Saturday, April 30, 2011

My Sleep Bible

All righty folks. I had this post scheduled for later next week, but it is 3am, I cannot sleep, I'm waiting for my bowl of Honey Nut Cheerios to kick in, and thought, I would tackle this now rather than later.
 
So here goes.  

I wrote a post the other day on my current life as a mommy to two toddlers who are just eight months apart. I immediately had quick comments about my tips for kids sleeping through the night. (Since I posted this originally in 2011, I have added two more children to my brood, all of whom have slept through the night by three months old.)

I want to preface what I am going to say with two things:

  1. I know that all children are different. I do feel that we have pretty good "advice" based on the fact that what we did worked two four times with two four different children who are not genetically related. My boys slept through the night at 8 weeks (bottle-fed Isaac) and 10 weeks (breast-fed Elijah). My girls were right around the same time. They have, ever since, gone to bed at bedtime and not gotten up until the morning again barring unusual circumstances (like an illness.) They do wake up early, but they go to bed early as well. What we did, DID work (even with a very hungry and not content newborn Elijah). Glean from this what you want. Don't take it as gospel. Please don't see what I am saying as slamming what you are doing. This is just "what worked for me."
  2. Children sleeping through the night and NOT sleeping in our bed and NOT needing to be rocked to sleep was important to us. It may not be important to you. If what you are doing works for your family, that is great. In our case, I had two babies. I did not have the luxury to be rocking one to sleep when another was needing my attention as well. I was incredibly fatigued with flip-flopped nap schedules all day long, and JB and I needed our full night of sleep. (When Elijah was born, Isaac was still taking three naps a day. Add three naps for Elijah and you are having a child napping and one awake six times a day. Craziness!) Some people do well on little sleep. You can ask anyone who has known me well, and they will tell you that I am NOT one of those people. So sleep was a huge focus for us as we entered parenthood.
  3. In addition, my husband is a family medicine physician. Not only does he recommend what we do to his patients, but he approved of it in our house. He has used this with MANY patients who come to him at the end of their ropes from now sleep.
Okay, that said, here is what we did.

Firstly, we read the book Baby Wise. My friend Shannon and her husband Tristan had three boys that were all good sleepers. I wanted that. So I asked her what she did. She loaned me her book. I read it. JB read it.




I did not read this and do everything it said. Far from it. In fact, we gleaned only one major technique from this book (which was an underlying theme albeit) that we took to heart. When our boys were newborns, right away, we implemented a pattern for their sleep. That pattern went as such:
  • Eat time
  • Play time
  • Sleep time
  • Repeat
The book talked about scheduling feeds and what-not. We didn't really do that. We attempted to find a good schedule for how often our boys ate, but as I mentioned previously, Elijah had a very difficult first three months. Long story short, I was producing enough milk but he, well, as JB likes to say, "He sucked at sucking." I was feeding him an hour on and an hour off. Not good when you have an eight month old waiting in the wings. However, even with that schedule, we implemented the pattern above.

The idea is that baby learns to fall asleep without needing Mom there to comfort. So we would feed, play with the baby (this might last 2 minutes with a newborn or an hour with an older baby) and then we swaddled and put the baby down to fall asleep on their own.

This is not to say that I did not hold my boys during naps or put them in their swing or car seat for naps. I did all those things. But I didn't do it all the time. My general rule was one nap a day on Mommy's chest. I loved it. They loved it. But I didn't want them to require that. I wanted it to be an extra luxury. If baby fall asleep by you, and every time they wake up you are there, waking up without you there will cause great stress, crying, and a desire to be comforted by YOU again. And YOU need to sleep too.

The other MAIN thing we did was to let the baby self-comfort. This can be very hard for some parents. It was hard for me. JB had to practically block the door a few times to prevent me from going and picking up one of my boys. But if they had eaten, played, and were clean and dry, the idea is that they are able to fall back asleep when they wake up. You can go in and comfort them. You can give a pacifier or whatever else you want to help. But picking them up, feeding them, letting them fall asleep on you, will tell them that they need Mom to help them fall asleep. And they WILL require that again.

I remember when Elijah was a newborn. My mother-in-law was with us for the first two weeks, and I am pretty sure it took every fiber of her being not to go and pick up Elijah as he screamed to be held when it was "sleep time". It is not a comfortable feeling. However, we believe, from the beginning, that baby has the power to put themselves to sleep when they wake up and find Mom not there. So we let them cry it out. We set time limits. Especially during the first 2-3 months. They might need an extra feed during this time.

It was nearly a year and a half later, that I left my boys with my sister-in-law for JB's graduation banquet. When we came home, she said to us that it was a busy night. Lots of activity. Lots of crying and whining and fighting. But she then added the caveat, "I have never seen boys go to bed like your boys go to bed." I remember my mother-in-law laughing and telling us then how hard it had been to not say anything when Elijah was a newborn, but now, she saw why we did what we did.

If my boys wake up in the night now, they do NOT get out of their beds. Now obviously there are exceptions. Illness or being in a strange place is a major one. You may have to spend a few nights getting a child back on track once you return from a trip or after an illness. However, my boys know that they do not get up until it is morning time. There is no juice or climbing in Dad and Mom's bed. Ever. That's just how it goes.

When baby is under a year, the major thing to note is that baby has the ability, from about 2-3 months on, to go eight hours without needing to eat. If baby is eating, it may because they are having dietary issues. But other than that, it is a comfort "thing." Baby wants to be comforted and being with mom and fed, comforts baby.

JB has a saying, "Exhaustion WILL win." He would say this to me when Isaac and Elijah were 4 or 5 months old and they had eaten and were changed and had fallen asleep and had then woken up and were screaming for us to come and get them. He would almost literally hold me down in the bed. We would time it. The longest either boy went was 45 minutes. But they never went 46 minutes. Once they did it for 45, the next night, it was almost always less. 40 minutes. 35. Way down the scale. I would have ruined it had I gone in at 45. If I did, the next night, they may have had the ability to push to 50 knowing that we came in the night before.

JB sees many new moms as a doctor. Especially when he was a resident. Almost always, when a mom came in complaining that the baby wasn't sleeping, the baby was being held most of the day. The in-laws and parents were there and every time the baby cried, baby was comforted. Then everyone left, and it was just dad and mom, and they couldn't get baby to sleep. JB would share this pattern with them, and nearly always, they returned 1-2 months later telling him that things were markedly improved. Not always perfect. But any improvement when talking about sleep is good!

The other thing we do is create a good sleep environment. We use white noise machines. We keep the rooms well-carpetted to prevent sound from traveling. We do not, however, especially when the child is very little, attempt to create a noise-free environment, as this is not reasonable to expect. Kids will need to learn how to sleep amidst noise. If the dog barks, he barks. Get used to it kid!

So that's our trick. If you have something helpful to share, please do, but PLEASE PLEASE PLEASE remember that this is just MY PERSONAL ADVICE. As the wife of an intellectual, I am well-aware that saying, "This will work!" because it worked for three of your best friends, is not good research. John cringes every time someone gives him an old wives tale and says, "No seriously! My Aunt did it and it works." Working for one person does not give medical credence to something. Just because Mary drank a potion and got pregnant didn't mean that I would drink that potion and get pregnant. Really!

I cannot promise that this will work for you or your children. I can only say that this worked for me. I may have baby #3 and come back on here and say, "Well, throw all that out the window." I do not propose to be the Bible on Sleep. But I do think, if you follow what I am suggesting, you will see an improvement. And improvements are good.

Secondarily, this "style" may not be right for you. You may enjoy the night feeds or the child sleeping in bed with you. If you do, and it is working for you, that is great. But in our case, with two babies eight months apart, this style would have broken me down and left me a bumbling mess in the corner of a room. I didn't have grandparents around to help if I had a bad night of sleep. I had a husband working 90 hour weeks. I had a new puppy and two babies, and I needed to get a full night's sleep to be on my best the next day. (In addition, having time each evening with my husband is important to me.)


Did you know that it is recommended that a child gets the following amount of sleep?
  • 1-4 weeks old (15-16 hours per day)
  • 1-4 months old (14-15 hours)
  • 4-12 months (14-15 hours)
  • 1-3 years old (12-14 hours)
  • 3-6 years old (10-12 hours)
  • 7-12 years old (10-11 hours)
I cannot tell you how many crabby kids I have met. And when I observe their sleep schedule they are getting, sometimes a quarter less sleep each night then they are supposed to. My toddlers are supposed to be sleeping HALF OF THE DAY! They need that. Yes, my boys wake up early. But they sleep from about 7:30pm until 6am every day. That is 10.5 hours of sleep a day. They then take a nap for 2-3 hours bringing them to their 12-14 hour requirement. Kids need more sleep than they are getting. Kids that are staying up into the evening and not taking naps, are, in my opinion, sleep-deprived, and their behavior is a result. Isaac has begun fighting his naps. I truly don't care. He will be at least in kindergarten before I stop requiring him to rest in his room for 2 hours a day. Rest is better than nothing.

People also tell me that they feel letting a child cry it out is cruel. I have to disagree. We, as parents KNOW better. We know that the sleep will make them feel better. We are just helping them to get what they need.

I'd appreciate positive comments or comments sharing your own advice. But please do not "smash" mine. This is my blog. I was asked for my advice. Advice is information that can be taken or left behind. It will not hurt my feelings if you disagree. But do so kindly. Parents can get very touchy about this issue. JB and I offer our advice as simply "what worked for us." We have many people ask us what we did when they see how well our boys sleep.


P.S. We also swaddle. Here is a video showing our technique.

So, there you have it. My Sleep Bible.

Amen.

P.S. I have since created a My Sleep Bible Part II.  I have also begun compiling the Q&A that I have been having with different moms. You can read that by clicking here: The Doctor's Wife: Sleep Q & A. If you want to read some testimonials from moms who reached out to me, click here. 

P.S.S. And here are some other articles that couple with our philosophy:
  

11 comments:

Jenny said...

I am also 2 for 2 in the sleep department (both breastfed). My girls slept through the night at 6 weeks (11-6), and I truly believe it was a result of getting a certain number of feds in, and the baby wise method. I wasn't quite as militant as he was, but did use the wake, eat, play, sleep method as my guide. My second (Caroline) took to it even better than my first. Poor Hannah had some serious reflux though in the beginning, so feeding was a bit harder for her. I too am hoping to go 3 for 3! With a 4 year old, 2 year old, and a newborn I am really counting on getting a "reasonable" amount of sleep at night.
Also, I recommend the book "Healthy Sleep Habits Happy Child. This is an excellent reference!

Krystal said...

Wendi, I have 3 children. I did not know about Baby Wise when we had our first born and she slept awful for her first year!!! It was rough! But after having baby #2, we went out and bought it and followed it like you did. My last 2 babes have slept like a pro since 9 wks and 5 wks! Made my life soooo much easier! I was sooooo rested! I just wished I had of known with baby #1! Great advice!!!
Krystal

Faith said...

I certainly am like you as far as the desperate need for sleep! And I, like you, have 2 infants and they are only 6 months apart. I HAD to be sure Jax was sleeping well before Addy came. We always followed the eat, play, sleep routine even before I read Babywise. Jax naturally did it, and we kept up with it with him and with Addy. And it does help. I did the crying it out method with Jax, too, but not until he was about 4.5 months. The first 4.5 months of our life with him was AWFUL as far as sleep was concerned. I mean, once he was asleep, he slept until his next bottle, then again until morning. But getting him to sleep was a nightmare for EVERY nap and at bedtime. A true nightmare. But, I struggle with sleep training really early with my babies, I worry they are not neurologically ready to regulate themselves completely and have always felt they need my help to self regulate through the third month or so. I guess that's the attachment therapist in me:).

With Addy, we just found that if she is fed and clean, we swaddle her and put her in her swing for naps and she goes right out. And at night I walk her for about a half hour and that way she sleeps in her bassinet. And she is currently sleeping through the night (if you count 7 hours as sleeping through the night) - going to bed by 10pm and getting up around 5:30am (6:30am this morning!) to eat. Then back down for a couple of hours usually. So, the moral of the story is I think I create monsters when it comes to getting them to sleep, then have to go back and re-train when they are a little older. I know that's my choice, I can't stomach the crying when they are very little. Just can't do it. So, I pay the price later, lol! But I DO eventually do the training and get them to sleep well. Jax goes down at 7pm and doesn't get up until usually 8am and then he takes 2 naps a day for 1.5 hours. Not bad at all!!! It took only 1 or 2 days of him crying (like your boys, he never went longer than 45 minutes) and we were on our way to blissful sleep:). I'll do it for Addy in a month or two as well...

Thanks for your advice, it's good to know I'm on the right track as far as what worked for you!

Rachel and Hans said...

Great post. I really agree with what you said and am pretty sure we are similar in our parenting styles with regards to sleep (and probably other things as well). I nursed Kaia for 11 months and she was consistantly sleeping through the night (6-8 hour stretches) from about 2 months old. She is an amazing sleeper now. Goes to bed without a fuss (naps and bedtime) and sleeps 7 p.m. to 7:30 a.m. (with the occasional 6 or 6:30 wake-up) every night. I will say that it's not always easy...ditto to what you said about it being tough in the beginning to help them learn to self-soothe, etc.
We actually didn't have to "sleep-train" Kaia until about 5 1/2 months when she regressed (and was nursing every 1-2 hours! Yikes!). Hans could hardly stand to hear his little girl cry at night when we sleep-trained...but because I was the one that had to feed her, my opinion on the situation won out in the end! :)
Totally worth it, though! We'll see how #2 does in a very short time! :) I'm guessing your #3 will do just fine!

Lisa Cronk said...

I absolutely agree that teaching babies to self soothe is a wonderful skill and makes everybody (baby, parents, etc.) happy in the end.

As a pediatrician, my advice to my patients is often quite similar to what you've written. Way to go!

: ) Lisa

Rae said...

Love this post! I agree so much with kids being crabby and yes it's they aren't getting enough sleep. I have friends whos kids stay up till 10PM!! GHAST!! I shake my head and will tell them you ae going to regret this! Our kids go to bed early (7) and often sleep till 7, or later!! BUT i do feed them during the night when they were baby's. Our 4 month old will sometimes nurse at night, sometimes not. Our 4.5 yr old we did the CO, she was old enough to sleep thru the night and needed to!
So yeah we didn't have such a routine of eat, play, sleep but i do feel strongly about getting enough sleep!! Even if that means going to bed at 7pm, or earlier. They are so used to going to bed when it's still light out and people are shocked when i say how early they are in bed!

Emily said...

Wendi, thanks for writing this post, and for responding to my question on HP. You've given me increased hope for a good night's sleep! I think I'm going to print this out and re-read when I need encouragement and inspiration. :)

kelli4481 said...

Wendi,
Do you have any other baby book recommendations? I am newly pregnant with my first baby and would love to use similar techniques as you, because you have been so successful!
Thanks!
Kelli

Angie said...

I have never read BabyWise but I did read Healthy Sleep Habits, Happy Child. They sound pretty similar. Like you, I took what I wanted from it and used it as what was best for us. Like you, my girls are close, 7 months. We allowed the girls to cry it out as well and both were sleeping throught he night very early. Holly was hardest but only because she was stubborn. She would cry for 4 hours if we let her. There was never a time when she went 45 mins, then 40, then 30, etc. She just cried. But it was a phase and eventually she was an awesome sleeper! For me, I was a nazi-schedule mommy! I was worried about Holly with having Hannah coming so soon. And, being a pediatric nurse, I was used to scheduling feeds. So, I had both girls on schedules for feeds and it worked. Both when I bottle fed Holly and breastfed Hannah. My girls still go down at 8pm and I leave them in their room until a minimum 8am. They have never slept in my bed. They know that their bed is their bed and that is it.

From day one, my family was skeptical (esp my sister) and my MIL was horrible when she knew we were letting one cry it out. But, in the end, it works and I'm proud of my sound sleepers! My sister brags about how well my girls sleep! Oh, and they both sleep a 2-3 hour nap every day! Glad to see by your post (and many comments) that I'm not alone!

denise said...

I think you said it all and said it well! I TOTALLY agree! We obviously had three infants at the same time, all three are TOTALLY different and we dealt with it. Sleep for this Mommy and Daddy were super important since we were the only ones around to care for our kids - no family lived nearby to help. I remember when the DR said we could start letting them try to sleep through the night - their preemie weights had gone up enough. After the HARD first two nights, that third night of 5 hrs straight uninterrupted sleep was H.E.A.V.E.N.!

BTW, my three 5 years olds go to bed really well now with a short bed time routine. They rest/nap one time during the day and I have never regretted doing the Babywise cry it out method.

Neverending Joy said...

Hey Wendi! It's HeatherAZ from HP - I just wanted to let you know I loved your post. :) We did pretty much this exact thing with our little one and she is an AMAZING sleeper and we get comments all the time on how happy she is when we are out and about. She has been in her own room and crib since she was just 2 days old. Rested mama, rested baby, happy home! :) It works for us and I love it!