Motor Skill Milestone Specific Sleep Regressions: Rolling, Crawling, Standing.
We get a lot of questions on this topic! Chances are, if you started to follow us back in January and your baby was very young, you’ve experienced at least one regression since then. If you haven’t already, be sure to read our popular blog on the 4 month regression (which doesn’t necessarily occur right at the four month mark). This can help you evaluate if your child is having a sleep regression that is actually due to a sleep association rather than physical milestone. If it’s pretty clear a new milestone is the cause, we hope you find the following information helpful. We’ve indicated some potential response patterns for you to implement as you navigate a milestone, but we want to be very clear that though common, these are NOT the only options! The age and temperament of your baby and the realities of your daily life will have significant impact on the type of interaction that may be the best fit for your family.
The Science: For some babies rolling starts as early as 3-4 months and for others is not until more like 6 months. The problems pop up when your baby learns to flip onto her tummy and she’s NOT comfortable – she’s stuck and she can’t sleep! This can be magnified during the early morning hours or naps when REM sleep is dominating yet your young baby does not have REM sleep paralysis. This can cause her to perform new skills in her sleep (like rolling) which then wakes her if she’s uncomfortable or feels stuck.
The Sleep: Rolling causes sheer panic in many parents who are aware of the AAP recommendation that sleeping your baby on her back is safer. First things first –if your baby is learning to roll and it seems she may be able to roll while swaddled, you’ll need to stop swaddling her now. Take a look at our swaddle and swaddle transition blogs for information on how to do this. You may wish to transition into a Merlin Sleep Suit to help keep your baby positioned on her back for longer if she’s rolling very young. If you had been, you’ll want to stop using a mobile at this time too in anticipation of the next milestone of pulling up and reaching/grabbing. Next, familiarize yourself with current AAP safety recommendations. At time of publication of this blog the recommendation is to place your infant on her back to sleep for all sleep episodes during the first year. If she rolls herself into a preferred sleeping position independently, she’s “allowed” to sleep there! Your job is to make her crib as safe as you can – no swaddles or suits, no blankets, pillows, bumpers, strings, ties, toys, wedges or positioners, soft mattresses, etc – and continue to practice tummy time during the day!
The Real Life Challenges: If your baby rolled over happily and snuggled in for sleep on her tummy in a safe crib (as she probably will when she’s 9-12 months, maybe sooner) things would be great! The problem is when young babies roll over and then become stuck or uncomfortable OR their parents have some anxiety which prevents them from sleeping when their baby it learning to roll. If your baby is stuck on her tummy – please rescue her! Sure, this might mean repositioning her every 60-90 minutes (or even more) during some parts of the night, especially the last part of the night but we don’t want your baby stuck on her tummy. As you reposition your baby try to coach/guide/half assist her back onto her back for more comfortable sleeping and practice the skill of rolling tummy to back during tummy time in the daytime. As she masters the skill, coach and assist less and let her take over! For many babies, once the new skill is mastered, the novelty of flipping over wears off quickly and in just a few nights of disruption and assistance from their parents things go back to normal. If they don’t AND your baby is old enough to start some sleep training, it may be necessary now. As you begin the sleep training method that feels right to YOU and YOUR family, incorporate rescue rolls and assistance at each time you offer soothing to your baby if she is still unable to reposition herself. For example, if she flips over and starts to fuss, you may respond and lean over her crib and “shhhh”, rub her back, and murmur some coaching words to help her reposition. If she cannot on her own, you can assist her to roll and then fade away your response (perhaps leave the room, perhaps sit in a chair close by, perhaps resume soothing at the side of the crib). If she drifts off to sleep, that’s great! Continue to assist her less and less each night as she masters her skill. If she flips again right away, return to the cribside to FIRST try to coach/cue her to do it on her own. If she cannot, help her. There are many different algorithms to how the ins and outs of a response like this might play out in your family and for your baby, and that would be best discussed in a personalized sleep consult but the general premise is underlying: help your baby if she’s stuck, practice during the day, as she masters the skill reduce your response!
Sitting, Up On All Fours, Crawling:
The Science: Typically, over the span of 6-12 months at least one of these three milestones will disrupt your child’s sleep. Some babies seem to be very sensitive to all three! As described in the rolling section, naps and the second half of the night are notoriously more difficult due to REM sleep, but falling asleep times (bedtime, naptime) are often affected as well. Low sleep pressure and sleep pressure/circadian rhythm mismatch and schedule irregularities at this age can exacerbate the problem so be sure your baby is going to sleep at age appropriate times, and staying awake for age appropriate lengths of time.
The Sleep: Now is the time to lower the mattress if you haven’t already and prepare for the next stage of sleep! Although these milestones can be disruptive, the great news is your baby is most likely old enough now to be “sleep mature” which will make it easier for you to assess your expectations in the night. Swaddles and sleep suits should definitely be removed at this point, though we recommend continuing to use a sleep sack throughout early toddlerhood so loose blankets are not needed and to help reduce crib climbing at an early age. As your baby begins to move around her crib she may bump and roll into the sides. She may also pick up some more unusual, though rarely concerning, soothing habits like rocking, rubbing, banging, or rhythmic movements. Although it will be tempting to add bumpers or blankets to soften the crib sides, the AAP does not recommend use of these items due to suffocation/entrapment/SIDS risks. A little bump may occur from time to time inside a crib, but a serious head injury certainly will not and it won’t be anything more than some parental TLC can’t quickly cure!
Real Life Challenges: If sitting or crawling around the crib has become more entertaining then sleep, take a deep breath. First, you cannot force your baby to fall asleep, you can simply continue to provide the time, place, and opportunity for it to happen. Assess your child’s schedule and make sure you’ve allowed her to move into an older baby sleep pattern with enough sleep pressure to support falling asleep quickly and make sure her daytime sleeping environment is nice and dark so it’s less interesting to look at.
Happy Sitters: If your baby is sitting up or rocking up on all fours while trying to fall asleep but is happy about this – you might just let her be! She may topple over eventually and figure things out in her own way. If she’s sitting up and quite happy but STUCK, try responding in and out of the room from time to time and gently repositioning your baby and place a heavy hand on her hip or pelvis for a moment or two to encourage her to lie down. Don’t force, and don’t hold her down. Leave the room and give her another chance on her own. If she happily sits again, wait a brief time and then respond and repeat the practice of helping her lie down for sleep. Practice the skill (sitting to lying down) frequently during the day! At nighttime, with a happy sitter/or crawler, eventually your baby’s sleep drives will cause her to fall asleep so just be patient and calm and predictable. During the day, it’s possible your baby will resist her sleep pressure for an entire nap. You’re left with two options: give up after 15-30 mins and rock or soothe your baby to sleep in a new way (yes, possibly picking up a new sleep association but…salvaging a nap) OR take a break, play for about 45 -60 mins and retry when sleep pressure is very high and complete nap resistance is less likely.
Unhappy Sitters: For an UNHAPPY sitter/crawler our advice is only slightly different in that you might choose something a bit more interactive. For example – if you place your baby into her crib for a nap and she immediately sits up and cries, frustrated by her new independence and/or unable to lie back down – stay close. Reach through the crib bars or lean over the cribside and help her reposition, using the same heavy hand as described above but without physically restraining your baby. “Shhhh” her, soothe and pat her, and when she’s calm try to take a step back. If this cribside soothing doesn’t do the trick, go ahead and pick her up and rock or sway her until she’s calm and then put her back into her crib to try again. If she pops right back up……lather, rinse, and repeat! Continue this as long as it takes at bedtime (her sleep drives will take over and she will fall asleep without about 40-60 mins in most cases) or for naptime see options 1 and 2 from above. Again there are many different ways to incorporate sleep training into this skill – some very structured, more restrictive and fast timeline to success, and some more gradual changes over time. The above are just EXAMPLES of common techniques used to get through these milestones. Like with rolling: help your baby if she’s truly stuck, teach her and practice the skill with her during the day, and step back/solve new sleep associations that may have popped up when she’s mastered the skill!
Pulling up to Stand:
The Science: As early as 7-9 months but sometimes not until closer to age 1 is when babies learn to pull up to a stand, and some will begin to cruise the inner perimeter of the crib. Nine months is also a prime time for some separation anxiety so you may have some overlapping regressions around this age.
The Sleep: It’s essential your baby’s crib mattress is on the lowest setting now, and that she cannot reach out to unsafe items in the room such as dangling cords, wires, heavy objects, etc. Be sure furniture is moved away from the crib so she can’t use it as a step to get over the bar. As your baby approaches age 1 she may be old enough for a small, washcloth sized lovey to bond with in her crib but do avoid pillows and stuffed animals which some resourceful babies will stack up and use like a step to get out of their cribs!
Real Life Challenges: Pulling up is very similar to sitting up in terms of response. If your baby is pulling up at cribside and happy about it – you may want to just let her be and see if she’ll figure out how to lower herself or eventually flop down into the mattress. If she’s happily pulled up, but also stuck – you’ll want to do some checking in and out from time to time to guide/coach/half assist her down from the bars. One of the best ways to do this is to go in and squat right down next to the crib so you are eye level with the mattress and pat or rub the mattress. See if you can get her to come down to you! If she cannot, you can certainly reposition her/lay her down once and put the same heavy hand on her hip with a gentle “shhh” to encourage her to lie down. Duck out of the room again. If she happily pulls up again, give her a few moments to figure it out then repeat, repeat, repeat.
If she’s pulled up and UNHAPPY or frustrated, and especially if there is any separation anxiety going on, you might choose to stay with her. First, give her the chance to lower herself down by squatting down and patting the mattress. If she can’t figure it out and she’s frustrated, lie her down or even pick her up and rock her/re soothe her before placing her back into her crib. If she pulls back up immediately FIRST, give her the chance: stand there at the side of the crib and sway/slow dance with her, squat down again eye level to the mattress and encourage her to get down on her own. If she’s truly stuck, reassist. The big take away here is that you do NOT want to get into an up/down/up/down/up/down battle with your child. If she pulls up the second you place her down, go with it! Stand and sway with her, squat down with her, coach and cue her and when you’ve both had enough, give her a quick hug or rock and then place her in her crib to try again. Like above – this is one commonly used technique but there are MANY more. At bedtime do this until she falls asleep. Practice lowering self during the daytime and when you see your baby has mastered the skill be sure you fade away your responses and let her take over!
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Copyright Baby Sleep Science: Sleep Resource Center 2014