Sudden sleep change in my 3.5 month old

by Jen Naegelkraemer
(Ottawa, Ontario, Canada)

Question: Hello, I am a first time mom and thoroughly enjoying my new parenting life with my son! Chase is a little over 3.5 months old and i have been exclusively breastfeeding him, with few problems. He initially was quite a good sleeper, consistently going 6-8 hours between feedings by about 1.5 months of age (meaning he would wake up once during the night for a quick feed and going back to sleep until about 9am). This continued until he was about 2.5 months old. Then we noticed a shift, his bedtime of 10-11pm didn't change, however he started to wake for a night feed at 4am and 7am, eventually wanting to wake up for the day at 8-8:30am. This trend continued for approx. 2 weeks until a new trend started... He now has been waking up 3hrs after his last feeding before bed, then again every 1.5-2hrs until morning. When ever he wakes in the middle of the night I feed him for about 5 minutes until falls asleep.

Since he's been born he's been sleeping in our room in a bassinet. We use a foam sleep positioner and swaddle him. Generally the bedtime routine includes a bath (which he likes), diaper change, putting on his pjs, swaddling him, then he feeds. He usually gets very sleepy or falls asleep during his last feeding. We then take him to bed, rocking if necessary, and put him in the bassinet. We shut off the lights, other than a night light, and shut the door. If he wakes up either myself or my husband goes in, picks him up and quietly soothes him and rocks him back to sleep, repeating the process.

Through the day he generally goes 2.5-3 hrs between feedings and often has a nap 1-1.5 hrs after eating. He is a relatively happy baby but occasionally has gas issues which make him uncomfortable. I try to burp him both during feedings and after feedings.

Hopefully you might have some suggestions or insight how to help Chase sleep for longer periods of time through the night as he did a month or so ago. Any help is appreciated!

Best wishes,
Jen

Heidi's Answer:

Dear Jen,

First of all congratulations with your first baby and for clearly doing such a great job at this first parenting experience!

It will not solve your problem but it may be good to know that this is quite a common 'pattern' we see with babies. Sleeping very well in the first months, and then there is some retrogression around 3-4 months old ... Often it starts with a growth and development spurt, when they simply need extra food, and start waking up more often again, which parents shouldn't hesitate to tend to.

This is absolutely fine and most of these babies go back to sleeping well again within a few weeks. But it is also a time where you need to be alert to avoid him getting in to the habit of feeding, rather than out of need.

First of all, please read my page on baby sleep positioners: they are disadvised because they are not safe.

Swaddling correctly is fine, but I do recommend to wean that gently early on. For now, keep the swaddling though, but start weaning (by gradually loosening) once his sleeping has gone back to normal.

For his sleeping issues now:

- Your bedtime routine is very good. But, he may be too drowsy already to get a satisfying feed. Do make sure that you keep urging him (like tickling his feet to gently wake him back up if he dozes off) to get him to take a full feed. Do offer both sides, but only offer the second breast if he has emptied the first one 'completely'. You want him to get to the hind milk because it is more nutritious and he needs that.

So encourage him to drink well from the first breast. Then have him burp in between, and then start the second breast. And again try for him to have as much as possible. Even if he fell asleep, hold him upright again so he may burp (in his sleep). (Not having burped may wake him up at night too).

- When he wakes at night, after 3 or more hours of sleep: feed him. I do advise to feed him for longer than 5 minutes. He may be hungry but too tired to drink a lot so fall asleep again. But not having had enough, he may wake after 1-2 hours again. So why not invest in a good feed (gently keeping him awake enough to feed a bit longer) to keep him going.

Of course, I am talking about gently encouraging. Never force him to feed more than he wants, only help him stay awake long enough to take what he needs.

What will also help with sleeping through the night is if you can spread some extra food intake during the day, or even add an extra 'snack' in late afternoon.

- If he has a had good night feed, and still wakes up after 1 or 2 hours, do as you have been doing now: soothe him back to sleep when necessary. It will be most efficient if your husband does this.

Since you mention he has gas problems sometimes during the day:

For some moms and babies, gas problems easily disappear if mom leaves out dairy products. To see if that could help for you, leave out dairy products for a good week. If you feel things improve, you might want to keep doing this for a good while. See the baby gas for more ideas.

Burping frequently is definitely a good idea anyhow, and of course also during day feeds you do want him to get to the hind milk of the first breast before offering the second. Let me know (just post a comment below) if you are unsure about this, we can then nail it down further. Mention also if you have seen changes in his growth and weight gain the past few weeks.

Kindly,
Heidi