Sleeping at Four Months

 

Now that your baby is older, the times when your baby will become sleepy are more predictable. Another way of saying this is that the biological sleep-wake rhythms are more mature. This allows you to change your strategy to keep your child well rested. Previously, at 2 months of age, the focus was on brief intervals of wakefulness to avoid the overtired state; now you can begin to use clock-time as an aid to help your child sleep well. Stated simply, you can use your child’s natural sleep rhythms to help your child fall asleep. Let’s start in the morning and go around the clock.

Starting the Day: Most children will awake to start the day about 7 a.m., but there is a wide range (between 6 and 8 o’clock).

First Nap: The first nap occurs about 9 a.m. and may last about an hour or two. Sometimes you will stretch your child to get to this time, or you may wake your child at 7 a.m. in order for your child to be able to take this nap. Please remember that previously you focused on maintaining short intervals of wakefulness, but now you try to anticipate your children’s predictable best nap time. If your child takes this too early or too late, then it is difficult for your child to take the second nap on time. This morning nap disappears between 15-21 months.

Second Nap: the second nap occurs about 2 p.m. and it may last about an hour or two. The most common problem at this nap time is too long of an interval of wakefulness following the first nap. This causes your child to become overtired. This time-window for this second nap is between 12 noon and 2 p.m., but you may notice that your child’s own time-window during which it is easiest to fall asleep is much narrower. This afternoon nap commonly continues for about 4 years.

Third Nap: The third nap may or may not occur. If it does occur, it may vary between 3 and 5 p.m. Also, the duration of this nap may vary, but it is usually a very brief nap. Usually this nap disappears by about 8 months.

Bedtime: Because of the variability of the third nap, the bedtime may also vary. Most children are asleep between 6 and 8 p.m. The most common problem at bedtime is keeping your child up too late. If the child is put to sleep after his time or tiredness, he has more difficulty falling asleep and staying asleep. If you keep your child up past the time when he is drowsy, for example, because you return home from work, then you are depriving your child of sleep. Please try to avoid making your child overtired as you would not deliberately make your child go without food when he is hungry.

First Night Waking: this may occur 4-6 hours after your child’s last feeding. Some children do not get up at this time. Feeding your child differently, or giving cereal will not help your child sleep better. There is a shifting from deep sleep to light sleep throughout the night. Partial awakenings or light sleep stages called arousals occur every 1-2 hours when your child is asleep and sometimes, your child will call out or cry during these arousals. Loud crying during these arousals signifies an overtired chid. If your baby is not sleeping with you in your bed, going to your child at the time of these partial awakenings will eventually lead to a night-waking or a night-feeding habit. This is because your social stimulation, occurring when you pick up your baby, hold your baby and feed your baby will eventually cause your baby to force himself to a more alert state during these arousals. Consequently, he will learn to expect to be fed or enjoy the pleasure of playtime with his parents at every arousal. However, if you are sleeping with your baby and breast feeding, you might promptly nurse at all of these arousals while your baby is still in a somewhat deep sleep state and then sleeping through the night habit might develop. The most common problem regarding these naturally occurring arousals is to project psychological problems into our children such as saying that they must be lonely or afraid. However, 4-6 hours after the last feeding, many children are actually hungry, and you should promptly respond by feeding.

Second Night Waking: This may occur around 4 or 5 a.m. Some children do not get up at this time. Most children who do awaken at this time are wet, soiled, or hungry and a prompt response is appropriate. Maintain silence and darkness because your child should return to sleep. A common mistake is to play with your child and prevent the return to sleep. The return to sleep is important so that your child will be able to comfortably stay up to the time of his first nap. Although this pattern of getting up once in the middle of the night and/or in the early morning is common, some children will simply get up once around 2 or 3 a.m. or not get up at all. Some night waking is very common during the first 8 months.

Watch for the development of an earlier bedtime signaled by drowsy signs: around 6 pm. After soothing, try to put your baby down at night drowsy but awake. Consider moving the baby out of your bedroom for night sleep. Try to have fathers involved in soothing to sleep at bedtime and in the middle of the night.

Northwestern Children's Practice

Pediatricians located in Gold Coast, Chicago, IL

The Northwestern Children’s Practice team educates parents to help them raise healthy and loving children and educates children to help them develop healthy habits. As one of the best pediatrician offices in Chicago, our health care providers are dedicated to providing anticipatory guidance to help families navigate from one visit to the next. Founded by Dr. Marc Weissbluth in 1973, the Northwestern Children’s Practice continues to thrive in Chicago’s Gold Coast, a few blocks away from Lurie Children’s Hospital. This welcoming team of experienced child health advocates cares for families in the Chicago-land area and beyond. The Northwestern Children’s Practice offers annual check-ups, lactation support, adolescent visits, sports physicals, vaccines, and more. Besides providing health care for children from infancy through young adulthood, the practice has doctors and nurse practitioners that specialize in sleep consultations, nutrition, and weight management counseling, treatment and prevention of childhood obesity and safe immunization practices. Several of our nurses are trained as lactation consultants to provide support during newborn well-visits. Our lactation consultants and doctors also lead a weekly support group for new parents. Topics often discussed are newborn feeding, including breastfeeding, sleep, development, and safety. 

The Northwestern Children’s Practice has continued to grow throughout the years and now includes a team of doctors, nurse practitioners, nurses and office staff who work together to provide comprehensive care with individualized attention. The office is located several blocks from Lurie Children’s Hospital, Prentice Women’s Hospital, and Northwestern Memorial Hospital. Patients can be seen at Northwestern Children’s Practice’s convenient walk-in clinic at 8-11 am, Monday through Friday and at 10 am on Saturday and Sunday. No appointments are necessary for the walk-in clinic. Scheduled visits are available Monday through Friday as well as a limited number of well-visits on both Saturday and Sunday. 

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Northwestern Children's Practice

The Northwestern Children’s Practice team educates parents to help them raise healthy and loving children and educates children to help them develop healthy habits. As one of the best pediatrician offices in Chicago, our health care providers are dedicated to providing anticipatory guidance to help families navigate from one visit to the next. Founded by Dr. Marc Weissbluth in 1973, the Northwestern Children’s Practice continues to thrive in Chicago’s Gold Coast, a few blocks away from Lurie Children’s Hospital. This welcoming team of experienced child health advocates cares for families in the Chicago-land area and beyond. The Northwestern Children’s Practice offers annual check-ups, lactation support, adolescent visits, sports physicals, vaccines, and more. Besides providing health care for children from infancy through young adulthood, the practice has doctors and nurse practitioners that specialize in sleep consultations, nutrition, and weight management counseling, treatment and prevention of childhood obesity and safe immunization practices. Several of our nurses are trained as lactation consultants to provide support during newborn well-visits. Our lactation consultants and doctors also lead a weekly support group for new parents. Topics often discussed are newborn feeding, including breastfeeding, sleep, development, and safety. 

The Northwestern Children’s Practice has continued to grow throughout the years and now includes a team of doctors, nurse practitioners, nurses and office staff who work together to provide comprehensive care with individualized attention. The office is located several blocks from Lurie Children’s Hospital, Prentice Women’s Hospital, and Northwestern Memorial Hospital. Patients can be seen at Northwestern Children’s Practice’s convenient walk-in clinic at 8-11 am, Monday through Friday and at 10 am on Saturday and Sunday. No appointments are necessary for the walk-in clinic. Scheduled visits are available Monday through Friday as well as a limited number of well-visits on both Saturday and Sunday. 


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More NWCP Resources
  • Our new parent support group meets weekly (Tuesdays at 12:30), this group is led by our lactation consultants and physicians and helps to advise on the concerns of families of infants. Topics often discussed include newborn feeding (including breastfeeding), sleep, and development.


  • We offer complimentary prenatal visits to expecting parents as a forum for the concerns of new parents. We have an exchange of information to discuss any prenatal issues, family history of medical issues, what to expect in the hospital, what to expect from your doctor visits in the hospital and what to expect during the transition to home. We will discuss important things to think about including newborn feeding, circumcision, vaccines and newborn screening tests.

    We also offer similar visits to adoptive families and to families who are considering changing pediatricians.

  • We have walk-in clinic hours 7 days/week. Patients can be seen at 8 am by physicians and pediatric nurse practitioners on Monday through Friday. Later walk-in hours with a nurse practitioner are available until 11 am also on Monday through Friday.

    Patients can be seen during our weekend walk-in clinic hours on Saturday and Sunday at 10 am.  

    No appointment is necessary

Our Office

Announcements
  • In June 26, 2016 Ann and Robert H. Lurie Children's Hospital launched a new advertising campaign. Dr. Unger is one of the doctors featured in the brand concept. You can see her and other doctors from Lurie Children's Hospital in magazines, and on billboards at the hospital and on the expressway. All, for your one.

  • We will have evening hours and weekend well-visits available by appointment!

    Please call to schedule.

  • Come in for your summer/school physicals!

    Make sure your child is up to date with vaccines. At the 11 year old visit we recommend the 3 adolescent vaccines including Tdap, Meningitis and HPV.

    At the 16 year old visit we give a booster for meningitis, and we initiate the Meningitis Type B vaccine series.

    To learn more about the HPV vaccine, please click here.

    To learn more about the Meningitis Type B vaccine, Please click here.

    American Academy of Pediatrics, Healthychildren.org 

     

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Accepted Insurance Plans

Listed are the major insurance providers we accept. For more information regarding specific plans, please call our office.

Aetna
BCBS
Cigna
Coventry Health Care
HFN
Humana
Interplan
Land of Lincoln Health
Multiplan PHCS
PHCS
United Healthcare
Testimonials

Words from our patients

  • Yelp

    "I have been taking my 6 month old son to NCP since he was born and I have only encountered top level service and medical advice from the doctors and nurses."

    Don J.
  • Yelp

    "We've been going to NCP for almost ten years...I am more than ecstatic to say that they've been very dedicated and have always been there for our family health issues."

    Sylvia O.
  • Yelp

    "They are in tune with our girls, proactive about health care and give honest, practical advice. We moved out to the suburbs but will not stop going to this practice..."

    Pam B.
  • Google+

    "Very happy with my experience with NCP for my three children! Our primary is Dr. Hirsh but had great experiences with Drs. Unger, Li, King and Goldstein as well!"

    Sanna B.
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Northwestern Children's Practice
680 North Lake Shore Drive
Suite 1050
Chicago, IL 60611