Gentle Removal Plan

[BetsyAnh]

This information mirrors Tracy's advice nicely.  
Site Admin Team
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I just want to add that, following posts from other mothers and what I have picked up from this message board, if you can find your own combination of the 'gentle removal plan', pu/pd, and pat/shh that suits you and your LO, it is YOUR best (and hopefully least stressful!) way of helping your baby sleep through the night


i have ordered and read the no-cry sleep solution by Elizabeth Pantley and i just want to post what i have found- it seems very hopeful!!

- keep the last hour before bedtime fairly low-key and keep to your bedtime routine EVERY night

-follow a flexible yet predictable daytime routine because it helps to set baby's biological clock-- and earlier bedtime does NOT mean earlier awake time! if baby is going to sleep too late, she might be too tired to sleep properly!

-it's a cycle- good naps mean good night sleep and visa versa

Click on the links below for more information on each topic:

PANTLEY'S GENTLE REMOVAL PLAN

GRADUALLY WEAN CO-SLEEPING:HELP YOUR BABY TO FALL BACK TO SLEEP ON HIS OWN

GRADUALLY WEAN CO-SLEEPING:HELP YOUR BABY FALL BACK TO SLEEP WITH ANOTHER PERSON

HELP YOUR BABY TO FALL BACK TO SLEEP ON HER OWN

[RachelC]

"...TO CHANGE BABY'S SLEEP ASSOCIATION- WHEN YOUR BABY WAKES, GO AHEAD AND POP HIS PACIFIER OR BOTTLE INTO MOUTH OR NURSE HIM. BUT, INSTEAD OF LEAVING HIM THERE AND GOING BACK TO BED, OR LETTING HIM FALL ASLEEP AT THE BREAST, LET HIM SUCK FOR A FEW MIN UNTIL HIS SUCKING SLOWS AND HE IS RELAXED AND SLEEPY. THEN BREAK THE SEAL WITH YOUR FINGER AND GENTLY REMOVE THE PACIFIER OR NIPPLE.

OFTEN, ESPECIALLY AT FIRST YOUR BABY THEN WILL STARTLE AND ROOT FOR THE NIPPLE. TRY TO VERY GENTLY HOLD HIS MOUTH CLOSED WITH YOUR FINGER UNDER HIS CHIN, OR APPLY PRESSURE TO HIS CHIN, JUST UNDER HIS LIP AT THE SAME TIME ROCKING OR SWAYING WITH HIM (USE KEY YOUR KEY WORDS IF YOU DEVELOPED THEM). IF HE STRUGGLES AGAINST THIS AND ROOTS FOR YOU OR HIS PACI OR BOTTLE, OR FUSSES, GO AHEAD AND REPLACE THE PROP, BUT REPEAT THE REMOVAL PROCESS AS OFTEN AS NECESSARY UNTIL HE FALLS ASLEEP.

HOW LONG BETWEEN REMOVALS? EVERY BABY IS DIFFERENT BUT ABOUT 10-60 SEC... IT MAY TAKE 2-5 (OR MORE) ATTEMPTS BUT EVENTUALLY BABY WILL FALL ASLEEP W/OUT THE PROP IN HER MOUTH. WHEN SHE HAS DONE THIS A NUMBER OF TIMES OVER A PERIOD OF DAYS, YOU WILL NOTICE THE REMOVALS ARE MUCH EASIER, AND HER AWAKENINGS ARE LESS FREQUENT...

Pantley's Gentle Removal Plan looks something like this (this example shows a bf baby, but the plan is the same whether baby is bf, using a bottle or paci)

baby is awake and nursing vigorously
baby's eyes close and his sucking rate slows
you gently remove your nipple
baby roots (moving his mouth open towards you)
try holding the chin, but he'll have none of that!
you put him back to the breast
count: 1thousand, 2thousand,... ten thousand*
you gently remove your nipple
baby roots
you try stalling, but no dice
you put him back to the breast
count :1thousand, 2 thousand,... ten thousand
you gently remove your nipple
baby roots
you put him back to the breast
count: one thousand, tow thousand,... ten thousand
you gently remove your nipple
baby moves a little, and you gently hold his mouth closed (betsy says- my baby won't let me do this, so i place her on my shoulder and rub her back)
baby doesn't resist, he is nearly out
you place baby in bed
he goes to sleep

* the counting is really more for you, to give you a gauge to measure your time and a way to keep yourself calm during your repeated attempts. you can be flexible as you figure out what time spacing works best for you and your baby

REPEAT THIS PROCESS EVERY NIGHT UNTIL BABY LEARNS SHE CAN FALL ASLEEP W/OUT THE PROP. IF YOUR BABY IS A "GOOD NAPPER" YOU CAN USE THE TECHNIQUE FOR NAP TIMES TOO.

IF NOT A GOOD NAPPER, DON'T TROUBLE YOURSELF W/ TRYING TOO HARD TO USE THE REMOVAL TECHNIQUE DURING THE DAY. REMEMBER THAT GOOD NAPS MEAN BETTER NIGHTTIME SLEEP- AND BETTER NIGHTTIME SLEEP MEANS BETTER NAPS. IT'S A CIRCLE. ONCE YOU GET YOUR BABY SLEEPING BETTER AT NIGHT, YOU CAN THEN WORK ON THE NAP TIME SLEEP- ALTHOUGH ONCE YOU SOLVE THE NIGHTTIME ASSOCIATION, THE NAP TIME SLEEP MAY RESOLVE ITSELF.

THE MOST IMPORTANT TIME TO USE THE PANTLEY'S GENTLE REMOVAL PLAN IS THE FIRST FALLING ASLEEP OF THE NIGHT. OFTEN THE WAY YOUR BABY FALLS ASLEEP WILL AFFECT THE REST OF HIS AWAKENINGS FOR THE NIGHT. I SUSPECT THIS IS BECAUSE OF THE SLEEP-ASSOCIATION AFFECT... IT SEEMS THAT THE WAY IN WHICH YOUR BABY FALLS ASLEEP FOR THE NIGHT IS HOW HE EXPECTS TO REMAIN ALL NIGHT LONG.

BECAUSE WE WANT NO CRYING, THIS IS NOT A 1-DAY SOLUTION. BUT WITHIN 10 DAYS AS YOU GENTLY BREAK THIS STRONG SLEEP ASSOCIATION, YOU SHOULD SEE A MAJOR REDUCTION IN THE NUMBER OF YOUR BABY'S NIGHT WAKINGS...."

CHANGING YOUR ROUTINE
very often we parents have a routine we have followed with our babies since birth. the final step before sleep is often nursing or having a bottle. some babies, like my Coleton can continue this pattern and still sleep through the night. others, though, need to have the final step in their routine changed before they begin to sleep all night w/out needing your help to fall back to sleep. what you'll want to do is take an objective look at your final steps in putting your baby to sleep and make some changes if necessary

you may want to use massaging, cuddling, or the key words idea (sleep cues) to help your baby back to sleep. eventually the key words and a loving pat will take over for nursing or bottlefeeding, and then that too will fade away and your baby will be sleeping longer. Here's what one test mommy reported:     "i have changed the way I'm putting Carlene to sleep and it's working! instead of nursing her down, i just feed her until she is relaxed and then i just let her do whatever she wants in the very dim room with me. when she rubs her eyes and looks sleepy i put her in her crib. i used to go out of the room, hoping she would drift off herself, but she would just get agitated and work herself up until i came back. but now, i just stay there. i stand next to the crib and encourage her to sleep. i say my key words, 'shhhh, it's night-night time, close you eyes sleepy girl,' and i tell her that it's OK to go to sleep. i rub her head or her tummy. she shuts her eyes right when i do this. she'll open them back up a few times, but eventually she settles. since I'm not nursing or rocking, she is falling asleep without these, so when she lightly wakes during sleep cycle transition, she is finally able to go back to sleep w/out me. it's been a major breakthrough."     Rene, mother or 7-month-old Carlene

[RachelC]

make sure that you've read the safety list in chapter 1. much of what i have read about the dangers associated with co-sleeping point to unsafe sleeping environments as the real issue. read up on the topic and make a wise and informed decision, and religiously follow all safety measures

the challenge with bf and co-sleeping mother-baby pairs is that each partner is so in tune with the other that the slightest movement or noise will have both awake. mommy and daddy end up creating additional wakings in between the baby's natural ones, thus creating and all night wake-sleep pattern

the trick is to get baby accustomed to sleeping beside you but able to go back to sleep w/out your help (typically in the form of nursing). you can do this by shortening your nighttime help routines. i know that this is possible because today my son Coleton is 18 months old, still breastfeeding and co-sleeping= and sleeping about 10 hours at night w/out a peep/ this is the same baby that a few months ago woke up every hour or so to breastfeed. so i am living proof that you don't have to give up a sleeping ritual that you love just to get some sleep. not all babies will respond as coleton did, of course. but many of my test-mommies practice bf  and co- sleeping (i will refer to this as CS now..) and many found their own sleep success w/out having to move their babies out of their beds. some stubborn little ones do require a move to another room before they will give up the luxury of nighttime nursing, but do try all of my ideas for a few weeks before you assume this to be correct for your baby.

when baby wakes you probably have a routine to get her back to sleep. for Coleton and me, it was bf. i used to nurse him until he was totally asleep; the nipple would literally fall out of his mouth. every hour, we had a very exact pattern. Coleton woke, i shifted him to the other side, i kissed his head, he nursed- a beautiful, soothing ritual. sometimes he would wake up and pucker up, looking for the kiss and the shift. as sweet as this ritual was, after 12 months of this hourly ceremony, i desperately needed a change

      STOP FEEDING A SLEEPING BABY- as with the writing of this book, learning how to break the association was a gradual, thoughtful process that required much self-examination. i found i was responding to Coleton so quickly and intuitively that I'd put him to the breast before he even made a real noise- he would fidget, gurgle, or sniff and i would put him to the breast. i began to realize that, on so many of these occasions, he would ave gone to sleep w/out me.

as you know, i am a follower of the "never let your baby cry" rule, and i took it very seriously. what i didn't understand though, is that babies make sounds IN THEIR SLEEP (Tracy Hogg refers to this as a 'phantom cry') babies can even NURSE in their sleep

the first step to helping your baby sleep longer is to determine the difference between sleeping noises and awake noises. when baby makes a noise, stop. Listen. Wait. Peek. as you listen attentively to her noises and watch her, you will learn the difference between sleeping snorts and "I'm waking up and i need you now" noises

when i learned this eye-opening piece of info, i started "playing asleep" when Coleton made a nighttime noise. i would just listen and watch- not moving a single muscle- until he began to make actual wakeful noises. some of the time he never did; he just went back to sleep!

     SHORTEN YOUR NIGHTTIME NURSING TIMES-- you may be following the pattern that we were- putting baby to the breast then both of you falling back to sleep. it's very easy to do, because the act of bf releases hormones that make mommy sleepy, just as much as the milk makes baby sleepy. the problem is that your baby falls soundly asleep at the breast, and begins to believe that keeping the nipple in her mouth is the only way she CAN sleep. therefore, every time she reaches a brief awakening, she looks to re-create her sleep-inducing condition. you can help your baby learn to fall asleep w/out this aid by shortening your nighttime nursing intervals.

when you are sure you baby is awake and looking to nurse, go ahead and nurse him for a short time. Stay Awake! and as soon as he slows his pace from the gulping, drink mode to the low fluttery comfort nursing, you can gently disengage him while patting or rubbing him (See Pantley's Gentle Removal Plan above)

Sometimes you can put your baby's hand on your breast during the removal, since many babies will accept this touch as a substitute for nursing; it seems to keep you "connected" and he knows that the milk is nearby if he needs it

another option is to make the latch-on a little less comfortable and convenient for your baby. so, instead of laying tummy to tummy with you baby cradled in your arm, shift yourself slightly onto your back so that he has to work a bit to keep the nipple in his mouth. often he'll decide it's too much effort and he'll let go and go back to sleep

if your baby whimpers at any point during this removal process, or somehow lets you know that he is up for real (by crawling onto your chest for example!) go ahead and bf him. then repeat the process to keep the nursing session short, and disconnect him before he is deeply asleep/

sometimes, it may take 3-5 times before your baby will settle back into sleep. after a week of using this technique with Coleton, he began to disengage HIMSELF, turn over with his back to me, and fall asleep! it was wonderful; perhaps only a cs and bf mommy can understand just how sweet her baby's backside can be at this time. in fact, coleton (at this writing 18 months old) STILL does this; he nurses until he's very comfortable, then rolls away from me and goes to sleep. now that he's sleep 10 or so hours, i leave him in bed with his brother david in our sleeping room and i am free to join my husband in our own bed for baby-free sleep and couple time

     MOVE THE MILK-- here is another idea especially for co-sleepers. after you nurse your baby, scoot yourself away from her. if she is snuggled right up against you, she will awaken and want to nurse more often- sometimes, as i mentioned earlier, even in her sleep. if your baby is used to feeling you against her, then you may want to try a tactile replacement. a small stuffed animal is perfect for the job. simply place the toy next to your baby's body or legs (away from her face) when you move away, so that she feels something against her.

for those persistent night nursers, you may even want to change your sleeping arrangement for a few weeks until you get the frequent night waking under control. i put 2 mattresses on the floor next to each other in our sleeping room. during the period of change, i began to nurse coleton on one bed; once he was asleep, id move to the other. granted, it was only 5 feet away, but it was far enough away that i did not cause any additional awakenings. if you have a crib, you can try the sidecar arrangement- pushing the crib up next to your bed and letting baby have his own sleeping cubby (at the risk of sounding like a nag, follow good safety measures if you do this)

i must tell you though that some very persistent co-sleeping night wakers have "mommy radar" and may continue their numerous nightwakings until mommy and baby sleep in different rooms.

you may want to use your key words (Tracy dubs 'sleep cues') to help your baby back to sleep. eventually, the key words and loving touch will take over for nursing, and then that too will fade away, and your baby will sleep longer without waking you.

just like most of the ideas in this book, the one here is based on gradual change over time- no quick fixes or tearful transitions

[RachelC]

In most cases, breastfeeding and c-sleeping babies wake up because they love having access to mommy all night long. anytime they wake up, they see, hear, smell, and feel you and think, "aha! lovely warm milk and cozy mommy. gotta have it!" so, if you have a husband, partner, mother or someone else who is willing and able to help for a week or so, you might want to ask that person to sleep near your baby in your stead.

if your baby is younger than about 18 months, set up a crib, cradle, or mattress right next o the helper's bed, as it's NEVER a good idea for someone other than mom to sleep right next to a tiny baby; only mom has that "mother's instinct" that prevents rolling over on the baby. this should e a person your baby is very close to and comfortable with. if possible, have him or her start this process with naps for a few days first (if not that's OK- start right in with bedtime)

when baby awakens, have your helper rock, walk with, hum to the baby- anything that helps her go back to sleep. try to avoid using a bottle, as you'll substitute one prop for another. if you helper uses a paci to calm baby, keep in mind that at some point down the road you'll probably have to deal with weaning from the paci. many parents find that they are comfortable with that scenario.

tell your helper that it isn't "do or die." in other words, if baby starts to cry and get upset, or if your helper is losing patience, tell him or her it's OK to bring the baby to you. and try again with the next waking. when baby comes to you (notice i said "when" not "if"), follow the ideas in the section called Help Your Baby Fall Back to Sleep on His own

from Elizabeth Pantley's- no-cry sleep solution--

[RachelC]

*this idea may help crib sleepers

It's likely that every time your baby is crying or calling out to you during the night you are doing something to help him to fall back to sleep. to gradually get baby to go back to sleep w/out your assistance, you need to shorten these helping routines during the night.

When baby wakes, you probably have a specific routine to get her back to sleep, such as picking her up, rocking her, nursing her, and giving her a bottle or pacifier. as you read in chapter 2, your baby thinks she NEEDS this routine to go back to sleep. we don't want to go cold turkey and cut out the familiar, nurturing pattern that you have established' that's a sure way to cause stress and tears. instead, very gradually modify the LENGTH of your help routine so that you are doing less each night. eventually, your baby will develop a new routine that doesn't require your presence.

When your baby wakes up, go ahead and use your regular means of getting him back to sleep, but gradually SHORTEN the DURATION and VARY THE TECHNIQUE. so, instead of letting him fall asleep totally, encourage drowsiness and then see if he'll finish falling asleep on his own. if he fusses, repeat the process. this ma take 3,4,or more attempts the first few nights; and you may even have to abort your mission on some nights. over a period of a week or 2 you will see definite progress, which you will evaluate when you do your 10-day logs.

Your nights might now look something like this:
-baby wakes
-you pick her up;sit in a chair';; and rock, nurse, bottle feed, or take her to bed with you until she's sound asleep
-the you probably ease her gently into the crib w/out waking her. when you move baby from your arms to the crib, you do it very slowly and carefully, so as to not wake her
-then you creep out of the room and await your next call

if you are going to use this suggestion, and if your baby uses a paci, bottle, or the breast at every night waking, then you will want to incorporate Pantley's Gentle Removal Plan (as in PART 1 of my previous post) along with the ideas that follow.

I have found that many mothers have been told to respond to their babies immediately and never let them cry. one problem here. "experts" forgot to tell you that babies make sounds IN THEIR SLEEP. babies moan, grunt, snuffle, whimper, and even cry IN THEIR SLEEP. mothers often run to their little ones at the first noise and scoop their babies out of their cribs. i did this with my first baby, 14 years ago, and i can still remember that sometimes she was asleep in my arms before i even got to the rocking chair to sit down. what i didn't know was that she had never really been awake.

The first step to helping your baby sleep longer is to determine the difference between sleeping noises and awake noises. i'm not suggesting that you ignore a baby's true cries by any means; she may need you, and this is the only way she can communicate this. in fact, when you wait too long and she wakes up fully-- crying and yelling- she will find it much harder to fall back to sleep. rather, keep her door and yours open, or use a baby monitor. when she makes a noise, stop. Listen. Wait. as you listen attentively to her noises, you will learn the difference between sleeping snorts and "I'm waking up and i need you now" noises.

The following sample pattern shoes the duration and type of nighttime help being shortened. this is by no means an exact plan, you own method may be quite different, but his will give you an understanding of the concept:

PHASE 1: COMFORT UNTIL BABY'S ALMOST ASLEEP
once you determine your baby is really awake, go and get her. sit in the rocking chair and rock, nurse, or bottle-feed baby but only until her eyes close, her sucking rate slows, and she's falling asleep. try not to wait until she is totally asleep. stand up with her in your arms and rock or sway gently. when you lay her down, keep your arms around her for a few minutes, making gentle rocking motions (yes, this can be tough on your back, but it's only temporary) she will accept the change from your lap to her bed if you don't abruptly "dump" her there. keep in mind that, when she sleeps on you, you are moving and breathing, while the bed is still and silent. so gentle movement in the transition helps. once she seems settled, gently slip your arms out from under her. if she stirs, put your hand on her; whisper your key words (pat/shh or what works!!) or turn on the soothing bedtime music; and rock, pat or touch her gently until she's asleep. if she wakes and cries, pick her up, and repeat this process. you may have to do this 2,3,4, maybe 5 times, but that's OK- REALLY. if you or your baby gets upset at any point, just go ahead and put her to sleep in your usual way and ditch the plan for the moment. eventually she will get more comfortable with your new routine and she will go to sleep. she will still be depending on you to help her go back to sleep, but because she is finishing the falling-asleep process in their crib, she will be one step closer to being able to put herself to sleep when she wakes in the night.

Remember, you are making a change. it may take a while for this to work, but this beats spending another year or more in a sleep-deprived stupor!

When you feel that your new routine is working, go on to Phase 2

PHASE 2: BABY'S SETTLED AND SLEEPY
sit in your chair and rock, nurse, or bottle-feed baby until she's SETTLED and SLEEPY, but not yet falling ASLEEP. play your sleep-cue music or sounds. put her in her crib, pat or touch her, and say your key words (or pat/shh etc.) until she's asleep. if she wakes and cries, pick her up and repeat this process. you may have to do this 2,3,4, maybe 5 times, but that's OK. if you or your baby get upset at any point, just go ahead and put her to sleep in your usual way. as in Phase 1, she will become more comfortable with your new routine and will go to sleep (yes, i repeated that idea; it's important to give yourself permission to stop the process for the night any time it's not working. you will see improvement over time.)

When you feel that your new routine is working, go on to Phase 3.

PHASE 3:COMFORT W/OUT PICKUPS
when your baby makes waking sounds, go immediately to her, but try not to pick her up; instead, play your music or sounds, pat her, touch her, or put your arms around her in the same ways you have been, until she's asleep. while she's falling asleep, say your key words. if she wakes and cries, go ahead and revert back to Phase 2 or even Phase 1, but try to make it brief. And repeat this process.

When you feel that your new routine is working, go on to Phase 4

PHASE 4: SOOTHING PATS
go immediately to baby, but try not to puck her up. lay your music or white noise sounds very quietly, pat her or touch her. just stand by her crib and say your key words. if she wakes and cries, revert to Phase 3 or even 2, but try to make it very brief. Repeat this process.

When you feel that your new routine is working, go on to Phase 5

PHASE 5: VERBALLY SOOTHING BABY
go immediately to baby's room, and stand in the doorway. experiment to determine if you need to turn on your music or sounds. say your key words. if she wakes and cries, revert back to previous phases, but try to make it very brief. and repeat this process.

When you feel that your new routine is working, go on to Phase 6

PHASE 6: COMFORT FROM OUTSIDE THE DOORWAY
go immediately to baby's room, stand OUTSIDE the doorway where she can't see you, and say your key words. if she wakes and cries, revert back to previous phases, but try to make it very brief. repeat this process.

the idea is to take small gradual steps toward your goal. this example is not meant as a blueprint for every baby; rather, it's one demonstration of the idea. you'll need to examine your own bedtime rituals and modify them slightly every few nights until you reach your sleeping goal.

Keep in mind that the phases are not meant to be rigid, inflexible steps. watch your baby. stay in tune with your own feelings. follow your heart. modify your plan and be flexible as you move through the steps. as long as you are gradually moving toward your goal of having your baby sleep all night without your company, you eventually get there...."