When Waking is NOT Normal: A Quick Reference Guide

Part of our role in supporting families to get more sleep without sleep training is normalizing infant and toddler sleep. We spend a lot of time talking about why night wakes are not only normal, but also important as a protective mechanism. It is important to us that we advocate that it is normal for babies to wake for the first year and beyond but there does come a point when waking is NOT normal. 

We’re going to talk you through some signs that there may be something more going on. Sometimes sleep can be telling us a bigger story about what your child is experiencing and there are some reasons babies wake up that are actually due to underlying issues that may require the help of a medical professional. 

Hourly Wakes

  • What It Is:
    • If your baby or toddler is waking every hour or so, this is definitely a sign that something more is going on. 
    • If your child is waking hourly it likely does not have anything to do with how you are putting them to sleep, it is happening because your baby is trying to tell you something. 
  • What It Looks Like:
    • Frequent wakes may happen during a growth spurt, developmental progression or while working through teething or illness
    • If your baby NEVER settles in for a long stretch of sleep this is a concern of something that is interrupting sleep that needs to be addressed 
  • What It Might Mean:
    • Hourly wakes could mean that your child has an undiagnosed tongue tie, is experiencing discomfort from food sensitivities or digestion concerns, may need to be seen an ENT doctor to have airway assessed

Mouth Breathing

  • What It Is:
    • Babies and toddlers should not be sleeping with their mouth open. Your child should be able to breathe through their nose while sleeping for optimal oxygen distribution throughout their body. 
  • What It Looks Like:
    • Their lips  should be sealed with their tongue resting on the roof of their mouth. 
    • Sometimes mouth breathing may be happening if your child is congested from allergies or illness. Temporarily this is not a concern. It may often just be the position they are sleeping in. 
    • If you notice that your child’s mouth is open you can try to gently close their mouth. If they can continue sleeping while breathing through their nose then it is likely not a concern. 
  • What It Might Mean:
    • There is an oral restriction of some kind 
    • There may be an undiagnosed tongue tie
    • Their airway may be obstructed in some way - this could mean enlarged adenoids or enlarged tonsils


  • What It Is:
    • Just as babies should not be sleeping with their mouth open, they should not be snoring while they sleep 
  • What It Looks Like:
    • Often snoring may occur if your child is congested from allergies or illness. Temporarily this is not a concern. 
  • What It Might Mean:
    • There may be an undiagnosed tongue tie
    • Their airway may be obstructed in some way
    • Possible indicator of sleep apnea 

Tongue Tie

  • What It Is:
    • One of the most commonly undiagnosed conditions
    • A tongue tie is an abnormal attachment of the lingual frenum. This is the tissue that connects your tongue to the bottom floor of your mouth
    • Tongue ties can also cause chronic head and neck issues. 
  • What It Looks Like:
    • Makes it difficult (or impossible) for baby to sleep with their mouth closed and tongue on the roof of their mouth as the tie prevents the tongue from moving into this position. 
    • They may find it difficult to lay flat because it is physically uncomfortable for them due to their tongue positioning.
    • They also may wake often due to hunger because it is a lot of work to move their tongue and they often fall asleep eating. 
    • You may notice clicking sounds while eating or milk spilling out of the sides of their mouth while feeding
    • Possible that there is increased gassiness or fussiness (can be misdiagnosed as reflux)
    • We have attached a great self-assessment tool HERE if any of this is sounding like what is happening in your family. 
  • What It Might Mean:
    • The tongue till will need to be corrected through a process called a frenectomy 
    • The procedure takes approximately 15 minutes and is done using a laser and numbing gel. There are typically follow up exercises prescribed to prevent re-attachment as well. 
    • It is best to seek support from a pediatric dentist. Be sure to also follow up with body work to correct tension caused by the tongue tie. 


  • What It Is:
    • Normal for little ones to move around at night but it should not be all night long
  • What It Looks Like:
    • Having difficulty falling asleep at night
    • Constantly moving the entire night
    • Fidgeting and having a hard time settling 
    • Restless limbs 
  • What It Might Mean:
    • Your little one may be low on iron. You will need to advocate for a blood test with your doctor if you feel appropriate for your child. Ferritin levels under 50 are important to address. A naturopath can be a great resource for guidance on supplementation. 

Food Intolerances 

  • What It Is:
    • If you are struggling with hourly wakes it is possible it is caused by some sort of food intolerance
    • Both food sensitivities and food allergies can be a huge sleep disruptor
    • Although dairy intolerance is the most common one we see, there are several things your child might be struggling with 
  • What It Looks Like:
    • You might notice hourly wakes as well as:
      • Eczema or rashes
      • Reflux
      • Colic
      • Discomfort 
  • What It Might Mean:
    • You may need to eliminate specific foods from your child’s diet but also yours if you are breastfeeding
    • This may take some trial and error
    • A naturopath or allergist can be a helpful resource in this situation
    • Remember that it may take some time to see improvements as your child’s body will need some time to heal 

Hopefully these explanations have provided some insight for you. Trust your gut. If you think something more is going on, it’s quite possible you’re right! We are always here to chat (you can book a 1-1 call HERE) if you would like some more guidance on these concerns and how it may be applicable to your little one! 

Categories: Sleep Without Sleep Training, Motherhood, Normal Infant & Toddler Sleep, Red Flags, Night Wakes