When Your Baby Wakes Frequently to Feed: The Pantley Pull-off

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