Reflecting on 2018, I realise that this has been a year of mums asking me when their baby will “self-settle”? (Interestingly no dad has asked me this). I have come across this question in my private practice, at the local Chemists where I give free advice and support and in the Early Parenting Centre, Sydney where I work for NSW Health.
“Self-Settling” has been brought up as a concern by mums with babies anywhere from 6 weeks to 2 years of age and from all walks of life and circumstances. I have found this term “self-settling” being used as a type of “gold standard” for mothers to aspire towards and by which to judge the mothers and their babies that are doing well and those that are not.
This trend leads to parents feeling cross with their baby who cannot yet “self-settle” and feeling like they, as a parent, are failing when they are actually doing a great job as a kind and responsive parent. I am cautious about this emphasis on “self-settling” as the ultimate goal at this stage of life given our knowledge about babies’ needs for touch, cuddling, rocking, comfort and support in their care-giving relationship to promote brain development and attachment in the first 3 years or more. Also I know from professional experience that most babies at some stage in the first 3 years will have trouble with settling at one time or another. I know that the majority of babies in the first year will struggle to settle without parental hands on support or at least parental presence a lot of the time or for at least some sleeps. We also now know that babies do not actually have the capacity to calm or self-soothe when they get upset till at least into pre-school years and beyond without parental support (Gethin & Macgregor, 2011, p.57-58;).
WHAT IS MEANT BY the term “SELF_SETTLING?”
When parents talk about “self-settling” most mean being able to put the baby to bed without cuddling, rocking, or having to spend time as a parent settling the baby prior to sleep, so that there is less parental time involved at sleep time – they can just put them in the cot, bassinette or bed and be able to walk away.
As a mother of four (now adult) children, I understand how tired parents are and I can understand how much they would like this “self-settling” thing to happen but sometimes you can’t rush these things for some babies. Unfortunately, we have changed our lifestyle in the past 2,000 plus years but babies needs have not changed at all. So, we need to work out ways to help them adjust to our lifestyle with empathy, kindness, responsiveness and understanding. Remember we always (as parents) need to be “bigger, stronger, wiser and kind” (Circle of Security principles; www.circleofsecurityinternational.com)
SO WHAT FACTORS INFLUENCE SETTLING FOR INFANTS AND TODDLERS?
First of all, I think it’s important to think about how you as a mum or a dad calm and settle yourself. How hard is it for you? Think about what you need and try to incorporate that into helping your baby settle. For example is there a certain type of music that helps you or perhaps deep breathing (singing actually helps you deep breathe) helps you relax? Also try your best to manage your own feelings. If you are uptight and frustrated it is so much harder to be able to settle your baby down for the transition to sleep (Gethin & McGregor, 2011).
Secondly I think it is always important to think about the baby’s experience in their world. This includes their actual experience so far of settling with parents, their history of pregnancy and birth and their temperament. We also know that medical conditions such as reflux, colic or ear infections can have an impact on settling in that they can disrupt sleep cycles over a longer period of time than the actual duration of illness.
Consider other influences in the baby’s life such as parental style, stress, depression, anxiety and illness. We know that ongoing low-level stress in pregnancy and afterwards can influence cortisol levels in the baby and may affect settling (Gethin & Macgregor, 2011; Stevens, 2017). We also know that parental depression or anxiety in either parent influences the baby and family in a dramatic way (www.cope.com.au) so if this is the case, get help for this before looking at settling as an issue.
Temperament also impacts both parent and baby. Recently I have been assessing temperament in babies as young as 0-5 weeks of age using the Brazelton Newborn Scale (NBAS) (http://www.childrenshospital.org/research/centers-departmental-programs/brazelton-institute/nbas) and realise more specifically how babies are so different in what they can manage and cope with in their life. Some love adventure and learning new skills, others are scared by everything and need to be reassured a number of times and have something presented a number of times before they can manage. Some love social interaction, others are not so keen but love physical play. They all have strengths, needs and weaknesses like adults.
SO WHAT ARE SOME THINGS THAT YOU CAN DO TO HELP YOUR BABY SETTLE MORE EASILY?
Some babies need lots of rocking, singing, wrapping and dummy or breastfeed to feel safe. They just do. Some babies need eye contact or to hold your hand while they are trying to learn to fall asleep at first. It’s ok to rock and settle your baby in arms to go to sleep (as long as they are not getting too big to hold, then you might need a chair) as a transition phase towards helping them be able to settle and re-settle in the cot and feel safe with reduced parental presence over time. Remember your baby will not be the same as your other babies or anyone else’s baby. Sometimes taking the pressure off yourself to get your baby to ‘self-settle’ takes the pressure immediately off the baby and settles everything down a lot.
Babies and toddlers love repetition (it’s how they learn) and predictable sequences of feeding, play and sleep with a transition lead in time help to tell them what is coming next. E.g. dinner, bath, bottle or breastfeed, book, cuddle and lullaby song before bed or, during the day, wind down time looking at the garden or birds – make it simple though as once this is established they will want you to continue with that predictable routine. When you have all this above, you can start to move towards less parental hands on if possible, but that may take time. Respond whenever baby is distressed – yes, vomiting or trying to vomit is a sign of distress – and don’t keep going with any sign of distress – go back to an easier level or just cuddle together until calmness is achieved. Sometimes the pram can be useful and going for a walk if this settling is not working. Just start again next sleep time or start again tomorrow when you feel able or get support to help you with this transition.
Parenting is an art, and each baby is different and needs different skills, so don’t expect to come up with all the solutions. However, know what you are willing and not willing to do when you have someone help with your child. Keep a limit of time to settling and re-settling (of course responding whenever distressed); don’t go on forever and make yourself and your baby miserable. Some parents and babies can manage 10 minutes, others 30 minutes with responsive settling. Remember it is the repetition that helps and changes brain pathways (Stevens, 2017) so don’t worry if you can’t do this for long or if you need to use the pram inside. Often older toddlers may need their parent to lie down in the same room on a mattress next to the cot. There is no ‘should’ and no right or wrong apart from following Sudden Infant Death Syndrome (SIDS) and Safety Guidelines as recommended by NSW Health www.sidsandkids.org. Do whatever works for you and your baby.
LINKS TO SERVICES
These are just a few ideas to help you feel ok if your baby is not settling. However if you are struggling with this issue or depression/anxiety, please go and get help. You can talk to your local Child and Family Health Nurse, or to Tresillian or Karitane help lines and chat lines for Free (back of your blue book). Also look at Beyond Blue website for dads and mums. Dads also have Mensline 24 hour counselling service www.mensline.org.au and Gidget House in Sydney www.gidgetfoundation.org.au also does phone counselling appointments for postnatal depression/anxiety of mums and dads now. Also PANDA (Melbourne) is a great website and phone support.
If this does not help you can try your GP or look for extra help from private services like mine. Feel free to message me on my face book or website – Brazelton Newborn Assessments are currently free!
As you can probably tell from this blog, my motto and ethos is always that “Gentle techniques work best” (Gethin & McGregor, 2011). This is obviously a very brief overview of what can help with settling since every situation is different; so if your scenario is not here, don’t worry. Infant settling issues are often a combination of factors. Remember infant and toddler settling is actually quite complex and can involve looking at diet, milk intake and daily patterns as well as how parents are going in themselves. It is almost never one thing alone so no wonder we often can’t manage it ourselves as parents, but need to talk it through with health professionals and supports.
NEXT BLOG FROM ME
Keep in mind with this article I have not touched on Infant and Toddler Cues, which is also a crucial knowledge and skill, so this will be my focus for the next blog.
Gethin, A & Macgregor, B. (2011). Helping your baby to sleep. Why gentle techniques work best. Finch Publishing. Sydney.
Stevens, H. (2017). Connect to Sleep. Theory and Neuroscience of Gentle Bedtimes 0-12 months. Busybird