Letting Your Baby Fuss: How Long Is Too Long?

Babies can be fussy at night for a variety of reasons, including hunger, discomfort, illness, overstimulation, or separation anxiety. While it can be distressing for parents, nighttime fussiness is common and typically harmless. There are several techniques parents can use to soothe a fussy baby, such as swaddling, rocking, using white noise, or offering a pacifier. If basic needs are met and there are no underlying health issues, it is generally okay to let a baby cry it out to encourage self-soothing. This can be a challenging but effective sleep training method that often results in better sleep for the baby and reduced stress for the parents.

Hunger

If your baby is over 4 months old and has developed independent sleep skills, but is still waking up frequently at night, it could be because they are hungry. If they've been sleeping for 5+ hours but now wake up every 2 hours, it's likely they are hungry. In this case, you should feed them.

If your baby is close to 6 months old and a healthy weight, check with your pediatrician to see if they think overnight feeds are still necessary and how many. Some babies are ready to drop overnight feeds and sleep 6-8 hours as early as 3-4 months, while others may keep a night feed until 6 months.

If your baby is over 4 months old and has dropped their own night feeds, but is still waking up frequently, it could be due to a sleep regression or disruption not associated with hunger. In this case, you can use other methods to soothe your baby during those wake-ups.

How to Get Back on Track

• Early bedtime: Frequent night wakings are associated with babies who are overtired by bedtime or who didn't get enough sleep during the day. Keep their bedtime early, especially during the first few days or a week while they are getting back on track.
• Regular naps: If your baby is overtired, it may be difficult to get them to nap. In this case, do what you can to help your baby get a great nap (e.g. contact naps, car rides, etc.).
• Watch their wake windows: Wake windows are key to avoiding an overtired baby and understanding your baby's cues (both tired and hungry).
• Keep a consistent bedtime and nap routine: A consistent sleep routine can help your baby sleep longer and better.

Other Reasons for Fussiness

In addition to hunger, babies may be fussy at night due to:

• Being too hot or too cold
• Wet or soiled diaper
• Illness or digestive issues
• Overstimulation or boredom
• Feelings of loneliness or frustration
• Teething
• Separation anxiety

Overstimulation

Signs of an Overstimulated Baby

• Loud crying
• Acting fussy or irritable
• Not wanting to be held (older babies may become clingy)
• Clenching their fists

How to Avoid Overstimulation in Babies

• Stick to a set feeding schedule
• Keep errands as short as possible
• Arrange for some quiet time
• Avoid screen time for children under 2 and limit it for older toddlers
• Work around nap time

How to Soothe an Overstimulated Baby

• Take them out of the triggering environment and into a room with few stimulants, such as lights, noise, and people.
• For newborns and younger babies, breastfeed or bottle-feed, swaddle, hold, or rock them to sleep.
• For older babies and toddlers, ensure their physical needs are met by checking if they are hungry, thirsty, hot, or cold. Then, lay them down in a dark room and do a quiet activity, such as reading a book or cuddling.

When to See a Pediatrician

If you are concerned about your baby's overstimulation, consult a pediatrician, especially if their emotional response seems disproportionate to the situation. This can indicate issues related to emotional or information processing difficulties, such as autism spectrum disorder or attention deficit disorder.

Overheating/getting too cold

It's important to ensure your baby is dressed appropriately for the temperature of their room. Overheating can increase the risk of sudden infant death syndrome (SIDS) and cause other issues such as heat rash, heat exhaustion, heat stroke, and dehydration. Signs that your baby might be too hot include:

• Flushed skin
• Damp hair
• Restlessness
• Fussiness
• An elevated heart rate
• Tiredness
• Confusion
• Weakness
• Dizziness
• Nausea or vomiting

If you think your baby is too hot, you should:

• Move them to a cooler room
• Remove some of their layers
• Give them a lukewarm bath or place a cool washcloth on their skin
• Offer them breastmilk or formula

To prevent overheating, keep your baby's room temperature between 68 and 72°F (20-22°C). Avoid using loose blankets, electric blankets, or heating pads, and don't put a hat on your baby for sleep. Instead, wrap them in a breathable swaddle.

On the other hand, if your baby is too cold, they might be fussing because they're uncomfortable. Make sure they are dressed appropriately for the temperature of the room, adding only one more layer than you would wear yourself.

Needing a diaper change

It is important to change a baby's diaper regularly to prevent skin irritation and infections such as diaper dermatitis. During the day, diapers should be checked and changed every two to three hours, or as often as needed. At night, however, the decision to change a baby's diaper depends on several factors, including the type of diaper used and whether the baby is sleeping. Here are some tips for handling nighttime diaper changes when your baby is needing a diaper change:

• Use super-absorbent overnight diapers: Opt for diapers designed for overnight use, as they are more absorbent and can reduce the need for frequent changes. These diapers are more expensive but can provide uninterrupted sleep for both you and your baby.
• Change before bedtime: Putting on a fresh diaper before your baby's bedtime ensures that the diaper remains dry for a longer period, reducing the chances of diaper rash.
• Apply diaper rash cream: If you are concerned about diaper rash, apply a thick layer of diaper rash cream or a protective barrier cream before putting on a fresh diaper. This creates a barrier between the skin and the wet diaper, protecting your baby's sensitive skin.
• Minimize light and sound: When changing diapers at night, use dim lights or a night light to avoid fully waking your baby. Keep the room quiet, and avoid loud noises, conversations, or playful interactions that may disrupt their sleep.
• Change during feedings: If your baby wakes up for a nighttime feeding, change their diaper just before or halfway through the feeding. Changing the diaper after feeding may fully wake them up again.
• Change poopy diapers immediately: While it is generally acceptable to leave a slightly wet diaper overnight, soiled diapers must be changed immediately to prevent infections and skin irritation. Change these diapers quickly and quietly, without engaging or playing with the baby.
• Establish a nighttime routine: A consistent nighttime routine, different from the daytime routine, can help your baby settle back to sleep faster after a diaper change. Avoid eye contact and playful interactions during nighttime changes to prevent fully waking your baby.

Remember, it is essential to change diapers regularly to maintain your baby's hygiene and comfort. Assess your baby's needs and adjust your diaper-changing routine accordingly.

Self-soothing

It's important not to try to teach your baby to self-soothe before they are 3 months old. Newborns need help with soothing as they don't yet have the ability to control their emotions. Learning emotional control is a gradual process that takes years, so don't expect too much from an infant or toddler.

Meet your baby's needs first

Before assuming your baby is cranky, review their list of needs. Your baby won't be able to self-soothe if:

• Their diaper is wet or soiled.
• Their clothing is too hot or too cold.
• There are too many distractions in the room, like a TV or other children.
• They have gas or need to be burped.
• They're hungry or thirsty.
• They're overtired.

Stick to a routine

Babies love routine. Try to put your baby to bed at the same time every day and don't skip naps or keep them up late. A schedule keeps them from becoming overtired, which makes self-soothing difficult.

Use white noise

The sound of a fan or a white noise machine can help your baby to self-soothe. Many babies prefer a steady sound over a quiet room as it helps to drown out other sounds that could startle them.

Stay close without picking them up

After placing your baby in their crib, don't leave right away. If you give your baby some attention without holding them, they'll learn that being put down isn't a bad thing. Talk to them or gently put your hand on their belly, then calmly leave the room.

Be cautious with pacifiers

Pacifiers can be useful for babies under the age of 1, but use caution. It can be hard to take the pacifier away from a baby who has become reliant on it. Limit pacifier use to naptime and bedtime, using it alongside other methods like white noise and a consistent routine.

Wean them off feeding to sleep

It's normal for young babies to fall asleep at the bottle or breast, but as they grow, they need to learn other ways to drift off. Don't feed your older baby right at naptime with the sole purpose of getting them to sleep, as they might overeat or rely on the nipple even when they're full.

Frequently asked questions