Wednesday, June 16, 2010

Baby sleep

I'm going to preface this post with a caveat that I am not at all an expert on baby sleep. Not because I can't get my baby to sleep. I can very well. But I am aware that I have an incredibly easy baby, as far as sleep goes, and therefore I can't take much credit for his excellent sleep habits. So, this post is about what works for him, with the proviso that most babies would require a little more.

When we brought Marko home from the hospital, he didn't know the difference between night and day. This is usual but quite exhausting. Generally he would eat, sleep for a few hours (three if we were lucky, more often two or less) and wake up to eat again. There wasn't much "awake time" in there at all. During the daytime it was so nice to have him sleep so much ... at night, the interruptions in sleep meant that I was asleep (if I was lucky) only half the night.

The pediatrician told us that it's quite normal for him not to know the difference between night and day, but that we should be able to train him to sleep more at night by making nighttime as boring as possible: just feeding and changing, no playing or turning on the lights. In the daytime, we should interact with him a lot whenever he woke up. That did work after a week or two -- he would sleep three-hour chunks at night, and always go right back to sleep after he woke up. For his daytime naps, he mostly slept in his grandma's or aunts' arms for the first week, but when they left, he started taking crib naps. And those started stretching to three hours as well. His awake times were never much more than an hour, so I admit to feeling a bit lonesome with a baby who slept all the time!

He sleeps in a Moses basket a couple of feet from the bed. I tried the cosleeping thing, but it just didn't work for us. He absolutely wouldn't sleep in my bed for more than maybe half an hour, and I couldn't sleep at all if he was next to me. I wasn't afraid of rolling over him -- I just can't sleep if anyone's touching me.

Now, I might open myself up to some real criticism here, but in the interest of honesty I have to admit it: Mark is a tummy sleeper. I tried and tried to get him to sleep on his back, but he would have none of it. He would wake up within a few minutes if you put him down on his back. Even in the womb, I believe he was always tummy-down at night. Every pediatrician ever will advise you to put a baby to sleep on his back. This is believed to reduce the risk of SIDS (Sudden Infant Death Syndrome, also called crib death). Since we still aren't completely sure what causes SIDS, the idea is just to get on the right side of the statistics game. But in every other part of the statistics game, we're on the right side: he was born at full term, at a normal weight; he is exclusively breastfed; we don't smoke; he sleeps in our room instead of a room of his own.

And babies on their backs have a few problems too. The pediatrician warned us that back sleepers will get flat spots on their heads, and are also physically delayed because they don't get enough time on their tummies to exercise. Often they can't even lift their heads up well -- which puts them at further risk for SIDS or smothering if they do end up on their front once or twice. Also, sleeping on the back triggers a startle reflex. Have you ever been dozing in a chair and felt like you were falling? This causes the startle reflex which wakes babies up. They throw their arms and legs in the air. We swaddled him to try to keep him from waking himself up, but he was a strong baby and would fight his way right out of it (if we could get him in it in the first place, and then get him to sleep, which was rare). Finally my mother-in-law said, "Just go ahead and put him on his front. We were always told to put babies down on their front when I was raising mine." So I gave in, and I'm glad I did because he finally got some good sleep and has been getting it ever since. It makes me feel safer to know that, with him so close to me at night, I wake up if he gets too quiet, and I always check on him.

Another piece of conventional advice is, "Put the baby down drowsy, but awake, so that he will learn to soothe himself to sleep." Um, a "drowsy but awake" baby doesn't get drowsier when you put him down ... he gets awaker. I could imagine this works for some rare babies, but considering I have a rare specimen of a good sleeper and it doesn't work for us, I really don't think it would work for many. He does sometimes wake up as I put him down, and occasionally I leave him that way, half-asleep, but he has to be soundly asleep before I put him down, or he wakes right up and flails around grumpily.

I also ignore the "don't nurse him to sleep" advice. What's the point of nursing if you can't take advantage of its handy calming powers? (Well, there are tons of good reasons still, but really -- if something always makes baby sleepy, why make a rule that they must never fall asleep while doing it?) He can and does occasionally go to sleep without nursing, but usually nurses to sleep. (I am thankful that he can go to sleep without nursing, though, because it means John can put him to sleep too. In fact, he can often do it when I can't, like last night when baby was a big old fussy-pants!) Once he's pretty well out, I move him up to my shoulder to burp. He stirs a bit, but doesn't generally open his eyes. I burp for awhile and rock the rocking chair, and gradually slow down the back pats and the rocking until I think he's ready to go down. Then I carefully lay him down in his crib, which invariably does wake up a little bit, and wait for him to stop moving around. If he opens his eyes for more than a second, all is lost and I have to do it over. Still, I think most babies are a lot harder to put to sleep than that.

So, what about a nap schedule? Some babies have no schedule, and some you could set a clock by. For awhile there Mark was very scheduled. He got up at six exactly, stayed awake till eight or nine, slept till noon or so, was back down by three, up at six, and down for the night at nine. It was like clockwork -- three hours up and three down, all day long! Well, in the past couple of weeks the whole nap schedule has fallen apart. I'm not really sure why. It might be because he doesn't need as much sleep as he used to, especially as he sleeps better and better at night. I think a big part of it is that he is sleeping more lightly for whatever reason: he wakes up after one sleep cycle, about 45 minutes after going down, and can't get back to sleep like he used to. (He used to wake half-up and screech a few times, fuss a bit, and settle back down without ever opening his eyes. My trick to figure him out was: eyes closed, he's just fussing and needs help to settle back down (back pats or a soothing voice), eyes open, he's ready to get up.)

His original nap schedule was completely of his own making; he woke and slept as he wanted, and I just followed his cues. If he was fussy at all, I nursed him. If he dozed off while nursing, I rocked him and put him down. When he woke up happy (waking up screaming has been a sign he needs more) I played with him. Once the schedule was established, I reinforced it by keeping him awake for a nice long time before naps, so that he would be able to sleep soundly instead of taking little catnaps. Now that the old schedule is shot, I'm back to just following cues. I figure he knows how much sleep he needs. If he's fussy, I generally try to get him to nap, but if he won't go down, I just wait till he will. Lately his naps are not very long, except when I hold him. I know people will say I'm spoiling him by holding him for a whole nap, but he sleeps so much better in my arms, and besides, I love to hold him. I know he won't want to be in my arms forever, so I need to get my snuggles in now! (It helps that I can surf the internet while he sleeps in my arms.) If he wakes up crying, I try and get him to go back down. Once he wakes up and smiles at me (the BEST feeling!), he's up for awhile.

Now for a word about baby sleep schedules. A lot of parents decide on their baby's sleep schedule for him, and have rather strict methods of reinforcing it. Different methods include the Ezzo or "Babywise" system and the Ferber or "cry it out" system. Babywise dictates certain schedules the baby is to follow from the day he comes home from the hospital. You feed only every three hours. When it's time for a nap, you put the baby in his crib, shut the door, and walk away. Obviously the baby screams and cries, but eventually he wears himself out and falls asleep. Whatever happens, you are not to open that door until the scheduled nap is over. This method, besides striking me as cruel and inhumane, has been linked to failure to thrive -- babies lose weight or stop gaining weight because they are not getting enough to eat. Every three hours is just not enough for some babies. But my main objection to this method is the notion that a baby only cries because something is wrong, and if he cries, you should go get him. Wild, I know.

This same objection applies to the Ferber method and all other "cry it out" techniques. The advantage is that you are supposed to wait until the baby's a little older and has a better ability to fall asleep on his own. But the system still requires you to let the baby cry, for hours if necessary, until he falls asleep. I simply couldn't do that if I wanted to. Eventually, they say, it does work: after a few days the amount of crying is reduced and the baby will usually go to sleep fairly quickly. But I don't want my baby to fall asleep crying alone, feeling abandoned and unheard. Proponents claim that "he'll never remember it"; however, there are some studies out there that show they do remember it on an emotional level, and grow up more disconnected from their parents. Extended crying also does damage to the brain, as it is flooded with stress hormones for an excessive period of time. Only in the Western world is it considered okay for a baby to cry for hours --in the developing world, babies cry for minutes a day. As for me, I don't need the science -- I just love my baby and don't mind caring for him. I know he will learn to sleep on his own later, but for now, while he's a baby and doesn't know how to fall asleep on his own, I will help him. When he cries, I go to him.

We still sleep at night with the crib a few feet from the bed. Baby goes to sleep about 9:30, sometimes earlier or later, but I've found that it has to be dark outside or he won't stay asleep. Unfortunately our bedroom only has light blinds, so I have to wait for real darkness. I put him in a thick diaper and try to avoid nighttime changes unless he's soaking through the diaper. Someone told me about this when he was little, and it's true -- nothing wakes a baby up like a cold, wet wipe on the bum! I use either a plastic diaper or my fancy bamboo-fiber diapers.

These days he generally wakes once at night, if at all. When I hear him start to fuss, I shush him a little to see if he will go back to sleep. Sometimes he does. (He did at 4:30 this morning, much to my delight ... I really didn't want to get up!) If, after a minute or so, he's still fussing, I get up and gently pick him up. Since he's generally still not completely awake, I try to avoid anything that will wake him up. Instead I bring him to the rocking chair, feed him, and burp him. When I see that he's still and contented again, I lay him back down and creep back into bed. Sometimes he keeps stirring for awhile, but when he sees it's dark and his tummy is full, he drifts back off. (When he was little it took a lot more work than this, and I sometimes had to pick him back up several times! But now he knows the drill, and he goes back to sleep very easily.) Then, around six (sometimes 5:30, when Daddy's alarm goes off) he'll wake up full of smiles and cheer. I feed him, change him, and we're up for the day. Occasionally he'll wake up at this time and still be fussy, in which case I put him back down after I feed him, but generally once he wakes up and it's light out, he stays up until his morning nap.

He's been sleeping through the night with only one wakeup (around 3 or 4 a.m.) since he was six weeks old. This is NOT the norm, so don't go thinking you can have kids and get a full night's sleep too! We have gotten a lot of amazement from friends and family, who have raised kids that didn't sleep through the night till one or two years old. Babies are ready to sleep through the night at different ages, and that's okay. It doesn't mean there's something wrong with the baby, or that he's not developing as he should. It just means he has a big appetite, he isn't tired, he doesn't like the feel of a wet diaper and needs a change, he's a light sleeper, he needs more snuggling, or whatever. A lot of moms feel bad that their babies don't sleep while other mothers' babies do. Sheesh, babies are all different! It doesn't mean you're a better mother or have a better baby just because yours is a good sleeper. A "hard" baby is just as likely to grow up into a wonderful, intelligent, well-behaved kid as an "easy" baby.

So, that is how a non-expert gets her baby to sleep. None of this is an attempt at giving advice, though if any of it works for you, go for it! I would advise, though, that NO ONE ever use the "Babywise" method on their children, because it has been so heavily linked with harm to babies. I am a firm believer in the notion that you can't spoil an infant, so you should follow their cues and pick them up when they cry. It's a little harder on the parent, but parenting isn't easy no matter what you do, so why not pick what's easiest on the baby? Just my two cents.


Enbrethiliel said...


My grandmother likes to brag that all her children have nice shaped heads because she put them to sleep on their stomachs; and she advised my mother to do the same to me and all my siblings. No SIDS cases at all! But yeah, she's not a physician or anything. =)

Bev said...

What a beautiful post. It is really similar to my experience with my daughter as well. I love how you are sensitive to balancing medical advice, your needs, and your baby's needs.

Sheila said...

Sometimes you listen to the doctors, sometimes you listen to your baby, sometimes you've just got to listen to your gut. We all do what works for us. :)

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