May 15, 2012

How to: Help Your Breastfed, Co-Sleeping Baby Sleep Better

Earlier today, I shared this story on the Facebook page of a breastfeeding support group I participate in, and I've received positive feedback so I thought it might be useful to post on my blog  My hope is that other families who co-sleep, nurse to sleep and experience frequent night wakings that are soothed back to sleep only by nursing can gently encourage their little ones to sleep longer. I'm not a medical, sleep or lactation professional - this is simply what has worked for us and I'm sharing it in hopes that it might work for you too.
Given others here have been very helpful in giving me advice on breastfeeding related concerns, I thought I should share how sleeping is going at our house (two wakings last night in ten hours and a similar stretch of nights last week before the onset of the nine month growth spurt) in the event that some of the the things that worked for us might work for some of you too in similar situations (baby waking every two hours or much less looking for a nipple to soothe back to sleep).

Our son sleep regressed from waking once a night at 2:30 am to waking every 30 minutes or less at four months. Slowly he's gotten better (every 45 minutes, every hour, every hour and a half, every two hours and now every three or more hours).

I searched online everywhere, but couldn't find clear advice on how to help a breasfed baby who nurses to sleep and who co-sleeps to sleep better while continuing to nurse to sleep for bed in the first instance and co-sleep. So I spent a lot of time observing him sleep and watching what happened when he woke up. It was clear that he would always stir and move at the end of his sleep cycle, which is the only time he would wake up. So I knew if we wanted him to sleep longer than that, he'd need to be able to stir and then go back to sleep without a nipple in his mouth.

Here's what we did to gently guide him to sleep better:

1. I have always offered the breast upon waking, so I continued to do so because this is his routine. However, I started by unlatching him during the most difficult waking of the night for me (normally the one between 11 pm and midnight) after his sucking had slowed and his eyes were closed. I would always hold him close (which he likes) and say "shhhhh" as I did this. Sometimes he would cry for a few seconds and then go to sleep, other times he seemed to already be asleep and other times he would cry so much I'd need to relatch him. If I relatched him, I let him suck until he fell off the breast. I think this helped him be able to sleep since he was drowsy but not fully asleep and gained confidence in his ability to fall asleep on his own.

2. My husband would take a shift at night during one or more of the wakings most nights. He'd walk, pick him up, sing etc. (whatever he had to do) to get our guy back to sleep. If he wasn't asleep within 30 minutes or he didn't stop crying, I stepped in and nursed him back to sleep. But he most definitely learned through this process that he could fall asleep with Dad. This was helpful since he now often rolls over to Dad for a back rub (see how we started to include this in the night routine below) at night when he wakes or stirs.

3. I combined nursing at night with a gentle head rub (which I found calming for both of us) or back rub. This way the gentle head rub or back rub became part of the falling back to sleep routine, and we could then (many times) use this to put him back to sleep without needing to nurse. We did the same thing with lullabies, so they became a way to put him to sleep as well.

4. I always fed him if it had been three hours or more since his last feeding (the typical amount of time he goes between feeding during the day). I also saw he slept longer when I nursed him on both sides. So I started to unlatch, roll him over my chest and relatch him on the other side after about 15 minutes. The rolling across the body woke him just enough for him to feed a little more. This has helped avoid frequent wakings due to hunger.

As we more frequently put him back to sleep with a little back rub or song, we saw he was sleeping longer. I think this is because those activities required a greater ability on his part to fall asleep on his own. Last night, I watched him for more than three hours. He sat up a number of times, rolled over etc. but each time he went right back into a deep sleep without calling for me. It was amazing. In January I never thought we'd get there. I hope some of these tips help.

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