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. Jill

    I have 12 month old twins who cosleep with us and are still BF on demand. They are doing great but I am really needing to get more sleep than I currently do. I want to try to implement this program, but I don't know how to adjust it for twins.

    Currently our nighttime routine looks like this: tandem nurse both babies to sleep around 9 PM, transfer to cribs (which are in our bedroom). They sleep in their cribs until 11-12 PM, and when they wake I usually get up and bring them to our bed, where they then have unlimited access to me for the rest of the night.

    This has worked out to some degree because I get a lot more sleep this way, but cosleeping with twins isn't as easy as with one baby – lots less room in the bed, active crawling/climbing babies are getting past the barriers and we fear them falling on the floor, etc. Plus, DH is getting to the point where he is pretty insistent about them being transitioned to cribs, as he wants the bed back. In any case, it's time for a change but I just don't know how to implement it with all of these variables in place.

    For the last couple of nights I've tried nursing them and putting them back in their own beds instead of keeping them with us. I've been getting up/down over 10 times a night (between two babies, getting up to nurse and then putting them back to bed) … which means I am getting NO sleep. This isn't going to work …!

    Please help this exhausted twin mama with some advice on nightweaning twins … thanks!

    1. Cheryl Taylor

      Yes it is tricky to cosleep with twins! When my twins were one I had transitioned them to sleeping on their own because I also found that they woke me frequently. Some babies are extraordinarily mobile while they sleep. My boys thrashed and flopped around all night long, and I found they didn't sleep well together. Have you considered setting up your bed on the floor and putting smaller mattresses to the side of them to give them their own space to sleep in? Many cosleepers find that extending their space is the answer. That can allow you to lie down beside a baby that wakes to nurse and one of them may learn to sleep longer at night before the other. Another option is to leave your room/bed as it is and put mattresses on the floor of their room at night time. I still would recommend giving them some space to sleep in, whether that means more than one mattress or a large mattress.

      If you feel they are ready to night wean you'll need to have a plan of action for means to comfort that doesn't involve nursing. You can soothe with voice, patting, holding their hand…whatever you think will be most helpful for them as a tool to soothe back to sleep without nursing. You are the one that is the best judge of whether they are ready to night wean and what might work best for them.

      Hope this helps. I feel your pain! I was a very tired, though happy, mom of twin toddlers…but there does come a point when exhaustion rules and you have to adjust things simply for survival.

    2. Quinn

      No advice here, just writing in understanding! My 18 month old twins still sleep in the family bed,(which for the most part we love!) and each nurse many, many times during the night. I am exhausted! And not ready to wean, but don't know what else to do other than try this. We will start Dr. Jay's advice tonight. Wish us luck! If I get more than 2 hours of consecutive sleep anytime soon, I will be a happy mama!

    3. Lisa

      It’s not an original idea, but we took our bed off the frame and put it on the floor. I put a pillow on the floor on my side of the bed just in case, and we trained our baby the firemen crawl, so that when he exits the bed on purpose, he does it feet first, with his tummy on the mattress. I’m really desperate otherwise, because our little dictator nurses four and five times a night while he’s teething, and he’s working on sixteen teeth at fifteen months old. (Help!)

  2. Eileen

    Hi, first I have to say I am so very grateful for this website. There is so much information out there saying you have to sleep train your baby early on or you'll be sorry. Your recommendations are so much more in line with what feels right to me as a parent.

    I'm trying to night wean my 12 month old. So far we've done 3 weeks of no nursing or picking up between 7pm-3am (after 3am I nurse if she wakes). In spite of this, she continues to wake 2-3 times between 7pm-3am; I settle her by holding her hand and speaking to her. Why is she still not sleeping through this 7-8 hour stretch?

    1. Cheryl Taylor

      That's the million dollar question. There are so many things that can interrupt a one-year-old's sleep that I'm more surprised that any of them sleep through the night! That she is going 7-8 hrs. without nursing during the night time hours is a lot of progress toward night weaning, even if it's hard to see from the perspective of a tired mom that has her sleep interrupted for a year. It is really HUGE progress that she will settle down with you holding her hand and speaking to her. What you've done is build the foundation on which she is going to learn to sleep through the night, because you've given her the tools with which to do it. What you can't do is push her into being ready. Continue with your program of teaching her that night time is for sleeping as long as you feel you are continuing to make progress. Some babies that are not ready to night wean at 12 months will do so easily 2 or 3 months later. She just isn't quite ready to do it yet, but you're really doing a good job of teaching her. You may need to take a look at her nap and night time schedule and adjust it. As they get older and slowly need less sleep their naps may need to be shortened or bedtime scooted a little later in order to allow their deepest sleep during the portion of the night when YOU would also like to be sleeping.

      Regarding sleep training…I always found it ironic that some of my friends that were so gungho about sleep training their infants went on to have an older child with whom they had major night time bed battles that dominated their evenings.

      Hope this helps.

  3. Kristin

    Thank you, Dr. Gordon! I am so grateful to read this article, and will be bookmarking it so I can visit it often.

    My husband and I both feel that co-sleeping with our baby, who is now an active, engaged, intelligent and confident 24 month old toddler, was the right decision for our family. But other than Dr. Sear's encouragement to co-sleep, I have not found much helpful information about what the family bed looks like with a growing toddler. Co-sleeping is a semi-secret in our circle of friends, family and doctors, because we do not want to be dissuaded from what feels natural and right to us.

    That said, we know that change is the only constant, and have been casting around for an honest discussion of options and education regarding rearranging the family bed as our child grows. We will not be weaning him from night nursing or the family bed anytime soon, but it is such a relief to know there are thoughtful and sensitive plans, and support, for parents to help teach a child that nighttime is for sleeping.

    We could never tolerate reading discussions that involve the intolerable "cry it out" or "mommy and daddy are exhausted sexless martyrs for your benefit" methods. There is a third way! Thank you for your important discussion on "baby-centered" and "baby's family centered" sleeping. What wonderful words and ideas to add to our vocabulary and experience!

  4. Monica

    Thank you for advice on night weaning for people who share a family bed. Sadly, my 12 month son has developed cavities and we will have to night wean. We were perfectly happy with our routine – I enjoy nursing my son and wasn't resentful of the wakings.Wish us luck. We start tonight.

    1. Cheryl Taylor

      Breastfeeding is not the cause of dental caries. Take a look at other foods and liquids in his diet for the source of sugars that can lead to dental caries. Some children also simply have very thin enamel on their baby teeth that is particularly susceptible to dental caries.

      Here is a link to some information on dental caries and breastfeeding: (from our Link Library that is currently under complete renovation!)
      http://65.61.36.192/alezav16/default2.asp?tree=61

  5. Jennifer

    I love this plan…I have nursed all my kids until 2-3 and coslept with all. I nightweaned my first two at about 20 months, and it went beautifully. My third baby is 23 months old and was still nursing every few hours and not sleeping well at all. Our hope was that he would sleep better if we broke the nursing-every-few-hours pattern. We nightweaned him over a few weeks period (it ended up being a modified plan…Ezra had a nasty cold and we had some unexpected guests). He has adapted quite well to not nursing (it's been over a month now), but his overall sleep has not improved at all! He still awakens every 2 hours or so, and about 3 times a week he will have these awful restless nights…he awakens around 3:00 and tosses and turns for several hours…sometimes until my husband's alarm goes off. He has done a similar thing for about a year, but at least when I nursed him he'd lie still and eventually fall asleep. Now he just tosses and turns and flops and flaps forever! No crying or fussing, just incredibly restless. No one can sleep and it's so frustrating that nightweaning hasn't brought us any more sleep. I have considered his nap schedule, physical playtime, my caffeine intake, etc…but I can't figure out a pattern. I'm feeling like our only option is to quit co-sleeping, so that at least his flopping around won't keep us up. BUT, this would be very traumatic for him…he doesn't even do well in his crib in our room. So…can you see something here than we're missing??? Thanks SO much…sorry it's so long!

    1. Cheryl Taylor

      Have you considered a twin bed on the floor next to your bed on the floor? Sometimes it's just the trick needed to give space for a thrashing toddler yet proximity to parent's soothing voice. Another idea is to put a mattress on the floor of his room, so that he can get up and come to you if he needs you, or you can lie down with him for a bit and then leave. It certainly doesn't hurt to try either one and see what might work. You're obviously well experienced with the values of cosleeping and have been navigating through this because you are aware of the important bond you have created and want to maintain. Some children just have a very hard time actually coming all the way conscious from sleep and then aren't really aware that they need to soothe themselves back to sleep, and in that half awake state really thrash about a lot.

      Let me know how this progresses.

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