Postpartum Pain
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Crying at bedtime, restlessness, frequent awakenings… These difficulties are common and can have multiple causes, often related to your baby’s development and physiological needs. What are the common sleep issues in a baby struggling to fall asleep? What are their needs? How can you help them fall asleep? Let’s take a closer look.
Baby struggling to fall asleep: common causes
In a baby who struggles to fall asleep, certain causes are particularly common.
Baby struggling to fall asleep: a baby’s physiological needs
Your baby may struggle to fall asleep due to their physiological needs:
- Your baby is hungry.
- They need affection and to feel secure.
- They are sick: for example, if your child has a fever or a stomachache, it is normal for their sleep to be disrupted.
- They have accumulated too much fatigue: this may seem paradoxical, but if your child builds up a lot of fatigue over a long period, they may find it increasingly difficult to fall asleep.
- Bedtime is offered too late in relation to your child’s signs of fatigue and they have missed their sleep window: excitement and restlessness can then override tiredness, and your baby may struggle to calm down and surrender to sleep.
Baby struggling to fall asleep: learning to fall asleep independently
- Difficulty falling asleep independently: self-soothing at bedtime is not innate. Many babies require an adult’s presence to calm down.
- Night wakings: these are frequent because your baby has short sleep cycles and often wakes between sleep phases. Some babies need reassurance to fall back asleep.
Baby struggling to fall asleep: changes in baby sleep patterns
- There has been a recent change in habits: babies are very sensitive to routines and habits. Disruptions (moving, changing bedrooms, absence of a parent, etc.) can also disturb their sleep.
- Irregular sleep schedules: your baby may struggle to fall asleep if naps are too short or poorly distributed throughout the day.
Good to know: from 3–4 months onward, changes in wakefulness also influence your infant’s sleep. Depending on the baby, this phase can lead to calmer nights because they expend more energy during the day, or conversely to more restless nights, as their curiosity may sometimes override fatigue.
Baby struggling to fall asleep: medical causes
Some babies experience sleep disturbances due to medical causes. Here are the main situations to consider:
- minor digestive discomfort such as reflux or colic,
- physical pain such as teething, ear infections, or other physical discomfort.
Baby struggling to fall asleep: environmental factors
The environment in which your baby goes to sleep plays a key role in their ability to fall asleep peacefully. Here are the main elements to monitor:
- Light: the room should not be too bright so as not to interfere with your baby’s melatonin production and delay sleep onset.
- Noise: choose a quiet bedroom. Sudden noises or an overly noisy environment can cause micro-awakenings and prevent your baby from reaching deep sleep.
- Room temperature: a temperature between 64 and 68°F (18–20°C) promotes better sleep quality.
- Bedtime routine: a stable and reassuring routine helps your baby transition from wakefulness to sleep.
Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your journey as a new parent. 
Sleep needs by baby’s age
Sleep needs in terms of hours vary greatly depending on your baby’s age and stage of development. At birth, a newborn can sleep up to 20 hours per day, divided into several short cycles interspersed with wakeful periods. Deep sleep and the ability to distinguish between day and night develop only gradually, as your baby’s biological clock becomes established. Therefore, it is normal for your baby to wake frequently and struggle to fall asleep independently during the first months of life. A lack of sleep or poor-quality naps can also lead to an accumulation of fatigue and make bedtime more difficult. Good to know: this pattern evolves quickly. These figures are indicative and may vary from one child to another: 
How to recognize the behaviors of a baby who struggles to fall asleep?
Restlessness at bedtime is one of the most common signs in a baby who struggles to fall asleep. A child who has difficulty calming down may show:
- Repeated or prolonged crying as soon as they are placed in their crib.
- Constant movement: arching their back, kicking, stiffening, clinging to you, or waving their arms.
- Quick awakenings after being put down, or frequent micro-awakenings before falling asleep.
These reactions are often a sign that your baby cannot let go, either because they are overstimulated or already overtired. 
How can you help a baby fall asleep?
There are practical solutions to improve your baby’s sleep quality, including establishing a reassuring routine and gradually supporting more independent sleep onset.
Establish a reassuring routine
A consistent and predictable evening routine helps your baby anticipate bedtime. This reassuring cue promotes the transition from wakefulness to sleep. Here are some routine ideas to adapt to your habits:
- a warm bath or soothing wash,
- a gentle massage or cuddle,
- a short story or lullaby,
- dim lighting with a calm voice,
- guiding them to their crib.
The key is to repeat the same actions every evening, in the same order, to help your baby understand that bedtime is approaching.
A word from Clémentine Testuz, pediatric nurse:
“The bedtime routine must take your child’s level of fatigue into account! An overtired child is not able to benefit from a routine, and it may turn into a nightmare! That’s why it’s important to recognize the right bedtime moment in order to anticipate the routine.”
How can you encourage learning to fall asleep independently?
From 4 to 6 months of age, your baby can go several hours without feeding, distinguish between day and night, and benefit from longer sleep cycles. They can then gradually learn to fall asleep on their own. Each baby develops this skill at their own pace. If you would like to help them develop independent sleep onset, you can gradually get them used to falling asleep without your presence. To do this, progressively reduce the time you spend with your baby at bedtime. To achieve this:
- If your child usually falls asleep while nursing: offer the feeding outside their bedroom, then continue the bedtime routine by rocking them. Over time, try guiding them toward falling asleep directly in their crib. Gentle strokes can reassure them and signal your presence, which you will then make increasingly discreet, until you are simply present in the room.
- If your baby usually falls asleep in your arms: place them in their crib while they are still drowsy. If they wake up, pick them up and try again. By repeating this process, they can gradually integrate new cues and gain autonomy at bedtime.
Good to know: try to identify signs of fatigue (yawning, rubbing eyes) so you can offer bedtime at the right moment. If possible, put your child to bed within 15 to 30 minutes after the first signs of tiredness appear. 
Baby struggling to fall asleep: when should you consult a healthcare professional?
Sometimes, despite your best efforts, your baby may continue to have difficulty falling asleep. It is then recommended to seek your doctor’s advice in the following situations:
- Sleep deprivation is chronic and affects your child’s growth or weight gain.
- Night wakings are very frequent.
- Your baby shows signs of physical discomfort (reflux, pain, illness).
- You are experiencing significant distress or exhaustion.
A healthcare professional can assess whether there is an underlying medical or emotional cause and guide you toward solutions suited to your situation. In summary, sleep issues in babies can have many causes. Helping a baby who struggles to fall asleep involves listening to their needs and establishing a reassuring bedtime routine. Observing signs of fatigue and respecting your baby’s sleep cycles can make it easier for them to fall asleep and improve sleep quality.
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Photo credits: ArseniiPalivoda | joaquincorbalan | OlgaSmolina
This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May US/UK app and consulting the healthcare professionals who are supporting you.
