Saturday, May 1, 2010

Day 99: Night wakings all over the place

Mari has gotten down to a number of night wakings I consider more or less acceptable -- one or two. Though of course none would be ideal, it may be asking too much at this stage, especially given that Mari tends to sleep a fairly long stretch in total at night -- from about 7:30 AM to 6:30 AM. However, looking back at the so-useful graphs on Babybix.com, I see no pattern at all as to when the night wakings occur.

Mari does normally nurse when she wakes up. She definitely seems to need to nurse at least once at night, though whether she needs a second night feed is more questionable. However, given that she goes to bed at a fairly consistent time, her totally unpredictable night waking times make me wonder what's going on. Can it really be that sometimes she's hungry at 10:30 PM and other times, not until 5:00 AM? Or is something else going on? If so, what?

Especially if she wakes up early in the night, we try to get her back to sleep without feeding, but yesterday, I went out for awhile and left Jon in charge, only to find that Mari woke up at 10:15, a pretty much unheard-of hour for night wakings, and Jon was unable to get her back down, leading him to conclude she was hungry. I (stupidly) left the cell phone in my pocket and didn't hear it until he had called 11 times and Mari had been up more than an hour. Oops.

When I got home, I tried to feed her right away. When Mari's really hungry, she can go at me like a vampire. This time, she popped on and off the breast in a nonchalant manner, finally nursed from one breast, then rejected the second after only about 30 seconds. However, she then went back to sleep easily. So while she was hungry enough to eat, she didn't seem very hungry.

Mari seldom nurses to sleep now and I know she knows how to put herself back to sleep without nursing because sometimes I hear her cry out in the night, only to quickly stop without any intervention on our parts. Therefore, I've started to wonder if she's developed a sleep association not so much with nursing, but with me.

I'm always the one who puts Mari to bed. This makes sense because I nurse her because bed. I'm almost always the one who goes to her in the night. Again, this makes sense because she usually nurses if she's up at night (though occasionally I will soothe her without nursing, which may or may not work depending on how long it has been since she last nursed.) However, I don't want to be the only one who can respond to her and have her go back to sleep. (When I nurse her at night, she doesn't actually fall asleep on the breast, but she gets very close.)

Jon, of course, has work to do during the day. I'm on maternity leave. Mari is my job. Should we nonetheless make a point of having Jon respond to her more often when she wakes up at night, so I don't have to be there for her to be able to fall back asleep?

Sunday, April 25, 2010

Day 93: Teething? Growth spurt? Wonder week? Or just plain fussy?

Mari has become fussier than usual again for the last several days, and I can't quite tell why. When she cries, she's screaming louder. She's having more difficulty going down without a fuss. Though we really have been trying to keep her to her usual schedule, she seems more sensitive to the slightest variation.

Also, though it used to be that she almost never woke up before about 1 AM, for the last couple of nights in a row, she has been waking up after only a few hours of sleep and screaming at the top of her lungs. The only way I've been able to get her to calm down has been through nursing. She has drank greedily from the boob at those times, making me think maybe it's a growth spurt. She has been eating more during the day too.

But tonight, though I nursed her and put her down, and she was quiet for awhile, she soon started crying again. Jon is upstairs with her as I write this. So maybe something other than hunger is bugging her -- maybe her teeth. Mari has been sucking on things and drooling like crazy. However, she has been doing that since she was about three months old, and she just got her first two bottom teeth recently. A few days ago I thought I felt swelling in her upper gums, but now it seems to be gone. So how do I tell if it's teething or not?

Another thought is that Mari is coming up to Wonder Week 37 (though she's currently 35.5 weeks). (For more on Wonder Weeks, see the book by that name or the brief overview here.) She certainly is crankier, clingier and having more trouble sleeping, so that would fit.

But what this comes down to is that I feel like I have no clue as to what's going on with my kid. Sigh.

Thursday, April 22, 2010

Day 91: Book reviews continued

Continued from this post...

3. Healthy Sleep Habits, Happy Child, by Marc Weissbluth, M.D.

There was a good deal I liked and found useful about this book. However, in my opinion the most fundamental thing about this book -- the recommended "extinction" crying method is overly harsh and unnecessary for most babies.

But let's start with what I did like, most of all the maxim that sleep begets sleep. Here, I have found that Weissbluth is right and Ferber is wrong. Almost always, an earlier bedtime, not a later one, is better for Mari's sleep. She sleeps more and better than when I've tried to keep her up longer or later. Of course, there is a limit, though Weissbluth sometimes seems to imply otherwise. Mari cannot and will not sleep for more than 14 hours in a day at the most, and she averages about 13 hours, though if I recall correctly, Weissbluth recommends 14-15.

Another thing I liked is the emphasis Weissbluth places on baby temperament and his acknowledgment, missing in many other books, that some babies just aren't going to be as good of sleepers as others, and that what works for most babies may not work for a certain percentage -- especially those who were very fussy as younger babies, which Mari certainly was. It was reassuring to me to know that just because some techniques work with other babies and don't seem to work with Mari, it's not necessarily because I'm doing something wrong -- it's because Mari is a different baby.

For the above reasons, I am prepared to believe that there are some babies for whom the extinction crying method Weissbluth advocates may be the only thing that works. However, I also believe that it's highly stressful for babies. It's plain that babies don't like to cry. Their faces turn red, their temperature goes up, they give every indication of being in extreme distress. Babies cry to communicate. Whether it's because they're in pain or because they just want their mothers, for the baby, something is wrong. I believe those needs should be responded to promptly (though not necessarily immediately), unless there's a damn good reason to delay response. In my opinion, a parent should consistently and patiently try every other method possible before resorting to the extinction method.

It's true that babies need to learn to fall asleep and stay asleep on their own. It may be true that for some babies, a certain amount of crying is necessary before they learn. However, just plain ignoring the baby's cries, no matter how long it takes, ignores the possibility the baby may be in pain or discomfort, which if fixed could get him or her to sleep.

I did find Weissbluth makes good points about why it's so important for children to be well-rested. However, I thought he overstated the case. I found myself worrying as I read it that I had already caused Mari irreparable damage by letting her stay up too long in the past. I even wondered if that was the cause of her not doing things such as crawling as fast as some babies (though she is still very much within the normal range). With a little more distance, I found the book was making me worrying too much. More guilt is something parents don't need.

Another issue I have with the book is that it is overly long, repetitive and written in a convoluted manner. However, that may be the editor in me talking.

4. The Baby Sleep Book, by William, Robert, James and Martha Sears

I like Dr. Sears a lot. I find what he says about attachment parenting (I have the book by that name and love it) makes a lot of sense. Though I no longer follow it to the letter (I allow some limited crying alone, I no longer "wear" Mari much at home, we no longer co-sleep), I believe in the philosophy of maintaining a strong bond between parent and baby. I believe the amount of time I spent in earlier months wearing or carrying Mari, co-sleeping, responding immediately to her cries, bonding with her immediately upon birth, and breastfeeding (still going strong there) laid the foundation for us knowing her well and her trusting us. I also found The Birth Book, also by Dr. Sears, to be the best, most balanced resource I read about birth. So certainly I have nothing against Dr. Sears.

However, I did not find The Baby Sleep Book to be terribly helpful. When I tried to follow his suggestion of waiting until Mari had been asleep for 20 minutes before putting her down, I found she was more lightly asleep than when she had been asleep only about 5 minutes. It also delayed my going to sleep myself -- but then, generally, I found the book didn't give enough weight to parents' needs.

Really, I found the whole concept of actively putting her to sleep each and every time problematic. I do believe Ferber's assertion that babies develop sleep associations. If Mari is rocked or nursed to sleep, then put down once deeply asleep, she does indeed tend to wake up when her sleep cycle becomes shallow, probably because she's alarmed that the conditions she associated with going to sleep (rocking, nursing) are no longer present. It was only when I started working to break those sleep associations that Mari started sleeping better.

Basically, the message I took away from The Baby Sleep Book was that if I didn't like Mari waking up constantly, I should just be very, very patient and she would eventually, by the time she was a toddler or preschooler, learn to sleep better and more independently. In the meaning, Jon or I should always carry her until she fell asleep and then sleep with her, even if it meant a more disrupted sleep for everybody. I found this unacceptable.

To be fair, there are bits about other ways of doing things, and a good chapter about night weaning, but I generally found the book to be simplistic, not that informed about sleep and not very respectful of the need to teach a baby to fall asleep and stay asleep on her own. Though just as gentle, I found the No-Cry Sleep Solution to be better about all that.

Next up: The No-Cry Nap Solution, The Baby Whisperer

Wednesday, April 21, 2010

Day 90: Eight months old and busier than ever

Mari turned eight months old yesterday. I can hardly believe it -- time goes so fast. Since I haven't posted photos in awhile, here are a few of the very latest ones.


Mari has been busy learning new skills too. She can now get up onto her hands and knees and her very latest trick is getting onto her hands and feet in the "downward dog" position. No crawling yet, but she seems very close. She's still doing her backwards creeping and is more efficient at it than ever.

She can now say "dada" and "daddy," though I'm still waiting for that elusive first "mama." She has two teeth now. She can now eat an awful lot of solid food. The photo above is from after she polished off half an avocado. While it may look like half an avocado is smeared all over her, I am convinced the vast majority of it went into her mouth. She's also getting good at eating even small, slippery bits of food. Oh, and she can drink from her sippy cup now, though there is still some spillage as she will only drink from it without the non-spill valve in.

As for sleep, she has been getting somewhat better about staying asleep longer for naps, which is HUGE for me, though she's still not consistent. At night, though, she's back to waking up twice most of the time, when for awhile we were down to one or none. I am thinking again about starting to limit her second night feed.

Today: An average day for sleep. A decent morning nap of nearly an hour and a half, but an afternoon nap of less than an hour, which is less than optimal. She woke up still cranky but wouldn't go back down. She was up super early this morning (6:10) and was so tired she had to be put to bed early (just after 7 PM), so I hope this doesn't lead to an even earlier waking and the beginning of a vicious circle.

Day 89: Bedtime disaster

I am writing this post a little late, but it's about April 19, which was the biggest bedtime disaster since I began this blog.

Honestly, I'm not sure what happened. Yes, I got Mari to bed a little later than usual, but by just 10 minutes. This has happened before with no real consequence. She napped fairly well during the day. I knew she was getting tired at night, but Jon had a lot on his mind and I spent a bit of extra time talking to him after dinner. I then performed the usual bedtime routine and everything seemed fine. I put her down at 7:40. She was starting to fuss a bit, but I expected she'd be able to fall asleep. Instead, a few minutes after I left the room, she started screaming at the top of her lungs.

She was so upset, none of the usual tricks (rocking, bouncing, singing, etc.) made one iota of difference. She wouldn't nurse anymore; she'd just eaten. She has seldom cried quite so hard or so loudly. In desperation I let her get up for a little while to try to "reset" her. She watched her mobile (still hung over the now-unused co-sleeper), which she likes, then I turned the light on in her room and read her one more story. Then I tried to put her down again. As soon as her butt hit the mattress, she started screaming again, if anything even louder than before.

I picked her up right away. I was prepared to abandon my usual rules about having her fall asleep on her own. I just wanted her to calm down. But no matter what I did, she wouldn't calm down again. She didn't even seem to notice I was there. She screamed until I thought she'd lose her voice, then she screamed some more. I alternated between trying to soothe her and leaving her for a few minutes at a time in the hope she'd cry herself to sleep, even though I don't really believe in that method. Neither worked. Finally, in large part for the sake of my own sanity, I just left her and closed the door to my own room. I thought I'd give her 15 minutes to cry, but at the 15-minute mark, her cries FINALLY started to peter out, though she kept them up weakly for a further 10 minutes or so. She didn't fall asleep until nearly 9 PM.

Now I feel bad for having left her to cry it out because it wasn't planned. As I've stated before, I don't believe Mari needs to "cry it out." I tried it intentionally once. It didn't work well then and the more I thought about it, the more uncomfortable I became with the idea. I don't want her to cry it out again. But I didn't know what else to do with a baby who wasn't responding to any of my soothing efforts at all. What would you do in this situation?

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 babybix.com 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.