Sleep, Changing Patterns In The Family Bed

Sleep, Changing Patterns In The Family Bed

  • Posted by Dr. Jay Gordon

I can only imagine a mom and dad who are as tired as anyone can be, eager to see this article on sleep, and finding that we had made it unavailable for a little while!

We had to do that because I didn’t write the article clearly enough and need to clarify some very important facts.

It would be hard to find as strong a proponent of the family bed as I am. Yet, I have received email commenting that there were sections of this “plan” which were easy to misinterpret as being just another angle on “sleep training” for young babies. It is not meant to be that. Not even close to an endorsement of the benefits of getting your baby to “soothe herself to sleep” during the first year.

Here’s what I really want to do: I want to offer an alternative to Ferber and Weisbluth and the Whisperer. I never want to see my ideas applied to a four month old or even a seven month old baby. As a matter of fact, I am not too excited about pushing any baby around at night but I know that sometimes it will be done and I’d like to offer a gentle, supported plan for after the first year.

Before I go any further, let me express my overriding concern. Babies do better when we answer all their questions as best we can and meet their needs as best we can.

Most of the families I have taken care of in my pediatric practice sleep in a family bed.

Their babies tend to breastfeed for more than one year and they don’t sleep through the night any better than most of us would if we napped and cuddled within inches of the best restaurant in town and knew it was open 24 hours a day.

This arrangement is not just adequate and tolerable, but actually feels easier to moms who can just roll over, nurse a while and fall back to sleep with their babies rather having to get out of bed to nurse or, alternatively, refuse to nurse and get their babies back to sleep some other way.

Lots of parents continue this pattern through the first year and well into the second and beyond, but some get tired of it — or just plain tired — after a while and are looking for a way to change things. Saddest of all, some moms and dads think that total weaning from breastfeeding is the best way to get more sleep. They choose not to look into nighttime weaning as a good option instead.

There are dozens of confusing books and magazine articles implying that there can be some quick and easy way to get your baby to sleep or to not nurse through the night. I have yet to read one which told parents the complete truth: It’s not easy, it’s rarely quick and it’s usually a little loud and heartbreaking for a few nights . . . or more. I have seen too many families needing help and getting offered choices they didn’t like at all.

I have a better alternative to completely weaning or to letting the baby cry it out. Babies wake up for the optimal interaction with their moms, breastfeeding back to sleep. If we offer them a little less than that for a few nights and then a little less and still less in the ensuing nights, gentle behavior modification will lead them to realize that it might not be “worth it” to knock on the door of a closed restaurant, so to speak.

I don’t recommend any forced sleep changes during the first year of life. Probably the only exception to this would be an emergency involving a nursing mom’s health. There are many suggestions in books and magazines for pushing “sleeping through the night” during a baby’s early months or during the first year. I don’t think this is the best thing to do and I am quite sure that the earlier a baby gets “non-response” from parents, the more likely he is to close down at least a little.

Don’t get me wrong. I love the family bed, child-led weaning and cuddling all through the first, second, third year or more if it’s working well and if the family is doing well. Don’t let anyone convince you that this is a harmful choice or that there will be “no way” to get him out of your bed if you don’t do it now. Don’t believe anyone who says that babies who cuddle and nurse all night long “never” learn to self soothe or become independent. This is simply nottrue but it sells books and the myths stay in our culture.

Some moms just don’t want to do this after some months or years and there should be a third choice to the dichotomy of crying it out or giving in to all-night nursing. Again, I support the family bed and frequent night nursing for a long time and even attempt to pull some parents along “just a little farther,” but I often have to switch tacks and support and help families with difficult choices.

Here’s what I recommend for older babies:

Choose the most valuable seven hours of sleep for yourselves. I personally prefer 11p.m. through 6 a.m. but you might have a slightly different idea.

Change the rules during those hours and be comfortable that a “well-built” family bed baby’s personality can withstand this rule changing and the mild inconsistency of getting everything he wants all the time . . .oops, almost all the time. That’s the word we want to show this baby. The word “almost.” If only we could explain to him that “tired moms and dads take their children to the park a little less and that children of well-rested parents get to go the zoo and for hikes a lot more than children of exhausted parents.” If that explanation only made sense to kids somewhere before the third birthday (and it doesn’t!) they would simply roll over, say, “See you in the morning,” and let us get the sleep we want.

I try to do this in three- and four-night intervals.

I’m assuming that you have a wonderfully healthy 12-, 15-, 20- or 30-month old baby who still loves to wake up every 2 to 4 hours to cuddle, eat or . . . whatever. I’m assuming that you have thought this through, decided you want to make changes and alerted the neighbors that it might be a little noisy for a week or so.

I’m assuming that both parents agree — or almost agree — that this is the best thing to do. And, most important assumption of all, you are willing to go “in a straight line” to the goal of seven straight hours of sleep.

The reason for that last statement: If your baby learns that crying, squirming and fussing (euphemisms, let’s just say “crying” . . . sorry) for an hour will get him fed you will set yourself back quite a bit. This is the best program I have seen but it’s far from easy. And now, to say it again, I really like what you’ve been doing. Cuddling, nursing, hugging through the night. Don’t change this with my program or any other if you’re happy doing what you’re doing. But . . .

The First Three Nights

At any time before 11 p.m. (including 10:58) nurse to sleep, cuddle and nurse when he wakes up and nurse him back to sleep, but stop offering nursing to sleep as the solution to waking after 11 p.m.. Instead…..

When your baby awakens at midnight or any other time after 11 p.m., hug him, nurse him for a short time but make sure he does not fall asleep on the breast and put him down awake. Rub and pat and cuddle a little until he falls asleep but don’t put him back on the breast (or give him a bottle if that’s what you’ve been doing). He must fall asleep with your comfort beside him, but not having to nurse to feel comforted enough to drift off.

Now, he will tell you that he is angry and intensely dislikes this new routine. I believe him. He will also try to tell you that he’s scared. I believe he’s angry, but a baby who’s had hundreds of nights in a row of cuddling is not scared of falling asleep with your hand on his back and your voice in his ear. Angry, yes. Scared, no, not really.

During these first three nights, repeat this pattern only after he has slept. He might sleep for fifteen minutes or he might sleep for four hours, but he has to go to sleep and reawaken to get cuddled and fed again.

These will be hard nights.

You may have decided you’re really not ready to do this. That’s OK. Stop and start over again in a few months if you like. Choosing the right time is crucial and many people choose a time suggested or pushed by friends, doctors or in-laws. This doesn’t work as well.

Is it better to do this in the family bed, a crib in the same room or using a crib in another room? I prefer to continue the family bed even though it might seem harder at first, but it has always seemed harder to me to be putting a baby in and out of a crib. However, a crib or toddler bed in your room may be what works best for you. Another option is to expand your bed’s limits by placing another mattress against your mattress. A bit more space for each family member may help to solve some of the sleep issues. My least favorite choice is a crib or bed in a separate bedroom.

Again, during these first three nights, between 11 p.m. and 6 a.m., cuddle and feed short, put him down awake, rub, pat, talk until he falls asleep and repeat this cycle only after he’s slept and reawakened. At 6:01 a.m., do whatever you have been doing as a morning routine ignoring the previous seven hours’ patterns. Many babies will roll over, nurse and cuddle back to sleep and give you an extra hour or so. Some won’t.

For me, one of the most reassuring parts of this “sleep plan” is seeing that babies wake up fine, happy and grudge-free about the change in the rules. You’ll see what I mean, even if the first few minutes of the morning are not exactly as they’ve always been.

The Second Three Nights

Again, the nursing to sleep stops at 11 p.m. When he wakes up, hug him and cuddle him for a few minutes, but do not feed him, put him down awake. Putting him down awake is a crucial part of this whole endeavor because it really does teach him to fall asleep with a little less contact and then a little less. Not feeding is the big change during these three nights. One-year-old babies can easily go for those seven hours (or more) with no calories. Theylike to get fed a little through the night, but physiologically and nutritionally, this is not a long time to go without food.

If I could wake my wife a few times each night, ask her to squeeze me a little fresh orange juice (my favorite drink) and rub my back while I drank it, I wouldn’t choose to voluntarily give up this routine. My wife might have some different ideas and get tired of the pattern quickly. Babies rarely give up their favorite patterns and things — day or night– without balking and crying.

I really don’t like listening to babies cry. I actually hate listening to babies cry. Unlike them, though, we adults can truly understand the implications of lack of sleep for a family of three, four or more people. Sleep patterns sometimes have to be changed. The incredible safety and reassurance the family bed has provided, and continues to provide, supplies the best context and location for these changes.

During these second three nights, some babies will cry and protest for ten minutes at a time and some will go for an hour or more. Your toddler is aware that you are right beside him, offering comfort and soothing. It just isn’t the mode of comfort he wants at the moment. It is hard to listen to him fuss, but it will work. I believe that a well-loved baby, after a year or more in the family bed, will be the ultimate beneficiary of his parents getting more sleep. Not coincidentally, the parents benefit “big time,” too.

“Yes, for the past many months we have enjoyed voting “1 to 2″ — non-democratically — in favor of . . . the baby. ‘Anyone want to get up all night, feed and walk the baby and be really tired all day and the next day too?’ Well, the vote is 1 to 2 in favor of the baby.”

Now, what we’re saying is, we will sometimes be voting two to one in favor of the baby’s family. This “baby’s family” concept may be abhorrent to he who considers himself the King of England, or Emperor of the Whole World, but our knowing he has that feeling of power allows us to confidently demote the dictator to a majority-respecting member of the family. His family.

By the end of the sixth night, your baby is going back to sleep without being nursed or fed. He’s going back to sleep after a nice hug, a cuddle and with your hand on his back and your words in his ear.

If, at any point this is feeling “wrong” to you, stop, wait some months and start over. Don’t go against your “gut instincts” which tell you that this is the wrong time to get longer sleep intervals from your baby. Your instincts are better than any sleep-modification program ever written.

The Next Four Nights

Nights seven, eight, nine and ten. Don’t pick him up, don’t hug him. When he awakens after 11 p.m., talk to him, touch him, talk some more, but don’t pick him up. Rub and pat only. No feeding either, obviously. He will fall back to sleep. Repeat the rubbing and talking when he reawakens. By the end of the ninth night, he will be falling back to sleep, albeit reluctantly for some babies and toddlers, with only a rub and a soothing voice.

After

After these first ten nights, continue to cuddle and feed to sleep if you like and he wants to, but do nothing when he wakes up except to touch a little and talk to him briefly. This may continue for another three or four nights but occasionally keeps going for another week or more. Then . . . it stops. He has learned that he is just as well-loved, gets virtually everything he needs and wants all day, but must give seven hours per night back to his parents and family.

What happens if you travel, he gets sick or some other circumstance demands a return to more nighttime interaction? Nothing. You do what you need to do (cuddle, nurse, walk, in the middle of the night, as many times as you need to) and then spend a night or two or three getting back to the new pattern the family has established.

By the way, pay the baby. Make sure that he really does get a lot of the benefit of your getting a good night’s sleep. Go to the park more often. Do all those things with him you said you’d do if he ever let you sleep longer. Explain it to him as you’re doing it. He’ll understand in an ever increasing way and will be OK with all this.

191 Comments

  1. Marissa

    A few months back, I'm so glad that I read "older baby" when I did – it really helped me to stress less about sleep and just continue to meet the needs of my 9 month old child, cosleeping, during the night. When she turned one, I think we both knew it was time for a new pattern. She's in her own bed at 8pm and wakes once around 1 or 2am for a full feeding (I think she needs it because she's a VERY active toddler and doesn't really eat much during the day). I put her back in her bed, she sleeps until she hears the birds chirp, and joins mommy and daddy for the rest of the morning sleep until after 8am (!!!)… and more milk. It took awhile to establish, but seemed much easier to do after trial (I regret that I did) and error when she was younger. It works for us. I now advocate to sleep-junkie mothers to WAIT and enjoy cuddling and spending time with their babies at night… while they are still babies:-)

    1. Cheryl Taylor

      I also read a book when my twins were newborns, Dr. William Sears “Nighttime Parenting”, that stopped the battle I had created for myself regarding sleep and made for a much more relaxed approach. I enjoyed years of cosleeping with my babies and they all grew into young children that slept very well in their own beds. I strongly feel that the process of allowing each child to transition as they were ready was key to the elimination of night time battles.

  2. Aaron

    We have a 1 year old son that was diagnosed with Eosinophilic esophagitis after an endoscopy. Breastfeeding is still basically his only source of nutrition. He is just now showing some interest in food, and doesn't gag anymore when feed puree food. Still he only eats about 6 bites in each sitting a couple of times a day. He night feeds thoughout the night with 2-5am being the worst. We want to try this program, but I am concerned that he is asking to feed so much for both nutrition and comfort. Are there any specific signs that I can look for to know that it's only comfort that he is looking for in the night and can go 7 hours without food. We are desperate for a change. Any help is greatly appreciated. Thanks.

    1. Cheryl Taylor

      It is more common than you might realize to have issues with swallowing food at a year old. There is no concern nutritionally for a breastfed one year old as it is completely fine to have only breastmilk in the first year and meet all nutritional needs. There is not a rush to make the transition to food, but should be something that happens over the next year as he mixed solids in with breastfeeding. Have you tried offering him little bits of ripe fruit to move around in his mouth on his own or to suck off of? Some toddlers react to pureed food when they don't do more solid pieces that don't slide down their throat as easily. It can be the difference between what feels like a thickened liquid and being in control of soft solid pieces. It would be worth experimenting with if you haven't already. There is often a lot of progress with the consumption of food between 12 and 18 months, and the whole picture may change dramatically within 6 months.

      I know that this is probably not what you want to hear, but I would be hesitant to encourage night weaning with the food issue present. You may be able to encourage more nursings during the day and particularly in the evening, but I would be careful about cutting out nursings at night unless daytime nursings increase when his sole nutrition is coming from nursing. Since he is nursing well, swallowing itself isn't an issue but texture. There are some things that can be done to assist with adjusting to texture and an informed professional could assist you with ways to work with this. I would also do some experimenting with seeing if he has aversion to feeling different textures with his hands or feet. For some kids it isn't just an issue with texture IN their mouth but touching anything. There are many things that can be done to help with this that are as simple as teaching them to play with a large container of beans or rice much in the same manner that you would play with toys in sand. This is also an area of specialty that you should be able to seek some help with that does not focus on the consumption of food as the only solution.

      Hope that helps.

  3. Kerry

    We are on day 15 of this night weaning my 16 month old and it has worked so well. On the third night, the first night of no milk between 11 and 6 we had 45 minutes of crying but after that it got much easier. Now if she wakes for milk she usually resettles herself or with a little rub on her back. At 5am we sometimes have more of a struggle of her trying to get into my t-shirt with the sun coming up but usually she will go back to sleep.

    This method has really helped, but I might not have been able to put it into practice before now, I am thinking this was the perfect time for her. At the moment she is sleeping in her own bed usually till about 2am before she wakes and toddles into our room. Thank you.

  4. Christine

    Hi,

    I am wondering about the 7 hours (11-6). Does the 7 hours begin when baby goes to sleep? For example, if I nurse my 16 month old to sleep at 9pm, is that when the 7 hour stretch starts? So, basically, I wouldn't let her nurse again until at least 4am? I often don't go to bed until midnight. Is it unrealistic to get her to bed at 9pm, but not let her nurse for 8-10 hours later? If she wakes at 4am (7 hours later after her last feeding), should I feed her, or let her cry and go back to sleep until 7am?

    Thanks!

    1. Cheryl Taylor

      Yes, time period would begin when baby goes to sleep, not mother. I would not leave a baby to cry during the process. If she is with you and you are offering other comfort and teaching to sleep at night, and she cries or fusses during that process, it is a dramatically different thing than leaving a baby to cry to sleep. I never advocate leaving to cry it out.

      1. Christine

        Ok, yes the process has been working for us. I was not letting her cry it out, but right there beside her to comfort her until she fell back asleep, which didn't take too long. So, once we have them sleeping with no nursing for 7 hours straight, is it ok to follow this same process to get them to go longer, like 8-10 hours total before nursing again? If I put baby down at 9pm, I really don't want to feed her at 4am. Another option would be to wake her to nurse when I go to sleep at 11 or 12. Which do you think is best?

        Thanks!

        1. Cheryl Taylor

          Both ways can work, approaching with slowly extending the length without nursing or waking prior to going to sleep yourself for the last nursing of the "night". You would be the best judge of which will work best for your child. Glad you're having some success with her accepting your comfort at night without nursing all night.

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