Why Baby Won’t Sleep
I often get questions from parents about why their baby won’t sleep. A baby that wakes constantly throughout the night and is not easily comforted can be very concerning for a parent. This is a question recently asked of me at my practice:
My three-month-old is constantly waking up during the night, and I often can’t figure out what she wants. I usually just try to hold her and give her a bottle. What should I do?
While babies do sleep more lightly and for shorter periods than adults, your baby needs her rest as much as you do. She won’t wake frequently unless there’s a reason. Consider these possibilities:
Nighttime Separation Anxiety
A common reason that baby won’t sleep is that she may want to sleep closer to you. Try different sleeping arrangements until you find one that gets everyone a good night’s sleep. Your baby may sleep best snuggled safely next to you in your bed, or in a 
bassinet or crib right next to your bed.
Even if she used to sleep just fine in the next room, you may find that some experimentation is in order. Babies’ nighttime needs often change as they reach a new stage of development. A sleeping arrangement that worked in the past may not be appropriate now. If you are not comfortable with your baby sleeping in your room or in your bed, gradually move her sleep space further from you as she gets older as she sleeps for longer periods in deeper states of sleep.
Gastroesophageal Reflux
GER is the most common hidden medical reason that baby won’t sleep. When a baby with GER lies flat, her stomach acids regurgitate up into the esophagus, causing pain similar to what adults call heartburn. These are some symptoms of a baby with GER:
- frequent spitting up during the day
- awakening with painful outbursts of crying that signify more than simple restlessness
- frequent “colicky” bouts of abdominal pain during the day and night
- throaty noises that occur when baby regurgitates food back up into his throat
- colicky pain right after feedings
GER can be successfully treated with medication, so discuss the possibility with your pediatrician.
Formula Allergies
If your baby is particularly fussy after her feedings, she may be allergic to her formula or, if you are breastfeeding, allergic to food in her mother’s diet (dairy is a common culprit). Other signs include a red, sandpaper-like rash on her cheeks or a red, raised rash around her anus. If you suspect food allergies are the reason your baby won’t sleep, try changing formulas or, with the advice of a doctor or nutritionist, eliminating common “fuss foods” from your diet.
Airborne Allergies
An allergy to something in baby’s sleeping environment can cause a stuffy nose and a buildup of fluid behind the eardrums, making it difficult for her to sleep. If your baby consistently wakes with a stuffy nose, dust-proof her sleep environment as much as possible. Stuffed animals and fuzzy toys are common dust collectors and should either be cleaned regularly or removed.
Crying is Communication
Well-meaning friends and relatives may advise you to let your baby “cry it out.” Don’t! Keep looking for possible causes that your baby won’t sleep. Eventually, you’ll find the right arrangement, diet, sleeping position, and environment that will get everyone the best night’s sleep.