Because I'm a labor & delivery nurse, does that mean I'm supposed to know what I'm doing with my own baby?

Sunday, July 13, 2008

Sleeping Like a Baby

Recently Jen over at Surviving Wyoming sent me an article from Slate about "Ferberizing" your baby. It's gotten me thinking about baby sleep.

I should start out by saying that Baby Stewgler is good sleeper. She started sleeping 6-8 hours at a stretch when she was six weeks old and has been sleeping 11+ hours since she was about three months old. What can I say? She's an awesome baby. She's like a special emissary from the society for Irish Twins.

I won't pretend to be an expert on sleep because, frankly, I feel like I got lucky. I feel a little guilty even bringing it up. I felt similarly guilty one day in mom/baby yoga class when all of the other mom's started bemoaning their 6, 12 & 18 month old babies' sleep patterns, or lack thereof. I had the youngest baby in the class by far & she was clearly the best sleeper. I can't necessarily take credit for it, but I'll share our thoughts about sleep in the hopes that maybe our ideas might help the sleepless.

First let's start with Jen's question... No, we're not "ferberizing" Baby Stewgler. Which is to say that I never read his book & don't know the specific tenets of his sleep plan. I saw that Ben Stiller movie, but that's pretty much all I know about Ferber.

My main advice is this... talk with your partner about your plans for baby sleep before he/she's born. I'm convinced that WHATEVER sleep plan you implement you're better off if you get it going from day one. Co-sleep or crib, cry it out or rock 'em to sleep -- you should have a plan in advance.

So here's what we decided in our house...

1. IK sleeps in a crib. It's in a different room (OK, it's a closet -- in NYC you have to be creative). I think it's good for her to have her own space & we appreciate that we have our own space too. My sense (from vacations and visits to Nana's where we have IK in our room) is that sharing a room makes you hyper-reactive to the baby's mid-night noises. There have been many times when I've heard IK make noises on the monitor & I've found that many times she quickly goes back to sleep on her own. I guess my point is that you should ignore the first few noises. If she's really awake you'll know it soon enough. If she's not really waking up, you're better off if you let her drift off again rather than reaching for her and waking her up for sure.

2. IK will sometimes cry it out. When we put her to bed we are sure that all of her needs are met -- clean diaper, tight swaddle, full belly, binky, etc. If she cries, we'll sometimes give her binky back a few times, but we're also not afraid to let her cry. When we put her down, we set a timer for 15 minutes. If, after 15 minutes, she's still crying we go back and reassess. We might feed her a little more or hold her for a little while. In her life, she has only ONCE cried for more than 15 minutes. These days she cries for about five minutes. Sure, even those five are torture and when she was only days old it was heart breaking to hear her cry, but I'm glad we did it. I recommend setting the timer because each minute of crying feels like a lifetime & having a running timer helps you keep it all in perspective. Credit for the timer idea is due to IK's Nonna. Worked for the last generation & seems to be working for this one.

3. We're not afraid to depend on crutches. IK's Nonna sent her a "Sleep Sheep" which we set to ocean noises -- in the early days the white noise really helped (people also recommended running the vacuum or setting a radio to static). We also have a music box which works as a distraction technique when she's crying -- she seems to like to listen to it and will often quiet down so she can hear it. She loves watching her mobile and will often drift off while mesmerized. The swaddle is key -- even at 3.5 months old we still swaddle her at night. We'll stop doing it when she seems like she's fighting it, but even now she seems to relax once she's swaddled. I think many of these crutches turn into sleep cues & she's learning that crib + swaddle + mobile + music + ocean noise = bed.

4. Feeding. As I've mentioned before, because of breast milk production problems on my part IK has been getting some formula from the beginning. I think it's helped her sleep because it seems to stick to her ribs a bit more than breast milk. Our pediatrician agrees. She was telling me that she'd noticed that during her residency when she worked at a hospital clinic with a population that largely bottle fed their babies she rarely got questions about sleep. Now that she's in private practice in a tony Brooklyn neighborhood where her patients are predominantly breast fed she spends all day talking about sleep problems. An unscientific study, no doubt, but interesting. According to my mom (who's a family NP) babies over nine pounds don't "need" mid-night feedings -- meaning that they have sufficient reserves to get through the night without eating. IK's Nana also recommends that you don't make the mid-night feedings a party -- turn on as few lights as possible, don't turn on the TV, don't make it fun for the baby or else they might start waking up just because they're looking forward to seeing you and the fiesta you create for them.

5. Remember that you can't will your baby to sleep. In IK's first few days at home I made the mistake of thinking that she wouldn't fall asleep if I didn't rock her. She was clearly tired but as much as I rocked her she just wouldn't quiet down and sleep. That's when Mr. Stewgler passed on his mom's advice that we should meet all of her needs & then feel OK about putting her down. I do believe that babies need to learn how to fall asleep on their own. This means that they need to be AWAKE when you put them in their bed. Sometimes it feels like tough love, but I have every confidence that it will pay dividends down the line. In fact, it already seems to be paying off.

So, yeah, the thing about Ferber, or any of these sleep specialists is that they pretend that all babies are the same. They're not. I know that & you know that. You just have to make a plan, try to stick to it & hope for the best. When IK's dad and I talked about baby sleep, we tried to imagine what we'll hope bedtime will be like when she's, say, three years old. We want her to have a consistent routine -- bath before bed, story time before bed, bed time at a vaguely regular time each night & then that's it, she's in her bed drifting off to la la land with no great battles. Because that's what we're working toward, her infant sleep routine is largely the same. Think of it this way, you don't want your ten year old in your bed or needing to be rocked to sleep at his first sleep-over.

I don't know how it will work out over time. She's such a good baby that we know we're going to have the pay the piper eventually -- maybe she'll rebel and announce that she wants to be a tri-delt in college, maybe her younger sibling(s) will be a total disaster. In the mean time we're working to create a routine so that she knows what to expect from us & as a benefit we're learning what to expect from her. It's proven to be a great balance.

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