Parents attend two or three private sessions with a healthcare professional trained in infant sleep intervention.
Session 1: Education and choice of intervention
Discuss normal sleep cycles, the learned behaviours of sleep (eg falling asleep independently, settling after night waking) and how factors that reinforce sleep problems can be eliminated with appropriate behavioural interventions.
Give parents a choice of intervention (controlled crying or camping out) and techniques to manage other factors that affect infant sleep such as bedtime routine, weaning off overnight feeding and dummy use during the night.
Provide the parents with a sleep management plan, information about the development and management of sleep problems and a sleep diary to monitor progress.
Session 2: Follow-up after 2 weeks
Warn parents about ‘extinction bursts’. This is a burst of behaviour that happens 2–4 weeks after the behaviour was extinguished. This occurs in about 20% of infants and takes the form of infants waking again overnight in the absence of an explanation (eg febrile illness).
Advise parents to manage this by re-instating their chosen behavioural technique; infants typically settle back to their good sleep habits after a few nights.
If the sleep problem has not improved, consider possible reasons, such as:
- behavioural technique not being correctly implemented
- parent disagreement about how to manage sleep problem
- maternal or paternal depression.