Sleep & Nap Issues: Nighttime Crying & Proof That Crying It Out Is OK

Don't flame the messenger, but here's more proof that SOME nighttime crying won't harm your baby -- and actually may help the whole family by boosting mom's mental health. A big shout-out to mom's health advocate Katherine Stone for being on-record about this hot-button issue. She risks the backlash that I've experienced here, but she does it for the health and well-being of families and babies. Kudos to you, Katherine!

The bottom line is this: Neglect, hostility, and abuse DO hurt babies. Blowing off some steam to settle down for a better night's sleep DOESN'T. Of course, individual personalities and circumstances make a difference: Pick up and comfort your baby if she's sick, super-scared, or if she has an unusually sensitive temperament (or, if you have a crying/barfer, like one of my kiddos. Who wants to be up all night AND clean a barfy crib?) If you want to argue, argue with the respected journal that published the research today, Pediatrics.

Judging parents for their reasonable decisions about their own children is NOT good for families and babies. So hurray for more proof that this controversial parenting decision doesn't deserve the attacks it often gets. Parents and children who get more sleep are happier AND healthier. That's nothing to cry about.

Aloha,

Dr. Heather

The BabyShrink Mom of Four, Parenting Expert

"Crying It Out": Acceptable -- or Abuse?

One of the most primitive, innate reactions any mom has is to comfort her crying child. But as we've talked about here before, many babies can tolerate -- and thrive -- with some crying, when their parents thoughtfully decide why and when that might be necessary.

That's why articles like this leave me mystified -- especially when they come from one of my shrink colleagues.  Her bottom line is that CIO is dangerous. She trots out all the old arguments, hailing the Dr. Sears "science" behind her claims, and providing one of the most common misinterpretations of infant research. She makes the mistake that clinical research findings about abused and maltreated babies -- babies who were pervasively denied their needs over the long-term -- should be applied to NORMAL babies in NORMAL families.

The fact is, there is no evidence whatsoever that occasional CIO in typically developing babies causes any damage. PERIOD.

More importantly, there IS evidence that severely sleep-deprived mothers are at much higher risk of developing an already common --and dangerous -- condition: postpartum depression. And PPD certainly CAN lead to long-term damage to both baby -- and the entire family. CIO is a method that, when implemented thoughtfully, can often lead to improved sleep (and health and happiness) for everyone.

Firebombs like those thrown in the Psychology Today article only make the burden heavier on moms. What a shame.

Aloha as always,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

PS: Wow, what a response! After commenting here, please also see the comments developing over at the Fussy Baby Site.

Sleep & Nap Issues: How To Cope While Sleep Training Your Baby

We're doing our own version of Sleep Training around here, since baby #4 has proven to be immensely resistant -- and LOUD -- in our efforts to help her sleep through even a decent portion of the night. Adorable as she is, she's the most rotten sleeper I've yet produced. Tough Love is in order. Sure, she sleeps OK in the stroller.

But Tough Love is rough on me -- and on the family. A fussing (or screaming) baby feels like a constant reminder of some kind of parental inadequacy, and is really grating on the nerves. Not to mention the fact that it often happens at ridiculous hours of the night when most other babies are surely sleeping soundly. And forget sleep for poor mom. I'm a zombie.

But persist I must. I won't give in to an 18-pound 8-month old, no matter how cute she is (in the daytime, at least). It will be worth it in the end.

Here are my tips for getting through this rough time, if you're going through Sleep Training:

Make sure you and your partner are on the same page. There's nothing worse than arguing about sleep training techniques at 2 am, standing outside the door of a screaming baby. Agree ahead of time -- or don't attempt it.

Prepare the older kids for nighttime noise. I tell my lightest sleeper that he may hear the baby fussing at night. "But you're a big boy and can roll over and go to sleep. Soon we'll all get better sleep."

Use a little reverse psychology on yourself. (You're so sleep deprived it just might work!) Instead of preparing for a night of sleep, prepare for a night of watching "guilty pleasure" TV, listening to great music from your (childless) past, or even folding laundry. Fooling yourself into thinking you don't really need to sleep somehow makes it less painful to be up at weird hours.

Take a deep breath, have a zen moment, do some mindfulness meditation, yoga, or pray -- pick your version of expressing gratitude and relaxation. Having a non-sleeping, screaming baby at 2 am is really hard. But in the scope of things, not really that big of a deal. A few moments recalling the years when we feared we couldn't get pregnant, or thinking of friends who have a baby who's quite ill, and others who have God forbid lost a child, and I'm ready to get through another tough night of sleep training. Having a healthy, happy, non-sleeping baby is a high-class problem we're blessed to have, quite honestly.

I've written other posts about getting through the sleep deprivation aspect of this, but let me also mention our friend caffeine here. Don't overdo it. At my peak, I have a mug of java in the morning, some iced tea at lunch, and another cup of coffee around 2. That's 3 servings a day. Any more and I get frazzled and nutty -- and no more awake than if I had stayed with the 3 servings. Studies say that some coffee is fine for most of us, but too much will definitely make you feel worse.

Sleep Training eventually works -- I'm writing this now as the baby sleeps nicely in her crib. Get through the rough nights and I promise things will improve!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Sleep & Nap Issues: Got a New Baby? How to Manage The Sleep Deprivation

Boy, am I tired. You'd think I'd get used to the lack of sleep by now -- this is our fourth child, after all. But the crushing effects of sleep deprivation continue to be the hardest part of parenting, for me. I could change diapers and nurse and even chase toddlers all day long, if I could just GET SOME SLEEP. But this baby is just like her siblings, and she sleeps sporadically at best. At 4 months of age, she sometimes awakens once or twice at night -- but more often three or four times -- to nurse and be comforted. I've got 3 other kids, a day job, and you, dear reader, to keep me more than busy. I'm tired. IMG00341

When I had our first child, I had secret visions of the wonderful sleep-inducer that I'd be. "Babies need sleep, and so do parents. I'll get the baby to sleep." Somehow, I thought I could use my super-shrink powers to calm, soothe, or hypnotize her to sleep.

I was wrong. Our first didn't sleep reliably through the night until she was four. FOUR!

Since psych grad school, oddly, is completely unhelpful in the preparation for parenthood, I sought out and read every single "Baby Sleep" book out there. All the major titles. I tried everything, religiously. Didn't work.

And in the process, I got more and more sleep deprived myself.

There's not much recognition out there that parents' sleep deprivation often goes on for a really long time, and despite how difficult that is, it's actually quite normal and typical for a baby to be up a lot at night for several months, and even beyond. I was doing some research for this post and I found something really annoying -- most articles only address the FIRST MONTH of how to survive with a newborn. The implication is that things really improve in the sleep department after that first month of your baby's life. AS IF! In the first month, you're getting by on adrenaline, grandma's help, and that extra sympathy and interest everyone still has in the new baby. It actually gets WORSE after that first month; you lose most of those extra perks, the baby STILL doesn't sleep very well, and you're slowly but surely losing your mind from the accumulated lack of sleep.

And of course there ARE some babies who sleep beautifully from very early on. (But parents of THOSE babies aren't reading this post, are they?) It makes those of us with crummy sleepers feel there must be something wrong with my baby; or, there must be something wrong with my parenting. The urge to compare our babies to other babies is just too tempting. Not recommended, but hard to avoid.

When Your Baby Starts to Sleep Better...and then Regresses It's also easy to worry that "something is wrong" when your baby seems to be sleeping better....then all of a sudden is back to waking several times a night. Please know that regression is normal in many developmental areas, especially in early childhood. Sleep is no exception. My second-born slept a good NINE hour stretch from the age of 9 weeks until the age of five months. Then he started trying to roll over, and he roused himself several times a night with his new-found pursuit. After prematurely congratulating myself that we finally had a decent little sleeper, I just about lost it when he regressed back to waking several times each night again. Just as you get used to being up all night with a newborn, you also quickly get used to regular sleep again. And when your baby regresses and you have to go BACK AGAIN to being up and down all night, it somehow feels WORSE than when you were used to it before. "Of Course, MY Baby Sleeps Through the Night!" Another thing that happens is that we compare our experiences to other parents'. That's a mistake, because PARENTS LIE. Not all parents, but enough of them DO get caught up in the game of comparing kids that you end up getting some pretty skewed information. And for some reason, the misinformation also comes from other parenting "resources", which are often misleading. Even most pediatricians have little sympathy for our sleep deprivation. After all, most of these doctors take overnight call and had to be awake for their residency training for a couple of days at a time for years, so sleep deprivation is a relative term for them. And when your pediatrician says you can expect your baby to "sleep through the night" at 12 weeks of age, guess what she means? Sleeping a 6-hour stretch (sometimes, at least), is considered "normal". But in my book, that's not sleeping through the night, especially when most babies that age want to go down for the night at around 7 or 8 pm. By the time YOU get to bed, the nighttime rounds are just beginning.

The WORST advice you get is to "sleep when the baby sleeps". Well, DUH. But it's not that easy, is it? Babies' sleep cycles can sometimes be so unpredictable that they have their best stretch of sleep smack in the middle of the day, when you need to shop, cook, do stuff with your other kids, and otherwise live your life. Waking up every hour or two in the middle of the night is often more the reality for many young babies.

And I don't know about you, but it's impossible for me to sleep "on command". OK, baby's asleep now, ready, get set...SLEEP! It doesn't happen that way, does it? There are biochemical reasons for that. Once we're awake for far too long, or we're awakened one too many times at night, our bodies start to produce hormones to keep us awake. That's when you get that hyper, wired, "I-know-I-should-be-sleepy-but-I'm-wide-awake!" feeling at 3 am.

You might think that I'm going to give you some fabulous secrets for getting your baby to sleep. Sorry, folks -- sleep is one of the things you can't "make" your child do -- along with other bodily functions like eating and pooping. And if I had found the holy grail of making a baby sleep through the night, I would be a very rich Baby Shrink indeed. The truth is, nobody's done that. But I have come up with some tips, over the years, from both my experience as a shrink and as a mom, for how to SURVIVE the sleep deprivation that most of us experience with babies:

How to Survive Baby-Induced Sleep-Deprivation In order to be safe behind the wheel of a car and to keep your body (and mind) relatively healthy, you MUST get at least adequate sleep a couple of times a week. Consider this a Doctor's Order: GET HELP so that you can at least 1) sleep in at least 2 mornings a week, complete with eye shade and ear plugs so that you don't feel like you're "listening" for the baby, and 2) get at least a 90 minute break most afternoons when you can lie down and rest (and hopefully sleep). If you're a first-timer, it might not be easy to trust anybody to care for your Babe, even if you're eyes are crossing from lack of sleep. But you MUST force yourself allow a trusted person to help you. Not easy to arrange? I know. Essential for your health and well-being? YES.

Get some exercise -- preferably outside -- for at least a few minutes each day. I know it feels impossible when you're wiped out, but there really is a magical effect in taking even a few minutes' brisk walk. Getting outside in the sun will also help to re-set your circadian rhythms, which are being hammered by your 24/7 schedule. I promise, you'll feel better. You might also be able to sleep better when you get an opportunity later on.

Learn meditation and breathing techniques to calm the stress hormones that keep you awake when you should be sleeping. Any "mindfulness", prayer, yoga, or other meditative technique that focuses on breathing will work. If you feel hyper and over-tired, even TEN SECONDS of mindful breathing will help you slow down and feel better. But do strive for 15 minutes a day in order to get your stress hormones under control. This will help you to sleep better when you DO have a chance.

Don't obsess over how little sleep you're getting. Believe me, I've been there -- staring at the digital numbers on my bedside clock, getting madder by the minute about yet another night of lousy sleep, up and down with the baby. The less sleep you get, the more upset you become, and a vicious cycle begins. Don't obsess about it. Let it go. Tell yourself: Oh well, another late night. This is something I can look back on later in life and laugh about. I know I feel beyond exhausted right now, but this too will pass. And if you can't sleep, then read or watch TV. Just give yourself a break about it.

Don't compare the amount of sleep you're getting now to how much sleep you USED to get or need. I know you used to sleep in until noon, and you couldn't function with less than 8 hours before this, yadda yadda. But your body has changed -- you're a parent now, and things ARE different. Yes, your body needs sleep, but you're also pretty good at adapting to less sleep -- at least for the short term. It feels impossible to "roll with it", but that's what you've got to do.

Don't be afraid of the "Cry It Out" method for your baby -- once she's old enough. I think you can safely start that at about 9 months of age for most babies -- after they have sufficiently developed the memory skills to remember that you'll be coming back eventually, despite being left to cry (and sleep). Before then, you can (of course, with your pediatrician's blessing), allow baby to fuss, grunt and make noise before rushing to get her; many babies are NOISY sleepers (another reason for them to sleep in their own rooms), and don't actually need to be picked up. Try to learn the difference between "grunty-noisy-baby-sleep" noises and actual "come feed or comfort me" noises.

And finally, try to adopt a bit of a Zen attitude about all of this. Because your crushing sense of exhaustion will quickly dissipate one day, sooner or later, as your baby naturally develops a better capacity to sleep at night. Then you'll be on to the next parenting challenge. So pace yourself. Our oldest is almost 9 and I still almost cry in relief as I check in on her, in a deep sleep, late at night. How can they grow this fast? (Cue the music to "Sunrise, Sunset".) Is this the baby that so challenged my sense of order in the world, simply because she wasn't a great sleeper for the first few years of her life? And here she is, a beautiful, intelligent, happy third grader, reliably sleeping from 8 pm to 7 am every day. Development is a magical thing, people. We parents can only provide love, structure, safety, support and guidance to shape these fabulous creatures that are our children, while the amazing processes of "growing up" happen before our (sleep deprived) eyes. We can't "make" them sleep, but we can't "make" them roll over, sit, stand, speak, and run, either. So step back for a minute to bask in the miraculous glow of your child's growth and development. It's a beautiful thing! I hope this helped. And now, please excuse me while I try to get some sleep!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Here's another post on babies and the normal range of their sleep patterns.

Attachment Parenting: More Discussion On Its Pros And Cons

There's an interesting discussion that's taking place on several sites simultaneously, and rather than responding to comments down below one of my more recent Attachment Parenting posts, I thought I'd highlight the discussion here, since lots of us are interested. Many of us are confused when we read parenting advice by "gurus" like Dr. Sears (who coined the term "Attachment Parenting"), because it makes us wonder whether we're doing a terrible disservice to our children if we use some form of "Cry It Out", DON'T co-sleep, engage in "babywearing", or do "extended breastfeeding". Poor Susanna came over to BabyShrink, after feeling scolded by AP proponents when she tried the "Cry It Out" (CIO) approach in a desperate attempt to get her son to sleep. We've continued to discuss the issues, with Annie at PhDinParenting bravely supporting her beliefs here, and elsewhere.

Annie left a link on a fascinating, very thorough anthropological review article looking at aspects of "natural parenting" worldwide. If you've got the time to read through the 82 page document -- go for it. Seriously, it's extremely interesting. I certainly find very little to quarrel with in the report. Perhaps Annie doesn't realize it, but here at BabyShrink we agree that responsive, "tuned-in" parenting is crucial in child development, and that physical -- and emotional -- contact, and very involved care, is an essential component in the ultimate well-being of a child. And that the lessons learned from in-depth study of attachment -- via well-accepted research -- informs our approach and intentions.

But the research review that Annie showed us mainly focuses on the young infants we ALL agree need to have close, physical contact and deeply involved parenting. It doesn't extend much to a discussion of toddlers and preschoolers, which is the group most often asked about at BabyShrink. It also doesn't tell us that the "Attachment Parenting" approach is somehow BETTER than the "Good Enough" parenting we strive for.

My beef is with those who take excellent research, and make unwarranted generalizations about it. The research shows us that excessive crying and non-responsive parenting is bad for the development of babies. --Well, duh. The research does NOT say, for instance, that a certain amount of crying, in the service of getting an older baby or toddler to sleep through the night, in their crib -- is a bad thing.

The bottom line here is that I'm against any sort of "holier than thou" parenting approach that doesn't respect individual differences in babies' temperaments and family circumstances. Good Enough is GOOD ENOUGH -- and there's research to support THAT. You don't have to be a perfect parent, and in fact in trying, you can make everyone nuts. There are far too many parents out there on "information overload", worried that they are daily making bad decisions for their kids, and in the process, not learning to trust their own best instincts as parents. You know your child best. I've always said to take what I say, or what any "expert" advises, with a grain of salt. Take what makes sense, leave the rest, and improvise from there.

Do I think Attachment Parenting can be applied with excellent results? Of course. Are there AP parents who are doing a fantastic job? Absolutely. But there is a vocal AP minority who insist on spreading the "gospel" to those of us who don't appreciate the prosteletyzing -- and whose children are turning out pretty great, thank you very much.

FOR MORE OF DR. HEATHER'S THOUGHTS ON ATTACHMENT PARENTING, SEE THIS POST, AND THIS ONE TOO. IT'S BECOME A HEATED TOPIC!

Dr. Heather The BabyShrink Mom of Four, Parenting Expert