Setting the stage:
Remove baby to a calm setting which will most likely be his or your room. Get the room ready for sleep by closing the blinds, turning on music or doing whatever it is you do (see some of the ideas in pre-sleep routine). Try to keep things low key to help your little one calm down and transition for sleep time.
Swaddling:
Swaddling is absolutely essential to help your young baby sleep better. See swaddling.
Sitting:
This is the really important part where a lot of people start throwing in "accidental parenting" techniques and sleep props to get baby to sleep. After you have set the stage and swaddled baby you sit with baby in your arms in a vertical position--preferably with his face tucked into your neck or shoulder so he doesn't have any visual stimulation. Next you sit nice and still (that's right, no wiggling, jiggling or rocking) with baby until you start to feel him relax and maybe jerk a little too as he tries to descend into sleep. Some babies may even cry for a few minutes during the sitting as they try to settle themselves down. The "sitting" may take 5 or so minutes but will vary depending on the baby. Often the "sitting" length decreases as baby gets older and more used to going to sleep on his own. Once you feel baby relax and his breathing gets slower and deeper you place him into his crib, ideally before he falls asleep. As you place baby in his crib say some comforting goodbye words to him that also let him know what is happening (e.g. "Your going to sleep now. I'll see you when you get up") As long as baby stays calm you can leave the room. If he is fussy or crying move onto the shush-pat below.
Shush-pat:
The shush-pat is suppose to be used in babies under 6 months old that are fussy or cry when transitioning for sleep or when you place them in their beds. If a baby is over 3 months old and the shush pat doesn't work then you can move onto P.U./P.D.
Additional Tips not from the Baby Whisperer
*Many people I know use this method but instead of doing the shush-pat do CIO (cry it out). The length they do CIO varies with the age of the baby, how their baby responds, and how comfortable they feel with CIO.
*I have noticed that sometimes calming your baby down with the shush-pat instead of letting him cry for a couple minutes during the sitting stage actually prolongs your routine and how long it takes baby to calm down. Some babies will fuss on and off for 30 minutes if not more while you shush-pat them every time they fuss/cry (remember that they are getting more over tired every second they are up) but if allowed to cry for a couple minutes will quickly stop fussing and be ready for sleep.
*If baby gets really fussy before this routine or even during it I might throw in several seconds of movement to help calm him (i.e. do knee squats a dozen times--works wonders in a fussy baby) and then I will continue with the sit down routine. I try not to overdue this movement. If you put baby to bed with good timing not much of it should be necessary, except for maybe in the evening newborn fussy periods.
If this post has been helpful for you, please consider following me on facebook, twitter or subscribing to my posts through email or a reader.
thanx! very useful information!
ReplyDeleteAnonymous,
ReplyDeleteYou are very welcome!
Dear Rachel, I have recently found your blog. Your writing is extreamly helpful and together with reading one or two books it helps to complete the full picture and get on with educating ones baby. I just wanted to thank you very much for putting it all together.
ReplyDeleteRegards from Tokyo.
Anonymous,
ReplyDeleteSo glad you have found the blog helpful!
Hi Rachel...Last question, I promise. I can't seem to find why pick up, put down isn't recommended for a baby under 4 months old. I'm fine to not do it, I was just wondering why you stick with just the shush-pat. Thanks again!
ReplyDeleteLisa C,
ReplyDeleteShe doesn't recommend P.U./P.D. for babies under 4 months bc it will very likely overstimulate them with all the up down stuff. Plus, if a newborn gets overtired (which might happen with P.U./P.D.) he will have a really hard time going to sleep.
I have done a variation of this with a newborn where you hold until sleepy, then put down (instead of just when they stop crying) then pick them back up again if they cry and hold until sleepy. It has worked pretty good with the few babies I have tried it on. But once again, overtiredness can be a problem with this approach too.
You are fine to ask questions. No worries :)
Ahhh....that makes sense. Trying to figure out this sleep thing is all consuming. I started off with just doing what worked in the moment since I was so sleep deprived and now am seeing I need ot make some changes now before the habits get worse.
ReplyDeleteIf you're ok with it, I do have 4 last lingering questions:
1) We've been doing the baby whisperer's routine - eat, activity, sleep. Now, let's say what ever method we decide to use (whether crying it out or the four s's) what do we do if the baby has not gone to sleep before his next feeding time or if he won't sleep the entire time we're trying to get him to sleep?
2) What other routines do people use besides the eat, activity, sleep route?
3) When we do start whatever method we decide is best for us to start sleep training, is it better to start it at night or first thing in the morning on the day we pick?
4) If we are doing sleep training because of a sleep prop issue is there a better method to use over others?
No worries if you can't answer all of these - I hope I'm not taking too much of your time. I am just desperate to end our babies sleep prop addiction since I know it will only get harder to break the habit as he gets older....and sleep will be hard on us. (although he does sleep for a loooong time in it). You're a lifesaver! Thank you!!
Lisa C,
ReplyDelete1) With a newborn you probably only want to try for a relatively short period of time (I do like 15 minutes but some people will do longer) then help them go to sleep or they will get too overtired and never be able to sleep. I also help newborns go back to sleep when they wake early from naps. Might give them a few minutes to see if they can do it themselves, but if not, I help. With an older baby some experts like healthy sleep habits happy child says to try for an hour for a nap. Some people will try the entire nap. If baby sleep bad for a nap he will need to go to sleep much earlier the next nap, especially if he is under 6 months or so. There is good and bad about both methods. If you give up part way through a nap then help baby he may learn slower. If you keep going through the entire nap he may get so tired that he can't sleep at all--then again he could get so tired that he will eventually sleep. really depends on the baby and his age. Sorry I don't have any exact advice to give you. It is very personal.
2)If baby take short naps or eats every 4 or so hours but cannot stay up very long they you might do eat/play/sleep/play/sleep/eat....repeated over and over. Many people just nurse whenever baby fusses whether he is hungry, bored, tired etc. That is sort of a no routine method. Pretty common. Just keep baby up, feed him whenever he seems hungry and help him go to sleep whenever he seems sleepy. Either way, as kids get older you'll move out of the eat/wake/sleep routine and have normal eating times (breakfast, lunch, dinner and 1-2 snacks) with scheduled naps.
3) As for when to start (this is on a to do list for future posts:) many people will start with naps bc then you are not a zombie in the middle of the night. but at the same time, then you sort of have a limited time to train with each nap bc it is time to get up and eat. At night there is no set time (well, baby should be asleep by the time they need to eat again!) sometimes that makes it easier. Since it sounds like you are tackling both at once, I'd probably start during the day when you have more energy.
4)Well, a gradual withdrawal of prop will probably result in less upset from baby, but it will take a lot longer. If you tackle things with a little more force things will be quicker most likely. As for which method will work best, I can't say for sure. They will probably all help to break the sleep prop either way. Some will just work quicker than others (like cio will possibly be quicker).I'd suggest trying a more gentle approach first since it will be easier on the both of you and some babies respond very well and quickly to this. If it doesn't work then maybe try something a little more---not as gentle :) I didn't really answer this question well. I guess I don't have a good answer to it. No sleep methods have been proven to work better than others, some just require more time/work than others and work better with different kids. I think this also holds true in regards to what kind of sleep prop issue there is. There are definitely different ways you'd do gentle sleep prop methods to work with a prop issue (I mentioned these in an other comment) but if you are doing more hard core methods it probably doesn't make a big difference.
Thank you so very much. I truly appreciate the time you took to answer my questions. You're wonderful! Now...time to get to work on all this.
ReplyDeleteLisa C,
ReplyDeleteYou are welcome. Good luck!
Dear Lisa,
ReplyDeleteThank you for a very helpful blog! With this 4S approach, when does feeding happen- before Setting the Stage? Should it be done in the same room? During feeding, should the room already be ready, i.e blind closed etc? What about swaddling? Should the baby eat already swaddled? Thank you in advance!!
Dear Rachel, I am sorry, of course I meant to say, "Dear Rachel", not Lisa!
ReplyDeleteMarina,
ReplyDeleteLol about calling me lisa. Someone called me the name of the previous person who commented the other day too :)
The baby whisperer does a eat/play/ sleep routine. So baby get up in the morning and eats then play for a bit then goes down for a nap (hopefully a long one). When baby gets up you start the routine again. So keeping with what she does, you would feed long before you do the 4S routine, with the exception of maybe bed.
But if you don't do any kind of feeding routine I think this can still work. What you do will depend a bit on the age of your baby and when you do it. I think it is fine to set the stage and swaddle before you feed baby before bed at night as long as it doesn't cause any problems. If baby is used to always eating to sleep, you might want to do the same thing at nap times too, trying to make sure that baby isn't fed to sleep but just gets drowsy. Over time I would try to put feeding before the swaddling and setting the stage. This is especially important as baby gets older and into more habits. One of the main focuses of the baby whisperer is to have baby get used to going to sleep without any sleep props, feeding being one of the most common ones. You want to eventually be able to walk into baby's room and have anyone be able to do your super quick pre-sleep routine with her, lay her in her bed then walk out with her falling asleep quickly and easily on her own. BUT if you plan on always feeding baby before sleep then I think this approach is still really helpful because as most babies get older they don't feed to sleep very easily any more--at least not unless they are way overtired.
Hope that response answered your question :)
Hi Rachel! I just finished the book TBW on sleep, although wondering: Is four S suitable for an almost toddler, swaddling definitely not, and sitting? My son is almost 1 year and our wind down bedtime ritual developed into breastfeeding, followed by laying next to my son in our bed until he falls asleep. I would like to teach him to sleep alone and also to switch the last feeding before the bath. I don't want to do CIO or similar, I am ready for gentle, more time consuming method. Is PU/PD suitable?
ReplyDeleteNap time is either at home with prop (rocking) or in a pram, where he falls asleep easily. I'd be thankful for any advice! monika
Monika,
ReplyDeleteI think it is suitable for a toddler. He will probably fight you quite a bit if you do this and no bg/laying but if you keep at it he will get better. Just keep in mind that he will likely cry and that it is not a cry of death but a cry of protest :) If he is really laid back he might not protest, but I think this is unlikely.
Pu/pd will very likely involve a lot of crying even though you are there by your child's side. Just fyi.
The no cry sleep solution methods might be a better fit for you (see index) since it includes a more gradual approach with no crying. You will slowly phase out props you are using.
Regardless of what method you do, you do want to have a good sleep routine in place that includes other things besides nursing and lying next to your son so that when you take these things away he has something else that signals sleep to him. It is also a good idea to incorporate some sort of lovey right now so he has it to comfort him when you are not there.
Adding in something right after bf before bed (like reading) can help out when you stop the bf then.
Hi Rachel
ReplyDeleteOur 12wk old son is having trouble with his naps. He used to go down for 1.5hrs but it was always hard to get him to sleep, and sometimes we had to hold him til he fell asleep and then put him down. Now we have gradually weaned him off that and he has 3 - 4 regular naps a day. But they last only 40 - 45mins. I try to resettle him when he wakes, but sometimes it can take up to 45mins to get him back to sleep.
He simply lies there mushing his head and keeping himself awake. I have rocked him back to sleep before but I would rather not as he's already a big baby (7kg at 12 wk) and is heavy enough as is.
We're on a 3/3.5 hour routine e/p/s, so this can also sometimes completely disrupt it. He is on the breast only.
Some other stuff that might help:
- falls asleep without issues for naps and night time
- at night sleeps 7.30pm - 3am - 8am
- uses dummy for naps only, never at night
- has not been swaddles for 2 weeks now (on advice from maternal health nurse)
Any advice is most welcome.
Cheers from downunder.
Eva,
ReplyDeleteIf you haven't already, Look over the short nap post. I would especially be aware of overtiredness and environmental distractions. There may not be much you can do at this time, it is often developmental. Check out the nap extension tips too which may or may not work. Will he fall asleep with a dummy reinsertions (if you rush in right as he wakes or after you leave him a bit to see if he'll go to sleep)? Hope the weather is lovely there!
Cheers,
Rachel
Hi Rachel,
ReplyDeleteI have a 5 week old son and I am struggling with his naps and sleeping in general. We do a lot of the 4S's that are recommended - swaddle, set the stage (close curtains, turn on white noise) and I will rock him for a few minutes although I think I am going to start sitting still now.
Anyway, I will do all of this and he is still not drowsy so I will lay him down anyway. He will cry for the first two minutes that I leave. Unfortunately, after this he just continues to stay awake, not falling asleep. What can I do to get him to sleep? If I didn't have a video monitor I would think he is sleeping as he is so quiet but I can see his eyes wide open looking around. I try and look for sleep cues with my son so I try and put him down by a max of 60 minutes (I have tried 30 and 45 minutes as well) nothing really seems to make a difference. Any suggestions are appreciated....thanks!
Roxy T,
ReplyDeleteWhile some babies don't get sleepy in the arms very quickly or easily and need to be put down to do this, I think your problem might have to do more with either overstimulation while awake (too much activity, noise, faces close to his) or too little waketime. What you might want to do to figure out timing is do whatever works to put him to sleep (car, bouncing) so that you can see when he easily falls asleep. Some babies will easily fall asleep in the car at this age even if they are up for 5 minutes so just keep this in mind to make sure he isn't one of them if you do this. Good luck. This stage can be tough with some babies--both of mine included :)
Rachel
Dear Rachel, thanks for responding my question from February. It was quite helpful and encouraged me to try PU/PD, actually only PD since my son was standing up himself. I must say that it went surprisingly smoothly and fast. There was also not so too much of cry. As you said, it was clearly cry of protest and since I was still with my son, it wasn't heartbreaking at all. We are happy that our baby likes his cot for bedtime and naps. Although he still needs our presence when falling asleep, this doesn’t bother us for now, and we can work on it slowly. However, recently we started to have problems in the morning, please if you have time, I’d be interested in your opinion (section early morning awaking). Thank you
ReplyDeleteHi Rachel! So glad I found your blog! I just tried this for the first time today and my daughter cried the entire time she was supposed to be sleeping. My hand feels like its going to fall off and my lips feel like they are stuck permanently in the "shushing" position! Is this normal? Any suggestions? Any advice would be VERY welcome! Thank you! Kellie
ReplyDeleteKellie,
ReplyDeleteI felt the same way the first time I tried to do this! I think this is why tracy hogg encourages getting others to help with her sleep training so much (not that any form of sleep training is easy both emotionally and physically all the time) I ended up using a sound machine instead which worked pretty good for my kids. And I changed how I did things a bit to work better for me. For you, I would work on making sure the wakeitme is just right with not too much waketime stimulation, especially if she is a newborn. Is she in her crib when you are doing this? If so, I would probably take her out after so much time and calm her down in her arms if she is really young. She might be getting so worked up that she can't calm herself down with the shush-pat and she needs a bit more body contact. Once calm, I would put her in the crib again and try again. After so much time with newborns, I will help them go to sleep so they don't get too overtired. This is me, not tracy hogg speaking though ;) Look at the short nap post for more information on this. I am about to go out of town for several days so if you have a follow up question I will not be able to get to it for a while.
Good luck
Rachel
My l/o will be 3 wks on tues...he used to feed then would sleep after that. Now after I feed him he dosent want to go down...very fussy and cranky but i know hes tired...I was going to try the shush/pat method...but Im not sure how it works. Can someone help..Im so exhausted! I cant nap if he doesnt nap!
ReplyDeleteChristina Marie,
ReplyDeleteThere is a link to the shush-pat post on this current post that will tell you how to do it.
Rachel
Dear Rachel,
ReplyDeleteYour blog has been amazingly helpful in understanding my baby and his sleep habits. Thank you so much!!!
I have an 11 week old baby. I’ve been doing the four s wind down ritual for the past two weeks. He always cries during the sitting part. I stand up and do a bit of movement like you suggested and he immediately stops crying. After sitting down/standing a couple of times I then put him down and he fusses for a few minutes. I do the shush/pat once or twice and he falls asleep. My question is: Will he ever not cry when I sit with him? I've already experimented with adjusting waketimes and it hasn't helped. Also, have you posted something about pacifier use? Will it become a sleep prop if I use it during the wind down ritual? Sometimes it seems like he desperately needs something to suck on. I’m not sure if I want him to suck on his hands/fingers… I’ve seen too many children that can’t stop sucking their thumbs until they seem way too old to do so. Thank you!
Marisol,
ReplyDeleteBabies go through all kinds of phases ( cry when going to sleep, then don't, then do it again) but generally they cry less over time. Some babies will cry more if held before sleep and will stop crying when you put them on their beds--just something to look out for. I know of some moms that try to fight this characteristic in their babies but it just results in more tears.
Pacifiers can become a prop but they are easier to control and get rid of than a thumb or other fingers. If you don't use a pacifier, you might end up with finger sucking so you have to weigh your options. At 11 weeks many babies do need it to soothe themselves so I would be hesitant to take it away at this age.
Rachel
Hi Rachel,
ReplyDeleteThank you so much for all the great info onthis site!
I have a few questions about sleep training...our current sleeping situation is a total nightmare and I am desperate for some help. I have a 7 1/2 month old girl that will only fall asleep if rocked. She will sometimes fall asleep while nursing, but I have to wait a long time tomake sure she is in a deep sleep before I can put her down in the crib. She was a colicy baby for the first 3 months and cried for hours at a time, so I resorted to rocking her tocalm her and put her to sleep.
She currently takes 3-4 naps all 30 mins long and sleeps 6pm-6am for her nighttime sleep. She wakes up every hour at night, sometimes more often and I have to rock her back to sleep, or bf her. When she goes to sleep at 6pm, she then starts to wake up every 20-30 mins until 9pm and then every hour or so. I also have a 2.5 year old and I am at my whits end. My husband insists I put her in the crip and let her cry for as long as she will, but I am against that. I am ok with some crying, but this child can go on for 1 hour or longer. I tried the Ferber method, and after 2 20minute crying periods, she was only getting more frantic and I gave up. I was feeling like a monster and a horrible mother.
PLEASE offer some suggestions on which problem I should work on firs, naps or nighttime, and which sleep training method may work best(some crying is ok. Another problem I have is I cannot let her cry too long at night bcs she will wake up my older daughter. Please offer some suggestions, the sleep problems are too big for me to tackle on my own! THANK YOU!
Vesna
Vesna,
ReplyDeleteFirst off, I can't imagine how worn out you are! I'm so sorry. Being a mommy sure can be tough. Adn no sleep doesn't help the situation.
First off, make sure to look at the post, choosing a sleep training approach. Sounds like you have an idea of what you can handle.
Work on a good presleep routine. Sounds like you are doing an early bedtime which is good.
Nigtht time often works best to start with first. I personally like to do all at once if it is manageable. You will have to see what you think you can handle. Look over the short nap post and the night item waking post to see if there are things you can do (outside of prop use, which is obviously going on) that might help out.
Next you will need to decide what sleep training method you need to do. Sounds like you are defiantly at the point where you want to try something. I doubt things will change too much at this age unless you do some sort of method, although the things mentioned above that I had you check out might help a litte. If you don't want much crying, you could always go in and check every 5 minutes and sooth shortly then leave. Some people that do this method will stay until baby soothes then leave right away, some will just stay for several seconds each time. Either way, most people say not to pick baby up. Sorry, I don't have a post up on this method right now. This still may take a long time though, althoug baby won't be left a long time crying, so it may not be up to you.
The no cry sleep solution might be something for you. There are several posts in this in the sleep training section. It will likely take longer than some sort of cio, but if you can't handle the cio, then certainly don't do it.
Teh baby whisperer (also posts on this in index) might be another good path for you. She is a good in between with cio and pantly.
Either way, try to get some support through all of this. It is super tough whter you are sleep deprived or doing sleep training and having crying. One of my sister in laws actually has my brother do the sleep training when they get to a certain point. My brother just stays with the baby through it adn it lasts 2-3 nights. But that is what works for them. She doesn't think cio will harm baby, but she'd rather not be there if my brother will.
Anyway, good luck. Let me know if there is anything I need to clarify on.
Rachel
Hi I've recently started the baby whisperer routines after reading her book and deciding it was much better than contented baby book!! In BW she says not to let baby go to sleep longer than a normal span between feeds during the day (3 hours) and to wake baby up if this happens. I woke my son up earlier as he had been asleep for 3 hours, gave him 15 mins to wake up properly, changed his nappy and then fed him. Straight after finishing his feed he began yawning and getting very agitated so didn't get any 'activity' done as he was showing signs of becoming over-tired and was getting quite upset. So I put him down in his Moses basket as his eyes were dropping. He was awake for about twenty minutes, a little fussing but sent himself off to sleep eventually. My main concern is that he is not staying awake enough during the day as it is becoming common for him to be very tired after a feed and becomes agitated if we try to keep him awake/stimulate him within a matter of minutes!! We don't always have to wake him for a feed, he is usually waking up every 2-2 1/2 hours between feeds but still becomes easily agitated regardless of this. Any advice would be greatly appreciated!!
ReplyDeleteThank you :) x
Kayla
DeleteI do like the contented book under some situations--but not as a sleep method unless you cannot get your child to sleep any other way. Anyway, I'm not sure how old your son is. I'm guessing a newborn. Most newborns are barely awake long enough to eat and have a diaper changed. Your playing is pretty much holding baby during the show time he is awake. He will be awake longer very soon. As long as you are sure he is awake enough to get a full feed in and isn't just falling asleep after that initial sleepy milk episode you are fine. I wouldn't try to keep him up longer at all. Here is a post on wake times to guide you a bit...
http://www.mybabysleepguide.com/2009/02/wake-time.html
And if he can settle himself to sleep on his own he is doing FABULOUS in the sleep department :)
Hello
ReplyDeleteSOOOOO happy I found your blog! I have a 6 week old baby with Acid reflux. He usually drink 3 and a half oz of Similac sensitive with 3 tsp of oatmeal cereal (per Dr recommendation) and Zantac twice a day. Finally after lots of crying and switching of formula etc Baby seams to NOT be in pain and has actually started smiling and staying awake longer during the day...BUT also started waking for his 2am feeding and staying awake for 2 and a half hours just taking in the scenery until he gets bored and starts to cry.. sometimes he will stay awake till next feeding.
I came across your blog while searching for a solution to said problem. I read up on the cluster feeding and started it yesterday. Baby had formula at 5 then first cluster at 7pm. As soon as he was done with the bottle he projectile vomited. Not just a little spit up down his chin or on his bib, I'm talking about over my lap hitting the couch type vomiting. This was the first time that has ever happened. He did not cry he only looked at me with wide eye (probably mimicking the look on my stunned face) 10 minutes later he was turning his head looking for the bottle. I did not feed him, instead i bathed him at 8pm and at 830 or 845 ( cant rem) i gave him a bottle and put him to bed.
Baby slept from lets say 9 to 1:30am he had his bottle of 3 and a half oz with oatmeal and come 3am he was till asleep. When 4am rolled by he started grunting a little moving around and trying to eat his hand. I tried feeding him and he had 1oz all the while asleep. I changed his diaper and put him back down. His daddy woke up got ready for work and at 7:22am he called me to ask what time baby had last bottle because he was trying to feed him and he was not drinking, he would suck on the bottle and keep the milk in his mouth,he was still half asleep. He also woke to explosive poop. I cant say diarrhea because it was not watery just very wet, not pasty but not watery either, he had two of these.
I recently (4 days ago) changed him form ready to feed to powder formula and this may be the cause of that..but since i started the cluster feed, and with him having that one projectile vomiting and sleeping for so long. I am a tad worried and would REEEEALLY appreciate your input.
Could Acid reflux babies handle Cluster feeding?
Could the powder formula cause the very loose stool?
WHY DO I FEEL SOOO guilty?
I should add Baby is 22inches and weighs 11 pounds 6oz. So I know he wont starve over night.
ReplyDeleteAdding to the posts above.. My sister ( who cared for Baby while i work) let me know that Baby has been fussy all morning. He cries when you put him down and drank 4oz of formula and Oatmeal and she fed him another oz shortly after because he was "acting" hungry (putting hands in mouth, turning head) I'm a tad worried now that i may have screwed up his tummy with the powder and the cluster feed... eeeeek
ReplyDelete