Ask Malia: Gently Shifting a Nurse-to-Sleep Association

Dear Malia,

Okay, I finally found the charger to my Kindle and read your e-book. I have to say it the best to-the-point sleep book I have read. I do have some follow up questions if you don't mind. For history into our lives, our son is 12 months typically takes two naps a day at 9:30 and 2:30. Some days he will take one nap for 2.5 to 3 hours. I work and my husband stays home. He usually goes down for naps well, but it’s the bedtime we are struggling with. We have a routine of bath, diaper, sleepsack, pacifier( he only uses the pacifier for sleeping), up to three books, four songs (same each night), nursing, then rocking (now patting) then in his bed...this is where the trouble starts. He gets drowsy during the routine, but he usually starts squirming in bed and then pops up and starts crying.

Right now I leave at the end of the 4th song and he stands and cries. I let him cry for five minutes then go back in find his pacifier (which he has thrown somewhere), pick him up and for sit in the rocker until he is drowsy again and then back to bed pat and pat. By now there is no music cue for me to leave, so I stay and lay him back down if he stands up and pay his back/bottom. I usually continue like this for 10 to 20 minutes until I get really frustrated and have to leave because I feel like my anxiety is keeping him up. I let him cry another five minutes and then back at it, same process again. Sometime I throw in more nursing. He eventually falls asleep but it can take an hour to two hours, and he can be so overtired that he is hysterical and nothing calms him down. If I am at my white end my husband goes in and bounces him to sleep.

We start the routine at 6:30 to 700 and finish about 8:00 to 9:00. We have tried our best to make the room dark but there are cracks in the door we can't do anything about (old house). In terms of night sleeping he sleeps in his crib all night long about 3 to 4 nights a week. The other nights he wakes up and starts crying so my husband goes and gets him and brings him until our bed where he sleeps until morning. About 90 percent of the time, I nurse him when he comes into our bed. Every once in a while he has a bad night and is restless and wakes up in the middle of the night for an hour or so, but I have blames that on teething because once I put on his amber necklace he calms down and goes to sleep. Any suggestions on any of it? Thank you.

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Hi there. I do have some ideas as to what might be going on. First, I believe he might be a bit undertired when you are putting him to bed. Have you checked out this blog post of mine on how to tell the difference between overtiredness and undertiredness?

I also believe that he has a nurse-to-sleep association—your statement "Sometime I throw in more nursing" was my clue, because I was looking for what it is that eventually helps him get to sleep. He's fussing around, on-off crying and basically holding out for you to give him what he wants so he can finally go to sleep.

Your statement that you nurse him 90 percent of the time when he comes into your bed is another clue that he is depending on nursing to get him back to sleep, and basically forcing himself to stay awake or nearly awake until you do that.

Please read the chapter in Ready, Set, Sleep on breaking a nursing-to-sleep association. After reading that, please let me know if you have any questions about that process. This blog post on helping babies learn to sleep in their own beds (without resorting to letting them cry) may also be helpful.

To gently work toward a better bedtime, I suggest nursing earlier in his bedtime routine (right after pajamas but before stories, for example), ensuring that he does not fall asleep while nursing, and patting him or rocking him fully to sleep before leaving his room. As I describe in Ready, Set, Sleep, soon you'll begin shaving minutes off the time you're spending patting him. Eventually you will be able to put him down, pat for just a moment or two (or not at all), and then walk out.

Also, and this should be good news, I think he will make a quick transition to going down easily once you correct the nurse-to-sleep association.

To do this, I recommend that your husband perform the final steps of the bedtime routine for the next couple of weeks so you are not tempted to give in and nurse him.

I also suggest going into HIS room to attend to any night wakings there, without bringing him into your room. This is so you won't end up nursing him back to sleep. Not to say that you cannot nurse him if he wakes and you feel he is hungry (though at 12 months you probably know that is not likely hungry at night if he's eating enough during the day). If you do choose to nurse him at night, make sure you are not nursing him back to sleep, and that he gets put back into his own bed.

Once the nurse to sleep association is fully broken and you find the right bedtime for him, my expectation is that he will sleep through the night.

Also as you probably know if you read my work, I'm not a fan of three-hour naps, ever. They cut into nighttime sleep and often result in nighttime awakenings and really difficult nighttime sleep problems. Also, two-naps per day is age appropriate for him. Most babies transition to a single nap (of 1-2 hours) around between 15 and 20 months.

Hope this is helpful. Let me know if you have more questions!

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