WHEN I WORKED with parents in their homes, the majority of the babies I helped care for were given a dummy in the first few months. If used with discretion, I find the dummy to be a great asset, especially with a ‘sucky’ baby or one who gets fussy and irritable prior to sleep times. However, my advice has always been that the dummy should be used to calm a tired or irritable baby and, if necessary, help settle him at sleep times, but it should always be removed before he actually falls asleep. In my experience, allowing a baby to fall asleep with a dummy in his mouth is one of the worst sleep association problems to try to resolve; if a baby becomes ‘addicted’ to the dummy he will wake up several times a night and be unable to get back to sleep unless given the dummy.
Some recent research has suggested that using a dummy when putting your baby down to sleep may reduce chances of Sudden Infant Death Syndrome (SIDS). The Lullaby Trust advises that if you use a dummy, it is very important that you should ensure that you wait until breast-feeding is established first (about a month), and make sure you offer it for every sleep. This advice is echoed by The UNICEF UK Baby Friendly Initiative; it says that research shows dummies may be protective but that infants may be ‘at greater risk of SIDS if they routinely use a dummy but have not been given their dummy on a particular night.’
The Lullaby Trust offers some key points for anyone who chooses to use a dummy for putting their baby to sleep: ‘Don’t force your baby to take a dummy or put it back in if your baby spits it out. Don’t use a neck cord. Don’t put anything sweet on the dummy, and don’t offer it during awake time.’ There are also certain health concerns to be aware of. The UNICEF UK Baby Friendly Initiative warns about potential risks of dummy use, which include increased risk of ear infection and dental problems, as well as ‘risk of accidents such as obstruction of the airway’. If you have any safety concerns about the use of a dummy, I would urge you to contact The Lullaby Trust directly to discuss the matter with them personally.
Since the publication of the advice that babies should be put to sleep at every sleep with a dummy, I have seen a huge increase in sleeping problems where the baby’s reliance on the dummy has become so bad that parents can find themselves replacing it every 30 to 40 minutes from early evening right through to 6 or 7am. I have witnessed first-hand the serious affect that the lack of sleep has both on the baby and parents when this happens.
If this is the case for you, please see below for some practical strategies to help you cope with the lack of sleep that can come with the persistent use of the dummy.
THE LULLABY TRUST recommends that you withdraw the dummy from your baby between six and twelve months old. Until your baby reaches an age when you feel comfortable getting rid of the dummy completely, I would recommend that you give up on battling bedtime out if your baby is just not settling in the evening without it. One of the things that most parents find really difficult to cope with when their baby is dependent on the dummy is constantly trying to settle their baby in the evening when he wakes every 30 to 40 minutes needing the dummy. Sometimes a baby wakes up after 30 to 40 minutes looking for the dummy, but even when given the dummy he can take a further 30 to 40 minutes to return to sleep, only to wake up again and the same pattern repeats itself.
If this is what is happening with your baby in the evening, I would recommend that you don’t even attempt to settle your baby for a longer sleep around 6 or 7pm. Instead, until you are in a position where you can implement a plan to totally eliminate the dummy, I would advise that for a short period you aim to settle your baby for a nap and then extend his day by having a further one or two awake periods during the evening, so that he is not getting himself worked up into a fretful state looking for the dummy.
For this method to work you will need to adjust your baby’s feeds so that when he wakes he can have a small feed and then stay awake happily. How long he will stay awake for will depend on his age: babies under three months will probably manage to stay awake between one to two hours, and babies between three and six months usually manage to stay awake for up to two hours.
• If your baby’s bedtime is normally around 7pm, I would recommend that you give him a small milk feed at 5pm, then, instead of starting his bath and bedtime routine at 6.15pm, that you just feed him, then settle him for a nap.
• Hopefully, he will sleep for somewhere between 45 minutes to one and a half hours. As he had a small feed within the last couple of hours, he will probably not be very hungry when he wakes, but if he is very irritable offer him a small top-up feed so that he can stay awake happily. This will be for around one to two hours depending on his age.
• Treat this awake time like you would his other daytime awake slots. However, if he is irritable you may find that he prefers to just be cuddled on your lap, rather than play. This is absolutely fine. Remember, what you are trying to achieve here is to have him awake slightly more in the evening, so that he is not needing to be given the dummy repeatedly to get him back to what is probably a very disrupted sleep.
• Depending on his age he will be tired again after one to two hours of being awake, and you should aim to give him another short nap before his bath and bedtime routine.
• Usually the bath and bedtime routine comes between 5 and 7pm. However, using the extended-day method, your baby’s bath and bedtime routine will now come somewhere between 9 and 10.30pm, depending on when he last woke.
• For example, if he woke up from his last nap at 9pm, you would probably start his bath around 9.30pm, so that he is feeding around 10pm and settled in his bed around 10.30pm. Depending on when he fed, he may need a split feed at 9pm and 10pm.
• Please refer to the chart below on how to adapt and adjust the feeding and sleeping early evening, so that your baby still takes a really good late feed.
| 5pm | Tea time solids as usual |
| 5.45pm | Offer his milk earlier so that he takes less now and more at 10.30pm |
| 6.30pm | Settle baby for a nap – this can be in his pram or as you take him for a walk in his buggy |
| 8.30/9pm | Wake baby up and have some social time before his bath |
| 9.00pm | Offer him a small milk feed if he seems hungry |
| 9.30pm | Start bath and bedtime routine |
| 10.00pm | Bedtime milk feed and wind-down time done in his room |
Obviously, your baby may still wake up in the night for the dummy, but you should find that because he has been awake more in the evening, the wakings in the night are slightly less. It is also important to remember that the aim of this plan is to reduce the stress in the early evening of constantly trying to get a fretful baby who is waking up several times needing the dummy to sleep. The above method will not resolve his need for the dummy, but it should make things a little easier until your baby has reached an age where you feel comfortable about tackling the dummy dependency problem.
ONCE YOU HAVE decided the time is right to tackle your baby’s dummy dependency problem, you will have to decide whether to totally eliminate the dummy or allow your baby to have it at selective times during the day – when he is bored or tired, for example. In my experience, I find that parents who do not totally eliminate the dummy altogether can all too often end up offering it to their baby again at sleep times. Therefore, my opinion is that if you are going to eliminate it at sleep times it will be easier in the long term to eliminate it totally and not have a dummy in the house at all. You will not then be tempted to resort to it a few weeks down the line.
There is a lot of advice about how to ditch the dummy, many claiming to be ‘gentle’, promising a method that involves ‘no crying’. One of these such methods involves allowing the baby to suck on the dummy and, as the baby’s sucking lessens just prior to him falling asleep, you remove the dummy. While I am sure that this method works for some babies, it does not work for the majority. From listening to parents who have attempted and failed with this method, they say that the reason they gave up is that, contrary to the claims that their baby will not cry, there is usually some degree of crying involved. That, along with the fact that this approach can take up to two weeks or even longer to work, is the reason that I believe so many parents give up because they simply cannot cope with night after night of crying.
I am not going to promise that using my plan will not involve some crying, but what I can say is that any crying will be kept to the minimum and that within a few nights your baby should be settling to sleep with only a short spell of crying down. Please refer to here so that you understand the difference between crying down and crying up.
DAY ONE
• Eliminate the dummy at nap times by taking him out in his buggy for a walk or in the car.
• He can still be given the dummy at bedtime and during the night.
DAYS TWO TO THREE
• Implement the later bedtime described on (here) so that he is only given the dummy at the 10pm feed or in the night.
DAYS FOUR TO FIVE
• By this stage your baby will only have been having the dummy at the late bedtime and when he wakes in the night, therefore now is the time to eliminate the dummy completely.
• Bring his bedtime back to 7pm and settle him in his cot sleepy but awake and shush and pat him to sleep (see here).
• If he gets very upset he can be picked up and calmed down, but it is important that you put him back in his cot before he goes to sleep.
• Each time he wakes in the night, use the same approach: shush and pat him back to sleep, only lifting him out of the cot if he is getting really upset. Remember that he must be settled back in the cot sleepy but awake.
DAYS SIX TO SEVEN
• By day seven I usually find that most babies are settling within a few minutes of waking by being shushed and patted, therefore now is the time to allow him to self-settle.
• Place him in the cot sleepy but awake, and for a minute or so gently stroke or pat his tummy and say, ‘Night, sleepy time,’ and then leave the room.
• At this stage you should be able to implement crying-down time, as described here.
• Most babies will settle within a few minutes of crying down, although I do find that a few babies will fight sleep and take a little longer to settle.