The Four Month Fussies

Four months, or thereabouts, is a very challenging time for breastfeeding. Take the following story:

“Little Johnny has always been such a contented baby. He would smile at everyone, he always breastfed well and he slept for four hours at a stretch. But all of a sudden, it’s like something has gone wrong. He keeps pulling away from the breast, but he obviously can’t be full because he wants to drink again twenty minutes later! He’s cranky and irritable. And worse of all, he doesn’t sleep anymore – he’s up every hour at night! What happened to my sweet, happy little baby?!”

If you’ve ever lived through the four month mark, this probably sounds pretty familiar. And it seems like everyone, from your mom-in-law to Dr. Google, has the same diagnosis: your breast milk is obviously not enough anymore; you need to start giving solids and/or formula. After all, Suzie’s baby is on formula, and look how happy he is…

But what if I told you that all these behaviours are a predictable part of a baby’s normal development, and that they have nothing to do with your milk? I first heard the term “four month fussies” in La Leche League’s excellent book, the Womanly Art of Breastfeeding, and it was a real eye opener! Here’s the inside story on what’s going on with your four-month-old monster:

Development at four months of age

Around four months of age, babies are going through a whole lot of changes, both in their brains and in their bodies. They are learning to roll over and gaining control of their trunk muscles in preparation for sitting. They are exploring their world with their hands (putting quite a lot of said world into their mouths in the process!). And perhaps most excitingly, they are becoming aware that there is a big, scary, fascinating world out there. Previously, baby’s entire world consisted of himself and whoever happened to be holding him at the time. Now, all of a sudden, baby is discovering that the world is filled with interesting people and noises and things to look at. It is a very exciting time in a baby’s life.

How the four month fussies affect breastfeeding

Unfortunately, all this can make breastfeeding really exhausting! Where baby used to be focused on feeding, he’s now suddenly pulling off the breast and looking around at every little noise or movement. The world is just too new and too exciting to ignore! And as soon as the worst of the thirst and hunger is stilled, baby forgets all about the breast in favour of looking around at the big wide world. Of course, with such short feeds, baby never really fills up, which is why he will be wanting another feed in no time – when, needless to say, the whole pattern will just repeat itself. The problem is that while baby is becoming aware of his surroundings, his brain isn’t yet so developed that he can check out the world and remember to keep breastfeeding at the same time.

These short feeds during the day mean that baby never really fills up, which is part of the reason why four month old babies suddenly start to wake up more at night – they’re hungry! Baby finds it much easier to concentrate on feeding at night, because there’s not much going on. If it’s dark and quiet, baby can concentrate on feeding and get a few good feeds. Now please note that this doesn’t mean that breast milk is not enough anymore. Baby still needs nothing but breast milk; he just needs to drink more of it at night because he’s not drinking as much during the day. I can almost guarantee you that adding cereal at this age will do nothing for your baby’s sleep – except possibly make it worse, because his tummy is not yet ready to handle the digestion of solid foods.

The four-month fussies seem to be more prominent in breast-fed babies, and I have a theory why: if a baby is drinking from a bottle, he can drink and look around at the same time. Because their curiosity doesn’t interrupt their feeds, bottle-fed babies do not drink any less during the day, so they do not have to catch up as much at night. That said though, all babies do tend to go through a rough patch at 4 months, simply because of all the developmental changes that are taking place. You will see this pattern every time baby goes through a major developmental spurt – around 9 months and 18 months are two other monsters.

How to survive the four month fussies

From someone who’s been there and survived it – twice! – here’s some tips on how to get through this trying time:

• Undoubtedly, the most important thing is just to understand what’s happening. This will stop you from worrying unnecessarily, and it will help you to ignore everyone who blames it on your breast milk.
• Go with the flow. Don’t try to push baby into a certain pattern of feeding and sleeping; you will just end up frustrated and with a very unhappy baby.
• For daytime feeds, keep the environment as quiet and free of distractions as possible. Close the curtains and ban everyone else from the room. Putting on some white noise to drown out distracting sounds may help. I used to throw a light blanket over my shoulder and my son’s head, so that he was in a little dark, quiet cocoon.
• During the night, feed more often; your baby needs it. Don’t try to limit night-time feeds, or you will end up with a baby that isn’t gaining enough weight. Co-sleeping will save your sanity.
• Don’t be tempted to introduce cereal to try and get your baby to sleep longer. It’s one of those pervasive urban legends: everyone says that giving solid foods will make your baby sleep better, but I have never met a single baby for whom it actually made a difference!

And when it gets tough, when you feel like you haven’t slept in a thousand years and you’re going to run away screaming if you have to breastfeed one more time… Just take a deep breath and remind yourself: “this too shall pass”. It really will, promise. In a short time, baby will be able to keep an eye and ear on his surroundings and breastfeed at the same time, and the four month fussies will be just a memory.