Day 114: Why won't she go to sleep?

Despite all the sleep problems Mari has had, going to sleep at night has seldom been one of them. Going to sleep for naps, yes. Waking up at night, yes. But she has seldom had trouble falling asleep at night, since she's tired then. Now, all of a sudden it's a huge problem. She still seems as tired as ever. She's still napping at more or less her usual times, though she woke up after only 40 minutes this morning and wouldn't go back down. We haven't changed the bedtime routine or her bedtime. So why is she spending so much time getting upset before she finally falls asleep? I'm mystified.

I do definitely think we're in a sleep regression. We're close to the 37-week "Wonder Week" so that may be part of it. I don't know if she's teething -- I can never tell. I'm afraid I haven't figured out a consistent strategy yet -- I'm alternating periods of letting her cry for 5-10 minutes with going in and soothing her, but she doesn't seem very soothed by anything I do. I'm at wit's end.

I know Mari's overtired and what she needs is more sleep. But I don't know how to get her more sleep. She won't go down for naps if she's not tired enough, and she keeps waking up before she should, both in the morning and from naps. How do I stop the cycle?

Day 72: Scheduling feedings

I've never really scheduled feedings. When Mari was younger, I fed on demand. More recently, I've been noticing she hasn't been as demanding -- she can go for longer between feeds, even if she is in fact hungry enough to eat well before she starts to fuss to be fed. So more recently I've been trying to offer her the breast every three hours or so during the day. However, I haven't been very consistent about it. Of course, when she fusses to be fed, I feed her right away. But sometimes I've been feeding her more often or less often as convenient.

I've decided this needs to stop. Mari needs a better-wound internal clock, not just for naps, but also for sleep. Also, if I feed her more often during the day, hopefully she won't need to feed as much at night. For the moment, I still won't push the night weaning issue. However, I will as of tomorrow try to feed her at more consistent times, every 2.5 hours during the day, so ideally she gets six feedings in during the day. Also, I should be more consistent about nursing her before she gets solids, so she's getting the important calories in first.

One variation in the every 2.5 hours rule is that I will try to nurse her before her afternoon nap. At all times, I will not force her to nurse if she doesn't want to. If she's about to go down for a nap and doesn't want to nurse, I'll let her go to sleep without worrying. She's unlikely to wake up because she's hungry, as she has proven she can go four hours or more between feeds during the day. If she refuses to nurse when she's up, I'll try her again in half an hour and try to make up for the stretched-out feedings by offering her the breast every two hours, rather than 2.5, after her afternoon nap.

So her ideal schedule should now look like this:

7 AM - Up and nurse
7:30 - Breakfast (solids)
9:30 - Nurse, followed by naptime routine
10:00 - Nap
11:30 - Active play
12:00 PM - Nurse, followed by lunch (solids)
2:00 PM - Nurse, followed by naptime routine
2:30 - Nap
4:00 - Active play
4:30 - Nurse
6:00 - Dinner (solids)
6:30 - Bath and bedtime routine, including nursing close to end of bedtime routine
7:30(ish) - Sleep

I will continue to allow half an hour of flexibility on either side for naps, depending how how tired she seems to be.

Day 20: Elimination communication dilemma

Mari and I practice elimination communication (EC), which might be briefly described as infant potty training, though really it's not as much about "training" as it is about my trying to be aware of when she needs to pee or poo and giving her the opportunity to do so in the potty instead of expecting her to sit in a dirty diaper for ages. (A better explanation can be found at www.diaperfreebaby.org)

Mari is only actually diaper-free for certain periods during the day, when we're home, I'm not going to be very distracted (such as when I'm making dinner) and she's not breastfeeding or sleeping. We don't EC at night; never have. However, I still consider that we EC pretty much full-time. 

Lately, though, I've been wondering if EC-ing should take a back seat (no pun intended) when I'm trying to get Mari down to sleep or for her naps. One of the fairly reliable times when she's likely to pee or poo is right after a feed (occasionally during, which is why I always diaper her before I nurse her). At the moment, pottying is incorporated into our naptime and bedtime routines for right after she nurses from the first boob. 

However, sometimes pottying can take significant time, especially when I'm sure she has to go but she's taking her sweet time about it. By the time she's clean and has her clothes back on, the potty trip can take up to 10 or even 15 minutes, eating into her sleeping time. Also, if I take her to the potty when she's drowsy, it tends to wake her up.

On the other hand, if I try to put her to sleep without having gone to the potty, she often wakes up quickly because she has to pee or poo -- she never seems to go without waking up at least a little. So I'm constantly torn between taking her to the potty and emphasizing sleep. Any input would be appreciated.

Today: Things went a little better in terms of keeping more or less to the schedule and getting a decent amount of total naptime, though I ended up having to hold her for a significant part of her last nap, because she kept waking up still tired. Today is logging day, so I'll post results tomorrow.

Mari's sleep plan

Finally – I'm done the sleep plan for at least the next 10 days. If necessary, I will re-evaluate after that point. This will likely be the longest blog entry ever, but here's the plan. (Jon, you may want to bookmark this page.)

1. 
   
   I will breastfeed every two hours during the day except when I can't because she's napping. I will try to get her to take both breasts. If she won't immediately take the second, I'll try again in half an hour before giving up. After she's gone to bed, I will breastfeed her no more than once every three hours, and only when she's up and won't readily go back to sleep.
   
   
2. 
   
   I will follow a bedtime routine, starting at 6:30 PM, as follows:
   Bath, Massage, Put on pajamas and sleep sack, 2-3 stories, Lights out, Lullaby, Breastfeed but not completely to sleep, Rocking and shushing but not completely to sleep, Put down in crib, Sleep by 7:30.
   
   
3. 
   
   I will strive to follow what Pantley calls a “flexible yet predictable” daytime schedule, the ideal of which is as follows. Naptimes don't have to be exact but should be in the ballpark. The bedtime routine should start at 6:30 PM sharp unless there's very good reason to vary it by no more than half an hour.
   7:30ish: Up (I will not set an alarm, but this is the one area in which Mari is relatively predictable – she tends to get up between 7 and 8. Sometimes she wakes up earlier, but if it's earlier than 6:45, I will do my best to get her back to sleep.)
   Play independently while Mum & Dad shower and eat breakfast
   Play actively with Mum
   Play quietly with Mum
   9:30 – 11:00 Nap
   Play independently OR outing
   Play actively with Mum OR outing
   Play quietly with Mum
   1:00 – 2:30 Nap
   Play independently OR outing
   Play actively with Mum OR outing
   Play quietly with Mum
   4:00 – 5:30 Nap
   Play independently while Mum and Dad have supper
   Play quietly with Dad
   6:30 Bedtime routine
   7:30ish: Sleep
   
   
4. 
   
   I will try my best to get Mari to nap for 90 minutes at a time. If she wakes up after less than an hour, I will do anything in my power, including rocking her in the sling or nursing her to sleep, to get her back down right away. This is the only time these techniques will be used. I will not take her to the potty until she has napped more than an hour. I will deviate from the scheduled naptimes if Mari seems tired – then I will try to get her down right away.
   
   
5. 
   
   Mari's naptime routine will consist of:
   One story, One lullaby, Breastfeeding but not totally to sleep, Rocking and shushing if necessary, Put down and sleep.
   Of course, this will be easier said than done.

6. 
   
   I will spend some time every day playing quietly with Mari in her crib so she's comfortable in it and likes it.
   
   
7. 
   
   I will try to get Mari to take at least one nap a day in a place other than snuggled up next to me in our bed. This can be in her swing, in her car seat, or ideally in her crib. However, if she doesn't fall asleep within 15 minutes of trying, I'll let her snuggle up next to me in bed, since at this point that she naps is more important than how she naps. (As she gets better at napping, I'll try to increase the naps in her crib and decrease naps in our bed and in her swing. But that's is for a future 10-day plan.)
   
   
8. 
   
   I will try to encourage her attachment to her bunny and give it to her for every nap and sleep, so she associates it with sleep. I will frequently put the bunny in my shirt so it smells like me.
   
   
9. 
   
   I will help her differentiate between naps and nighttime sleep by keeping the curtains (but not blinds) open during naps, and making it as dark as possible for nighttime sleep.
   
   
10. 
    
    The following sounds will be sleep cues: shushing, “it's time to go to sleep,” and white noise via the fan/heater in her room or the white noise machine in ours.
    
    
11. 
    
    I will avoid nursing or rocking her completely to sleep. If she seems in danger of falling asleep on the breast, I will pop her off and try to hold her mouth closed as the book instructs. If she continues to try to latch on, I'll let her for a brief time, then pop her off again, until she no longer tries to latch on.
    
    
12. 
    
    In this 10-day plan, I will put her to sleep in her crib at least until it's time for me to go to bed. I will then bring her to our room and put her in the co-sleeper to sleep until morning. I will try to avoid having her sleep directly in our bed. (As time goes on and she sleeps better, I will keep her in the crib for longer, until she's sleeping in the crib all night long.)
    
    
13. 
    
    I will try to differentiate between still-asleep noises and I'm-waking-up noises. If the former, I will monitor her but take no action until it seems she might be really waking up.
    
    
14. 
    
    In this 10-day plan, I will stay with her while she sleeps as much as possible. When she starts to stir, I will put a hand on her and quietly shush her to try to keep her asleep. (Once she learns to keep herself asleep a little better, I will still stay near her but wait until she makes a sound to put a hand on her and shush her. Once she's not waking up as much, I will leave the room but respond quickly once she makes an I'm-really-waking-up sound and try to keep her asleep or immediately get her back to sleep.)
    
    
15. 
    
    If putting a hand on her and shushing her doesn't work and she seems to really be up, I will pick her up and rock her briefly on the spot, put her back down and put my hand on her and shush her. If that doesn't work, I will pick her up again up to five times. If after five brief pick-ups, she's not falling asleep, I will take her to the rocking chair and rock her fully to sleep and try again to get her to fall asleep on her own next time. If it has been more than 3 hours since her last feed and she's not readily going back to sleep, I will feed her instead of rocking her in the rocking chair, but avoid having her fall asleep nursing.
    
    
16. 
    
    If by some chance she hasn't woken up around the time I want to go to sleep, I will give her a “dream feed,” avoiding waking her, and put her back down in her crib. In this instance it's OK to nurse her to sleep, since she isn't the one who woke up and in fact may be feeding in her sleep.
    
    
    (For future 10-day plans: As she gets better at putting herself to sleep from a nearly-asleep point, I will move her into her crib when she's settled and sleepy but not net nearly-asleep. When she can fall asleep from that point, I will try to comfort her when she wakes without picking her up, though I will put a hand or hands on her. When she can handle that, I will try to comfort her without touching her, just through shushing and my presence. When she can handle that, I will try to comfort her from outside the doorway, where she can hear me but not see me. Though hopefully she'll be sleeping through the night by that point.)

Tomorrow: Day One of the new sleep plan.