Moving Through The 4 Month Sleep Regression in Under A Week – Case Study


I recently had the pleasure of working with a family with their first child. This little boy went from sleeping beautifully as a newborn, to suddenly waking every 2hours through the night for a feed, naps also became very short, 20 minutes in duration and he was exhausted.  

I educated Mum and Dad that the 4-month regression is often the beginning of the end in terms of habitual wake-ups and that it is something that is best addressed quickly as it does not self-resolve. Many families that come to me at 9, 12 or 18 months say “Everything was fine until he stopped sleeping at 4 months of age”. At 4 months a baby’s sleep cycle changes to become more adult-like, and they have a leap forward in development and understanding. Habits can form at this age as they learn by association and start to feel the shift between sleep cycles, they begin to realise that they have been moved from where they fell asleep and ask for those conditions to be recreated at each sleep cycle, which is 2 hourly at night, and every 20-40 minutes through the day. I explained that the key to overcoming this regression is to make the sleep environment consistent.

I met the family for an in-home consultation, and I could see that their baby was not coping with the level of sleep deprivation.  This baby boy was waking crying and grizzly each morning, with dark circles under his eyes and looked quite unwell from being so, so tired.

Mum and Dad were also exhausted, but their main concern was how this was impacting their child. They wanted a gentle method and to avoid “crying it out”, although they knew that some crying would be involved in changing habits. We worked together to find a strategy that felt comfortable to them as parents, which allowed them to be supportive with in-room settling and pick-ups but would work on eliminating the need to feed every 2 hours and lengthen the naps out.

For this baby’s weight we determined that he needed 2 breastfeeds at night. All the other wake-ups we would address with settling in the cot, along with working on cot settling for bedtime and nap time. The room also needed to be made darker as their baby was very alert, and even with self-settling, I could tell that he would struggle to link sleep cycles if he could see everything.  Cues were also being missed, so we temporarily scaled wake time back to 1 hour 40 minutes to get on top of the sleep debt, this instantly increased nap duration along with the dark room.

Mum and Dad followed my directions for teaching Bub to settle in his cot exactly. He was not happy at first, but they felt reassured that they could comfort, pick up and calm their baby whilst still teaching him his cot was where he needed to fall asleep.

Within 1 week we were down to ONE night feed (he spontaneously began sleeping through the 2nd feed). Feeds in the day were more productive as he was not waking for the day full of night time milk, naps lengthened out to 1 hour plus and this little boy’s disposition changed, he was always smiling, stopped needing to be carried constantly and was very content to be left to play by himself for 10 minutes at a time.