Friday, June 29, 2012

Sleep: our secrets

As I've stated before, Natalie is a champion sleeper, and everybody asks us to reveal our secret. Matt always says it's 95% luck, but I think we deserve a little more credit than that. I'd say it's 75% luck and genetics, but I think it's 25% the work we do to try to maintain a lifestyle that is conducive to a sleeping baby's schedule. Here's that 25% as I see it.

All credit for that final 25% must be given to the book Healthy Sleep Habits, Happy Child by Dr. Marc Weissbluth and our attempts to follow his philosophy. I am so glad I settled in for several nights with this book before giving birth because it is the closest thing we have to a secret for sleep success. If you do nothing to prepare for the birth or adoption of a child I recommend reading this book. Even if you don't go out and buy diapers or a bassinet, at least read this book.

Here are some of the major take-away points from Healthy Sleep Habits, Happy Child:

1) Sleep begets sleep. If you only remember one idea from this book, it would be this one. Essentially, Weissbluth's point is that when children nap better during the day, they sleep better at night. Babies go from three naps, to two naps, to one nap, and they hold on to that one nap for years, well into the preschool years (or graduate school years, or life, as Matt likes to call it...he naps like a champ).

2) Early bedtimes lead to better sleep. Instinctively, we might think that keeping our babies up later in the evening would lead to them waking up later in the morning. But most parents quickly discover that no matter what time children go to bed at night they tend to wake up at the same time each morning. We have tested this out a couple times and it is true in our experience.

3) Consistency and routines are key. This to me is the most obvious of his main points as it seems to be a theme of all things parenting. A nighttime routine signals to the baby that it's time to start winding down.

4) Sleep training may begin at four months of age, when babies are capable of self soothing. Before four months parents need to really just read the baby's cues, though they can begin to start establishing bedtime routines.

5) Crying it out can be effective with babies who are at least four months old. Although most parents do not like the idea of crying it out, if done correctly, it often takes just a few unpleasant nights of using the technique before a baby learns to go to sleep. Crying it out does not mean simply letting your baby scream until he's so worn out he just falls to sleep. Instead, it involves going to check on the baby and soothe him after five minutes, and then if the baby continues to cry checking on him and soothing him after another 10 minutes, and then after another 15 minutes, and so on, until the baby is asleep. A key point here is that soothing does not involve picking the baby up, which is likely exactly what he wants, but instead involves talking to him quietly, holding his hand, generally reassuring him that you're there.

6) There are chapters about sleep for toddlers, children, and teenagers, which I didn't even bother with yet, but it's good to know they're there should we encounter problems down the road.

We have followed the guidelines in this book as well as we possibly can, and the result truly has been a baby with healthy sleep habits who appears to be happy. And, we can say it's led to two very happy parents. It hasn't been sunshine and rainbows and unicorns every single day, but the general progression of Natalie's sleep habits has been amazing.

Here's Natalie's sleeping timeline:

The early days
Weeks 1 through 6 she was a typical newborn, waking up every three hours to eat. There were a few rough nights thrown into that mix, where she seemingly woke up every hour, but those were a major exception.

Sleeping through the night
Using the term "sleeping through the night" to mean six hours of uninterrupted sleep, Natalie officially slept through the night when she was six weeks old (on Saturday, February 25, to be exact). As I wrote when this phenomenon occurred, this was followed by a pattern of amazing nights of six or eight hours of uninterrupted sleep as well as a couple horrible nights of basically not sleeping. In retrospect, the uncertainty of the 6-8 week range and her general fussiness during the day made it the most difficult time of Natalie's post-hospital life thus far.

New sleeping quarters
After a week of decent night sleeping we moved Natalie to her crib Saturday, March 3 when she was 7 weeks old.

Bedtimes
By mid-March when Natalie was a little over two months old and had been sleeping in her crib for a couple weeks she started to establish a new 9-9:30 bedtime for herself. Gone were the days of going out to dinner late and knowing that our baby would just put herself to sleep in her car seat while we finished our meal.

Natalie's self-imposed bedtimes became progressively earlier until by her three month birthday she needed to be in bed by 7 p.m. I distinctly remember taking Natalie out to dinner with my friend on April 5 and meeting at 7 p.m. That will go down in the record books as the last time baby Natalie could go out at that time. By the next week that wouldn't have been possible.

Night feedings
When Natalie moved to her crib a little before she turned two months old she was still waking up at least one time at night to feed. Often she would wake up at 3 or 4 a.m., be up for a short 15-minute feeding or a long 45-minute feeding, and then immediately put herself back to bed. Then she'd usually wake up again in the 6 to 6:30 range, eat, and then sleep again. At this stage in Natalie's life I would bring her into bed with me for the 6:30 feeding, and then she and I would continue to sleep in my bed until about 9 or 9:30. This pattern of sleeping lasted until she turned four months old, and that was a glorious experience. I know people have strong opinions about co-sleeping, but I viewed this as our co-napping time and I loved it. I knew there would be a short window of opportunity for me to cuddle with Natalie in this way, and I'm glad I did this with her when I could.

Weird red-toned photo (thanks to our red curtains) from the last time Natalie and I co-napped

Crying it out
The world changed when Natalie turned four months old. That's when she seemed to come to life. That's when she really started playing with her toys, paying attention to people when they were talking or singing, and getting distracted while nursing. It's also when I knew that, according to the book, we could start true sleep training. In retrospect it seems appropriate that we're encouraged to attempt having babies cry it out right when the world opens up to them because they're suddenly impressed by everything and therefore have to learn how to tune out all the stimuli around them when it's time for bed.

Before Natalie turned four months old it seemed like she fell asleep the moment her head hit the mattress. At four months, though, she would start to fight sleep. So we tried having Natalie cry it out. This method worked like a charm on Natalie. The longest we had to let her cry was 15 minutes and then she was out.

Dropping the night feedings -- Honest to goodness for real sleep
Now here we are at five and a half months, and we've been fortunate to say that for the past six weeks Natalie has been sleeping from 7 p.m. to 6 or 7 a.m. every day with a few exceptions. Right around the four month mark Natalie started to drop the night feedings. Granted, in the last six weeks there have been a few times she's wanted to eat sometime around 4 or 5 a.m., but those have been the exceptions. Most nights she is getting 11 to 12 hours of uninterrupted sleep. And when I say uninterrupted, let me throw out there the fact that she is often making noise in the middle of the night, but it is not the kind of prolonged noise that indicates she actually needs something. Instead, I almost liken it to her waking up from a bad dream. For example, Wednesday night she was completely asleep by 7 p.m., but then she started crying around 9:30 p.m. After a few minutes of crying, before I even thought of checking on her, she was back to sleep. She also made noise at 5 a.m., but again within a matter of minutes was back to sleep. Learning not to respond to every little noise Natalie makes has been key to her sleep training.

A nap schedule
I have struggled to define a nap schedule for the majority of Natalie's life because in the early days there really was no difference between napping and sleeping at night, and then as Natalie got older she'd sort of just sleep when she felt like it. It wasn't until the four month mark, when we knew we'd had major success with night sleeping, that I even bothered to consider a more consistent napping schedule.

At Natalie's current developmental stage most babies are taking three naps a day. Only in the last couple weeks can I say that Natalie has a defined morning nap and early afternoon nap. We are still working on having a consistent third nap, but maybe Natalie's general refusal to settle down at this time of day is her way of telling us she doesn't need a third nap because she has an early bedtime and a reliable nighttime schedule.

Right now Natalie seems to be taking a two-hour nap from approximately 8:30 to 10:30 a.m. The she's ready for a nap around 12:30 p.m., and will typically stay asleep until 2 or 2:30. But then that leaves this long stretch of day, with her awake for another 4-5 hours, which is rather challenging. She still can't sit up on her own, so entertaining her in the afternoon typically involves lots of holding her, carrying her, or taking her on walks.

Yesterday we took her to the pool at 5:30 to see if she would really enjoy that and it could give us some sanity during the worst time of the day, but she hated it, so she screamed a good amount. Right as we were getting ready to leave she fell asleep in her car seat, so Matt and I decided to stay at the pool for another 45 minutes while she napped (I was not about to wake her). So maybe we need to go to the pool every day at 5:15 and get her to sleep in her car seat?

The challenge of consistency
Matt and I base our lives around Natalie's nighttime sleep schedule, not in a scary our-baby-must-be-asleep-by-7-p.m.-or-the-world-will-end kind of way, but we just know that most nights we are going to be at home from about 6:30 p.m. on so we hunker down. We also know increasingly that she needs to be at home in her crib for her early morning and mid-day naps. So when we want to do something later in the night (usually in honor of a special occasion) we ask my mom to come over and babysit. On regular nights we know that if we want to go out to dinner we just need to get the early bird special and be there at 5 p.m. Or if we want to meet someone for lunch, it's probably better to call it brunch at meet at 11 a.m., right between naps. There have been a few times that we've broken with this schedule, and ultimately everything turns out fine, but it still means dealing with a cranky baby who gets less sleep, which means a mom who gets less sleep too.

You keep me up past my bedtime and I refuse to look cute for a photo.

I'm crabby.

Early bird special.


Though staying consistent is a major challenge, it is something we've built our lives around lately, and for that I give us credit. So while maybe 75% of our success has to do with pure luck of the draw, I do think applying the principles from this book has impacted our baby's sleep habits, and I don't think it can all be attributed to random chance.

Healthy sleep habits, mostly happy baby.

2 comments:

  1. Great post. I've read your blog for a while and have a 2 month old of my own. It's always helpful to see what has worked for other people (we are using HSHHB as well). I am hopeful that we will have as good of luck as your family has had!

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  2. I never had sleeping issues with my infants. I used "The Baby Book" by Dr William (Bill) Sears. It is awesome! He is a pediatrician & his wife a nurse & they have successfully raised TONS of kids (7-10). It was the version published last before 1997. EVERYTHING from birth - 2yrs. It did promote co-sleeping or a side sleeper crib. But it worked great for me (I never used medications or alcohol). It was natural & loving & worked wonderful for breast feeding.

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