This week we’re talking all about why your baby might be waking up at night!
This was inspired by a conversation I had with a friend at church on Sunday. She mentioned she was scrolling through my podcast to see what could help her – her daughter had a really tough night waking the night before and fought a nap really hard recently.
And as a pediatric sleep coach, my brain went 10,000 different ways with what could be going on and I had so many questions I could have asked her!
We only had a few minutes to chat, so I thought, let’s make a whole post she can read or listen to and gain some insight as to why her daughter might be waking in the night!
This week I’m focusing on why your baby is waking up at night, and by babies, I’m talking those who are 4-17 months old. Next week I’ll dive into why your toddler or older child might be waking in the night!
I’m peeling back the curtain on what I think through when a family reaches out to me and says, “Why won’t my baby sleep through the night?!” Or, “My baby was sleeping through the night, but now they’re waking again. Why??”
Sometimes it’s pretty straightforward, but sometimes we have to play 20 questions to get there.
So here’s where my wonderings start, in the following order…
Question one: Has your baby been sleep trained?
If your baby is still waking up multiple times a night but they have not yet been sleep trained – meaning they are not independent sleepers – we kind of have to stop right there. That’s very likely why they’re still waking overnight!
As some sleep eduction 101, we all actually wake in the night. For you and me, we can usually roll over and go right back to sleep – we know how to fall asleep on our own. But for babies and kids who still need help to sleep, like rocking, feeding, or a parent laying with them, when they experience those natural wakings, they wake up looking for that same help getting back to sleep.
Which is why, if your baby still wakes up at night and they’re not yet sleep trained, that’s very likely the reason why!
That’s not to say that there are no other reasons, keep reading. But if you “perfect” everything else I share, but your baby isn’t sleep trained, I don’t have much confidence that they’ll be able to sleep through the night.
So start there.
And if you need more help figuring out what sleep training might look like, read here!
Sub-question: Does your baby need a pacifier to sleep?
So, “Is your baby sleep trained?,” is my first question, and then I dig a bit more.
If you say, “Yes,” I’m going to wonder if they still use a pacifier. Because yes, some babies who sleep with pacifiers are absolutely capable of sleeping through the night. But also, pacifiers are very often the problem or part of the problem!
So whenever we work with families of babies four months or older, we take the pacifier away! Read here if you’re wondering why in the world I would say such a thing.
Sub-question: Are they going down drowsy at all?
I also wonder, “Okay, you say they’re sleep trained, but are they really going to bed awake? Or is there any drowsiness?”
If you are singing to your baby for a few minutes, or cuddling them for a few minutes before laying them down, there’s a good chance they’re going to sleep drowsy.
Or if they nurse or drink their bottle at the very end of their routine, there’s a good chance they’re going to bed drowsy, or at least connecting milk to sleep, which could make them still feel the need to have milk in the night to fall back asleep. We call this a “loose and lingering association” – they don’t need it to actually fall asleep, but they get it so close to sleep it feels super connected.
You can dig more into bedtime routines and why I recommend milk be the first step in the routine here. In that post, you’ll also learn that for babies over 12 months old, we actually don’t want milk anywhere in the bedtime routine, it ideally should end with dinner.
So maybe you’ve sleep trained or your baby is mostly an independent sleeper, but I’d say not fully if they still need a pacifier, still go down pretty drowsy, or have milk to close, too.
Question two: What is their sleep schedule?
Okay, so after, “Your baby is likely waking in the night because they’re not sleep trained,” my next instinct is their schedule. If they’re independent sleepers, their schedule might be off!
Wake Windows and Set Schedules
Are they overtired, causing cortisol to run through their little system and just make sleep harder?
Are they undertired, not giving them enough sleep pressure to actually be tired enough to not just fall asleep, but actually stay asleep?
This means we need to look at wake windows or schedules – wake windows for those 4-6 month olds, but clock-based schedules for babies 7 months and older on a two nap or one nap schedule!
And all of this schedule info is in one place for you, so make sure you snag our free schedule guide!
Consistency Day-to-Day
Beyond just wake windows and set schedules, is your baby’s day-to-day fairly consistent?
When following wake windows we know there’s going to be more variance, but ideally your baby’s morning wake time and bedtime will be within about an hour of itself day to day. 1.5 hours is often okay, too, but we don’t want a huge variance.
For example, if they wake up at 6 am some mornings, but 8 am other mornings – that’s two hours different! That’s just too much for their little body clocks. Similarly, does bedtime vary wildly day to day? Is it 6:45 some nights, but 9 pm other nights? That’s just too different – they need some consistency.
And if your baby is on a two-nap schedule or one-nap schedule, we’re looking for even more consistency day to day – we want their sleep times to be within about 30 minutes of each other.
So even if their morning wake times varies from 6-7 am, we want their naps to be at pretty much the same time every day. Again, there’s about 30 minutes of wiggle room there, but that consistency day to day makes a huge difference!
So if you’re listening to this and your baby’s schedule is widely different day-to-day, focus there! Or if you still follow tired cues instead of wake windows, snag that schedule guide and start following wake windows!
Or if your 15-month-old takes one nap but it still changes day-to-day based on their morning wake time, and their bedtime changes day-to-day based on how long they nap, snag that guide and move toward a set schedule!
And I’m not talking about off days here, no child’s schedule is going to be perfect every single day, that’s life! But I’m talking about their norm – is their schedule consistent and age appropriate?
Total Daytime Sleep
We can’t, however, just look at wake windows and sleep pressure and schedules, we need to also look at total sleep – is your baby getting too much daytime sleep? Maybe their wake windows are spot on, but they’re just getting too much daytime sleep! That generally impacts early mornings more than night wakings, but it could still be a factor.
Nap Transitions
Still in the same schedule conversation, is it time for a nap transition?
Maybe it’s time to go from four naps to three, or three to two, or two to one? That’s all a sleep pressure thing!
Again, those daily maximums and ages when most babies transition is all in that schedule guide.
Because sleep schedules can be so involved, if you think your baby’s tough nights are due to a scheduling issue, I recommend logging their sleep each day – when they woke up, when they napped, for how long, when they went to bed – so you can start catching patterns and know where to make the tweaks and changes, and then track how they do from there.
Question three: Has your baby recently reached a new physical milestone?
Okay, so your baby is waking up at night, and we know they’re sleep trained, and truly an independent sleeper. We feel good about every piece of their schedule.
My next thought is a potential sleep regression! And if they’ve been sleeping through the night for a long time and now your baby is suddenly waking in the night again, a sleep regression is high on my list.
Because sleep regressions are real! If your baby has started sitting up, or crawling, or pulling to stand, or cruising, or walking, or talking, a sleep regression is a very real possibility! You can learn more here, but my general rule of thumb here is if we can tie the off-sleep to a physical milestone and therefore think it’s a regression, try to remain consistent for about two weeks before changing things up, like their schedule!
Because once that skill is normal, their sleep might go right back to normal again.
And if it doesn’t, it either wasn’t a regression and we need to adjust their schedule, or it was a regression but we went back to helping them with their sleep a bit too much out of survival mode, and we might need to touch up on sleep training with some leave and check, to remind your baby that they are, in fact, an independent sleeper!
Other Reasons Babies Wake in the Night
I’d say about 90-95% of the time, babies continue waking through the night due to a lack of independent sleep skills, the need for a schedule change, or because they’re learning a new skill.
But, if we’ve truly checked all of those off and your baby is still waking up, there are some other less common reasons…
Sickness
Your baby could be sick! Maybe they have an ear infection or congestion that’s waking them up. That’s not why they’ve been waking up for weeks or months, but maybe why they’re suddenly waking more? I talk all about sickness in this post.
Teething
Maybe it’s teething, which I share more about here. Don’t blame teething for all sleeplessness, but maybe that molar is causing two days of sleep disruption.
Environmental Disruptions
Or could it be something environmental? Maybe your baby’s nursery is too hot or too cold, maybe some strange sound goes off at 2 am, or there’s a flashing light out the window.
Or does your baby’s sound machine time out at some point? Because we want that white noise running all night long so their environment feels the same no matter what time of night they stir. And note that I said white noise, we should not have music playing all night!
These are never my go to wonderings, but maybe something’s happening there!
Dirty Diaper
Is your baby waking up because of poop? Maybe you can change up what solids they get at different times of day – maybe more fruit in the morning, and more binding food toward evening. I’m not a nutritionist but if they’re diaper is dirty each waking, I’d wonder what I could adjust with their feeds, or bicycle kicks or something.
And I’d coat their little bums in lots of cream at bedtime so it hopefully doesn’t bother them as much overnight.
Low Iron
I’ll cover this next week with toddlers and older kids, but it’s worth mentioning iron here. I don’t know that I’ve worked with a baby who has low iron and that’s causing sleep challenges, but I’ve worked with older kids who have low iron and it’s causing sleep trouble! So worth putting on your radar.
Low iiron and poor sleep can be connected – again, not my go-to thought, but it’s a factor.
Medical Challenges or Other Discomfort
Medical challenges are not my go-to when I hear a baby isn’t sleeping through the night, but it could be a cause!
Your baby might be waking in the night due to some sort of discomfort. Maybe they have some gas, or maybe they have on oral restriction causing discomfort and problems with nursing or bottle feeding? Maybe they have bad reflux or awful eczema? Maybe they are mouth breathers, or have some sort of airway challenge? That’s what we’re chasing with our baby right now.
We are certainly not doctors and can’t diagnose anything, but we are often able to hear red flags when something really isn’t working, and we always try to point you to providers who may be able to help you more!
Now don’t hear me say if your baby is waking a lot in the night, there’s something medical going on. Most of the time sleep is totally behavioral rather than medical, so don’t let this make you nervous – we’re talking small percentages here.
Hunger
Now before we wrap up, let’s talk hunger. Because I know you’re thinking it!
Could hunger be the reason your baby is still waking up at night? ABSOLUTELY! But for those asking why their baby is still waking at night, it’s usually for an older baby who shouldn’t need a night feed anymore, which is why I’m sliding it in at the end.
But it needs to be discussed!
So, could a 4-month-old be hungry in the night? YES! It’s so common for a 4-month-old to need one or two night feeds. Not four feeds, but one or two.
Is it common for a 5-month-old to need a night feed? Sure! One, maybe two night feeds.
Is it common for a 6-month-old to need night feed? Maybe one, but also maybe not!
It’s right around six months when most babies, as long as they’re healthy and growing well, are able to sleep through without needing a night feed! Some absolutely sleep through sooner, and some might still need a feed for a bit longer.
But come to me with a healthy 8- or 9-month-old who is growing well, do I think they’re waking due to hunger? I don’t! That’s when I’d jump to sleep training, schedules, and regressions.
Or similarly, come to me with a 4-month-old waking 4-5 times a night… Is it due to hunger? Like I said, maybe for one or two of those wakings, but we’re still talking sleep training, schedules, and regressions. And when we get those all in place, if baby is still waking for a feed or two, great! But there’s also a chance that now those are in place, they’ll sleep through!
Conclusion
In wrapping up, the whole goal here is to let you in on how we, as pediatric sleep coaches, think through your baby’s night wakings. And then to help you put that hat on and figure out why your baby is waking up at night!
Some people think that sleep consultants have this extra level of knowledge that you can only attain if you hire us – like there’s a secret sauce you only reap the benefits of if you work with a sleep coach. But that’s just not true – you can find everything you need on the internet.
Although that’s also the problem, because there’s just too much info out there, and it’s hard to sift through, and can feel like a second job. This is literally a job I trained for and of course get paid for, so you’re not expected to also be a sleep coach!
So for the parents who are DIYers, that’s why we have our online baby sleep course, Baby Sleep from A to Z. We put all of the info you need to successfully sleep train your baby into 60 minutes of video and a printable guide so you don’t have to piece-meal everything you find online or on social media.
Also remember…
You might have gotten through this whole post and you still don’t know what’s going on – why is your baby still waking in the night? Or you know it’s a schedule issue, but you just don’t have the bandwidth to piece it all together. Or you know it’s time to sleep train, but that sounds so daunting, or you want some hand holding, or just accountability to make sure you actually do it!
THAT’S WHAT WE’RE HERE FOR!
We work one-on-one with families, not just delivering the sleep training plan they’ll work through, but setting the right schedule, helping parents remain consistent even when it’s hard, tracking the baby’s sleep over time to see what needs to be adjusted…because sometimes it’s not so straightforward!
The content isn’t the secret sauce, we are! Our trained eyes and experienced ears to get your baby finally sleeping through the night.
So if that kind of personalized sleep plan and follow-up sounds like something you might be looking for, we’re so glad you’re here, and would love to chat with you. Sign up for a free discovery call and hear more about what it would look like to work together!
With Grace,
Lauren
