Paediatric sleep problems: dealing with sleep crutches

by Tia

During the first three months, babies establish a rhythm of feeding, wakefulness, and sleep. Then, at around three to four months, babies’ circadian rhythms begin to mature. According to Dr Alison Bentley, Restonic sleep expert, this is often when paediatric sleep problems arise. Parents may end up relying on “sleep crutches” to get their baby to fall asleep, such as bottle or breast feeds or using touch, such as rocking, patting or having to lie with their child.

“While these behaviours are natural and comforting in the early months, they can become problematic if they develop into long-term dependencies,” she says. “Babies may develop anxiety or resistance to sleep without their preferred crutch, leading to bedtime battles and sleep disturbances. Crutches teach a baby a ritualised way of falling asleep – and that’s fine until the baby needs to fall asleep without that particular crutch (for example, the specific way mom holds the baby, which means dad can’t get baby to sleep).”

Importantly, Dr Bentley says, parents shouldn’t feel guilty about a child having developed a sleep crutch. “Things happen that interfere with being able to fall asleep, that you have no control over. For example, your baby might have acid reflux, so lying down is a disaster, so they learn to only fall asleep being held upright, which becomes their sleep crutch. Or it might be as simple as travelling to stay with family for two weeks and you compromise on how you handle nighttime wakeups to avoid disturbing everyone, and your baby learns that whenever they wake up, you’ll put them in the bed with you. These things are not your fault. Your baby learns a way to fall asleep and sometimes there’s no accounting for what works or why.”

Sleep training – tips from Dr Bentley

  1. Check for health issues: Check that there is no medical problem interfering with sleep, such as reflux, ear infections or lactose intolerance before you start sleep training.
  2. Don’t fight at bedtime: Make it a pleasant time you spend with your child. Bedtime is separate to what happens in the middle of the night, so treat it that way. Do what you need to do to get your child to sleep.
  3. Deal with the first nighttime wake-up: The first time your child wakes after bedtime is when you need to make your stand. Don’t give them the sleep crutch. They don’t need a feed. They need to practice falling asleep on their own. In my experience, it normally takes at least three nights to even get that on their radar. But then it gets easier.
  4. Expect three phases: First, they will be furious because you won’t help them fall asleep the way they are used to. And that’s understandable – they don’t know what you want them to do and they don’t think they can fall asleep without the crutch. They are frustrated and they’re entitled to be. They will scream. You should keep talking to them to calm them down. You are welcome to pat them or touch them to help. If your baby can already stand, part of this process is trying to keep them lying down – they can’t fall asleep in any other position. It might take 40 minutes. And they will go from furious to almost sad (the second phase), and then finally to sleepy (the final phase). Eventually, they’ll fall asleep.
  5. Only fight once a night: The next time the baby wakes up that night, you give them the crutch they’re used to. You only fight once a night, at the first wake-up. After three nights, they’ll fall asleep faster because they’re less anxious – they know they’ve done it before.
  6. Keep it up: If you keep going, the first wake-up should move later in the night. So, if you were getting up at 11pm, you might now get up at 1am and do the same thing. Gradually, that first period of sleep should become longer until eventually they’re getting through most of the night.

Parents can find a more in-depth look at paediatric sleep issues, as well as other sleep advice and bedtime stories for children, on the Power of Sleep with Restonic Podcast channel.

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