# Pantley's Gentle Removal (the PPO) - did it work for you?



## aiea (Jan 27, 2007)

Hi all,

I'm trying to get my babe off the nipple all night. She seems to need it perpetually while teething and lately that's for weeks & weeks in a row - and she will take no paci.

I have tried the nipple removal before she goes fully to sleep first of the night, but she either fights it like crazy, lunges in her sleep at it repeatedly, or it's too late and she's already asleep - only to awaken minutes later rooting for it. I think maybe I just need to know that it'll be like this, and do it anyway for x number of nights. But then we always go to sleep fighting over the nipple.

So my questions are - Did you try the PPO and did it work?

How long did it take & how old was babe when you started?

And finally - Doesn't it seem odd that fighting over the nipple while drifting off would help babe sleep *better*? It's always seemed to me that it would make babe restless going into sleep.


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## NotTheOnlyOne (Oct 23, 2006)

My baby is a month older than yours and I have been using the Pantley Pull Out method... and it does seem to be working. Around 8 months, my ds started crawling and gave up the binki all in one week. He then preceded to make ME his binki. After a week or so of that, I started pulling it out. I nurse him to a sleepy state and then pull it out. If he protests, I give it back for a minute then pull it out again. I keep doing that until he no longer protests. It totally worked for us. He is sleeping for longer and longer stretches. Occasionally he sleeps all night without waking to nurse.


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## riversong (Aug 11, 2005)

I use a variation of the PPO method. It worked to reduce my dd's all night sucking and it works with ds now.

I wait till he gets to the flutter sucking stage (when he's done drinking milk and basically asleep but still latched on) and then quickly pull my nipple out of his mouth. I don't break the suction with my finger. I just pull the nipple out. The faster the better. He may startle a bit, but he doesn't wake up. Usually he doesn't even move at all.

Try not to have her legs on you or her hands grabbing your shirt before you do this, because then you'll still have to untangle yourself. The less your body is touching hers the easier it works. A mom in my parenting group advised me to do this because it worked with her son and I was amazed at how well it worked for me.

To answer your questions, this worked immediately to reduce the amount of time she and he needed to suck while sleeping. Dd was probably around 8 months when I started, but I've done it with ds since the beginning. My advice is to follow Pantley's "move the milk" recommendation after you pull out. Move as far away on the bed as possible or turn your back to her. If my breast was in my dc's faces they would wake up more often from the proximity and the smell.

Good luck!


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## hanno (Oct 4, 2006)

What is the benefit to this?


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## aiea (Jan 27, 2007)

Hi Hanno,

The idea is that removing the nipple before sleep will break the association between the two. Baby will not think "I must always have the nipple while going to sleep" anymore. At least that's the hope. The No-Cry Sleep Solution (book by Pantley) has a lot more info.

I tried again last night and this time it was easier & seemed to help. I am going to figure out when to *start* the PPO each night... that seems to be my problem. If I start it too soon (while comfort-sucking & eyes closed but she's still very conscious), we fight over it to no end. I've enlisted DH to watch and time the whole event so we can get some idea of when to start. I think I'm too frustrated to have an objective sense of things at that point.

April


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## hanno (Oct 4, 2006)

So is it to discourage baby from relying solely on one way of getting to sleep? Sometimes my baby falls asleep nursing and eventually he's no longer latched (maybe 10 minutes) and sometimes he falls asleep while looking around and kicking, he'll sleep in the carrier or in the car or in my arms of on my chest.
It seems like maybe there's a need for PPO that I'm not understanding due to lack of experience with other babies.


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## kuhlmom (Sep 23, 2005)

This helped me with DS #1 - he was attached to my nipple 24 hrs a day. I remember it took a while and he didn't like it at first, but in the long run it helped out a lot at nighttime.


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## sarbear (Mar 21, 2007)

I didn't have great luck w/the PPO, but you never know what to attribute to 'other' causes for more night waking (like teething,etc.) Just when I thought it was starting to work, ds would want to be latched on more than ever throughout the night. It's not an exact science I guess, but I think over time, if you have the patience, it does work.
I am going back to work soon, so we are in a bit of a hurry, and are trying a modified version of Jay Gordon's plan. We are trying a 5 hour stretch to start out with instead of the recommended 7 hour stretch, since ds is not a year old yet. We were both awake for over an hour (from 3:30-4:30) this morning, so it isn't easy, but I think if you want to somehow cut down the night nursing/waking you have to go through an uncomfortable transition period. Hopefully for both of us it is a short one


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## Jennisee (Nov 15, 2004)

It never worked for my DD. She was probably 2.5 years old before she could go to sleep without nursing, but she eventually outgrew the need all on her own.


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## UmmBnB (Mar 28, 2005)

Worked for dd. So wish that book had been out when ds was an infant.


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## mightymoo (Dec 6, 2003)

It worked for us - basically if you persist at it night after night, the baby gets more used to the experience, and some nights, they will be tired enough to not bother making a fuss and will go to sleep, other nights they will keep asking for it and its okay to at some point just nurse them to sleep, if you keep at it, eventually it becomes normal to them and they get used to it. At least that was my experience. It wasn't a gradual progression, it was one night great, the next it didn't work, etc but over time the good nights were more frequent than the bad, etc.


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## aiea (Jan 27, 2007)

Hi all,

Thanks for the replies. I have to remember that it won't be progress made in a straight line, but with good nights & bad ones. Last night was great - got her off the nipple and wiggled to the other side of the bed, total wake-ups were 3 or 4 I think (just nursing & back to sleep). That's a lot better.

Sarbear - It sounds like you & I are in the same boat time-wise (my DD is 9.5 months now). If teething is not an issue, nights are A-OK (maybe 2-3 wake-ups). And I can't expect DD to always have an easy night even if her teeth are OK. The other night we had a reaction to dairy, and Yikes!

Dr Jay Gordon's method is exactly what we are getting ready for mentally, but I don't think we can try it until DD is well over a year, for scheduling reasons (my DH goes back to work when DD is one year) I don't want to overburden the both of us. I am hoping the PPO will help out enough in the short term that we won't need Gordon's method so soon. I would love to be updated with how your DS does at < 1 year with Gordon's method. How old is your DS?

Hanno - You said: So is it to discourage baby from relying solely on one way of getting to sleep?

Yes, that's the idea. From your sig line I think your babe is about 2 months old, right? My babe would go to sleep in all the ways you described above when she was 2 months old (I'm a new mom too). But after a couple more months, the only way she'd sleep is by sucking & rocking (both at once, preferably), though sucking was/is by far the more profound help to her.

In the OP I wondered how aggravating DC by removing the nipple would help him/her sleep sounder. That doesn't make sense to me, and it sounds like you might be confused by it too. But going to sleep w/out the nipple (hence waking up not expecting to have it later) does make some sense. I think it's just a help to break the association and meantime replace with other sleep cues.


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## mezzaluna (Jun 8, 2004)

we started doing this at 6 mo. it didn't change his sleep associations, but it helped him learn to sleep without being latched on... consequently i got more sleep because i can't really sleep with a babe latched on! he still nursed to sleep, but then i would take him off the nipple, he would stay asleep, and i could go to sleep.

the first time i tried it i had to unlatch and relatch him about 20 times. the second time 5 or 6 times... and then after that it usually worked the first or second time.


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## Erin M (Nov 6, 2006)

We're working on it now. It has greatly reduced the amount of time I spend trying to nurse dd to sleep the first time. I used to spend over an hour and a half lying next to her waiting for her to be asleep enough to get away from her. the PPO has turned bedtime into a 20 minute thing most nights. I still nurse her until she's asleep but then as soon as all her fingers relax I pull out. I usually have to repeat 5 or so times. If I don't wait for the sleeping signal she wakes up and gets angry.


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## aiea (Jan 27, 2007)

Hi Erin,

Your description of "how asleep" before you disengage was really helpful. Thank you!

I usually wait until DD has eyes closed, flutter-sucking, is no longer restless (ie moving appendages), relaxing into sleep and yet I know she's barely aware. For me, the skill I am now trying to develop is finding that window - too short, and she wakes up just a few minutes after I leave - too long and there's no new learning involved on her part (i.e. no nipple is OK).

I'd like to just be able to time the minutes (though I am not a clock-watcher), but I think it varies too much depending on how tired she is per night.


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