What causes baby not to sleep well?

Reasons for Sleep Problems for 0 to 3 Months

While newborns sleep most of the day, you’ll probably find that this sleep comes in bursts, and there are a lot of night wakings. If your little one isn’t sleeping for more than three hours at a time at night, don’t panic: This is actually completely normal.

“In general, from birth to 3 months, babies will sleep 14 to 18 hours per 24-hour day,” explains William Sears, M.D., pediatrician, professor of pediatrics and infant sleep specialist. “It is very unusual for babies to be ‘sleeping through the night’ in the first three months.”

However, Dr. Sears notes that if you notice your newborn won’t sleep for more than 30 minutes at a time at night, then there could be another reason at play, including the following.

They’re Hungry

The issue: One of the biggest reasons a newborn doesn’t sleep for more than a few hours at a time is because they need to eat. “Their stomachs are fairly small and they need to eat frequently to maintain their growth and stabilize their blood sugar,” says Harvey Karp, M.D., a pediatrician, baby sleep expert, author and creator of the baby bassinet SNOO. He points out that infants are used to being fed every second in the womb, and they’re still adjusting to a different pattern of feeding.

The solution: Make sure your baby is eating enough during the day so that they don’t feel too hungry at night. Dr. Karp suggests setting a normal feeding pattern for around eight to 10 times a day for breastfed babies and eight times a day for formula or bottle-fed babies. This might mean waking them up from long naps during the day to ensure they’re eating enough. Still, know that no matter how much you feed them during the day, at 0 to 3 months they will still wake up several times a night to eat—which is essential for their growth and development—so you will still need to be available to feed them every few hours throughout the night.

Their Sleep Cycle Is Off

The issue: Newborns often have their days and nights mixed up, which throws their sleep cycle off. “In the womb, babies sleep when mom is awake, mainly because motion lulls baby to sleep,” says Dr. Sears. “And babies awaken and kick when mom goes to sleep.” You’ll know their sleep cycle is off if your little one is sleeping for longer stretches throughout the day and much shorter ones at night.

The solution: As hard as it may be, try keeping your baby awake more during the day. “The more often you feed and interact with your baby during the day, the longer stretches they are likely to sleep at night,” says Dr. Sears.

Dr. Karp recommends waking your baby up during the daytime after an hour and a half or two hours of sleep and offering a feeding. “It also helps to take your baby outside and get fresh air and sunlight to help orient their brains’ melatonin (the sleep-promoting hormone) release,” he says.

They’re Uncomfortable

The issue: After being so warm and cozy in a snug womb for nine months, sleeping on a mattress in a bassinet can be an adjustment. The safe sleep guidelines from the American Academy of Pediatrics (AAP) recommend babies sleep on their backs on flat surfaces, without soft toys, pillows, blankets or other bedding. Unfortunately, babies often feel less secure on their backs, and have a startle reflex that can wake them when in this position, says Dr. Karp.

The solution: To make your baby feel more comfortable and limit the startle reflex, Dr. Karp strongly recommends using a swaddle. “Babies do better when their arms are swaddled down,” he says. “They’re less likely to wake themselves up. Even though many babies seem to struggle against swaddling when first wrapped, it almost always calms them down.” Keep in mind, though, that the AAP states you should stop swaddling as soon as your baby starts showing signs of being able to roll over—which could be as early as 2 to 3 months of age.

Dr. Karp also recommends using white noise, rocking them to calm them and giving them a pacifier so they have something to suck on.

They Have Reflux

The issue: It’s not uncommon for infants to experience reflux, or spitting up, and other gastrointestinal issues. Some babies have reflux if they lay flat on their back right after eating, according to Sarah Adams, M.D., a pediatrician and medical director at Akron Children’s Hospital in Akron, Ohio.

The solution: Dr. Adams recommends talking to a pediatrician if you think your baby has reflux, as they sometimes need over-the-counter or prescription medication. She also advises against positioners (a type of mat with raised supports or pillows, designed to keep your baby in a certain position), calling them unsafe, and recommends that you avoid laying your baby down for sleep immediately after a feeding.

Reasons for Sleep Problems for 4 to 6 Months

At about 4 to 6 months, you should notice that your baby is starting to sleep a little bit more. “In general, babies aged 4 to 6 months are capable of sleeping through the night as long as they have no other health problems or concerns,” says Dr. Adams. “Babies this age typically sleep between 14 to 16 hours a day and take between two to four naps a day.”

There are several reasons, though, you might find that your little one is sleeping less.

They Need a Better Nap Routine

The issue: If your baby isn’t sleeping at night, take a look at their daytime sleep, says Dr. Sears. If they don’t have a consistent nap schedule and they’re sleeping too much, they may not be tired enough to sleep through the night. On the contrary, if they’re not sleeping enough during the day, they may be overtired at night.

The solution: Focus on establishing a consistent naptime routine. “The pre-nap routine should be consistent and predictable, so your baby knows it is time to take a nap,” says Dr. Adams. She recommends a short routine such as rocking, reading a book and putting on a white noise machine.

They’re More Aware of Their Surroundings

The issue: Around 3 to 4 months of age, babies become much more alert to their surroundings and they become more social, according to Dr. Karp. This means they can be woken up more often by things that didn’t wake them up before, like light or noise.

The solution: Dr. Karp recommends using white noise to block out surrounding noises and to also create a comforting sleep environment. Black-out curtains are a good way to ensure that no extra light gets in the room as well. “Sometimes a warm bath can help before bedtime and a little bit of a massage and singing lullabies,” he says, encouraging parents to focus on getting their baby as relaxed as possible before bed.

They Need a Diaper Change

The issue: Their diaper is dirty. Don’t shy away from changing a baby’s diaper at night because you don’t want to wake them up. Instead, their dirty diaper actually could end up waking them up, or could even cause diaper rash. “Nighttime bowel movements necessitate a change,” says Dr. Sears.

The solution: When babies wake up, quickly check their diaper to make sure they don’t need to be changed. If they frequently have dirty diapers at night, Dr. Sears recommends changing their diaper just before their last or midnight feeding, especially if they tend to fall asleep during or immediately after a feeding.

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Reasons for Sleep Problems for 7 to 12 Months

At 7 to 12 months, babies need less sleep overall, but they should be sleeping for longer stretches at night. At this age, many babies stop waking up for night feedings. “They should be napping around two hours a day, maybe three, and sleeping 10 or 11 hours at night, “ says Dr. Karp.

Here’s what could be going on if they’re waking often, aside from the reasons mentioned above.

They’re Teething

The issue: Teething can start early and last longer than you would think. “The first tooth generally erupts between 5 and 9 months, but teething has been known to start as early as 3 months,” says Dr. Karp. “And the last big molar will come in between 2.5 and 3 years.” Teething is a common reason babies wake up at night, due to the discomfort. “Teething pain seems to top the list for more frequent night waking around 6 months of age,” says Dr. Sears. “Even though you may not see or feel the teeth until around 6 to 8 months, the teething discomfort may start as early as 3 or 4 months of age.” You can tell they’re starting to teeth if you notice increased drooling, a drool rash on the face, frequent finger chewing and wet bed sheets, he notes.

The solution: Do your best to keep your baby as comfortable as possible, but know that sometimes you just have to ride it out until that tooth comes in and they feel less pain. “Prior to bedtime, consider using teething rings to numb the gums or a cold damp clean wash rag,” says Dr. Adams. “You could also try giving them something cold to eat like slushy apple sauce. I do not recommend numbing gels or creams.” You can ask your pediatrician about over-the-counter medications like acetaminophen or ibuprofen if they’re over 6 months of age.

They Don’t Know How to Self-Soothe

The issue: If you rock your baby to sleep each night, and they only know how to fall asleep in your arms, they might have trouble putting themselves back to sleep without your help in the middle of the night.

The solution: Keep in mind this isn’t the case for every baby. “If they sleep through the night and you are still rocking or feeding them to sleep, I say don’t fix what’s not broken,” says Dr. Adams. “Babies, like children and adults, wake up during the night, but the key is that we want them to fall back to sleep on their own, which is the advantage of learning to fall asleep on their own at the beginning of the night.”

If you suspect that your baby needs to learn how to self-soothe, there are a few different things you can try. First, Dr. Adams stresses the importance of making sure your baby’s needs are met—if they’re hungry, overtired or have a dirty diaper, they’ll have a hard time self-soothing. She recommends putting them to sleep when they are partially asleep or awake so that they learn to go to sleep on their own and can do so in the middle of the night, too.

Dr. Sears also recommends leaving something of one of the parents behind, like a tape recording of a parent singing or reading, or a few drops of milk on the sheets. He also recommends repetitive sounds like white noise machines.

They’re Going Through a Sleep Regression

The issue: Sleep regressions—which happens when babies slip out of a consistent sleep pattern—are common throughout the first year of life, although they do vary greatly. “Sleep regression can start at any age,” says Dr. Adams. She notes that the most common ages are 4 months, 8 months and 18 months, but adds that some babies might never experience them. They’re often tied to developmental milestones. “Sleep regression simply is when your baby’s sleep pattern shifts,” says Dr. Adams. “It can happen if they are going through a growth spurt or their brain is developing.”

Dr. Sears adds that they often wake up when they’re learning something new, like sitting up, crawling or walking, because they want to “practice” their new skill. Signs of a regression include fighting naps, skipping naps, taking shorter naps, difficulty falling asleep, fighting bedtime and frequently waking at night.

The solutions: Sleep regressions are usually short (typically around a week or so), but they’re frustrating, and riding them out can be hard. Dr. Adams suggests giving your baby plenty of time to practice their new skill during the day.

To soothe them in the moment, Dr. Sears suggests, “try to quickly get your baby back to sleep before they fully awaken, preferably without taking them out of their crib, with soothing words, a familiar lullaby, a gentle pat on their shoulder, and then gradually diminish touch until baby sinks back into sleep again.” Be sure to maintain any established routines as well.

5 Expert Tips on How to Cope If Your Baby Won’t Sleep

Dealing with a lack of sleep is extremely overwhelming for any parent. “People joke about the exhaustion of parenthood, but the extreme exhaustion experienced by new parents is no laughing matter,” says Dr. Karp. “Sleep deprivation pulls the rug out from under your health, it shortens your fuse, slows your thinking, creates distance between you and your partner and increases your chance of anxiety, depression and even car accidents. In other words: You need to do whatever you can to get sleep.”

Sleep During Their Nap

Yes, their naps are a great time to get something done, but if you need rest, Dr. Sears encourages you to take that time to sleep, and to nap while the baby is napping. Instead of feeling like you have to clean the house or make a home-cooked meal, allow yourself to take a nap (and get someone to help with the baby). “This is the time to cut yourself some slack and get into survival mode,” says Dr. Karp. “The dishes can wait, the toddler toys on the floor can wait, writing thank you cards can wait… your mental and physical health cannot.”

Divide Up the Night

If you have a partner, take turns handling the night shift, recommends Dr. Karp. For example, “if one parent needs to breastfeed, the other can take over the middle-of-the-night activities, like burping, changing diapers, rocking the baby back to sleep, etc,” he says. “If you’re bottle-feeding, you might alternate nights on baby duty.” You can even split up the night, like having one person handle the baby up until 1 a.m., and the other person taking the rest of the night.

Get Outside

Prioritize getting some time outside, as it can help you feel refreshed. “Don’t drive if you are tired, but put the baby in a stroller and take a walk,” says Dr. Adams. “Exercise and sunlight have proven to help tired people stay awake.”

Do Something for Yourself in the Morning

If you’re able to make the time, do something to make yourself feel more like yourself, even if you’re exhausted. Dr. Adams recommends taking a shower or opening the curtains and letting some sunshine in to help yourself feel more refreshed.

Ask for Help

Don’t feel shy about asking for help, whether it’s from your parents, siblings, in-laws or friends. Dr. Adams recommends asking anyone you’re comfortable asking for help with anything from cooking to cleaning to just helping with the baby so you can rest.

You might also find someone to talk to in a support group or even something like a Facebook group for parents in your area. “The comradery of a mom/dad group where other parents share their experiences is always helpful and reassuring,” says Dr. Sears. “A member might have just gone through what you are experiencing and their solutions might help you with your child.” Dr. Adams recommends asking your pediatrician for recommendations as well.

When to Call a Doctor

Sometimes, your baby’s inability to sleep may be a sign of a medical issue that requires a doctor’s care. Dr. Sears says you should discuss your baby’s sleeping habits with a pediatrician if:

• A good sleeper suddenly becomes a restless sleeper. “Especially if the baby awakens with sudden, colicky-type cries, as if having abdominal pain,” he says.
• They cry inconsolably at night.
• Your intuition tells you there is another reason for the frequent wakings.

Dr. Sears recommends journaling how often your baby wakes up, what type of cries they have, what sleep position helps them sleep the best and if feeding in the upright position stops the crying.

The first year of a baby’s life can be full of sleepless nights, which can be overwhelming and exhausting for any parent. It’s not easy to deal with, but things will get better, especially if you try different methods of coping and helping your baby sleep longer. Don’t forget to reach out for help whenever you feel you need it and know that this time is temporary—even if it seems like it isn’t.

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