 Mom, surely you don't mean that you don't want to hang out with me at night? If you are feeling ready to sleep through the night again, you aren’t alone! I am working towards that goal myself. Here’s how to night wean.
Step One Gradually, gently lengthen out the interval between feeds during the day. Start with a goal of feedings every 3 hours, then work towards every four hours. There is no rush. Try distraction as a tool for increasing the time between feeds. My favorite distraction is going outside for a walk. It’s amazingly effective. Once your baby is comfortably feeding four times a day plus any night feeds, proceed to step two. Don’t be surprised if you already see an improvement in night sleep just from completing step one! You may also find that your baby is much less likely to cry to eat once you are on a regular schedule, and that they are happy to wait until the scheduled time. Step Two Gradually, gently, reduce one night feeding at a time. If your baby only feeds once per night, start with that one. If your baby feeds two or more times per night, pick one of those feedings. I usually suggest the second feed, then the first feed, then the third feed, if there are three. Every other night, reduce that one feeding only by either 30 seconds (if you are breastfeeding) or ½ ounce (if you are bottle feeding). If your baby takes both bottle and breast, experiment and see which is easier to reduce. I have done it both ways. Your baby may fuss when you reduce the feed, but in my experience, they rarely cry for long. Rest assured, you are only reducing the feed by roughly 15 calories every other night, so your baby really won’t be starving. It’s normal to be anxious about this but they really will be fine! Once that first feeding is eliminated, start reducing the next feed, if there is one, until all feedings are successfully eliminated. And voila, you have a baby who sleeps through the night! Caveats Most sources say to wait until 12 pounds but none of my three babies were that big and none of them had issues with weight gain despite night weaning. Check with your pediatrician if you are concerned. Tribeca Pediatrics, a huge practice with offices all over New York City as well as in LA and Chicago says that you can night wean at 2 months old. Other pediatricians are much more conservative. Another thing: if you are breastfeeding, you want to make sure that your supply is well established before reducing the number of nursing sessions… but you can use a breast pump to make up for one or more missed sessions. Using a high quality pump and pumping on both sides will increase your output. I suggest a hands free pumping bra to make this a lot more convenient. Not to worry, you can use the same bra all day long. It's worth the investment! That said, some women’s supply never gets beyond a certain limited volume and if that is you, you may need to nurse more frequently and/or supplement. I have had very good luck with Mother’s Milk Tea for boosting supply. Another caution, if your baby has reflux, you may not be able to increase the duration of time between feeds. (The general rule of thumb with reflux is “half as much (volume), twice a frequent.” That being said, my baby is a heavy spitter (though does not have pain nor difficulty gaining weight and therefore does not have a diagnosis of reflux) and I manage this with a LOT of spit up cloths and offering a dream feed in the evening before I go to bed, in order to boost her total daily intake without overloading her stomach at any given feeding. Conclusion Night weaning really isn’t that complicated, but that doesn’t mean it’s easy, for emotional reasons, of course. If you’d like help getting your little one sleeping through the night, whatever their age, set up a free consult and we will make your dreams a reality.
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 Five-year-old Amelie got into my makeup and thus, her "Doggy" got an unfortunate makeover. Luckily a trip through the washing machine returned "him" to normal.
If you are wondering why Doggy looks like a monkey and not at all like a dog... Well, Amelie named Doggy when she was a young toddler and ALL animals were “doggies.” Amelie is nearly six now but her monkey remains a “doggie.” Only “he” got named Jack a while back… but in moments of stress, he is called Doggy again. Doggy has special significance for us because my mother gave him to me before Calliope was born. Calliope never needed a transitional object because she twiddled her ear for comfort (along with sucking her thumb). So when Amelie was born, Amelie inherited the love object, and unlike Calliope, Amelie quickly grew attached. My mother died just before I successfully conceived Amelie. I had been trying to get pregnant with frozen embryos as my mother was dying of cancer and so I was able to tell my mother that her future grandchild, if a girl, would be named after her. (My mother's name was Amy, and she was named for her grandfather, Emil,) Doggy is Amelie's one gift from her grandmother. What are transitional objects and how do they help? A “transitional object” is a physical item, such as a blanket or stuffed animal, that represents an extension of a young child’s primary caregiver. It reminds the child of the warmth, love, and security he or she feels in the presence of the primary caregiver. It allows the child to separate from a parent with less distress. Transitional objects can be a huge help for children who resist separation, particularly at bedtime. It's normal for children to fear separation from their beloved grown ups, and it's also normal that their grown ups need that separation to function. Particularly if your child is dependent on your physical touch to fall asleep, consider introducing a transition object. If your child is mobile, you can let them choose which they would like to sleep with. For a younger child, you may have to choose for them -- ask your pediatrician when it is safe to introduce one. The American Academy of Pediatrics says nothing in the crib before 12 months but your healthcare provider may say earlier is acceptable. It should be large enough to not be a choking risk and small enough to not be a smothering risk. You may wish to slide the love object between you during bedtime snuggles, or even put it inside your shirt to acquire your scent. You can tell your child, "Lovey will keep you safe all night long." Don't be afraid to create a dependence on the love object. It's much healthier for a child to be dependent on a transitional object than on you for the small stresses of daily life. It's not a substitute for you, it's in addition to you. This is one sleep crutch that you actually want to have. Most loveys are adopted during infancy but don't be afraid to try to create one into the preschool years. Also, if you are afraid your child will never outgrow their dependency on the love object, don't be. Some children outgrow it gradually and others reject the love object seemingly overnight. All children outgrow their dependence sooner or later. One piece of advice though: acquire duplicates as soon as your child has identified a favorite love object! Rotate them regularly so the child doesn't have a preference. And keep the beloved love object safe at home and use a back-up for daycare and outings. I actually threw away Doggy's duplicate before Amelie was born, since Calliope wasn't interested in it. And now I can't find an identical lovey. I live in fear of the day that Doggie gets lost -- he gets misplaced occasionally and we all feel terror as we search! Don't make my mistake. Also, some children adopt "lovies" that are nontraditional. If your child loves bringing a favorite truck to bed, not a problem! Other children like carrying a cloth diaper around, or an item of a parent's clothing. Whatever creates a feeling of security in your child is perfect. If your child is resisting separation at bedtime, set up a free chat to discuss how we can get your family the sleep you deserve.  During the haze of the newborn days, we all do what we have to do to survive. I remember standing in front of my stove, exhaust fan roaring, jiggling little Amelie in my arms for what felt like hours. I thought the exhaustion would never end.
Those habits that develop in the early days can sometimes go on far too long, though, and can end up costing our children and ourselves great sleep later on. Typically what happens is parents feel like they’ve finally figured out a way to get a few solid hours of sleep with a small infant, perhaps nursing them to sleep. But then that little baby grows and those nighttime habits stop working as well. Often around four months old, your baby starts waking up more often instead of less. In a frantic attempt to get some desperately needed shut-eye, you up the ante. You find yourself nursing and rocking every two hours all night long, even as your baby shouldn’t need to eat so frequently (or at all) during the night. As your baby grows, you are both more and more tired. This exhaustion has real consequences. Your baby is unable to focus on her play as well when she is overtired. She may be hyperactive, or cranky. Your ability to enjoy parenting is diminished Sleep deprivation is a risk factor for depression, obesity, hypertension, and heart disease. Your domestic partnership will suffer. And worst of all, as a sleepy driver, you are a mortal danger to yourself and others. Sleep deprivation is a very big deal. We know that sleep training results in some short-term protesting, aka crying. No parent wants to hear her child cry. It’s hard for everyone. And some parents, who may identify with the “attachment parenting” philosophy, fear that allowing their children to cry can cause real psychological or physical damage. But studies have shown that the short-term crying associated with sleep training is not dangerous to health and does not prevent a strong, healthy attachment. Fostering a strong attachment is not the same as an attached-at-the-hip approach to parenting. Imagine a parent swooping in to lift her child each time he attempts to pull to stand. We would call her a helicopter parent, and think that she is blocking her child’s biological drive to walk. In the same vein, rushing in to soothe children back to sleep at night is helicopter parenting, and is impeding their development. We can trust that children have the same biological drive to sleep as they do to walk. We need to get out of the way and let them practice and learn. As good, non-helicoptering parents, we provide safe and supportive ways for our children to grow, even knowing it can hurt them or us. We let our children squirm and roll and eventually crawl, clearing the floor of dangerous objects, knowing a bumped head will still probably happen at some point. We let him practice climbing at the playground, even knowing he may fall someday. And far too soon, we will go on lots of practice drives before finally handing over the keys to the car, even while we fear for our children’s lives. In the same vein, we must also provide safe opportunities for our children to learn to self-soothe. This ability allows our children to not only sleep independently but also to weather hardship when we are not there to comfort them. We can’t always be there to take away every hurt, much as we would like to. The path to self-soothing will look different for different families, but all children can to self-soothe learn in a safe and supportive environment. A fascinating article on childhood anxiety in the Atlantic found that while parents don’t create childhood anxiety, when parents stop changing their own behavior to accommodate the anxiety -- be it lying down with the child at night or bringing the child into the parental bed -- the child’s anxiety improves. And the entire family’s well-being improves as a result. “It sets in motion a virtuous cycle: As parent behavior changes, kids will start coping for themselves. As they cope, they’ll come to feel more capable, and they will be treated as such by their parents, who will further reduce accommodation. In turn, the entire family’s well-being will improve.” Childhood is an 18+ year journey to independence. Much as we might wish to, we can’t keep our children dependent. What we can do is provide them with a strong, nurturing connection that sends them confidently out into the world… and welcomes them back with loving arms when they need support and comfort again. It is not our job to prevent them from ever feeling pain, because that would be impossible. Instead, we teach them courage and resilience and a belief in themselves by providing them with ever-increasing, age-appropriate, challenges. Many parents fear that sleep training can hurt their child’s attachment or psychological health but this couldn’t be further from the truth. Sleep training and teaching self-soothing actually strengthen the entire family’s connection. As The Happy Sleeper says, “Warm, supportive parenting and a full night of independent sleep are not mutually exclusive… they work together naturally and seamlessly.” If you are ready to create strong family bonds by guiding your child to stronger self-soothing skills but aren't sure where to start, set up a free chat with me and enjoy great sleep in two weeks or less, guaranteed.  As parents, we – with the best of intentions – tell ourselves a lot of stories about our children. And sometimes those stories can seriously undermine our families' needs. Putting a night light in a baby' s room is a perfect example of this.
Children don't develop a fear of the dark before age 2-3. Before that time, their brains simply don't have the developmental maturity to imagine scary monsters under the bed. And light in the bedroom is a bad idea. Light signals the brain that it´s time to be awake. We want to send the opposite message at bedtime and nap time, that it´s time to sleep. Darkness cues the body to release the hormone melatonin, which makes us sleepy. For this reason, putting a night light in your baby's room is hurting her sleep without any benefit. If she cries at bedtime, it´ s because she doesn't want to separate from you, or because she is overtired, not because she's scared of the dark. Adding a night light will only make things worse in that she'll have an even harder time falling asleep. (And by the way, separation anxiety is perfectly normal and is not a reason to keep your tired child up, even if is what she thinks she wants. It´s only making things worse. When you get her caught up on her sleep debt, you will both see this.) The best way to sleep, at all ages, is in total darkness. You should not be able to see your hand in front of your face. You will likely need blackout shades to achieve this level of darkness. Your local hardware store can sell you inexpensive stick-on shades that you can try before you invest in a more permanent solution. You can also do what I did with my oldest, and tape up black garbage bags over the windows. Depressingly ugly but remarkably effective! You may also need to add painter's tape around the edges of the blackout shades to prevent any light leakage. This may seem like overkill but it´s an easy step to try if your child is waking up too early. Even a tiny bit of morning light can wake a little one in the early morning. At age 2-3, your child may develop a true fear of the dark. Only at this point should you consider introducing a night light. I use a portable Munchkin night light for my own kids. It turns off on its own after a few minutes, so it won't disturb their slumber once they drift off, plus the portability is great for those scary midnight trips to the bathroom. If your child needs a light that stays on all night, pick something that has red light, not blue. Blue light is stimulating to the brain and tells us to wake up. Electronic screens contain blue light and for this reason, you should avoid exposure to screens in the hour before bedtime, too. I recommend turning down all the lights in the house in the hour before bedtime. This is one more cue to the brain to start winding down. Keep night lights as far from the bed as possible. And keep the number to a mínimum. Your child should not sleep with more than one all-night night light. If your older child (preschool or older) child is sleeping with multiple night lights, you will need to wean him off them. When making big changes to your child's routine, I always suggest having a conversation with your child ahead of time (not at bedtime!), getting his buy-in, and rewarding his cooperation. After all, this is your idea, not his. I might say something like, ¨"I have learned that sleeping with too much light on makes it harder for our brains to relax. I want to work on having fewer night lights in your room. I know that might be hard for you. What prize would you like to earn for working on this?" Some parents fear that creating a dark sleep environment will create dependence or worse, that their children will wake up cranky and miserable if they sleep in darkness in the middle of the day. It´s true that if you put your child to sleep in the dark, he may require darkness to sleep. And that dependence on darkness can occasionally be inconvenient. But wouldn't you rather have a child that is (nearly) always well-rested and occasionally doesn't sleep well because you can't recreate his ideal sleep environment on the go? Versus a child that is so overtired that he will fall asleep wherever he is, but is never well-rested? (A child that always falls asleep in the car is an overtired child.) As for your child waking up cranky after a nap in the dark? The problem is not the darkness. The problem is the timing of the nap. A correctly-timed nap will not result in crankiness. A correctly-timed nap in the dark will coincide with your child´s natural surge in melatonin, the sleepy hormone, so your child will nap well and wake up well-rested and happy. An incorrectly-timed nap results in that cranky, miserable feeling we adults feel, too, when we sleep at the wrong time. It´s called nap inertia, and my older daughter had it all the time because I didn't know better and put her down to nap too late. It was miserable for both of us. If you can't put her down on time, it's better to keep her up and implement a very early bedtime instead. It can take courage to make big changes in your child's sleep routine, like eliminating night lights. Be patient and encouraging with both of you. If you would like some support along the way, schedule a free chat and get your family the sleep you deserve, guaranteed.  Dear Abby, I am conflicted about using blackout shades in my twins' room. I'm reluctant to use them because whenever I nap in a dark room in the middle of the day, I wake up feeling cranky and miserable. I don't want that for my girls. But right now, they never nap on the same schedule and I am going absolutely bonkers. I can never leave the house and I never know when I'll get a break. Please help, Kate, single mom to 11-month-old twins Kate is an amazingly devoted mom. I admire her tremendously. But. We parents should take all the help we can get. It's not cheating to help them nap. It won't make your young children wake up feeling cranky and miserable. That's because their young bodies have totally different sleep and wake cycles than we do. Babies' bodies are designed to nap during the day. Unlike ours. When we wake up cranky and miserable after a nap, it's because we have nap inertia. Basically, we are sleeping at a time that our bodies weren't designed to nap. Babies, on the other hand, absolutely need naps during the day. If babies nap at the biologically ideal times, they won't have nap intertia. For twice-a-day nappers, those times are roughly 9 am and 1 pm. Once-a-day nappers should sleep at around 12 pm. Just timing naps appropriately can make a huge difference. That's step one. And it's the furthest thing from cheating. It's taking advantage of biological sleep and wake cycles. Step two is yes, using all the sleep crutches you can find that don't require your active, ongoing participation. So blackout curtains? Heck, yes! White noise? Absolutely. Fan or air conditioner to keep the room cool and air circulating? Definitely. Swaddle (for newborns) or sleep sack? Sure! Pacifier that you have to reinsert 16 times during the nap? Nope. Offer the pacifier once and that's it. Either she finds it and re-inserts it herself or she loses it and learns to sleep without it. There may be some tears in the short-term but otherwise, she will never learn to sleep independently (or at least, not until she gives up the pacifier). The same goes for breastfeeding or bottle feeding to sleep. If your little one can fall asleep and stay asleep, feeding to sleep is fine. But if he needs another nursing session or an additional bottle to link his sleep cycles, you are doing him a disservice. You'll know this is happening if your baby (4 months or older) is waking for multiple feedings every night. By four months, your child should be able to go several hours without feeding, and that should gradually decrease from a maximum of three a night to two to one or less at nine months old. By a year old, most babies should not need any feedings at night. My five-year-old recently started to give up her nap. The timing feels pretty terrible -- stuck at home for months at a time during a global pandemic -- but I hardly feel like I can complain. Five years of napping is a pretty good run. But then we tacked up a heavy blanket over an internal window to her room that was letting in a good bit of natural light. Lo and behold, my preschooler is napping again. Gloriously long naps that leave her well-rested and cheerful, a delight to be around. If this "cheating" means I can avoid the cranky miserable mess she was on the days she missed her naps... I'm a devoted cheater. But I prefer to think of it as smart parenting. Helping my girl get all the sleep her body needs to be her best.  (Note the white noise on her table, the standing fan pointed at her, and of course, the heavy blanket tacked up over the internal window.)
If you'd like help getting your little one napping better, or need support tackling a different sleep challenge, schedule a free consult so we can get your child, and your entire family, the sleep you deserve.  Pacifiers -- blessing or curse?
I am unapologetically a huge proponent of pacifiers. Some breastfeeding support folks argue that pacifiers interfere with a good latch, and that pacifiers shouldn't be introduced until six weeks of age, or not at all. But no one argues that you shouldn't offer a clean pinky to suck on. And why wouldn't that interfere with a good latch just as much? Moreover, evidence-based research doesn't support the idea that pacifiers interfere with breastfeeding. Babies know the difference between what we call "non-nutritive sucking" and feeding. When I was a NICU nurse, I read academic articles that showed that pacifier useactually helped premature babies prepare for breastfeeding. This double-blind meta-analysis (the most rigorous form of research) of 1302 infants found no difference in breastfeeding duration between babies who took a pacifier and those who did not. The study's authors concluded, "This meta-analysis shows that pacifier use does not decrease breastfeeding duration in full-term infants. The new evidence contradicts current WHO (World Health Organization) recommendations, however, which are based on less rigorous studies.8,9,13,14 The AAP (American Academy of Pediatrics) now recommends that pacifier use be implemented after breastfeeding is established.4 Based on the evidence, we think mothers who are motivated to breastfeed their infants should be allowed to make their own decisions regarding pacifier use, and pacifier use should not be discouraged." Moreover, the AAP actually recommends the use of pacifiers as a way to decrease the incidence of SIDS. Dr. Harvey Karp recommends sucking as one of his "5 S's" as a way to soothe a newborn to sleep. Anectdotally, as a parent and as a healthcare professional, I have never understand why one would offer breastfeeding when a baby wants to suck for comfort, not hunger. We wouldn't offer formula to a baby who wasn't hungry. Why would we offer breastmilk, then, when a breastfed baby isn't hungry? As a baby grows older, out of the newborn stage, I recommend that pacifiers be restricted to times that a baby is tired or fussy. Babies use their mouths to explore the world, and that should be encouraged. They also need their mouths to coo and babble as the earliest stage of language development. But when it is time to sleep, pacifiers can be a wonderful tool. That said, if pacifiers start to become more of a blessing than a curse, it's fine to eliminate them. Some babies love pacifiers but can't keep them from falling out of their mouths, and then cry for them to be replaced. If this happens to your baby multiple times a night, the pacifier may not be worth the inconvenience. In that case, I would recommend offering the pacifier once at bedtime but not replacing it, especially if your baby is no longer in your bedroom. Tugging gently on the pacifier once it's in your baby's mouth can strengthen the suction so it's less likely to fall out. By six months, babies no longer have a biological need for sucking, but many still enjoy it for comfort. It's up to you if you want to eliminate it then or wait longer. Both of my children used pacifiers. My older daughter used it until about four months old, and then gradually transitioned to sucking her thumb. She didn't stop sucking her thumb until five and a half years old and the weaning process required a full-scale assault. I wished many times that she used a pacifier instead -- it would have been so much easier to stop pacifier use than to stop using a thumb that was always with her! My little one used a pacifier until age 3. It was an amazing help for her in sleeping through the night at ten weeks old. We kept her pacifiers -- a lot of them -- in the crib and car seat, only. Only once she was climbing in and out of the crib, and then transitioned to a toddler bed, did more frequent pacifier use become an issue since she was able to reach them whenver she wanted. At age three, on the dentist's advice, we picked out a reward for giving up the pacifier -- she chose an Elmo doll -- and on the day she was ready, she threw the pacifiers in the trash and got her Elmo. Of course, a few minutes later, she changed her mind and wanted to throw Elmo in the trash and have her pacifiers back. But I held the boundary. At bedtime that night, I rubbed her back while she cried. I didn't try to plead or explain or convince her that her grief was wrong. And after about ten minutes, she fell asleep. The next night, she cried even less. And by the third night, we were done. She continued to speak fondly of her "pacis" for months to come but she never cried for them again. I'm so glad that she was able to have the comfort of sucking when she needed it, and that she was able to partner in the process of giving them up. So to those who would argue that if you give a pacifier, it'll be hard to get rid of them -- no, I don't agree. My girls preferred different kinds of pacifiers. One like the Phillips Avent pacifier while another preferred the Nuk. For each, I bought a few different options to see which they liked best. Oh, and each breastfed past a year, despite pacifier use and taking a bottle while I was at work. So I recommend stocking up on a few different options and experimenting. Offer the breast or bottle first, if you think your baby is hungry. But if she's crying and pushing it out of her mouth, or if it's been less than 90 minutes and you're confident that she had a good feeding, try swaddling her or popping her in the baby carrier and offering a clean pacifier. She might just need some non-nutritive sucking to soothe herself to sleep. Rest assured, when the time comes that you need to wean her off it, you'll be able to manage it. For more help with soothing your baby to sleep, or getting him to sleep all night, schedule a free chat with me and get your family sleep you deserve. |
AuthorAbby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and certified life coach for parents. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico. Archives
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