old enough to stop sleeping on the incline. Also you might want to feed her when she wakes up. She could be going through a growth spurt and need a little extra food. My daughter was an excellent sleeper. She slept through the night most of the time. But when she had a night or two of wakeful nights I would nurse her because I it filled her belly and allowed her to back to sleep for a couple more hours!
Good Luck

I feel your pain, up until about a week ago, my 6 month old son was sleeping in the bed with me, and still waking every 3-4 hours as he has done since birth. I have been putting him in the crib now, and he falls a sleep fine...he even likes being in the crib, but he is still waking up every 2-3 hours now....I am going crazy. My doctor told me it is out of habit, and to give him water instead of the formula I was guilty of giving him at night. I tried this with no effect...he doesn't want water and whines for the bottle. My friend, another single mother, recommended just letting him cry himself back to sleep and he will eventually learn to do it on his own... I ahte hearing him cry...especially at 3 in the morning when I am trying to sleep, but I guess thats the only way to get him to break the habit...

She's probably just cold. It's a very common problem with babies. you should try one of those sleep sack things that they wear over their PJ's. It's a sack that you zip them into, it has arm holes but no sleeves. you can get them in cotton and fleece. try looking-up sleepsack on amazon and you will see what i mean. My 3 month old daughter hates to be cold too! I use a safe heater in her room and thick PJ's. Btw, when i had my son 3 years ago, he was in the NICU because he was a premie. The nurses told me that you shouldn't use sleep positioners at all (or bumpers at any age). If you want to raise her up, a phone book under the mattress works great (as long as they aren't the type of kid to move around the crib all night)

If she is sleeping well with the blanket, give it to her. She may just like the way it feels. My daughters both liked the way fleece blankets felt between their fingers & used it to soothe themselves by rubbing it. If she is too tall, put it over her. I ditched the incline when they started squirming away from it. Check to may sure she isn't teething. That would make her wake up too. Good luck!

I'm sorry I don't have much advice on this, just wanted to let you know that we went through the same thing. My little guy LOVED the miracle blanket...slept wonderfully from two months until four months...I thought we had it made with the sleep issues until he started squirming his way out of it and just would not stay asleep. I knew it wasn't hunger, because, as you said, he had been sleeping through the night fine before. After MANY sleepless nights, we became a co-sleeping family... Hang in there...

Hi Laury

That's super that she was sleeping 10 hours a night! I never used a swadller with my first two. I'm pregnant now and might have to try it if this one doesn't want to sleep! I don't really know too much about needing to wean them between 3-4 months since I never used it. I guess maybe they are getting to be an age that they might be rolling over and it's better for them to have that ability to scoot and wiggle if they want. Although if she's getting lots of tummy time during the day and playtime on the floor to reach and wiggle and practice stretching her arms and legs, I would imagine it wouldn't be that big of a deal. Maybe ask your pediatrician what they think.

As for the incline - again I never used one with my kids so I'd say by 4 months she should be fine unless there is a particular health issue that made you begin using it in the first place. If she appears to be having a hard time getting comfortable, I'd definitely stop using the incline. Although my son did go through a period when he would sleep well in his car seat (so I guess that's like an incline and a bit swaddled). We would put the car seat in the bassinet and he'd sleep longer that way. Once he was maybe 4 months he was rolling and wiggling and was happy to be flat again. At that point he was able to find a new position on his own if he wasn't comfortable. I think that's a big thing for them in those early months - especially as they get close to rolling.

Another thought on the disrupted sleep - is she rolling yet? or is she trying? Mine would always got through a period (some longer than others) of difficult sleep when they were working on a new skill and just about to get it. It was like they were so focused on the new skill that they didn't have time to waste sleeping. Once they were able to accomplish the new skill, they usually returned to normal sleeping again.

Good luck. I know going back to disrupted nights is tough especially when you've got a toddler to deal with all day. My first 2 are 17 months apart and the next will be about 27 months younger than the younger one.

H.

Laurie,

I'm having the same problem but with nap time. He will not nap unless he is swaddled. We got him off the swaddle for night time but for nap time he will only sleep for about 30min at a time, unless he is swaddled. I don't want to swaddle him but then he gets so over tired he doesn't sleep well at night. I already tried to just let him cry and it didn't work. Let me know if you get any good advice.

I swaddled my oldest until she wouldn't stay in it. If that makes her sleep, I say go for it. I've never heard they should be weaned, just that after a certain age they don't stay swaddled very well.

Hi Laury,
My daughter is 10 weeks old, and she sleeps through the night, we put her in her boppy pillow in the crib. I think she sleeps because she feels she is cradled by the pillow.
Good Luck!
J.

My honest advice? Feed her! Babies grow through several growth spurts, including one around the 3-4 month milestone.

As far as swaddling, I continued to swaddle my daughter as a method of soothing until she was about five months old. Being held tightly is comforting to them, and it's not destructive in any way, so what's the harm?