Creating Healthy Sleep Associations
There are many reasons a child wakes up in the middle of the night: hunger, pain, being overtired, under-tired or a sleep association.
But what is a sleep association?
Put simply: it’s when babies associate particular actions, activities or objects with sleep. Essentially it’s something YOU do to signal to your baby it’s time to sleep.
This could be a number of things including:
Dummies
Nursing
Having a bottle
Lying in bed with them
Rocking them in your arms
Twisting their hair
Sitting with you in a chair
They can be used in a positive way to help your little one wind down and get them ready for sleep. Rather than call them sleep associations, we prefer to see them as sleep support. When used effectively, this support provides the comfort and reassurance needed to get your child to a drowsy state but not yet fully asleep. And this last point is key - we’ll come back to that later.
Why do sleep associations get bad press?
When applied badly associations and support strategies can become overused. This means babies get to a point where they become dependent on that association to fall asleep. They do not develop the power to control their own sleeping and it can impact the quality of their sleep.
This is because throughout night we sleep in cycles and we all, even as adults, wake up a number of times a night. We might fluff our pillows or turn over before going back to sleep without even realising we were ever awake.
If we think about that in the context of sleep associations, if a baby wakes and does not have the support mechanism they need to go back to sleep, they will remain awake until they get the association cue they need. Imagine if you went to sleep in your cosy bed and woke up on a bus. You’d think to yourself, ‘that’s not how I remember feeling when I went to bed, I want my warm duvet and cosy bed again to go back to sleep’. That’s how a baby feels if dependent on associations.
It’s important to stress, there is absolutely nothing wrong with these associations and support strategies when used well and you shouldn’t worry about what you’re currently doing to get your little one to sleep, as long as you’re careful not to create these dependencies.
When it becomes a problem
As well as creating a dependency, sometimes it may be simply that the strategy you were using that once worked well is no longer sustainable and that’s when it’s problematic. We’ve worked with parents in this situation to help reset bedtime.
In order to get better quality, more consolidated sleep and fewer night wakings, the key is to provide a support strategy for your baby that empowers them. When they wake up and stir you want them to be able to roll over and go back to sleep on their own.
Whichever strategy you choose, you need to ensure you use it to get your baby to the point of feeling drowsy before you put them down to bed. This prepares them for sleep by setting the right mood but means that they do not have to rely on anything to finally fall asleep. They can learn the art of sleeping themselves.
Common Associations: Providing Comfort & Dummies
If you hear your child wake up it’s completely natural to want to go and provide comfort. For a young baby, this is going to be the most important way to get them to sleep and it’s a positive and normal response.
But think about the comfort you are providing and what your baby actually needs. If a baby is hungry of course they need food, but if they’re overtired what they need most is sleep. When you get in after a long day and are tired if someone offers you your favourite food you’re likely to eat it, but what you actually need more is some rest and an early night. Feeding may provide comfort but it won’t directly address the actual need so remember not to default to the same behaviour every time.
Working out what your baby needs can be a challenge. If your baby is waking up regularly and only taking a little bit of milk each time it’s unlikely that they are hungry. If you find they do need more food, try to slowly increase the amount of food they eat during the day.
If your baby is tired you could provide comfort by holding your baby rather than feeding. If you are breast feeding it might be tempting to let them feed so you could try to ask your partner, a friend or other caregiver to support your baby back to sleep. It isn’t about leaving your baby to cry it out but thinking carefully about your approach. Eventually you can work on gradually stepping down your support - just remember to ensure consistency from settling at the start of the night and across each waking, as well as putting your baby down in a drowsy (not asleep) state.
If you are considering using a dummy, make sure you’ve established feeding consistent patterns first. Dummies can also help during the day - some babies have strong sucking reflexes and dummies help soothe. Some research highlighted by the Lullaby Trust also suggests that using a dummy when putting a baby down to sleep could reduce the risk of Sudden Infant Death (SIDS).
As with all strategies, be mindful that if a baby relies on a dummy to get to to sleep (not to a drowsy, but to a full state of sleep) you may well find yourself in a run and plug routine several times a night. It’s also not uncommon for parents to unintentionally rouse their baby even more when ‘re-plugging’ the dummy.
Well intentioned parents may often attempt to replace the dummy with another form of comfort such as stroking or patting and this can just shift the problem by adding a new association.
To avoid dependency you could provide the dummy to get your baby to a drowsy state and remove for the transition to a full state of sleep. Encouraging your child to be able to replace the dummy themselves could also help them to be in control rather than reliant on you. Whilst they may not have the motor skills to do this initially you can at first, guide them by placing their hand on the dummy to find their mouth. By regularly reinforcing the habit, once they have developed enough, they will ave learnt to do it independently.
Perhaps you’ve got to the end of post and you’re thinking this all sounds easier said than done? We know it can be difficult and that’s why we’re here to work with parents and caregivers so if you’re struggling don’t feel alone - drop us a message and let’s have a chat!
