Sleep associations — the main cause of sleep problems
The most common childhood sleep problem is frequent waking during the night. This is where a baby or young child continues to wake frequently during the night long past the age at which they would be expected to do so (approximately six months). The main cause of this type of sleep problem is sleep associations. Sleep associations are all the things your child associates with falling asleep.
All children will have slightly different sleep associations. A typical example would be a baby who is always rocked to sleep before being put into the cot. This baby will come to associate being rocked with falling asleep and may in time find it difficult to fall asleep without being rocked. This isn't a major problem with a very small baby but can become a problem when baby reaches six months and cannot settle on his own.
To figure out what your child's associations are, simply write down all the things that are happening with your child as he falls asleep. These may include sucking on a bottle, suckling on the breast, sucking a soother, being rocked by you, twiddling a lock of your hair, rubbing his blankie, lying beside you, lying in his cot/bed, lying on the sofa in the living room, or in your bed. Or is he simply falling asleep on his own without any aids?
Sleep associations which don't cause problems are generally those in which parents aren't involved. These are the favourite toys that are there when the child falls asleep — so when the child wakes during the night he just has to cuddle his teddy bear, doll, blankie, etc, before turning over and settling back to sleep.
If a sleep association involves you, it is likely that when your child wakes during the night, he is unable to settle back to sleep without his sleep association, eg, you rocking him, having a bottle or breast feed, you putting his soother back in, etc.
How to overcome this problem
Your first step will be to figure out what your child's sleep associations are and then decide what your options are. You may need to look at giving your child an alternative association, or just cutting out the existing one. If considering an alternative sleep association, remember to choose one that does not require your input during the night, eg, a cuddly toy, favourite cloth, etc.
The approach you take can involve either gradually changing your child's sleep associations or instantly changing them. Each approach works well and which you choose will depend on your child's sleep associations and on your own circumstances.
Gradual change
The gradual approach can work well with a baby who is continuing to wake for feeding long past when this should be happening. Some parents may not consider this a problem but many others may feel that this has become a habit rather than a necessity, as it was when he was very little. In this situation a gradual approach is best. It can be done in a number of ways — the periods between feeds are gradually extended, the amount of feed is lessened, eg, milk becomes more diluted with water, the child spends less time at the breast, etc. A gradual approach works well but can take some time.
Instant change
The more drastic approach is where the parents decide that this is it — they are withdrawing from their child's sleep associations. This approach involves putting the child to bed or in his cot and encouraging him to get to sleep independently of Mum or Dad. It can be a difficult approach to implement, as it will involve some crying and distress on behalf of baby. However for parents who feel things have reached a crisis point it can work quickly and successfully.
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