Showing posts with label cry it out. Show all posts
Showing posts with label cry it out. Show all posts

Saturday, August 14, 2010

Sleep Solution: Lay Me Down to Sleep.... Gently

One of the most commonly asked questions among parents of infants is how they can get their baby to sleep better at night. It can cause stress, exhaustion, and an sense of being overwhelmed. I am a strong advocate of using gentle methods of helping your infant sleep and of helping mom feel better about the sleep situation.





1. Change Your Expectations - The first thing that we need to consider is changing our idea of what normal baby sleep consists of. If we expect our child to sleep through the night before the age of 18 months then we just might be kidding ourselves. And 18 months is pretty much an arbitrary number but I've put it in here to let you know that anything younger than that is completely up in the air. In fact the human adult wakes up, on average, every 90 minutes. So perhaps it is all just a big joke. Our children will never sleep through the night. The sooner we accept this the easier this sleep issue will become. We know that mother's stress levels affect baby's mood. We know that mother's emotional availability affects baby's sleeping habits. And we know, or should know, that biologically human infants were made to wake often during the night. This being exaggerated for breastfed infants but still true for every infant. And if they do sleep through the night it is likely that will change during a growth spurt, a developmental change, an illness and so on. This doesn't mean there aren't the rare few who do sleep through the night with little intervention and those babies aren't abnormal. They are just ahead of the game. I guess all-in-all this is a soft way of saying that when you became a parent you gave up your right to a good night's sleep. It will likely be a long time until you get one and that is fully normal especially for the infant who is just responding to how nature made them. And, in fact, accepting this will actually help you get a better night's sleep. Yes, I realize that is quite an interesting conundrum.

2. Make a Happy Mommy - The next thing we can work on is helping mom feel better. Since we have accepted that our babies are not going to sleep through the night we can focus on making mom's (and/or dad's) mental health and mood positive. This could mean feeling better through night wakings, for the mom who has a baby that isn't napping, or just feeling better overall.

Mommy Wellness Tips:

A. Naps - Do your best to fit in a nap. Even cat naps are restorative. So if you can slip in ten minutes in the car after work that will help! Or sleep 20 minutes during LO's afternoon nap. The afternoon nap is the one where baby is likely to sleep deepest and longest.

B. Stations - Set up food and drink stations around the house. That way if you become overwhelmed you can nourish yourself easily. You *will* feel better if you drink plenty of water and keep up on your calorie intake. So, put water bottles where LO sleeps and little snack baggies.

C. Enjoyment - Find something you can enjoy during the Middle of the Night wakings. Play on the internet, watch your DVR or a DVD, read a book. Anything that can take your mind off your stress and bring you a bit of mindless pleasure.

D. Anticipation - Try to build up a sense of anticipation for your Middle of the Night wakings. Even make it fake if you must. Figure out anything you can focus on as enjoyable during the MOTN so you can wake up happy.

E. Assess - Assess Yourself! Are you hungry, too hot, thirsty? Yes, we know you are tired! But what about your other needs. If you aren't meeting them all then it can make everything more difficult.

3. Educate Yourself! Knowledge is power. The more you know the less difficult your challenges will be, the more normal they will seem, and the less likely you will try non-gentle parenting techniques. this will also leave you armed with information in case a friend or a doctor recommends non-gentle parenting techniques.

A. Read some gentle parenting sleep books.
My top three recommendations are (in no particular order):
aa. The No Cry Sleep Solution
bb. Sleeping with Your Baby
cc. Nighttime Parenting

B. Dispel common myths regarding infant sleep.
aa. Rocking your baby to sleep, nursing your baby to sleep and at night, and/or cosleeping does not create sleep issues and will not create a child who has problems sleeping in their own bed.
bb. Infants are not supposed to sleep through the night. Their sleep cycle biologically has them wake at night. It is even preventative of SIDS that they wake at night.

C. Learn how the Cry-It-Out (CIO) method works.
aa. The cry it out method creates stress hormones to be released in moms body. That is one reason you feel so bad if you have tried to do this. You biologically were designed to respond to your baby's cries.
bb. The cry it out method creates abnormal and harmful amounts of stress hormones in your baby's body.
cc. The cry it out method does not teach your baby to self-soothe. It teaches them to shut down when they have night time needs.
dd. This video is a fantastic resource on how the CIO method works: "Penelope Leach Talks about Crying".

4. Gentle Sleep Tips - Here we have the heart of the matter. Gentle tips that you can put into practice to help encourage better sleep habits. Now I'm going to admit up-front that nothing here is going to shock your pants off. They are all fairly simple ideas and are not at all uncommon. They are not methods like what you will find in books. They don't require you to keep a journal or watch a clock. They are simple tips that if brought into your lifestyle will likely make sleep a less challenging issue. The more you are able to incorporate, the better.

A. Routines - Establish three types of routine to help your baby sleep better. You want a bedtime routine, a naptime routine, and a sleepy sound. Routines help your baby expect sleep. A sleepy sound is something like a gentle shush that you do when you want baby to calm down and sleep. Only use it at this moment. It will teach them that when this sound is made it is time to calm down.

B. Natural Light - Exposure to natural light helps infants sleep better. So get your kid outside for a walk daily or sit in the park. Even if you can only expose your child to five minutes a day you should see some benefit to it. If the temperature outside is simply too hot to take your child outside then open the curtains and have some play time in front of the window. Please remember to always use sunscreen. And know that artificial light cannot replace natural light. I will also mention that the natural light in combination with fresh air seems to have the biggest benefit.

C. Dark and Unstimulating - When it is time for sleep try to make your baby's sleeping environment as calm as possible. When it is night you also want it to be dark.

D. White Noise - Some babies respond very well to white noise. However you should try several types of white noise if your baby is not responding to it at first. Some examples are: mimic of mom's heartbeat, white noise machine or CD, light music, natural white noise such as a box fan or dryer.

E. Skin to Skin - The more skin to skin time you have during the day the better. If you can't have skin to skin time then body to body time also has great benefits. So babywear if possible. If not then just hold your baby and bathe with your baby as often as possible. You should always be touching your baby when they are feeding from a bottle or breast. Okay so breast is kinda obvious. Consider all the devices that exist to keep your baby away from you: strollers, playpins, walkers/bouncers, bath chairs, etc...

F. Deep Sleep Cues - Be able to read your baby's deep sleep cues. If you can read these you will know when baby is in a deep enough sleep that you can set them down or leave the room without them waking. Of course it would be nice if you didn't need to use this but quite frankly that is not always possible. One of the most typical deep sleep cues is heavy limbs. If you can raise your baby's arm and it falls down to the side then that is a good sign.

G. Quick Arousal Response - Notice when your baby begins to stir from nap or night sleep and respond quickly by putting your hand on LO, patting LO, offering a binky (if you use one) to try and avoid a full waking.

H. Soothing and Distraction - Use soothing responses when your LO does wake up. Perhaps LO just needs a minute of mommy patting his/her tummy before s/he goes back to sleep. Sometimes distraction can be helpful as well. Offer your hand as a toy to play with. Some moms prefer to try these methods before a night feeding b/c often a baby will fall asleep using these methods within a minute or two. If baby does not fall asleep then please consider night feeding, whether for hunger or for comfort.

I. Smells Like Mom - Put something that smells like mom next to your baby if you are laying baby down without you. Then when LO falls into a deeper sleep remove it so as to avoid a sleep hazard.

J. Reduce Your Anxiety - Babies do pick up on their parents' anxiety and will respond accordingly. So when you are starting to feel overwhelmed take a deep breath, drink some water, get a snack, take a shower. Do anything to give you a little pick-me-up.

K. Sleep Begets Sleep - Keep in mind that the more naps your baby will get the better your baby will sleep during the day and at night. An overtired baby is much harder to put down to rest. So offer more naps and an earlier bedtime. If you need to switch a bedtime then please make sure to do it incrementally.

L. Baby Needs Activity - During the day your baby needs activity! So engage your little one in play. Make sure your LO is active.

M. Diet - If your baby is on solid foods or formula you want to consider that you may be offering something that is causing your LO some digestive issues. If poor sleeping started recently try eliminating some foods to see if it helps or with your Pedi's help switching formula. If you are breastfeeding then consider the same for what is in your diet.

N. Comfort - Make sure your baby is comfortable. The first thing you want to check is baby's diaper of course. Check baby's fingers and toes to make sure they are not red and there is no hair wrapped around them. Check for a rash under baby's neck or in baby's armpits or on baby's bum. Check inside baby's ears for redness or ooze. Check baby's mouth for mouth sores, teeth, and thrush. Check baby's clothes to see if they are too tight around the arms and legs or if there is a scratchy tag. If all of these things check out think about the temperature of the room. Is it too hot or too cold? Remember too hot is a risk factor for SIDS an blankets in bed/crib is a risk factor for SIDS.

O. Co-Sleeping - This is one of the tools I suggest strongly. Co-sleeping can greatly affect mom's ability to get some sleep! If you want to know more about it's safety and how to do it safely I highly suggest reading the book "Sleeping with Your Baby". The author is a leading authority on parent baby sleep.

P. Medical Issues - Please keep in mind that your baby may have a medical issue causing sleep loss. There are lots of medical issues that can cause sleep issues and many of them are common such as earache and reflux. One primary reason your Pediatrician asks if your baby is sleeping is to assess if there is a medical sleep issue going on. Sometimes that can get lost when the Pedi also offers parenting advice that is unwanted.



Stay tuned... I will post resources for this information soon.

Tuesday, July 27, 2010

Rants: Gentle Parenting

I'm a fan of using the gentlest most compassionate method available in your toolbox. When we have mothering decisions to make I am a firm believer that we should first evaluate the decision and then choose the most gentle method available. If that method doesn't work then keep at it or seek out a support system to find other tools of compassion. I cannot back up methods that cause pain or stress for your infant.

There are gentle methods of helping with baby "problems". Spending (even) more time in close physical contact with your baby is one of them and I deeply believe it will help with a majority of the issues people proclaim to have with an infant. Now I know we all spend lots of time in contact with baby. I'm just suggesting more of that! Use it as your tool to get baby to sleep, to nap, to be less fussy instead of finding other tools to do so.

As you know I'm a reader and researcher. I also believe in natural and attachment parenting. Apparently for good reason. If you practice some attachment principles research shows you will have a baby who is less fussy and sleeps better. Instead of using methods like allowing your baby to cry you can use gentler methods that have the same outcome. I do!

Now I've heard several arguments to the contrary: that a high needs baby won't respond to these methods, that working mothers have a harder time using such methods, and that each parent chooses what works best for their family. Of course I agree there is some truth in those arguments but I don't believe they have to be contrary. You can have a high needs baby, be a working mother, and be choosing the best choice for your entire family while making the decision to choose gentle methods. I even believe that if you do you will have less baby "problems" and more happiness!


(cartoon is from The Parenting Pit another compassionate mothering blog!)

The principle is simple and it is two parts.

A. The more time you spend close to baby the more baby feels secure and thus has fewer issues going down to sleep and being less fussy in general.

B. The more you give in to the fact that your baby will cry, be fussy all day some days, be up at night for weeks at a time the better your emotional health will be and thus the better your relationship with baby and becoming less frustrated and overwhelmed.

Things to try:

1. More skin to skin contact. In our society we've created a lot of "tools" to keep baby away from us. Strollers vs slings, cribs vs. our bed, highchair vs. our lap, even baby's holding their own bottles etc...

2. Babywearing!

3. Co-Sleeping or part-time co-sleeping: An example of part-time co-sleeping would be laying next to your baby when you put him/her down for a nap until baby falls asleep.

4. Outdoor Time: Going for a Walk, Time in the Park, Etc..

5. Giving in to the idea that babies are not biologically designed to sleep through the night. Have a set-up so when you are up at night you can have fun (internet, movies, snacks, etc..).

Please feel free to comment with more ideas I can add to this list!


Here is research to back me up:

Research 1: Maternal Emotional Availability at Bedtime Predicts Infant Sleep Quality

This is a research study that is about exactly what the title says. I am research minded and to find a high quality study like this makes me feel quite happy that we are able to quantify some good quality parenting.

Research 2: "Sleeping with your baby by James McKenna" Dr. James McKenna is a leading authority on parent baby sleep. He has a Ph.D. and works from the University of Notre Dame sleep lab in which the National Institute of Child Health and Human Development fund his research.

" Human infants are more helpless than any other animal species. .. Most mammals are born with 60-90% of adult brain size. Humans are born with just 25% of adult brain size. Compared with other mammals, human infants take the longest time to grow up, and they remain in a biologically dependent state for the longest period of time...human infants are "extero-gestators, meaning they complete their gestation after birth, and someones got to be there to help with it. .. Due to this extreme developmental immaturity , babies require parental (especially maternal) smell, touch, sounds, and movement in order to feel secure and have their physical needs met at an optimal level. All primate infants, including humans, biologically expect to be in close contact and proximity with their caregivers. .. There is no such thing as giving a human infant too much contact or affection. .. When deprived of these sensations, a baby will use her primary survival response - crying - and will produce cortisol, a stress hormone, as she attempts to attract the attention of her parents."

Research 3: It is natural to feel stressed your baby is crying! As mothers we release a stress hormone when our baby cries. But the natural response is to soothe your baby not let them cry more that is why we have this hormone to trigger us to respond. It is better for both mom and baby to come together when baby is crying. The more that happens the less both parties will be stressed out.

Quote from Parenting Magazine (link above): "When a baby cries, it triggers the release of the hormone prolactin (dubbed "the mothering hormone") in moms, which creates an urge to pick up the baby and meet her needs. You're hardwired to soothe your baby, and when that doesn't happen, it can make you feel like a failure. But your baby's fussiness is not a reflection on your parenting skills - and it's completely normal for a baby to cry even when there doesn't seem to be a direct cause."

I have an infant now and cannot speak from experience to raising an older child but this is reminiscent of another issue that will be coming up soon for us mother's of babies. We must choose gentle practices now because the decisions only get more complicated as our children age. It strikes me as similar to spanking. There is a method that is non-invasive and harmful (not spanking) and then there is one that is a invasive and painful if not harmful (spanking). They both may work but why not choose the more calm, least painful, more nurturing alternative?