Your baby was finally sleeping a bit longer, and now they are waking more often again. Is it teething? Or a "sleep regression", as you read on parenting blogs? Often more than one thing is going on. Here is what Belgium's child health agencies, Kind en Gezin in Flanders and ONE in Wallonia and Brussels, and the Netherlands Youth Institute (NJi) say.
Is a sleep regression a real thing?
The term does not appear in what Kind en Gezin, ONE or the Dutch youth health service write about sleep. They describe sleep as having ups and downs, and that is normal.
"Sleep does not grow in a neat straight line of ever better sleep. For most children, it has ups and downs."
Tine, educational psychologist at Kind en Gezin (translated from Dutch)
According to Kind en Gezin (in Dutch), developmental milestones such as learning to sit, crawl or walk, separation anxiety or physical discomfort can disturb your baby's sleep. Exciting or unsettling times, such as starting childcare, moving house or the arrival of a new baby, can also make children wake again, says Kind en Gezin.
Ages that are often mentioned:
- Separation anxiety usually starts from 6 months and can last into the third year (NJi, in Dutch).
- Stranger anxiety develops in most children between 9 and 12 months (NJi). At around 9 months, babies usually do not like being alone in the evening, according to NJi, and process at night what they experienced during the day.
A fixed "4-month sleep regression" does not appear in the Belgian and Dutch guidelines covered here. The Dutch youth health care guideline (in Dutch) describes a development at around 3 months: thanks to a day and night pattern and better self-regulation, babies find it easier to fall asleep and sleep for longer. At the same time, according to a Finnish study the guideline cites, half of babies at 3 months do not yet fall asleep without a parent present, and most do not yet sleep through (in that study: unbroken sleep between midnight and 6 am).
Teeth: when, and what do you notice?
The first tooth comes through at around 6 months on average, says Kind en Gezin (in Dutch). A first tooth at 12 months is nothing to worry about. If your child is 16 months old and no tooth has come through yet, see a dentist. ONE (in French) says all milk teeth come through between 6 and 30 months.
Kind en Gezin lists these discomforts when teeth come through:
- red and irritated gums
- a runny nose
- dribbling
- less appetite
- restless sleep
- sometimes a slight rise in temperature
Physical discomfort such as teething can make sleep a little harder for a while, says Kind en Gezin. Is your baby crying because a tooth is coming through? Comfort them until they are calmer, then put them back in their own cot, NJi advises.
To ease sore gums, you can press gently on the sore spots or massage them, or give your baby a teething ring (Kind en Gezin). ONE (in French) warns: never cut the gum, as it may become infected.
Fever and teething: the sources differ
Kind en Gezin is clear on this: fever and diarrhoea are not caused by teething. Teeth can at most cause a slight rise in temperature. A fever means a body temperature of 38 °C or more, and then you should always think of other causes. With a fever or diarrhoea, see a doctor.
ONE puts it differently: according to its brochure, inflamed gums can sometimes cause a little fever or diarrhoea. ONE advises keeping a close eye on your child and seeing your doctor if needed.
What helps?
According to the Dutch youth health care guideline (in Dutch), it is normal for babies to need help to settle. You can rock your baby, soothe them or talk to them softly. Once sleep improves, gradually cut back until you can put them down drowsy but still awake.
- Stick to a calm, predictable bedtime routine: it gives your child something to hold on to (Kind en Gezin, NJi).
- Going along with what your child needs is the message during these periods, says Kind en Gezin.
- Sleep problems are usually temporary and go away by themselves after a few weeks or months (NJi).
How long your baby can stay awake between naps is covered in our article on wake windows. What is normal at each age is in our article on baby sleep patterns.
Following the nights with the Dream Sock
The Owlet Dream app records how long your baby sleeps and how often they wake. Owlet's help centre adds that it is normal for children to wake up and fall back asleep during a sleep session. The Dream Sock also measures heart rate and oxygen level: if a reading moves outside the preset zones, the base station gives a light and sound signal and you get a notification in the app. The Dream Sock is intended for routine home monitoring of healthy babies. Its notifications help you decide whether to seek medical advice. They do not replace a diagnosis or treatment by a doctor. More questions? See our FAQ.
When to ask for advice
If you are worried about your child's sleep, do not wait. In Flanders you can call the Kind en Gezin line (078 150 100) or talk to your Kind en Gezin nurse; ONE's free consultations are there for questions about sleep too. You can also talk to your GP. With a fever or diarrhoea, see a doctor. In an emergency, call 112.