Thursday, March 4, 2010

Day 44: Top 10 things I have learned in the last six weeks or so

While Mari's sleep habits are nowhere near perfect, they are certainly a lot better. And while I continue to learn, these are the most important things I think have worked so far to help improve her sleep. Some are derived from the No-Cry Sleep Solution, some are from Healthy Sleep Habits, Happy Child, and some are of my own invention. These points are roughly in order of importance, in my opinion. Of course, every baby is different, even babies at the same age, but from what I understand from my research, these are points that would help most, if not all babies.

1.  Trust your baby. One of the hardest things for me to wrap my mind around is that Mari has often proven herself capable of more than I have expected. Maybe it's because babies grow and change so fast. I tend to think rules that applied a few weeks ago as still applicable, but often that's not been the case. The biggest thing for me was getting over the idea that Mari would never be able to put herself to sleep, because there was a time when that was true. The first time I left her alone in her room still awake, if very drowsy, I was afraid she'd freak out and it would then take me forever to get her to sleep. Instead, she "talked" for a little while and then there was blessed silence.

2.  Trust yourself. Another hard thing for me has been to weed through all the contradictory things all the different books say and pick out what I think will work for us. Consistency is important, yes, but sometimes I've have to do a bit of experimenting to find out what does work. Once I've found it, I've been trying to be consistent yet flexible -- i.e. if something disrupts her routine. It's a hard line to walk, and sometimes I have to stop and tell myself I'm a good mom and I know my child best.

 3. You do have to alter your life to fit your baby's sleep needs. Being well-rested during the day is crucial to a good night's sleep, and an older baby isn't going to be well-rested if she's not home and in a sleep-inducing environment at consistent times. I miss the days of newborn portability, when Mari could nap anywhere, at any time. But those days are gone and I have to accept it. So I have to keep any outings short and be strict about it. Yes, it's a bit of a pain for me. But a decently rested baby is so worth it and it makes for better rested parents too. 

4. Not every cry is the same and not every sound from a baby necessitates an immediate response. Leaving a baby to fuss for a bit is not the same as crying it out. For more: http://sleeplittlebaby.blogspot.com/2010/03/day-41-talking-fussing-calling-crying.html

5. Your child's temperament will affect his/her sleep habits and your responses to them. Some babies might be able to set and stick to a schedule on their own. Others will not. Some babies will cry very persistently, others will not. Some need a lot of cuddling, others don't like it. For more: http://sleeplittlebaby.blogspot.com/2010/02/day-36-temperament-and-sleep.html

6. By about six months at the latest, natural sleepy times develop, even in an irregular child, according to Healthy Sleep Habits, Happy Child author Dr. Marc Weissbluth. If one nap is short or skipped it may be better to keep the baby awake until the next naptime, to keep the baby on some sort of schedule, though that needs to be balanced with the need not to get the baby too overtired. The morning nap should start between 9-10 and the afternoon nap, between 12 and 2. For Mari, her morning nap has been starting around 8:30 to 9 and her afternoon nap around 1-ish. A third nap is variable, according to Weissbluth. Mari's has been around 5-ish and she's OK with it only being half an hour if the first two have been long enough. I have been having an easier time convincing her to nap around these natural sleepy times than I did strictly watching the clock to make sure she was up exactly, say, two hours and 15 minutes between naps.

7. The first nap of the day is crucial, and needs to start no more than two hours after the wake-up time. Apparently the morning nap is something of a continuation of night sleep, with plenty of REM sleep. I have found the morning nap sets the tone for the whole day. If Mari is sleeping again within two hours of waking up, she goes down more easily and is more likely to sleep longer. If the morning nap turns out to be shorter than an hour, she'll have a crankier day and will tend to wake up more easily from her naps. However, for some reason it's harder to get her back to sleep if she wakes up prematurely from her morning nap than from afternoon naps. This is something I'm still struggling with -- today, her morning nap was only 40 minutes and I couldn't get her back down. Lo and behold, she was a bit cranky.

8. A parent's presence can be a hindrance, not a help, in getting to sleep. Mari has always been a bit clingy, and my presence can reassure her if she's upset. However, my being around once she's calm at night seems to often delay her falling asleep, because she'd rather interact with me than sleep. However, at naptime, it's harder for me to leave the room, because she's more awake and gets upset if I leave. Having her put herself to sleep for naps is still something we need to work on.

9. A comfortable, sleep-inducing environment is important. Mari has started napping a bit better since I put the blackout fabric on the other side of the bamboo blinds. However, it's still not a very dark room and sometimes I regret not having bought black blackout fabric. On the other hand, I don't want to train her into only being able to sleep in a bat cave. Other environmental things that help: a white noise machine that stays on all night long (we have one on a timer too but she often wakes up when it turns off), removing all toys from the crib (wasn't necessary a few weeks ago, but it is now -- she's more aggressive about getting at them and more active in her sleep -- I usually put her down on her back, head to the left, and very often she wakes up on her tummy, head to the right).

10. It's normal for breastfed babies to wake up once or twice a night to feed until the age of 9 months, according to Dr. Weissbluth. Knowing this has helped me be OK with one or two night wakings and responding fairly promptly with feeding.

Near-future posts: ideas I have not found useful, ideas that may or may not be working, things I have learned specifically about Mari.

Tuesday, March 2, 2010

Day 42: Still struggling with naps

Why is it that one day can go so well and the next day everything is all screwy again when I've changed nothing?

Mari had bad naps again today, napping only tiny periods before waking up still tired. I'd rock her back to sleep and put her down and she'd wake up again, still cranky and easy to put to sleep again -- but also too easy to wake up by putting down. Argh!

Anyway, it occurs to me I didn't post Mari's 6-month pictures, for those of you who might be grandmas or otherwise interested primarily in the cute.

Monday, March 1, 2010

Day 41: Talking, fussing, calling, crying and screaming

I used to think if a baby made noise at night, a parent needed to respond right away, no matter what the noise. I thought anything else was leaving the baby to "cry it out," and that was cruel. But slowly, I've been changing my mind.

I've been developing the theory that Mari's nighttime and pre-falling-asleep vocalizations come in five varieties: talking, fussing/whining, calling, crying and screaming, and that I should vary my response to her based on what type of vocalization it is. Please note both her cries and my responses are different at naptime; this is only for night sleep.

Talking: She doesn't sound upset, just using her voice. If she was old enough to say more than "ah-eh" and "oogie" it would sound like she was saying: "...and then we went to the store and Mommy bought me new socks..."  If she's "talking," I leave her indefinitely, until she falls asleep or gets upset.


Fussing/whining: She's a bit upset, but not too much. It sounds at first blush like crying, but the sounds are fairly quiet, intermittent and sound more annoyed or whiny than really upset. If she could talk, it would sound like she was saying, "I'm bored," "I'm tired" or "this sucks." I feel comfortable leaving her to fuss for between five and 20 minutes, depending on just how upset she sounds. I go in if the fussing turns into crying, but often she manages to put herself to sleep. Exception: if it's just after I've put her down for the night but she still hasn't fallen asleep and is getting upset, I go in fairly quickly (after only a few minutes of fussing) for a quick cuddle, then I set her back down still awake. The one-time "Mummy may have left the room but she hasn't abandoned you" visit seems to reassure her and she almost always falls asleep quickly afterward. I'm not sure if I should keep doing this but for now it seems to work.

Calling: She's a little upset, but I get the impression she's testing my boundaries more than anything else. The cries are louder than fusses but very intermittent -- from several seconds to as much as two minutes between cries. If she could talk, she'd be saying: "Mum! Where are you?" "Come pick me up!" Or: "Waiter!" "What's a baby got to do to get service around here?" Often calling is intermingled with fussing, and I respond the same way, on the same timeline.

Crying: She's really upset or hungry and there's no way to translate the sounds into speech because even if she could talk, she'd still be crying. I only wait a minute or two to make sure she's really awake and not crying out in her sleep (unlikely) before going in to comfort her. My response would usually include nursing, unless she ate less than three hours ago. Often if she's hungry the sounds start off as fussing but become more insistent and more like crying quite quickly.


Screaming: A panicked scream, again no way to translate into speech. Will either turn into crying if she's awake or it's a night terror, in which case she's not really awake and will quickly stop. Though she sounds more upset than if she's crying, I wait a little longer before going in -- a few minutes -- because it's reasonably likely it's a night terror. If she keeps screaming, I have to turn on a dim light so I can see well enough to make sure there isn't anything hurting her, though that's never yet been the case. I may have to revise that when she starts teething.

Today: A good day for naps. Mari slept only an hour and ten minutes in the morning, less than I like to see, but unusually she slept for two straight hours in the afternoon -- no waking up and me having to put her back to sleep. Her late-afternoon nap was only half an hour, but this is becoming more common and seems to be OK.

I think I have to slightly revise the schedule I set out the other day, since Mari seldom wakes up after 7 AM, so it's impractical to try to keep her sleeping and/or quiet until 7:30. So I will let her have active time from 7 AM until the naptime routine starts at 8:15. Also, if she has a decent but not two-hour morning nap, I will let her have active time starting at 10:30, not 11.

Friday, February 26, 2010

Day 38: Imposing a schedule, of sorts

I've been trying to respond promptly to Mari's cues and keeping track of when she sleeps for quite awhile now in hopes a pattern would emerge. Unfortunately, the only conclusion I've come to is that Mari is highly unpredictable and has little or no internal rhythm of her own.

She wakes up wide awake and ready to play anytime between 2:30 AM and 8 AM, though of course with the earlier times I try really hard to get her back to sleep, though it often takes up to an hour and a half. Her nap number ranges from two to five, though three is most normal. She has gone to bed as early as 5:30 PM and not until nearly 9 PM. Her morning nap has started as early as 7:40 and as late as 10:10. Her nap lengths vary from 20 minutes to three hours.

Having learned a little more about temperament, I can conclude that Mari is a highly irregular baby and will not put herself on a schedule no matter how long I wait and keep track of what she does. So I've decided I have to impose one.

No, Jon, I'm not going to be inflexible about this. Because I'm going to try to balance establishing a schedule with making sure Mari gets enough rest and isn't overtired, it may take a long time for her to get the idea. Nonetheless, I'm going to try. Someone has to set her circadian clock.

The key is going to be establishing quiet times and active times. Ideally she will sleep during the quiet times and play during the active times, but if not, she will play quietly during the quiet times and nap in a brighter, noisier environment during the active times.

The ideal schedule will be as follows:

7:30 AM - Up, active play
8:15 - Naptime routine (feed, potty, story, lullaby and rocking, down)
9:00 - Nap/quiet time
11:00 - Active play
12:15 PM - Naptime routine
1:00 - Nap/quiet time
2:30 - Active play
3:45 - Naptime routine
4:30 - Nap/quiet time
5:30 - Active play/suppertime
6:30 - Bedtime routine (feed, potty, bath, massage, 2 stories, lullaby and rocking, down)
7:30 - Sleep

Of course, Mari won't follow the ideal schedule exactly. So I have the following contingency guidelines:

- If Mari wakes up from a nap while it's still naptime, I will try my hardest to get her back down. If after 20 minutes of rocking and soothing, she won't go back down and it's still naptime, I will let her play quietly in her crib for up to 20 minutes or until she shows tired signs. Then I will try again, until she goes down or until it's active time.

- If Mari wakes up while it's still naptime and I'm able to get her back down, but she wakes up again I'll try a second time to get her back down -- and this time I'll rock her all the way to sleep. At all other times I will endeavour to rock her only until she's drowsy and put her down still awake. If she wakes up a third time while it's still naptime I'll let her play quietly in her crib until it's active time.

- If Mari shows signs of fatigue during active time, I will immediately stop what I'm doing and put her to bed. I won't do the whole naptime routine -- no feed, no potty, no story. Just lullaby and rocking.

- For naps during active time, I will not try super-hard to be quiet. I will walk around, flush the toilet, etc, though I won't actively try to disrupt her sleep. I will close only the blind over her crib, not the one over the roof, unless it's very sunny, in which case I'll close the bamboo part of the blind only, not the blackout fabric. For naps during quiet time, I will close both blinds and I will try to be as quiet as possible.

- If Mari wakes up from a short nap during active time I won't try to put her back to sleep unless she's very fussy and obviously tired and continues to be for more than a few minutes.

- For most naps, even if they go into the next scheduled time, I will not wake her up or disturb her. However, if the last nap of the day goes beyond 6:30 PM, I will go into the room, walk around, open the blinds, turn off the white noise machine. If that doesn't wake her up I'll try again in another 10 minutes. By 6:45 at the latest, I will actively wake her up by picking her up.

- During active time, Mari will play downstairs, not in her crib. I will try to play actively with her as much as possible, though I don't promise to do so all the time.

- If Mari is happily playing in her crib during quiet time, I will either leave her alone in her room or sit in the chair and read, interacting with her only minimally, if at all -- looks and smiles, no talking.

- If Mari is playing in her crib during quiet time, I will provide only her lovey and perhaps one other toy at my discretion, and she will be facing the direction she faces to sleep, unless there's less than 15 minutes remaining in her quiet time, in which case she can play with whatever she wants, facing whichever direction, as long as she stays in her crib.

- If Mari starts to fuss when I've left her alone to play in her crib during quiet time, I'll take this as a sign she's tired and will try again to put her down for a nap.

- If Mari naps during active time, I will nonetheless try to put her down for her next nap on schedule, unless she has woken up less than half an hour before the naptime routine is supposed to begin. If the latter is the case, I'll let her play actively for 30 minutes before beginning the naptime routine. If she seems wide awake even then, I will use the time normally allotted for the naptime routine as a transitional time. I will feed her if she'll eat, read her stories, play with her very quietly until she starts to lose steam or until the actual nap is supposed to start. Then I will try more aggressively to get her to fall asleep.

- The bedtime routine starts at 6:30 PM even if she's just woken up, because she's tired at that time of day anyway and because the bath and massage will provide some activity before bed.

- While I will try to feed her at the beginning of every naptime/bedtime routine, it's not a big deal if she's hungry earlier or refuses to feed because she's not hungry -- I will feed her on demand. If I end up having to nurse her at the end of the naptime/bedtime routine I will pull her off before she falls asleep completely. I will try not to make a habit of nursing her immediately before bed.

- I will try to potty her toward the beginning of the naptime/bedtime routine. If she doesn't go, I won't take her again unless she clearly needs to poo (not pee). If she does, I will use the bowl in her room; I won't take her to the (brighter) bathroom.

- If she wakes up before 7:30 AM, I will try hard to get her back down. But if she's wide awake between 7:00 and 7:30 and seems unlikely to go back down, I will let her play quietly in her crib until 7:30. In this case I will potty her if need be.

- If she seems very tired at night, I will shorten the bedtime routine and concentrate on getting her down, even if it's earlier than 7:30 PM.

- I hope that eventually, if she's sleeping better during the day and waking up less at night, I can move the bedtime up to 8 PM and allow her to get up at 7 AM, since she probably only needs about 11 hours of night sleep.

Today: Last night we were back to the bad old days -- four night wakings. She was up from about 2:15 to 3:30 AM and wouldn't fall back asleep. I don't know what's up because yesterday was a fairly average day. Maybe it's the developmental leaps of Wonder Week 26 making her fussy for up to five weeks. Sigh. As for the new schedule, yesterday was the first day I tried to follow it, and we were fairly successful. However, today, Mari screwed it up by napping only for about 45 minutes in the morning and refusing to back down. She ended up having four short naps today, one of them during an active time. I really, really wish I could get her to nap longer.

Thursday, February 25, 2010

Day 37: Do babies have nightmares?

Wow, Mari just woke up SCREAMING. Usually she wakes up with a little cry that turns into fussing or calling but this time it was top-of-her-lungs shrieking. I waited only about a minute before I went in, just long enough to be sure it wasn't just a sleep cry. It took only a moderate time to settle her down and I didn't have to nurse her, but for awhile she seemed truly in a panic. It almost sounded like she was in pain, though I didn't notice anything that could possibly be hurting her. She isn't teething yet. The only thing I can think of is: was it a baby nightmare? If so, what nightmares do babies have?

Today: Naps were problematic again, though not as badly as some days. She woke up twice during her second nap and had to be rocked back to sleep because she still seemed tired. Also, she only had a 30-minute late-afternoon nap. I feel like I'm making no progress whatsoever on the nap front.

Tuesday, February 23, 2010

Day 36: Temperament and sleep

I'm still not done reading Healthy Sleep Habits, Happy Child by Dr. Marc Weissbluth, but the book's discussion of infant temperament made me wonder how much Mari's temperament affects her sleep.

The widely accepted measures of infant temperament are as follows (more details at http://en.wikipedia.org/wiki/Temperament#Nine_Temperament_Characteristics_of_Thomas_and_Chess):

Activity (General motion and energy):  Mari is pretty squirmy, always has been. Even when she's on her back she's always kicking and flailing in a jerky way. Though she's not yet creeping or crawling, I would put her activity level at fairly high.

Rhythmicity
(Regularity of bodily functions): Mari is definitely not regular or predictable. Today was a fairly good day -- she napped regularly and was pretty happy and energetic. But I swear, I didn't do anything differently than I did yesterday, when she hardly napped at all. I can never predict when she'll nap or for how long, when she'll poo, how much she'll eat, etc.

Approach/Withdrawal (first reaction): Hmm, I'm not sure on this one. Mari has some pretty fierce stranger aversion, so she's definitely withdrawing when it comes to people. But she's not necessarily fearful of new places, experiences or tastes, as long as we're with her.

Intensity: Mari is very intense. When she's happy she's ecstatic. When she's unhappy she screams like a dying jet engine. She can careen between the two in less than a second.

Mood: Not sure I get this one. Mari's moods vary a lot, but don't most babies' moods vary? When she's well-rested she's generally cheerful. When she's not she's fussy. So I suppose she's somewhere in the middle of the scale.


Persistence: Mari is very persistent, for better and for worse. When she was learning to roll over or to sit up it was all she wanted to do for days. She can also be extremely persistent in crying and resisting sleep even when she's tired.

Distractibility: Mari is quite distractible, though she's not on the extreme end of the scale. She's very easily distracted by unusual or new sights, noises, and toys. Picking her up can distract her from fussing quickly, but it doesn't last. Same goes for novel soothing techniques -- they seem to work quickly at first, but she goes back to fussing quickly.


Threshold (sensitivity): Mari is very sensitive, especially to noises. She's easily startled by even not-so-loud noises such as a wooden block falling into a small box. Truly loud noises such as the sound of the vacuum make her howl. When she's sleeping she's very easily awakened even by tiny sounds such as the rustle of paper or the crinkle of plastic.

According to the book, intense babies also tend to be slowly adaptable, negative in mood and withdrawn. These traits make for a "difficult" temperament. Well, I'd say Mari is very intense but in the middle on the other supposedly related measures. So I suppose she has an "intermediate" temperament by the book's classification system. But Weissbluth also notes babies who are highly active and highly sensitive are also at risk of sleep problems, especially when routines are disrupted. This is obviously true for Mari. So despite her natural lack of regularity she really needs me to try my best to impose a routine and a schedule. Too bad it's so hard.

There are other ways of measuring temperament. According to The Baby Whisperer, Mari is "spirited" -- a baby who knows what she wants and doesn't want and doesn't hesitate to let people know, and loudly. (An abbreviated version of the quiz in the book is available here: http://quiz.ivillage.com/parenting/tests/knowyourbaby.htm)

Mari is also a "high needs" baby according to Dr. William Sears, the guru of attachment parenting. She fits all 12 of the characteristics listed here <http://www.askdrsears.com/html/5/T050400.asp> to a tee.

All this adds up to Mari not being hard-wired to sleep well. Dr. Sears has a good article about it here: http://www.askdrsears.com/html/5/T050900.asp. So I suppose sleep will always be somewhat of a struggle. Still, the changes I've made so far have made a world of difference, though I clearly still need to do more work on trying to get her to fall asleep on her own, especially for naps, since I'm still having difficulty putting her down before the very-nearly-asleep stage.

Monday, February 22, 2010

Day 35: Bad, bad naps

Argh. Mari slept for only 35 minutes in the morning, which always bodes poorly for the day. Sure enough she was fussy all day but wouldn't sleep. She went nearly five hours between her first and second naps, which is unprecedented. In total she only napped 2 hours, 10 minutes and was clearly overtired and squawky most of the day.

Night sleep is going mostly all right now, so why are naps such a problem?  I've been so desperate to get her to nap I haven't been good about following the sleep plan. I think I need to take a more hands-off approach to her naps, though, even though it makes for some cranky days, because if she doesn't learn to put herself down for naps this will continue to be a problem. I am still reluctant to let her cry it out entirely, but maybe I need to tolerate a little more fussing.