Baby sleep associations and self-soothing

Registered nurse, midwife and author of The Tresillian Sleep Book Fran Chavasse says too many people mistakenly believe that children can learn to sleep at any age. In this three-part series, Fran offers her advice on dealing with baby sleep associations and self settling.

All babies from birth to 12 months usually wake at least one to three times during the night. During these awakenings some babies are very good at soothing themselves back to sleep and some are not so good at it and may call out for you several times during the day and night.

Your normal response when your baby calls is to go and see if he’s okay. Once you’re with him he’s usually pretty pleased to see you so you do all sorts of lovely, soothing things to get him back to sleep. 

During the first three months your baby’s sleep rhythms are still maturing so it’s perfectly normal for your baby not to be able to self-soothe himself between sleep cycles.

Sleep cycles are about 50-60 minutes long, and at the end of each cycle, your baby moves into a drowsy state before settling back to sleep. So, between the cycles a little help with going to sleep and re-settling sometimes during both day and night sleeps.

Using calm soothing strategies such as wrapping, gently cradling, rocking and rhythmic patting your baby back to sleep can be helpful when your baby is very young.  

However, as your baby gets older and his sleep develops to a stage where he has more capacity to self-soothe, these types of strategies become less necessary and are only required when your baby has an awakening when he can’t self-soothe himself.

What are sleep associations?

So, what other factors cause disruptions to sleep or sleep difficulties? There are two types of sleep or sleep difficulties; the first occurs when you put your baby to bed and he can’t go to sleep on his own, and the second occurs between the sleep cycles when he can’t self-soothe back to sleep. Your baby could have only one of the difficulties or both.

These types of disruptions can cause sleep difficulties because the way you soothe your baby to sleep during these wake periods always involves some type of rocking, patting, bouncing, feeding and whatever other method you find puts your baby to sleep.

These methods are called sleep associations and very often these associations can become habit. Some parents don’t mind this particular habit, but other parents find it a problem.

Most often the baby is blamed for sleep difficulties and you’re advised to just teach him to sleep. However, the sleep situation is much more complicated than just your baby’s behaviour.

The development of your baby’s sleep is a complex interplay between his biology and his environment, which includes you. So, you and your baby have a sleep relationship therefore, difficulties don’t just arise because of your baby’s personality, temperament or biological makeup.  

Just like all relationships whenever there’s difficulties it’s important to consider both you and your baby’s point of view. Similarly to your baby, you have your own unique temperament, personality, biological make-up and your own sleep needs. Importantly you and your baby experience all the demands of your home environment. Therefore, you and your partner are also closely caught up in your baby’s sleep.

All this means you can’t “fix”, teach or change the process of your baby’s biological sleep development. What you can do is modify the behavioural ways you are currently helping your baby go to sleep and resettle during sleep.

Common reasons for sleep associations

A very common reason for sleep difficulties is that you continue to resettle your baby throughout the night when he could begin to do some self-soothing himself. 

This is very easy to do, if your baby continues to stir and make noises or call, but not actually start to cry between sleep cycles.

The problem begins when he starts to associate the kind of help you give him to settle to sleep or back to sleep. Usually by the time you want to do something about your baby waking multiple times a night you can’t figure out how you got there in the first place.

Consequently, when you want to do something about you and your baby’s sleep difficulties it’s a good start to look back and consider how it all began.

Your difficulties could have originally started for quite a few reasons. Here are some of them:

• You’re worried your baby is frightened or lonely
• You’re feeling very anxious about your baby
• You’re anxious about separating from your baby
• Your baby is simply stirring and making noises between sleep cycles and you think he needs help, but the way you soothe your baby may be a bit too stimulating
• He might be hungry so you feed him and he goes to sleep during the feed
• You feel guilty for not going to him
• You don’t like hearing him cry so you go to him before he starts to cry

These are all very common and totally normal reasons why loving parents get up to babies that call or fuss when they stir between sleep cycles.

What you can do

The first helpful step to solving your difficulties and understanding why you’ve become so involved in helping your baby settle back to sleep is having some awareness of why you continue to respond to your baby’s night-time awakenings.

Knowing why you’re responding could give you some relief; reduce your anxiety or give you more incentive to try modified and flexible settling strategies to suit you and your baby.

Anxiety

If you’ve realised that you are constantly very anxious it’s essential that you talk about this to someone close to you. You will need support and reassurance to work through why you are having so many anxious thoughts.

It’s important for you to feel reassured about him before you even try any sort of modification to your baby’s sleep routines. You may even need to check in with a health professional to make sure your anxiety is recognised and well-managed as required.

If you need extra help with settling your baby, you can get professional help from a metropolitan or regional parenting centre.

Feeding to Sleep

A very common sleep association is feeding your baby to sleep. Feeding to sleep becomes a sleep association because your baby just gets used to going to sleep during a feed, usually with a breast feed. It’s lovely and it’s easy – at first.

When you’re baby is little he does need frequent feeds during the night but as he gets older, night feeds become less frequent because he doesn’t need them and normal sleep development means he has the ability to sleep for longer periods.

The easy answer of course is to stop feeding to sleep, but this is a hard sleep association to stop especially when you have a baby heading towards toddlerhood and beyond.

This is indeed a very tricky sleep association that involves you and your baby in a conflict of interest. You and possibly your partner need to stop feeding your baby to sleep because you’re exhausted and can’t keep it up.

Now looking at it from your baby’s point of view, he loves seeing you during the night, cuddling in close and feeding to sleep.  He simply doesn’t want to stop and will protest very loudly. There’s your dilemma.

So, for as long as it takes to change the association between feeding to sleep and settling without a feed he needs you to be gentle, loving and kind while you help him get over his disappointment at not getting a warm drink of milk while snuggled up against you.

This is tough on you all and requires a team effort. From your baby’s point of view this is one of his first big disappointments, so he needs all the love and support you can give him.

Bit by bit, as he calms down you can help him self-soothe in his cot as he gets used to not being fed to sleep. Even if you’re breastfeeding you can still be a part of helping him kindly and lovingly understand “milk is all gone now”. He’ll be disappointed and angry but he’ll still love you and everything will be okay.

Stimulating Settling

Perhaps when you do go to settle your baby when he wakes, your settling technique is a bit too stimulating for your baby. This is easy to do if you’ve been up multiple times during the night and you feel exhausted, tired, muddled-headed and bleary-eyed.

The reason why you can be a bit too vigorous is because you could be feeling anxious, frustrated, tense and even sometimes irritated. Naturally you want your baby to go back to sleep as fast a possible.

The use of active soothing strategies is very common and quite stimulating rather than soothing. Unfortunately, these strategies may hold up your baby’s likelihood of soothing. Here are some types of active soothing:

• Picking up your baby as soon as he wakes
• Vigorous arm rocking
• Vigorous bouncing and patting
• Too much handling, talking, noise and overstimulation
• Overexposure to blue light during the night

All these vigorous settling methods are more arousing than soothing. The best way to soothe your baby is provide a darkened environment during the night and movement that is:

• Slow
• Rhythmic
• Repetitive
• Calm
• Gentle

Cuddling to sleep

Cuddling your baby in your arms to sleep can turn into a sleep association. Once he starts to associate going to sleep in your arms he will expect that each time he wakes, he’ll need to cuddle back into your arms to go back to sleep.

You and your baby may go through the process at least one to three times a night and maybe more.

Dummies/pacifiers

These are of course sleep associations but of a completely different type and may serve a useful purpose if you choose to use one. Your baby likes to suck and during the first few months sucking on his hands, fingers, thumbs or a dummy is very soothing and satisfying and one of his best ways to find comfort.

That’s partly why feeding to sleep is so comforting and soothing. Sucking as a way of finding comfort is developmentally appropriate in the early months so giving your baby a dummy is neither good nor bad, just a matter of choice.

There are two drawbacks: you have to put the dummy back in when it falls out between sleep cycles, but that is usually pretty quick and not a major resettling strategy. The other is you have to wean your baby off the dummy at some stage of your choosing and this involves some level of disappointment which you handle in a similar way to ceasing breast feeding to sleep.

Giving your baby the opportunity to self-soothe

When you feel as if you’ve got to know your baby a little better and he’s about eight weeks old you can start to give him opportunities to self-soothe to sleep.

If you haven’t started a bedtime routine this is the time. That can be making sure your baby is drowsy and ready for sleep, have nappy change, swaddle or wrap him, sing a lullaby, place him on his back, in his own cot drowsy and sleepy, a gentle pat and leave to drift to sleep himself.

When you put your baby to bed in his cot drowsy, but still awake with a minimum of settling strategies this helps him self-soothe without too much help from you.

This means he doesn’t develop any major sleep associations, and hopefully when he wakes between sleep cycles he can begin to sometimes self-soothe. During the other times he wakes between sleep cycles you can leave him in his cot and only need provide the minimum settling strategies.

Settling strategy

If your sleep difficulties have persisted and you are trying to modify settling strategies you can try a period of gentle settling strategies. First of all it’s important to be consistent and persevere with whatever strategy you choose.

Changing sleep associations takes time – after all they are a habit that took a while to establish, so like all our habits we find it hard to change them without a lot of effort so this will take a little while to change.

You need to settle your drowsy and sleepy baby in a darkened room, in the same safe sleep place, on his back in his own cot, for each sleep as often as possible. However, if he’s crying he needs to be picked up, cuddled and given plenty of reassurance.

When he cries he’s telling you he can’t cope and needs your help and support. Once he’s calm put him back in his cot and gently use a rhythmic pat, stroke, gentle “shhhh” or soft singing until he’s drowsy and almost asleep.

Then try leaving the room. if your baby calls for you and depending on age stands up, cries or some other behaviour start over again. Repeat the soothing steps calmly and gently until your baby falls asleep.

You are allowed to make contact with your baby; in fact it’s essential because your baby needs to see your face and eyes to gain reassurance from you.

You’ll need help and support to continue to do this as you’ll get tired and frustrated. If you don’t get support, you won’t be able to support your baby and it will be hard to continue.

A good way to for you and your partner to help each other is to take turns being “on-duty” and doing the resettling while the other has a sleep. Working as a team is essential and research shows that families who modify sleep difficulties as a team have a much higher success rate.

It doesn't last forever

Sleep associations are easy to establish and quite difficult to remedy. However, with some knowledge about how your baby sleep develops, how sleep associations occur and some settling ideas you may be able to modify some of your difficulties.

Finally, it’s so important to remember that your baby won’t keep waking you up at night forever. Even though it seems like what’s happening to you will last forever, sooner or later it will end and your baby will sleep through the night for you. Hopefully with some family support your baby will sleep longer through the night sooner.