It is 2 a.m. and a scream comes through the monitor. You rush in and find your little one crying hard, maybe looking scared or not quite awake. If your baby wakes up screaming, you are not alone, and there is usually a common, manageable reason.
Below: the usual causes, night terror vs. nightmare, what to do in the moment, and when to call your pediatrician. A calm, predictable bedtime routine is one of the simplest things that can help.
For naps and schedules, see our baby sleep guides.
Quick answer: why a baby wakes up screaming
A baby or toddler who wakes up screaming is often hungry, uncomfortable, unwell or missing you. In toddlers and preschoolers, night terrors and nightmares are common reasons too. Night terrors usually happen early in the night and your child does not fully wake. Nightmares happen later in the night, and your child wakes up scared and wants comfort.
- Hunger or a need for a feeding or diaper change
- Pain or illness, such as an ear infection
- Separation anxiety, often from the second half of the first year
- Night terrors, most common in toddlers and preschoolers
- Nightmares, which can start as early as 6 months
Why babies and toddlers wake up screaming
Normal night waking. The AAP notes that babies do not have regular sleep cycles until about 4 months of age, and that it is normal for a 6-month-old to wake during the night and settle again after a few minutes. Learn more about baby sleep cycles.
Hunger and discomfort. Young babies may still need night feedings, and a dirty diaper can wake them too.
Pain or illness. The AAP says ear infections can cause serious discomfort and sleep loss, and ear pain is often worse at night. Teething can make babies fussy too (see the FAQ below).
Separation anxiety. Beginning in the second half of the first year, the AAP says separation anxiety can cause many nights of disrupted sleep, with a child waking several times and crying for a parent. It is a normal stage that usually fades around the second birthday. See also why babies wake up at night.
Night terrors. These happen during deep sleep, usually early in the night, and are most common in toddlers and preschoolers. Your child may scream, thrash, sweat, look glassy-eyed and not recognize you. The NHS lists being very tired or unwell, sudden noises and stress among common triggers.
Nightmares. These scary dreams often happen in the second half of the night. Your child wakes up crying or afraid and may struggle to fall back asleep.
What to do when your baby wakes up screaming
| What you notice | Night terror | Nightmare | Hunger, pain or illness |
|---|---|---|---|
| When it happens | Early in the night, during deep sleep | Later in the night | Any time |
| How your child acts | Screams or thrashes, seems awake but is not, may not recognize you | Fully awake, scared, wants you | Awake and crying; may have fever or other signs of illness |
| Remembers it? | Usually not | Often yes | Not applicable |
| What helps | Stay calm, keep them safe, do not try to wake them, wait for it to pass | Go quickly, hug and reassure them, help them back to sleep | Feed, change or comfort; call your pediatrician if you think they are sick |
During a night terror: stay calm; the AAP notes your child is not aware of it. Gently keep them from getting hurt, for example if they try to climb out of bed. The NHS advises not trying to wake them. Tell babysitters what to expect.
After a nightmare: go to your child quickly and reassure them they are safe. The AAP says a night-light may help, as can removing anything that looks scary in the dark.
For babies: check for hunger, a dirty diaper or signs of illness. When your baby settles, the AAP advises placing babies on their back to sleep for every sleep until they are 1 year old, on a firm, flat surface with nothing else in the crib. If crying goes on, try these calming tricks for a crying baby.
Over time: the AAP recommends a regular bedtime each night and moving bedtime earlier if your child seems overtired. The NHS suggests a relaxing bedtime routine and keeping a sleep diary to help spot patterns.
Related: 18 month sleep regression and night waking in toddlers.
When to talk to your doctor
Call your pediatrician or their after-hours line if:
- Your baby is younger than 3 months and has a temperature of 100.4°F (38°C) or higher (call right away)
- Your child has a fever, pulls at their ears along with fussiness, or has fluid coming from an ear
- Your child snores often, seems to have trouble breathing at night, or is very sleepy during the day
- Night terrors keep happening, happen often, or regularly disrupt sleep
- Your child gets hurt, or nearly gets hurt, during an episode
- Anything about your child’s sleep or crying worries you
Call 911 if your child stops breathing for more than 20 seconds, or their skin turns pale, bluish or gray.
Frequently asked questions
Should I wake my child during a night terror?
No. The NHS advises against it, because your child may not recognize you and could become more distressed. Stay nearby, keep them safe and wait for it to pass. Most children fall back asleep and do not remember it.
Can babies have nightmares?
Yes. According to the AAP, nightmares can start as early as 6 months, though they peak between ages 3 and 12.
Can teething make my baby wake up screaming?
Teething can make babies fussy, but the AAP says the discomfort is generally not severe enough to make a baby cry more than usual, and teething does not cause fever. If your baby has a fever or seems in real pain, talk to your pediatrician.
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Sources
- Nightmares, Night Terrors & Sleepwalking in Children: How Parents Can Help (HealthyChildren.org, AAP)
- Separation Anxiety & Sleeping Trouble in Young Children (HealthyChildren.org, AAP)
- Getting Your Baby to Sleep (HealthyChildren.org, AAP)
- Brush, Book, Bed: How to Structure Your Child’s Nighttime Routine (HealthyChildren.org, AAP)
- Ear Infections in Children: Information for Parents (HealthyChildren.org, AAP)
- Teething Pain Relief: How to Soothe Your Baby’s Discomfort (HealthyChildren.org, AAP)
- Sleep Apnea in Children: Detection & Treatment (HealthyChildren.org, AAP)
- Fever: When to Call the Pediatrician (HealthyChildren.org, AAP)
- Night terrors in children (MedlinePlus, U.S. National Library of Medicine)
- Night terrors and nightmares (NHS)
This guide is general information, not medical advice. If you are worried about your baby, talk to your pediatrician.