Sleeping and settling services

For struggling new parents dreaming of sleep, help's at hand if you know where to look.
 
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01 .Sleep issues

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Having a new baby in the house can come as a big shock. Each one comes with its individual set of behaviours and, at times, problems.

The good news is that help is at hand. We spoke to some of the organisations that specialise in “baby craft” to find out what kind of services are out there.

Family care centres based in each state and territory in Australia do similar work with babies and toddlers (see Where to get help). CHOICE spoke to both Tresillian and Tweddle about the services that they assist frazzled parents with. Among other things, both offer help for parents in the form of day visits and residential programs for parents who have been referred by either a GP or baby health clinic. Tresillian also runs a helpline.

Settling the sleeping problems

Both centres say they deal with sleeping problems using a technique called responsive settling.

Leanne Daggar, a centre manager and director of Tresillian, describes the technique as being very gentle and working in partnership with the parent. “The basis is listening to the child’s cues, recognising the tired signs [and] trying to develop a settling program. We encourage parents to work with us and certainly don’t let the babies become distressed.”

Clare Pridham, clinical nurse consultant with Tweddle, says, “One of the biggest misconceptions is that the more tired a baby gets the longer they will sleep. If they are overtired they don’t sleep as well. The key is being consistent. For example, if you put them down in one place for a day sleep and then somewhere else at night it can cause problems, so when you come here we work on all these issues together.”

Should you call the baby whisperer?

Over the last 10 years or so there has been a rise in the number of private individuals offering commercial sleep and settling programs.

Elizabeth Sloane, the author of the The Gift of Sleep, has been working privately to help parents instigate a sleep program. Sloane, who originally worked as a mothercraft nurse, started developing a sleep program after struggling with her third child who was not sleeping well.

She now runs her popular program full time and often has a waiting list. Sloane says that lot of what she does is what she provides in person. “I am a circuit breaker; I am there to be calm, consistent and to provide guidance.”

She claims she has approximately a 90% success rate with the families she works with. “When it works, I call a sleep program a magic wand because it is life changing – the babies are sleeping, the parents are rested, they have more partner time, the babies are waking up happy and with an appetite and the family and the baby have a real sense of routine.”

 
 

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Settling babies: baby going to sleep

Sleeping success

Eithne Healy was referred to Tresillian when her daughter Lucille was about 16 months old and was prioritised for a residential stay at a centre when Lucille was 18 months.

“Lucille was a terrible sleeper and was quite happy to be awake all the time, I on the other hand was not! I would resort to rocking her to sleep and then putting her into her cot. She usually would wake 45 minutes after being put down to sleep and on a good night would be waking three to four times – 10 times at her worst.”

After seeking advice from the local baby clinic, and employing a sleep consultant at home, things did improve, but only marginally. Finally her GP referred the whole family to do a residential stay at Tresillian for several nights.

The family found that the residential stay was a positive experience with staff who guided them through maintaining a routine, which resulted in a quick improvement in Lucille’s sleeping habits. Eithne also says it was good to speak to other parents who were having problems at home, and in some cases relieved that their problem wasn’t as bad as some other families’. “It was hard to hear other mothers crying, as they struggled to respond to their children’s difficult behaviour.”

Eithne says she would definitely recommend using a centre like Tresillian. “It was much better than I expected and they never let her cry for more than a minute before I could reassure her. When Lucille woke up at night, I felt confident to follow the nurses’ lead on how to reassure her, but give a firm but caring response, which sent the message that it was sleep time and she was OK.”

A dad’s perspective

Lucille’s father Dayne Steggles says he found the Tresillian experience a lifesaver for the whole family. “While Eithne was the primary respondent to Luci’s never-ending waking, it still was very disruptive during the night and I often took up the slack during normal waking hours outside of work hours. I also felt a little helpless as the sleep deprivation took its effect on Eithne.

“To put it in perspective, we’ve never had another night of disrupted sleep from Luci, except when she has been sick. It’s like Luci was just waiting for the right kind of direction and support from us so as to learn how to go to sleep soundly, alone and with total confidence.”

A work in progress

When Jo Levy's  baby girl Noa wasn't sleeping for more than 20 minutes at a time, she didn't hesitate to seek help. “I was going downhill fast. I wasn't functioning or coping at all.”

Jo contacted her local baby health care nurse for help, and was referred to Tresillian. Jo says she was unsure about going to the centre as she'd heard some negative things about the place and didn't want to put her baby under stress. “I was concerned that they would leave her to cry it out, but the nurse reassured me that their approach was very gentle.”

She says that her day stay at the centre was a positive one. “It was much better than I thought it would be. You do need to have a good relationship with the nurse you work with – and in the residential they are very supportive.”

Jo says it took a couple of attempts to get Noa to sleep on her own.

Noa is now 10 months old Jo says that while the techniques she learned at the centre have worked well for day sleeps, nights are still tricky. “At times I’ve been tempted to try other things but I think this is a good routine and worth sticking to.”

Despite the plethora of products on the market promising that they will be the magic bullet to help your baby to sleep, the experts we spoke to agreed that less is best when it comes to getting your baby to sleep.

“All you need is a cot – a safe one,” says Leanne Daggar from Tresillian, “the rest isn’t needed.”

One expert says she has seen parents arrive at her centre with three car loads’ worth of mobiles, music and other products that promise to induce sleep when in fact all they have done is overstimulate the baby.

Clare Pridham from Tweddle says,  “It’s about getting back to basics. You don’t need gadgets. Less is best.” Meanwhile, Daggar says, “I went to a baby shop and I was staggered by all the things you can buy for a babies now. Babies need love and attention and you can’t buy that. We are very caught up with gadgets, and apps and websites and that’s how we get all our information but when it comes to babies you need to read their signs by watching and listening and being consistent – not using a gadget.”

Between a sleep-deprived parent and the almost overwhelming amount of advice out there is also some controversy around some of the sleep techniques that are used. One of the best known techniques is controlled crying – hailed by many as the solution to sleep time problems, but derided by critics as emotional abuse that could cause long-term psychological problems.

CHOICE spoke to Dr Monique Robinson, Associate Principal Investigator at the Telethon Institute for Child Health Research at the University of Western Australia.

CHOICE: Can you outline the difference between "controlled crying" techniques and leaving a baby to "cry it out"?

Robinson: This is a really important distinction. Controlled crying is about responding and returning to the baby, though at increasing intervals so that the baby learns to self-settle and doesn’t rely only on the parent to settle. Crying it out or "extinction" is where the parent closes the door and does not respond at all, and this is where most of the controversy is focused in terms of the impact of this stress on the baby.

Parents who are having trouble working out how to enact controlled crying and where the boundary between controlled crying and extinction lies might find the resources offered by Tresillian and its equivalents of benefit.

Many parents who are struggling with sleep issues say they are wary of using places such as Tresillian or Tweddle because of the techniques they use. Is there any research that has been done into this area to allay their concerns?

Tresillian and Tweddle (and their interstate counterparts) may not suit every parent, but for some parents a short stay program or education session can be of immense benefit. The really important factor with controlled crying (or controlled comforting, self-settling, and so on) is that the baby should be six months or older, and parents need to distinguish between controlled crying and "extinction" or crying it out.  

The comprehensive Pediatrics study by Anna Price and colleagues did not find any difference in behaviour or emotional functioning, sleep problems, attachment or maternal mental health six years on, indicating that controlled crying techniques did not cause long-term damage, so this should be reassuring for parents who are looking for some support. 

There is also no shame in accessing these agencies for support. We don’t know why some babies find sleep more difficult than others, but there is no need for mums and dads to feel guilty about needing some advice and support.

Are there a lot of myths around sleep and teaching to sleep techniques? 

I think the biggest myth is that there is one technique that will be the answer for everyone, which is often either subtly or not-so-subtly the message promoted by some infant sleep books.

I have seen mothers who have read every book they can find and trawled Google for answers and sometimes it just results in increased anxiety in addition to the lack of sleep. So while it is important that families look for a solution that will suit them and access relevant supports, it is also really important that we don’t assume there is a solution out there if only we look hard enough! 

Sometimes problems will resolve with time and some babies may never be great sleepers.

 What would you say to a parent struggling with sleep problems?

As a psychologist working in this area I would encourage parents to seek support for sleep problems as we all know that lack of sleep (especially over a long period) can be a major factor in determining our overall wellbeing. These problems are really common and even the very best parents find themselves needing to ask for help, so it is no reflection on parenting if a baby is having trouble with sleep patterns. The controlled crying technique has not been shown to be harmful and in fact it has many benefits for mums in terms of reducing depressive symptoms. 

However, not all parents will feel comfortable with this technique and that is okay too, it’s just important that parents look into different techniques and ask around for advice so that hopefully they will come across something that feels right and works for them.

 

Where to get help in your state

NEW SOUTH WALES
Tresillian Family Care Centres
Phone: (02) 9787 0800
Tresillian Parent’s Help Line: (02) 9787 0855  (in Sydney)
1800 637 357 (outside Sydney, within NSW)

Karitane

Phone: (02) 9794 2300
Fax: (02) 9794 2323
Karitane Careline: 1300 227 464

The Hills Parenting Centre

105 Showground Road, Castle Hill, NSW, 2154
Phone: (02) 9659 7760

VICTORIA

The Queen Elizabeth Centre
Phone: (03) 9549 2777 

O'Connell Family Centre

Phone: (03) 8416 7600

Tweddle Child & Family Health Service

Phone: (03) 9689 1577

QUEENSLAND
Ellen Barron Family Centre
Phone: (07) 3139 6500

SOUTH AUSTRALIA

Torrens House
Phone: (08) 8303 1523

Women's and Children’s Health Network
Phone: (08) 8161 6003

WESTERN AUSTRALIA

Ngala Family Resource Centre
Phone: (08) 9368 9368
Country access: 1800 111 546

AUSTRALIAN CAPITAL TERRITORY

Queen Elizabeth II Family Centre
129 Carruthers Street (PO Box 126), Curtin, ACT 2605
Phone: (02) 6205 2333

TASMANIA

Department of Health and Human Services, Child Health & Parenting Services
Parent Line: 1300 808 178

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