Case Study: Lucas
Broken night’s sleep
Lucas was a well grown baby who was enjoying solids and developing well. At bed time he was settled to sleep with a breastfeed and was then transferred to his cot. He would wake up anytime from half an hour to two hours later in a very upset state. The only way that he could be comforted was by being breastfed back to sleep. At each waking, he would become increasingly difficult to settle, until his parents moved him into their bed in the early hours of the morning. Here he would settle but continue to breast feed at each light period of his sleep cycle.
Unable to settle
Andrea explained to Lucas’ parents that it is quite normal for babies to wake at night. His difficulties were down to the fact that he was unable to re settle without help. His parents were concerned that he was hungry, and they needed to be reassured that he was feeding purely as a sleep prompt. They also learned that he was not able to accept his cot as a safe and permanent sleeping place. This was because he only ever went into it when he was asleep. Each time he woke, he felt alarmed to find himself in a strange place and he cried. The natural response of his parents was to remove him from his cot, and bring him to their bed, where he was comforted and fed back to sleep. He had learned that the right and proper place for his sleep was in bed with his Mum and Dad!
Establising a routine
In order to help Lucas sleep through the night, the family needed him to:
- Fall asleep in his cot at the beginning of the night aware of being in his cot. For the first night or two it was enough that Lucas was placed in his cot to fall asleep. Andrea advised that one parent should remain beside him until he fell asleep. As he became accustomed to falling asleep in his cot, they were to gradually withdraw their contact.
- Drop his night breast feeds and lose his suck/sleep dependence. This was to be achieved by limiting the duration of his feeds, so that he stopped feeding to the point of sleep. The shortened feeds would also help to wean him off having a full tummy during the night.
- Overcome the expectation of the transfer to his mum and dad’s bed and to learn that his cot was his safe and permanent sleeping place.
Peaceful night times
Once Lucas’ parents understood the reason for his frequent waking and feeding, they felt confident about tackling his sleep problem. They were relieved that they did not have to leave him alone to cry.
On the very first night of sleep training, Luca cried for half an hour at the beginning of the night. At no time during the crying was he left alone, however, and his parents understood that the crying was down to frustration and not fear or feeling abandoned. Even on the first night, however, he slept for a four and a half hour stretch, in his cot, which was longer than he had ever done. He still, woke twice more in the night and was re settled back into his cot after the recommended short feeds. There was little or no crying when he went into his cot. Although the two short feeds were hard going, Lucas’ mum was used to very little sleep, and realised that she was now using her time with him during the night in a much more positive way. On the fourth night of the plan, Lucas’ mother stopped feeding Lucas altogether. Instead, she went to him, re positioned and reassured him and then left him to re settle without her. Given that he now had the skills to sleep without the breast in his mouth and was no longer expecting to come in their bed, Lucas settled very quickly.
On the fifth night, his parents were delighted that Lucas slept through the night from 7pm until 7.30am. He has managed to maintain his good sleep habits, and the family now enjoy peaceful nights.