A History of Sleep Deprivation

I've been enjoying the TimeHop app on my phone. It's fun to see old Facebook posts about things my kids said, or pictures of them, or other random happenings, or information I came across and wanted to share.

What has struck me, though, is just how many of those posts are about sleep, and how I wish I could get more of it.

Since I've been on Facebook for about seven years, give or take, some of these posts go back pretty far, at least to S's infancy. And almost daily, one of the posts from one of the years going back to when S was a baby has said something along the lines of, "I hope [whichever baby] lets me sleep tonight," or "WHY is [baby] not asleep yet?" or "I need more coffee," or "[Baby] actually slept through the night last night!"

And I'm still feeling that way, with Y approaching 19 months. Sleep is such a feature when it comes to babies and toddlers, it's such a central theme. I've had a baby or a toddler in my life nonstop for 8-1/2 years now, and in all that time, I've had just a few months here and there in which everybody in the house was sleeping through the night. This is not an exaggeration. It's simple truth. My Facebook history is witness to that.

Sleep is such an issue that there is a whole growing industry of "sleep consultants" who will meet with you in person or virtually, assess your baby's sleep habits and environment, and give you a personalized plan to get your baby sleeping through the night. A consultation and plan, with follow up, can run in the hundreds of dollars, and I imagine many parents feel it is money well spent. I feel like I know enough about infant sleep that if I had the will and the strength, I could do all this myself and have my kids sleeping through the night. But since I don't have that willpower, I don't think I could bring myself to follow someone else's plan, either. I'm not saying you shouldn't use a sleep consultant if you think it will help. I'm just saying I don't think it's the answer for my family.

The problem is that there is such a wide range of advice and rhetoric around infant and toddler sleep. At one end of the spectrum are those who say that by three to four months of age, you should put your baby in a crib in a dark room at a set bedtime, shut the door, and walk away, and don't return until the time he is "allowed" to wake up. No amount of crying from him should sway you to comfort him or in any way appear to be giving in to him. Because, they say, babies need to learn to sleep on their own, and if they don't learn it young, it will be harder and harder to learn it as they get older!

At the other end of the spectrum are those who say that a baby needs what she needs, and you should respond every time she asks for you. Indeed, if she needs to sleep in bed with you and suckle at your breast all night, then that's what you should do so that she feels safe and protected and secure, and so she knows that you will always be there for her. Some kids will need to sleep with you until they're five or six, but most will ask for their own bed at some point. After all, they say, in other cultures, the whole family sleeps together in one big bed anyway, so why do we in the West think it's wrong?

With this kind of contradictory advice about what you "should" be doing for your baby, and what your baby "should" be doing, what is a new parent to believe? Who's right?

I think both are right. And neither. I think parents and baby have a right to a good night's sleep, have a right to their needs being met, and have a right to negotiate the best possible sleep for everybody. I adamantly disagree that if you don't "teach" a baby to sleep through the night when he's six months old, then he'll be waking at night for years. I also adamantly disagree that if parents are simply uncomfortable allowing a baby or toddler to sleep in their bed, they should do it anyway for the best interests of their child.

How you go about finding this middle ground will vary depending on your personality and parenting style. I'm a hands-off type, and after four kids, I've learned that eventually you hit a wall and have to make a change, and usually at that point it's easier than you expected it to be to make that change. I'm also lazy about enforcing a schedule or pattern, and I am pulled in too many directions at night to focus so strongly on just one of the kids. Usually I get a sense of what I need to do, then find a way to work up to it, and then suddenly implement the new rule, which takes a few nights or weeks to stick. I tend to take things in stages. First, put him in his own bed (as opposed to mine). Next, wean him from needing to nurse at night (in the hope that if he doesn't have that to wake up for, he won't bother waking up). Finally, if he is still waking for comfort even if he's not nursing, help him learn self-soothing techniques so he can put himself back to sleep instead of calling for me. This was the general process I did with G starting at about 15 months, and it took about eight months until he was totally falling asleep on his own, in his own bed, and sleeping through until morning without waking me.

I have the benefit of knowing that they do eventually sleep through the night. My 8 and 6-year-olds take their own bath or shower, get themselves in PJs, and read to themselves in bed, then put themselves to sleep and sleep through until morning (barring illness, bathroom, or nightmares, of course). Neither was always that way, and indeed both woke me many, many, many times at night until I finally decided to attempt a change. Change is slow but inexorable, and eventually you realize, hey, it's been a while since I needed to tend to him at night!

I'll be starting the next stage of this process with Y soon. He's already sleeping in his own bed, but, unfortunately, I usually end up sleeping there with him most nights. He also nurses several times a night and nurses to sleep for naps and bedtime as well. My next project will be to night-wean him, so that he no longer needs or asks to nurse at bedtime or throughout the night. I hope that he will simply start sleeping through the night at that point, but, judging from my experience with G, I will probably have to tend to night-wakings for a few more months, and possibly do some light sleep training, before everyone in the house goes to bed, goes to sleep, and sleeps through until morning.

What a luxurious time that will be!

Maybe a few years from now, when I look at my TimeHop or my Facebook history, I won't be inundated with complaints about my babies' sleep. Instead, I'll be relatively well-rested, alert, and able to focus more of my energies on living life, instead of craving sleep.

I wish you all good nights and good sleep.

If you have any questions about infant sleep, I've written on this subject many times. Check out the sleep tag for lots of stories and information.

Let's Talk about Sleep, Baby!

If there's a topic common to all parenting blogs, websites, Facebook pages, and playgroups, it's sleep. Sleep, sleep, sleep. "Does your baby sleep well?" "When did your baby sleep through the night?" "How many times do you feed your baby at night?" "How much sleep are you getting?" "Does your baby sleep in your bed?" Sleep. Always sleep.

Sleep is a necessity, and we feel it when we don't get enough. The whole day is affected by how well we slept the night before, whether or not we have kids. But when our sleep is disrupted because of an external force - the baby - we can become resentful and frustrated, because it feels like something outside of our control. Then the discussions about "sleep training" begin. "How do I get my baby to fall asleep on his own?" "How do I get him to stop waking up at night?" "Is he really hungry at night or just eating out of habit?" "Would a pacifier help? What about a lovey?"

Here's what I know about baby sleep.

1. Sleep patterns are not linear.
We have this idea that babies start out waking every three hours to eat, then decreasing the night wakings over time until they're *poof* sleeping through the night, at which point they will continue to do so. This is really, really not the case. Many full-term, healthy, breastfed newborns will sleep fairly soundly, waking every three to four hours or so to eat, especially when they sleep in close proximity to their mothers. However, at around four months of age, there are some major developmental spurts that cause what we call a "sleep regression." Your baby who was sleeping three to four hours at a time, or even more in some cases, suddenly starts waking every hour or two to eat, fussing, crying, needing to be held or rocked. All the "tricks" you had don't work, and you're exhausted. Things slowly improve, and then, around eight or nine months, it happens again! And again at 13 months. And again at 18 months. While you probably will experience these changes in your baby's sleep habits, you should notice an overall trend, over months and years, toward more acceptable (by adult standards) sleep patterns. Some kids don't sleep through the night until after two years old. Some sleep through the night for a while and then stop. Just because your formerly excellent sleeper is now waking every hour and a half doesn't mean you're doing anything wrong. It just means your baby is growing and experiencing physical and mental growth, learning new skills, erupting teeth, and meeting milestones. And while those years sure seem long when you're in them, one day you will sleep again. I promise.

2. Babies don't need to be taught to sleep on their own.
Sleeping through the night is not a skill that needs to be taught; it's a developmental stage that will be reached when the baby is ready. You have not fallen into some great trap if you don't "teach" your baby to sleep through the night by six months, or a year, or two years. You are not doing your baby a disservice by feeding or comforting him when he wakes at night. You are not reinforcing "bad" habits by shushing, patting, rocking, nursing, feeding, offering a pacifier, or bringing him to your bed when he wakes up at night. You are not creating a future insomniac by assisting your baby in falling back to sleep. There are some methods that may help your baby sleep in longer stretches or cease to wake you up at night, and these range from slow and gradual night-weaning to "extinction" crying. Some of these methods work some of the time for some babies. You may successfully teach your baby to sleep well at night and then find, a few months on, that he starts waking again at night. You haven't done anything wrong if you do "sleep train" and it wears off, and you haven't done anything wrong if you don't "sleep train." And, just because your baby sleeps through the night doesn't mean there's anything wrong with someone else's baby who doesn't.

3. Some babies do need to eat at night, and some don't.
Many pediatricians and sleep experts, especially the "old school" ones, will tell you that a baby older than six months doesn't need to eat at night, developmentally speaking, and that if your eight-month-old baby is still waking to nurse or takes a bottle at night, it's because you're reinforcing a bad habit and not because the baby is genuinely hungry. While some babies will stop waking to eat by six months of age (my oldest stopped waking for a bottle at about 5 months), others will continue to wake up hungry throughout the night long beyond that arbitrary age. A baby needs a given number of calories in a 24-hour period, and while some will take in enough during the daylight hours to sustain them through the night, others will not. If your baby is eating enthusiastically at those 1:00 and 4:00 a.m. wake-ups, then I think it's safe to say she really is hungry at those times. If she sucks a few times and then falls asleep for three hours, she's probably doing what we call "non-nutritive sucking," meaning she's not taking in much milk but just needed a little help soothing herself back to sleep. Increasing daytime feeds (in frequency and/or quantity) may help to decrease nighttime feeds. Remember that, especially in the early weeks and months, those early morning and middle-of-the-night feeds are essential for your milk supply, as prolactin levels are much higher at night.

4. Do what works for you and your baby.
If your baby sleeps the best cuddled up with you, then let your baby sleep cuddled up with you (assuming you're in a safe cosleeping environment, of course). If your baby sleeps the best swaddled in a bassinet in another room, then put your baby to bed swaddled in a bassinet in another room. If you simply cannot function because of how often your baby wakes at night, try a method to get him to sleep in longer stretches, whether that's crying-it-out or cosleeping or something in between. If you are content with your baby's sleep patterns and you can function during the day with the amount of sleep you're getting, don't let someone else's experience make you think you're doing something wrong by leaving things as they are. If you feel there is a medical reason your baby is not sleeping, consult with a doctor. If you feel that your baby is not getting enough sleep for her, see what you can do to help her sleep better. With sleep, as with all things baby, finding what works for you is going to make your parenting journey that much smoother.
 

Sleep: 16 Month Update

I've said it before and I'll say it again: There's something about 16 months. I was able to make major changes in both N's and S's sleep habits when they were 16 months, and now I've changed G's sleep situation at 16 months, and it's gone amazingly smoothly so far.

We finally purchased bunk beds for N and S, which made room for G to have his own bed in their room. My plan was to introduce his bed (S's old bed) as a new nursing and sleeping place and start to eliminate my bed as a place that he would expect to sleep. I had thought this would be a slow process, but I was surprised at how agreeable G was. I'm telling you: 16 months.

Let me give you a little timeline.

Around five or six months of age, I had started introducing a blankie. I always had it on hand when we'd nurse in bed. He'd play with it, fidget with it, stroke it while he nursed, and he started to associate the blankies with nursing and sleep. Indeed, sometimes when he wanted to nurse, he would go get a blankie and bring it to me! This wasn't exactly what I was going for, but it certainly served one very useful purpose. It meant that wherever I wanted to nurse him to sleep, I but needed to have one or two of his blankies (there are several, actually) there so he'd know that's what was expected.

When we got the boys' new beds at the beginning of January, I left S's bed where it was, planning to slowly start having G nap there and working up to always sleeping there. I had to wait until we reasserted our regular routine, with N going to school all day, vacations being over and done with, and random day outings kept to a minimum. This way, I could be sure that we'd be home for G's nap. On Monday, with winter break over, I put a clean sheet on G's new bed and told him he was going to nap on his new bed! I made it sound very exciting. "Look, here's your new bed! Do you want to nurse here? You can nap here in your room now! Wow!" He giggled and saw that his blankies were on the bed and promptly climbed onto the bed and signed that he wanted to nurse. Okie doke.

I nursed him down for his nap, which went much more smoothly than I'd expected. I was worried that being in this new environment would be distracting for him and that he wouldn't buckle down and concentrate on nursing and falling asleep. Fortunately, he'd spent plenty of time in that room with us and was not overly excited about the new scenery. His nap was shorter than usual, a little under an hour, and when he woke up, he came to find me and definitely still seemed tired. Still, I counted it a success. I put him to bed in my bed as usual that night, but for some reason he had trouble falling asleep, and he didn't end up going to bed until 10:00, much later than usual. There were a lot of variables on Monday, so I'm not sure what happened to make bedtime so difficult. I don't think the new bed was related.

Tuesday, I again enforced a nap in his bed. Again, it went fairly smoothly, but he woke after about an hour and was clearly still tired. I ended up nursing him on my bed and letting him sleep for a while there. He was very tired because he'd been up so late the night before, so needing a longer nap was reasonable.

Tuesday night, he wouldn't fall asleep in my bed before I put his brothers to bed, though that's how I normally handle bedtime. He wanted to join us in his brothers' room for books. He then lay down in his bed, gathered his blankies around him, and asked to nurse. I nursed him to sleep in his bed, and he slept there for four hours straight before waking around midnight to nurse. I trudged from my room to his to nurse him in his bed (the reason for putting him straight into a twin!). He woke three times that night to nurse, around midnight, 3:00, and 5:00 (I think), but spent the entire night in his bed and went back to sleep reasonably easily after each nursing session.

Wednesday, he napped well in his bed, wanted to sleep for the night there, and again woke three times, although this time it was around midnight, 4:00, and 5:00. I'm amazed that he's slept in four-hour blocks at all, as that isn't typical (I don't think). I think part of it is not having me nearby - he doesn't feel me shifting next to him, he doesn't smell me there, so he doesn't instantly wake to nurse. Also, since I don't hear every move or snuffle and immediately offer him the breast, he settles himself down more often. When he does wake, he yells for me.

After that, we went downhill a bit and started waking more often and not settling as quickly, but he's still spent the whole night in his bed each night so far, so I'm going to stick with it. It's certainly harder to get up and walk down the hall, doze lightly while he nurses, then get back up and trudge back to my room when I'm sure he's done than it was to simply roll over and let him nurse, but there are distinct advantages. First of all, if he's sleeping in longer blocks, that's good for both of us. (Time will tell if this remains the case.) Secondly, I'm able to sleep in much more comfortable positions in my own bed! Sunday night, I ended up spending most of the night in his bed because I kept falling asleep with him. Sleep deprivation + getting over the flu will do that to you.

I'm sure at some point, it will occur to him that he can get out of bed and come to me, and I don't know what will happen when he does. I anticipate a great deal of walking/carrying him back to bed.

Now that he has his own space, at some point I can start trying to teach him to fall asleep without nursing. That will probably be considerably more difficult than this first step has been so far. I'll let you all know when I start that process and how it goes, but I'm very encouraged by how easily he slipped into this new sleep routine.

What is it about 16 months?

Sleep Training Is Not Happening Yet

Since I had reasonably successfully gotten both NJ and SB to fall asleep in their own beds on their own around 16 months, I had been waiting for GI to reach an age at which I felt ready to "sleep train" him as well. He is still sleeping in our bed, and he has been sleeping very poorly, nursing often through the night, and I'm sick of it. I'm ready for him to be out, in his own bed, sleeping better.

He hit 15 months, and I hit a breaking point. He had shown some signs that said to me that maybe he was ready. First of all, he occasionally sleeps two or three hours by himself in our bed before I go to bed. Secondly, the other night, I sent him downstairs with my husband so I could get a little sleep, and he had no trouble sleeping without me nearby. Finally, I have witnessed him, on occasion, wake slightly, roll over, and go back to sleep without needing me. I thought, surely he is ready.

I want to take the "sleep training" in slow, steady steps. The first step, I had planned, was to get him to fall asleep on his own in his crib, instead of nursing in my bed. I felt I had established a fairly strong routine at this point (which is really the very first step), and he knows it's dinner, then bath, then get in PJ's and nurse to sleep. I thought, we'll do everything, except I won't let him fall asleep at the breast. I'll nurse him to almost-asleep, then tell him he needs to sleep in his own bed and lay him down in his crib, then do a Ferber-style controlled crying. He'll be asleep in no time, surely!

I was wrong. So, so wrong. At first, he was a little confused about being placed in his crib awake. I said good night, told him to lie down, and left. He didn't cry. He decided to try to climb out of the crib, instead. Now, for lack of a better place to put it at the moment, the crib is right next to my bed. It's been there since he was about three months old. I had left the mattress at the highest setting, because it would be easier to lift him in and out, and it was safe since it was between my bed and the wall, and if he did climb out, he'd just end up on my bed.

After I returned, laid him down, and told him once again to go to sleep, and he realized I intended to leave him there, he started crying.

When I went back in three minutes later, he clung to me for dear life, as if he thought I'd never return, despite never giving him reason to think that was so. I unhooked him from around my neck, laid him down gently again, and told him again to go to sleep.

He started crying hysterically.

When I went back in five minutes later, he was sitting in the middle of my bed crying, red-faced, and signing "nurse" for all he was worth.

How can a mother do such a thing to her child? Only one who is desperate for sleep, I guess. I steeled myself, hugged him, calmed him as best I could, put him back in the crib, and told him to go to sleep. He promptly climbed back out. I put him back in, told him again to go to sleep, and left. I went to my computer to do a puzzle so that the seven minutes would pass more easily. SB came to me and told me that GI doesn't know how to fall asleep in his bed, and he needs me to nurse him to sleep. He told me GI is sitting on my bed and needs me to come.

From the mouths of babes, eh?

I told SB gently that GI needed to learn to fall asleep without nursing and that he would be okay. And then I heard the unmistakable sound of a baby about to vomit. I rushed to him and let him vomit his dinner and before-sleep milk all over both of us. And then I wiped us off with his bath towel and hugged him and told him that he could nurse, but I was just going to change his pajamas.

And then I nursed him quietly to sleep, which took a lot longer than it would have if I had just done so in the first place.

I don't know how anyone has the strength to watch their baby suffer like that, especially when it is unnecessary. My baby needed me. He didn't understand why I would just leave him like that, and he couldn't fathom a world where Mommy wasn't there for him.

Sure, one day he'll learn that I can't always be there, but why does he have to learn it at 15 months? Instead, I'd rather he learn that Mommy is there for him, that he can be secure in knowing that I love him, that I will always return, and that when he calls me, I'll come.

I think I'll change the first step of my slow sleep-change process. I'll wait until he has a twin bed in a room with his brothers, which will hopefully be in a month or two. Then I'll nurse him to sleep in his own bed. I'll worry about getting him to fall asleep without nursing sometime after that. It seems far less cruel that way, and should involve considerably less crying.

In the meantime, I guess I'm stuck with my cuddly, sweet boy in my bed. And is that really so bad?