Baby Nathan was 9 months when his mum called us.

She had experienced the 4 month sleep regression, combined with disrupted sleep after the introduction of solids, she thought she was on the home stretch until this 9 month sleep regression hit...

• Separation anxiety
• Learning to crawl
• Dropping a nap
• 3 meals a day
• Language development

Nathan was a good size, he was tracking since birth on the 75th percentile and until 8 months was exclusively breastfed.

Unfortunately mum was convinced by well meaning friends that Nathan’s night wake ups were due to her feeding him breast-milk and that he was hungry at night. This lead mum to believe she needed to wean him off the breast and onto the bottle and this would solve her night wake up issues and napping issues.

But alas the introduction of formula did little to help Nathan sleep well at night.

Together we decided that hunger wasn't the reason Nathan was waking at night.

He was thriving weight wise, eating 3 meals a day, and the extra night feeds actually resulted in less day feeds.

During my overnight stay with the family, I agreed with mum, hunger wasn't driving Nathan to wake so frequently at night.

Nathan was meeting all his milestones, he started crawling (commando) at 8 months and was now fully crawling around the house, following mum everywhere she went.

Mum felt part of Nathan’s issues was separation anxiety, this made mum feel even more anxious about going back to work in 3 months time.

I had to agree that it did appear Nathan was having some separation anxiety issues over the day, and he was quite upset when mum left the room and he didn’t know which direction to head in to follow her.

I asked mum to start to tell Nathan he she was leaving the room he was in, and to call out to him as she did leave so he could easily follow her or find her.

She also started popping out of the room for a minute at a time, then coming back and showing Nathan that when she leaves she comes back.

We worked up from 1 minute to 5 minutes over a week, and Nathan was happy to wait with his toys for 5 minutes knowing mum was coming back. We had taught Nathan object permanence. (An object still exists even when out of sight).

After reviewing Nathan’s sleep logs, it looked to me like he was waking after every partial sleep cycle – (every 2 hours over night) some nights, and after every complete cycle every other night.

Some nights he was awake at 1am for 1-2 hours, this was most stressful for mum.

I felt the 1am wake up was a developmental leap wake up associated with Nathan’s learning to crawl, and mum realised Nathan was happy awake at this time, it was mum who was stressed out thinking she needed to get him back to sleep.

Mum felt Nathan didn’t need formula every 2 hours so she was not feeding Nathan until midnight, but was rocking him back to sleep every other time he woke up.

Essentially Nathan had developed a rocking to sleep association, and a feed to sleep association for his other wake ups.

During our home consult we spoke about her options and different sleep training methods. Mum felt due to Nathan experiencing some separation anxiety she would chose and in the room technique and spend the time involved with gentle sleep training.

This was entirely mum’s choice and we are happy to work with any technique which is age appropriate.

I spent the majority of the first night in Nathan’s room with mum teaching her the technique and teaching Nathan to go back to sleep, we were both exhausted but optimistic by morning.

We decided to keep the one night feed for a week, and teach Nathan to have consolidated sleeps either side of this feed.

We also had to look at his nap timing, I felt his day was a bit top heavy sleep wise, and he was having his bottles very close to his naps, meaning he was essentially eating every 2 hours over the day.

These day time changes took 10 days to settle down, but Nathan’s night sleep consolidated within 5 days, and then we tackled dropping his night bottle. At the end of 14 days Nathan was only stirring around midnight and sleeping the rest of the night peacefully.

Mum’s final comments:

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