Preventing the dreaded 4 month baby sleep regression

Preventing the dreaded 4 month baby sleep regression

I’m back from my UK trip. My first holiday in 4 years and I’ve come back refreshed and ready to help many more sleep deprived families out there. And it’s back to my blogging ASAP and some really good blogs on all things baby sleep and parenting.

I’ve missed my writing while I was away and I’m sure you’ve all missed it too 🙂 Starting with that pesky 4-month sleep regression that derails so many babies and starts off the spiral of sleep deprivation. baby sleepingThis is really huge. It’s only taken me a little under 16 years to work this out so don’t worry if you haven’t! This little gem is going to really turnaround sleep for many parents.

Most of you who know me, will relate to my analytical scientific brain and way of thinking. Having 2 science degrees and conducting research in my dissertations has made me a very different type of nurse, midwife and baby whisperer. When I started Nurture Parenting just over 5 years ago I had no idea how much that 4-month sleep regression was impacting families. Fast forward 5 years and it’s one of the biggest issues that leads to frequent night waking and subsequent maternal exhaustion.

Baby sleep learning

I’m taking you right back to my English training as a Health Visitor. Parents are taught at 2-8 weeks postnatal, how to put their babies to sleep. It is a very simple no-frills approach. I had very few sleep problems following a prevention model of baby sleep learning. Babies are put down awake in the cot of not under or over tired but just right. We didn’t wrap or swaddle. Instead we placed them on their back to sleep. Feet placed at the foot of the cot. Tucked in firmly at shoulder height with a firm cotton sheet and a blanket or two. Babies were never patted…ever. If they got upset we picked them up for a quick cuddle. Then put them down awake in the cot when quieter, but not asleep. We kept on doing this and used a hands-on technique until they fell asleep. Now fast forward to my Australian experience of baby sleep and how many sleep problems in New South Wales? There are way too many to count.baby sleep Looking at my UK practice at all the things we did differently here in OZ.

So many mums telling me their sleep problem was really a 4-month sleep regression caused by wonder weeks. Well I never had any 4-month sleep regressions in England ever and not very many in Melbourne. So what is it about the 4-month wonder week that makes sleep come undone? It’s the World of Events at 4-months…which are patterns and sequences,  a real aha moment. I looked at the practice of other baby sleep practitioners both private and health service sleep school. I get quite a lot of clients who ‘fail’ sleep school and asked the parents what they were getting taught.

Patting babies to sleep

For a lot of families I worked out it’s the patting to sleep. It’s rhythmic and leaves such an imprint on the baby. Unless they are patted they can’t get back to sleep. Toddlers are asking to be patted, saying to their mum, ‘pat mummy pat, pat mummy’. I’ve seen 7-month old babies either get hold of their mum’s hand and place it on their tummy and pat. Also, babies patting their own mattress. It’s really quite astounding. And how many baby sleep books and parenting experts in Australia recommend PATTING a baby off to sleep? Way too many to count. I’ve heard Pinky McKay, Dr Howard Chilton, Baby Bliss and Jo Ryan, Tresillian and Karitane, sleep school, Raising Children’s Website and thesleepmama of Instagram infamy, all advocate patting babies off to sleep. I’d like them to please look at their practice and reconsider teaching patting. It’s not helping Australian parents or their babies and children and if anything it’s having a detrimental effect on parental exhaustion. I see way too many parents with postnatal depression and who are really teetering on the edge. It has to stop. Dr Lynne MurrayThe real clincher for me was reading an article by Dr. Lynne Murray an eminent UK psychologist in the Mail Online and saying that if babies couldn’t recreate the thing that put them to sleep then their sleep would come undone.

Psychology of Baby Sleep

http://www.dailymail.co.uk/health/article-2661995/The-price-rocking-baby-sleep-Infants-note-going-drop-want-thing.html As soon as her new book came out, ‘The Psychology of Babies’ I went straight to the chapter on sleep. And lo and behold, there was my UK baby sleep method and not a mention of a pat anywhere and babies had their hands free and unswaddled. Hallelujah for Dr Lynne Murray, the voice of reason and evidence-based practice.

Buy my new Ebook

Do yourself a favour and avoid that 4-month sleep regression by buying my new Ebook Help I’m a New Mum and I Don’t Know What To Do. Find it in my online shop now and on Amazon Kindle this week. Help I'm a New MumIn this book

I look at all things baby sleep under 4-months. This is NOT for babies older than 4 months. Once you hit 4 months a whole different approach is needed.

It covers my own unique (trademarked) techniques of hands on settling and Baby Sleep Learning (BSL) that I’ve been teaching to families for the past 17 years. There is not a pat in sight. And a bargain at $7.99 AUD.

It could be just the thing you need to read to avoid that dreaded 4-month sleep regression.

Remember you can ask me anything during the weekly Nurture Parenting Facebook live broadcasts, usually on Tuesdays. Here’s the link to the FB page: https://www.facebook.com/NurtureParenting.BabySleepGuru

4 month sleep regression

Babies and crying, what is OK?

What is involved in my sleep methods?

Baby boys and sleep problems

Baby boys and sleep problems

Here’s something else from the anticipated baby sleep book I’m writing. Something that when I researched it, blew me away. It’s HUGE.

Gender and effects on sleep.

This may surprise parents and when I had my light bulb moment it shocked me too! A chance comment my partner Steve said, “Do you only see boy babies and children, Karen?”

I replied, “What do you mean by that?” He said, “No, you do, you only see boys?!” I had a good think. Often when you’re helping families day in day out you’re so engrossed in the pure intensity of the situation. You don’t see the patterns and trends that are evolving.

Wow it stunned me. He was totally correct. Steve is a building manager so knows nothing of my work. Apart from what he sees from the outside. There must have been more boys names being mentioned than girls! I had to research this further. Anyone who has met me will know I have an insatiable thirst for having to know everything about an issue.

Approximately 6 out of 7 babies I help for sleep disturbances are boys

Does that surprise you?

This chance comment of ‘Do I only see boys?”, was so profound it made me look at how many of each gender I was seeing. And what were the key ages of the boy babies. The majority of babies are around the classic wonder week ages of 4 months, 6-8 months and 18 months. When a baby approaches a growth spurt their brain turns on like a light-bulb. They may have a few wakeful nights and parents respond with new ways to try and settle them. And voila you have a new sleep association the baby cannot repeat themselves. It happens so often. Parents try and go back to what they were doing before. Baby protests because they’ve got a taste of the new treatment and they’re actually quite preferring it! I’m sure many of you have been there!

day napsWhy do baby boys cope less well with developmental leaps?

I had finally decided to read the book by Tasmanian Psychologist, Steve Biddulph, Raising Boys [2009] and voila I had my light-bulb moment!

I can even see the difference in my nieces and nephew as babies. The 3 girls were less needy, more independent, liked to be cuddled less and more settled. My nephew was like a little koala and always in his mums’ arms, rarely in his cot. Yet he’s grown up to be a well-adjusted young man with normal emotional health. As a midwife and nurse I notice boys do, on the whole, need more love and cuddles. They handle sleep training much better if it’s done in a kind way, often using parental presence and plenty of cuddles. So why is this need for more love and comfort common in baby boys and what does it do?

As a generalization we as a society treat boys more harshly, we expect them to be not be so needy and sooky, yet if we gave more to them, in terms of love and cuddles we’d actually get a much better adjusted boy and later man. Boys have a 50% greater mortality rate when born premature, than baby girls. That for me was huge when I read this. I remember working as a midwife in NICU and if a premature baby girl was admitted we’d comment, “Oh it’s a girl, she’ll do well.” We never ever said that about a premature baby boy. Those stats are huge, 50%. So what is it about the boy thing and survival and coping with stress you’re probably wondering by now?

The boy vs. the girl brain

A baby boys’ brain is known to develop much more slowly than a girls’ and the 2 hemispheres are less connected via the corpus callosum than a baby girls brain. Aha so that’s why they cope less well with stress. A fully communicating brain copes with a lot more stress. This ability occurs fully by the time they are several years old. Another aha moment from me. I see lots of  boys up until 3 years old.

Boys read faces less well so cope less well with large crowds. They handle separation anxiety and the 6-8 month wonder week less well than a girl baby does.

I can see when I do sleep training on the boys at 7.5-8 months old in particular, they don’t cope as well. If you add to the mix bed sharing (permanently), a dummy, always held, rocked, nursed to sleep and never allowed to cry at all, ever. And I’ve met a few of these babies. The contrast between these boys and a girl (with the same sleep associations) at the same age is HUGE. The boys are very sensitive and cry so much more. They handle stress incredibly badly. Whereas a girl with all these factors rarely sounds as distressed.

Sleep training should be of the kind variety. 

There are lots of gender studies on all things baby and development. As a result we know from research (Murray, L., et al, 1992) that baby boys with mums with PND performed worse on object concept tasks, were more insecurely attached to their mothers and showed more mild behavioural difficulties. Postnatal depression had no effect on general cognitive and language development, but appeared to make infants more vulnerable to adverse effects of lower social class and male gender. When Murray studied attachment and gender in relation to PND she found that the odds of insecurity are 3.6 times greater for boys than for girls.

crying baby

There are also hearing issues that help explain the delayed speech that is so common with boys.

Boys have more hearing issues than girls claims Leonard Sax in his book, Why Gender Matters [2005]. Dr Sax claims that girl babies have a 80% greater brain response to sounds than baby boys do. Australian audiologists, Pollard and Rowe found this wasn’t actually a hearing issue it was an auditory processing issue. So the way we communicate with boys needs to be taken into account.

At birth a boys brain is only partially formed and only a third of its’ eventual size. The language part of the brain is not fully formed until aged 13 years, I’m sure some mums would argue that was even later with all the grunting teenage boys do, rather than speaking! This is why reading to baby boys and singing repetitive nursery rhymes and songs from an early age (6 weeks) to encourage language is so important. This love of reading must be encouraged and fostered right through babyhood, primary school until teenage years (Hardman,M. & Jones, L., 1999).

SIDS and boys

When we look at SIDS, boys are 60% more likely to be affected. At 2-4 weeks old a boy has a higher brain arousal rate than a girl. This all settles down by 2-3 months when the 2 genders are similar in relation to sleep.

When we look at crying, again boys score higher. In a Dutch study with 1826 babies, Van der Wal et al (1998) found that problematic crying occurred less frequently among girls, second and later born children, Surinamese infants, and breast fed infants.

Historically research has disputed a gender bias in neonatal and baby sleep and the jury is still out on this. Whilst Bach et al (2000) found that boys slept less, with more wakefulness after sleep onset, more active sleep and less quiet sleep than girls. And interestingly “In contrast to sleep architecture, most of the sleep continuity parameters exhibited greater variability in boys than in girls”.

baby sleepingHowever I’m not disputing the bias. I think it’s fact and 17 years of baby whispering can be classed as qualitative research. It’s not to say that I don’t meet girls with sleep problems because I do. I just see much less of the girls compared to the boys.

Treat boys with sensitivity

As a result of all these research findings I think it’s so important to treat boys sensitively. I’m not saying that girls can cope with harsh sleep training or we should be less kind to girls. Both genders deserve kindness and compassion however we just need to be aware that we are not crushing those developing sensitive boy brains with harsh controlled crying. As I mentioned previously there is never a one size fits all for sleep training. I’m OK with a checking method for 6-8 month olds, which some might define as controlled crying or controlled comforting, as long as we respond frequently and sensitively to escalation of crying and offer cuddles when they sound distressed.

Findings are reversed with adults

Interestingly these gender differences are reversed as adults. Recent research has found (using 7500 subjects in twin studies) that females are 1.4 times more likely to suffer from insomnia compared to their male counterparts. Taking into account disturbed sleep caused by children, work etc. they discovered that this insomnia was inherited and mainly genetic. This is the first and largest study of its’ kind. So while boys may struggle with self settling and sleep training it’s actually the females who have long standing sleep issues (Lind et al., 2015).

newborn baby

This makes me an even more determined baby whisperer to help mums with helping their babies and children sleep. 

If  you’re struggling with baby sleep you can access even more of my 3 decades of experience as a registered midwife and child and family health nurse via the Nurture Sleep Program.

You can take your baby from sleepless to slumber in up to 7 easy lessons across 3 age groups once you join the program.

https://nurtureparenting.com.au/nurture-sleep-program/

🍌 FOODS that promote sleep
ROUTINE: easy, flexible, sleep-ready
💡 ENVIRONMENT: getting it right
👶🏽 DEVELOPMENT changes: how these affect sleep
😴 SLEEP METHODS: secret tips that will change your life

It will stop the guesswork and give you:
A tried and tested approach (20 years of helping families with baby & toddler sleep)
Evidence-based
Gentle baby sleep methods
Holistic assessment
Nurture & Nourish nutrition program – all recipes have sleep-inducing ingredients and a perfect balance for a good nights sleep
Access to a closed Facebook group for one on one support from Karen and 90+ timecoded Facebook Live videos
Prevention for under 4 months so no need to do sleep training ever
And all at a low $97 for a very limited time

Nurture Sleep Program

Some further reading below on boys’ diet and sleep

Reasons baby sleep may come undone

What is involved in my sleep methods?

Common food allergies and gender

 

Frequently Asked Questions

Frequently Asked Questions

Nurture Parenting’s Book of Sleep Knowledge What scientific studies say about newborn sleep Anders TF. (1979). Night-waking in infants during the first year of life. Pediatrics 63: 860-864. Bennett C, Underdown A, and Barlow J. (2013). Massage for promoting mental and...
Parents need Baby Sleep Learning

Parents need Baby Sleep Learning

The old chestnut raises it’s head once more – Controlled Crying. Why oh why are we still talking baby sleep training? Parents need Baby Sleep Learning (BSL). It’s a gentler way of helping babies sleep.

http://www.smh.com.au/good-weekend/does-controlled-crying-really-work-20150220-133tf9.html 

Parents need Baby Sleep Learning

There is little or no crying. It’s extremely gentle and promotes healthy sleep habits with no need to do sleep training. At all. Ever.

It’s a preventative health model.

In the UK working as a Community Specialist Nurse Practitioner I visited all new parents weekly. From two to eight weeks, for FREE from the good old NHS. Supporting parents, educating and helping them with baby sleep. I can count on one hand how many babies/children I sleep trained.

Fast forward to Australia 15 years later and how much sleep training? Way too much.

Parents don’t know about preventing sleep problems. Instead they are told to hold and feed to sleep and ‘do what you have to do’. Parents have a treatment model of health. 

What sort of plan is that long term? 

baby sleepSome parents may want to hold and feed their babies to sleep, and that’s OK. But what if you were given a choice and another option? Would you like an option of a baby who could self settle?

Here’s an article worth reading on “The price of rocking your baby to sleep: Infants take note of what is going on as they drop off and then want the same thing

I see many distressed parents, upset babies, relationship stress and postnatal depression. More than I ever saw in England and Melbourne (Australia) and it needn’t be like this.

When I started work in Community Health in NSW I was actively discouraged by my nurse manager from educating and helping parents manage their babies sleep. I was told “I had other things to do and I had to fill the form out, fax it off to sleep school (Tresillian or Karitane)”. I couldn’t believe it. I’d spent 3 years working in Melbourne in Community Health Outreach as an Enhanced Home Visiting Nurse and it didn’t happen there.

I find the crying of sleep training older babies distressing and it’s unnecessary.

This system is broken and it needs fixing.

I’m on a mission. And I’m going to give parents better options if they’d like them.

I’m busy writing my second book on sleep. It will be out very soon. My methods are very gentle and there is no controlled crying. Learn more about my methods at this link: https://nurtureparenting.com.au/baby-sleep-training-gentle-methods/

So if you need help what can you do right now?

With my medical training, I’ve worked with many parents to resolve medical and behavioural sleep issues. Read one of my many case studies here: Complex medical cases and sleep training

You can access my 3 decades of experience as a registered midwife and child and family health nurse via the Nurture Sleep Program. You can take your baby from sleepless to slumber in up to 7 easy lessons across 3 age groups once you join.

https://nurtureparenting.com.au/nurture-sleep-program

🍌 FOODS that promote baby sleep
ROUTINE: easy, flexible, sleep-ready
💡 ENVIRONMENT: getting it right
👶🏽 DEVELOPMENT: changes, how these affect sleep
😴 SLEEP METHODS: secret tips that will change your life

It will stop the guesswork and give you:
A tried and tested approach (20 years of helping families with baby & toddler sleep)
Evidence-based
Gentle baby sleep methods
Holistic assessment
Nurture & Nourish nutrition program – all recipes have sleep-inducing ingredients and a perfect balance for a good nights sleep
Access to a closed Facebook group for one on one support from Karen and 90+ timecoded Facebook Live videos
Prevention for under 4 months so no need to do sleep training ever
And all at a low $97 for a very limited time

Nurture Sleep Program

What is involved in my sleep methods?

Reasons baby sleep may come undone

What age is the best age to do sleep training?

Preventing the dreaded 4 month baby sleep regression

 

Sleep deprivation and mental health in mums

Sleep deprivation and mental health in mums

Todays’ blog is a heavy read but it’s something that I’ve wanted to say for a long time and it’s something I feel ever so strongly about. I’d like to see a pivotal change within this generation. For the sake of our mums and their children it has to happen.

Reading an article on puerperal psychosis transports me back to all the mums whose experience of motherhood wasn’t all overwhelming love and magazine perfect photos of a baby sleeping in his crib.

Instead I’m transported back to helping mums muddle through the daily brain fog of overwhelming anxiety, postnatal depression and puerperal psychosis. These are things we don’t like to mention. Instead we sweep it under the carpet and pretend it doesn’t happen.

http://www.dailylife.com.au/life-and-love/parenting-and-families/i-fought-postnatal-psychosis-in-a-mum-and-baby-unit-20141024-11b8ra.html

As a Health Visitor in England we were trained in non-directive counselling and I offered this as a treatment therapy to mums with PND with and without anti-depressant therapy. It was such a forward thinking approach to healthcare and getting mums the help they needed quickly. The success rate was amazing and it turned things around quickly and was less expensive than psychologists and psychiatrists. We know that baby boys are at high risk if their mum has PND compared to baby girls. The outcomes for these babies was vastly improved. We visited in the home, once a week for an hour or so. And best of all we were FREE and employed by the health service.

Fast forward 12 years and I’m here in OZ. I’m looking at the support system for mums and families and I’m not liking what I’m seeing. I know a preventative health service within a health system is more expensive but what it does for families far outweighs any cost.

Recently a client of mine I’ve known from when I  first started Nurture Parenting experienced severe sleep deprivation with her second  child. It was so sad to see. She got scheduled and had to be separated from her baby as the public mental health system had no mother and baby unit. It made me very sad and very disappointed. It needn’t be like this. There is a better way. Her family had her transferred to a private psychiatric hospital once she was considered well enough to not be scheduled. Finally after about 10 days she was reunited with her baby. The out of pocket expenses to this family who had private health insurance were prohibitive.

I tried to get help for the family, husband and older sibling, together with young baby in the evening at bedtime. There was no free or low cost service unless I wrote a letter stating the baby was at risk of harm. How wrong is that?  He wasn’t at any risk of harm. His dad was caring for him. In the end I went to help them pro bono over a few evenings until her transfer.

I’m going to take you back 9-10 years ago when I was working in Melbourne in an outreach position as an Enhanced Home Visiting Nurse. I could get a bed and have a mum admitted to a mother and baby unit in a public health system. They had 3 mother and baby units. The waiting list was a week or less depending on severity. Where are these places in New South Wales? Why can this not happen here?  And remember I’m a nurse and I had the authority to do this. How different are our States in their approach to maternal and child health. I mourn for the English and Victorian health systems. Why does New South Wales not have these services and see the mental health of new mothers as a priority? Sleep school has a waiting list of 3 months. How many mothers are not getting the care they need and deserve because of lack of service provision? It’s a sad reflection on society when we place the needs of mums and babies way down on our priority list.

I feel better now for writing this. I’m hoping to raise this issue with people who can change things and I’d like to see caring coming back to the very people who need it. Pass this onto your friends and maybe together we can make change happen. It so desperately needs to.