Wednesday, November 6, 2013

Sleep Training

"Sleep training" is such a polarizing topic, but I think those are the ones we need to talk about most. If we share our rationale, thoughts, feelings, and experiences with each other, then we create more opportunities for conversation, agreement, and disagreement, which ultimately leads to more purposeful parenting. Someone may read this and think, "That's definitely not the route I want to go," which is completely understandable. At the end of the day, we are left alone with our thoughts and we have to feel good about the choices we make as parents. 

Matt and I started sleep training Henry around five months because our pediatrician recommended that we do it (if we were going to do it) between 4 and 6 months. He said it got much, much harder after 6 months. The three of us had been traveling around the Southwest, and it really threw off Henry's sleep. He was waking up all night long (even more than when he was a baby, baby!). We were exhausted by the time we got home (both from traveling and from months and months of fitful sleep) and were ready for a change. We decided to start sleep training. 

Our pediatrician also told us that 4 month-olds can go 8-10 hours at night without milk (6-8 hours at two months and 10-12 hours at six months). So if Henry woke up earlier than the recommended length, we let him cry for five minutes before going into his room and soothing him. If he was still crying, we went in ten minutes later. If he was still crying, we went in 15 minutes later. 

The first night, he woke up three times. The second night he woke up twice. And the third night he woke up once. After that, he basically slept from 8pm to 7am (barring new teeth or sickness). As his naps changed over the months, his bedtime gradually moved earlier and earlier. He still sleeps until 7am. 

We've been really happy with the way Henry sleeps, so we knew that we wanted to try sleep training with Tate when he hit the four-month mark. The decision was a lot easier the second time around because we've seen the benefits for both us as a couple and Henry. The first time around, I was really worried about interrupting Henry's attachment to us. I very much believe that infants absorb everything. Part of why we tried to have a homebirth was because we wanted Henry to have the gentlest, kindest welcome into the world. The primary reason we decided not to circumcise is because it felt unnecessarily cruel to subject a baby to the pain that comes from severed skin. 

So deciding to let Henry cry for 5-minute, 10-minute, and 15-minute increments was not something we took lightly. In the end, though, we ended up feeling fine with it. We felt like a full nights sleep was definitely good for Henry. He has always grown really well, and he seems well-attached and adjusted. We also felt like we were better parents because of it. We have more patience when we sleep for the recommended period, and we benefitted from having time alone or with each other in the evenings. Sleep and time to ourselves help meet our needs so we are more available to meet our children's needs. 

With Tate, we were eager to start sleep training right away. Where we are in our lives right now (two full-time jobs and a toddler) makes us even more exhausted. In the weeks leading up to Tate's four-month birthday (November 1st), his sleep got worse and worse. He was waking up every couple hours (and sometimes in 30-minute increments!). He would only go back to sleep if I fed him or we put him in the Moby and carried him around. Since he was fine going back to sleep in the Moby without eating, I felt like he wasn't waking up out of hunger. 

The first night, we left his Montessori floor bed (i.e., a crib mattress) next to our bed. When he woke up, we tried not to respond for five minutes. However, he rolls so much that he would roll himself into the wall and we would need to intervene to help him. Still, he was able to put himself back to sleep and significantly reduced the frequency of wakings. 

The next night, we moved his mattress into his room and put it in the center of the room on a plush carpet. The first time he woke up he fussed himself back to sleep. The second time, I fed him. Then he slept until 7am. 

The third night, he woke up once and I fed him. Then he slept until 7am. 

We'll see how tonight goes! Matt and I are both feeling a huge sense of relief that our sleep deprivation days might be coming to an end. 

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Sara said...

It is one of my biggest challenges as a parent to sleep train - my husband is much stronger than I am when it comes to hearing our little man cry! We've sleep-trained various times throughout the past 17 months, with some success, but we've never stuck to a routine enough to make it work. I just love cosleeping, but my hubby is not so keen on it.

Your post has inspired me to try sleep training again, especially as we plan for baby #2!

Melissa said...

Thank you so much for this post. My little guy just turned 5 months and his sleep sounds similar to your Tate (a big time roller who will only go back to sleep if I feed him, which right now is twice a night). My husband and I have been debating sleep training but part of me is wondering if he just needs more milk during the day? We are trying to increase his bottle volumes but if that doesn't work I think we'll need to sleep train. If soothing (not feeding) doesn't work for that first cry, do you walk out and let him keep crying for 5 minutes? Am trying to run these scenarios in my mind :)

Anthropolochic said...

We didn't sleep train. We were really pushed to do it, but the process went against what I felt in my gut at the time. Our baby had very bad reflux, and was often in pain those first few months. Had she not had reflux, I probably would have gone ahead with training. My rationale was, basically, that I had seen my daughter self-soothe a few times in the past, so if she cried out, she must really need me. I don't know if I was right.

What we did do was set up a bedtime routine and added a bottle/nursing before bedtime to help get her through the night. It worked like a charm until she started teething. It seemed to work again, until she developed a serious infection. During that period she woke constantly - every 30 minutes for many nights on end. Once that infection resolved, she suddenly slept all the way through the night. By that time, she was 10 months old. Late by most people's standards.

I can tell you that the lack of sleep led to poor job performance and quite a bit of bickering in our household. Like I said, I'm not sure the choice we made was the right one. I am happy to have not been trying to train her over the period when she was really sick and we didn't yet know she was sick - but, I mean, hindsight is 20/20. Next time, I might take a different approach. A second child would completely alter sleep dynamics in the house.

...all of that said, I don't regret the decision to leave training to others. I think training might be a baby-specific kind of game. In our circumstances I think it would have been really hard on our daughter, as she was basically in pain or sick for almost 10 straight months. It's hard for me to tell if it was the right move because I only have a sample of one. I think about when she was ill and we didn't yet know - all of those missed symptoms and opportunities to help her feel better, and I'm happy that in this one way, I could be there for her.

Kelsey said...

I'd be interested to hear more about your approach - I can ask you in person on Friday! I am still getting up 2-4 times per night with Dashiell and he's never slept through the night (almost 7 months old). We do hear Dash put himself back to sleep at times - he will cry out and then be silent - and I do not go and get him if he is just fussing, I wait to make sure he won't go back to sleep. So there are some positives but he's not there yet. It can be frustrating at times and I certainly would love to get more than 3 hours of sleep at a time.

We tried to do some modified sleep training around 5 months, the Baby Whisperer method. In this method you pick them up to soothe them and then put them down. If they cry you pick them back up. What resulted was Dashiell not being soothed but screaming and becoming so overwhelmed/frustrated that we were essentially doing cry it out but holding him. It would take an hour to get him settled and fall back asleep although we were holding, walking, rocking, shushing, talking calmly - trying to be as soothing as possible, doing everything but nursing. On the second night I just couldn't do it any more, our normally happy baby was screaming like we'd never heard and started to cry just when we set him in his crib for a nap when he was otherwise happy. We decided we would rather wake up at night than press on.

Maybe we would have seen results if we kept at it - I've heard some people say that 3 days is the magic number for this. But I'm now so hesitant to try any kind of training, it still feels like a nearly traumatic experience!

So I do wonder how much of sleep is personality and how applicable one method can be to other babies. I'm stuck wondering how to know what works best for your baby. Although I'm open to some sleep training such as the method you describe as long as there is some type of soothing, I'm just nervous to even try because it was so upsetting for all of us. I guess I worry that we could let Dash cry for 10 minutes or so but would we be able to settle him back down without nursing? If not then it seems I might as well just nurse and save us both the tears!

Rathna said...

As a sleep consultant and a mother to two boys I can totally relate to this post. I have a lot of parents come to me when their child is 6 months and older and are so sleep deprived. You are right that it gets much harder after they are 4 or 5 months old.
Sleep training (I am not a big fan of that word), is a very polarizing subject. People are either totally for it or totally against it and a lot of judgment is passed by others whatever side you are on. It doesn't have to be that way!
My take is that it is your god given right to bring up your child any way you want as long as it makes them happy and makes the parents happy. Parenting is a very personal choice and is not an easy job. So let's be there to support each other's choices whatever they may be.
As a child sleep consultant, I offer support and guidance to parents when they decide that it's the right choice for them. I get a lot of criticism and harsh feedback from mothers who choose to co-sleep, but I am only here to help those who need it, not to force my belief on somebody else.

Avila said...

Hi Sara thanks for sharing your approach! I'm interested to know (I hope you don't mind me asking) did you breastfeed Henry, and if so did sleep training impact on your supply at all? we have a 4 month old and i have been wary of things like this mostly because breastfeeding has been a hard won victory so far in our house and i would be so sad to reduce my supply unintentionally.
we basically feed on demand (though if Jonah wakes for a feed less than 3 hours after his last one i usually try to soothe him back to sleep first). we've been lucky that he's actually a very good sleeper (so far!! i know it could change) but i even get nervous about supply when he ocassionally sleeps through the night by himself. he's fine without the feeds, but i'm not always sure if i would be!
i'd be interested to hear your experience.

Anonymous said...

I found the book Bed Timing by Marc Lewis and Isabela Granic is interesting on the topic of when best to sleep-train and why. In the UK lots of the advice seems to be to wait until 9 months when they know you exist when you're not there, which seemed odd to me because I'd thought it'd be harder for them when they start experiencing separation anxiety. The book I mentioned recommends five and a half to seven and a half months as being an ideal time, but also suggests other windows of opportunity. Our son however decided to start sleeping through of his own accord and five months one week!

Sara E. Cotner said...

Thanks for all the comments, All!

To answer a few quick questions:

Kelsey, I know exactly what you're talk about! Before Henry was four months, that's a lot of what we experienced. We would be holding him and trying to soothe him while he cried. Once he hit the four-month mark and we began sleep training, there was much less crying if we left the room.

When Tate wakes up and starts crying, we're able to put the pacifier in his mouth and walk out. If he starts crying right away, we'll wait several minutes before going back in. When we put the pacifier in his mouth again, it's almost more soothing to him because he's been crying a little bit. We only have to do this one or two times before he falls back asleep permanently.

With Henry, three was the magic number. By the third night, he was sleeping from about 8pm to 7am. Tate is still waking up once before 4am (we're trying not to feed him before six hours), and it usually takes one or two times of going in their and returning his pacifier before he falls asleep. Then he wakes around 4 or 4:30 and we feed him. Then he usually sleeps until 7. It's way better than what he was doing a couple weeks ago.

@ Avila: Yes, I breastfeed Henry for 14 months before getting pregnant. I never had any supply issues (I had other difficulties like nipple sensitivity, plugged ducts, soreness, etc.). My supply always adjusted to meet Henry's needs. I always made any changes gradually to give my supply time to adjust. Toward the end, I was only feeding him 1-2 times/day, and my supply was still ample during those times. Things seem to be working the same for Tate, although it's still only a sample size of two!

@ jvvw: It's interesting that the French approach (in general) is so different. They use "The Pause," which gives their children more time/room to learn how to connect their own sleep cycles. They are typically sleeping through the night around three months (according to the one book I read about it).

JT said...

Have you heard of the book The Continuum Concept? You might find it interesting.

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