4 Month Progression

Let’s change the way we talk about babies…

Starting with the “4 month sleep regression” or as I like to call it the 4 Month Progression.

Imagine you just discovered a new and exciting place where every sight and sound captivated your attention. You felt inspired to play and discover new things. Would you be concerned with eating and sleeping?  Babies can only see black and white in the first few weeks and can’t see further than 12 inches in front of their face. Now at 4 months, not only are they seeing color but their field of vision has increased. Their awareness of their environment is expanding.

I am going to be honest, I cringe everytime I hear the words “4 month sleep regression”. If we truly knew and understood what was happening from our babys’ perspective, if we could see the world through their eyes during this time, we would be inclined to use more positive language. It is only a regression because it is inconvenient for us. Babies, they are just trying to grow and develop in a world that wants to label them and fix them. 

I get it, trust me I do, I returned to work with all three of my kids at about 8-12 weeks. I am very aware that we live in a society that does not support leave policies for parents. However, I have also witnessed all the parents who tried to force their child onto a sleep schedule or wish away this rapid stage of development because their child’s sleep changes impacted their sleep. Sleep is important for everyone, that fact is undeniable. However, no matter what we do, babies will grow and develop in the way they are designed too and having awareness of these changes with a concrete list of interventions is going to work far better than trying to prevent it from happening. 

Using the words “4 month sleep regression” is a way of posing a problem that needs to be solved. Instead, we can view this time as normal development, acknowledge that our babies are discovering the world around them and find ways to manage during that time of rapid growth and development. Each period is time limited, even though it doesn’t feel like it when you are in the thick of it, it will pass. 

During the first year of life babies will grow and develop more in that first year than any other year of their life! That sleepy newborn period is not meant to last. I am an advocate for setting parents up with confidence and realistic expectations. When we have realistic expectations we are more likely to view our babies as growing and developing humans experiencing very normal (albeit inconvenient for us) developmental milestones rather than a bunch or problems that need to be solved..

At 4 months you may notice that your baby is more awake during the day, they are not sleeping after every feed anymore, and they are more easily distracted during the feeds. You may have also noticed that your baby is waking more at night. 

Congratulations! Your baby has hit another developmental milestone. Those first 3-4 months are often referred to very accurately as the 4th trimester. Human babies, even born at term, are still underdeveloped as far as mammal species go; they can’t walk, talk or get food on their own. It takes weeks for their liver to start working adequately (hello jaundice!), they struggle to control their body temperature for the first few weeks of life, and breastfeeding doesn’t occur more effectively until about 4-6 weeks of life. They need help with regulating their sleep, emotional regulation and constant contact with their caregivers to feel a sense of safety. Is it any wonder that our babies want to be held for the majority of their first few months of life?

The first few weeks of life until your milk volume matures and is in higher volume, babies will feed frequently, so you will be waking at night, often, to feed your baby. However once they go through their 2 day, 3 week and 6 week growth spurt they begin to fall into a more manageable rhythm of eating and sleep. Their stomach has grown from the size of a cherry to the size of a lime at that point! Changes in sleep begin to occur when they exit their 4th trimester at about 4 months. 

At 4 months babies are rapidly developing, they are becoming more mobile, staying awake more during the day and they are finally discovering that there is a whole world out there. The first few months, YOU, as the parent are their world. We know scientifically, that babies do not view themselves as individuals in the first few months of life, they don’t understand that you are a separate being, they view you as part of them, as one person. Now, at 4 months, they are realizing that there is so much more to their world and they just can’t help but explore it! 

Lucky for you, you knew this was going to happen, hopefully you are reading this before your baby turns 4 months old and you can develop those realistic expectations and have a plan in place. If not, don’t worry there are ways to manage this time. If you are looking for ways to solve this “problem”, I can’t help with that, we can’t control infant development and we can’t control our babies. Unfortunately, we need to ride this wave. Just because this stage of development is normal, it doesn’t mean there aren’t strategies to help!

So how can we manage during this time of yet again more sleep deprivation and night waking?

Here are a few ways:

Feeding in the sling during the day

You have likely already discovered that your baby is more content when you are standing up, moving and walking with them as opposed to sitting with them. This is natural as it reminds them of being in the womb, movement is always a great way to calm your baby. Putting your baby in a baby carrier to walk while feeding can keep them more engaged with the feed and lessen distracted behaviors. If you have concerns about feeding this way, please talk to an IBCLC about how to safely feed in a baby carrier.

Make the daytime feeding environment as quiet as possible to eliminate distractions

The car honking outside, the dog barking across the street, the TV on in the house, phone ringing, siblings coming into view while feeding are all distractions for a baby. It is difficult to eliminate every distraction but eliminating a few can be beneficial. Many parents find that going to a quiet space in their house with dim lighting and reduced noise can help make daytime feeds more effective. 

Offering feeds during the day, even if your baby isn't showing hunger signs

As babies move out of the newborn phase they don’t cue to feed in the same way. Those “tell tale” signs of hands to the mouth, moving in their sleep, smacking their lips, or rooting may have all disappeared. They may not fall asleep immediately after feeding anymore or may have more wakeful periods between feeds. You may have to go through a period of relearning their hunger cues or feeding rhythm. Offering feeds even when they may not be showing cues can help get more frequent feeds throughout the day and help you learn their new hunger cues. When in doubt…just try to nurse. 

Breast compressions while feeding

Have you ever noticed how eagerly your baby feeds at the start of a feed when the flow of milk is fast and strong from the letdown? This is because babies will always respond to a flow of milk. When the flow is strong, babies will suck more consistently. Increasing the flow of milk manually with breast compressions can help your baby stay more engaged with the feed.

Going to bed a little earlier than usual to make up for lost sleep 

I know this one can be hard, especially after you've found a feed and sleep rhythm that has worked. We know at certain points through a child's development their sleep will be impacted. Planning ahead to find ways to get extra sleep for yourself can be beneficial. That could be going to bed a little earlier than usual or taking a nap during the day if possible. 

Try to keep your routine as consistent as possible 

Babies are experiencing a lot of changes during this time. Being overtired or overstimulated can add to their changing sleep behaviors. Having a good sleep routine doesn't necessarily mean your baby will sleep through the night but it will help them settle and the consistency will aid in helping them with their new sleep rhythm. Starting a bedtime routine if you haven’t already can be beneficial. Bath, infant massage, change of clothes, reading a story, cuddles and nursing can all be things to consider in your bedtime routine. 

Know that it will pass! 

This phase of sleep changes is developmentally normal as they are coming out of the "sleepy baby newborn phase" and these changes are time limited as they adjust to a new rhythm of sleep. For some parents, knowing that this time will eventually pass, is reassuring.

Continue to room share

Room sharing is highly recommended through the first 6 months of life and encouraged through the first 12 months of life. We know from research and cultures that practice room sharing as the cultural norm, that room sharing improves breastfeeding, helps babies sync their sleep/wake cycles with parents and increases sleep for parents by 1.5 hours every night! Room sharing provides continued protection against SID’s as does night waking and feeding. 

Safe co-sleeping

Many proponents of co-sleeping/bed sharing will tell you that this method helped them and their babies get more restful sleep. Following the Safe Sleep Seven is a great strategy and has not been shown to increase the risk fo SIDs. Dr. James Mckenna has done immense research on this topic and has coined the term “breastsleeping” which is when a baby feeds at the breast and sleeps simultaneously. This may also be referred to as “dream feeding”. His book Safe Infant Sleep: Expert Answers to Your Cosleeping Questions is a great starting point for parents exploring this option. 

Lastly, it is okay if you want to nurse your baby to sleep, if it works for the both of you it is not a bad thing. Sleep training programs and encouraging sleeping through the night from a very young age has become an expectation in western culture, however, around the world, this concept is entirely foreign to parents. In other parts of the world, a pacifier is called a dummy, because it is a dummy nipple and the baby knows it! Here we have become used to parents being referred to as “pacifiers” when in actuality a baby nursing for comfort in addition to food is developmentally normal and beneficial! Breastfeeding is not just about food, it is also warmth, comfort and stability for your child. This form of parenting often referred to as “attachment parenting” is the developmental norm. 

It is okay, and developmentally normal to nurse your child to sleep or just for comfort. There isn’t anything wrong with this, you are not creating bad habits and you don’t need to feel guilty about it.

I am not saying pacifiers are bad, many parents use them for a variety of reasons and those reasons are valid but if your baby doesn’t take one or you are trying to replace the breast with a pacifier because society convinced you it is better or normal, it is okay to just offer the breast. You are not creating bad habits. You are not causing harm. You are comforting your baby in the way nature intended and there is nothing wrong with that. Both options are valid and have benefits. There isn’t a right or wrong way.

If you have any concerns about your baby’s feeding or sleep pattern, reach out to an IBCLC for additional strategies or assessment to rule out other possibilities.