My 4 month old baby is waking up many times in the night, but not always to eat

by carol
(canada)

Question: My son just turned four months old. He has always been an okay sleeper. He had reflux early on and needed to sleep on me for the first two months, but that seems to have cleared up. It seems for the last couple of weeks he has been waking up numerous times in the night and I know he is not hungry and capable of going 5-6 hrs without eating. Lately he has been waking anywhere from 5:30-7am (he used to always wake at 7)
Here is an approximate daily schedule:

wake 5:30-7 ish
eat 7:30 am
nap 9-9:45
eat 11am
nap 12-2:30
eat 2:30-3:00 ish
nap 4:30-5:15
eat 5:30-6:00
eat 7:30 (I usually try to feed him- not always hungry)
bed 7:30-8

He will usually sleep until 12:30 and eat. Then he will wake many times after that, each night is different- but each day is quite similar. I always go in a give him a soother and he will often go right back to sleep. I never take him out unless I am going to feed him. I try to wait until after 3:30a to feed him again, but I know he is capable of going longer (he has gone as long as 7 hrs before). For instance, last night, he ate at 6:45 pm, then woke at 11:00 to eat, then woke at1:30 and 2:00 but went back to sleep with a soother, and I fed him at 2:30 when he woke again. He slept until 5:30, took a soother until 6:45 when he woke up.

I am exhausted and would like to see him sleeping longer. stretches. Am I putting him to bed too early each night? (7:30) even though I know he is tired? Should I stop giving him that extra feed before he goes to bed? Should I wake him before I goto bed, say at 10pm and feed him? Should I have a set time I feed him in the night, say 3am? Or do, I just let him work out his feeding routine and keep trying to soothe him each time he wakes up.?

Thanks for your help,

carol

Heidi's Answer: Dear Carol,

Around 4 months old is when lots of well-sleeping babies typically have some regression. Going 5-6 hours without eating as you mention your son did until recently was quite good indeed.

But this is an age where a lot (!) is going on: big mental and physical steps combined with a plain growth spurt right now are an easy cause for more frequent night awakenings. And yes also hunger at night, even if he was capable of sleeping for 7 hours or longer before.

The very first thing to do is to keep up the good habits and not give up on them. You seem to have a very nice regular daily schedule. And from your story I also get the impression he goes to sleep rather easily, and is often easily soothed back when waking at night. So all of that is important to keep up now. Quite logical but I mention it because when things regress like this, we often tend to question what we've been doing, and start changing and giving up on too many good things.

What you have been doing so far was good, and now it's your baby's growth and rhythm developing and producing the change.

So to keep things at best, besides keeping up the good habits, we will be working on adjusting to his new rhythm and making sure he feeds well.

First off, see if you can up his food intake during the day. I want to be very clear: it's not about 'stuffing' him right before bed but really try to add a bit to each meal so he gets more, spread out through the day. No forcing and no over-doing of course but just a little extra at each feed, or an extra 'snack' squeezed in here or there can help.

Actually, looking at the schedule you have now: by shifting things to earlier you may be able to ensure that the 7.30pm feed becomes a full one and that will give you the extra feed you need:

Start by shifting the 11am feed to earlier (say around 10.30am?). Shift the noon nap after that along to a bit earlier. Then the next feed moves to earlier, the next nap as well and then finally the next feed too. That should have him decently hungry by 7.30pm to eat well. Experiment towards this kind of schedule for a couple of days. Of course be very attentive that he does not get over-tired here or there.

Because you are right: you are not putting him to bed too early: if he's nicely tired then that is his bedtime, no use to make him go later.

After that, as you have been doing, do feed him if he wakes around 11pm - or any awakening that is still before midnight - but I do not advise waking him up. Then soothe if necessary in the early morning. Make an arrangement with yourself not to feed again under 4 hours after the previous feed.

Keep all soothing-awakenings as short and boring as you can. Same with the feedings: feed the minimum and don't give any more attention than necessary. Keep lights dim all the time, low voices, no silly faces or funny smiles, ...

See how this all goes in the next couple of weeks, with the focus on that food intake during the day. You may see the night awakenings disappear very easily. Or you may be left with one feed after midnight. That is one you will then (in a good month or later, when you feel it's time) be able to gradually wean from by offering a bit less each night (just one breast, or more diluted formula, ...).

Good luck!
Kindly,
Heidi