Sleep Plans
Troubleshooting my Sleep Plan
1. You’ve tried sleep training in the past.
Babies whose parents have “dabbled” in sleep training tend to have a longer “protest phase” and can resist the new pattern due to past changes. For these kiddos it can take a few extra days before their brain adapts and responds to the consistent change in response and fully accepts that pattern.
2. Your child wasn’t feeling well.
Although we strive to minimize it, it's common for some children to experience teething or illness right in the middle of the training window, necessitating a pause in the plan. When a child is unwell while attempting to acquire a new skill, it naturally takes longer for them to develop and adjust. It's important to remain patient and persevere because you're nearing the end of the process. Hang in there!
3. You modified your approach.
Making adjustments to your sleep training plan during the initial stages is understandable for parents who believe that the original plan isn't working for their child. However, it's important to note that introducing additional support or changes to the behavior pattern can potentially prolong the time it takes for your child to achieve their sleep goals. It'is recommended to stick with your current plan and allow a few more days for your child to adapt and make progress. Consistency and patience are key in this process.
4. You removed your “dream” feed.
Many parents include a dream feed in their sleep plan to ensure their baby is not hungry during the night. Dream feeds provide reassurance that your child's hunger needs are being met and preventing nighttime crying. However, it's important to eventually phase out the dream feed so that your baby can learn to sleep for 11-12 hour stretches without requiring additional calories. Removing the dream feed may cause a temporary regression, which is a normal and expected part of the process. You should give your child a few more days to adjust and continue making progress.
5. You’re not sure, but you see progress.
There are situations where your child may not fit precisely into any of these categories, but it's evident that they are making progress towards meeting their sleep goals. Sometimes, a few extra days can make all the difference. Based on your child's progress, Presence Sleep will encourage you to extend your timeline to allow them to complete the sleep plan successfully. We will continue tracking their progress alongside you and provide additional support if needed in the coming days. Hang in there, and keep up the great work!
Extending a sleep plan is not available as a selection. Instead, on the final day of your plan, a screen will prompt you with the option to extend it. This feature enables you to continue monitoring your child's sleep states for an additional 2 days beyond the official end date of the sleep plan.
Parents can remove the sleep feed when they’re ready by reducing the amount 1-2oz every other night (for bottle babies) or 1-2 minutes every other night (for breastfed babies) until the feed is eliminated. 2
You can incorporate multiple dream feeds for babies accustomed to eating multiple times per night, as long as they are fully asleep during the designated nighttime sleep window (11-12 hours from bedtime). If your child wakes up one hour before their intended wake-up time (around the 10-hour mark), the temptation may arise to feed them at that moment to allow for a few more hours of sleep. However, this can reinforce a disrupted sleep pattern. It's preferable to provide additional dream feeds within the 11-12 hour sleep window, rather than having one "awake feed" outside of that timeframe..
Try closing the app and restarting it. If you are still having trouble, please contact us at support@presencesleep.com.
If your child wakes and becomes upset, a sleep feed may be too disruptive. Finish offering the feed and if your child refuses to eat, place them back in the crib and switch to your typical response pattern. Parents who are nursing can try using a bottle to see if it’s less disruptive, but should remove this additional support if it also seems to be too disruptive. If your child does not weigh enough to sleep for 11-12 hours without a feed, talk with your pediatrician about postponing sleep training until your child weighs at least 12lbs.
Cries typically taper off so if your child has suddenly stopped crying then immediately go into the room and check on your child. Although there's a risk of potentially waking them up, it's crucial to ensure their safety and rule out any potential issues, such as a small object that could be lodged in their airway. Therefore, it's recommended to prioritize their well-being over the risk of interrupting their sleep.
If you have any concerns about your child's crying patterns or if something seems amiss, do not hesitate to enter the room and assess the situation. It's always better to be proactive and ensure your child's safety and comfort. Trust your instincts as a parent and take necessary precautions to address any potential risks or discomfort that your child may be experiencing.
If you notice that your child is unable to transition from standing to sitting, it's recommended to respond promptly by gently sitting your child back down and leaving the room. It's normal for your child to immediately stand up again in response to the change in your behavior. However, if you consistently follow the pattern of sitting them down and leaving the room, over time they will learn to stay seated and eventually lie down.
Alternatively, you may choose not to respond and allow your child to learn how to sit without assistance. Regardless of the strategy you choose, it's important to practice this skill with your child during the day. Encourage them to stand at the couch or coffee table and practice squatting or sitting to reach toys on the floor. This will help them develop their motor skills and improve their ability to transition from standing to sitting.
As babies improve their motor skills development, it's very common for them to move around a lot during sleep. It's recommended to consult with your pediatrician to determine if your child is at an appropriate age to safely sleep with bumpers, which can help prevent excessive movement. Until your pediatrician confirms that your child is ready for a modified sleep environment, it's important to avoid using pillows, bumpers, and blankets.
If your child is attempting to climb out of the crib, then it poses a potential danger and it's recommended that you take appropriate measures to ensure their safety. One option is to lower or remove the front of the crib, allowing your child to enter and exit the crib safely.
To maintain the established response pattern during the sleep training period, you have a couple of options. You can utilize a baby gate to contain your child within the room, or you can modify your approach by staying in the room and consistently returning your child to bed until they remain and fall asleep. If your original response pattern involves providing soothing at specific intervals, using a baby gate aligns with your initial plan.
During the initial nights, your child may fall asleep near the baby gate, but over time, they will gradually learn to return to bed without requiring parental assistance. It's important to ensure that the room is childproofed and completely safe for your child to explore without constant supervision if you have opted for a modified crib.
If you notice your child's face is wet during check-ins, take a moment to gently wipe their face to ensure their comfort. The aim throughout the sleep training period is to keep your child as comfortable as possible while they learn to self-soothe. If you suspect any discomfort, such as a wet diaper, wet face, or wet clothing, it's important to address it promptly to promote their comfort. However, remember to avoid adding extra soothing time beyond what is planned. Once you have attended to your child's comfort, promptly return to your response pattern.
If your child tosses their lovies or pacifiers out of the crib, it's best to maintain consistency by ignoring the behavior until the next scheduled check-in. Once the designated time arrives, you can offer these items back to your child, but limit it to one time per check-in.
If you've chosen a plan without a specific wait time and you're staying in the room until your child falls asleep, avoid returning the lovey or pacifier until your child is asleep. This ensures that these comforting items remain available to your child if they happen to wake up during the night.
Babies often experience vomiting if they have a full tummy and start crying. If this occurs, it's recommended to promptly remove your child from the crib and change their clothes and crib sheet to ensure their comfort. It's important to avoid providing any extra holding or soothing outside of the crib to prevent reinforcing this behavior, which could lead to more frequent episodes of vomiting.
If your child vomits and you have concerns about their health, it's advisable to temporarily halt the sleep training process and only resume once you are confident that your child is well. Prioritizing your child's health and well-being is crucial throughout the sleep training journey.
If you notice a full diaper during one of your check-ins, it's recommended to promptly change your child's diaper and place them back in their crib. It's important to anticipate that this transition may cause some distress for your child. If that happens, you should return to your established response pattern and refrain from providing any additional comfort by holding them. This approach helps maintain consistency and supports your child's sleep training process.
Adjusting your sleep training plan in the early stages can be beneficial for parents who feel that the current plan is ineffective for their child. However, it's important to note that altering the behavior pattern can potentially prolong the time it takes for your child to achieve their sleep goals. In our app, you have the option to make one modification to your plan one time. If additional changes are required, we recommend creating a new sleep plan that is better tailored to your family's specific needs.
If your child gets sick then pause the sleep plan until your child is completely recovered.
We understand that unexpected situations such as illness or travel may arise during your sleep plan. In these cases, we offer the option to pause your plan for up to one week. However, it's important to note that the longer the plan is paused, the more challenging it may be for your child to seamlessly resume their progress. If the plan is paused for longer than one week, it will be automatically deleted and you will be prompted to start over. This reset is necessary to ensure that your child's learning process remains effective and consistent.
To pause your plan:
1. Navigate to the "sleep" page in the global footer
2. Scroll down and tap on "Sleep Plan Synopsis"
3. Scroll to the bottom and tap on "Manage Sleep Plan"
4. Tap on "Pause Sleep Plan"
Definitely! You can always lengthen out response wait times if you notice that your child could use a little more time to practice independent soothing. Additionally, if your child’s cry times are getting significantly shorter it’s better to give her a few more minutes to try to settle herself before going into the room.
Parents have two options here. You can begin by giving your child a few minutes alone before responding and then step back out every few minutes OR you can stay in the room but gradually move farther away from the crib/bed each night until you’re outside the room. The goal is to eventually have your child feel comfortable falling asleep and returning to sleep without you in the room.
Absolutely- it’s very normal for your child to “protest” the change in response. It takes a few days for your child to adjust to the new pattern so in the meantime keep consistent and avoid falling back on old supports that keep your child from practicing her self-soothing skills.
Crying is a normal and essential part of the sleep training process because it allows your child to experience frustration in an environment where they are safe, fed and comfortable in their own beds. By allowing your child to self-soothe, without immediate parental intervention, they can learn to regulate their emotions and calm themselves down. This skill is not only crucial for better sleep at night, but also for developing resilience and coping with frustrations during the day. Learning to self-soothe is a vital skill that supports ongoing learning and development throughout early childhood.
Whimpering/Whining:
Whimpering or whining is a common behavior that babies may exhibit when they are transitioning to sleep or when they wake up. This type of crying is a self-soothing mechanism and usually subsides once the baby finds a comfortable position and falls asleep. The transition to the first stage of NREM sleep requires a child to remain still for about ten minutes, so whimpering is usually an indication that the baby is feeling sleepy but may be having difficulty settling down.
Continuous Crying:
Continuous crying is the next level up from light whimpering that your child may experience when they are tired and struggling to fall asleep. It's a full cry that is continuous without many breaks in the pattern. In the initial nights of sleep training, your child may cry continuously because they are accustomed to their usual sleep associations. However, as they are given the opportunity to learn new sleep associations, this continuous crying will gradually decrease. It's important to provide them with space and support during this process to help them adapt to the new sleep routine.
Hysterical Crying:
Hysterical crying can occur when you remove the last remaining sleep support, such as a pacifier or back rub. This higher level of crying is related to your baby's dependency on the support. This type of cry often panics parents and may tempt them to deviate from their established response pattern. Most parents will take their babies out of bed and either hold/rock or nurse/feed them back to sleep when this happens. It's crucial to first check if your child is safe and not caught in the crib rails. Once you have confirmed their safety, it's important to stick to your response pattern and allow your child time to calm down independently. Learning to self-soothe from this point is essential for your child's sleep development, although it may take some time for them to master it. Remember that a few hours of crying may feel long, but it's actually a relatively short period for a child to learn a new skill and establish new sleep associations. You will see improvement in just a few nights by staying consistent with your response pattern, so hang in there
High-low Crying:
High-low crying is a natural part of the self-soothing process as your child becomes more skilled at calming themselves down. You may notice a range of cries, from full crying to hysterical to whimpering. This variation is a positive sign of progress, indicating that your child is improving their ability to self-soothe. During this stage, it's important to be cautious with your response because intervening too soon during high-low crying can disrupt the progress and trigger more hysterical cries. Consider extending your wait times to allow your child the opportunity to calm down and fall asleep on their own. By giving them space and time, you are encouraging them to develop their self-soothing skills further.
To promote self-soothing, it's recommended to swaddle your child with at least one arm out. If your child is rolling, then both arms should be free to allow for safe movement during sleep. Additionally, as your child starts using their hands for self-soothing, it's important to keep their nails short and filed to prevent any accidental scratching.
We recommend using your crying response pattern for 1.5 hours during nap time and 11-12 hours during nighttime sleep. For example, if you put your child down for a nap and she cries for ten minutes but then falls asleep, only to wake crying after 20 minutes, you should continue using your response pattern until she either calms down and falls back asleep or it an hour has passed. If your child is still crying at the 1.5-hour mark, you can take her out and try again at the next nap. However, if your child falls asleep near the end of the 1.5hr mark, then let her sleep for another 30-45 minutes before waking her up to maintain the schedule.
Similarly, for nighttime sleep, if your child wakes up before she has been in bed for 11 hours, use your response pattern until she calms down and falls back asleep. If she's still crying at the 11-hour mark, you can take her out of bed. However, if she falls back asleep close to the 11-hour mark, let her sleep for an additional hour before waking her up to maintain her sleep schedule.
Tips and Tricks
There are three main components when setting up your little one's sleep space: light, sound, and temperature.
Your child's room should be dimly lit for pre-sleep routines and dark for all sleep events to stimulate the release of natural melatonin (sleep hormone). Parents can use music as part of the pre-sleep routine but then switch to brown/white noise (sound machine, fan) while the child is sleeping to help filter background sounds when they're in lighter stages of sleep. Finally, the recommended room temperature is 67-72 degrees Fahrenheit (19.4-22.2 degrees Celsius) because this promotes consistent and regulated sleep quality.
During the first four months of your baby's life, you provide constant support and tend to their every cry, so it can be challenging for you to suddenly remove that support during sleep training. Reach out to friends who have successfully gone through this process so that you have their guidance and support readily available as you go through the steps. Additionally, take the time to educate yourself on the significance of uninterrupted sleep for your child's development.
Many parents express feelings of guilt or selfishness for wanting to sleep train, as they are willing to sacrifice their own sleep for the sake of their baby's rest. However, it's important to understand that even waking your baby up to eat or to be rocked to sleep can disrupt your child's sleep patterns. Sleep training ultimately benefits your child's well-being. Having access to medical and scientific research that supports the importance of this process for your child's development can provide reassurance and motivation throughout the journey.
Remember, every parent has their own self-care strategies while their baby is learning to sleep independently. Whether it's reading a book, enjoying a glass of wine, having a friend on call, or watching your favorite TV show, have those self-care activities ready to go when you need them.
Sleep Plan Builder
Dream feeds are designed for babies who are old enough to undergo sleep training but have not yet reached the weight of 12 lbs, or for those over 12 lbs who are accustomed to nighttime feedings. For babies below 12 lbs, dream feeds provide additional calories until they reach the recommended weight. For babies over 12 lbs, dream feeds support the transition to sleeping uninterrupted for 11-12 hours during the training process. However, it is important to consult with your pediatrician to determine the appropriateness of dream feeds for your child.
Please note that dream feeds are only provided within the nighttime sleep window and can only be offered if the baby is fully asleep. This approach helps break the association between waking/crying and receiving food, encouraging the brain to adjust to consolidated sleep patterns. Over time, the dream feeds are gradually phased out until the baby is able to sleep through the night without the need for additional feedings.
Support is provided in the early stages of the sleep plan to offer additional options for helping your child learn to self-soothe.
As the plan progresses, it becomes important to gradually reduce the level of support, giving your child increased opportunities to calm themselves independently. This gradual removal of support allows parents to choose which support they would like to eliminate first, saving the most effective support for the final stage. The ultimate goal is for parents to be able to place their drowsy babies in bed and leave the room without the need for any additional support to facilitate sleep.
This is one of the most important aspects of sleep training and a natural part of the sleep training process.
Along with sleeping through the night, one of the key skills for your child to learn at this age is self-soothing.
As children grow older, we want their ability to cope with reasonable stress to improve. It's normal for babies to cry for varying lengths of time, ranging from 20 minutes to a few hours. Choose a response pattern that you feel comfortable with and can stick to. Your child may cry more during the first two nights, but you'll notice significant improvements on nights 3 and 4. Remember, it will get better!
Depending on your family, picking a bedtime can be earlier or later. There isn’t a right answer. What’s important is establishing a consistent bedtime that allows your child to stay in bed for at least 11-12 hours. For example, if you want to set a 9pm bedtime, your child should be able to stay in their bed until 8am or 9am. If your job or other responsibilities require your child to be awake earlier in the morning (6am) then you’ll need to set the bedtime for 11 hours earlier (7pm). Additionally, naps need to coordinate with morning wake-up and bedtime, so if your child is still napping twice per day, it’s important that they can take one morning and one afternoon nap before bedtime.
Health Screener
What’s happening internally is often expressed through the skin, so we tend to see allergies or reactions to food through the presence of eczema or rashes. If you live in a dry climate, try introducing a humidifier to their bedroom to provide additional moisture. If the rash or eczema persists, talk to your doctor about treatment and possible causes for the skin irritation. It’s very important that your child is comfortable during sleep training, so finding out about treatment of a skin irritation should be the first step.
The consistency of bowel movements can vary depending on whether your baby is breastfed, formula-fed, or eating solids. Babies who are exclusively breastfed often have looser bowel movements, while formula-fed or solid-fed babies should have soft but formed stools. If your child is exclusively breastfed, it'd important to consult with your doctor or a lactation consultant to ensure the consistency is appropriate for a breastfed baby. Diarrhea or loose stools can indicate gastrointestinal distress and may affect your child's ability to sleep well.
If your child has mucus in their diaper or poop, they may be experiencing intestinal irritation during digestion, a potential food or milk protein allergy, or a sinus infection. Please talk with your doctor about the appearance of mucus in the bowel movement.
This can be an indication of constipation which can cause stomach pain and discomfort when pushing during bowel movements. Talk with your doctor about safe remedies for softening the poop and determine if further medical attention is needed.
Babies who have GI or reflux pain often display frequent vomiting, excessive spit-up, and/or back arching. This type of pain makes self-soothing impossible and may require hypoallergenic formula, diet changes, allergy testing, or reflux medication. Please discuss this behavior with your doctor before beginning a sleep program.
While baby snoring may seem adorable, it's not something that should occur regularly unless your child is unwell. Snoring or breathing through the mouth can indicate an obstruction in their nasal passages. It's important to discuss this with your primary care physician to determine if your child may have allergies or a cold. Depending on the severity of the snoring, your doctor may recommend a visit to an ENT specialist.
Your child does not need to weigh 12 lbs to benefit from a sleep plan, but we recommend incorporating nighttime feeding to support their weight goals. Once your child reaches 12 lbs, they will be able to sustain an 11-12 hour sleep stretch at night without requiring additional feeds. At this stage, you may also notice improved eating patterns during the day and increased appetite for regular meals, rather than frequent snacking throughout the day and night.
General
Wake-time activities are vital for promoting alertness in your infant between sleep events. Younger babies should be kept in well-lit areas during these wake-times to reduce melatonin levels and help establish day-night sleep patterns. Tummy time is an excellent activity to engage in during wake-times because tummy sleep is not recommended for children this age. Providing opportunities for babies to experience tummy time during the day helps develop motor skills, trunk strength, and arm/hand coordination. Always supervise tummy time to ensure the baby is not lying with the face completely flat on the floor.
As your child grows older, using wake-time activities to explore their senses is recommended. Toys with different sounds, textures, and colors can stimulate your child's interest and encourage exploration. While bath-time is often associated with pre-sleep routines, the feeling of water and the water temperature actually provide an alerting experience for babies, helping them stay alert during the day.
If you notice your baby getting sleepy during feed times, you can use a damp washcloth against their hands and feet or gently tickle their hands and feet to promote full feedings. These techniques can help keep your baby alert and engaged during feeding sessions.
Sleep training is generally recommended for children aged 5 months and older as it aligns with the development of their motor skills, allowing them to start practicing self-soothing. It's also important to note that babies find it easier to fall asleep when they have the ability to reposition themselves independently, which is typically not possible for those under 5 months who may still rely on swaddling. However, even for younger babies, establishing a consistent feeding and sleep routine can be beneficial.
At Presence Sleep, we're here to provide support, strategies, recommendations, and troubleshooting throughout these initial months. Keep tracking your baby's progress, and we'll be with you every step of the way!
Motor skills play a crucial role in a child's ability to self-soothe. Typically, we expect to see these motor skills develop by the age of 5 months or older. If your child is not yet demonstrating these skills, it may be challenging for them to effectively self-soothe. Sleep training involves providing opportunities for your child to learn self-soothing techniques, which relies on consistent access to these motor skills. If you have concerns about your child's motor development, we recommend discussing them with your primary care provider (PCP) who can provide more information about motor development and suggest strengthening exercises if necessary. For safety reasons, it is recommended to keep your child's crib empty, with only a crib sheet, and have them sleep on their back until they have achieved their 5-month motor milestones.
Sleep Plans typically take 14 days to complete, but can be shortened or lengthened by factors such as crying wait time, support removal, and user consistency.
Sleep is one of the most essential needs for children to meet their developmental milestones on time. In addition to helping support the brain’s development, it also provides an opportunity for children to learn how to self-soothe. As children get older, self-soothing becomes essential for managing stress and maintaining a calm and regulated state throughout the day. Children under the age of 3 years need almost double the amount of sleep as an adult to support brain development. Any interruption to this sleep pattern can lead to health issues, mood disregulation, and developmental delays.
Babies 5-24 months old are ideal for sleep training through a sleep plan. Presence Sleep provides personalized options for all types of sleepers to regulate specific patterns around sleep. Establishing these patterns helps babies learn to self-soothe and ultimately reach developmental milestones on time.