Case Study: Poppy
Unable to settle
Poppy was a lively toddler who was developing beautifully despite having been born two months prematurely. As all babies are, Poppy was very precious indeed to her parents, and they were afraid that any form of sleep training would be not only detrimental to her but also traumatic for them. Despite having a great bed time routine, Poppy was waking 45 minutes after being going to sleep in her cot. She had invariably lost her dummy, and needed one of her parents to find it for her and help her to re settle. She subsequently woke up and needed help with settling up to 4 times later during the night.
After some discussion, it was clear that Poppy was over dependent on a dummy to help her to sleep. This was particularly problematic when she had a blocked nose due to a cold or a teething episode. When she fell asleep, the dummy fell out of her mouth, and when she woke during the light phase of a sleep cycle, she felt something was missing and couldn’t re settle without it. She had also come to expect the ritual of contact with her parents when she woke in the night.
Andrea asked Poppy’s parents to choose one of two options:
- To teach Poppy to manage her dummy more effectively
- To help her to learn how to get by without it altogether
Her parents chose the second option.
Introducing Sleep Triggers
In order for Poppy to sleep through the night, she therefore needed to do two things:
- Learn how to sleep without her dummy. This was to be achieved by tightening up her bed time routine, so that it became a clear system of little sleep triggers. Part of the routine would include a familiar goodnight story. This routine and the sleep triggers would very soon perform the same soothing function as her dummy – but were better for her and would promote more peaceful sleep. Learning to sleep without her dummy was to be taught at the beginning of the night, and then reinforced when she woke during the night. As Poppy learned to fall asleep without her dummy, one parent was asked to stay beside her to minimise her stress. After two nights, her new bedtime routine would be established and she would have learned how to fall asleep without the dummy in her mouth. On the third night, her parents needed to gently withdraw and allow Poppy to fall asleep alone.
- To stay in her cot and overcome her expectation of cuddles and contact with her parents during the night. Poppy’s parents needed to support one another and be calm and resolved about this. For the first two nights, each time she woke in the night, she had to be comforted back to sleep in her cot. After this time, if she continued to wake up, they were to go to her and reassure her very briefly before leaving her to self settle. Andrea knew though, that once the dummy was gone and that Poppy had stopped expecting to get out of her cot during the night, it was unlikely that she would wake on the third night.
Unbroken night’s sleep
On the first night of Poppy’s sleep plan it took her fifty minutes to settle to sleep. As expected, she cried a lot and spent a long time standing up, rattling the bars of her cot. Even though her parents found this very difficult, they managed to remain calm and resolved. Once she had gone to sleep, she did not call out until three am. This seven hour stretch was the longest period that she had slept since her birth! Re settling Poppy at 3am took over an hour, but her crying was not as distressed as it had been at the beginning of the night. She woke up for the day, happily at 7.30am. On the second night it took Poppy 20 minutes to settle alone and without her dummy. Her parents took it in turns to go to her, in order for her to realise she would receive the same calm consistent response from each of them. At five am, she briefly stirred and called out, but managed to settle back to sleep before her parents got to her! Since then, apart from odd periods of illness, Poppy has slept through the night.