1 year old - Sleep through the night?

Dr. Markham
I'm desperate to get some sleep. Our 12 month old son is still sleeping in our bed. Is it possible to get him to sleep through the night – in his own bed?!
Exhausted

Dear Exhausted,
The challenge with babies is that their genetic makeup is essentially from the stone-age.

Whether you believe humans started off in the Garden of Eden or a primeval forest doesn't much matter. The point is that moms didn't have to go to work the next day, and babies couldn't sleep by themselves without getting eaten by predators.

So babies are designed to sleep with their moms. When they wake slightly between sleep cycles – which all of us do – they don't put themselves back to sleep naturally. They first look around for mom and make sure everything's ok.

So the bad news is that many babies do not fall asleep without being held, and do not sleep all night in their own bed, unless they are “trained” to do so. It simply isn't a "normal" thing for small humans to do, biologically speaking. But of course that presents a problem for parents who expect to get a good night's sleep so they can function the next day.

The good news is that if your baby is over a year old, you can teach him to put himself to sleep. I hasten to add that many families opt to continue to nurse babies at night well into the second year, and I was one of those moms. There is nothing wrong with that approach. Sooner or later, your child will begin sleeping though the night. Speaking from experience, as a teen your sleepless baby may well sleep a lot.

But I hear from many moms who have little ones over a year old and are so sleep-deprived they're considering sleep training. Unfortunately, most sleep training methods are traumatic for the baby, and even for the parent.

However, I'm happy to say that you can teach little ones to go to sleep in their own beds without leaving them to cry. This is not an overnight process -- it can take weeks or even months -- but it definitely works. It's just a matter or retraining their sleep associations.

Your goal is to help your child sleep through the night. For most babies and toddlers, that means helping him learn to fall asleep by himself, so he won't miss you when he goes through the stage of his sleep cycles when he wakes slightly. This is a normal part of sleep for everyone, but we all know how to go right back into sleep so we don't even notice. Your baby, unfortunately, moves into slight wakefulness and looks for Mom and Dad.

Often, however, when you teach your baby to put himself to sleep in the evening, he will then use that skill to put himself back to sleep during the night, and begin sleeping through the night. The exception to this is kids who are still used to waking up to eat at night. Kids who sleep with their parents and nurse are more likely to insist on being fed at night for longer than other babies. Is this because breast milk doesn't hold kids for as long as formula, or just because the snack bar is right next to them?

We don't know, but it does mean that weaning your child from night feedings, once he's over a year old, is usually the first step toward getting him to sleep through the night. This is not a step to be taken lightly, and parents who opt for it should know that it will mean your little one will need to nurse (and eat) more during the day.

If you're ready for night weaning, the best way to do this is usually for Mom to sleep in another room for a week, so when Baby wakes up, Dad can rock him back to sleep. (You don't have to rock him, but it will probably work faster than anything else.) This isn't Ferberizing, because you never leave your child. Dad is there comforting him the whole time, while he gets used to going without food at night. It isn't really even sleep training, it's night-weaning. However, your child will certainly cry, and this is a very hard few nights.

I personally do not think that kids need everything they want, even if they think they do, and I think night weaning is sometimes best for a family because it produces a well-rested mom. On the other hand, this is a lot to ask of your little one, and a big adjustment. I would always advise you to hold out as long as you can before night-weaning. I personally waited until my kids were old enough to at least understand what was happening.

Kids in the family bed often seem to sleep better -- at least once they're night-weaned -- since they're reassured by their parents' presence, and since sleeping with the mother is certainly a natural state biologically for babies and toddlers. But clearly the Family Bed really isn't working for you, so you want your son to sleep by himself. That means you need your son to learn to fall asleep by himself, so that then he can put himself back to sleep when he does wake up at night.

Start by teaching new sleep habits.

1. Help your little one learn to fall asleep without sucking. If you've been helping your son fall asleep with feeding or rocking, he is likely to wake during the night unable to fall back to sleep until he is fed or rocked again and again. Unless you want to rock or feed him to sleep over and over at night, your goal now is to help him fall asleep in his own crib or bed, comfortably. That means putting him in his bed when he's awake, so that he can get used to falling asleep there himself. Breaking his established habit can be challenging -- it's hard for him to understand why you can't nurse him or rock him now. You can expect him to need your close physical proximity to settle down to sleep.

You can break the association with sleep completely by nursing or bottle-feeding your little one in the living room before beginning the bedtime routine. Since sucking is a harder habit to break than rocking, you probably want to use a two step process. First, get your child used to falling asleep without feeding, even if you have to rock him. This is where having Dad put baby to sleep is great. Mom can nurse the baby, or feed him, in the living room, and then Dad can take him in the bedroom and rock or walk him to sleep. Your baby may cry, but you know he has a full belly, and the comfort of Daddy.

2. Help your little one learn to fall asleep lying still (in your arms).
Eventually, he will learn to fall asleep without nursing or a bottle. Once he's used to falling asleep being rocked or walked instead of eating, the next phase is to get him falling asleep without rocking. So you begin with rocking, but then, before he is actually asleep, you stop rocking, and just sit holding him. If he protests, begin rocking again. Keep repeating this. It may take 25 attempts, but eventually he will begin falling asleep even though you have stopped rocking. That's a real victory. Do this for a week or so until he's used to it as your new routine: getting sleepy while rocking and then falling asleep in your arms while not rocking.

3. Help your little one learn to fall asleep in his bed. The next step is to
 wait until Baby is almost asleep in the chair, then stand and hold him still in your arms in his sleeping position (on his back) until he is almost asleep and accepts the stillness. If he protests, rock him in your arms as he falls asleep while you're standing. Again, do this for a week until he is used to this routine.

Next step is to begin lowering him into the crib or bed still awake although almost asleep. When he protests, pick him up again in the rocking position and rock a little, then stop. Keep repeating this. It may take 25 attempts, but eventually he will let you put him in the bed without protest. Now you are almost home.

Eventually, you will be able to put your baby in the crib and hold him there while he falls asleep, because he will not need rocking any more. Then you move to touching, but not holding, your baby, while he falls asleep in the crib. Eventually, he will be able to fall asleep with you simply holding his hand, or putting your hand on his forehead. Keep doing this until he accepts it as your new routine -- getting sleepy rocking, but then being put into his bed lying on his back and falling asleep there, eventually without you even touching him.

Although this is a long process, the first few nights are the hardest. If your little one is used to you rocking him to sleep, and now you won't do that, naturally he is likely to protest with vigor. After all, he doesn't know how to go to sleep without rocking. Your son is probably able to understand more than you think, and sometimes kids his age are helped by having you act out the new routine with stuffed animals. He may still protest, but at least he understands more about what is going on.

What if he cries? Your little one is learning new sleep habits, and that's hard for him. He may well cry, especially at the beginning. That's why I advise you to go very slowly. If you feel your child is too upset, there is nothing wrong with trying again when he's older, or simply making your teaching more gradual.

This is not "Ferberizing" which requires the parent to leave the room, even though you are actively "teaching" your child to put himself to sleep. Throughout the process, while he learns this new skill, a parent is there offering comfort and sympathy. Your child's deeper needs for connection and trust are always being met, he is never left alone to feel abandoned, wondering why Mom and Dad don't come to answer his cries. And eventually -- within a few months, or even weeks -- your son will lie right down to sleep as soon as you put him in the crib, and will sleep through the night. Sweet Dreams!

Peaceful Parent, Happy Kids

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