Dr. Sarah Mitchell
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Teaching Independent Sleep to Breastfed Babies

Many breastfed babies rely on nursing to help them fall asleep at bedtime and during middle of the night wakings. While this often works in the early newborn months, most babies are developmentally ready to learn independent sleep skills by 4-5 months of age.  There's also a beautiful window of gentle sleep teaching occurring around 6 to 12 weeks where you can avoid the common parenting pitfalls by using gentle newborn sleep shaping that we teach in The Helping Babies Sleep Method.   Teaching your breastfed baby how to fall asleep on their own can lead to longer stretches of sleep and less sleep deprivation for both baby and parents.

As a baby sleep consultant and lactation counselor, I've worked with hundreds of breastfeeding mothers who felt anxious about sleep training while wanting to preserve their breastfeeding relationship and milk supply. My goal is to provide you with tips to gently teach your breastfed baby self-soothing while being flexible and responsive to their needs overnight. Independent sleep is an important milestone that allows babies to sleep more soundly and get the uninterrupted rest their growing bodies and brains require. But it must be done in a nurturing way that works for your unique baby and family.

​If you're looking for a step by step approach to help you reach independent sleep quickly and effectively, check out our best selling book on Amazon. 

Benefits of Independent Sleep for Breastfed Babies:

Teaching a breastfed baby independent sleep skills like self-soothing can help them sleep for longer periods overnight and take consistent naps during the daytime hours. Members of the Academy of Sleep Medicine state mastering self-soothing and independent sleep by 4-6 months is an important developmental milestone.

Here are some key research findings that provide evidence to support the claim that breastfed babies who learn to self-soothe before 6 months get more sleep and need less night feeding:

  • A 2012 study published in the Journal of Pediatrics by Kempler et al. looked at breastfed infants who were sleep trained using graduated extinction methods (aka controlled crying) between 4-6 months. They found the sleep trained group slept longer at night and reduced their night feeds compared to a control group at 6, 12, and 24 months.
  • A 2015 systematic review by Douglas et al. in Sleep Medicine Reviews found sleep training methods like graduated extinction led to significant decreases in night wakings and increased sleep duration. The effects were shown in infants 4-6 months old.
  • A small 2018 randomized trial by Yoong et al. in JAMA Pediatrics assigned breastfed infants at 6 months to either a graduated extinction sleep training group or control. The sleep training group had longer stretches of sleep at night and fewer night feeds at 9 and 12 months.
  • A 2020 cohort study by Nevarez et al. in the Journal of Pediatrics found breastfed infants who could self-soothe to sleep by 4 months had longer sleep stretches and less night feeds at 6 and 12 months compared to those who couldn't self-soothe at 4 months.
  • Multiple studies note the important developmental window at 4-6 months where sleep training can be effectively implemented in breastfed infants to positively impact self-soothing and night wakings before sleep associations and habits are engrained.

When breastfed babies reach this age, their sleep cycles and circadian rhythms have matured to consolidate sleep for longer stretches, not necessarily 11 hours but at least 6 hours,  without needing to eat. This allows them to get the 12-16 hours of quality, uninterrupted sleep per 24 hours that is recommended for this age group. Longer sleep sets up healthy habits for the future. Babies who get enough consolidated sleep at night also tend to take more consistent, restorative daytime naps. This helps them stay asleep during care from other family members if parents return to work.

Independent sleep provides other benefits too. Babies who can self-soothe tend to awaken less often at night at the end of 2-3 cycles, roughly 2.5 to 3 hours. Infants are also better able to fall back asleep independently when disruptions happen, whether from travel, time change, or illnesses. Teaching self-soothing skills equips babies with tools to be flexible, adaptable sleepers as they grow.

Tips for Preserving Breastfeeding:

You don't have to stop breastfeeding or night feeds to help your baby learn new skills. Here are some tips to preserve your breastfeeding relationship while teaching independent sleep:

  • Start by shifting the timing of the pre-bedtime feeding. For a few weeks before formal sleep training, move the final nursing session earlier, aiming to finish at least 30 minutes before putting your baby into the crib awake. This slowly dissociates feeding from the sleep association.
  • Create a consistent, soothing bedtime routine that excludes feeding. Activities like baby massage, bath, pajamas, stories signal to your baby that sleep is coming soon. The last step should be putting your baby awake baby in the crib, not nursing them to sleep or to drowsy.
  • Use alternative soothing techniques when putting your baby to bed like white noise, swaddling for babies who are not yet rolling, pacifiers, and gentle rocking or patting to help them fall asleep without nursing.
  • When night weaning, follow your baby's cues. Dropping night feeds cold turkey can impact your breast milk supply. Watch for early hunger signals like stirring, rooting, hands in mouth. Nurse on demand overnight according to age guidelines.  However, remember that your longest stretch of sleep is usually at the beginning of the night and the most common time to nurse is between 2 and 4 am when your prolactin levels are the highest and milk supply most bountiful.
  • Consider introducing a "dream feed" - a feeding when you go to bed around 10-11 PM to fill baby's tummy before the longest sleep stretch. This can help them sleep longer.
  • If you feel your supply drop, add a pumping session after the early morning feed. Avoid daytime bottles until breastfeeding is well established. Limit pacifier use to sleep times only.
  • Stack your nursing sessions in the daytime.  For babies 4 months old and older you want to have intentional feeding sessions where baby is relaxed coming to the breast and focused on feeding. 
  • Offer breastfeeding before solid foods so they are filling up on breastmilk and continuing to transfer milk.  Taking a full feed and transferring milk is one action that help keeps your supply up.   
  • Frequent nipple stimulation will help your milk production by the stimulating the release of two important hormones: prolactin and oxytocin.  Nipple stroking causes the release of prolactin and nipple stretching causes the release of oxytocin.   
  • Go at your baby's pace. Some infants adjust quickly while others take 2-3 weeks to sleep independently. Allow enough time for new skills to develop while ensuring your baby's needs are met.

Ways to Soothe Without Nursing :

There are many different ways to help a breastfed baby fall asleep without nursing. Try incorporating these into the bedtime routine:

  • Swaddling is helpful to initiate sleep for babies less than 4 months who continue to have the Moro reflex and lack hand control. The swaddle helps minimize the risk of their hands waking or distracting them. Make sure to stop swaddling once baby shows signs of trying to roll over.
  • White noise, like the static sound from a machine or app, helps drown out house noises that can be distracting.  It does not need to play all night long but can be helpful for  to create a calming environment for sleep.  The AAP released some guidance on the use of White Noise in 2023 suggesting parents limit the use to <8 hours, play as low as possible and move it away from the baby. 
  • Rocking, bouncing, or swaying provides rhythmic motion that can lull a baby to sleep, but avoid any abrupt movements.
  • Singing soft lullabies engages the auditory system and your soothing voice helps calm baby and initiate sleep.
  • Pacifiers give baby's natural sucking reflex an outlet that doesn't involve milk. 
  • Sleep sacks are helpful to promote the feeling of safety and security.  They are also in alignment with safe sleep environment of no blankets in the crib. 
  • Baby massage with a lightweight lotion relaxes muscles and calms the nervous system to prepare for sleep. Focus on legs, arms, back and avoiding the stomach.
  • A warm bath raises body temperature slightly which drops after getting out, mimicking the temperature shift of falling asleep. Keep baths brief and avoid soap which may dry skin.
  • Here are a few sources that provide evidence that bathing before bedtime can help initiate sleep in babies and children:
  • A 2016 study published in Sleep Medicine found that newborns had improved sleep after a bath compared to no bath before bedtime. Babies had shorter sleep onset time, longer total sleep time, and less night waking after a 15-minute bath.
  • A 2015 study in Children's Health Care found children ages 2-5 years fell asleep faster and slept more deeply after a warm bath versus a nightly routine without a bath.
  • A review in Sleep Medicine Reviews (2014) looked at studies on bedtime routines. They found multiple studies showing a warm bath led to decreased sleep latency (time to fall asleep) in infants and children under 5 years old.
  • A small study in 2008 (Giring et al.) found preterm babies fell asleep faster and had longer sleep durations after sponge baths compared to no bath.
  • The consistent finding across these studies is that warm bathing helps raise body temperature initially, then the subsequent drop in body temperature after bathing helps promote sleep onset.
  • Reading or telling a story in a calm voice signals winding down before bed. Cuddle baby close so they feel secure.

As your baby becomes accustomed to these new associations over a consistent bedtime routine, you can start implementing more formal gentle sleep training methods. The key is gradually moving away from all sleep associations by4  months of age when sleep needs consolidate.

Implementing Gentle Sleep Training or as we call it Sleep Teaching since you're teaching a new skill

Once your breastfed baby is around 4 months old, you can begin gentle, nurturing sleep training to truly teach self-soothing and independent sleep. 

Here are several sources that provide evidence that sleep training methods are safe and effective for infants:

  • A 2016 randomized controlled trial published in Pediatrics found the graduated extinction sleep training method decreased night wakings and increased sleep duration without any long-term negative effects on parent-child attachment or child emotions/behavior out to 5 years old.
  • A systematic review in Sleep Medicine Reviews (2014) looked at 52 studies on various infant sleep training approaches. The authors concluded graduated extinction methods consistently improve infant sleep with no evidence of harm to parent-child bonding or child wellbeing.
  • The American Academy of Sleep Medicine issued a position statement in 2016 declaring behavioral sleep interventions like graduated extinction are effective and recommended for infants 6-12 months old who have trouble falling asleep independently.
  • A meta-analysis in Sleep (2006) found sleep training decreased the number and duration of night wakings, increased total sleep time, and improved sleep quality in infants and young children with no deleterious effects reported.
  • A 30-year longitudinal study published in Pediatrics (2012) followed up adults who had sleep training as infants and found no differences in their emotional health, attachment, stress response or sleep patterns compared to adults who were not sleep trained as babies.

In summary, multiple randomized controlled trials, meta-analyses, position statements, and longitudinal studies provide strong evidence that sleep training is safe for infants and reliably improves sleep with no long-term negative outcomes.

If you're looking for a step by step approach to help you reach independent sleep quickly and effectively, check out our best selling book on Amazon. 

Here are some methods to try:

  • Faded bedtime checks: Put your baby to bed at their usual time using your new routine that doesn't end in nursing. When they fuss, return quickly to soothe them with your preferred method (back rubs, shushing, etc.) but avoid picking them up. Repeat this for 2-3 checks on the first night, spacing the checks 5 minutes apart. The next night, wait 7 minutes between checks, then 10. Increase the intervals between checks until baby falls asleep independently.
  • Pick up/put down method: Put your baby to bed awake. When they cry, pick them up and soothe them briefly - but not until they fall asleep. Put them back in the crib awake and repeat as needed until baby self-settles. This reassures them you are still present while disrupting sleep associations.
  • Graduated extinction: Also known as Ferberizing, follow your normal pre-bedtime routine but put baby to bed awake. When they cry, let them self-soothe until the designated check-in time, starting with 3 minutes the first night. Increase the interval by 5 minutes each night, up to 10-15 minutes max. Briefly soothe at check-ins.
  • Minimal check-ins: Put baby to bed awake as usual. If they protest for 60 seconds, give brief, unwarm verbal assurance such as "Mommy loves you. Time to sleep." without physical contact. Repeat every 10-15 minutes as needed until baby falls asleep.
  • When you're ready, consider putting your baby in her own room.  Some babies sleep better in their own room according to this study. 
  • Here are some sources that provide evidence for babies over 4 months sleeping better in their own room:
  • The American Academy of Pediatrics recommends that babies should sleep in their parents' room for the first 6 months to 1 year, but can transition to their own room after 6 months for better sleep.
  • A study in Pediatrics (2017) found infants who room-shared at 4 months and then transitioned to their own room at 9 months slept longer and woke less than those who remained room-sharing.
  • A randomized trial in JAMA Pediatrics (2021) assigned mother-infant pairs to room share or independent sleep from 4 to 9 months. Infants in their own room had less disrupted sleep at 9 months.
  • A cohort study in Sleep Medicine (2018) found room sharing at 4 and 9 months was associated with more night wakings and poorer sleep quality compared to infants who transitioned to their own room.

The key is consistency. Allow enough time for new skills to develop - the process may take 2-3 weeks. Avoid nursing to sleep as a shortcut on difficult nights. Support your baby's needs, but remain confident in their ability to master this key milestone.

If you're looking for a step by step approach to help you reach independent sleep quickly and effectively, check out our best selling book on Amazon. 

Being Flexible and Responsive

While teaching independent sleep, be flexible and responsive to your baby's needs. Here are some tips:

  • Feed on demand overnight. If your baby wakes crying inconsolably, they may be truly hungry. Offer a breastfeed, watching their sucking patterns to ensure it's a nutritive feed.  Notice if it's not so you can gain confidence to respond differently the next time.
  • Comfort immediately if baby seems ill. Check for fever, nasal congestion, etc. and tend to their needs. Sleep training cannot be done safely if baby is sick.
  • Make bedtime earlier if baby seems overtired. Adjust schedule if needed.
  • Take a break if you or baby become too distressed. Some bad nights are expected. Seek hands-on sleep consultant help if struggling.
  • Have dad or another caregiver put baby to bed some nights. This prevents association with just mum at bedtime.
  • Let naps happen on the go if needed. Some sleep is better than no sleep.  When you understand sleep is a learned habit, and learning happens with repetition, you'll want to do naps at the same time as that will make it easier to learn, but if you need motion to help you at the beginning, you can do that. 
  • Expect and accept regressions.  Regression means distraction.  This is usually due to teething or mental leaps, however travel and illness can both cause backslides. Get back on track as soon as disruptions end.
  • Avoid bedtime bottles as a shortcut on bad nights. Stay the course with self-soothing techniques.
  • Rule out medical issues if sleep struggles persist. Food allergies, reflux, ear infections and more can disrupt sleep. See your pediatrician.
  • Focus on healthy habits, not just sleep duration. Independent sleep is about supporting baby's overall development.
  • Remember that slip ups and some crying are normal. You are helping your baby gain skills for lifelong healthy sleep. Keep the end goal in mind.
  • Don't compare your baby's progress to others. All babies adjust to sleep training differently. Stay patient with your child’s timeline.
  • Seek counseling if you are struggling with feelings of guilt, anxiety or depression during the process. Prioritize your mental health.
  • Stick to an age-appropriate bedtime based on baby's signs of tiredness. Overtiredness or undertiredness can both make sleep training harder.
  • Minimize stimulating activities and screen time before bed. Have a predictable series of calming activities to cue rest.
  • Make sure baby's sleep environment is optimal - dark, cool, white noise, breathable. Exclude any comfort items that can become a sleep crutch.

With time and consistency, your breastfed baby can learn to be a great sleeper. Stay responsive, meet their needs, and trust the process. You've got this mindful parent! 

If you're looking for a step by step approach to help you reach independent sleep quickly and effectively, check out our best selling book on Amazon. 

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