by Elizabeth Pantley
If your baby is waking up every hour or two to breastfeed, bottle-feed, or locate his pacifier, you may be wondering just what it is that causes him to wake up so often. The reality is that brief nighttime awakenings are a normal part of human sleep, regardless of age. All babies experience these. The difference with your baby, who requires nighttime care every hour or two, is that he is involving you in all his brief awakening periods.
Your baby makes a sleep association, wherein he associates certain things with falling asleep and believes he needs these things to fall asleep. My baby, Coleton, spent much time in his early months in my arms, his little head bobbing to the tune of my computer keyboard. From the very moment he was born, he slept beside me, nursing to sleep for every nap and every bedtime. By the time I looked up, he was 12 months old, firmly and totally entrenched in a breastfeeding-to-sleep association.
Your baby, like my Coleton, has learned to associate sucking (having your nipple or his bottle or pacifier in his mouth) with sleeping. I have heard a number of sleep experts refer to this as a negative sleep association. I certainly disagree, and so would my baby! It is probably the most positive, natural, pleasant sleep association a baby can have. The problem with this association is not the association itself, but our busy lives. If you had nothing whatsoever to do besides take care of your baby, this would be a very pleasant way to pass your days and nights until he naturally outgrew the need. After all, this is natural. You may not even see this as a problem, in which case it is not. It's all a matter of your perception and your personal needs.
However, in our world, few parents have the luxury of putting everything else on hold until their baby gets older. With this in mind, I will give you a number of ideas so that you can gradually, and lovingly, help your baby learn to fall asleep without this very powerful sleep aid.
To take the steps to change your baby's sleep association, you must complicate night wakings for a while, but in the long run you can wean your baby from using his pacifier, bottle, or your breast as his only nighttime association. In other words, be prepared to disrupt your own nights for a while to make some important, worthwhile long-term changes.
Pantley's gentle removal plan
When your baby wakes, go ahead and pop his pacifier or his bottle in his mouth, or nurse him. But, instead of leaving him there and going back to bed, or letting him fall asleep at the breast, let him suck for a few minutes until his sucking slows and he is relaxed and sleepy. Then break the seal with your finger and gently remove the pacifier or nipple.
Often, especially at first, your baby then will startle and root for the nipple. Try to very gently hold his mouth closed with your finger under his chin, or apply pressure to his chin, just under his lip, at the same time rocking or swaying with him. If he struggles against this and fusses or roots for you or his bottle or pacifier, go ahead and replace the nipple, but repeat the removal process as often as necessary until he falls asleep.
How long between removals? Every baby is different, but about ten to sixty seconds between removals usually works. You also should watch your baby's sucking action. If a baby is sucking strongly or swallowing regularly when feeding, wait a few minutes until he slows his pace. Usually, after the initial burst of activity, your baby will slow to a more relaxed, fluttery pace; this is a good time to begin your removal attempts.
It may take two to five (or even more) attempts, but eventually your baby will fall asleep without the pacifier or nipple in her mouth. When she has done this a number of times over a period of days, you will notice the removals are much easier, and her awakenings are less frequent.
"We got to calling this the Big PPO (Pantley-Pull-Off). At first Joshua would see it coming and grab my nipple tighter in anticipation. Ouch! But you said to stick with it, and I did. Now he anticipates the PPO and actually lets go and turns and rolls over on his side to go to sleep! I am truly amazed."
—Shannon, mother of 16-month-old Joshua
If your baby doesn't nap well, don't trouble yourself with trying to use the removal technique during the day for naps. Remember that good naps mean better nighttime sleep and better nighttime sleep means better naps. Once you get your baby sleeping better at night, you can then work on the naptime sleep.
The most important time to use Pantley's gentle removal plan is the first falling asleep of the night. Often the way your baby falls asleep will affect the rest of his awakenings for the night. I suspect that this because of the sleep-association affect that I explained earlier. It seems that the way in which your baby falls asleep for the night is how he expects to remain all night long.
Stop feeding a sleeping baby
I am a follower of the never let your baby cry rule, and I took it very seriously. What I didn't understand, though, is that babies make sounds in their sleep. And these sounds do not mean that baby needs you. Babies moan, grunt, snuffle, whimper, and even cry in their sleep. Babies can even nurse in their sleep.
The next step to helping your baby sleep longer is to determine the difference between sleeping noises and awake noises. When she makes a noise: Stop. Listen. Wait. Peek. As you listen attentively to her noises, and watch her, you will learn the difference between sleeping snorts and I'm waking up and I need you now noises.
"Last night he was nursing and I pulled him off and put my finger under his chin. I was thinking, 'This will never work; he'll be mad!' But it worked; he went to sleep! The other trick is working too. When I take him off and then roll over, he thinks I'm asleep, then he goes to sleep, too!"
—Carol, mother of nine-month-old Ben
Changing your routine
Very often we have a routine we have followed with our babies since birth. The final step before sleep is always nursing or having a bottle. Some babies can continue this pattern and still sleep through the night. Others, though, need to have the final step in their routine changed before they begin to sleep all night.
What you'll want to do is take an objective look at your final steps in putting your baby to sleep and make some changes if necessary. You may want to use massaging, cuddling, or sleepy-time music to help get your baby to fall asleep. Eventually these steps will take over for nursing or bottle-feeding, and then they too will fade away, and your baby will be sleeping longer.
"I have changed the way I'm putting Carlene to sleep, and it's working! Instead of nursing her down, I just feed her until she is relaxed and then I let her do whatever she wants in the very dim room with me. When she rubs her eyes and looks sleepy, I put her in her crib. I stay there and stand next to the crib, and encourage her to sleep. I say, 'Shhh, it's night-night time, close your eyes, sleepy girl,' and I tell her that it's okay to go to sleep. I rub her head or her tummy. She shuts her eyes right when I do this. It's been a major breakthrough."
—Rene, mother of seven-month-old Carlene
Patience, patience, and just a little more patience
Take a deep breath and repeat after me: "This too shall pass." You're in the middle of it all right now, and it's hard. Keep in mind that your baby's seeming inability to fall asleepon his own is not his fault. He's done things this way since the day he was born, and he'd be perfectly happy to keep things as they are. Your goals of helping him feel loved and secure while discovering ways to fall asleep without you, without your succumbing to the temptation of letting him cry it out are admirable. You have his best interests at heart. Be patient, take your cues from your baby, and in no time at all, your baby will be sleeping. And so will you. Then your concerns will turn to the next phase in this magnificent, challenging, and ultimately rewarding experience we call parenthood.
Elizabeth Pantley is a mom of four, a parenting expert, attachment parenting supporter and the writer of several parenting books, including The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night and The No-Cry Sleep Solution for Toddlers and Preschoolers. Elizabeth is a regular radio show guest and frequently quoted as a parenting expert in magazines such as Parents, Parenting, Working Mother, McCalls, Redbook and on over 50 parent-directed Web sites. She publishes a newsletter, Parent Tips, that's distributed in schools nationwide.
Copyright © Elizabeth Pantley. Permission to republish granted to Pregnancy.org, LLC.