My most challenging cases have always been the cases I've learnt the most from.   This case study was not actually from my work as a night nanny but from my day job so to speak. I was working as a member of management at a Day Nursery and was in charge of the Baby Unit. Names have been changed.


Background info
Baby Victoria aged 10 months old, At fulltime nursery and needs to be held and rocked to  fall and stay asleep both at naptime and overnight.

I met baby Vicky when she was 7 months old, a gorgeous little girl with a passionate fiesty spirit. Vicky was a  quiet observant little girl but if she was upset boy did we know about it. Her personality/ temperament type was The Grumpy Kid to a T, particular, observant ,tactile,thrives on routine doesn’t cope well when they can’t anticipate whats happening next . Vickys mum had recently returned to to work and up until heading  back to work had been babywearing & breast fed  Vicky on demand.

During her  settling in period at nursery mum informed us that vicky needed/ demanded a lot of attention  at home and so  had resorted to baby wearing in order to get things done. Vicky was used to being in close contact with her mum at all times, she was either in her arms of her mum or dad pretty much all the time and  according to her mum did not like to venture off and play by herself.

Concerned about vickys extremely close attachment and need  of them, her  parents hoped  that her being at nursery would encourage more independence in their daughter.

" Vicky is very demanding, she wants me and my attention all the time so i baby wear and breastfeed on demand.  I do feel touched out at times, I don't resent vicky's need of me but i would like for her to be a bit more independent. I’m worried we've inadvertently created a bit of a diva. When she’s tired we rock her to sleep, we have to wait at least 30 mins before we can put her down, if she stirs or wakes and realises we have put her down she screams and cries and gets louder and louder til we get her and then  takes a very long time to calm, then she fights sleep or  flinches and opens her eyes if we move as she is terrified we are going to put her down.

In the mornings she's usually very grumpy as she is such a restless sleeper and again has to be in my arms even at meal times.  Whenever i do need to put Vicky down, she screams  until i’m finished what I'm doing and pick her up again. I'd like to be able to get her to sleep on her own but i dont want hours of crying. Vicky cries for every thing so we are used to  tears but i'm not happy to leave her to cry by herself."

 

I wasn’t working with vicky's mum as a night client, she was one of my charges during my time managing a baby room, she became my key child as  she had setttled into nursery with me primarily and was most calm when with me, she didn’t  take to anyone else at the nursery other than myself and the 3 other baby room team members. I must admit i was very fond of Vicky, & i became quite protective of her during her settling in period as she really struggled being seperated from her mum at first.She was as precious & adorable  as she was demanding, so i quickly  understood what mum meant when she  felt touched out.  Vicky with time adjusted well to nursery and after  8 weeks at nursery  despite having difficulty initially, She’d  learnt how to play more & more  independently but always needed her prefered grown up ( myself or my co worker) to be close by in the background in case she needed us, you would often see her playing and then periodically looking around to see where I was & if she couldn't see me she’d cry out til I either appeared or she heard my voice.


Nap Time at Nursery
As you can imagine nap time was  a difficult time for Vicky at nursery she would be super tired  and could really fight sleep. plus she need a lot of adult intervention to help her get to sleep. Which was tough when you had over 12 babies to get off to sleep at 1 time. some days she didn't nap at all  On other days when she nod off  but would need to be rocked to sleep for a considerable amount of time. The rocking was taking longer and longer every day.Yet she would always wake up the second you put her down. I'm convinced that it took us so long to get her to sleep, because she'd be fretting about the moment we'd put her down.  we were spending 2 hours getting just one child to have a sleep when we had 11 other babies and toddlers to get off to sleep too.  Mum was struggling at bedtimes and i was struggling ( with her and 11 other babies) at naptime i asked mum if i could teach her how to self settle Mum agreed as long as she was never left to cry alone., I knew vicky was going to protest and cry  but i also knew how tired she was by the end of the day and ultimately i was convinced her tiredness was leading to more crying.

My goal was to help her fall asleep more independently so that she wouldn't immediately wake up when put down or when the rocking stopped.

I'm not going to lie to you I was dreading it.  I knew vicky  was seriously tired but no matter how tired Vicky was relaxing to sleep was not easy for her with help.

Plan A

My initial plan was to help her get used to falling asleep without motion first and then  gently transfer her from my arms to her bed.
For the first 3 days I alternated between rocking and standing still to get vicky off to sleep. that worked very well as i found as long as vicky was in my arms and had been wound down she'd fall asleep.  I went from rocking to sleep for 30 mins on monday to just standing still for 30 mins on friday to get her to sleep......but that wasn't the tough part. Actually getting Vicky off to sleep was easy ( when we regularly did her pre nap routine)
Our struggle was putting her down. She would sleep happily in arms but once you put her down she would wake and refuse to go back to sleep.

day 1 - Rocked for 5 mins stood still 20 seconds repeated til she nodded off, 
day 2  - rocked for 5 mins stood still for 1 min and repeated till she fell asleep,
day 3 - rocked for 5 mins stand still for 5 mins
day 4 - rocked for  2 mins stand still for 8 mins
day 5- no rocking to sleep only holding her close to sleep

Plan B

After the first week i decided to reassess what to do. Getting Vicky to sleep wasn't as hard as we thought it would be it was putting her down where she would be sleeping that was the hard bit so building on what Vicky could already do, we suspected she was resisting sleep because she was anticipating being  transferred  to, so we decided to settle her in her bed and not in my arms to avoid gher waking up. At nursery the babies slept in cots and the toddlers on foldable mattresses on the floor. after lunch we'd turn the floor into a huge bed with lots of mattresses for the toddlers. so i decided to try and settle vicky already in the place where she would be sleeping. And to make getting her to sleep a bit easier on my back i used a mattress on the floor like for my toddlers rather than try to settle her in the cot. If i lay next to her so she can see me and touch me if she wanted i wouldn't need to move her again once she was asleep.

Day 6
instead of rocking vicky to sleep in my arms i lay with her in my arms....... Vicky really didn't like that. I laid her down she sat back up and screamed at me, i lay her down again she screamed at me again.we  repeated this a few more times until i sat up and crossed my legs, vicky sat inside my lap and hugged me still crying ( i remember this like yesterday as it was like  a battle of wills)

"Vicky i know you're tired but Charmaine isn't going to hold you in my arms like always,vickys a big girl now!"  vicky just screamed at me in between pouting ( i swear it was the cutest pout ever)

"can charmaine give you a cuddle and lay down next to you?" I asked her, she held out her arms to me i scooped her up in my arms as if to rock her to sleep but instead i lay her on her mattress and lay next to her with my arms cuddling her

Vicky screamed again and sat up so sat up with her
"Vicky's tired isn't she? So is Charmaine ( i yawned for effect)
Vicky put Charmaine to sleep yes?"
and i layed down with her again this time vicky cried but didn't try to  sit up

I stroked her cheek and her hair as i always do to get her off to sleep and she stroked my cheek  too 10 mins later she was asleep.....with my arm trapped underneath her!!!!  So she woke up when I tried to move my arm! We still had progress though.

Day 7
I sat down on Vickys bed and crossed my legs and vicky crawled over to sit in my arms on my lap
as soon as i lay down with Vicky ( this time without my arm underneath her) vicky began to cry and sit up, i lay her back down and began to stroke her face and hair as usual
" I know vickys tired charmaines tired too" and i pretend to close my eyes and i stroke her cheek and hair
vicky continues to cry but her cry changes from angry to more quiet and whiny until she eventually falls asleep, i lay with her for a further 15 mins  then get up , vicky doesn't wake when i leave her she sleeps for 90 mins ( virtually unheard of for her!!)

Day 8
I sit on Vickys bed and she crawls over to my lap again and we cuddle and lay down, vicky cries and sits up again and i repeat the same line to her just once and then i lay her down and stroke her face and cheek
"i  i know Vickys  tired Charmaines tired too"
Vicky falls asleep in her bed with me next to  her sleeps for an hour and 10 mins

Day 9
Vicky still cries going off to sleep - it's like it's her final protest before falling asleep but today her cries are different not so urgent or angry and she calms much quicker. she doesn't sit up when i try to lie her down and she falls asleep  in less than 5 mins

With a little trial and error i managed to get my toughest little terror to self settle to sleep. By Day 15 we only had to sit next to her and stroke her face and cheek to get off to sleep. Technically Vicky  didn't settle to sleep by herself however we had made HUGE progress. We didn't have to an age rocking her to sleep only to have her wake up as soon as we put her down. And mum had the same at home settling her without rocking her to sleep just by staying close by and stroking her hair and cheek.

Although Vicky did  cry, we didn't stop what we were doing and revert back to what she was used to. Nor did we leave her to cry on her own. I supported and reassured her and listened and comforted her when she cried, but I still continued in what i was doing.
even though we changed tactics halfway through notice that i did not leave her on her own at any point in the process.
she cried and protested but i stayed with her throughout. I'm certain that's why she fell asleep so much quicker because she didn't need to worry about when i was going to put her down or leave her.

Here’s 6 tips i learnt from teaching to Vicky to Self Settle.

1. Build on what they can already do 
if you notice we know that Vicky can get to sleep as long as one of us is with her so we built on that. she didn't need to be rocked but she did still need the close contact/ presence of a grown up.
2. If they cry, reassure them but continue consistency is key.
Vicky is a cryer it's what she does and it usually gets her what she wants but i know that crying is ultimately her communicating. so i listened to what she was communicating to me, repeated back to her what I thought she was trying to let me know, which at the time was a) "I'm tired" b)" This isn't what we usually do what are we doing?" confusion C) "go back to rocking me to sleep it's what i know and like !" Frustration. she didn't understand what was going on at first but i continued anyway as i knew how tired she was and i repeated the same steps the next day and the next til she knew and understood and could predict for herself what was going to happen next.
3. Don't be afraid to change tactics if something isn't working BUT give it time before you decide it's  not working. We followed our first plan for 5 days and then realised we needed to tweak things
We noticed getting her to sleep wasn’t an issue after all it  was putting her down when she was asleep  that was the real issue so we changed tactics
4. Be consistent in your approach once you decide which course of action to take.
once we changed tactics we followed through and remained consistent so Vicky quickly got used to her new way of going to sleep.
5. Model the behaviour you want to see in your little one.
Instead of panicking that trying to get her to self settle wasn’t going to work or battling with her to get her to lie down. i worked on helping her relax  by being calm using a calm voice and pretended i was tired too and lay down with her, quietly and calmly. She quickly joined me ( after a small protest) Remember your little one is learning and You are their role model.

6. Don’t try to get away or be in a hurry to.Babies and toddlers can sense this,  and if they're anxious or sense that you are in a hurry to leave them or get away they’ll find it hard to relax and nod off. Stay with them throughout and even a little after they nod off.

If you'd like to teach your little one to self settle but not sure how you can purchase my video class How To Teach Your Little One To Self Settle. download it instantly to your tablet or smartphone and watch and learn how to help your little one get off to sleep without being rocked or fed to sleep. Click here for more info or to buy the class