Saturday, December 7, 2013

Sleep Begets Sleep

After a long hiatus from my blog, I guess the best way to come back is with a topic I feel very strongly about; SLEEP.  Sleep is essential to life and is one of the most common sources of anxiety for all expectant parents.  I know that it was the thing my husband worried most about when I was pregnant (as I am writing this, having been awake for 3 hours already, my husband is still snoring in bed), he does not function without approximately 9 hours of uninterrupted sleep each night and babies notoriously mess that up.  I read countless books before Kennedy was born and found that I could expect for her to sleep well at night by the 4 month mark...which I found relieving.  Until the four month mark, I could "sleep when the baby sleeps" and drink copious amounts of coffee in order to survive...sounds like a plan!  I had it all figured out until, of course, Kennedy was born.  After that, I had absolutely no idea what I was doing and threw all of my previous knowledge out the window.  Feed-Wake-Sleep Cycle, "Pausing" before responding to cries (therefore making 'Cry It Out' unnecessary), Keeping baby in her crib (not giving into co-sleeping), circadian rhythms; these were all great in print, but implementing them was a completely different story.  How could I let her cry for a few minutes before responding?  She would wake up my sleepyhead husband!  Maybe she is hungry (and needs to eat NOW)!  She will think I don't love her!  I have absolutely no idea what I am doing (how could anyone allow me to take care of an infant?!)!

At six months, Kennedy was not napping at all (15-20 minute naps were lucky) and waking up hourly at night (in our bed...co-sleeping is a sleep deprived mother's only chance for survival).  Kennedy was delirious but seemingly okay, but I, on the other hand, was a mess.  So tired, so stressed (couldn't get anything done because she wasn't napping), and feeling like such a failure.  Babies need sleep... it is much more important to them than it is to me, and I was feeling it.  I felt like a failure because I was breaking away from the values I held about the kind of mother I wanted to be versus the mother I perceived myself being (the root of mommy guilt).  I decided that Kennedy needed to cry it out, which was a terrifying prospective...was I doing the right thing?  Was this going to permanently scar my daughter?  As a psychology major and a woman who has been in therapy several times, Kennedy's emotional well being is of utmost importance to me.  But I also knew that not sleeping was bad for her physical and emotional well being, not to mention my physical and emotional well being.  I brainstormed and (arbitrarily) decided that her bedtime should be 8:30pm.  This time gave us time as a family together every evening, time to eat dinner out (if we wanted), and set her wake time to be between 7-8am, which allowed me to "sleep in" (a relative term as a mom).  She cried it out when she was a little over 7 months old, and only woke once that night!  Once a night wakings at this point were common; I would get up, feed her, and rock her back to sleep.  Life was seemingly going toward a good track...for about a month.  Once a night turned to twice a night, turned to three, four, five, and she was back in bed with us.  Desperate, I reached out to the doula that had helped us through L&D, and she recommended I hire Jennifer Metter, a sleep expert.  Sleep expert?!  I didn't know such a person existed!  I could see a light at the end of the tunnel!

Jennifer aka Jenni June, is based in LA and is a certified sleep expert.  She boasts a 100% success rate, which made me even more hopeful.  After filling out an extensive survey, we had our initial phone consultation.  Here is the plan (for a 9 month old) that she presented us with:

Wake: No earlier than 6am, no later than 7am
Nap 1: Around 9am, must have at least 1 hour in crib
Nap 2: Around 12:30-1pm (Depending on Nap 1 duration), Wake must be NO later than 3pm
Night Sleep: 4 hours after wake from Nap 2 (Approximately 6-7pm)

If a strict schedule overwhelms you, I felt the same way at first. The idea that I could only leave my house for (seemingly) very short periods of time about twice a day felt very restrictive and eating out at night was going to be very difficult with a 7pm bedtime.  Not to mention, Kennedy was involved in baby classes that directly interfered with this schedule!  Sleeping in the car or in a stroller are not considered restorative forms of sleep (Kennedy won't sleep this way anyway, but I know many children do!) and therefore discouraged except for very rare exceptions.  I think every woman before having a baby knows that when having a baby your life is no longer your own, but knowing it and living it are two very different things.  You can expect the impending changes on your life, but that doesn't necessarily make them easier to deal with.

Even though I was a bit overwhelmed, I implemented it right away and gave it the best effort I could.  The first step, to stop *rescuing* her between bedtime and 6am, and to stop *rescuing* her if nap time was less than 1 hour.  Kennedy knew (by previous experience) that I would eventually give into her middle of the night crying if she cried *longer* and *louder*, which was very hard to listen to (this is something that happens a lot… if you decide to let your child cry-it-out and then give in at any point, your child has now learned your breaking point… i.e. "If I cry for X amount of time, mom will come get me and I don't have to sleep!").  I stuck to my guns and in about two weeks, we had a sleeping baby.  It was absolutely incredible.  12 hours at night, two naps that were at least 1hr, and usually they were closer to 1.5-2hrs.  And going out to dinner?   Now, I gladly trade going out to dinner for *four* uninterrupted hours of: time with my husband, a long bubble bath, reading a good book, or plenty of time to Keep up with the Kardashians.  When we implemented the plan, my husband and I decided that the money we would save on eating out several times a week affords us extra money to pay a babysitter once a week so that we can have dinner *on our own,* which is much more enjoyable!

Quick FYI: This schedule is based on Circadian Rhythms.  Why is 7am waking and 7pm sleeping important?  Because it has do to with the natural rhythm of the body in relation to the sun.  Once your child (and you) is on this schedule, you will recognize your urge to grab a cup of coffee or a Red Bull around the same times that your child is needing a nap.  Coincidence?  I think probably not. Interesting Fact: Jennifer also informed me that sleeping disorders were not nearly as prevalent before the invention and common usage of electricity.

So, a few tips if you are having sleep issues with your child (and let's face it, almost everyone does at some point):

  • Start a schedule (for sleeping and eating too!) very early on.  Stick to it at all costs, it will make your life so much easier.  
  • Between 4 to 6 months (sometimes earlier), babies start to *learn* that if they wake up and cry, someone will get them.  This is great for when they are first born, however, at a point parents (myself included) start to rob their children of the ability to learn how to go to sleep and *stay* asleep.  This is a skill that you learn, not something we are born innately with.
  • Put your baby down drowsy but awake.  Everyone has heard this and it is absolutely true.  It is so so so important.
  • Have a routine associated with bedtime and nap time.  Make them different and stick to them.
  • Sleeping on a schedule based on circadian rhythms really helps to create a well rested child.  Studies show time and time again that children who go to sleep earlier, sleep longer.
  • Naps take longer to come together than night sleep.  Be more patient with this when working on a good schedule.
  • If you are stressed whenever implementing a new schedule, have someone babysit and take a little time to yourself.  When your child isn't sleeping, it is so stressful and you need energy to recharge.  Trust me, I know!
  • Look for transition times (baby needing fewer naps) around 8-9months and 15-18months.
  • If your child has had trouble sleeping lately, put them to bed early.  This is my "go-to" way to help or fix sleep problems.  It seems counter intuitive that your child would sleep better and longer if they go to bed earlier, but sleep does beget sleep.  I have put Kennedy to bed as early as 5:30 before (and she still slept until almost 7am) :)!
  • Dinner is best approximately 2 hours before bedtime (I know that this means you eat around 5pm, which is very difficult for most people).  Having a big meal and then going straight to bed can cause night sleep to be interrupted.  This is not as true for day sleep which is less restorative than night sleep.  If you are having a lot of trouble with night sleep, this may be something to take into consideration.
  • After you have been on the schedule for a few weeks, it is much easier to read your child and learn what times *exactly* work best for them.  While bedtime and wake time should be very rigid and hold true for all children, nap times (in my opinion) can be a vary a little between children.  Kennedy liked for nap #1 to be around 8:30am (even if she didn't wake up until 7am) and this was usually her long nap of the day.  Because of this, nap #2 could often be pushed until closer to 1:30. 
  • Obviously, if your child is sick exceptions to the schedule need to be made.  But chances are if your child is sick, you will know this before they go to bed.
  • Optimal sleep temperature is between 68-71 degrees.  Buy a fan for your child's room if you don't want to keep your whole house this cool.
  • Before starting your child on a sleep schedule, make sure that you can dedicate 4 weeks to be at home and stick to it.  Starting a routine while on vacation or when you are about to go on a trip isn't ideal.  When you start the routine, try not to make any exceptions for a month (this includes naps in the car or stroller)
  • Sleep is to the brain what food is to the body.  Your child needs quality sleep and a lot of it, just the way that they need a healthy variety of food.

Sample Schedules for Ages:

Between 4-7 months- 3 Naps/Day

Wake: Between 6-7am
Nap 1- Around 9am
Nap 2- Around 12pm
Nap 3- Around 2:30pm (This is usually a shorter nap than the first two, wake by 3:30pm)
Bedtime- Around 7-7:30pm

This schedule I am not as familiar with because we had so much trouble during this time.  Waking times should be about 2-2.5hrs at this age, so if your baby wakes at 6am, nap might be around 8-8:30am.  If his/her nap is 1.5hrs or less, the next nap and/or bedtime may need to be moved up accordingly.  

Between 7-18months- 2 Naps/Day

Wake: Between 6-7am
Nap 1- Around 9am
Nap 2- Around 12:30-1pm, must wake by 3pm
Bedtime- Around or before 7pm
** During Transition, baby may need an early bedtime to help combat over tiredness!  Naps need to be at least 1hr in duration.

18months+- 1 Nap/Day

Wake- Between 6-7am
Nap- Around 12:30pm, must wake by 3pm
Bedtime- Around or before 7pm
**Try to make the nap approximately 2-2.5hrs to allow for a pleasant afternoon!



If all else fails, call Jennifer Metter.  She was an absolutely invaluable resource to our family and definitely one of the best investments we have ever made.  Having her to coach me through implementing the schedule was so comforting and helped me know that I was doing the right thing and the best thing for both Kennedy and our family.  And she was absolutely right.



**Crying it out is not everyone's cup of tea, and it certainly wasn't my first choice in plan of action.  Consult your doctor and follow your instincts when it comes to this.  I can say with confidence that it was the right thing for my daughter and my family, but it may not be right for you.   When implemented consistently it works wonderfully.






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