Changing your baby’s sleep pattern

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As lovely as it is cuddling your baby to sleep, if he goes to sleep every time being rocked in your arms or having a bottle, he will expect to be rocked or fed back to sleep when he wakes overnight. If he falls asleep in the family room, he will be surprised to wake up in his cot. And he will call out for your help with re-settling.

The first step to an uninterrupted night's sleep is to help your baby acquire the knack of falling asleep on his own at bedtime. This means creating a new sleep pattern.

• A new sleep pattern: in a nutshell
• Four steps to better sleep
• Older siblings
• Sharing your room or bed with baby
• Looking after yourself
  
• Relapses and other difficulties
• Recapping on baby sleep

A new sleep pattern: in a nutshell

• Put your baby in his cot awake. This way, he can begin to learn self-soothing skills and how to fall asleep independently. Your baby will not learn to fall asleep by himself if you do it for him.
• Usually, when your baby has learnt to fall asleep by himself at the start of the night, he can get back to sleep without your help during the night.
• It takes 3-14 days to change a baby’s sleep patterns, just as it takes a few days for adults to get over jet lag (when our sleep patterns are changed).
• You can change your baby’s sleep pattern, but do expect your baby to protest for the first few nights until he gets used to the change. Sleep will then improve for everyone.

To find out more about the causes of common sleeping problems before you start, read Concerned about your baby’s sleep? and What causes sleep problems?

Four steps to better sleep

The key is to change habits associated with going to sleep and allow your baby to develop the ability to settle himself. Here are the steps:

1. Identify the habit associated with the sleep problem.
2. Gradually phase out this habit.
3. Establish a positive bedtime routine.
4. Teach your baby to settle himself to sleep. 

Usually, the way a baby falls asleep at the start of the night is the way he will expect to go back to sleep when he wakes overnight. Therefore, if a baby is rocked or fed to sleep at the start of the night, he will expect to be rocked or fed back to sleep in the middle of the night. This becomes a problem when parents have to interrupt their own sleep to help baby get back to sleep.

The first thing to do is work out what habits your baby is associating with going to sleep. The following table has some tips to help think through your baby’s sleep habits over the last 24 hours. 

Does your baby have a predictable bedtime routine? Do you do similar things together before bedtime? If not, introducing a routine will help your baby ready himself for sleep. 

If your baby is falling asleep in another room, or you are rocking, holding or cuddling your baby to sleep, develop a new habit of putting your baby in his cot drowsy but awake. This gives him the opportunity to learn a new sleep habit that does not require your presence or help. In rare circumstances, this might do the trick. However, more than likely, your baby will need some help learning to settle himself to sleep, and a positive bedtime routine will make this easier (see Step 3).

• Night feeding: If your baby routinely falls asleep at the breast or with his bottle, he may now depend on feeding to help him fall asleep. You can begin to change this habit by trying to finish the last feed at least 20 minutes before bedtime, and feeding him outside of the bedroom so that the association between feeding and sleep is weakened. If you are trying to consolidate your baby's sleep during the night, then fading out night feeds altogether is an important step. You can be confident that babies six months and older who are developing well and putting on weight as expected can be taught to re-settle overnight without a feed.
• Dummies: If a dummy is causing problems (i.e. he needs you to find and replace it overnight), you can either help your baby give up the dummy or, for older babies, you can teach them to manage their own dummy during the night.
• Music and mobiles: In general, if your baby is having problems re-settling overnight, it is probably best to stop playing music at bedtime. This is especially the case if re-settling means you climbing out of bed to turn the music back on during the night!
• Baby monitor: In general, you will not need to use a baby monitor when carrying out settling techniques. If your baby is a long way from your room a monitor can be used - but avoid responding when your baby is only grizzling. 

A positive bedtime routine helps prepare a baby for sleep. This means organising bedtime around a series of consistent activities and tasks, done roughly in the same order and at the same time each night. A positive routine is predictable and includes calming and soothing activities.

In addition, you need to make sure that your baby is getting enough sleep during the day so he does not go to bed at night overtired. A daytime bed routine and the strategies described below can assist you in improving daytime sleeps for your baby. 

A good bedtime routine sets your baby up for success. However, you will need a strategy for managing crying out at bedtime or during the night when he wakes.

Research suggests that the two approaches described here - controlled comforting and camping out - are successful in 80% of cases. 

If you are confident that you are giving your baby enough attention throughout the day, and you feel your baby has become dependent on you to fall asleep, then you can try controlled comforting or camping out.

The idea is to choose the approach you are most comfortable with and try to use it consistently for a period of time.

• Controlled comforting: sometimes called 'controlled crying', controlled comforting has been practised since the 1970s. It is a systematic way of gradually reducing your attention to crying and calling out. It takes longer, and can involve more crying in total, but some parents find it easier to withdraw attention more slowly.
• Camping out: is based on the idea that parental presence is reassuring to a baby. It involves the parent staying in the room, gradually reducing the amount of help they give their baby to settle. It’s a good option for a parent who wants to stay near, but may not be the best idea for a parent who is easily upset or frustrated when their baby cries. However, research suggests that the process involves less crying than the controlled comforting strategy.

Both approaches can be demanding and tiring. Consider your timing before you begin. If your child is ill or you are going through a major upheaval such as moving house, wait until later.

It is best to stop using a behaviour management strategy if you or your child becomes ill during the program. Similarly, if you can’t take any time during the day to have a rest and catch up on some sleep, you may be better off to wait until you can.

Although we know that these approaches are successful 80% of the time, we don't know why they don't work with every baby. We do know that choosing the approach you are most comfortable with, and that fits best with your family and situation, is an important part of success.

Older siblings

Parents are often concerned that a baby’s crying may wake a sibling during the night. There are a couple of possible approaches to this problem:

For settling:

• Tell your older child that you are going to settle the baby five minutes before you do so. Make it clear to the sibling that they either need to stay out of the baby’s room or remain quiet if they are going to go in.
• Find something to keep the older child interested and engaged in while settling the baby, for example, food, a different toy, video/TV or settling her own toy baby (best done outside the baby’s room).
• Reward the older child for staying out of the room or remaining quiet in the baby’s room.

For waking overnight:

• Keep in mind that crying babies rarely wake older children overnight. If you are concerned, you can pre-warn the older child that the baby might wake and cry. Tell her not to worry because mummy and/or daddy are taking care of it.
• If crying does cause problems, it might be helpful for the older child to sleep in a room further from the baby (if possible). 

Sharing your room or bed with baby

If you share a bed with your baby, you can pat him briefly to settle him and turn away when he is quiet to allow him to settle to sleep. See Sharing your bed with baby for more information on safe co-sleeping.

Looking after yourself

Changing a baby’s sleep patterns is a challenging and tiring task. You need to look after yourself as you see it through. 

• Rest at least once a day. Even if you don’t go to sleep, resting can help restore your energy and stave off fatigue.
• Go to bed at night soon after your baby has gone to sleep to ensure at least 2-3 hours of unbroken sleep.
• Accept offers of help. 

Relapses and other difficulties

About 20% of babies who learn to re-settle during the night will begin to wake again for no apparent reason. If your baby is otherwise well, persist with your settling program. Usually babies will go back to their good habits after a couple of nights. A burst of night waking usually occurs two weeks after babies have learnt to re-settle during the night. 

If after seven days you are still having problems, talk to your doctor or child health nurse. They may be able to help you tailor a program that will work better for your baby. You may also wish to contact an early parenting centre in your state or territory where you can receive more support and help.

Recapping on baby sleep

Here’s what you need to know about your baby’s sleep before starting out on a change program (for babies six months and over):

• Your baby usually needs the same amount of sleep from one day to the next.
• Babies differ in their sleep needs.
• Both adults and babies cycle through ‘quiet’ and ‘active’ sleep during the night.
• The first few hours of your baby’s sleep is usually quiet (deep) sleep.
• The rest of the night has more active (lighter) sleep – this is when babies usually wake up.
• Waking during the night is normal, but it can cause problems if your baby can’t get back to sleep without your help.

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