Sunday
Feb012009
Sleep Associations: The Good, The Bad, The Ugly
Sunday, February 1, 2009 
Sleep associations can have a big impact on the ability of babies, children and adults to drift off to sleep. When a baby first comes into the world, he is usually able to sleep just about anywhere but doesn't sleep for long stretches. Over time, your baby's ability to sleep anywhere will change and sleep associations will be created.The good news is that sleep associations can be extremely powerful. You can create and use cues to help your baby understand that it is time to go to sleep and to help your baby feel comfortable doing so. For some babies that is the mother's breast. For others it is a pacifier. For some it is a familiar place such as a crib. For others it is the movement provided by a swing, the car, a stroller, or being rocked in a parent's arms. For some it is silence and for others white noise. Whatever the sleep associations are, it helps your baby to understand that it is time to go to sleep and makes the bedtime transition easier.
The bad news is also that sleep associations can be extremely powerful. If a baby relies on mom's breast to go to sleep and she goes out in the evening, it can be a difficult experience for the baby and the caregiver. If the baby needs a pacifier and they all go missing, it could be a long night if there is no 24/7 pharmacy open. If the association is with a specific place, it can make it difficult to go out in the evening and take the baby with you or to go on vacation or to stay with friends. The absence of those sleep associations can make for a difficult night and even throw sleep off for a week or more afterwards.
I think it makes sense for parents to think carefully about sleep associations with their newborn and decide what types of associations they are comfortable with and willing to maintain. Elizabeth Pantley's books, such as the No Cry Sleep Solution and the No Cry Nap Solution (you can check out my review of the book too) talk about sleep associations, how they are created and how to change them.
In our case, we were not willing to be tied to the house all the time, so we created a strong sleep association with the parents rather than with a place. As a result, we were frequently able to go out in the evening and just have the baby nurse to sleep and then sleep in the sling while we enjoyed a party or a visit with friends. But that does mean that we need to be respectful of our children when considering any nighttime activities that could involve us being separated from them. They will not go to sleep for just anyone, so if we want to go out without the kids we could go for an early night out if they are with people they know and trust and if they don't go to sleep for them they just stay up a bit longer. Or, alternatively, we can go out separately (I go to the party this week, my husband goes to the party next week, I play basketball one night, he goes snowboarding another).
The time often comes when sleep associations need to change (e.g. the baby outgrows the swing) or when the parents want them to change. There is absolutely nothing wrong with maintaining sleep associations that involve parenting to sleep, but if the parents do want to change sleep associations whether it is learning to go to sleep alone, moving a child that is attached to her crib into a "big girl" bed, getting rid of a pacifier, or stopping a the need for a bedtime bottle, then the attachment parenting approach to making that change should be to do it gently. Do not abruptly remove something that brings your child comfort and expect him to be okay with it. Instead, find a way to gently support your child through that transition. This requires patience, as so many aspects of parenting do, but I think a gentle approach in these situations is the most healthy for the parent-child relationship and for your child's sleep habits.
Have you gone through any gentle transitions with regards to your child's sleep associations? How did you approach it?
Reader Comments (30)
Transitioning Peanut from our bed to her crib was extremely difficult, but necessary for my sanity. We used Pantley's book and we ended up "hush"ing her to sleep every night. I have to say that it was not a "no cry" sleep solution, there was crying, but we all supported each other and Peanut and got through it. Whenever I needed a break, H would come in and hush for a while. We did it over a weekend, and by the next week, Peanut was sleeping in her crib. (We still needed to give her a sleep feeding to get her through the night, she was genuinely hungry.) I do agree that gentle transitions are best. I also think it's important to realize when it's developmentally appropriate to transition your baby/toddler/child. Peanut needed to be close to me for feedings up until she was about 6 months old. After that she was able to go for longer stretches that made it possible and practical to sleep apart. She was also able to handle the change and to self-soothe (with support). Obviously every baby is different, and every experience is unique, but I completely agree that change should be gradual and not a shock to the system.
We are in the process of changing sleep associations. For us, it was the sling we relied on heavily to get our refluxy high needs son to sleep. I don't envision slinging him to sleep and watching TV on the couch with him working in toddlerhood, and my lovely DH wants some "us" time, so we are slowly and gently working on just those first few hours of sleep being in his crib, where he does take naps rather successfully, and then resuming our regular nightime routine of cosleeping once we go to bed. Using the NCSS techniques, I crotched a "lovie" that I hold between us when nursing and cuddling, and he holds it in his hand as he falls asleep. We have a consistent bedtime routine that involves a quick tubby, story time with daddy, a massage, then cuddling, same sounds (ocean waves), and then nursing to sleep. I don't mind the nursing to sleep association. I do the PPO (plantley pull off) and hold him for 10-15 min before I lay him in his crib. We will slowly slowly chip away at how long I wait. He does that darned 45min wakeup stuff, so I go to him immediately, resettle him, usually without the boob, and lay him back down after holding him that obligatory timeframe. We are only on week 1 but I know this will work while being super sensitive to his needs.
I'd be interested in a post about solutions that others come up with. We worked very hard to give our daughter a positive sleep environment; she slept side-car style in our room until about 6 months, when she needed to stretch out in her crib.
At that point, we made sure to always transfer her with her lovey blankie (an 8" square silky fabric), and stayed consistent with rocking, nightlights, a fan.
That first transition (from side-sleeping to crib) went really well, mostly I think because she was ready for it. However, part of her routine is the pacifier, and I'm worrying a bit about how best to remove that without stressing her at bedtime.
Any suggestions to that end?
@bessie.viola - I think she'll probably outgrow the pacifier on her own with time. Is there a reason you want to get rid of it?
I used to breastfeed Ara to sleep, then moved onto just holding (with the shhhh), then onto laying next too, then onto sitting next too (and some times holding the hand), then slowly moving to the door...(over weeks)...and then I became pregnant and have bad morning sickness and now go to bed before Ara so she sleeps in the sidecar cot beside me (I parent alone most of the time).
I'll have to start again and find some other associantions but I know I will and there will be very few tears as I know to take things slowly. Yes I do get a bit frustrated but as the saying goes we can always play tennis later ;-)
We are working on getting DS to sleep longer stretches thru the night. I start him out in his crib and he will sleep anywhere from 1-4 hours,but once he wakes up I usually bring him into our bed and nurse him back to sleep. I say that I will move him back into his crib (which is in our room) after he nurses but once I fall asleep myself we don't wake until he wants to nurse again. Any ideas on how I can help him to sleep longer stretches or at least be able to soothe him back to sleep with out nursing? He will literally scream at night until I let him nurse,he is almost 8 months old now..
I really wish I would have known more on how to develop a good sleep association before I had children. I had only read Dr. Sears Baby Book, which is awesome, but doesn't really go into detail about sleeping. I nursed my kids to sleep and it was really hard to change that. If I had it all to do over again, I think I'd look more into The Happiest Baby on the Block. I have friends who did it and it seemed to work wonderfully.
I think I got really lucky with my son.
While I breastfed he definitely had a sleep association with my breast and sleeping in my bed, but he weaned himself from my breast and my bed when he was 10 months old. Since then as long as he had his singing frog he would go to sleep anywhere that I laid him down.
When we moved to Ottawa 4 months ago I opted to purchase a "big boy" bed for him rather than moving the crib all the way up here (we left it for sleepovers at Grandma and Grandpa's) and he has since taken very well to that bed and has also weaned himself from his frog.
Considering how colicky and fussy he was when he was just tiny and how young he is now (21 months next week) I was very surprised how easily he's transitioned from stage to stage.
Talking to my friends about their frustrations and difficulties with putting their children to sleep makes me feel SO lucky!
I just thought that I should add that I didn't get THAT lucky with the whole sleeping through the night thing...
It was until a couple of weeks ago that he started *almost* doing that.
He's only getting up once or twice a night now whereas he was previously getting up between 4 and 6 times a night.
[...] liked the information on being thoughtful about creating patterns. Pantley explains that sleep associations and patterns can be powerful, which can be good and bad. Those consistent patterns and associations [...]
I know this thread and article are a little old however I wonder if anyone can help me... My son is 16 months old and I have had a rountine for quite sometime... quiet time, bath, story, bottle & cuddle then when he is half asleep I place him in his crib and he is fine... I also do the same thing bottle & cuddle for his nap. I am sure there are many peoiple out there that say get rid of the bottle which I do plan to do very soon as he hardly has much now and it is more of a comfort thing. However now at the moment he is in daycare and most days will not go down for a nap because the daycare worker wants to be able to just give him his bottle and put him in the crib and have him self sooth to sleep... many days I am told he just cried and cried, because she believes that crying it out will make him learn. I do not agree but I have no choice as to leave him there... I just need help helping him to self sooth to sleep and take away the cuddle time... as much as I love it :( Any suggestions?
@Melissa: I'm sorry that you are struggling with this. Can you not look for another day care? That sounds awful. The No Cry Sleep Solution and No Cry Nap Solution (listed in http://www.phdinparenting.com/my-parenting-library/" rel="nofollow">My Parenting Library) have solutions for trying to transition to having your baby go to sleep alone. However, the crying at day care is not going to help. He is only going to be more anxious now if you try to make any changes.
Honestly, IMHO 8 mos is too young to cut out night-nursing (unless the baby naturally starts to sleep longer stretches). They still need to eat in the night generally.
Oops, didn't realize this post was from 2009! He's probably old enough for night-weaning now LOL
This article came at a perfect time. I am working to get my 2 year old out of my bed and into her own. We are using her blanket as her association, even though I didn't know that was what it was called. When I weaned her a few months ago, the blanket was what we gave her as she went to sleep, as she normally nursed to sleep. That transition was smooth and I hope this one is too. It just seems to take some time, which is fine.
We are expecting our second in a few months and this is definitely on my mind. I feel lucky that we were able to successfully mix crib & cosleeping with #1, so hoping that will work with #2 as well. What I want to change is to have my husband do bedtime once or twice a week from the early days. My 2 year old CANNOT go to sleep without me, which is frustrating even when she goes down easily. Breastfeeding is part of it, certainly, but it seems the associations go deeper than that. I feel like I could wean much more easily than get her to fall asleep at night for anyone else. Any ideas?
Catherine:
It is a good thing to think of right from the start. You could try having your husband be the one to put her to bed right from the start. Either every night or alternating nights. That way she will hopefully fall asleep as easily for him as she does for you.
this is good fodder for my brain right now...sleep associations have been a long running theme here in our house. we have a VERY hyperactive little girl (now 16 mos) who is a total boobaholic. (lol!) love that I can still breastfeed, and we've gone through a heap of transitions already. pacifier and dr.karp's fab 5 sleep tips (which really really work) to sleeping with a cuddle, right back to more nursing and pacifying to sleep (on me!) From the firsst week of her life, she has consistently fought sleep for almost every nap and bedtime...it is maddening. I would really love to have a night out or a date night or SOMETHING soon. but my darling daughter puts up the biggest fight most nights if I am not there with breasts to comfort her. It gets really tough some nights.
We fear that she'll be screaming for bfeeding & comfort until she's much older and I did not prepare for this extention on the breastfeeding. I can get zen about it, and enjoy it knowing it's not forever, but some days, I wish I could have my body back and not have to fight my daughter to get to sleep. SIGH!
alas- I am sure this too, will pass in time.
Two things I would add.
First, little ones understand that there are different rules with different people. Not at one or two months -- at that age you'll see them root on anyone -- but at some point babies come to expect different behaviors from different people. My husband can hold our 9 month old and walk around with him and the baby doesn't cry but does this loud, sleepy, singing thing and drifts off to sleep. If I held him that same way, he would cry and insist on nursing. I nurse him to sleep, daddy holds him to sleep. Sometimes if daddy's been doing it, it takes a little longer for me, and if we are both home he may cry for mommy if he wants to nurse, but he is really OK with both ways. Sometimes moms who nurse their babies to sleep think it's going to be impossible for someone else to get their kid to sleep peacefully but that's not the case. I babysat for a one year old who nursed to sleep and I'd say, "time for nap. show me where your crib is." and he showed me, I helped him in, and he laid down and went to sleep in less than five minutes with NO crying. That would NOT have worked with my own children and it wouldn't have worked with him if his mom was around. But I just acted like I didn't know the regular routine. So sleep associations are flexible and complex. They are wrapped up in patterns and rituals and relationships. If you are worried about leaving the baby at bedtime, get a sitter who can sympathize and is patient and understanding with the situation.. a parent like you, perhaps. I knew to stay away from "the big bed" or anything that would make the toddler think, "oh yeah, its time to nurse." And if he cried, I was ready to pull him out of the crib and let him wait until mom came home or he got really sleepy and could crash in my arms.
Second, kids vary. My second child could be put down "drowsy but awake" like some books say, and drift off to sleep peacefully for the first 6 months, and even slept through the night often with no "training." Blew my mind! (Of course now he knows there's an all night diner open right next to him. Saw that coming, don't care.) My first child, well we just didn't put her down. She needed warmth and motion and a heartbeat from the very beginning. She had good instincts, I think. I couldn't tweek night time much using any method until after she turned two. And she still was rather needy for a year or so longer. But she's 6 now and she falls asleep alone in her own room, sleeps all night, and begs for a few more minutes of sleep on Monday mornings.
And here's my advice, especially for Catherine.
After nursing your two year old, move to the feet and give her a foot rub. Use fun lotions and make it a special treat. Foot rubs provide contact, and help with relaxation, but keep the kid still and laying down by herself, and keep your breast away from her head. Allow the bedtime routine to gradually change to end with the foot rub. Slowly move nursing to before tooth brushing (better for teeth anyway). Rub feet until asleep, then until almost asleep and just sit with her. Then start occasionally "remembering" things during that last quiet time. "Oh, I forgot to bring up the laundry.. be right back." "Oh I need to brush MY teeth. Be right back." Go do the things and then come back. Stay away longer and longer, but always come back. Soon you'll come back and she'll be asleep.
Sometimes all it takes is that last "remembering" things step. Eventually, "Be right back" turns into "Good night." And then you realize your kid is falling asleep on her own and THAT'S when you feel very glad you did nurse her to sleep for so long.. because it wasn't so long after all.
Then she will start roping daddy into laying down with her and they will fall asleep together and that will make you all warm and fuzzy inside even though he's messing with all your hard work. :)
Julie
My 2 year old son and I have been co-sleeping and breastfeeding to sleep since he was born. 3 of us sleeping in a family bed has been getting difficult and uncomfortable so we started transitioning him into his own bed when he turned 2. I started letting him have his day naps in his own room, then he started asking to sleep in there at night - very gentle, very easy. Most nights he still comes in to us when he wakes in the early hours of the morning. I would love it if I could teach him another way of falling asleep besides breastfeeding, as some nights he still nurses all night long. I've tried everything including Pantley's methods & have seen SOME improvement SOMETIMES but no long term solution - he just loves the boob too much. I'm going to wait until he's ready to give it up on his own.
Anna:
I just waited too. I wrote about that here:
http://www.phdinparenting.com/2010/03/01/a-different-kind-of-baby-led-weaning/
@ bessie.viola
I used to have concerns about the pacifier, too and was even hesitant to introduce it (she used to spit it out until about 4mo old). But then it was really a life saver and it made a transition to her crib (although next to my bed) much easier. Much later, at about 1.5y, it would actually make her wake up during the night. At that time she wasn't hungry during the night anymore, but paci would fall out and she'd wake up looking for him - meaning looking for me so I could find it LOL. I was still hesitant to wean her off the paci for fear she would suck her thumb (although she never did). Finally a tried a few evening for her to fall asleep without it kind of by distracting her when she was really tired, and it worked fine. I think she was 1y 10mo when a big blue balloon came and the paci went for a ride up into the sky. And that was that. For two weeks or so we had bedtime stories about all the adventures the paci was doing, and really her discomfort was minimal for maybe 2 nights.
BTW, as per our dentist, she has PERFECT teeth, no overbite etc.
So, I agree with the PP. Don't feel guilty and give her time time to outgrow it. You can do some test runs where the paci is "hiding" and see how much that upsets her. If she's still very attached and upset, then you "find" it, wait another month or two, and try again. Just make it fun, the more you worry or tense up about it, the more she'll feel the same.
love this comment :)
[...] I’m so thrilled! I’ve tried so many different types of “lovelies” for her to fall in love with — just so I could … you know, send her off to sleep [...]
We were able to slowly transition off the binky for my son, we simply sometimes couldn't find it and necessity required us to help him sleep without it. When we finally made our mind about getting rid of it, it was surprisingly smooth, it was those times we half heartedly went about it that it was hard, or he was simply ready. I'm all about a smooth and gentle transition, it's very important to me. In our case, it did mess up his front teeth (pushed them out) and I think it had a bit to do with his 6 cavities (the two biggest being on his front teeth).
Right now I'm sleeping in my son's bed, his association is a warm body, mostly mine. He needs someone in bed with him and wakes up very upset if he's alone. This works okay, but I wish he would let his brother sleep with him. :)
This is what I needed to hear :) THANK YOU
I have a 10 month old and she doesn't sleep through the night. She is up usually 4-6 times a night. I don't believe she is truly hunger and believe her bottle is more of a sleep association. I am not sure if I should take away her night feedings or not. She was born at 8 lb 9 ounces but now just reached 18 lbs. She had severe acid reflux she has affected her weight gain. Besides being small for her age she is a normal 10 month who crawls and gets into everything. Any ideas on how I decided if its a hunger or sleep association?
Emily:
Does she sleep with you or in a crib?
Does she take a pacifier?
Some babies have a strong need to suck, but it doesn't mean that they are necessarily hungry. So a pacifier can help in those cases with a bottle fed baby.
Some babies have a need for human touch, so they'll keep waking at night if they don't have that.
Hi there. I know this thread is old but I have a question I'm hoping someone can help me with. I nurse our 5 and a half month old to sleep. But the process takes two hours every night for her to fall into a deep enough sleep to transfer into her crib. I've tried moving her bedtime up, later and it makes no difference. Is this normal? Any thoughts on what I can do? Thank you!
What on earth is going on? My oldest is now 45 and her sister is 41. My step-daughter has two children (ages 3 an 1). I love these little ones but have never seen such "fuss-prone" children in my life. With my kids, forty and footy-four years ago, at bedtime they got a fresh diaper, probably a pacifier, and the off into bed. On rare occasions there may have been a few minutes of fussing, but they were allowed to experience it and then drift off to sleep. Well before their first birthdays they were both sleeping peacefully through the night. I really cannot understand what has happened to this sort situation. My daughters children are all school age and more now. They did not have these extreme situations with their children either.