Gentle Sleep Training / Sleep Improvement Strategies: What, When, and How…

There is a plethora of sleep training methodologies and advice available at our fingertips; so much so, that the decision of which one is right for you and your family can be overwhelming. Which one is best suited to your parenting style? your time commitments? your child’s temperament? or the most effective solution for the particular sleep difficulty you are experiencing?

There is no such thing as a “no cry” solution when changing sleep patterns. Old habits usually die hard as our children rarely give up their favourite thing without a fight (e.g. falling asleep on the breast, being rocked to sleep, the dummy and co-sleeping).

Although sleep training is not always necessary, below are some of the more ‘gentle’ strategies which can be effective for a range of sleep issues such as: rocking/feeding to sleep, habitual early rising (or overnight wakings), catnapping, and disrupted sleep patterns due to developmental milestones and life transitions. These solutions do not offer a “quick fix”. The success of any method you choose will rely on your stamina, commitment, emotional bandwidth, and time. The below options can be somewhat more labour intensive than other “cry it out” methods, so some patience, and a support network (spouse, friends, or family) can help you stay on track. Expect an average turnaround of 1-3 weeks.

I always maintain; before commencing any sleep training, ensure you have firstly responded to your child’s basic needs (hunger, discomfort, pain, illness, cold/hot etc.). I do not recommend starting sleep training of any kind if your child is currently ill, or in pain (which would require more intervention at these times, not less).

1. WAKE TO SLEEP

 

Wake to Sleep is a strategy pioneered by Tracy Hogg (The Baby Whisperer) to help reset a child’s pattern of habitual sleep awakenings/body clock. Just like any other sleeping method, it requires commitment and consistency, and can take an average of 3­-7 days to see results.

This technique is most successful when the wakings are in fact habitual (i.e. occur at the same time each night or morning), or during the day you know your baby consistently only sleeps for a set period of time ­e.g. 35-40 mins (the infamous catnap!).

When can I use ‘Wake to Sleep’?

❖ Habitual night wakings.
❖ Catnapping.
❖ Early rising.
How to use ‘Wake to Sleep’ overnight and early morning:

Go into your baby’s room one hour before your baby’s usual waking time (you may need to set your alarm for this!).
While your baby is still sleeping, gently rouse them from sleep (moving him/her around a little, stroking, maybe even changing his/her nappy). Your goal is to partially wake your baby up into a semiconscious state so that they start the sleep cycle over without completely waking. Use your desired settling technique to aid them back to sleep once they have stirred.
Tip: You don’t want to wake your child up too much or they may want to stay awake, especially in the early morning hours!
How to use ‘Wake to Sleep’ for naps:

Depending on the length of your baby’s nap, go into their room about 30 minutes into the nap (this is shortly before they begin to transition from a deep sleep to lighter sleep). Rouse him/her gently (without waking completely), and then use your preferable settling methods to soothe your baby back to sleep. The aim: to aid them in transitioning into the next sleep cycle without waking.

Additional Tips:

❖  Trial and error is necessary­ for timing, how vigorously to rouse your baby, and best methods for settling them back to sleep.
❖  If there are multiple wakings at night, focus on one at a time. Once your baby is out of the habit of waking at that time, move onto the next waking.
❖  Make sure you are timing things by when baby falls asleep for naps, not when you put baby to bed.
❖  Sometimes you have to do wake to sleep more than once.

2. PICK UP/PUT DOWN

 

This strategy was pioneered by Tracy Hogg (The Baby Whisperer). It is only to be used in children 3-­4 months or older, although it may even be too stimulating for some babies until 6 months of age. It is generally used up to a year, although you can do it with an older baby too.

When do I use PU/PD?

❖ Short naps.
❖ “Refusing” to nap.
❖ Early morning awakenings.
❖ Night time awakenings (besides possibly one more feed).
❖ Child is unable to put him/herself to sleep without outside assistance
❖ Help establish or extend a routine.

How do I use PU/PD?

Always give your child the opportunity to go back to sleep/self settle by waiting 2­-5 mins when they begin to cry. If the cry escalates or is consistent, go into your child and offer:
1) Comforting words/sleep phrase e.g.”it’s sleep time now darling”.
2) Place a firm hand on his/her back, or roll them onto their side in his cot (facing away from you) and shush-­pat (or place your hands over his face/eyes.
3) If you are unable to comfort your baby in his cot after a short period of time then pick him/her up.
The moment your child stops crying, say your sleepy phrase, place him/her back down in the cot and put your hand on their back (or shush­pat) and offer words of comfort. If they begin to cry again (which they probably will do) then pick him/her back up again and repeat the process as needed. As soon as your child falls into a deep sleep remove your hand from their back and leave the room. Over time you will want to remove your hand sooner so the pressure of your hand doesn’t become a sleep prop.
For 4-­6 month olds: Do not hold them longer than 2-­3 minutes at a time. Just put them down in the cot (all the way down) after this much time has passed then pick them back up again if they are still crying. Holding a baby too long at this age can lead to you turning into a prop.
Instead of keeping your hand on baby until he/she falls into a deep sleep, you may also want to try removing your hands from baby when they begin to settle to sleep and take a step back and see if he /she can put themselves to sleep the rest of the way. You can gradually move farther from the cot during this stage (either during the first attempt or over days) until you are out the door. This approach will help lessen the chance that your hand turns into a new sleep prop for your child.

For 6-­8 month olds:
If your baby gets more upset when you pick him up, first hold out your hands to him/her and wait until they hold out their hands to you before picking him up. Once you have picked up your baby, lie them in a horizontal position while saying comforting words then place him/her right back down in his cot again. You may need to walk away from their cot while your child is settling/calming down because your appearance can be distracting and stimulate more upset.
For 8-­12 month olds (plus): Babies this age usually settle better outside your arms so don’t pick them up unless he/she becomes very upset. Instead, do the put down part of P.U./P.D. when your baby completely stands or sits by taking him/her in your arms and laying them back down with their eyes facing away from you. When your child is lying in his/her bed, continue to offer words of comfort and place your hand on their back.


PU/PD Troubleshooting tips:

❖  If your baby starts to cry as you are placing them back into the cot, continue placing them into his cot all the way and then pick him/her back up again.
❖  If your baby arches their back, hits you, or is in any other way aggressive while you are holding them, place your child back down into their bed. Then start over from the beginning with comforting words with your hand on his/her back. If at any time you need a quick break, advise your child you will be right back – go out the room for a quick breather, then return. There is no point continuing this process if you are becoming anxious, upset, or frustrated – as your baby will pick up on this energy, affecting your progress.
❖  If your baby is acting out in his/her cot (thrashing around) then offer comforting words and maybe a hand on their back to help them calm down physically before you pick up (to avoid you getting hurt).
❖  Don’t be surprised if your baby protests. if he/she is not used to sleeping by themselves. This method does not prevent crying, but it does intend to encourage self settling in a secure environment, and in your presence.
❖  It usually takes an average of 20 minutes, although it can take over an hour (or more) with some babies.
❖  Remember to be consistent, stay calm and keep a calm, comforting voice.
❖  Avoid from engaging too much with your child; keep your eyes closed, room dark, and a calm voice. This is not play time.
❖  Inserting a dummy, feeding for comfort, and rocking are considered no nos when doing P.U./P.D. You should not be continuing a sleep prop likes these (or starting one) when you are doing P.U./P.D. to get rid of sleep props. Do not hand your baby his/her comforter; allow them to search for this on their own (so this is also not becoming a reliance upon you, or a sleep prop).
❖  If your baby will not stop crying during the P.U. part then P.D., offer some comforting words followed by (or at the same time as) a comforting touch or shush/pat if needed. If he/she remains upset, then continue with P.U. again. Using this method you are reassuring him/her you are there for them although you are not helping him/her calm down in your arms. The reassurance is the most important part.
❖  Try starting with words and moving to touch if needed because it is better if you can put your baby to sleep with only your voice compared to your voice and touch.
❖  Another variation of this method involves incorporating a bit of the disappearing chair method. You will do PU/PD as explained above, but you will move a bit farther from baby (about every 3 days) as you do this (see camping out below).

3. GENTLE REMOVAL PLAN

This strategy was pioneered by Elizabeth Pantley (The No Cry Sleep Solution), and can also be referred to as the “Pantley Pull-off”. It can be used for babies 4 months plus.

When do I use the Gentle Removal Plan?
❖ Reliance on sucking to sleep (e.g. Feeding to sleep with breast or bottle, or dummy use)
How to do it?
  1. Feed your baby until you notice the signs that he/she is falling asleep (i.e. sucking slowing down).
  2. Gently remove him/her from breast or bottle (or remove the dummy from their mouth).
  3. Place your finger firmly, but gently underneath his chin (encouraging him to keep his mouth shut).
  4. If your child continues to root for the breast/bottle/dummy, becomes distressed, or wakes completely, then you can replace the source of the comfort, and repeat the above three steps until they appear calm with the removal process (keep in mind this may be 5-10 times (or more).
  5. Aim to place your child in their cot (whilst he/she is still drowsy but awake) so they actually fall asleep by themselves.
  6. If you experience resistance once you remove your baby from the breast/or when placing into their cot, you may continue to use crying in arms, or PU/PD in conjunction with this technique to help your baby sleep independently.


For additional troubleshooting, refer to the No Cry Sleep Solution.


4. CAMPING OUT

What is camping out?

Camping out is another gradual withdrawal method; used mainly to assist with children who are having difficulty self-settling for naps and/or bedtime, or sleep, or are waking frequently overnight unable to get back to sleep without parental intervention (e.g. rocking/holding/cuddling or feeding back to sleep). It is most successfully used for children 6 months and over, and can also help with older children (2 years and over) when dealing with separation anxiety, or fears surrounding bedtimes. This method is similar to Kim West’s Sleep Lady Shuffle technique.

Steps for camping out:

  1. Place a bed or chair next to your baby’s cot, or child’s bed.
  2. Lie or sit next to your child (pat or stroke them off to sleep).
  3. When your baby is asleep, you can leave the room.
  4. When your baby is used to falling asleep like this (usually three nights or more), sit or lie by the bed until your child falls asleep. Don’t use touch.
  5. When your baby is used to falling asleep without your touch (usually another three nights), move your chair or bed away from the cot/bed a short distance. Stay here until your baby falls asleep.
  6. Position your chair or bed further away from your child’s cot or bed, gradually moving towards the doorway, and eventually out of your child’s room. This could take a period of 1-3 weeks.
  7. If your child wakes overnight, resume your position (at the point you are up to with settling). Stay there until baby goes back to sleep.


Important tips for camping out:

  • When sitting or lying next to your baby, keep things dark, calm, and quiet.
  • Avoid making eye contact, or engaging with your child while you’re settling them. It might help to close your own eyes while sitting beside their cot/bed.
  • If your baby gets upset, pat or stroke him until he/she calms. If they are very upset, pick them up and give him/her a cuddle. When your baby is calm, you can try settling them in the cot again.
  • When you’re trying any new settling strategy, it’s good to do remain consistent with how you settle your child each time to avoid confusion.

 

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