Common sleep regressions and how to handle them

Sleep regressions are every tired parents big fear.  Especially if you have completed sleep coaching your child and now things have gone off the rails, you are bound to be frustrated and discouraged if your baby begins waking again.  Parents ask me all the time, “Once my child has learned how to sleep, what regressions may happen?  What do we do when there is a sleep regression?  How do I help my child without falling back into bad habits.”

What is a sleep regression?  A sleep regression is when your baby was previously sleeping well (possibly through the night) for a long period of time and then, all of a sudden, without a known cause (such as the big sleep stealers:  illness, teething, travel), their sleep suddenly goes downhill.  Sleep regressions can last anywhere from 2 to 6 weeks and often coincide with cognitive or developmental milestones.  Commonly sleep regressions tend to happen at 6 weeks, 3-4 months, 6 months, 8-10 months, 12 months, 18 months and 2 years old.  Fear not, most children do not experience a full regression at each of these milestones.

Here’s what is likely to be going on at each regression

6 weeks:  Newborns frequently go through a series of growth spurts leading to increase hunger and fussiness.  Think about how rapidly your newborn is growing at this age!  So much happens in a relatively short span of time and this all takes lots of work on your baby’s part.

3-4 months (referred to as the 4 month sleep regression):  I often think of this as one of the hardest time periods.  In addition to a growth spurt, your baby is going through bursts of brain development increased awareness of her surroundings leading her to being more distractible in months past.  At the same time, many of the tricks (like Harvey Karp’s infamous 5 Ss) you may have used in the first several months to get your baby to sleep may stop working.  Whereas previously you may have been able to put your baby to sleep while holding her and transfer her to her sleeping spot, now the minute you put her down she wakes.  This is challenging because some babies are still really too young to soothe themselves from a wakeful state to a sleeping state so it may take several tries to get your baby into bed.  Some babies will also begin rolling at this point, which means if you are still swaddling, you will need to stop so that your baby doesn’t roll themselves in the swaddle.  Also, there are often a few days to weeks when your baby will roll from their back to front and get stuck (or vice versa) and not be happy in whatever position she is stuck in.  Lots of tummy time is essential to help your baby become proficient at rolling during the day so less practice at night is necessary.

6 months:  If your baby wasn’t an early roller, he may begin rolling more frequently by 6 months.  With rolling and increased core strength comes crawling.  Some babies will crawl as early as 5 or 6 months.  Others wait until a bit later.  Whenever it happens, it can become a big sleep stealer where you may see your baby up on all fours in his crib rocking back and forth, just practicing and getting ready for his upcoming mobility.  Some babies also go through a growth spurt at 6 months so increased hunger can occur.

8-10 months (referred to as the 9 month sleep regression):  This most often coincides with your baby’s new found ability to pull herself up to stand.  When this happens, your first job is to make sure she knows how to sit back down.  This can be practiced during play time when your baby is standing at a couch, coffee table, or ottoman height surface.  Place something on the ground that is sufficient incentive for your baby to reach down for it.  Maybe it is a favorite toy or something that is often off limits like your TV remote control or cell phone.  Guide your baby down to reach for the object, at first helping to bend her legs and then letting her do it on her own.  You can also practice this in the crib and can work on teaching your baby to walk her hands down the crib rails to a sitting position.  It is essential that you ensure that your baby can sit herself once she can stand, otherwise she will have no way of laying down to return to sleep if she wakes and stands.  You can end up in an endless game of “I lay you down, you stand up.”

This can also be an age where children experience their first big burst of separation anxiety.  While prior to this moment, your baby may not have cared whether you wanted out of the room for a few moments, now there is suddenly screaming when you attempted to walk away to use the bathroom.  Bedtime is often the biggest separation that children have from their parents all day.  As babies go through this point in their development, they begin to realize that they are a separate being from their parents.  This separation is often most strongly experienced as it relates to the parent with whom your child has his or her primary attachment.

12 months:  Walking!  Some babies will walk sooner then 12 months, some later.  I see 1 year olds having less regressions than younger babies but whenever your child begins walking, it can easily throw your child’s sleep for a loop.  This regression can crop up about 2 weeks before you see any significant skills emerge.  As with the earlier milestones, be sure to give your baby lots of practice time during the day so his is a bit more tuckered out when it comes time for sleep and is feeling less of a need to practice in bed.

18 months:  While many babies have been babbling away for months by now, words and direction following can really begin to emerge at this point.  Your toddler will still have difficulty communicating exactly what he wants, which can produce much frustration for both parent and child.  Remember, your child’s receptive language (what he understands) is likely to be move advanced then his expressive language (what he can articulate) so be sure to talk to him about what you are doing and when you are doing things that involve him.  Toddlerhood often brings the obsessive need for predictability to help your child have some semblance of control of their environment.  Being very consistent with your bedtime routine and in your response to any night wakings is essential to keeping any regressions short lived.

2 years old:  Some children’s verbal skills may not increase until closer to 2 leading to a later regression.  Some 2 year olds may also be potty training.  When children potty train at a young age, it can sometimes throw sleep for a loop.  Most children do not night potty train when they learn to stay dry during the day.  This typically follows later (by months to years for some).  Still, if your child potty trains early, it can lead to a few sleep troubles as she begins to master a new skill.

What to do during a regression

It may be that you don’t even realize that the regression is happening until your child masters his new skill and then you look back and think “So that is what was happening!”  If you find yourself in the midst of a sleep regression, do your best to soothe your child by being responsive but not creating any new sleep crutches or falling back into old ones.  Try to remind yourself that this is temporary, but if previously you didn’t need to step foot in your baby’s room at night, you may now need to make an appearance, even if it is just for a “parenting check.”  When you establish that your child isn’t sick and that there is nothing that you need to “do,” you can go back to a spot of increased support if you have gone through a behavioral fading method and your child was once comforted by having you close by.  Or you may need to do a few timed checks to reassure your child that you are nearby but that it is still time for sleeping.  Recognizing that your child also is tired and frustrated with whatever developmental milestone is happening is also helpful to keep in perspective.  Hopefully it will be short-lived and everyone will be back to sleeping great very soon.  If not, feel free to contact me for a free 15 minute consultation and get to the bottom of whatever is going on.

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Medical sleep stealers

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Make a smooth move from the crib to the bed