Tuesday 15 October 2019

Sleep regression explained

Lucy Wolfe answers some common questions about baby's four-month hurdle

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There is a lot going on developmentally between four-six months, it is undeniably tricky territory. It will be less tricky if you have been establishing the positive foundations, but if you have not been, then along with the "four-month regression", you may find that your sleep is worse than ever, and there is little scope to make changes outside of the feeding and sleeping suggestions. Don't despair - you can be preparing the scene. Although it may not seem helpful at the time, it often makes the learning cycle easier when you do go to address it at six months onwards.

Q: My baby was sleeping great, just waking once a night for a feed and now they are waking on multiple occasions and I just don't know what to do...

A: What happens to a lot of families in the first few months is that sleep can be pretty good. You may have developed a rhythm to your day that seems to suit your child and in return night-time sleep is reasonable, if not really good, waking one to two times for a feed, or for some actually sleeping overnight with little or no input from you. And then one day that all falls apart.

Q: What's going on?

A: Welcome to the four-month regression, but actually, more accurately, welcome to sleep maturation. Somewhere about four months or so, sleep characteristically locks into place and now, what used to work because your baby's sleep was immature, no longer works as their brain has taken over the controls for sleep. Whatever they associate with going to sleep now needs to be repeated, and in some cases, each time they cycle through sleep.

Essentially, what did work, stops working. This particular regression is mis-named as a higher level of adjustment may be required to help return you to better sleep rather than just waiting it out like some other developmental phases. This one demands adjustments, most of the time.

Try not to worry, there is a lot more going on than just that. Your child is developmentally racing through neuro-developmental stages; their previously later bedtime biologically gets much earlier, they may be starting to show an interest in solid food, they will be learning that they are more separate to you, they may be starting to teethe, they may experience their first sickness, or you may even be thinking about returning to work.

It may be exceptionally challenging at this period, but it will improve - you just might need to earn it.

Suggestions that help survive the four-month regression

⬤ Introduce my feeding and sleeping age-related balances for this age range with earnest; pay particular attention to the wake time (this now becomes earlier- between 6am and no later than 7.30am), the suggested nap times, nap durations and cut off points for day sleep.

⬤ Attempt the nap timings about 20 minutes before the suggested wake period so that you are avoiding allowing baby becoming over-tired.

⬤ To avoid your baby to becoming overtired, encourage the daytime sleep, in any way that works for them. If holding them keeps them asleep longer, commit to this.

⬤ Observe no naps after 5pm, even if they only fell asleep at 4.45pm, curate this nap ending to synchronise bedtime hormonally.

⬤ Establish a bedtime routine in the bedroom that your child sleeps.

⬤ Bring forward bedtime with immediate effect - there is no need to do this slowly - they are designed to sleep around this 7pm mark.

⬤ Create a dark environment for bedtime, overnight and naps - we need to strengthen sleep ability now as much as possible.

⬤ Share the load and draft in support during this time.

Q: General sleep regressions - why and when do they happen?

A: Your child will go through multiple developmental stages that may cause a sleep regression. The most notably is here at four months, but there may be others too around eight to nine months, 12-18 months and two years as well. It is not unusual for sleep to be affected by every developmental achievement - if they routinely sleep well and then without any symptoms of teething and or sickness we experience some uncharacteristic night-time activity. Growth spurts often overlap the developmental stages, but feed as needed and everything passes.

It is possible that as a new skill is being learned, such as rolling, pulling up to standing, walking, or language explosion, your child stays awake for long periods of time. They're calm but practising their skills and rolling, chatting, naming items, laughing hysterically for example, and then without need for your intervention, they return to sleep. Most sleep regressions last from two to six weeks. This can be extended when teething or sickness overlap. We need to be careful that we do not blame every sleep interruption on teething, sickness or leaps. They are only relevant if they accompany the symptoms as outlined previously.

Of course, any sleep interruption can be more challenging if your child does not routinely sleep well and this particular stage overlaps with their current poor sleep practices. You may find that you need to support your child a lot over night until this passes and maybe also you can start to address the extra layer of issues with the help of my book.

⬤ Practise - give your child plenty of opportunity to develop the skill they are gaining. Make sure they practise this lots throughout the course of the day. Make sure, regardless of the skill, that your child now is getting lots of floor time and is free to roam. Ensure they're not spending too much time in a play pen, cordoned off to a small space in your living room, too much time in the buggy, car seat or high chair. Do activity games with them to help them "get it out of their system" so they feel less like the need to practise this at bedtime and/or overnight. This won't stop this happening overnight, as this is where they will process everything they are learning, but it may reduce the vulnerabilities overnight.

( A ) Rolling

Let your child get really good at going from back to front and over and again. The more efficient they become, the more capable they become at getting comfortable overnight and avoid getting stuck from spinning about. Now that they can roll - although you will continue to place them on their back to sleep - it is appropriate to let them assume a comfortable sleeping position, be that back, front or side.

( B ) Standing

If standing is the new skill, then as above, encourage plenty of practice by day. Show them over and over again, how to go from standing to sitting to lying down. Play games like ring-a-ring-a-rosy - teach them the words that accompany the action, "lie down" and "fall down". Show them in the cot how to go from standing to sitting by running their hand down the bars, underpinning with the key words.

( C ) Climbing

If they try to climb out of the cot, don't immediately rush to a big bed. A big bed transition is more suitable from 2.5 years+ and generally not done as part of an issue or an effort to improve sleep. Supervise if they try to climb, push their knee down and say "no climbing". Stay on the floor and treat as above with standing and then when they are over it, phase yourself out of the room again. A big bed is generally better introduced when your child routinely sleeps well, is over 2.5 years, the nap in the day is over, and they are toilet trained too.

Every season has a reason, but this too will pass.

Lucy Wolfe, CGSC, MAPSC, H.Dip RM is a Sleep Consultant, Author of the bestselling book 'The Baby Sleep Solution', creator of "Sleep Through", a natural bed and body sleep spray and relaxing rub, and mum of four. She runs a private sleep consulting practice where she provides knowledge, expertise and valuable support to families across the country. See sleepmatters.ie |087 2683584 or |lucy@sleepmatters.ie

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