GENTLE REMOVAL PLAN - For frequent breastfeeders, night time bottle feeders and pacifier users (No Cry Sleep Solution)




**Pantley's Gentle Removal Plan Listed Below**

Many babies associate the action of sucking with sleeping and end up needing to suck to fall or stay asleep. Pantley doesn't consider this a negative sleep association, but says that it usually isn't practical (especially for an extended period of time) since most people have busy lifestyles and therefore have to do a lot more than just
take care of their baby 24 hours a day. There's cooking and cleaning and taking care of other children and possibly employment...you get the point.

Frequent bottle-feeding babies
There are a few reasons bottle-feeding to sleep isn't the best way to go in the long run. First, it can leave liquid in her mouth resulting in cavities. This can happen with babies that are nursed to sleep but isn't as common. Second, your baby may overeat since she feels like sucking to fall asleep but may not actually hungry resulting in her taking in more food than she needs. Third, wouldn't you rather sleep at night instead of getting up to prepare and give bottles every couple hours (or more)?

Pacifier use
If you choose to use a pacifier, it is suggested from 3 months (if breastfeeding) to 2 years of age. Before three month of age it can interfere with the establishment of breastfeeding (although I've heard from some sources that this isn't true) and after 2 years of age it can cause dental problems and speech delays.

Pacifier use can result in a sleep problems when baby needs it to go to sleep or stay asleep but it keeps falling out. When baby gets older you put several around her crib so that she can find one and reinsert it when she wakes during sleep times.

How to diminish the sucking-to-sleep association
Changing sleep associations will take weeks if not a month (or even more) so you need to be prepared to make some short term sacrifices in your sleep if you want long term future benefits. Use the gentle removal plan to help diminish the sucking-to-sleep association:

PANTLEY'S GENTLE REMOVAL PLAN:
When baby wakes, reinsert the pacifier or bottle or breastfeed. Instead of letting baby fall completely asleep sucking, wait until he gets relaxed and sleepy then remove whatever he is sucking on shortly before he falls asleep. If baby starts to root and tries to continue sucking (which he probably will do at first), gently try to hold his mouth closed by placing your finger under his chin or by putting a little pressure on his chin just below his lips. Rock/Sway/say comforting words to him while you do this. If he struggles or fusses, then reinsert whatever it was he was sucking on. Repeat the process until baby falls asleep. And repeat it every night until baby can fall asleep on his own and doesn't have frequent night wakings.

The length of time between each removal depends on baby, but Pantley says that it is usually between 10-60 seconds. She suggests counting while you do this to give you an idea of how long things are taking and to keep you nice and calm.

Pantley suggests you work on this technique at bedtime (especially when baby initially goes to sleep since babies often want to fall asleep the same way for the rest of the night) before you try it at naptime unless your baby is really good at going to sleep for naps. Once night time is going well, work on naptime.

Changing the last step in your pre-sleep routine may help your child go to sleep easier. For example, if you normally read a book then nurse right before bed, try nursing then reading a book before bed.


Related Post:
No-Cry Sleep Solution, The: Sleep Solutions for Older Babies (4 months to 2 years)

8 comments :

  1. Kelley commented on CHANGE YOUR BABY\'S SLEEP ASSOCIATION - For frequent breastfeeders, night time bottle feeders and pa - My Baby Sleep Guide:

    Hi

    I love your site - thank you for providing such great information to all us sleep-deprived mamas! I want to know if the Pantley Gentle Removal Plan actually works. Any success stories out there? My little guy is 4 months old, and we have been working hard for the last month at establishing bedtime and nap-time routines. Now he is a pro at going to sleep on his own with only about 5 minutes of rocking and some white noise. The problem is that he can't put himself back to sleep after a sleep transition without breastfeeding. So putting him to sleep is a breeze, but keeping him asleep is a chore, especially at night when I'm up all night to reinsert the boob. I don't want to do CIO if I can help it, but I'm worried it's going to be inevitable. I've been trying a swing and it's working ok but he still wakes up every 1.5-2 hours through the night, and after 45 min at his morning nap even with the swing! Any thoughts out there?

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  2. Hello - Pantley's plans really resonate with me as an extended bedsharing and breastfeeding mom to a 17 month old but I'm really struggling with the gentle removal. As soon as I started bedsharing he has refused a paci and basically just nurses all night long. Anytime I try and pull my nipple out he wakes up and has a total meltdown until he gets it again. The only way I can even remove myself at all is to wait until he is deeply asleep and pull it out millimeter by millimeter super slowly. This is just not sustainable and I'm feeling completely frustrated, touched out, and so ready for him to be in his own bed BUT not ready to stop breastfeeding. He is 17 months and currently wakes up 5+ times a night or basically latches on to me all night long sometimes. Please help. I have no idea what more to do to try and wean him off the need to nurse constantly and the gentle removal plan I think he's really too old and quick for! :-(
    -Kristina, sleepless in virginia

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    Replies
    1. Kristina,
      With many children, making this transition with sleep will be full of some protests. Your son needs to learn to be soothed to sleep without the breast and he'll likely be frustrated by any change here, even if you offer all attention but the breast. Have you tried turning your body away once he is asleep so the breadth isn't so close to him? Maybe moving a couple feet away from him. Having his father sleep next to him? These can help spread out the feeds with some babies. Soothing to sleep when he wakes up in another firm besides breastfeeding to sleep can also help spread out the feeds (and reduce constant waking for soothing to sleep rather than just feeds which would be more desirable). Your husband can be a lot of help in this area as baby may get more angry at you for being close but not feeding him. The real solution to your sleep issues (your and babies-you both need sleep) is stopping the nursing to sleep, particularly at bedtime. This time is the most impactful for night sleep and will lead to quicker and more pronounced change than just working with night wakings. It will be a hard change (most likely) but will make things much easier in the long run. There are a couple ways you can do it. The main idea exists, you will feed to drowsy then stop feeding and put baby down to sleep. You can pick up baby and refers if he gets upset and put him down again when he is sleepy (not asleep!). Continue until he stays down and goes to sleep. Repeat with wakings. Or for faster results, do something like the chair technique once he is fed which you can find under sleep training posts. You can also hand off baby to husband after feed to put to sleep, but then you will need to break the holding to sleep habit after. Good luck!!!

      Rachel

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  3. We have a very similar problem: our little boy is just under 7 months and has only ever been breastfed. Even though he will usually go to sleep in the evening without any problems, he wakes up every 1.5-2 hrs in the night and will only go back to sleep with a feed, or shall I say a suckle on my nipple as he's obviously not hungry. If I take him off the breast before he's gone to sleep, he will start crying and be inconsolable even when he's cuddled or rocked. His dad has tried rocking him back to sleep and it didn't work - he just carries on crying. I've also tried putting him back in his cot and letting him cry it out but felt that I had to give in after he cried for an hour. Can you give me any advice?

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  4. How can I get my 8 month old to nap without being breastfed? I work from home but need my parents to watch him in the day. He refuses bottles and sippys for milk.

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  5. How can I get my 8 month old to nap without being breastfed? I work from home but need my parents to watch him in the day. He refuses bottles and sippys for milk.

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  6. Hello, my one year old has been breastfed and over the past three weeks, when we were on vacation, she has nursed to sleep. We are back from vacation and she is refusing to sleep in childcare in the day, which is causing us to get an ultimatum from the childcare.. :(
    We are using your advice and having dad take over bedtime after i nurse her, she goes to dad for a book and then sleep time. She has been crying for a while with dad.. and then hopefully falls asleep. Today is the first night of trying this.. are there any suggestions that you think we can integrate to support her self soothing skills at sleep?

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  7. Rachel,

    My baby boy is 17 weeks old now. He was born with a tongue tie which impacted my breast feeding and I had to supplement him with a formula. Formula however caused his reflux to get worse. We have tried different formulas but no change. This had an impact on his sleep as he was waking up very frequently at night, hardly ever napping during the day and when asleep he would often wake up chocking, coughing or with a hiccup. There were days where he would get a hiccup every time we had put him down to either sleep or to change his nappy. As a result, to fight his over tiredness I have tired to do everything I could to make sure he gets some sleep including sleeping on me in an upright position (sometimes, although very rarely, all night long).

    The medication that he was prescribed for his reflux caused insomnia where he hardly slept at all for three days in a row. At this point we were told to stop giving him the drugs.

    For over 8 weeks he was waking up every hour at night and would nap for 20/30 minutes max. He wakes up tired and plays for only 20 minutes before he starts crying as he wants to sleep.

    Initially, he would only go to sleep when nursed. I tried to wean him off of it so I started to rock him a little bit after feeding - 1. He cant play after he's eaten - he continuously spits up milk and coughs even hours after feeding. As a result we are on a wake, play, sleep routine. As he needs to be held upright for about half an hour after every feed it made sense at the time to rock him a little bit to get him to sleep. 2. Ive read that nursing is a stronger prop and its easier to wean baby off of rocking than it is of nursing hence the change.

    Now, however, I would like him to self sooth himself back to sleep as I am seriously exhausted - and so is he! I have tried the shush/pat method but the results and quite poor. Sometimes, when I rock him a bit and he gets drowsy, as soon as his eyes start to close I put him down and do the shush/pat and he drifts off to sleep. But mostly however he will wake up, eyes wide open and will either start taking to himself or crying and wiggling so badly that nothing would calm him down. When he talks he starts playing with my hand and won't stop for 10/15 minutes at which point he will start crying due to over tiredness.

    After a minute or so of crying I would take and calm him down, put him back down when nearly asleep and then he would open his eyes, look around, play with my hand/cry. And it can be like this for an hour at which point I give up and just do anything to make him sleep.

    A couple of weeks ago I tried to do everything to make sure he sleeps better so that he stops being overtired including sleeping on me. You would have thought that he would sleep for longer but no...the longest he can go is 50mins.

    I am at the point of giving up. I'm stuck in our dark bedroom with him continuously getting him to sleep. If we leave the house it's for half an hour max as he then gets tired and won't sleep in his pram or baby carrier. I honestly don't know what to do anymore. Now he even cries in his sleep!

    I'm not sure whether he's feeling so unwell it going through a growth spurt/wonder week but I feel like it's getting worse with every week.

    We have a nap/night routine and I try to get him to bed early - 7pm but he quite often won't fall asleep before 8pm anyway. Generally he gets 10 hours of sleep over the 24-hour period.

    I've read your posts and other comments but can't seem to find a similar problem. It seems like other babies either can't sleep at night but nap well or are a horrible nappers but can sleep through the night. But our boy just can't sleep at all!

    We've even tried giving him a pacifier but he hates then all.

    I can imagine how busy you must be but any help would be greatly appreciated as I'm about to lose it!!

    Aneta

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