Night settling vs bedtime settling: what is the difference?

Today I answer the following question:
“Why is night settling different from naps? Got a 5mo who behaves differently settling for day naps and night wakings. He self-settles for nap time and bedtime, doesn’t use a dummy just has a comforter. Night wakings are a different story! Last night he woke every 1.5 hours, usually it’s every 2 hours and won’t be settled by hand on chest, wobbling, dummy or comforter. He only wants to nurse, so I feed him. I’m so aware he doesn’t need that many feeds, but I’m so tired I’ll do anything to go back to sleep!” 

Hello everyone, it's Anna. Thank you so much for tuning in today. You are listening to The Baby Sleep Project Show: the place to learn about baby sleep and sleep coaching.

Today, I'm answering a question that a listener sent to me. If you would like your own questions to be answered on my show, then I have a new page for you where you can submit your questions. The address is www.thebabysleepproject.net/submitquestion. So it's www.thebabysleepproject.net/submitquestion.

So today's question is the following: “Why is night settling different from naps? Got a 5mo who behaves differently settling for day naps and night wakings. He self-settles for nap time and bedtime, doesn’t use a dummy just has a comforter. Night wakings are a different story! Last night he woke every 1.5 hours, usually it’s every 2 hours and won’t be settled by hand on chest, wobbling, dummy or comforter. He only wants to nurse, so I feed him. I’m so aware he doesn’t need that many feeds, but I’m so tired I’ll do anything to go back to sleep!”

Okay, so this was the question. And before I answer the question, let's look at the background of this question. So why is this mother surprised by the behavior of her baby? And I think it's because sleep training is based on three assumptions and these assumptions are mainly true, but there are some exceptions and we will go through that.

So the first assumption is that night wakings are most often caused by problematic sleep associations. The second assumption is that problematic sleep associations can be removed by sleep training. And the third assumption is that after the baby learns to self-settle, they won't need parental help to fall back asleep in the middle of the night, thus, there will be less night wakings.

So let's go through these assumptions and see if they were true. So the first assumption: Night wakings are most often caused by problematic sleep associations. So this is probably true. I don't have numbers. I don't know how, what percentage of baby sleep problems are caused by problematic sleep associations. But if I have to guess, I would say that the majority of sleep problems are caused by problematic sleep associations. Of course, night wakings can be caused by other things, and you should always rule out these things before you start sleep training. And these could be an inappropriate nap schedule or feeding schedule, discomfort due to hunger or baby is too hot, too cold, noise from the environment, too much light, et cetera. Okay. So after you rule out these problems, the next step is usually sleep training on the sleep coaching journey.

So let's talk about sleeping associations first. So sleep associations are stimuli from the environment that we associate with sleep. They put us in the mood for sleep and help us fall asleep. For adults, it is usually their bed, their pillow, the smell of the bedroom, maybe their partner in the bed, et cetera. Now, we tend to wake up briefly between sleep cycles. We notice our environment and if everything is normal, the same as it was before we fell asleep, we go back to sleep and we don't even remember waking up. And babies do the same.

Now I will quote a paragraph from my book because I think it explains it pretty nicely, so... "But if something is different or out of order, we notice it and wake up completely to fix it. We can only go back to sleep easily, if our environment is as usual. Imagine going to sleep in your bed, then waking up in the middle of the night on the kitchen table. Wouldn't you freak out wondering what happened? Would you try to go back to sleep on the table or would you climb back to your bed instead? You would probably feel confused, afraid, unpleasantly, surprised, and even angry at the person who did this to you. Well, this is how babies might feel when they fall asleep in their parents' arms and wake up alone in their crib."

"So what are those problematic sleep associations? Basically anything that is present when the baby falls asleep, but it is not available throughout the night. Most usually it is the parent herself, or sucking on something or perhaps movement (rocking). The idea is to replace these sleep associations with something that is available for the baby throughout the night, like the crib, a nightlight, a lovey (after one year of age), sucking their thumb or a pacifier. You (or your breast) can be your baby's sleep association, if you co-sleep and you are prepared to be there the whole night (however co-sleeping is not recommended under under one year of age for safety reasons)".

Okay? So that was assumption number one. So night wakings are most often caused by problematic sleep associations. And now we know how problematic sleep associations can cause night wakings. Okay. Let's look at the second assumption, which is: Problematic sleep associations can be removed by sleep training, and I will quote my book again.

"So, If sleep associations are the cause of your baby's sleep problems, there are two things you can do. Either you change your habits, so that you can provide the same sleep associations throughout the night, or you break the unwanted sleep associations. The latter is the main goal of sleep training. Sleep training in theory is very simple: You stop providing sleep associations that cause a problem, when the baby falls asleep. This process is called bedtime sleep training. The goal is usually to teach the baby to fall asleep independently (this is also called to self-settle), without parental help (and this is when the dreaded sentence of all sleep training gurus comes up, "place your baby in the crib, drowsy but awake"), but keep in mind that more broadly it can mean anything that teaches the baby to fall asleep without sleep associations that cause a problem for you."

Okay, so that was assumption number two. So, basically it says that by.. with sleep training you can remove these problematic sleep associations, whatever these are for you. So if you would like your baby to fall asleep without you, then this means that the baby should learn self settling or falling asleep independently, without your help. And that is what, the goal of sleep training is.

Okay, let's look at assumption number three: After the baby learns to self-settle, they won't need parental help to fall back asleep in the middle of the night, thus, there will be less night wakings.

Okay. So the goal of sleep training is to remove these problematic sleep associations and to teach babies to self-settle and fall asleep independently. Depending on when you do sleep training, we can differentiate between bedtime sleep training, nighttime sleep training, and naptime sleep training. Usually, parents start with bedtime sleep training, and they expect that after learning to fall asleep independently at bedtime, their babies won't wake them up to help them to go back to sleep in the middle of the night.

But, unfortunately, not all babies transfer the knowledge of self-settling from bedtime to nap time (and night time). So if it doesn't happen automatically, you have to do nighttime sleep training. And of course, the same can happen with naps. So it is possible that your baby can fall asleep independently at bedtime, and he doesn't wake up in the middle of the night, but maybe you will have to do sleep training on naps separately.

So I think this surprise and misunderstanding, and the question comes from the misbelief that bedtime sleep training always solves the problem of night wakings. And it is true most of the time, but unfortunately not always. Okay. So nighttime sleep training would most probably solve your problem, but before you start nighttime sleep training, I have two tips for you, dear listener.

Tip number one is that nighttime wakings can be caused by changes in the environment. More specifically, not exactly nighttime wakings, because those are absolutely normal, but, changes in the environment can cause problems with going back to sleep. So maybe your baby falls asleep independently, but something changes in the room from bedtime to nighttime.

Maybe you leave the door open and a little light comes into the room from the hall at bedtime, but you switch the light off when you go to bed, so when the baby wakes up at night, it's completely dark. Or maybe the TV is on at bedtime, but the house is completely silent at night. So you can see that anything in the environment can become a sleep association. So maybe your baby is used to fall asleep to the sounds of the TV. And he cannot fall asleep in the middle of the night when the house is completely silent. So my advice is to keep everything constant, to help your baby transfer the knowledge of self-settling from bedtime to nighttime. So think about the environment, think about what's going on in your house during bedtime that might be absent at night. Okay.

My second tip is that your baby might be genuinely hungry. So you mentioned that your baby just wants to nurse, does he fall asleep easily after nursing? A five months old baby probably still needs night feedings, although probably not every two hours. So if I were you, first, I would try to make sure that the baby is not hungry at night.

So dedicate quiet time to feedings during the day so that your baby is not distracted and can eat enough. It happens very often that newborn babies can eat whenever and wherever, but as they get more, receptive to their environment, everything, especially social cues, other people around, or noises can distract them from eating. So they might stop feeding when something interesting in the environment happens. And you might think that the baby's full and he doesn't need more milk, but that might not be the case. It might be the case that he was just distracted by something in the environment.

The other thing is that you should try to fill him up before the night. Try cluster feeding before bedtime. So that's when you feed your baby more frequently before bedtime. Maybe you, um, maybe you introduce an extra feeding between the two regular feedings, or an extra feeding just before bedtime. And also you can try dream feeding before you go to bed. So that's when I suppose the baby goes to bed earlier than you do, but before you go to sleep, you try to feed your baby in his sleep. Not all babies can do this, but many babies are perfectly happy feeding half asleep. And that way, you can save yourself one night feeding.

And the third thing is that if you have started feeding your baby solids. I'm not sure some experts recommend that four months, others command at six months, so it's possible that you have already started solids. Make sure that he still gets enough breast milk or formula, especially before bedtime. Because solid food, especially the vegetable purees most babies eat, those are less calorific, so contain less calories than breast milk. So you might feel like your baby has eaten enough because maybe he has eaten a lot of vegetable puree, but calorie-wise, it might not be enough for him to sustain him throughout the night.

And the fourth thing is that it might be that it is just temporary. Okay, so it might be the case that there's no problem with your feeding schedule, that your baby would usually be satisfied with daytime feeds as they were, but maybe, just temporarily, he needs more. So maybe your baby is going through a growth spurt, which means that he needs more calories, just for now.

So, my advice is that first you make sure that there are no changes in the environment. Second, you make sure that your baby is not hungry. And if this doesn't work, then you should try nighttime sleep training.