Nursing to Sleep

Q: I’ve gotten into the routine of nursing my baby to sleep. How can I stop so that I can get away for an evening and have someone else handle bedtime?

A: For infants, nursing to sleep is quite a normal situation for about the first three to four months of life. After that, as they begin to consolidate their daytime and nighttime sleep, nursing to sleep can become a sleep association, which means that your baby cannot fall asleep without it. If your baby is older than three months, it’s best to try to finish feeding him 20 minutes before settling him down to sleep. After the feeding is complete, begin a bedtime routine using a story, a song and perhaps some gentle massage before putting him in bed drowsy but still awake. These techniques will help your baby to begin to learn about self-soothing to sleep. If your baby will take a bottle of expressed breast milk, you can express your milk and leave it in the bottle for another caregiver to feed your baby 20 minutes prior to bedtime.

Nap Schedule

Q: My six-month-old is a great night-time sleeper, but we aren’t very successful with consistent daytime naps. How can we implement a nap schedule at this point?

A: Your six-month-old is just getting to a stage where daytime sleep is becoming consolidated into usually two and somethings three naps a day. Your daytime nap routine depends on when your baby wakes up for the day in the morning. Most babies can stay awake for between 2.5 and 3 hours between naps. If they’re being settled for a nap after 1.5 to 2 hours, there is not enough time to develop sleep pressure and they won’t settle easily. The best approach is for your baby to wake up, feed, play and then sleep. If your baby is waking up at 7 a.m., she should be going down for her first nap at about 9:30 a.m. to 10 a.m. In an ideal world, your baby will sleep for about 90 minutes. If she is up for another 2.5 to 3 hours after rising, that should put the afternoon nap between 1:30 and 3 p.m. Often, the afternoon nap is shorter so your infant would be rising somewhere between 2:30 and 4 p.m. She might still need a short nap in the late afternoon to manage if bedtime is at 7 or 7:30 p.m. but she should be giving up the third nap in a short while and consolidating daytime sleep into two naps a day. Try to avoid naps that end later than 5 p.m. since late naps can interfere with trying to settle her at bedtime. Aim for putting her to bed for the night between 7 and 7:30, which is the ideal range for this age group.

Dependent Sleeper

Q: Our four-week-old will only fall asleep while lying on me or my husband. As soon as we transition her to her bassinet, she wakes up. Help!

A: Your daughter is still very young, so it’s not surprising that she’s falling asleep in the warmth and comfort of your chest. But you don’t want this to become a long-term habit because it will interfere with her learning to self-soothe and fall asleep on her own if it persists beyond the first few months of age. You can help wean her from this habit by waiting for at least 20 minutes after she falls asleep before you transfer her into the bassinet. If you try sooner, she’ll still be in a light sleep and wake easily with any kinds of movement. If you catch her at times when she is getting drowsy, perhaps after a feeding, try moving her into her bassinet before she falls asleep. Also, it’s never too early to start a sleep routine. You can help prepare her for sleep by singing he same lullaby or telling the same story every time she goes to sleep so that she will begin to associate going to sleep with those activities.

Co-sleeping

Q: We had a great co-sleeping experience with our 20-month-old, but now that we have another baby on the way, we want to transition him to his own bed. So far, it’s not working well.

A: It is always difficult to change the sleep patterns of children who are used to a particular sleeping arrangement. But it’s important to undertake the transition you describe before your new baby arrives, otherwise your son will associate the arrival of the new baby with being removed from your bed-not an ideal circumstance for welcoming a sibling into the family. The best approach is to be absolutely consistent with your son about where he’ll be sleeping. To do this, you need to settle him for the night in his won bed. You can use a bedtime routine, such as singing a song and telling a story, eventually to cue him that he’ll be going to bed in his own room. If he’s used to falling asleep with you present, let him know that you have to leave the room for a few minutes but that you’ll come back; gradually extend the time that you’re out of the room and he’ll fall asleep on his own. Just remember that if you’re using this technique it’s important to come back in the time frame you have promised. If he’s getting up at night to come into your bed, return him to his own bed and indicate gently that he will be sleeping there for the night. After a while, if you remain consistent, he’ll get the message that he needs to stay put. Don’t forget: You need to keep the same arrangement for naps or you’ll risk sending mixed messages.

Soother Habit

Q: My 15-month-old still uses her soother to fall asleep. I would like to wean her from the habit, but I have no idea where to start.

A: You can start weaning your daughter from her soother with her daytime naps. Offer her a lovey (a soft stuffed animal or a small blanket) to fall asleep with in place of the soother. You can help her learn to associate her lovey with comfort if you offer her it in the daytime if she gets upset or falls. If you are comfortable with her sucking her fingers or her thumb, you can also help her to learn to do that rather then relying on a soother to self-soothe. It might also help her if you institute a bedtime routine so she associates the routine with going to bed and it helps to cue her that bedtime is coming. After you have her falling asleep for her naps without her soother, you can remove the soother when you settle her at night. Once you take the soother away at night, you need to be consistent and not offer it again, otherwise, it will confuse her.

Daycare naps

My 12-month-old just started full-time daycare where the kids nap only once a day, but she still clearly needs two naps because she is exhausted by the time we pick her up. What should we do?

A: Unfortunately, many daycare centers have rigid nap schedules. If you’re seeing that your daughter can’t manage with one nap a day, try negotiating with your daycare provider to allow her to sleep on a mat in the corner of the room while the other children are focusing on quiet activities. If the daycare can’t accommodate this, you could try implementing two naps a day at home on weekends: This approach won’t fit with the routine that she follows at daycare, but it will give your daughter a chance to catch up on sleep on the weekend so that she is not quiet as exhausted through the week. Between about 14-20 months she will likely be giving up her morning nap. At that point, the daycare routine will be easier for her to manage.