Babies

Controlled comforting

Controlled comforting

What is controlled comforting?

Babies and children need sleep to grow and develop well. Good sleep is also important for their health and immunity.

But babies can have trouble settling to sleep by themselves.

Controlled comforting is a way of helping babies adjust to settling themselves to sleep. It involves putting your baby to bed, quickly comforting, settling and leaving him, and then quickly and periodically checking and reassuring your baby while he settles.

The idea behind controlled comforting is to help babies and children move away from needing you to feed, pat or cuddle them to sleep.

What can you expect if you try controlled comforting?

Most babies will cry while they're getting used to a new way of going to sleep. That's because they like their usual way of getting to sleep and might be upset by change.

Crying is upsetting for parents and babies.

So it's important to know that babies are safe if they cry when you leave them for short and predictable periods during controlled comforting. It might also help to know that babies whose parents have used controlled comforting are more likely to sleep better in the short term.

If you're unsure about controlled comforting or you'd like advice about your baby's sleep, talk with your child and family health nurse, GP or paediatrician.

Controlled comforting is different from crying it out or extinction crying, where a baby is left to cry completely alone until she falls asleep. Leaving a baby to cry for long periods of time can be harmful to a baby's development. But the intervals of up to 10 minutes used in controlled comforting are safe.

Is controlled comforting right for your family?

To help you decide whether controlled comforting is right for you and your baby, take a few minutes to consider the following questions. If you answer 'yes' to all these questions, controlled comforting might be worth a try:

  • Is your baby aged between six months and two years old? In particular, controlled comforting is not recommended for babies under six months.
  • Are you and your baby both well? If you think illness might be why your baby isn't settling, talk to a GP or child and family health nurse. Also, it's best not to commit to this strategy if you're unwell, because the strategy needs time and patience.
  • Do you think your baby is comfortable when you're not in sight? If he isn't, it might be separation anxiety. Although separation anxiety is normal, it can make it harder to do controlled comforting.
  • Can you recognise your baby's early tired signs? The strategy works best when babies are sleepy, but not overtired.
  • Do you have enough time to play with your baby when she's awake? And do you enjoy playing with your baby and sharing affection? These are good signs that your relationship is developing well, and you have good attachment.
  • Will you be able to cope if your baby cries more while he adjusts to a new way of getting to sleep?
  • Are things stable in your family, with no big changes like a new baby, a house move, or other stresses? Controlled comforting won't be helpful if other things are causing your baby stress.
  • Do you and your partner or other close support people agree that controlled comforting might be an option for you? It's best if you and your partner, if you have one, can agree on a consistent approach and work as a team.
  • Have you got time for controlled comforting? It takes around 3-14 days to work, and you need to do it during the day and at night. It's best to avoid important commitments for the first few days after you start.

Your relationship with your baby is unique. It's up to you how you settle her. It will depend on what feels right for you, and what works best for your baby and your family. Controlled comforting won't suit all babies and parents.

How to do controlled comforting

The steps below involve comforting your baby and then leaving him for a set amount of time before you go back to comfort him again. You're aiming to give your baby the chance to settle by himself, and to learn that you'll eventually come back.

  1. Establish a consistent and positive bedtime routine.
  2. When it's time to say goodnight, put your baby in her cot. Comfort your baby with talking or patting until she's quiet, or for one minute.
  3. As soon as your baby is quiet, or after one minute, say goodnight and leave the room. Leave before your baby is asleep.
  4. Listen to your baby. If she isn't crying, but is grizzling or whining, you can wait to see whether she settles by herself. Going in when your baby is grizzling might stop her falling asleep.
  5. If your baby starts to cry, wait for a set amount of time before going back to your baby - for example, two minutes at first.
  6. Leave your baby for a sequence of set time intervals - for example, two, four, six and eight minutes.
  7. If your baby is still upset after each time interval has passed, return briefly. Talk to your baby or pat her for about a minute, or continue talking or patting until she's quiet, depending on your preference. Try to soothe her without picking her up if you can.
  8. As soon as your baby is quiet (or after about a minute) but before she's asleep, leave the room again and wait for the next set time interval.
  9. Continue until your baby falls asleep by herself.
  10. When your baby wakes overnight, check that she's comfortable - for example, not too hot or too cold, not needing a nappy change, and not unwell. Then follow the routine again, starting from step 2.

Adapting controlled comforting
It's OK to adapt the steps above, depending on what you and your baby are comfortable with. For example, you can set your own intervals or keep your intervals at two minutes, rather than extending them to four minutes.

Also, if you're not comfortable leaving your baby alone, you could call out gently now and again to let him know you're nearby - for example, 'I'm here. Time to sleep now'. But remember that you're aiming for a quiet, non-stimulating sleep environment.

If your baby doesn't seem to be getting used to this new way of settling for sleep after a few nights, or she seems to be getting more distressed, it's a good idea to get professional help with settling your baby. You could start by talking with your GP or child and family health nurse. They'll be able to help you develop an approach that's right for your child or point you towards professionals who can help you.

Important tips for controlled comforting

These tips can help controlled comforting go well:

  • Use a clock or your mobile phone to time intervals.
  • Make sure you can still hear your baby.
  • Don't wait outside your baby's bedroom. Go into another room and distract yourself, perhaps by making a cup of tea or turning on the TV until the set time is up.
  • Keep an eye on your baby's nappy. If it's dirty, change it under low light and with minimal fuss.
  • Always ensure that your baby has had enough to eat during the day. Hungry babies can find it difficult to settle and might wake more during the night.
  • If you have a partner, work out what role each of you will play - for example, helping with resettling or timing the intervals. Consider taking turns each night.

If you use this strategy for daytime sleeps as well, your baby will be less confused by this new way of getting to sleep. If your baby wakes up from a day sleep after less than an hour, try to re-settle him for another 15-20 minutes, again using controlled comforting. If your baby hasn't gone back to sleep after that time, get him out of bed and try again later.

Common problems with controlled comforting

Here are some common problems with controlled comforting and practical tips for dealing with them.

  • If your baby is unwell, you should stop controlled comforting and start again when she's better. If she has a slight runny nose and cough but no fever, you can still use controlled comforting if you're happy to do so.
  • If you're concerned about teething pain, you can give paracetamol. Paracetamol takes about 20 minutes to work, so babies who settle after that might have been in pain. If you have persistent concerns about your baby being in pain, talk to your GP.
  • If you're really tired or upset, pick up your baby, calm him in any way you want - for example, with a small drink or a cuddle - and try again the next time your baby needs to sleep, or when you're ready.

What if controlled comforting isn't working?

If you feel that controlled comforting isn't working but you want to keep trying, it might help to go through the steps above again and check whether there's anything you're not doing or could do differently.

Keep in mind that some babies just find it harder to settle or harder to get used to change. This has a lot to do with temperament. Also, there might be times when happy, healthy babies find it harder than usual to settle. For example, sometimes this happens when babies are developing very quickly and they need more reassurance from you.

The goal of controlled comforting is to help your baby get used to settling by herself, so that both you and she have less disrupted sleep. But if the stress from increased crying has you wondering whether controlled comforting is worth it, it might be best to talk with a child health professional or go back to what you were doing before.

Most importantly, try not to blame yourself or your baby if controlled comforting doesn't work for you. There are other options you can try for helping your baby settle.