Has your baby started waking at unusual times again? Or maybe they have never slept through the night and you're completely shattered after months of little sleep. Whatever your baby's previous sleep was like, the majority of babies have disturbed sleep at around 4-5 months of age and often this continues for many months.
This is a long and detailed article so you can use the links below to click to the info you want.
Different sleeping environment to where baby fell asleep
If you have had a 'good' sleeper, try hard to stick to your routine. It's likely it was those good sleep practices that taught your baby to sleep well when they were a smaller baby.
Avoid re-introducing night feeds (apart from the dreamfeed, details below), or feeding them to sleep, as this will likely lead to further night waking not less! Try to identify what has caused the change from our list below, and take action.
Teething is often blamed for babies starting to wake again...but this is often not the real cause!
It's also quite possible that they have not yet learned to self settle, and the change to their sleep cycles means they are now waking fully in the night rather than drifting back to sleep. If you are rocking or feeding them to sleep, this will be causing their waking and needs to be addressed first. See Sleep associations & self settling.
If your baby has not been sleeping through the night, now is a good time to take action to teach them to self-settle. The longer you leave it, the hard it will become, as habits are more well-formed. And as babies get older, new challenges arise, such as your baby being able to stand up in the cot.
Before tackling the list below, ensure you have gone back to basics, such as trying swaddling (provided baby is not rolling) and ensuring you are using the Feed, Play, Sleep routine during the day.
It may help to remember that all babies over 5 months of age wake 4-6 times during the night, as they come to the end of each sleep cycle. This is normal, and also occurs with older children and adults. It's the falling back to sleep that can be the problem, particularly when the baby needs Mum or Dad to help them return to sleep. And crying out for Mum and Dad usually results in a baby who is fully awake, and harder to resettle.
So lets take a look at what may be causing your baby to not resettle when they wake in the night?
This is the most common reason that babies can not get back to sleep without help during the night. Babies with a sleep association struggle to self settle, so they don't know how to 'sleep through the night'. This is particularly true after the sleep cycle changes that happen at 5 months.
What does your baby need to fall asleep?
And is this missing when they stir in the night? For example, if you always feed your baby to sleep at bedtime, they have now learned that they need this to fall asleep. So they cry when they wake up and can't get back to sleep, as the feeding is missing. If your response is to get up and feed them to sleep every time they wake up, your response is causing the night-waking to continue as it reinforces your baby's belief that they can't get back to sleep without you.
Make sure your baby can fall asleep at bedtime without needing you present, either feeding or rocking to sleep, continually putting a dummy back in, patting them or cuddling them to sleep. For more information, read the below articles.
Teething is often given as the reason for night waking in babies of this age. It may cause the initial waking, but teething is generally not likely to be serious enough to cause waking and crying on an ongoing basis for weeks or months. Many babies and toddlers sleep through the night even when cutting painful molars.
If pain from teething is serious, your baby is likely to be very unhappy during the day as well, not just at night.
If you can see the tooth actually cutting through the gum, then your baby may need some pain relief for that night or two....and this is not the time to tackle sleep training!
If you believe your baby is waking from teething pain, please consult your GP, discuss suitable pain relief with your pharmacist or call Plunketline.
However, almost always it your reaction to the waking (eg getting baby up and feeding them) that causes continued waking and inability self settle. Remember that new habits can form in just a few days, so avoid falling back into night feeding and ensure your baby knows how to self settle.
Like teething, hunger is often given as the explanation for a baby who starts waking again during the night. This occurs even when a baby has been sleeping for long stretches and had stopped feeding in the night or was down to just a dreamfeed.
If they are 'rooting' (turning their head to the breast) when you pick them up, this may be the case. Or if baby has been unwell and you think they have missed feeds in the day.
However before you go back to regular feeds during the night, look for ways during the day to prevent baby from being hungry during the night.
Waking at about 5am is often due to hunger with older babies, especially when they can self settle and sleep through the night. We highly recommend doing a 'dreamfeed' (feed baby while they are asleep) at 10pm, so they can last all night without needing another feed.
Re-introduce a 'dream-feed' - the feed you do at around 10pm while your baby is still asleep.
Talk to your Plunket nurse about starting solids if your baby is over 6 months.
If you are breastfeeding, a good option can be to express a bottle of milk after the first feed in the morning and offer after breastfeeding at bedtime.
Review your routine, as the timing of milk feeds and solids can have a significant effect on both day and night-time sleeping. See the Sleep Store Sleep Plan for some sample routines.
Ensure you are eating well, not rushing around too much and resting when you can. The volume of late afternoon and early evening breastfeeds can be effected by tired, dehydrated and hungry mums!
Just because your baby or toddler happily accepts a feed in the night, that doesn't mean it's hunger that woke them in the first place. Remember babies over 5 months wake fully every couple of hours between sleep cycles whether they are hungry or not.
Waking between sleep cycles does not automatically mean your baby is hungry and NEEDS a feed.
If you woke up and couldn't resettle, and someone offered you your favourite comfort, would you take it??? Of course you would, and so will your baby accept a breastfeed or bottle if they are upset, regardless of what caused them to wake or struggle to resettle.
Feeding a baby when they don't need it can lead to a sleep association ...ie a baby learns over time that they can only fall back to sleep by being fed.
Once your baby is over 3-4 months, you can try other settling techniques to see if your baby can go back to sleep without a feed. A hungry baby will not go back to sleep with a cuddle, patting, dummy or being given the opportunity to self settle.
Of course newborns need feeding during the night and will wake every 2-4 hours as their tummies are so little - remember the info in this article relates to babies over 3 months and beyond.
Babies often wake from the cold, particularly once they are active enough to kick off blankets. The temperature between 3-5 am is often significantly cooler than when you put your baby to bed.
If your baby is waking around 3-5am and can self settle at bedtime, then cold is highly likely to be the reason. Plus it is a very simple problem to resolve, so you can then see if there is any other cause for waking in the night.
We recommend you use a quality baby sleeping bag that will keep your baby the right temperature ALL night, such as the highly recommended Woolbabes.
This means you don't need blankets (which can be kicked off) or that your baby could wriggle under. Click here for more information on baby sleeping bags.
We also advise using layers of merino clothing overnight, as this helps babies regulate their temperature whether it is warm or cool.
Adding merino socks is also another way to help your little ones (and bigger children) stay warm through the night.
Wriggling all around the cot or pulling up is also a very common reason for babies to not resettle in the night, including babies who were previously sleeping through the night.
Babies often 'scoot' up the cot and bang their head, or end up with arms or legs out the cot. As babies get older, they are also likely to stand in their cot and find it hard to lie them self back down.
This problem can be easily solved with a Safe T Sleep Sleepwrap which will fix moving around in the cot and significantly increase the likelihood your baby will sleep through the night.
If your baby wakes in the night and finds they are in a different place or environment to where they went to sleep, they will be confused and likely to be unable to get back to sleep.....Think about if you stirred from a deep sleep and found you were sleeping on the floor...it would be hard to resettle!
Ensure you put your baby to sleep where they will sleep all night, with the same conditions they will experience if they wake, such as light, noise, warmth etc.
This also means we recommend not having your baby fall asleep on you and putting them into bed asleep. A younger baby may transfer to the cot OK and sleep through, but once a baby is over 4-5 months this will likely cause more night-waking as baby will find it hard to resettle.
Using a dummy can be a very strong sleep association for a baby, as they associate sucking with falling off to sleep.
As babies get older, they may start to need their dummy to resettle at each of the 4-6 times during the night when they wake......It's not the dummy causing the waking, your baby will wake anyway. The problem is that your baby likely doesn't know they can resettle without the dummy in their mouth.
If you find you are continually getting up in the night to replace the dummy, your options are:
You may want to think about weaning baby from having a dummy - The most gentle technique we have found for weaning off a dummy is in 'The No Cry Sleep Solution'.
Teach your baby to put it back in themself (can be learned from about 5-6 months of age) - then the dummy becomes a self-settling tool for your baby.
Or you will continue needing to get up!!
Basically if you continue to get up and put the dummy back in for your baby, they will continue to need you to do this for them.
It's a very personal decision whether to use a dummy with your baby, and you need to decide for yourself what do do from here.
If your baby is still being fed in the night after six months, this may be contributing to your baby not being able to go back to sleep during the night. They may now have a learned hunger or a habit on feeding to get back to sleep, rather than actually needing to be fed frequently like a newborn.
Also if your baby is being fed several times in the night, this may be leading to wet nappies and further waking as a result. There is good information on this cutting out/back on night feeding in 'The No Cry Sleep Solution'.
See our Sleep Plan for an age appropriate routine to ensure your baby is getting sufficient feeding during the day.
If your baby is getting a lot of calories from night milk feeds, this can impact on the amount a baby will eat and drink during the day.
If you feel your baby still needs night feeds, we recommend doing 1-2 'dreamfeeds' while your baby is ASLEEP. This mean you can ensure your baby isn't hungry but that they aren't leaning over time that the only way to get back to sleep is to cry and be fed.
If you always put your baby to sleep by feeding or rocking, they have not learned that they can settle themselves to sleep without your help.
The same applies if you feed or rock your baby until they are drowsy, and put your baby into bed straight after...so while their eyes may be open for a few seconds after the feed/rocking, they rely on that to get to sleep.
Start by trying to put her down for day-time naps sleepy but awake, then move to doing this at night. You can refer to 'The No Cry Sleep Solution', the 'Sleepeasy Solution' or 'our article on Teaching your Baby to Self Settle for ideas.
It is worth experimenting to see what happens when you do let baby try to settle themself. It may only take a few minutes of crying or grizzling during the night before baby does settle themself. We get constant feedback from parents that they are surprised how quickly their baby learns to self settle when given the opportunity. And the longer you don't teach your baby this essential skill, the harder it will be when you finally do, whether you choose a gentle and gradual approach or go cold turkey with something like verbal reassurance.
There are a number of medical conditions that make sleeping difficult for babies and toddlers, and will make teaching your baby to sleep through the night more challenging.
Two examples are ear infections and reflux (including silent reflux without spilling). If you have covered all other options with your baby, they know how to self settle and they are still waking crying or screaming, please urgently discuss this with your GP. If your baby has either of these painful conditions, adding controlled crying or other sleep training to the mix would be very unfair on your baby (and you).
Another issue some customers have mentioned to us is allergies - severe eczema can really make resettling difficult. Plus some food allergies, such as a bad dairy allergy, can cause a lot of difficulty with sleeping.
For more information on reflux, please visit the excellent website Crying Over Spilt Milk. For all other medical conditions, please consult with your medical professional. You may find our gentle sleep training information in the article 'Gently wean your baby off rocking' is relevant with babies who are unwell but still need improved sleep.
Another condition that can cause a baby or toddler to start waking again is worms! If your baby has been sleeping through and suddenly starts waking and is really hard to settle, investigate this as a cause!
Go in while your baby is asleep, leaving the light off. Use a torch to check if you can see any tiny white worms around your baby's anus. You may see worms in your baby's poo but often they are very hard to spot.
Worms are easily treated with hygiene measures and medication if needed. Visit your pharmacist for advice (or GP if your child is under 2) on how to treat them.
There are always lots of colds and tummy bugs going around babies and toddlers. These can cause babies to wake, especially with dirty nappies!
We recommend you take your baby to the doctor and ensure it's nothing serious. And as soon as your baby is recovered, get back to your normal night time routine so new habits with extra cuddles and night feeds don't stick!
If your baby suffers from more serious or ongoing health problems, good sleep is even more important, as it will help her heal more quickly. And you need a decent sleep to cope with the stress and workload of a sick child.
Consult with your doctor before starting a sleep program. The No Cry Sleep Solution is a good option if you are not comfortable leaving your baby crying to self settle.
And finally, babies who are in the process of learning something new are often awake more in the night and may find it hard to get back to sleep. You may see the disturbed sleep before you see signs of the leap, such as a baby starting to be more unsettled in the night then start crawling a few days later.
Little brains can be very active during the night. and little bodies often like practicing new skills during the night, often before they are even fully awake.
So you if your baby is healthy, can usually settle well and sleep through, night waking may well signal that a new skill is not far away.
So there are a number of reasons why your baby is waking and not settling herself back to sleep. We recommend you think through which reasons are relevant to you and your baby, and make a plan of attack from there.
While hunger and teething are the most common reasons given for continued night waking, you find that it is much more likely to be related to baby not knowing how to fall asleep at bedtime or helped back to sleep during the night.
You can download a free Sleep Store Sleep Plan here.
You can cross your fingers and hope things improve. But 50% of baby sleep problems are still a problem at preschool age..... so why not tackle your sleep problem now before the habits get further established!
To access more free expert sleep advice join sleep support groups curated by our trained coaches or browse our library of sleep articles here.
