4 month old baby sleep getting worse and worse, waking every 2 hours and can't be settled

by Cate
(Melbourne)

Question: Hi there, My four month old son was a pretty good sleeper for 12 weeks and would usually sleep for a stretch of 6 hours before waking to feed, then sleep another 3 etc. At week 13, overnight he began waking every 2, sometimes 1 hours. That was 4 weeks ago. I have stopped feeding him every time he wakes and try to stick to 3 hourly feeds. I was swaddling him for a week or two but have now stopped in an attempt to get him to sleep on his own. We usually put him in his cot awake at around 7pm (or 2 hours since his last nap finished) and pat and shush him to sleep. This was working really well and we weren't having problems getting him To sleep, just difficulty with him staying asleep. He will wake 45 mins after going to bed, and then 2 hours after that. We have tried leaving him for up to 5 mins to settle but he just screams.

Now, after implementing all these strategies he has gotten worse and now resists going to sleep. Also now whereas feeding in the night would put him back to sleep he now is still awake and takes another 40 mins or so to settle, only for him to wake again an hour later.

I have started giving him rice cereal in the past couple of days on the advice of child nurse however things are worse since then.

He was at least having 2 1.5hr naps plus a 45 min nap in the past weeks but in the last few days that has worsened too- he can't seem to stay asleep for more than 45 mins.

I don't know what else to do, I'm getting maybe 3-4 hrs of sleep a night, broken. I feel like the sleep training we've tried had made things worse. I feel like giving up and just feeding him all night in my bed, although I know I'll pay for that later.

I should say I'm breastfeeding and he is a big, hungry baby. I try to feed him both sides but often is not interested.

Please help!

Cate

Heidi's Answer: Dear Cate,

Thank you for your well explained post.

Yes, sadly, the training efforts seem to have made things worse. Not because they are wrong in themselves, but most probably because they were not ideal for your son at this time.

The good sleep you saw until recently shows that he has the ability to sleep well. And it will come back. A short (although each night is one too many, I know) regression as see now is quite normal though. It may have been early teething, a cold, a growth spurt, some tension, ... so many things can be at the origin. Or it may have simply been a change in sleep patterns, which are still constantly changing and evolving.

In any case, it is a good idea to not feed more than 3 hourly. Otherwise you have the risk of having many half-feeds which is not good for him (too much light fore milk, too little calories) and not ideal for your milk supply.

If you feel the swaddling was good for him, it would have been fine to keep that up. But if you don't fully believe it is necessary or working really well, and fear not being able to wean from it (although that mostly works well at a later age), then it is best not to continue.

I have a lot of respect for Tracy Hogg and her baby whisperer approach. The pat and shush works for many babies. Yet you are not the first parent who finds that although it helps with settling, their baby does not sleep restfully afterwards. This usually is either the effect of the shush pat itself, or the forced sleep time which does not work out for that baby.

At this age, it is not a real surprise that the rice cereal made things worse. I know it is still often recommended, by some health carers, but it is really disadvised. A 2010 study by Nevarez and colleagues also explicitly showed how introducing solids early leads to fewer sleep hours.

Ideally a baby breast/milk feeds exclusively until 6 months old. Before that age, baby's digestive system is not mature enough to digest solids well. This so often leads to discomfort (even though not always apparent during the day) that worsens sleep.

The other effect you will have, is that even with the little bit of rice cereal he takes, he may drink less (as you notice) and will immediately affect your milk supply. And that is exactly what you want to avoid with a hungry growing baby.

I'm sorry Cate, I know this is all sounding negatively. That's not how I intend it. Please don't feel bad. As I said, all you did was well-meant and well-tried. You were just unlucky that it did not work with your son.

The best steps ahead now will be to gently guide him back to not dreading sleep anymore and to get well-rested again.

First of all, I do think it is important to allow him to nurse well, as during a growth spurt. Forget about the cereal. Concentrate on regular feeds during the day. At night, feed as you said when he wakes unless it has been less than 3 hours.

At no-feed moments, help him with settling if necessary. Ask your partner for help at those moments if possible.

Arrange a good regular nap schedule and regular bedtime at night. Don't worry about short naps for now, just offer 2 or 3 regular moments at which he can take a nap. You may find the sleep schedule pages helpful.

This is really a simple back-to-basics approach. Give yourselves at least a good couple of weeks to get back on track. Feed him as he needs it, help him with settling so he and you get as much sleep as possible and work on regularity in his sleep times.

When all has settled down again you will be able to use the gentle self soothing method to help him settle independently, little by little. If still necessary, you can then also gradually reduce the amount of milk he gets at night which will further reduce the night awakenings.

Finally, you may want to have a look at early signs of teething. Often hidden when coming on early, they may still cause quite serious sleep disturbance.

Best of luck,
Heidi