Solutions to sleep concerns (11) - babies 6 to 12 months

Sleep concerns and your baby

If your baby’s sleeping patterns are not affecting you or your family and you have strategies that work, then you do not have a sleep concern. If your baby's sleeping patterns are having a negative impact on you or your family and this concerns you, then you have a sleep concern.

The following definition of ‘severe night waking’ provides a guide – however, you know your baby the best, and if something is a concern for you, you should seek help and advice from your local maternal and child nurse or the Maternal and Child Health Line on Tel. 13 22 29.

Severe night waking is when your child does one or more of the following things 5 or more times a week for 1 to 2 weeks:

• Consistently wakes more than 3 times a night.
• Consistently takes more than 30 minutes to settle.
• Stays awake for 20 minutes after waking.
• Goes into the parents’ or caregivers’ bed.
• Has difficulties with sleep and settling that is causing parents or caregivers significant distress.

Looking after yourself

All babies cry and sometimes their crying may be difficult to soothe. If you need to take a break, place your baby in their cot or another safe place and take a break for a few minutes. Your self-care is important.

If you have a sleep concern, you should talk to your maternal and child health nurse and your doctor to make sure there are no underlying health issues.

Strategies to help your baby sleep and settle

From approximately 6 months of age, babies’ sleep patterns gradually begin to become more like adults. They tend to sleep for longer periods during the night as they do not need to be fed as often.

Every baby is different, and some babies may continue to wake overnight.

Parents are encouraged to be responsive to the needs of their baby. Responsive settling is recognising that your baby needs help and responding appropriately.

You can do this by knowing your baby’s cues, tired signs and the intensity of their cry. It is important that your baby knows you are emotionally and physically available if they become distressed.

Developing positive sleep environments and routines can also support your baby at bedtime.

Every baby and family are different, and you need to use a strategy that you feel comfortable with and suits your baby and family.

Helping your baby sleep with parental presence

Parental presence aims to use presence as a way of helping your baby to self-settle.

Research shows this strategy is effective, but it may take longer than other strategies to reduce sleep concerns.

It is also more work for parents, as you need to stay in your baby’s room for 7 to 10 days whenever your baby is awake, so they know you are there.

However, you do not interact with your baby – the aim is to break the link between baby’s sleep behaviour and your attention.

How to use parental presence

• Decide on an appropriate bedtime.
• Start a positive bedtime routine (such as a warm bath and reading a book).
• Place your baby into their cot, preferably while still awake or drowsy.
• Gently pat your baby and say good night.
• Lie down on a bed or mattress in your baby’s room with a night light on and pretend to sleep where your baby can see you.
• If your baby wakes during the night and is distressed, make slight noises or movement (such as coughing or turning over), so your baby knows you are there.
• If your baby becomes very distressed, soothe them with gentle words and by touching them – but try not to pick them up.
• After one to two minutes, lie down and pretend to sleep.
• Continue doing this every time your baby wakes and is distressed. Repeat the process for day sleeps and naps.
• Continue with the strategy for 7 nights.
• After 3 nights in a row of minimal sleep disturbance, you can return to your own room.
• If your baby’s sleep becomes disrupted again, you can re-introduce the strategy.

Helping your baby sleep by camping out

Camping out is similar to the parental presence strategy. It may be useful if you don’t want to sleep in your baby’s room but find it hard to leave your baby to cry even for a few minutes.

If you use this strategy, it may be one to three weeks until your baby can go to sleep by themselves.

You will be more successful if you plan ahead and take time to progress through each camping out step:

• Decide on an appropriate bedtime.
• Start a positive bedtime routine (such as a warm bath and reading a book).
• Place your baby in their cot, when they are tired, but still awake and say good night.

Camping out steps

Try each of these following steps in order. Be patient, your baby may need some time to adjust to settling in this way. Each step may take 2 to 3 nights – it’s important that you and your baby feel comfortable before progressing to the next step.

1. Lie or sit next to your baby and gently pat or stroke them until they go to sleep, then leave the room.
2. Place a chair beside the cot and sit without touching. Allow your baby to go to sleep before you leave the room.
3. Sit at gradually increasing distances from the bed. Allow your baby to go to sleep before you leave the room.
4. Eventually, place the chair outside the bedroom door.

If your baby wakes, repeat the step you used at bedtime, to help them learn to self-settle.

Responsive settling

The responsive settling method (also known as controlled crying and checking method) has been widely used for many years. To be effective it needs to be done correctly.

If you have tried these strategies and there is no improvement after 2 to 3 weeks, talk to your maternal and child health nurse, call the Maternal and Child Health Line on Tel. 13 22 29 or see your doctor.

Information in community languages

This fact sheet is available for download in the following community languages:

Maternal and child health nurse visits are important

Victorian parents have free access to the Maternal and Child Health Service, which is a great support after your baby is born.

Specially trained maternal and child health will work with your family to help you care for your child until they are ready to start school.

As part of this service, you will visit a maternal and child health nurse in your local area at 10 key ages and stages in your child’s development. These visits are important because they you an opportunity to identify and address any issues and concerns early in your child’s development.

Visits take place:

• following discharge from hospital (home visit)
• 2 weeks
• 4 weeks
• 8 weeks
• 4 months
• 8 months
• 1 year
• 18 months
• 2 years
• 3 and a half years

Families can access the service at other times by telephone or through a centre visit.

Where to get help

• Your local maternal and child health service
• Your GP (doctor)
• Maternal and Child Health Line Tel. 13 22 29 – available 24 hours a day for the cost of a local call throughout Victoria
• Mercy Health O’Connell Family Centre, Canterbury Tel. (03) 8416 7600
• Mercy Health Woi-wurrung-yagila-wulumperi Whittlesea Early Parenting Centre, South Morang Tel. (03) 9407 6820
• Queen Elizabeth Centre (QEC) Tel. (03) 9549 2777
• Tweddle Child and Family Health Service, Footscray and Werribee Tel. (03) 9689 1577
• Aboriginal Health Service (VAHS) Tel. 03 9419 3000
• Parentline Tel. 13 22 89
• Translating and Interpreting Service (TIS National) Tel. 131 450 – available (24 hours, 7 days) for callers who speak other languages
• The National Relay Service (NRS) is available to help callers who are d/Deaf, or find it hard to hear or speak to hearing people on the phone
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health advice 24 hours a day, 7 days a week
• Kidsafe Victoria Tel. (03) 9036 2306
• Red Nose (formerly SIDS and Kids) Tel. 1300 998 698 – for safe sleeping information, education, and all other enquiries