The 4-Month Touchpoint and Sleep

by T. Berry Brazelton, M.D., author of Sleep: The Brazelton Way

After 4 months, a "touchpoint" is around the corner. Along with a burst in learning, a baby tends to fall apart—both night and day. She will be unpredictable and disorganized. The rhythmic sleep-wake pattern will suffer and she'll begin to wake more easily again. Her senses are sharper now, and she is able to take in much more information about her world.

For example, now she can focus not only on the nearby face of the parent who is feeding her, but also on objects on the other side of the room. Her new excitement about the sights and sounds all around her means that she's bound to lose interest quickly in feeding, and she won't stay at the breast or bottle. She is likely to start out hungrily, suck-suck-suck-suck. But, then, the infant notices a new noise—a plane out the window—or a sudden interesting sight—the pattern of light the sun makes on the wall. She won't suck. She pulls away to look and listen. Every feeding gets interrupted, unless she's fed in a dark, quiet room. She would rather look around or listen to an interesting sound than eat. Of course, this alarms parents unless they understand her reason for refusing to feed.

A breastfeeding mother is bound to take it personally. "My milk is no good. Maybe she's teething and it hurts to suck." She may be teething, it's true. If so, wash your hands and then rub on her lower front gums where her first teeth will emerge. You will rub out the swelling and she will feel more comfortable sucking again. But she may not be teething. She may just be disorganized by her new interest in the world around her. She can get enough milk in a short time, but it takes much longer to satisfy her interest in everything else. Although she won't eat like she used to, she is probably getting enough if she continues to grow and gain weight.

This same interest in her world is likely to affect her sleeping patterns. As she rouses from deep sleep every few hours, she is no longer interested in getting herself back down. If she hears a noise, even a snoring or groaning from your bed, or a clanking radiator, she's awake. If she can see anything exciting—even a reflected light from the street—she will want to follow it. She is likely to rouse and regress into her old pattern of demanding a feeding every 3 to 4 hours all over again. This waking up isn't likely to last more than a week, however, if parents can fall back on their earlier patterns: waiting to see whether she can put herself back down to sleep, and if she can't, patting her down in bed without taking her out.

If this doesn't work, feed and settle her every 4 hours, but watch for this new interest to wane. Then, begin to rely on the "wait to see" approach. It is likely that after the week or so of excitement, she will be ready to fall back into the sleep pattern she's developed earlier—of rousing every 4 hours, but then comforting herself back down into deep sleep.

If she rouses at 2 A.M. after having slept straight through from 6 or 7 P.M., try waking and feeding her again at 10 P.M., to see whether she will go from 10 P.M. to 6 A.M. while you are sleeping. Break the cycle for her. It may work. After this rousing is over, she is likely to sleep through a 6- to 8-hour cycle. In fact, many babies begin to sleep even longer—10 to 12 hours. But a baby who sleeps 12 hours is not actually asleep the entire time. She must rouse from sleep a few times during the night, and then settle herself. She is becoming independent.

Helping a 4-Month-Old to Sleep

• Realize that this is a touchpoint—a backward step that goes with new spurts in her ability to use her body and her mind. The regression won't last more than a week or two unless it is reinforced.
• Don't pick her up or feed her. If you really aren't sure whether she is waking because she is hungry or teething, wake her at 10 P.M. to feed her, rub her gums, and let her chew on her fingers to soothe her teeth. Then watch to see whether these maneuvers are the answer.
• If not, be prepared to keep her in her crib.
• At bedtime, reinforce the ritual of rocking, singing, reading to her, and giving her her "lovey"—a blanket, a stuffed animal, or her thumb.
• When she rouses, help her find her lovey. Encourage the thumb. Fall back on singing softly and patting her down. This is only a temporary backward slide. She is bound to be comforted by familiar old routines. "You can do it! You can do it! You can do it!" You are urging her to take over her own return to deep sleep.
• Gradually try to leave it to her. Wait a few minutes before you go to her. Call out softly to let her know you are there. If you do go to her, don't take her out of her bed. Remind her that she can put herself back down to sleep.
• Make her lovey important to her during the day—for example, when she's frustrated or hurt. Hand it to her and let her know that she can fall back on it. This may be difficult and may feel like deserting her, but it will help her become more independent. You are joining her in these new steps toward independence, and it may not be easy—for it may feel as if you're making your baby grow up too fast.

Excerpted from Sleep: The Brazelton Way © 2003 by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

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