What causes babies to wake excessively in the night?

What doesn't cause excessive night waking in babies

This might sound weird, depending on what you've heard, but excessive night waking in our babies is not typically caused by

• Wind or gut pain

• Gut dysbiosis

• Reflux

• Allergy which affects baby's gut (though occasionally allergy causes a severe eczema which might disrupt baby's sleep)

• Teething.

Your baby also doesn't wake excessively at night because baby

• Feeds to sleep, discussed here and here, or

• Shares your bed, discussed here

• Has developed a new motor skill. Although researchers have measured a slight increase in frequency of night wakings when a baby develops new motor skills, there is also no evidence to suggest that changes in motor development impact upon parents' quality or amounts of sleep. You can find out how to best support your baby's motor development here.

It's common to have the odd bad night or a short run of bad nights when we have a baby or toddler. You can find out about normal baby night waking here. But it's the pattern of sleep over time that's important for parents. Excessive night waking is a very fragmented pattern of baby sleep.

The most likely causes of excessive night waking in babies

Occasionally, a true medical or health condition can cause your baby to wake excessively at night. Does your baby snore? Sometimes, snoring due to enlarged tonsillar tissue can interfere with your little one's sleep, and requires medical intervention. If you have concerns about your baby's health, please see your family's GP for an assessment.

Here are the things that do cause babies to wake excessively at night. These reasons might also sound weird to you, again depending on what you've heard, so I'd ask you to please explore The Possums Sleep Program in greater detail so it all makes sense.

Babies wake excessively at night due to

1. Disrupted body clock settings. For example

   • Babies who nap for too long during the day may gradually end up with excessive night waking

   • Babies who go to bed too early in the evening may gradually end up with excessive night waking

   • Babies who start the day very late may gradually end up with excessive night waking.

2. A dialled up sympathetic nervous system, which gets in the way of easy sleep. This might be caused either by

   • Hunger for milk (due to a feeding problem, or by trying to space out breastfeeds or bottle feeds, which you might have been told will help)

   • Hunger for richer sensory motor experience (which can happen at night because parents are advised not to pick their baby up, or to delay responses. But the kind of sensory experience babies need in the night, from a biological perspective, is contact with a loving carer's body, which dials them down).

When you see this list of causes for the first time, you might think of all the things that led you to try spacing out feeds or delaying responses, or to try to get baby to bed early at the evenings and to have long daytime naps. You've been experimenting, which is a very important part of resilient, healthy parenting. After all, you know your baby best and you'll try out all sorts of things to see what works for your unique family.

I hope to show you other ways of thinking about what's been going on, and give you some new strategies to try out.

The video below discusses the way breastfeeding problems can cause excessive night waking in very young babies. This is mostly relevant in the newborn period, or when a baby in the first couple of months of life is not tracking well on his percentile line in the weight charts. It's also the case that your newborn's body clock is immature, and very often out of sync with yours. You can find out what to do about this here.

Selected reference

DeMasi A, Horger MN, Scher A, Berger SE. Infant motor development predicts the dynamics of movement during sleep. Infancy. 2023;28:367-387.