Thursday, August 28, 2008

Sleeping struggles of 12 week old

Hello friends,

Summer is coming to an end and school will be starting soon - if not already! I am in the midst of potty training 2 1/2 year old twins, which is going surprisingly well. These are kids that I took care of when they were born and have returned many times to "fix" things or tackle milestones.

My summer has been filled with sleep training consultations, parenting classes and spending time with my niece. One of the highlights was a dinner meeting with Dr. Bryan Vartabedian, author of Colic Solved. 

I just happened to be in Houston on a consult and Dr. V was kind enough to meet with me. His book is a fantastic resource for dealing with reflux in infants. In a world where some kids are treated unnecessarily and yet so many cases go undiagnosed, Vartabedian's book provides the facts on reflux and what parents and caregivers can do to advocate for their babies!

Now onto our latest question: Galtscrapper posted a comment about her 12 week old's sleep issues and hopefully I can help. Let's go through a few points from galtscrapper's post before I offer some suggestions.

My first child was a dream, sleeping 6 hours at a stretch practically from the get-go, but she was also drinking 6 ounces of formula from the get-go, which I now realize was a BAD IDEA, and one which we're paying for, so I don't want to repeat that with this one.

Why was this a "bad idea"? Did your first baby have allergies or some aversion to formula? If not, there is nothing "wrong" with feeding formula. Of course breast is best, but not all mothers are able to nurse. Some just don't feel comfortable or their babies have a hard time. I've always believed the best way to feed your baby is the way that makes Momma happy. Because if Momma ain't happy, ain't nobody happy! Every family is different, so breast or bottle or combination of the two - it's all about happy, growing babies. Parents shouldn't feel bad about using formula if nursing doesn't work out.

I can't see being able to go 4 hours between feedings, and from everything I've read, this is a bad idea anyway. MAYBE at night, but not during the day.

Babies less than 16-18 weeks old should not be going 4 hours between feeds during the day, in my opinion. Once nursing is well established, your baby should be able to feed every 3 hours on a FLEXIBLE ROUTINE. By following a few simple guidelines, you'll be waking your baby to eat, not the other way around. Breast fed babies, particularly, should be fed when truly hungry, regardless of the clock. This may be 2 1/2 to 3 hours.

I admit to being lousy at swaddling, anytime I try this, she simply kicks or flails off the blanket, crying the entire time.

Swaddling is the cornerstone of soothing babies and teaching them to sleep longer. You MUST master this skill to get any use out of my methods. There are tricks to getting it just right and you don't have to spend a fortune, although a $30 Miracle Blanket is fairly fool proof.

I need simple things I can do to get her to sleep without me spending two hours moving her from one breast to another waiting for her to get into a deep enough sleep to sneak off. And if she's in my arms and falls asleep, I don't care HOW deep it is, unless it's 1 a.m. if I put her down, she wakes right back up. And simply putting her down while sleepy results in a crying baby. 

Typically, putting a sleeping baby to bed will not work, at least not for long. Rocking, walking, feeding, driving or swinging babies to sleep will not help you in your quest for sleep. Even though you say putting her down sleepy results in crying, that's the best thing to do. Putting a baby down drowsy (but awake) only works if you use it in conjunction with other tools - swaddling, white noise, flexible routine, soothing methods, etc. You have to teach your baby HOW to fall asleep without your direct assistance.

You are probably not going to like the advice I'm about to give, but you asked for it so here it goes.

I'm fundamentally opposed to bed sharing. I am familiar with all the research and the different views on this practice, so my opinion has been well thought out. If you need or want your baby near you at night, consider a side car (also called a co-sleeper) or crib near your bed. In my opinion, bed sharing can be dangerous and often develops hard-to-break habits down the road when Mom and Dad want their lives back. Also, sleep training will go infinitely better if the child is in her own room. If you don't have the space, you'll need to create an area in your room where the baby can't see you. Try a folding screen or curtain off the area around the crib.

To achieve your goal, which at 12 weeks old should be 3-4 ninety-minute daytime naps and 10-12 hours at night, you'll need to create an environment that is conducive to developing good sleep habits. 

First, make sure the sleeping area is darkened. Many parents have been told that babies should learn to sleep in the daylight. Actually, they need to learn HOW to sleep first. Then they can learn to sleep just about anywhere! 

Second, get a good white noise machine (check out the best one for the money at www.gibsonnewbornservices.com/resources). You'll need it to buffer the sounds of the house and sibs, not to mention white noise is a soothing sound that clearly helps babies sleep longer. Place the machine under or near the crib and play it on the white noise setting about the volume level of a running shower or vacuum cleaner.

Third, remove anything stimulating or fun from the crib. This includes toys, mobiles, and anything that sings or lights up. Nothing fun happens at night, that's your new mantra. Once the baby learns how to go to sleep on her own and is 6+ months old, you can try crib attachments that keep her entertained when needed.

Okay, now that you have set the mood, it's time to cover the other important ingredients. As I mentioned earlier, tight swaddling is a must. Use the right sized blanket and if you need instructions, search youtube - many good demos are available.

Next, create a flexible routine that works with your family's busy schedule. Start at the same time each day, like 7 am. Nurse and then have some low stimulation awake time. Watch for sleepy cues and prepare to put her down for a nap within 60-90 minutes of waking (8 to 8:30). Swaddle, turn on sound machine, dim the lights and start sleepy time routine. Stand at the crib or sit in a chair and just firmly pat her bottom while holding her close. Hum or sing a lullaby and sway or rock for 2-5 minutes. Then say goodnight and place her in the crib. You may try using a sleep positioner and turning her slightly toward the wall (be sure she's still on her back). Leave the room and wait to see what happens.

My babies don’t generally cry much during sleep training, but they are trained early and I put an incredible amount of energy into the task. When my babies do need help going to sleep, I use the minute rule. One minute per week of age. Your 12 week old would be just fine if you let her fuss and cry for 12 minutes - as long as you can stand it.

Continue with your 3-hour routine, feeding about every 3 hours and getting her down for a nap after an hour and a half of awake time, including the feed. Babies often wake at the 45-minute mark during naps. This means the baby is in a lighter stage of sleep and can’t quite drift back into another sleep cycle without a little help. Use soothing techniques to help her back to sleep.

When you put your baby to bed  (7:30-8 pm) after the 7 pm feeding, use the same sleepy time routine and guideline from above. At this point you should allow her to sleep until she wakes on her own. Try to go at least 4 hours, but feed her if she’s truly hungry. Continue through the night, hopefully feeding only twice then wake her at 7 am.

There is so much more to sleep training than what I have posted here, but I don’t want to overwhelm you. When I consult with clients for sleep training, I spend a great deal of time personalizing their Plan of Action. I provide them with a detailed binder of information and go over every detail with them. It’s very difficult to unlock all the answers in a single blog posting!

Give these suggestions a try and let me know when you have mastered the swaddling, routine, naps and 4+ hour stretches at night. Then we can talk about the next step toward 10-12 hours of sleep at night!

Best wishes for a restful night,

Cortney