Jack was a 4month old baby, who mum and dad had struggled to get to sleep for more than 20 minutes in his bassinet. Mum would often rock him to sleep in his arms, and then transfer him into the bassinet, but not soon after Jack would be awake.
During a home visit, I was able to assess Jacks sleeping environment, and the first thing to note was there was too much light in his room. At his age, any light in his room will create distraction, and can also inhibit melatonin production in the evening. Some parents believe that they want their child to learn to sleep anywhere and not be bothered by light, but if you think about yourself as an adult trying to have a nap during the day, its a lot harder with the lights on. So bottom line is, if the room is light enough that you can read a book, then it will make it more difficult for your baby to settle.
We also initiated some white noise in his room, and the plan was to leave it on for all naps and overnight. This would become a positive sleep association for him, and learn to fall asleep to this sound, then when he woke at the end of a sleep cycle, he would still hear this noise and be able to associate it with sleep and link his sleep cycles. It needs to be very loud too, more so for newborns as this is a calming tool as it sounds like the womb and promotes the calming reflex.
In terms of his sleep, the biggest issue was that he was not learning to fall asleep in his bassinet. As it takes a baby about 20min to enter deep sleep, when Jack was transferred too soon after falling asleep in his mums arms, he would stir around the 20min mark as he began to enter the deep sleep phase and realise he is no longer being held and would wake up distressed. I wanted mum and dad to get him used to falling asleep in his bassinet, so that when he woke, he was not looking for mum or dads arms.
We used a shush-pat technique to use in the bassinet, some would know as responsive settling, with the idea of gradually reducing the intensity as he began to fall asleep, and also over the next few weeks we would be reducing the level of involvement so that he would learn to fall asleep independently, and not requiring hands on settling- what we all know as self settling.
During the home visit, we settled Jack using this method, and I received a text message half an hour later after I left to say he was still asleep in his bassinet. Mum and dad were thrilled!
By providing them with a thorough sleep assessment, including sleep environment, feeds, awake windows etc, and then advising on an age appropriate method of sleep training, over the next couple of weeks, Jack's sleep dramatically improved, and was only requiring one feed overnight, and had been able to start consolidating his naps.