Friday, April 16, 2010

Day 85: Teething hell, again?

Argh. Mari just had her first middle-of-the-night lengthy screaming fit in a long time. I actually went out for awhile and left Jon in charge, so I wasn't home when she apparently woke up around 10:30 PM. She was still screaming, despite his considerable efforts to calm her, at 11:10 when I got home. I tried nursing her, but she didn't seem very hungry and didn't eat much, and she still screamed for some time after. In total, she was up for an hour or so, and our usual rules (i.e. about not spending too much time comforting her, not letting her nurse just for comfort) went out the window. I don't want to make a habit of this, but sometimes exceptions have to be made.

Jon said he had to turn on the light because she was really upset, and wonders if that got her "really" awake. Maybe being up and in the light at a time when she's not usually up made her act up like when she's really overtired. But I think she's (also?) teething again. Her lower teeth are now definitely all the way up over the gumline (though they still have some growing to do) but now there's a bump on her upper gums. She seemed fussy all day today, despite getting some decent naptime in. So maybe she's already due to get her upper teeth, though she just got her lower teeth?

I don't like the idea of unnecessarily drugging up our baby, but I've gotten out the infant Motrin, which I may use if she wakes up screaming again tonight.

Thursday, April 15, 2010

Day 84: Book reviews and update

Sorry it's been so long since I posted. Mari's been having a more or less good run of sleeping lately, though she's still waking up about twice a night to feed. I've been thinking again about weaning her off the second night feed, since she doesn't really seem to need it -- she's fine when she sleeps well and gets up only for one feed. Also, if she has a second night feed she won't feed again when she wakes up in the morning, not until nearly time for her first nap. I would rather she feed when she gets up too. Also, she still quite often wakes up from a nap after only one sleep cycle, despite being obviously tired. I don't know what more I can do about that than what we're already doing. However, her naptimes have stabilized a little. I'm doing everything I can to ensure she sleeps at least 13 hours total a day, but she really does best when she gets 14 hours. More about that in the book reviews below.

I'm a big researcher, arguably an over-researcher, so I have read all kinds of books on baby sleep. All have had good points as well as not-so-good. Here's the lowdown on what I think of all the books I've read, in order from the ones I've liked most to least.

1.  The No-Cry Sleep Solution, by Elizabeth Pantley

The book that started me and Mari on this journey, and in my opinion, still the best. I like that it offers an organized way to create a sleep plan and to track progress. It also offers plenty of suggestions to create healthy sleep habits. You don't have to follow them all; just the ones that work for you. In fact, it offers a lot of flexibility, including no guilt about co-sleeping or crib sleeping. Most important, unlike most other baby sleep books, it doesn't involve making the baby cry it out, which despite my having dipped a toe or two into those waters, is in my opinion still an admirable and loving goal.

However,  as I have mentioned before, I have come to believe it's not always possible or necessarily desirable to achieve no crying at all. At least for Mari, I have not been able to prevent her from crying entirely, and until I stopped taking the book quite so seriously, I felt a lot of guilt about that. I believe there are different types of crying that should be treated different ways. There are indeed times when she seems to need to fuss a bit before falling asleep, and if I keep trying to comfort her, it actually takes longer or even prevents her falling asleep. Having said that, if I get the timing just right, she fusses little or not at all. She cries when she's overtired, so it's best to prevent her from getting overtired.

2. Solve Your Child's Sleep Problems, by Richard Ferber. M.D.

I've never systematically Ferberized, but I found this book very informative. It has the best explanations about child sleep that I've ever read and the chapter about sleep associations, I found to be better than in the NCSS. I read the whole thing out of interest, even though Mari doesn't have problems with things like narcolepsy or sleep apnea, and now I feel I know what to look out for if she should ever develop more serious sleep problems.

I had formed a bad opinion of Ferberizing before I read this book. However, once I read the book, rather than just what other people had to say about it, I found the description of the method to be more logical and less harsh than the extinction method of crying it out. I think the method could work for parents who don't have the patience to implement the gentler but more time-consuming methods of the NCSS first, but after a couple of months on the NCSS, I found that Mari's sleep habits were already mostly good enough that it was unnecessary to let her cry for increasing intervals. Most of the time now she goes down pretty easily and if she doesn't, it's either because she's not tired enough yet to go to sleep or because she's overtired, in which case it seems too harsh to me to leave her to cry for very long. 

I have, however, taken some things from Ferber. When necessary, I use the idea of increasing intervals between responses and keeping my time in the room short. If Mari cries after being put down, I will first respond and comfort her after about two minutes of full-on crying (I let her fuss longer if she doesn't sound very upset). At all times I limit my time in the room to two minutes unless of course I'm nursing her. If she still keeps crying, I next respond after five minutes. After that, 10 minutes and so on until half an hour has passed since I first put her down. If she's still upset at that point, I let her get up and play for a little while before I try again, because I figure she either wasn't tired or is overtired but has gotten a second wind. I have only had to let her get up for naps; never for bedtime sleep. I have not, however, increased time between responses from day to day.

There is one major area in which I tend to disagree with Ferber. Ferber constantly contends that sleep problems can be solved by at least temporarily making bedtimes later so the child is more tired when he or she is put to bed. Maybe, just maybe, this is something that could work for older children, but it certainly doesn't work for Mari and probably not most babies. The more overtired Mari gets the LESS she sleeps and the HARDER it is to get her down to sleep. 

Also, Ferber says a six-month-old should be getting about 12.5 hours total sleep a day. I find this just barely in the adequate range. Mari averages about 13, and she's happier when she gets 14 hours of sleep or more in a day if I can manage to get her to sleep that long. In the three weeks since I have been using to keep track of her sleep, Mari has slept a maximum of 14.5 hours and wow, she was in a great mood that day. Nor do I believe it's just that Mari needs more sleep than most. On the online message board for moms that I visit, it would seem the majority of 7-8 month-olds need 13 hours or more of sleep a day.

Wow, that took longer than I expected. I will post this now and continue the book reviews another day. Next up: Healthy Sleep Habits, Happy Child; The Baby Whisperer; The Baby Sleep Book.