As a parent of an infant or toddler, it is important to learn about sleep regressions; what they really mean and the common misconceptions surrounding them. When we begin research on how to get our baby’s to sleep well, we repeatedly run into articles and posts that use the word “regression.” As a result, I have watched parents obsess over these approaching time periods, anticipating the worst. The truth is, they are not that scary once we know why they are happening, and we develop a thorough plan on how to maneuver through them.
What is a “Regression?”
A regression is described as: A return to a former or less developed state. This is when many parents will reach out to me and report that their child’s sleep patterns have suddenly changed, that they are much harder to get to sleep initially, and that they have started waking repeatedly throughout the night. When this happens, it is our baby’s way of letting us know that there is a need for change.
What causes a “Sleep Regression?”
The common times that we see these regressions coincide with average ages of growth spurts, cognitive development, and schedule changes. It is not a coincidence that schedule changes happen at the exact same time as the regressions. For example: the very commonly feared 4 month sleep regression happens at the same time as the baby is leaving the newborn stage, entering into the infant stage, and transitioning into a solid 4 nap schedule. This period of time involves intense changes to both the child’s mind and body, (production of melatonin, circadian rhythm establishing, less rem sleep) and therefore a drastic change needs to occur on the outside as well.
Since a lot is going on developmentally throughout the first year, that means that your child is going to be working on several milestones. All developmental milestones will be disruptive to sleep, but some more than others. It is important to learn about milestones and the signs your child will show when they are approaching, that way you can stay ahead of them and try to prevent any major issues. Remember, the best thing to do is help them practice their new skill as much as possible during playtime!
Identifying the reasons that sleep is disrupted during these regression ages, will help us put a plan in place on how to handle the disruptions, and try to make sure they are short lived! It will help us make sure to: always be prepared!
The Four (4) Month Sleep Regression
When: The four month sleep regression occurs as your infant moves out of the newborn stage, and is now ready for a more predictable sleep schedule. (Occurs between 3.5-4.5 months, adjusted age if your child was born before 40 weeks)
Why?: This regression is caused by cognitive development. Specific to sleep, this is when they are ready to learn how to self-soothe and connect sleep cycles. Multiple things are happening at this age, including a significant growth spurt and the beginning stages of their first physical milestone. (Rolling) As a result of their brain development, they become more alert, which causes some babies to become distracted eaters.
We also need to keep in mind that every milestone will cause a disruption to sleep, so be prepared for that to happen. If we know why sleep disruptions are happening, and that they will be short lived, it helps ease our minds as parents and prevents us from scrambling to make unnecessary changes.
What to do:
Feedings: If your child has suddenly become a distracted eater, try feeding them in their room (in the dark, without noise) shortly after they wake up. Be careful not to encourage them to fall back to sleep during this time. Sit in a chair with a lamp of a dim light on so they know it is time to eat, and not time to sleep.
Night Feedings: Before you reach the fourth month mark, you were probably following an every 3-4 hour feeding schedule at night. At this age, we can move to only offering two night feedings, using specific cutoffs, (Ex: baby can’t eat before the 5-hour mark from their bedtime feed) but only if baby wakes for them on their own. We don’t wake them to feed at this age, unless instructed by your pediatrician to do so.
Milestone: This is a common age to see the first big enough milestone that will disrupt sleep, which is your child’s ability to roll over. For this reason, we need to transition out of a swaddle at this age, and into a transition sleep sack, (such as the Merlin’s Magic Sleepsuit).
The best thing to do to get through sleep disruptions due to milestones, is to encourage your baby to practice their new skill as much as they can while they are awake! Once they have learned this skill, they start practicing it when they wake, and sometimes get stuck in one position, if they have not yet mastered rolling both ways. I suggest waiting 10 minutes and then going in to help them roll back over when this happens, if they have not done so on their own already.
- Once your child reaches 16 weeks of age (adjusted if necessary), you want to start the transition to a solid 4-nap schedule if you haven’t already. No nap longer than 2.5 hours, with day sleep ending by 5:30pm
- During this transition, your child is also ready for a consistently earlier bedtime, between 6-7pm. They will also start to wake between 6-7am in the morning.
No Longer a Newborn:
Sleep props and associations are no longer age appropriate. An example of a sleep prop would be a pacifier, and an example of an association would be an “eat/sleep association,” (which means that your child only falls asleep while eating). We want to eliminate all sleep props and sleep associations by this age. An “association” can be defined as anything that a child cannot recreate on its own. (Another Example: Rocking to sleep)
When it comes to transitioning sleep cycles, Your child might have already started working on this skill, but if they haven’t, once they have entered the “infant stage” is it time to start. We can now use sleep training methods in order to teach them. The goal is to lengthen naps, and develop longer stretches of sleep at night before a feeding.
The Eight-Ten (8-10) Month Sleep Regression
When: The most common age that I see signs of this regression is 8.5 months, as a child’s body starts getting ready for the 3 to 2 nap transition. Although there will be a change to the schedule, this is different from the four month regression because sleep will resume to the way it was previously, just with extended wake periods.
Why: The biggest reason for this regression is the need to shift to a two nap schedule. If by this age the transition hasn’t happened yet, (i.e. there’s still a late 3rd nap taking place) the disruptions you will see are due to the need for longer wake periods in order to form a solid two nap schedule. Essentially, they are not awake enough during the day, so they start to make up for it at night. Also, that extra sleep period will throw a big wrench into their schedule.
On the other hand, if the transition to two naps started before the child was ready, the disruptions you will see at this age are a result of the sleep deficit that the early nap transition created.
What to do: Once your child reaches 8 months, you want to start the transition to two naps if you haven’t already. If possible, hold on to two naps until 8 months (adjusted if needed). Start with conservative wake times and slowly stretch to a solid 2-nap schedule over the course of the 8th month. After this nap transition has been completed, your child’s schedule will remain similar until the transition to one nap occurs (closer to 18 months).
This is also a common age for a lot of new teeth to appear. Although teething won’t necessarily cause your baby to wake throughout the night, it can make re-settling more difficult. It can also make falling asleep at bedtime challenging if they are experiencing a lot of discomfort. Teething does not influence a “regression,’ but if there happens to be one taking place with new teeth on the horizon, prepare for a few days of overall disruptions and trouble re-settling.
**It is important to note that if your child is waking habitually throughout the night, (every 60-90 minutes) that is most likely not due to teething, but rather a strong sleep association.
**If you give medicine, offer it to them 30 minutes before you plan to lay them down because there is sugar in it.
I have seen many pediatricians over the years instruct my clients to only give medicine if they can feel a tooth cutting through the gums. If that is the case, give a dose at bedtime, and then again around 1:00am.
The Twelve-Fourteen (12-14) Month Sleep Regression
When: Just after your child hits their one year birthday, we start to see some signs of this regression. The signs can be subtle and displayed over a few weeks, or they can be abrupt, quickly throwing off schedules and causing big disruptions. If it is the latter, I usually see that closer to 13.5 months.
Why: At 12-14 months of age, there is no need for a change to the nap schedule, but this is when the majority of children start walking/talking. The regression at this age is also due to cognitive development. The changes happening in your child’s brain will prompt the beginning of major milestones, which will serve as the main culprit of sleep disruptions during this regression.
Why: This is one of the biggest milestones, (next to crawling) and therefore will cause one of the biggest disruptions to sleep. When a child learns how to walk, they create their own ability to move about and explore, and as a result a whole new level of brain stimulation begins. Naturally, it would be hard for even an adult to turn off their brains and settle down for their next sleep period with so many new things around to explore, so it is understandable that our babies need some help deescalating as well.
What to do: When it gets close to naptime and bedtime, prepare the house for sleep to help counteract the overstimulation; close the curtains, turn off the television, play soft music, turn off some lights and use an extended soothing routine to help calm their minds before laying them down for sleep.
Why: Their developing brain function will increase their language. This is a mentally significant milestone and in combination with the significant physical milestone, (walking) these substantial disruptions to sleep schedules often cause parents to mistake this disruption as a sign that their child needs to transition to one nap.
What to do: Just like any other milestone, encourage your child to practice their new craft as much as possible during the day. This will help reduce the sleep disruptions.
Why: To add to a parent’s confusion during this time, if they have a child in daycare, their child is most likely being forced to transition to one nap. When a child turns one, they often move into the “one-year-old room,” which 9 times out of 10, only has a one nap schedule (that the daycare plans to strictly enforce). As a result, parents watch their child meltdown from exhaustion in the evenings, struggle to fall asleep at bedtime and begin to wake up repeatedly throughout the night.
What to do: Try talking to your daycare provider to see if they would be willing to let your child nap in the infant room in the morning, and with the rest of their class in the afternoon for their second nap. If the daycare won’t accommodate this request, the only thing we can do is compensate with an early bedtime and stay home on the weekends to offer two naps and make sure they catch up on day sleep.
Why: Under one year of age, milk is the primary nutrition source for your baby. When they start solids, the purpose is more for experimenting with taste and texture. Once they reach their one year birthday, the value of solids increases and they start to play a bigger role in their daily nutrition.
What to do: We need to make sure that solids are very well established, and that your child is eating from all four food groups in order to be able to sleep through the night.
The Eighteen (18) Month Sleep Regression
When: This regression is punctual and appears slightly before or slightly after a child turns 18 months.
Why: The transition to one nap is the biggest nap transition that takes place, and will have a significant impact on sleep if it is not done correctly.
What to do: If your child is still on two naps once they have reached 18 months, it is time to start the transition. Make sure to have a solid plan in place before you begin, and be prepared to compensate with early bedtimes throughout the process. The full transition takes about a month to complete properly.
This age is also when the “18-month molars” like to make an appearance, which definitely doesn’t help the situation. Teething Reminder:
- Give tylenol or motrin, and use baby orajel when you feel a tooth cutting through.
- Give the dose of medicine 30 minutes before you’re planning to lay your baby in their crib. Medicine has sugar in it and their bodies need time to settle.
- Give a second dose around 1:00am, even if baby is asleep.
Talking is continuing to develop at this age. Remember that milestones have some of the most significant impacts on sleep! In moments of frustration, keep in mind that the disruption is short lived, and there is not much we need to do to fix it, just ride it out!
Don’t let the word regression scare you. Just remember that there is a reason for the disruptions to sleep and things we can do to solve them!
Here are a few tips/reminders to help combat these sleep regressions:
- Know your child’s adjusted age.
- Prepare for nap transitions and go through them slowly, and with a solid plan!
- Transition to 3 naps by 5 months, if you haven’t already done so.
- Transition to 2 naps by 8 months, if you haven’t already done so.
- Transition to 1 nap at 18 months if you haven’t already done so
- Try to find a daycare that offers two naps until 18 months of age.
- Be aware of approaching milestones and the average ages we expect to see them
- Don’t let teething throw you off, or doubt your child’s ability to use their self soothing skills. If your child is in pain, the best thing to do is to let them rest!