Written by Claire Burgess, Family Consultant

Is your baby or child tricky to get to sleep at bedtime? Do they have multiple wake ups during the night? Are they difficult to get to nap?  If any of these things sound familiar, then this blog is for you! 

When supporting parents with their children’s sleep there are lots of aspects that we need to look at including routine, their sleep environment and how you put your little down at bedtime and for naps.  These points can often be the key pieces of information we need to look at in order to be able to help solve any sleep issues that you might be experiencing with your child. 

What is a sleep association?

A sleep association is what your little one needs in order to go to sleep.  We all have associations that help us to sleep; some of these are very individual and specific to the individual and some are much more common. 

Before thinking about your child’s sleep association, have a think about what your sleep associations are - this can often help you to understand what they might be for your child.  So, when you are getting ready to go to bed do you have a specific routine?  For example, do you have a bath or a shower, are there certain creams that you use, at what stage in the process do you brush your teeth? etc.  Then think about when you get into bed, do you need to have a duvet and a pillow, does the room need to be completely dark or do you need some light? Is it quiet or do you need to have some music playing? Do you need to have the TV on while you fall asleep? If you have or do any of these or other things then you have sleep associations.  So now imagine if you went to sleep with all of your sleep associations but then, in the middle of the night, your pillow and duvet are taken away, or the room goes from being completely dark to light.  Would you still be able to sleep? It is very unlikely and you would then be looking for these things in order to be able to go back off to sleep.  This is no different for your child. If for example they are going to sleep with milk or are rocked or cuddled to sleep, they are going to look for this to happen when they stir in the middle of the night to help them go back to sleep. 

When an association can cause sleep issues:

When we are looking at ‘sleep issues’ this is individual to each family.  What is an issue for one family might not be for another, and this is absolutely fine.  I want to make it clear that if you are happy with your child’s sleep and it works for you as a family then stick with it.  However, if you feel that there are issues then let’s see if we can be of some help.

Very often the sleep work that we do with families is when a parent wants their child to go in their cot or bed and settle independently to sleep without needing a ‘sleep association’ which involves them (for example rocking / cuddling to sleep). If you have a child who wakes multiple times in the night or who is tricky to get to go to sleep without a lot of input from you, they are likely to have a sleep association which is impacting on their ability to settle to sleep independently. We want our little ones to feel safe and secure when it comes to sleep and this is something we can create when we are consistent and our responses are predictable. 

Sleep associations which can bring their challenges:

Often sleep associations can be created without us noticing, as when we are sleep deprived we are desperate to find a way of getting our little ones back to sleep.  This can help in the short term, but can quickly become an expectation or routine for your baby / child.  

  Some common sleep associations:

·      Being rocked, patted, bounced

·      Feeding (bottle or breast) to sleep *

·      Dummy

·      Sleeping in bed with parents

·      Rocked in a pram or driven around in a car

·      Needing the parent to be in the room to help them go back to sleep

*Depending on the age of your baby they may need to be fed through the night, but the key is that the feed is to satisfy their hunger and not that baby is using the bottle or breast to resettle to sleep as a comforter (like a thumb or dummy).  

If you identify that your child has a sleep association which is causing you challenges, then it is about weaning them off this and bringing in associations which are predictable and easy to have in place.  This will mean that in the middle of the night your child can roll over, resettle and go back to sleep without the association which is causing them to wake (and without needing input from you). 

Healthy associations:

It is important to note that there are healthy associations which you can introduce.

Babies and young toddlers

• Predictable bedtime routine – having a predictable bedtime routine is one of the first places we start when looking at solving any sleep issues for little ones.  Having the same routine every evening to help your child to settle to sleep will absolutely help. 

• White noise – if you are going to use white noise then the key is to make sure that it is constant all night and for the whole nap time.  Devices which switch off after 30 mins or come back on when your baby or child stirs are not ideal…they also run out of battery very quickly!! There are some great white noise machines on the market and, because they are also portable, you can take them on holiday with you or when visiting friends and family. White noise can be used up until your child is 2 or 3 years old, and older if needed. 

• Comforter – this can be a cuddly toy or muslin etc (but just remember the guidelines on keeping a clear cot for babies https://www.lullabytrust.org.uk/safer-sleep-advice/clear-cot/).  If you are going to have a comforter then make sure that you have more than one of them in case one goes missing!! If your child associates the comforter with being what they need to settle off to sleep, it often means that during the night when they stir they will reach out for it and then go back off to sleep.  When settling your baby or child to sleep for bedtime or naptime then give them the comforter during that last cuddle with you before going into their cot or bed.  Put them into the cot or bed with the comforter and they will then use this to help settle off to sleep. 

• Naps – Aim to have 80% of naps in the cot if you can - the sleep they have is much better quality than it is in the car, pram etc. Try to have a short nap time routine (similar to the one you have at bedtime) so that your child is able to predict that sleep time is coming and they will naturally start the wind down to sleep. If you have white noise, a sleeping bag etc for night-time sleep where possible make sure that this is also in place for daytime naps and you will find that you will have much more settled nap times. 

• No light or some light – Having a dark room will help with your child settling off to sleep, but also helps to stop early morning wakings due to light.  Check out our videos on our social media accounts to see how dark your child’s room should be!  If you are using a nightlight then you need to make sure that the light is red rather than blue, yellow or white.  Red helps to ensure the sleep hormone continues to be released and your little one will hopefully stay asleep! 

Older children

Often as children get older and are in a bed they find this new found freedom exciting, but also a little overwhelming.  This is often the time that you will see changes such as:

• Wanting to have you in their room until they go to sleep

• Waking in the night and going into your room/bed

• Not settling at night and getting up frequently

These are all natural and normal responses to the new situation but it is about how we respond that will help them through this.  The boundaries have changed (quite literally as there is no longer a barrier around them) and they need to work out what the boundaries now are. 

Top tips for older children:

• As above, have a good, predictable bedtime routine. Don’t make it too long or too short. Your child needs to feel comfortable and at ease with going to bed and a bedtime routine will help with this. Do try to keep to this as much as possible.

• Decide what you are happy with. If it is ok for your child to come into your room at night and get into bed with you then that is absolutely fine – it is only a problem if it is a problem for you. Be clear with your child about the boundaries and make sure that you explain this to them every day so that they are getting a consistent message.

• Have an incentive for the next morning. It might be that they say what they would like to do when they get up in the morning and, if they have been able to follow the new boundaries that have been set, they get to do this. It doesn’t need to be rewards in gift form it can be as simple as choosing a game or a book, making a fun breakfast etc. Keep it as positive as possible, we don’t want children to worry about bedtimes but they also need to know what to expect.

• There are lots of books which are great for reading with children about sleeping in their own bed.

• Introducing some sort of comforter which they snuggle down with each night and if they wake in the night this is what you encourage them to reach for. If you are returning them to their bed in the night, try to encourage the comforter by helping them to snuggle back down and giving them the comforter.

If your child has an association which is not working for them or you then it is about gently changing the association to something which works for all of you.  It might take a little time for this new association to form, but it will if there is consistency with the approach that you choose.

Sleep is important for all of us and we want to create healthy sleep associations for our children so that they continue these for the rest of their lives.  For more hints and tips regarding sleep check out our 3 part sleep blog series:

Is your baby sleeping like a baby?

The Early Riser

Sleep and older children

For more information about Sleep you might be interested in ‘Your Guide to Sleep’ - a step-by-step video guide - click here to find out more!

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