A common question many breastfeeding mothers have is how to cope with their baby waking up at night. They may be feeling exhausted or even resentful about constantly broken sleep. Or they may have been told it is not normal for a baby to wake at night after a few weeks of age and that their baby is manipulating them and needs to learn to “self-soothe”. Some mothers may wonder whether to try night weaning, sleep training or whether to stop breastfeeding to find the answer to unbroken sleep. This article reviews the reasons babies wake at night, suggests coping strategies and answers frequently asked questions about night waking.
Night waking is normal
From a baby’s point of view it is developmentally normal to wake up at night12 at least through the first year and often for quite a while longer.
Reasons babies wake at night
- To breastfeed. Babies double their birthweight in the first four to six months, and since they have small stomachs and breast milk is digested quickly; they need to eat often! In order to get the calories they need they typically breastfeed every few hours day and night. Breastfeeding is also very comforting and reassuring and the hormones released help both mother and baby fall back to sleep. Dr Sears explains:
when babies wake frequently to nurse they are only asking for what they need to thrive. Thriving means more than getting bigger, it means developing to the fullest potential – physically, emotionally, and intellectually. Nearly all babies know intuitively how much nursing they need for nourishment and for comfort. Remember that at this young age, babies’ wants are the same as their needs. So when your baby awakens to nurse at night, respect his judgment. He really needs this feeding.
- Needing mum. Humans along with apes and marsupials are “carry” mammals whose immature young are constantly carried by their mothers for frequent feeds, warmth and safety. Carry mammal babies expect to sleep on or in contact with their mother and without this contact they may instinctively wake frequently seeking the security, companionship, warmth and comfort of their mother’s breast and body.
- Protective sleep cycles. Babies have shorter sleep cycles of deep and light sleep than adults and wake every 2-3 hours to feed and connect with mum.3 This frequent arousal from sleep, before a baby naturally starts to sleep longer, is thought to be protective against Sudden Infant Death Syndrome. 4
- Discomfort. Babies may also wake if they are too hot or too cold, teething, poorly, need to burp, need a drink, are aware of needing to urinate or poo or may have a wet or dirty nappy. It is thought that learning new developmental skills such as learning to sit up, crawl or toddle may accompany wakeful sleep.
But I need more sleep!
It can help to know that by responding to your baby’s nighttime needs you are helping him feel safe and secure, and that he is not “manipulating you” and neither a pre-schooler nor a baby are capable of plotting to keep you awake. However if your baby constantly wakes every hour or two through the night you may be feeling desperate for longer stretches of sleep.
Coping with baby waking up at night
#1 Get support
Finding other mothers who are going through the same, and learning from those who have come through the other side can be a good place to start e.g. try a La Leche League meeting.
#2 Sleep when your baby sleeps
Accepting that your baby has nighttime needs for this short time in his life and trying to work around them may help make night feeds more manageable. Some mothers find combinations of going to bed earlier, napping when their baby naps in the day or putting baby to bed later can help. Others find not checking the clock at night and not counting the number of times they wake are helpful.
#3 Sleep close to your baby
Worldwide and throughout history mothers have found that nighttimes are easier if they sleep next to their baby—both mother and baby usually sleep better this way. If you are considering bed-sharing for some or all of the night it is very important to be aware of the safety issues5 and know how to pre-prepare a sleeping surface for safe shared sleep. For more information and resources on how to co-sleep safely see Bed-Sharing With Baby and Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, LLLI, 2014 (reviewed here). Seven safe sleep guidelines are summarised in the poster below.
Other sleeping options
There are several ways to keep baby close at night. One option is to have a cot or crib attached to the bed called a co-sleeper cot or crib. It is important to check reviews and follow manufacturer’s safety instructions carefully if using this type of cot. Some families may use a traditional cot in the mother’s room; while others may put a mattress on the floor as a sleeping space for mother and baby.
#4 Respond promptly
Attending to your baby promptly and quietly in subdued light, can help you breastfeed him back to sleep quickly without him waking fully and expecting to play.
#5 New sleep triggers
An older baby may still wake up often at night and need a breastfeed to fall back to sleep without being hungry. The breast is your baby’s trigger to fall back to sleep, where a comfy pillow might be yours; if you woke up to find your pillow missing in the night you would most likely need to find it to return to sleep! Assuming your baby isn’t hungry or poorly, the key to encouraging your baby to sleep for longer stretches without leaving them to “cry it out” is to encourage them to associate falling asleep with alternative sleep triggers as well as or instead of the breast. The No-Cry Sleep Solution by Elizabeth Pantley makes suggestions of how to gently and gradually introduce new sleep associations for a breastfed baby without leaving them to cry or sleep alone.
Frequently asked questions
Why is my older baby suddenly waking more at night?
Reasons older babies might start to wake more frequently after a period of sleeping longer stretches include:
- Too busy to breastfeed. As babies grow they become more aware of their surroundings. Typically around four months of age is a common time when mothers notice their baby may be forgetting to breastfeed in the day as they are easily distracted by siblings and new adventures. This can mean they wake more at night to breastfeed to make up their calories. For more information and tips to help with this see The Fussy Breastfed Baby.
- New developmental stage. It is quite common for a baby who previously slept through the night to start waking more at night once they are mastering a new skill. Developmental changes such as learning to roll over, crawl, toddle, teething, or a growth spurt can all affect night waking and this can continue for quite some time in cycles. Babies may become aware of needing to urinate or poo or may have a wet or dirty nappy causing them to wake.
- Hunger. It’s accepted that tiny babies wake at night because they are hungry or thirsty. But older babies can do this too particularly if they have been busy during the day (see above) or you have a low milk supply. If your baby has a lot of trouble sleeping, fusses at the breast and has poor weight gain review their growth chart with your health professional and contact a breastfeeding specialist to maximise your milk supply.
- Illness. If your baby is unexpectedly waking at night or finding it difficult to sleep, check whether they could be poorly. Ear ache or teething pain are common causes for difficulty sleeping. A breastfeed is a great comfort for a baby or toddler who is not feeling well.
- Reverse cycling. If you have recently gone back to work or are busy with time away from your baby; increased night waking can be a reaction to spending less time in your arms during the day. Some babies don’t feed well in nurseries/child care situations and prefer to make up for missed breast milk at night by reverse cycling (feeding frequently at night).
- Not tired. Some babies and toddlers may wake in the early hours feeling refreshed and ready to play.
Is my baby hungry?
Sometimes it can be confusing to know whether your baby is waking from hunger or other reasons. If you are exclusively breastfeeding and worried that your baby might be waking more times than might be expected because they are hungry see Is my Baby Getting Enough Milk? and How to Make More Breast Milk. There are lots of ways to increase a milk supply and an IBCLC lactation consultant can help you get back on track.
Is my milk good enough?
Breast milk doesn’t stop being beneficial or nutritional as your baby grows older. Your milk is great for your baby even if your diet isn’t perfect. For more information about diet and breast milk see Mother Food and Best Breastfeeding Diet and Foods to Avoid. Rather than the quality of a mother’s milk being a cause of poor weight gain or night waking, a more likely scenario would be the baby who is not getting enough breast milk. Most cases of low weight gain in a healthy baby are related to insufficient milk intake. Note: some babies with extremely low gain may appear to sleep very well at night and not wake for feeds. Contact your health professional and IBCLC lactation consultant if you have any concerns.
Will starting solids stop baby waking up at night?
Babies wake in the night for many reasons (see above) and not just hunger. There is no evidence that giving solid foods will stop a baby from waking up at night. Carlos Gonzalez a Spanish paediatrician points out that many older children wake at night even after a substantial dinner;
Myth—with a good solid food feeding before bed, he’ll sleep all night
Well, no. Many children continue to wake every night even at two or three years old, even if they had potatoes and eggs or beans with sausage for dinner. It has been demonstrated, that children do not sleep more when they have solids.
For more information on the concerns associated with starting solid foods or formula to help a baby sleep longer stretches at night see Will giving formula or solids at night help baby to sleep better? by Kelly Bonyata, 2018.
Will night weaning help sleep?
Depending on their age, night weaning or stopping breastfeeding altogether may help with some children’s night waking (as long as they are not waking from hunger or because they are poorly). However, some infants will continue to wake up at night and without the breast there will no longer be a quick way to put your little one back to sleep. The following article from Kelly Bonyata shares ideas for putting limits on breastfeeding through the night:
Is breastfeeding back to sleep a bad habit?
Breastfeeding your baby back to sleep is usually the quickest (and easiest) way to settle him. If your older baby or toddler becomes very attached to the breast as a trigger for falling back to sleep, this can have advantages and disadvantages. If you feel the irritation is starting to outweigh the benefit, see the section above “New sleep triggers” which talks about introducing new sleep associations. See Breastfeeding to Sleep for a fuller discussion on the pros and cons of breastfeeding a baby to sleep. All children eventually learn to fall asleep without a breastfeed in just the same way as they all wean.
What about sleep training or crying it out?
Sleep training, also known as controlled crying or self-soothing is a way of training your baby to stop waking at night by leaving them to cry on their own. The idea being that eventually they give up crying and fall asleep exhausted with the realisation that nobody is going to come to help them. Sleep training is very upsetting for parents and baby and may cause harmful long term effects. The book What Every Parent Needs to Know describes some of these effects and the science behind the harm. You can read my review of this book here. James McKenna, sleep author and researcher explains;
prolonged crying decreases oxygenation and increases heart rate which in turn then augments cortisol, a stress hormone… elevated levels of cortisol in infancy can cause physical changes in the brain, prompting a greater vulnerability to social attachment disorders
Where can I get further information?
Useful books that discuss sleep, and how to get more of it, include Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family (2014), Sleeping with Your Baby: A Parent’s Guide to Cosleeping (2007), Nighttime Parenting: How to Get Your Baby and Child to Sleep (2007) and Three in a Bed: The Benefits of Sleeping with Your Baby (2003).
Summary
It is developmentally normal for a baby to wake at night, there are many reasons why they do this. However a baby who keeps waking up at night frequently can be difficult to manage. Although there isn’t always a quick solution, helping strategies that mothers have found include sleeping when their baby sleeps, sleeping close to their baby or introducing new sleep triggers. Leaving a baby to cry in the hope they stop waking up at night—by learning nobody comes to them—is stressful for your baby and may cause lasting harmful effects.