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发帖数: 699 | 1 How to SUCCESSFULLY teach a baby to sleep - 3rd ed.
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BabeGirlMom · Pass a Note!
Posted 02/11/2009
http://community.babycenter.com/post/a5417415/how_to_successful
1) WHY?
Sleep training is NOT a fix-all-solution to all sleep problems. If your baby
is not sleeping well, there are usually good reasons why.
The most common reasons are:
1) Overtiredness. All sleep problems are at least partly due to
overtiredness. Some problems my have been initiated by illness, teething, or
phases; but because these events do lead to a lost of sleep, the baby will
become eventually overtired.
The most common cause of overtiredness is due to an inappropriate sleep
routine/schedule. Babies DO need much more sleep than adults and older
children in order to be at their best, as well as, to sleep well. This is
because: Sleep Begets Sleep.
This means that well-rested children accepts sleep more readily, sleeps
better and longer than overtired ones. (Dr. Weissbluth - Healthy Sleep
Habits Happy Child).
Babies need an early bedtime, usually anywhere from 530-8pm; depending on
the child's natural wakeup time, if he's more of an 11hr or 12hr per night
baby, and how good/poor the previous nights/naps were. Your baby's bedtime
should be within this time frame by the time he's 3.5 months old. If he's
waking up every 1-3hrs all through the night, that is usually a clear
indication that his bedtime is too late and he's overtired.
Typically, babies over 4 months need 11-12hrs of nightsleep daily in order
to be well-rested enough to sleep well. This is true for about 75% of babies
. About 10% of the baby population, need slightly more (12-13hrs) or
slightly less (10-11hrs) than average, not including time lost due to
feedings/nightwakings. These statistics of well-rested children that
regularly sleep well, are obtained from my own experiences and those of
others on this board that I've had the privilege to share over a 3 year
period.
To determine how much sleep your baby need, watch your baby sleep cues, keep
a sleep log, and her behaviour during both days and nights. If your baby
tends to wake 1-3 times over a 12+hr night (feedings are generally age
dependent), take a decent feed during these wakings (i.e.appear genuinely
hungry), goes back down easily after eating (instead of fighting sleep) and
wakes up happy and well-rested in the morning; then she's probably had
enough sleep. If she's waking frequently at night crying, takes just a
nibble,
cries/fusses a lot, appear tired and cranky during both nights and day; then
she's probably overtired.
By 12 weeks, the baby should regularly have 1 distinct long sleep period of
at least 4+hrs, before waking up again at every 2.5-4hrs to eat just like
during the day. Note that there's ONLY 1 long sleep period. If your baby is
waking every 3-4hrs or sooner, that is a clear indication her current sleep
schedule is not meeting her sleep needs and that she's overtired. The more
overtired the child, the more frequent the nightwakings are; e.g. every 2-
3hrs or even every hour for severely overtired children.
Because well-rested babies (4+ months) that consistently sleeps well do
consistently sleep for 11-12hrs every night, as a guide, your baby's ideal
bedtime (actual time asleep) should be approximately 12hrs prior to his
usual/natural wakeup time. If you would like to start sleep training and/or
your baby is waking frequently at night, aim to have him asleep 12hrs prior
to his usual wakeup time for at least 5 days in a row before re-evaluating.
Because overtiredness is always involved in any sleep issue, minimizing
overtiredness and paying of previously accumulated sleep debts is essential
in helping your LO sleep better and longer.
Just because a child knows how to sleep does not automatically mean that he
will "sleep through the night".
Help him do so by minimizing overtiredness and having an appropriate sleep "
schedule".
For babies younger than 3/4 months, they tend to need about 11hrs of
nightsleep (because they nap more during the day). If your baby is just a
few months old, aim having her asleep about 11.5hrs prior to her usual/
natural wakeup time. Some sleep time will inevitable be lost due to feedings
and fussing etc for younger babies.
More info on how to maximize sleep for babies younger than 3/4 months can be
found here:
http://community.babycenter.com/post/a525805/how_to_maximize_a_
During the day, watch the baby's sleep cues and put them down at the first
sign of tiredness; OR within a maximum age-related wakeful period, whichever
comes first. Signs of tiredness includes yawning, eye rubbing, ear pulling,
general slowing down and quietness. Crying, fussing, crankiness, clinginess
and hyperness are signs of overtiredness.
Do especially watch out for the subtler signs of quietness and slowing down.
For most babies, it's already 20mins too late by the time you see the 1st
yawn/eye rub. For many babies, especially those over 5/6months, after the
subtler sleep cues, they skip the yawning/eye rubbing stage and move
straight to the hyper/fussy overtired stage.
Maximum wakeful period at various ages:
Less than 2 month = 1hr, 3 months = 1.5hrs; 4/5 months = 2hrs; 6 months = 2.
5hrs, 8/9 months = 3hrs; 10+ months = 3-4 hrs.
Once the child is on 1 nap (transition usually occurs anywhere between 13-18
months), the wakeful period extends to 5/6 hrs.
The average daily sleep requirements for the average child in order to be
well-rested enough to consistently sleep well are:
Less than 3 months = 15.5-18hrs, 4 months = 15hrs, 6 months = 14.5hrs, 9
months = 14hrs, 15 months = 13.5hrs, 2 years = 13hrs.
True some kids will need more while others less, but it will still be within
30mins for the averages above. If your LO is not "sleeping through" (
whatever that means for his age), it means that he's need more than what he'
s currently getting.
2) Hunger/growth spurts. Generally well-rested babies of 2-3 months of age
tend to sleep pretty well, even if they do not yet know how to sleep. Many
of this age have 1 regular long sleep period of 4-8hrs, depending on the
child. Around 3-4 months, this suddenly changes due to a major growth spurt.
The child wakes more often to eat, often 3 times per 12hr night, and could
barely go 4-6hrs between feeds. If the child is not overtired and does not
have major dependency issues (the paci/breast/bottle often becomes a problem
from 3 months onwards), the sleep related effect of this growth spurt will
be over in about a week.
Following this growth spurt, the next major one is around 5.5 - 6 months.
For this growth spurt, solids has to be part of the solution as bigger and
more active babies do need more food. By this age, milk alone can no longer
sustain many babies all night. Until solids are reasonably well-established,
many babies this age could barely go 6hrs without eating.
Once solids are well-established, meaning 3 fully balanced solid meals per
day that consist of all 4 food groups (in addition to the milk feeds):
grains, protein, fruit/veg and fats; the baby will naturally stretch out
longer between feeds at night. Most healthy kids start going all night (12+
hrs) without eating anywhere between 8-12 months. This depends on the
individual child and how advance the child is with solids.
3) Separation anxieties/new milestones/teething/illness. Any of these will
inevitable affect sleep to some degree, regardless if your baby knows how to
sleep or not. To minimize their affects and to help your baby get over
whatever she's going through more quickly, it's essential to watch her sleep
cues and minimize overtiredness. Since most of these do often make naps and
/or nightsleep more fragmented, moving the bedtime earlier to compensate the
lost of sleep will the the 1st course of action.
4) Dependency issues. Rocking/nursing/bottle/paci/co-sleeping are only
temporary sleep solutions. If your LO is resisting your efforts to put him
down to sleep, takes ages to get him down (30/40mins+), wakes frequently at
night just to repeat the whole process again because he does not know how to
self-soothe, resist sleep for your attention or for the paci/bottle/breast;
then it's time for a change. Some form of sleep training will be necessary
to change these sleep habits.
Dependency issues are usually more severe in older babies (over 5/6 months).
As the baby becomes older, she's also more alert of her surroundings will
eventually resist sleep for the pleasure of your company.
By 6 months, all night co-sleeping becomes difficult. They tend to move
around more, disturbing your sleep, they may want to nurse all night because
"it's there" not because they are hungry, and they may want to play. This
does not mean you have to give up co-sleeping if you enjoy it, but it may be
time for your LO to spend part of the night in his own bed. Because babies
do need an early bedtime (530-8pm) while it's 9-11pm for most adults, it may
suit your needs better if baby starts the night in his bed first, before
moving into yours. A convenient time for this transition to occur is after
the last nightfeed or during the last 1-3hrs before morning.
2) METHODS AVAILABLE
Most experts (Ferber, Weissbluth, Mindell) agree that the minimum age for
sleep training is 4months. From experience, a number of babies of easier/
common temperaments were ready for gentler non-CIO methods as early as
2months.
I think this discrepancy exist because the methods advocated by experts/
pedetricians tend to be more CIO. More non-CIO methods are relatively
unknown. Furthermore, some authors/experts like Dr. Karp (Happiest Baby on
the Block) emphasize the ease of "weaning" a baby from the swing/paci/
swaddle from 2-3months, but nothing/little is said on HOW to do so. If you
have a young baby of less than 4months and your usual methods are no longer
working, more non-CIO methods can be used to wean your LO from the old
methods.
For most babies less than 6 month olds, sleep training is more successfully
when some version of non-CIO/intermediate methods are used. These same
methods continues to be successful in older babies, and well into
toddlerhood depending on the individual child and specific method. The
sucess rate of stricter methods tend to increase with the child's age from 5
/6 months onwards.
There are many sleep training techniques available. For any method there
will always be some crying. You have to be willing to stick with it for a
week in order for any method to be successful. The baby has to realize that
the old method is gone for good, the new is to stay; and she needs to
practise, practise, practice.
Sleep training is never just for a few days or weeks. It's a whole different
way of putting your baby to sleep. Rather than putting your LO down asleep
by rocking, bouncing, nursing, bottle, or paci; all methods are just some
variation on how to put your baby down awake, and how to encourage her to
put herself to sleep all by herself.
Whichever method you choose, consider if that method would work well for
your baby, but also if it is one that you can consistently use and live with.
In general, there are 3 main techniques to teach babies to sleep:
1) non-CIO
2) CIO, and
3) intermediate methods, which lie somewhere between CIO and non-CIO.
The main difference between non-CIO and CIO is that the parent stays in the
room with the baby; occasionally offer reassuarances/soothing like hushs/
pats/rubs/PUPDs/heavy hand; especially during the 1st couple of days or 1st
week of sleep training. The baby is left in the crib to work things out for
shorter periods of time (with parent by her side) and tends to go down more
drowsy more frequently. With time, the child goes down more awake, soothings
/assurances are phased out or spaced further apart, and the parent gradually
moves away from the crib.
Various non-CIO methods are summarized in this link:
http://community.babycenter.com/talk/a3820995/how_to_sleep_trai
CIO without checks are also called strict-CIO or Extinction methods (
Weissbluth-Healthy Sleep Habits Happy Child). Since this method essentially
means letting the baby cry to sleep alone for as long as it takes, it is
potentially the most stressful method for the baby and most difficult for
parents to consistently use. This method is often the last resort for
parents. For a few babies, this method works very well, crying and falling
asleep within 30mins. For many, it's longer, crying for an hour or 2. For
some babies, particularly the younger ones (less than 5/6 months) and those
of a more sensitive temperament, it fails to work at all.
CIO with some form of checks/reassurance methods are intermediatary, middle-
of-the-road methods. Ferber's technique or modified-CIO are examples this.
For Ferber, if baby is crying, you reassure the baby with words/hush/pats
for up to a minute without picking her up at 5, 10, 15, 20, 25, 30mins
intervals, and then every 25/30mins thereafter.
There are a wide range of intermediate methods. One can make them more non-
CIO by offering more frequent reassurances, e.g. 5, 7, 10, 12 and then every
15mins; and/or pick the child up till calm and drowsy before putting him
down (but not asleep!) again. Picking up and putting down (PUPDs) are more
intensive soothing methods and usually take a few mins longer than hushs/
pats/words/rubs.
Likewise, one can make a method stricter by spacing out the checks more and
keeping them very brief, e.g. at 10, 15, 20, 25 and every 30mins, and hush/
pats/words/rubs/just PDs (no PUs) for a few seconds. This stricter method is
more often appropriate for older babies (8+ months) of spirited/strong-
willed temperament and young toddlers; who often would rile up and resist
sleep more if the parent lingers on too long.
Contary to what some may believe, gentler non-CIO and/or intermediate
techniques DO work as well and as quickly as strict-CIO methods, if not
better. This is especially true for babies younger than 7/8 months, those
more ascustomed to co-sleeping, and those of a more sensitive temperament.
Do realize that there's no 1 magic method that works for every child and
family. Some books/people claim that their method is the only one that works
- that's all rubbish. Only YOU know yourself and your child best. You can
devise your own method to meet your specific needs. The description of some
of the methods above are examples of the many variations you can have.
Little know methods include PUPDs (pick-up put-downs)and/or some combination
of PUPDs with attended-CIO (a non-CIO method) or CIO-with-checks. Not every
child is comforted by a 1min hush/pat on the bum or words alone. If your
child likes being held/rocked, some variation of PUPD would work well for
you.
Like all other soothing methods (PUPD/hush/pat/rubs), avoid providing beyond
the child's needs. Limit PUPD for when the child is genuinely distressed,
PU till she's calm to slightly drowsy (not to sleep) and PD. For babies
younger than 6 months, it's OK to PU till the child is very drowsy if does
not take too long (usually within 5-7mins). For older babies (7+ months),
most PUPDs would last no longer than 5mins and the baby should be just calm
to slightly drowsy (not super drowsy/asleep) on the PD.
Some books say never to pick your child up or you spoil your child - this is
not true. IF your child is genuinely distressed and/or is crying
hysterically, calming your child before putting them down again often
reduces the amount of hard crying and the child goes to sleep much sooner.
It also builds trust as you teach the child that you are there for her when
she genuinely needs you, but yet you expect her to put herself to sleep.
The main criteria to any form of sleep training is that the child does the
falling asleep part by herself.
It's OK to check/soothe your child when necessary (not just fussing/
protesting). This is also for your own peace of mind. Not every cry is
created equal. Fussing, complain, angry, protest cries can be left to wait
for a while. Distress, hysterical, sickness and in-pain cries are not easily
ignored.
TRUST your instincts and your baby. Listen and evaluate for a few minutes
before deciding what to do.
3) TYPES OF CRY
To help you cope with the crying, it may help to know kind of crying to
expect, how much, and what they mean. In general, there are 3 distinct cries
that one will hear when putting babies down to sleep. One tend to hear all
3 during the 1st few days of sleep training, but they can occur anywhere, as
most babies do cry before falling asleep, even in your arms.
1) The Peak. After the initial fussing, the baby's cry may intensify into
the "peak". This a hysterical, very intense kind of cry, and it's the
hardest to listen. The baby is distressed and may be screaming at this point
. However, this cry is also the shortest, lasting no more than 20mins (
mostly less than 5/10mins) at a time.
For each sleep attempt, there is usually only one peak, but there may be up
to 3 peaks at the start of sleep training. If you are doing sleep training
that involves some kind of checks or comfort, the most appropriate time to
offer reassurance is just before or during the peak(s).
According to Tracy Hogg, author of The Baby Whisperer, the will not be more
than 3 peaks. From my experience and that of other parents, this tends to be
true, but not always. Different children have different propensity for
crying. It also depends on the chosen sleep training method. Some children
fare better with less parental intervention, while others, more.
2) The Mantra cry. This comes after the peak. I am always relieved to hear
it as it indicates that the worst is over. It's an "I am reluctantly
settling" kind of cry. Every child as his/her own distinct mantra cry. It is
an on-off kind of cry that is pretty rhythmic and constant. E.g. - Wah (
quiet), Wah (quiet), Wah etc. etc.
Initially, the "wahs" start out fairly loud, but with time, they gradually
become softer and further apart. This type of cry last the longest, easily
30mins or more. Avoid intervening when you hear the mantra cry. The baby is
NOT in distress and is working things out himself.
3) Falling asleep cry. This comes after the Mantra cry. Before finally
falling asleep, the baby may either babble or give a soft long "aaahhhhhhh,
aaahhhhhhhh" cry and quietly drifts off; OR, give 1 loud shriek and
literally conks off.
4) OTHERS. If your chosen method does involve some checks and/or if your
parenting phisophy involves meeting the child's needs (not wants, BIG
difference!) while encouraging independent sleep; knowing what the different
cries means will help you read your baby and anticipate his needs better.
Protest cries - The first 5-10mins on putting the baby down and leaving are
classic protest cries. They can be very intense. The child is angry that he'
s not getting his way.
Letting-out-steam - After the initialy fussing period, the cries may
escalate into a peak-cry. The child may be almost screaming and slightly
hysterical, but typically lasts no more than 1-7mins. Most babies start
calming down after letting out steam, some conk out straight away. Typically
there's 2-3 of these cries during the 1st few nights of sleep training.
Distressed cries - sounds like peak or letting-out-steam cries, but more
intense and hysterical. It lasts longer and is continous. The child may be
screaming non-stop for more than 5/10 mins. If your LO is literally
screaming non-stop for the entire 1-3hrs night/nap training session, this
suggests that your chosen method is not a good fit to your child. Lenghty
continous distressed cries are mostly seen when using extinction on younger
babies and/or babies of a more sensitive temperament. Sometimes seen during
nap training (but not so during nights) where the child scream for the
entire hour, never calming down.
Overtired/overstimulated cries - cough, cough, WAH; cough, cough, cough
WAHHHHH!!!! This means that the baby should have been in bed 20mins ago.
Often heard after short naps when the child is still tired and during
nightwakings. The more overtired the child, the more your will hear this cry.
To help you cope with any sleep training and to help you see if it works,
try keeping a sleep and cry log. I found that most helpful. Also, realize
that children do not like nor understand changes, and they are bound to
protest hard. Do not take it personally but realize that she's just
expressing herself. Also realize that she will cry harder to you than to
anyone else because, just like adults, babies reserve their most passionate
and deepest emotions for those they love most. Most important, do realize
that you are not a bad parent because your LO cries. He will still smile
and love you unconditionally the next day. Babies do not hold grudges!!!
4) STARTING SLEEP TRAINING
Prior to sleep training, ensure that the baby is healthy and that you can
dedicate at least an entire week to sleep training and minimizing
overtiredness. This means avoiding travelling etc.
Start by ensuring her sleep "schedule" is approriate for her age and her
individual sleep needs. Not every sleep issue can be "fixed" with sleep
training.
For ANY form of intensive sleep training, if you are consistent and have an
appropriate sleep schedule, the baby usually starts sleeping through from
the 3rd night.
Remember - just because a child knows how to sleep does not automatically
mean that he will "sleep through the night". Help him do so by minimizing
overtiredness and having an appropriate sleep "schedule".
1) Night training. Always start sleep training with bedtime and the rest of
the night. After your usual bedtime routine, just put the child down in his
crib calm/drowsy, but awake. If he starts fussing/crying, use your chosen
sleep training method to encourage him to sleep. Stick with it for as long
it takes. If baby wakes up at night and is not hungry/soiled/uncomfortable,
continue to encourage him back to sleep using your chosen method.
2) Nap training. If you wish to do nap training too, start with bedtime the
night before and continue with naps the next day. You can do just nights, OR
nights and naps, but not just naps.
That's because naps are always much harder, and a common consequent of nap
training is shorter naps which will add to overtiredness. Hence, it's better
to get nights sorted out first, as night sleep is far superior, longer and
more restful than naps. You can then extend the better nightsleep by
temporarily moving bedtime even earlier, to compensate for the short naps
during nap training.
For nap training, there's a 1hr limit. If your LO is not still not near
settling within the hour, take her out for a quick change, feed and queit
play; and try again for the same nap within the hour for another hour. For
most babies, especially older ones who have more stamina and during the
first few days of nap training, the first nap attempt tends to be very
unsuccessful. Most nap training successes begin with the 2nd nap attempt.
3. Nightwakings. Regardless if you are sleep training or not, a CIO or non-
CIO advocate; every experienced parent parent, book and expert will advise
not to rush in when your LO wakes. This means waiting and listening for at
least 5-10mins before deciding IF any parental intervention is necessary.
This is because a child will naturally rouse/stir a little as he transitions
from 1 sleep cycle to the next. He is not quite awake and is still semi-
asleep (Dr. Weissbluth - HSHHC; Dr. Brazelton-Touchpoints & from experience
too). Sometimes he's dreaming and may give out "sleep-cries".
Sleep-cries are referred as such as the child is initially still asleep when
it 1st occurs. The cries are initially very intense, as if the child is in
pain or had a terrible nightmare. This initial intense cries often subside
on it's own within 2-5mins, followed by fussy/complainy/whiny cries, and the
child is in deep sleep again within 7-15mins. Hence, the importance of
waiting for a few mins. If one rushes in, one risks actually waking the
child and create an actual nightwaking.
If the child is overtired, these sleep-cries will be more frequent (at
multiples of a sleep cycle-45mins), slightly/moderately overtired-every 3hrs
, moderate to severely overtired-every 1.5hr or sooner. The more overtired
the child and the less practise the child has at independent sleep, the more
difficulties the child will have in transitioning from 1 sleep cycle to the
next and the more likely the sleep-cry will develop into a full-blown
nightwaking.
If after waiting and listening for 5-10mins and you are certain that the
child is awake and genuinely needs help, then use your chosen method to both
reassure him and reinforce independent sleep. If you are not sleep training
or prefer to put your child down asleep, do what you normally do after this
waiting period to get him back to sleep.
4) Nightfeeds. Most babies less than 9/10months old do need at least 1
nightfeed over a 12+hr night. Some up to 12 months. For babies younger than
6/7 months and if solids are not yet well-established, mostly 2; while
babies 4 months or younger may sometimes need 3, depending on the day and
if undergoing a growth spurt.
To address hunger issues at night while sleep training, it's important to
first establish how long can the individual child realistically and
comfortably go without eating during that 1 long sleep period.
5) EXPECTATIONS
1) Expect that there will be multiple nightwakings still, especially during
the first 3 nights. Every single nightwaking is just another opportunity for
DD to practise her new skill and to reinforce the message you want to send
her. Most kids will start "sleeping through" between day 3-5.
"Sleeping through" here means 5/6+hrs straight. This is what one can
reasonably expect from healthy babies younger than 5/6months. For older,
healthy, good-solid-eating babies (i.e. hunger issues are well-minimized),
their longest sleep period would be anywhere between 7-12hrs depending on
their age and individual nutritional needs.
2) Expect to work hard at any form of sleeping training for at least a week.
It takes that long for the child to finally except that the old way is gone
. This does not mean there will no longer be any crying, but after a week, I
would expect her to put herself to sleep within 30mins most of the time,
with some babbling, fussing and crying. One must remember that babies cry
when they are tired and they need to express that too. Most great sleepers
do fuss anywhere for 1-15mins before going to sleep. It's their way of
letting out steam.
3) Expect her to be sadder and more clingy during the day. She may also
resent her room/crib or diaper change. This will naturally go away sometime
between 5-14 days, depending on the child. Until then, always be positive
and praise her for her efforts. Give her more attention and cuddles during
the day. Just like older children, babies learn by repetition too. Soon she
will realize that you are still there for her even though you are not next
to her 24/7.
4) Expect regression. Usually between days 5-8. The baby starts to realize
that the changes are permanent, and it's her last attempt to resist the
change. It usually last between 1-3 days. Rarely it's as bad as the 1st
night, but for some strong-willed kids, it can be slightly worse.
5) Expect naps to suffer, regardless if you are doing nap training or not.
Naps tend to be shorter and there's more resistance to naps during the first
1-2 weeks.
6) Expect things to get better. Even if you do not do nap training, naps
will naturally start to improve on its own as a consequent of being better
rested by the end of the 2nd week. By the end of the 2nd week, unless the
child is in some kind of phase, I would expect her to go down more easily,
sometimes without a peep, while on others she may spend some time playing by
herself in her crib before sleeping. When you are in this stage, you will
have another challenge -how to handle the bedtime monkey business!!!
6) MAINTENANCE & REINFORCEMENTS
When a method is appropriate for a particular child and family, and if the
child's sleep "schedule" is appropriate, most babies will more consistently
"sleep through the night" (exactly how long really depends on the child's
age and readiness) after about 1 week of sleep training. The baby is
generally happier, appears well-rested, have 1-2 nightfeeds and promptly
returns to sleep, and usually puts himself to sleep within 30mins of putting
him down, sometimes even without a peep. Finally - the sleep training is
over!!!
However, we know babies change ALL the time. Nothing lasts forever, good and
bad days!!!
There is always something going on with babies - new milestones, separation
anxiety, illness, teething etc. These events usually do affect a baby's
sleep to some degree, and are particularly bad when a combination of them
occurs. So that you will never have to "re-train" your LO during/after each
of these occasions, it is important to have a back-to-bed plan for after the
sleep training. The purpose of this plan three-fold:
1) to comfort/reassure baby and yourself that all is OK,
3) to prevent "accidental parenting" or resorting to "old methods" which you
may regret in the near future, thereby undoing all the progress baby has
made thus far.
Having a back-to-bed plan is what will help you be CONSISTENT, thereby be
successful in the longer-term!!!
Remember - teaching a child healthy sleep habits is a way of life. It does
not end after just 1 week of "training".
Most parents' back-to-bed plan is similar to their sleep training methods.
Since I taught my DD to sleep using a version of attended-CIO, my back-to-
bed plan is a combination to PUPD and attended-CIO. After the initial sleep
training, I do not go in again unless my DD is genuinely distressed (not
just fussing) or she's been complaining/fussing for over 15/20 mins to check
that she's dry/not ill etc.
Once in, I do a PU till she's calm, PD and walk out. If she's distressed/
hysterical again, I repeat the above (but not the first 5 mins of walking
out as that's normal protest cry). If more than 3 PUPDs are required, I tell
her that that's the last PU and that I would stay with her to help her
through whatever she's going through for as long as it takes (attended-CIO).
Usually only 2 PUPD's are required and attended-CIO is very rare. The last
time attended-CIO was necessary was once during the peak of the 9 month
separation anxiety phase.
Others have their own version. Some conduct some variation of CIO-with-
checks for as long as it takes, while others set a maximum number of checks
(e.g. 3-5 PUPDs) before resorting to extinction. Whichever method is used,
the parents involved are comfortable and confident with their chosen methods.
The long-term success of any sleep training is much more than having a
method that merely works, but also a back-to-bed plan that YOU are most
comfortable and confident with.
Do realize that your baby's needs is constantly changing and that you may
need to tweak your methods a little to meet with his changing needs and new
challenges. E.g. it's OK to soothe your LO slightly longer or more
frequently if she's ill/genuinely upset. Her emotional and psychological
well-being is also a need that should be meet. As the baby grows and becomes
more independent, he will inevitably test his boundaries, especially those
related to sleep. When this happens, you may find that you have to firm up
your methods and be stricter.
2) to reinforce the sleep habits you want to nurture whenever sleep goes off,
Prior to starting, ensure that the child is healthy and that you can
dedicate an entire week to sleep training and meeting the child's sleep
schedule. This is not to say that a sick child cannot put himself to sleep,
but it's simply harder for the parent to know if the child genuinely needs
help or not, especially during the course of sleep training. Once the child
is a pro at independent sleep, the parent is also a pro at deciphering his
cries and needs during more challenging times like during illness, teething,
new milestones etc.
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