Friday, March 2, 2012

Newborn sleep: Predictably unpredictable

Here's a prediction: This is the first of many times I will write about sleep.

In my experience as a mom of seven weeks, get two or more new moms together and a significant portion of the conversation will come back to newborn sleep habits. How much does your baby sleep during the day? At night? What's the longest stretch of uninterrupted sleep you've gotten at night? How do you soothe your baby during the day? At night?

We do this, I think, not to compare our babies in the "my baby is better than your baby sense" but rather to see if we are at all within the range of normal and if other women have any wisdom to pass on to us.

My baby is not better than your baby, but she is awesome!

The unfortunate answer to these questions is that there is no such thing as normal and what works one day may not work the next.

The other unfortunate answer is that the absolute earliest "sleep training" can occur is at three months, and true sleep training likely won't occur until four months. At three months parents can, according to the experts, set up routines that encourage better sleep habits, but because the majority of babies can't self-soothe until they hit the four-month range there is not much parents can do but grin and bear their babe's sleep cycles.

I've acquired quite a few books about baby sleep (including Healthy Sleep Habits, Happy Child; On Becoming Baby Wise; Secrets of the Baby Whisperer) that I'll discuss more in coming months (once they actually apply to us) but for newborn sleep there is really only one book everyone will tell you about: The Happiest Baby on the Block by Harvey Karp, M.D. My friend loaned me her copy along with the accompanying DVD.

There are a few ideas that emerge from this book that are worth noting:

1) A lot of babies confuse night and day thanks to their time in the womb.

2) Babies are born three months too early, so newborns enter the world during something Dr. Karp calls the "fourth trimester." His whole theory is that human babies must be born when they are born because of their enormous brain size (and subsequently enormous head size). They wouldn't be able to make it out of the birth canal if they waited any longer. This also helps explain why, compared to other mammal babies, human babies are especially helpless during their first few months of life. It's interesting to note, also, that a lot of babies begin to roll over during their fourth or fifth month of life.

3) Because babies are born too early parents can best get their babies to sleep by recreating the environment inside the womb. This does not seem like a particularly revolutionary idea, as much of what he suggests parents do is no doubt what our great grandparents did for our grandparents, but he does package his suggestions neatly into an easy-to-remember mnemonic device: The 5 S's. These stand for: swaddling, side/stomach cradling (on the parents' bodies, essentially), shhhhhhh, swinging, and sucking. Parents are encouraged to follow these steps in this order to get their babies to sleep.

After reading/skimming this book, though, I soon discovered: this book doesn't really apply to us. Dr. Karp's suggestions, while they work for all babies, are really targeted towards "colicky" babies. He takes issue with the word "colicky," believing it's more of a Western concept, but regardless in my opinion you can simply replace the word "colicky" with "fussy" and you wind up in the same place with his suggestions.

With the exception of a few nights and one memorable day last week calming Natalie has never really been the issue. She cries when she needs something -- to be fed, changed, or held -- and once her need is met she usually finds her happy place and gets to sleep relatively quickly. I like to thank her regimented schedule in the NICU -- where she was fed and changed every three hours on the dot -- for encouraging her to expect this as normal. Again, with the exception of a few nights, she has never anticipated getting fed every hour. And once she surpassed her birth weight when she hit three weeks of age we no longer felt the pressure to make certain she was waking up at least every three hours for nighttime feedings.

So we've been fortunate to get at least three-hour chunks of uninterrupted sleep at night with Natalie between the hours of about 10 p.m. and 8 a.m. This means I have not felt particularly sleep deprived since we've been home from the hospital.

So, I started to get greedy and wondered what I could do to get her to sleep even longer at night and move her to her crib in the nursery. The answer, of course, is that there's probably nothing I can do, seeing as she's only seven weeks old, but here's what we've been experiencing this week.

Saturday night
On Saturday night, at the recommendation of my friend Kate, I took Natalie's Pack N Play with the bassinet insert (where she's been sleeping at night) and moved it away from my side of the bed. It had been so close to the bed that I could just reach over and grab her at night. Kate suggested that before we move Natalie to her nursery we try moving the Pack N Play to the other side of our bedroom, as far from our bed as possible. When we did this last Saturday I told Matt this was the first step of sending Natalie away to college, and that first night her bassinet felt so far away she might as well have been off at college.

I also thought that if we fed her a lot at night right before bed that might help her sleep for a longer time, so we gave her a 5-ounce bottle. She typically gets about 3 ounces in a feeding, so 5 ounces seemed like it would surely hold her over.
At the recommendation of my friend Mimi we also gave her a bath right before bed. Before we were giving her a bath whenever she seemed like she would best tolerate it, seeing as bath time has not been her favorite time thus far.

Miraculously, that night she slept for 6.5 hours uninterrupted from 11 p.m. to 5:30 a.m.! Sleeping through the night for babies is defined as sleeping for 6 hours uninterrupted, so here we officially hit a milestone!

I thought I was on to something by combining the wisdom of Kate, Mimi and my own intuition. Of course, Saturday was a really busy day for Natalie as we had relatives visiting from both California and Richmond and Natalie got held for hours by 13 different people.

Sunday night
With the bassinet now in its semi-permanent location as far away from our bed as possible, Natalie had another 5-ounce bottle and a bath right before bed. This time she slept for 7 hours uninterrupted from 10 p.m. to 5 a.m.!

Monday night
We repeated the pattern above and Natalie slept for 6 hours uninterrupted from 10 p.m. to 4 a.m.

Sleeping through the night puts us in our happy place! (Blurry newborn iPhone pictures = par for the course)

Tuesday night
Well, that all went out the window. I secretly hoped that after three nights in a row of sleeping through the night we had a new "normal." But then, after going to sleep at 9 p.m. she was making noise at 11 p.m. I thought to myself, "Baby, there is no way you could be hungry." So, I went over to her bassinet and looked at her for a while. She stopped whining. I went back to bed. She started whining at 11:15. Then at 11:30. Then at 11:45. These were not her all-out "I'm hungry" cries. Instead, these were true whimpers, her little fake-me-out noises that indicate she's basically not tired but doesn't really need anything either, which is the worst. Then she woke up at 12:30 a.m. for real needing to be changed and fed. Then she was up at 2 a.m. with the same needs. Then 4 a.m. Then I got her back to sleep until 8 a.m.

Wednesday night
This night was better than Tuesday night. She woke up twice at night to be fed, this time giving us 4 hours of sleep better feedings. This is basically "normal" for her, and it's really not bad at all. So I figured the sleeping through the night thing that we were blessed with for three nights in a row was just a random fluke and we'll stay in this 4-hours-of-sleep-at-a-time holding pattern until we can do real sleep training.

Thursday night
But then a funny thing happened last night. She slept for 8 hours uninterrupted! From 10 p.m. to 6 a.m. little girl slept so soundly I did, of course, have to go check on her a couple times to make sure she was exhibiting signs of life. There is a certain irony to the fact that even when she gets uninterrupted sleep I do not because I feel more of an urge to check on her.

This morning I came to a realization: Tuesday night and Wednesday night are the nights we skipped out on her bath. Coincide? Perhaps. Will she be getting a bath tonight? Absolutely!

Another thing I've noticed is that if Natalie sleeps a lot during the day she will wake up more at night. Yesterday I took her to the mall, we hung out with our friends Gretchen and Luke, and then we went to a party to watch our friend Susannah on Jeopardy. When Natalie gets good stimulation during the day, gets held by different people and doesn't sleep too long she seems to sleep better. Fortunately tonight she'll be going out on the town again to get some loving from a bunch of lady friends, and hopefully that can help encourage her to have another marathon sleep session. If good sleep habits continue I'd like to move Natalie to her crib in her nursery by next week.

Or not. Newborns are predictably unpredictable. And, by writing all this down and sharing it on this blog I have no doubt doomed us to a sleepless night.

1 comment:

  1. Congrats on the new found sleep stamina! We were blessed with a baby that slept through the night on a regular basis pretty early as well, Baby Wise helped a ton with that. Now, however, we feel so awful when we have to get up in the middle of the night. We're like zombies where as before we had the routine down perfectly. Great pictures, BTW.