Sleep Associations

What does your child associate with falling asleep? Depending on the age of the child it could be a binky, a blankie, a bottle, a stuffed animal, watching TV or even Mom or Dad laying down next to him. A sleep association is anything a child has linked to falling asleep and needs in order to fall asleep (at bedtime or during the night after a nightwaking).

A positive sleep association would be one that a child can re-create on his own without adult assistance. This would include such things as a binky, blankie, stuffed animal, white noise machine, etc. If a child wakes in the middle of the night (like we all do naturally), he would be able to recreate the situation he needs to go back to sleep independently. The object associated with sleep should also be limited to sleep as it will trigger to the child’s body it is time to sleep. A good recommendation is to leave it in bed during the day.

A negative sleep association would be one that a child requires adult assistance to re-create in order to fall back asleep. This would include being rocked to sleep, watching TV, needing Mom or Dad to lay down next to him, a bottle/breastfeeding, etc. When children with negative sleep associations wake in the middle of the night, they are unable to recreate the situation they need to fall asleep and therefore, require adult assistance.

Negative sleep associations are the basis for a very common sleep disorder found in about 25% of children: Behavioral Insomnia of Childhood: Sleep Onset Association Type. These children are unable to self-soothe and require parental intervention after a brief arousal that normally occurs at the end of a 60-90 minute sleep cycle. One way to prevent this problem is to put an infant in bed while he is still awake, but drowsy. Thus, preventing the creation of an association between being held or rocked and falling asleep. For a child that has already developed a negative sleep association, it is important to replace the negative association with a positive one – this may involve a lot of coaching with the child (talking them through it/preparing them for it) and possibly some crying from the child as he learns to self-soothe (a critical developmental milestone).

It is important to create positive sleep associations from an early age and there are a variety of options to select from. Just be sure not to use blankies, stuffed animals, etc. until your child is old enough (see American Academy of Pediatrics recent recommendations for Safe Sleep).

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2 Responses to Sleep Associations

  1. Jan says:

    At what age should parents stop assisting an infant to get to sleep? My 11 week old needs a white noise machine, shushing, and rocking in order to fall asleep for naps. I can’t just put her down when she is “drowsy,” because her drowsy usually includes crying that escalates into screaming 😦

    • Sleepy Kidz says:

      Great question! A white noise machine is great at any age, so I would not worry about that. How does he/she do when you put her/him down after the rocking? Most infants can self-soothe to sleep by 3-4 months. I would wait another week or two and then try. If he/she is able to do it for bedtime, then he/she can do it at nap time as well. You can still rock if you want, but I would put him/her in the crib while “drowsy.” You have to stick to your guns though if doing it this way, if you give in to the crying/screaming, then he/she will only scream longer the next time knowing you may give in. Crying it out at nap time is typically shorter than crying it out at bedtime, especially if the infant has already developed to put him/herself to sleep at bedtime. Also, the sooner you allow your infant to learn to fall asleep on her/his own, the easier for you both for the older he/she becomes the longer and harder he/she can cry.

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