Sleeping FAQ: 12-18 Months – Settling/Sleep Associations

1-year-old Jake cannot sleep without a dummy or a drink.

I have just read your book given to me by a friend. I feel we have made some major mistakes with Jake’s routine. Jake is now a year old and still does not sleep through the night. That is an understatement – he wakes up to ten times a night. He was weaned at 6 months and went on to soya formula milk which was recommended by his paediatrician. He was introduced slowly onto solids and it went very well. At this stage (6 months) he was waking two to three times a night to feed. He then got sick shortly afterwards and was hospitalised for a night owing to his dehydration. Since then he has slept terribly, waking every half an hour to hour in the night.

We used a dummy since birth and he goes to sleep with it in his mouth. He will often wake crying and all he wants is the dummy back in his mouth. When he wakes in the night all he needs is either a drink of formula or some very diluted fruit juice, or the dummy back in his mouth. So far he completely refuses to drink water!

His daily routine is as follows:

He wakes at around 6:30-7:00am and has breakfast at around 8:00am. This consists of cereal and some fruit. He has his first nap around 9:00am for about an hour. He is then very active until around 12:00pm. At 12:00pm he has his lunch. This consists of protein and some starch. He has his second sleep around 2:00pm and this usually lasts around 45 minutes. He is active again in the afternoon. At around 5:30pm he has his dinner. He is then bathed at about 6:30pm. From around 7:00pm we try to get him to go to sleep. He will never fall asleep on his own, or in his cot. How he usually falls asleep is with me on the couch, or lying with him on my bed. Once asleep he is carried to bed. He never drinks that much before bed but does drink his juice all day.

We have let him cry a few times but he works himself into such a state that he has vomited in the recent past. A few nights ago we left him crying for over an hour at about 1:00am. We felt so bad however that we eventually picked him up.

Both my husband and I work and we are desperate to get some sleep. During the morning (when I am working) he is with his nanny. They often come to work with me.

We would love some advice on controlled crying and what it is exactly, and some ideas on what to do to get our son to sleep at night. We would also love some advice on how to get rid of the dummy he is so attached to.

Many thanks and I look forward to hearing from you,
Jess

There are several different issues which need to be altered so you find life with your son easier. He has learnt the wrong sleep associations; a dummy and having someone with him in order to settle. He also seems to have a fairly high intake of fluids throughout the day and night. By drinking juice all day he is not really hungry for his last feed before bedtime. If he took a 6oz bottle then he may well sleep better.

Not knowing how much formula he takes in the night makes it difficult to know if he is waking through hunger or habit. If his high intake of juice during the day is limiting his formula and solid intake you must begin to cut it down. Offer Jake a drink in the middle of the morning, no later than 10am. Make it of well diluted juice and no bigger than 6ozs. After half an hour remove it. Offer him a drink when he has eaten at least half of his lunch, rather than at the beginning. In the afternoon offer him a drink no later than 3pm and again remove it after half an hour. At dinner offer him fluids after half his solids have been eaten. Make a note of how much he is drinking this way. I am sure you will find he is more interested in his bedtime milk.

In order to get him settled in the evening, continue with your bath and bedtime routine but give him his milk before you settle him for the night in his cot.At his age, Jakes fluid intake needs to be about 1.1 litres [2 pints] but this is composed of drinks such as formula and juice and also soups, mousses, ice cream, jelly. Fruit and vegetables also provide some fluid. If you keep a food diary for a week you will see how much fluid Jake is taking in the form of juice and how it may be affecting his daytime intake of food which is causing him to wake hungry in the night.

You may decide to tackle one problem at a time during the night. I suggest you start with getting him to settle asleep alone in his cot at 7pm. If he continues to need juice or formula in the night begin to dilute the feeds down gradually so he is given more water than juice or formula. At the same time you can begin to settle him in the same way as you have been doing at 7pm (see below) so he learns to get back to sleep without a bottle of juice or formula.

To get him to settle alone, without his ” props” of a dummy and you, you will need to put controlled crying in place. As you want to get him to give up his dummy I would “cold turkey” with it as you begin to sleep train him.

A very detailed description of this method can be found on page 45 of The Complete Sleep Guide. Both you and your husband must be committed to this method and not resort to picking Jake up. Rather than leaving him alone crying for long periods of time, controlled crying means you leave him for certain time, just 5-10 minutes to begin with before checking him and reassuring him. Reassurance must be kept to the minimum without picking him up and then you leave the room after 2 minutes, even if he still is crying. Return and repeat this procedure in another 5-10 minutes. After the first half hour begin to lengthen the time between visits to 10-15 minutes. Continue to do this until Jake falls asleep.The next day use the same method for getting Jake to sleep at nap times. Refer to The Complete Sleep Guide to see how to continue.

As you will have seen from the routines, the longest sleep of the day should be over lunchtime -12.30-2pm. This coincides with a baby’s natural dip in alertness. In the morning see if you can get Jake to have a shorter nap of about 30-45 minutes. Because he is awake a lot in the night he is catching up on sleep in the morning. Once you see an improvement in his night time sleep this should be easier to implement.

Although you may feel overwhelmed by the ideas given here, if you are really committed to them Jake will learn to sleep through the night. It would be a good idea to check with your doctor before attempting sleep training, to make sure Jake is healthy. Also see if your health visitor could put you in touch with a sleep clinic which specialises in problems such as yours.