Babies (and Toddlers) Wake Frequently at Night (Part One)

Regressions. White noise machines. Charts of sleep needs by age. Wearable blankets. Sleep trackers. Today’s parents, at least those in WEIRD societies (yes, that’s an actual term in anthropology – Western, Educated, Industrialized, Rich and Democratic) are overloaded with information and choices about where and how much babies sleep. This obsession promotes so much unnecessary anxiety and stress – no wonder parents have trouble sleeping!

“Is your baby sleeping through the night?” may be the most common question heard by Western parents. And when the answer is “no” or “for a while, but now they are waking up again,” parents often worry something is wrong with their baby. But here’s the thing – it’s biologically normal for babies to wake at night. Heck, it’s normal for adults – we get up to use the toilet, adjust blankets or even just roll over.

Waking at night is protective

For young babies, night waking is actually protective. Humans have the largest brains of any primate in relation to our size and our infants are born less mature so their heads fit through the birth canal. One result of this immaturity is an underdeveloped breathing system – and some SIDS researchers theorize that vulnerable babies may sleep so long and so deeply that they “forget” to breathe.

This may be why babies sleep less deeply and have shorter sleep cycles than adults – and why trying to “train” an infant to sleep more like an adult may be risky. It’s also why sharing sleep with a baby is important – a parent’s breathing and movements at night keep an infant from sleeping too deeply.

In addition, babies brains and bodies are growing incredibly fast, which sometimes makes it hard to stay asleep! The dreaded “sleep regression” is misnamed – it’s actually a developmental progression as an infant who had been sleeping longer stretches starts to wake more frequently. They may be becoming more aware of their surroundings or getting ready to crawl or any one of the other mental and physical milestones children progress through during the first few years of life.

But I’m tired!

So you may be thinking – ok, that’s fine, but I’m tired! How can I get a better night’s sleep?

First, don’t look at the clock or your phone and forget the sleep trackers – trust me, it helps not to know! And don’t worry if your child doesn’t sleep the average for their age – like adults, they all have individual sleep needs. Remember, you can’t make a baby sleep – you can only provide a calming atmosphere that is conducive to sleep. If your child truly seems sleep deprived (rubbing eyes constantly, looking dazed, etc.), try winding down earlier in the evening (see my post A Different Approach to Bedtime) or lying down with them in a quiet, childproof room during the day – even if they don’t nap, the rest time is restorative.

Second, share sleep with your baby (and toddler)! Make your bed a safe space (see How to Sleep Safely with your Baby) and work on getting comfortable in the cuddle curl so you can nurse without waking completely. An extra pillow under your head and one between your knees can make a world of difference. If baby likes to sleep with your nipple in their mouth all night and you find that uncomfortable, try easing it out (a finger in the corner of the mouth helps) when they are in a deep sleep and press up on their chin to keep their mouth closed for a minute or two.

Putting your top leg down on the bed and leaning over to nurse from the top breast sometimes can help stretch out your back. And don’t feel you need to sleep in one position the whole night – the cuddle curl is safest when infants are tiny, but even then many parents don’t stay like that the whole night. They roll on their backs for a while or turn over and stretch. For parents who bottle feed, having baby next to the bed in a co-sleeper or sidecar crib for at least the first four months makes it easier to put in a pacifier/dummy and pat baby’s back.

Stay horizontal

Are you sensing a pattern here? Staying horizontal is key! Some parents have heard that they shouldn’t let their baby fall asleep nursing or that they should put an infant down drowsy but awake. This may work for a few unicorn babies, but human milk contains melatonin, tryptophan and other substances that promote sleepiness. Nursing to sleep is biologically normal and often much easier than rocking or bouncing in the middle of the night.

If you already rock or bounce your little one to sleep, see if you can transition to back to nursing or something else you can do lying down. Patting or rubbing, shushing or humming, letting baby suck on your finger, or rocking baby’s bum may help. Patting and humming while breastfeeding can also be helpful if you will be going back to work or school and someone else will be helping baby sleep – your child will associate these other sleep cues with the comfort of nursing.

And remember – you don’t have to get baby back to sleep every time they wake. If they aren’t upset and don’t want to nurse, it’s fine to let bubs babble and roll around a bit until they are ready to doze off again. Take this time to breathe deeply and relax, which can be almost as restorative as sleep.

Many parents hardly notice when their babies rouse – they adjust covers, shift position, latch and drift off again without fully waking up. If this works for both you and your little one, there’s no need to change anything. But if frequent waking is disturbing either of you, Sweet Sleep has some great ideas on ways to “nudge” a baby into sleeping longer.

Try nudging

There isn’t much nudging that can be done in infants under six months old, but there are a few things to try. Breastfeeding more often during the day sometimes helps, especially in the evenings when babies often naturally cluster feed as they “tank up” for the night. Sleeping skin to skin – opening your shirt and cuddling bub close wearing just a diaper, or laying a hand on baby’s bare back – can encourage longer sleep sessions. Even just being held by an adult, whether it’s a contact nap with mom while she watches a movie or a snooze in an infant carrier as grandpa vacuums the floor, often stretches out the zzzs.

After about six months old, there are a few more “nudges” to try. Getting baby outside each day for some exercise and sunlight can encourage more restful sleep at night, even when it’s cold and overcast. Take a lesson from Scandinavian parents, who bundle up their infants in all kinds of weather for naps outdoors after a brisk walk in a stroller or pram.

A short bedtime routine, hopefully done as part of an evening wind down for the whole family (see A Different Approach to Bedtime), can include a relaxing massage if baby enjoys it. If bubs falls asleep before you, dream feeding (basically latching babe on in their sleep) right as you are turning out the lights and heading for slumberland yourself can stretch out your child’s first sleep interval.

Baths are traditionally done in the evening, but if they are stimulating rather than relaxing for your child, move it to a different part of the day. You may want to add Epsom salts to baby’s bath – magnesium is absorbed through the skin and can help calm restlessness.

Things to check

Anemia can also contribute to restless sleep, so have your child’s iron levels checked if he or she thrashes about and can’t seem to get comfortable. If babe sleeps with their mouth open (especially if they snore), check with your doctor in case sleep apnea could be keeping baby up or see an IBCLC if you suspect a tongue tie.

Allergies are another common culprit and sometimes eliminating certain foods or taking up carpet (in the case of dust allergies) can be helpful. Teething, reflux, colds and ear infections also keep babies awake at night. This quiz is a quick way to discover these and other possible reasons for sleep disturbances so you can follow up with the right health professional.

One frequent frustration for parents is the baby who wakes up in the middle of the night and simply refuse to go back to sleep for an hour or two – or even more. This is especially common between the ages of six and twelve months. Children are busy practicing new skills during this period – no time for sleep!

Two shift sleeping

They also may be doing two shift sleeping, something that was once typical for many of us. When mine were little I played dead (we had a floor bed in a childproof room) – they babbled and played (and yes, would head butt me and stick their fingers in my nose) and eventually went back to sleep while I did my best to snooze. Keep your eyes closed and model sleep with lots of turning over, grumbling and saying shhhh. 

Sleep patterns in babies – shorter sleep cycles, a larger percentage of light sleep – become more adultlike as your child grows, but this happens for each individual on his or her own timeline. Often parents expect toddlers over one to stop waking at night, but many still wake well into the second and third year of life. We will explore this in Part Two.

Sweet Sleep by Diane Wiessinger, Diana West, Linda J. Smith, and Teresa Pitman

Safe Infant Sleep by Dr. James McKenna