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When your baby wakes up screaming in the night

Dr Pamela Douglas20th of Aug 202321st of May 2024

baby screaming and crying in cot

Why do some babies wake up screaming in the night?

It's terribly upsetting when your baby wakes up screaming, night after night! Mostly, babies dial up more gradually when they wake, and parents are able to respond before baby moves into a full-blown cry.

Not so with these little ones. Parents in this situation often tell me that their small child goes from "zero to 100" within seconds, on waking. What's going on?

Many babies will occasionally wake up screaming in the night. Often we don't know what has happened. Perhaps she slept on her little hand or ear or foot in such a way that she woke with a painful sensation of pins and needles because the blood circulation was cut off, for instance. It all settles down after a cuddle and a feed, and she goes back to sleep.

You might be worried that your baby wakes up screaming because of gut pain, or wind, or gut dysbiosis, or reflux, or allergy. However, these are not typically the cause. From about 12 months of age, some little ones experience night terrors. You can find out about this here.

Occasionally, babies wake up screaming in the night because of a medical condition, such as a gut intussusception, ear infection, or a twisted testicle. If you're worried about your baby's health, please see a doctor for assessment. Also, some breastfeeding newborns or very young babies cry and scream a lot, including in the night, because of a true lactose overload, which resolves once you adjust your breastfeeding method. You can read about this here.

However, babies with a pattern of waking up screaming in the night in the first 12 months of life have usually developed a form of conditioned dialling up, which is associated with night-time waking. This baby has developed a pattern of screaming in the night because when he wakes, he immediately becomes frightened, and dials up as high as can be.

This might be an upsetting thing for me to say. What parent wants to think their little one wakes up so afraid in the night that she starts to scream even before she's opened her eyes? We might feel awful that we've not been able to protect our precious little child from such fear. Sometimes we might feel as if we're somehow to blame, which I'd like to say very strongly is never the case.

Let me tell you how I think this works. From an evolutionary perspective, human babies have adapted to a wide range of infantcare practices across many different cultures over the past 300,000 years. Most babies are reasonably resilient in the night, adapting to families' varying styles. But the little one who wakes and immediately screams is at the sensitive end of the spectrum. This might be because of his genetic make-up or because of his own unique character, or both. He is less able to cope with being away from your body in the night for even a short time, at least for now.

Of course, we know the distress your sensitive little baby is experiencing is not rational - she is perfectly safe, you are not so far away, no predators are coming to harm her. But these sensitive little ones just don't do well with delayed responses in the night.

What can you do if you have a baby who wakes up screaming in the night?

If you have one of these sensitive babies, I suggest that you

  • Respond as quickly as possible at first, as you try to turn things around

  • Apply one of your superpowers for dialling him down, sensory motor nourishment, which in the night means picking him up and holding him close

  • Apply your other superpower for dialling her down, a breastfeed (or feed), just as soon as possible.

Hopefully your baby soon learns that there is no need to be so dialled up and afraid in the night, that you will be there, responding to even a grizzle or small cry. For other families, it can work quite well to be rather slow and lazy in night-time responses to their baby, especially as the baby gets older. But for a period of time, with a sensitive little one like yours who has developed a conditioned dialling up in response to waking, it's best to get in as quickly as you sensibly can.

Some families with very sensitive babies decide, in the end, to bring their little sweetheart into the bed with them, at least for a time. Often they find it easier. This means being sure that your family isn't in the vulnerable category, for whom it's not safe to bedshare. You can read about safer bedsharing with a breastfed baby here, and with a formula fed baby here.

Over time, your sensitive baby will move into a different developmental phase, thanks to your responsiveness in the night. She'll learn to feel safe (even though she has always been safe) when she wakes up in the night.

Selected references

Boyde SD, Pott M, Starks PT. An evolutionary perspective on night terrors. Evolution, Medicine, and Public Health. 2018:100-105.

Douglas PS, Hill PS. A neurobiological model for cry-fuss problems in the first three to four months of life. Med Hypotheses. 2013;81:816-822.

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Next up in when baby wakes

When you don't have help with your baby's sleep in the night

mother sleeps on her side in bed with baby who is sleeping on its back close to her

It could be that you are an autonomous parent. Or it could be that your partner is away regularly for paid work. Or you might be a parent or carer who finds yourself alone with your baby most nights. Regardless, if you are doing nights with a baby on your own I'd like to suggest that you first look at the page on managing evenings with your baby when you don't have help here.

Here are other ideas for managing nights when it's just you and your baby. Our plan is to make the nights just as easy as possible, which means keeping your baby as dialled down as possible. This will mean breastfeeding or feeding...

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