Monday, July 6, 2015

Night Time Pacifier Use


Dear Melissa,
Whenever my 10-month-old cries at night, I respond by giving him a pacifier. The problem is that he cries 4 or 5 times a night until a pacifier magically reappears in his mouth again. Help, I'm sleep deprived! How do I wean this child from his pacifier?

This one is super tricky. It is one thing to address behavior modification during the day, or even when going to bed at night, but addressing undesirable behaviors in the middle of the night can be extra complicated. First, the child is sleepy and not in his rosiest mood. Second, YOU are tired and impatient, and certainly not in YOUR rosiest mood either. What makes things worse is that your child generally gets the benefit of a nap to “catch up” on the sleep, while the parent simply becomes more and more sleep deprived. Not a fun situation. 

My own son went through this phase when he was a bit older, from about 12-18 months. Whether you are dealing with an infant or a toddler, waking frequently in the middle of the night can be hard on everyone! There is no magic fairy dust to solve this problem, but here are a few ideas that just might help.

Fill up the tank
Infants have the desire for sucking for 2 reasons: for calming (non-nutritive sucking), and for calories/nutrition (nutritive sucking). Use of a pacifier is non-nutritive sucking, but it is easy for a hungry baby to confuse the two. It certainly doesn’t hurt to make sure that your baby has a full tummy before nodding off to sleep to help increase the odds of sleeping through the night.

Create a pacifier paradise
This seemed to work fairly well with my own son. I always put him to bed with multiple pacifiers. After around 6 months of age, a baby should be able to put a pacifier in his mouth. Placing several pacifiers in the crib at once increases the odds that he will find the pacifier himself and solve the problem without your intervention. Not to mention, teaching this self-sufficiency and independence is a useful life skill. One time I moved his crib and found THIRTEEN pacifiers stuck between the crib mattress and the wall!  Yes, this is a bit excessive, but we got sleep!

Make the pacifier less desirable 
Basically, this step is simply making the child not want the pacifier as much in the middle of the night. Some tricks to making the pacifier less desirable:
  • Decreasing/eliminating nighttime feedings (but only AFTER your child’s pediatrician thinks that your child is growing well enough to eliminate them).
  • Manipulating the pacifier so that it is less desirable by slowly cutting more and more of the pacifier tip until it no longer provides the desired sucking effect (modify with caution as to not produce a chocking hazard)
  • Eliminating the overall use of the pacifier so that the child knows that the pacifier is no longer an option (more tips on weaning from the pacifier next week!)
Monitor the situation
The video baby monitor is the best investment I have ever made. Even at ages 4 and 7, I still use it to check up on my kiddos at night! When my babies cried at night, I always had a “head off the mattress rule”. Babies, children, and even grownups can make random sounds, noises and even talk/cry in their sleep. When I heard crying, I would always intently watch the monitor (I promise, I was not simply ignoring my child!). If the baby’s head was still on the mattress, then he obviously was not too upset. This allowed for the possibility that he was simply crying in his sleep.  It also gave the baby the opportunity to self-soothe.  Again, I really feel that you can’t start teaching problem-solving skills too young!  If you are patient and wait just a bit, sometimes, just sometimes, the child learns to soothe himself – either with sucking on his hand, finding the pacifier, or simply moving into a more comfortable position. 

Does your baby sleep through the night?  
What did you do to stop frequent night wakings?  Please share your ideas!

Resources:
Sleep Training 101, Mondays with Melissa Blog, November 2014 
Common Mistakes Parents Make with Pacifiers, Mondays with Melissa Blog, June 2015
Bye Bye Binky, Ending the Pacifier Habit, Marguerite Lamb, Parents, accessed June 2015
Ask Dr. Sears – Weaning Off the Pacifier, William Sears, Parenting, accessed June 2015