4 month olds are so cute!

They are responsive alert, smiley, and starting to play with their toys. They can hold a rattle, play with their mobile, and some are even sitting up with help, or even alone. (washing baskets are great for help with this). Occasionally some little ones are biting-at-the-bit and starting to try to crawl. They love to play on their tummies more often, lifting their little heads so they can watch all the action around them.

4 months is also a time of changes, meaning lots of questions from mum and dad. Their increased alertness means that they sometimes have trouble staying asleep during their nap times. They just want to be where the action is!

In this section, I will look at what to do when your 4 month old stops sleeping for his whole nap. I'll also look at why they may seem hungry, and a few other bits and pieces that crop up around now.

Firstly, here is a sample routine for a 4 month old. Of course, times may change from family to family, but it will give you an idea of where to start if your routine is wobbly.

This sample is for a 4 month old that is on a 4 hourly routine:

  1. 7.00 - feed (breast/bottle), then waketime

  2. 8.15 - sleep

  3. 11.00 - feed (breast/bottle), then waketime

  4. 12.15 - sleep

  5. 3.00 - feed (breast/bottle) then waketime

  6. 4.15 - sleep

  7. 7.00 - bath, feed(breast/bottle), then waketime

  8. 8.30 - sleep

  9. 10.30 - top up feed if needed (breast/bottle), then bed for the night


Next I will look at some of those important areas: feedtime, waketime, sleeptime.



Feedtime.

Many 4 month olds are quite ready to go to 4 hourly feeds by now, if they haven't already. If your milk supply is going well (or you are bottle feeding), then you may consider moving to 4 hourly feeds.

How do you know if baby is ready, or your milk supply will keep up?

It is always helpful to check a growth chart - even recording your baby's wet/dirty nappies, as well as weight/height gain, frequency of feeds, length of feed times and such. This should give you a fair indication of how he is going with the routine you have been using.

A visit to your Clinic Sister or Baby Health Nurse is also helpful to reassure you that things are progressing normally.

A baby may be hungry if he is regularly waking early for feeds - and then feeding enthusiastically! If he is waking in the night, and seems hungry, then there also may be a milk supply issue to think through.

Why might mum's milk supply show signs of dropping at around this age?

Often, mums are back into their busy lives - shopping, meeting friends, playgroup, exercising, cleaning house, working, and a stack of other things. They feel great, but their baby sometimes gets left behind!

If you are breastfeeding, then you must slow down and look after yourself. You need to drink lots of water, and consume enough calories to produce enough milk to feed your baby. Some mums struggle with this. If this is you, then you may need to have a look at where you can make some changes to help your milk supply build up again. Have an afternoon rest, go to bed earlier, drink water, eat well and add extra feeds as needed.

If you are worried about your supply dropping, pumping after feeds is an effective way to increase your supply - just pump for a few minutes after a feed, store in the fridge, and offer to him after the next breastfeed. You can do this up to 3x day, for around 3-5 days to notice a difference.

Other temporary methods of boosting supply include giving a top up feed before bed in the afternoon (after the longest waketime), or adding another late evening feed, if you aren't already doing one. 

Sometimes mums are feeding quite well on a 3 hour routine, and a little reluctant to increase that, in case they come across problems of supply, or unsettledness. If you are happy feeding at 3, then of course you can continue for a while longer. Problems often arise as they get bigger, however,  because they are so much more alert. This affects their sleeping patterns, as their waketimes get longer and their sleeps get shorter. This can lead in turn to night waking because they don't get to practice moving through their sleep cycles during the day (more on sleep later).

Most mums who have a good milk supply (or who are bottle feeding) can at least plan to start to move through to a 4 hourly routine with their babies at around this age.

If you are breastfeeding, you may have noticed your baby feeding in a much shorter time. This is common, as baby gets stronger and more efficient at sucking.

If your baby is a 'slow coach', however, you may want to limit his feeding time (perhaps to 10/15 minutes a side), so that he can have more play time after his feed. Most babies soon figure out that it is worth their while to feed more efficiently.

I always suggest feeding from both breasts to give adequate stimulation, and maintain supply.

So, feeding should take anywhere from 7-10 minutes (for those faster feeders), to 30 minutes.

Another thing that you may need to think about, if you haven't already, is dropping the late evening feed. To do this, bring the time of that last feed (for example, 10.30 pm) forward 15 minutes each night, until there is a gap of 2 hours or so between the last 2 feeds. You would probably not even have a sleeptime before you feed them again. Then, once you are comfortable that they can stretch, put them to bed without that feed.

If they start waking early in the morning, you can just wait on the time that you are at (for example, 9.00), until baby is happy stretching to the morning start time again.

This whole process usually takes  a week or 2, and you can do this from around 3 months old onwards. If your supply has been iffy, then wait until it has established again.


Waketime.

If you are trying to keep a good routine with your baby, then it is really important to be aware of the length of his waketime. Too  much waketime, and you risk an overtired baby who struggles to sleep well. Too little waketime, and your baby will be frustrated, wake early for feeds (thus upsetting the feed/play/sleep routine) and also sleep poorly.

If you are using a 4 hour routine, then around 1 1/4 hours is usually plenty of waketime. This will increase gradually as he gets older so that at 6 months, he has 2 hours of waketime, and 2 hours of sleeptime.

For a 4 month old on a 3 hourly routine, 1 hour of waketime should be enough, or he won't get extended sleep.

It is always best to put him to bed after around the same amount of time each cycle, rather than regularly wait for 'tired signs' ( including jerky movements, clenched fists and screwing up face).

While tired signs are very helpful, and shouldn't be ignored, it is helpful to know that some babies really don't show tired signs until they are well and truly over-tired. Once your baby is over tired, they will often go to sleep quite well initially, but then wake into their sleep and struggle to resettle themselves.

Having a plan for their length of waketime is a way to avoid chronic over-tiredness in your baby.

After your baby's feed and burping, it is helpful to look at the 3 play phases of a waketime.

The first phase is playing alone - give them some play time on the floor. This will give them an opportunity to stretch and kick their legs and arms, and allow any trapped wind to escape. At 4 months, they love to play with mobiles and to hold toys in their hand - even if still a little awkwardly. They enjoy sitting up and watching the family, just waiting for someone to pay attention to them.

Using a playpen for a short time 2x day (morning and afternoon) can also be a part of this phase of waketime.

The next phase of their waketime is playing near mum  - playing with toys while watching mum from a short distance, looking quietly around the room, or perhaps even jumping in a Jolly Jumper.

The third phase is playing with mum - This means cuddles, reading, and singing with mum. It is handy to finish their waketime with this one. It is helpful if you are stretching a waketime a little, as well as if baby needs a little settling or calming before bedtime.

Keep this in balance, though. Sometimes first time mums find it difficult to allow their baby some 'space' to enjoy the rest of the room, and other faces besides mum!

Caution! Too much rapid change, and they can feel overwhelmed. Too little change and they get bored.

This is a lovely age to take out and about for short times. They are generally responsive to friendly strangers, and eager to see the world around them.

Again, however, keep your outings in check, as it can add to a general unsettledness in your baby if they are out and about every day. 3-4 outings a week is usually plenty for our little babies. A stable, consistent home routine is well worth it now.

If your baby is still waking in the night, or very early in the morning, then avoid waketime at those times. You want your baby to know the difference between playtime and sleeptime, so if you are needing to feed them during the night, try to feed them and put them back to bed without any play.


Sleeptime.

After their feed, waketime and play, the next thing to do is go to bed. Some are already showing signs of tiredness, others look like they could go on forever. Nevertheless, they need to sleep - they are still only little babies.

Up to now, they have probably very much appreciated being wrapped to go to sleep. Many mums find at 4 months, however, that their little baby has become Houdini! Many just don't want or need to be wrapped tightly as they did when they were newborn.

Sometimes a transition can help - gradually wrapping them loosely, so that the wrap becomes a 'cue' that it's sleeptime, rather than a means of restricting their arms and legs. If your baby still loves to be wrapped, then go ahead and wrap them for longer if you wish!

Most babies that have been on a routine from birth will go down to sleep quite well. Some still have a little protest cry, and you would hopefully be quite aware of what your baby normally does when they go down to sleep.

Being aware of what is normal is important so that you can hear when they are behaving differently, and respond appropriately.

4 months is the most common time of interrupted sleeps. This is especially frustrating  for those mums whose babies have been settled up to now!

One form of interrupted sleep involves the baby waking during a sleeptime, and staying awake for some time (up to 30 minutes), without crying. Mums discover that they are wriggling around and just watching their room, or overhanging mobile (possibly a time to put that mobile away for a month or 2!) rather than going back to sleep. Sometimes, after being awake for a while, they begin to start fussing, as they get tired once again.

This time of wakefulness is usually fairly short lived, and they only seem to keep it up for a week or 2. My guess has always been that while they were younger, they were not especially interested in their surroundings. Now at 4 months, though, they are processing their little world, and it is much too exciting to sleep through!

Once they start fussing, check the time to see how long they are crying (it often seems longer than it really is). If they are still fussy after 10-15 minutes, have a go at resettling (see below).

The other form of interrupted sleep happens when a baby has been asleep for 30-45 minutes, and then wakes right out of that sleep to cry.

This is sometimes called the '45 minute intruder' because of the time into the sleep they wake up in, usually because they are following a cycle of deep and active sleep. As they reach an active period of sleep - around the 40-45 minute mark, they come out of their sleep and wake to cry. Their cry can range from fussy on and off, to full on bellow!

The first thing I do is stop and check the clock. How long is it since my baby went to sleep? Is it time for a scheduled feed?

It is important to consider whether or not your baby is hungry. If you believe your baby is hungry - then feed him. From time to time, they do get hungry unexpectedly. Perhaps they are going through a growth spurt. Perhaps you have been ill or busy rushing around and your milk supply has been affected. Perhaps they have a cold and are extra thirsty.

If you are noticing a pattern, however, and your baby is consistently waking during sleeps, then it is worth having a think through what might be happening.

It is common for 4 month old babies to become over stimulated due to long waketimes, or too much activity outside the home. If that is what is happening, then think through whether or not you may need to make some changes. It is surprising how many babies fall back into routine once the issue of over-stimulation has been addressed.

If you are sure your baby is hungry, and is feeding enthusiastically earlier than usual, have a think about your milk supply and ways you can give it a boost (see Feedtimes).

If you are sure that your baby is not hungry, and just needs to learn to go back to sleep, then it is time to have a Plan.


Resettling.

To successfully resettle your baby, it is important to have a consistent plan. I will share with you what I have successfully done with my babies, and frequently recommend to mums (usually very successfully).

Given that I am sure my baby is just needing to learn to resettle himself (and isn't hungry, or stuck - usually they'll give  a different cry if they are), I will wait 10 minutes or so after first hearing him cry during his sleeptime.

Then I go in, pick him up and pat soothingly on his back until he calms down. this usually happens as soon as I pick him up, or it might take up to a minute or 2. Very often they will look around with bright eyes, sometimes even smiling, so delighted to be up and ready for action!

Many mothers have discovered that if they get them up at that point, they will remain happy for only a short time, before becoming fussy again. They need more sleep!

After he is calm, I put him straight back down, and softly tell him that it is sleep time now. Of course if there is a dirty nappy to change, I will take care of it. I then leave the room and wait around 15 minutes before going back in.

Most babies will protest loudly at that decision!

On rare occasions, especially if there has been some unsettledness for quite a few days already, the baby will persist right up to the next feed time, with mum going in every 15 minutes or so. Most babies will calm down, though, perhaps persisting to fuss on and off until they fall asleep.

By going in every 15 minutes or so while they are fussing, mum can assess what they are up to, as well as feel they are part of solving the problem.

If you go in, and your baby is fussing (rather than crying), and you feel that by picking him up you might only wake him up again, then you can wait a further few minutes and check again.

On rare occasions, particularly if they are unwell, mum may need to spend a little longer cuddling or rocking her baby to calm him down so he can get off to sleep. This is fine. If you regularly rock, bounce or swing your baby to help them get to sleep, however, you may have troubles down the track. They learn to depend on that to get to sleep, and it is not fun to be trying to rock your growing baby to sleep during the night. Also, this type of resettling is more stimulating, which only prolongs the cycle of over-tiredness.

If you have had a few days or even weeks of unsettledness, and you are attempting to implement a tighter routine involving resettling, then be prepared for a few days of hard work. Your baby will not be happy with the new rules at first, but most mums find that after 3-5 days, their babies are happy to go to bed, and happy to sleep for their sleep times.

Consistency on the part of mum is the key.

If you have tried to implement a routine, and you have faithfully followed the resettling guidelines, and you are sure that your baby is not hungry,  and are still having no success after a week, then a check to the doctor is helpful for piece of mind. You want to be sure there is no underlying reason (for example, and ear infection) that may be contributing to your baby's distress.


Frequently Asked Questions...

My four month old  baby is only sleeping for half  his sleeptime. He doesn't seem hungry - should I just get him up until the next feed?

Probably the most asked question!

Basically, there are a number of questions for parents to ask themselves when this begins to happen.

Is this a feeding/hunger problem, or a sleep/routine problem?

If you suspect a feeding/hunger problem, then feed baby earlier than expected, but have a think as to why baby is waking hungry earlier than previously. Is he going through a growth spurt? Has your milk supply dropped? If you suspect a drop in supply, then there are some tips for building up supply here.

If he is going through a growth spurt, or he has been unwell, or for some other reason just needs some extra food, then feed him early for a few days until he is no longer unusually hungry, and then you can get back to a routine that is suiting everyone.

If you suspect a sleeping/routine problem ( a common one at this age), then you will probably find that your baby is quite happy to get up after a short sleep, and doesn't really want a full feed, but after a short time, or after the next feed, he becomes tired and grumpy. He may also start waking in the night, unable to resettle. Sometimes they fall asleep straight after the next feed, and then wake early again, thus starting a tricky cycle of sleep/play/feed, instead of feed/play/sleep.

If this is the case, then it is worth looking at some other things that might be happening in his day. Are his waketimes too long? The most common reason (aside from hunger, and needing an extra feed to cope with a growth spurt) for unsettled babies (especially around the 4 month mark) is long waketimes. Overstimulation really doesn't produce a happy, well sleeping baby! Putting him to bed earlier is a start at allowing him some longer sleep times.

Likewise, if you have been putting him to bed soon after a feed, then increase his waketimes a little, until things get sorted out again.

Are your days too busy? If you are out and about too often in the week, then this can also be unsettling for a young baby. Do you have a lot of visually stimulating things in his room? Mobiles? Posters? These can be too much for some babies - put them away for a short time.

Are there other things happening in your home? Mother-in-law staying? Just moved house? Baby and/or family members sick? Something else unusual? All these big events impact baby, and it does often come out in baby being unable to resettle during a sleeptime.

If you are sure that this is a sleep/routine issue, then the best place to start is resettling.

My five month old is sleeping well at night, but regularly waking early for feeds during the day.  I am giving him a one hour waketime.

At five months, it is probably time to start extending his waketime. He is more alert now, and needing that extra time awake, to work off some energy. Try giving him a waketime of 1 1/2 hours or so (perhaps even a little longer at some cycles), and see if he sleeps through to the next feed better.

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