Friday, October 10, 2008

Sleep Training

It's becoming increasingly obvious that we need to do some sleep training in this family.

Now, since everyone has their own definitions of that term, let me explain what exactly I hope to accomplish with Gwen. I subscribe to the theory that every person - adult, child, baby - has several brief awakenings throughout the night. This is normal. When an adult has a brief awakening, he or she may turn over, adjust a pillow or blanket, glance at the clock, take a sip of water, or do some other similar thing to comfort him or herself, then promptly go back to sleep. When a baby has a brief awakening, though, he or she doesn't know how to get back to sleep without help. So the baby cries, and the parent enters, and the parent puts the baby back to sleep.

Although some babies learn how to soothe themselves back to sleep without help, most need training. Sleep training. And that's what Gwen needs.

I am absolutely positive that Gwen believes, with all her heart, that she cannot fall asleep without sucking on either a breast or a bottle. Last night Chris put her to bed, and she didn't drink a drop out of the bottle he offered - she just sucked on it for a few minutes and then went to sleep. Fine enough, until you consider that every time she wakes up for the next twelve hours she is going to need to suck on bottle or breast again to get back to sleep. And that means parental involvement, involvement we are becoming ever less willing to offer. We are exhausted.

We are following The No-Cry Sleep Solution for our sleep training. The first step is to take stock and do a 24-hour sleep log to see what's working and what's not. The next steps will be more challenging: to gently and slowly break the suck-to-sleep habit.

If you are interested in knowing more details about this, read on. If you're not a parent to a young baby (or don't plan on being one anytime soon), feel free to skip the next section.

The first trick to master is the "gentle removal plan", which removes the nipple from baby's mouth before s/he falls asleep. Quoting from "TNCSS":

"When your baby wakes ... nurse him. Let him suck for a few minutes or until his sucking slows and he is relaxed and sleepy. Then break the seal with your finger and gently remove the nipple.

"Often, especially at first, your baby then will startle and root for the nipple. Try to very gently hold his mouth closed with your finger under his chin, or apply pressure to his chin, just under his lips, at the same time rocking or swaying with him. If he struggles against this and roots, or fusses, go ahead and replace the nipple, but repeat the removal process as often as necessary until he falls asleep.

"How long between removals? Every baby is different, but about ten to sixty seconds between removals usually works.


"Repeat this process every night until baby learns he can fall asleep without nursing."

Once this is mastered, the author suggests a plan with several phases to "shorten the duration and vary the technique" of nighttime parenting. The examples given are as follows:
Phase One: Comfort until baby's nearly asleep
Phase Two: Baby's settled and sleepy
Phase Three: Comfort without pickups
Phase Four: Soothing pats
Phase Five: Verbally soothing baby
Phase Six: Comfort from outside the doorway

As you can see, with each phase you are reducing the parental involvement and helping baby learn one more step towards falling to sleep herself. Each step includes the instructions, "If she wakes and cries, repeat the process. You may have to do this two, three, four, maybe five times, but that's OK - really. ... When you feel that the new routine is working, go on to the next Phase."

If you read between the lines, there are two things to be learned here. First, sleep training without resorting to "crying it out" takes a loooong time. (Even if Gwen were to proceed through each phase at the rapid and unlikely speed of one phase per two weeks, that's six solid weeks.) Furthermore, proceeding through the phases and lessening the parental involvement actually takes more work than what we do now: putting her right to sleep on our laps and transferring her to her crib. This is why people end up putting off sleep training, because it's so tempting to just keep doing what "works" to allow the whole family to get rest. And that's how you end up with three-year-olds who still wake their parents up in the middle of the night... unless you have one of those miracle children who figures it all out on their own. We don't have one of those.

So, my interim step - in between doing a sleep log and starting the Phases - is to get some non-nighttime sleep myself. It's been months since I napped, but if I'm to have the stamina to put Gwen in her crib "two, three, four, even five times" every time she wakes, I'm going to need to feel more well-rested than I currently do. Which means not only less time to myself (for reading, blogging, needlework, dicking around on the 'net), but also less time to do the things that "need" to be done: laundry, dishes (especially the damn bottles), preparing and eating meals, social commitments, and so on. It's going to be a real challenge, and the reward of getting a good night's sleep seems so nebulous and far-off that it's hard to use that as motivation.

So, I might be posting less in the coming weeks - or if I do post, it'll likely be about this topic. It's bound to be a bit all-consuming for the next while.


Amberism said...

Look at me doing this sleep training and I didn't even know it. Something to be said for instinct, I guess.

Question (since you have the book, and let's be honest, I'll never read it :) ) - when I remove the nipple and she roots, I don't hold her chin, I just keep the nipple out of reach. This might take a few tries, and I'm trying to lesson that time because right now, it's an hour+ process in the middle of the freaking night. Anyway, I think if I tried to hold her chin it would wake her, and to me, the sucking she is still doing with her tongue sans nipple is one of her self-soothing so why force her to stop? It seems aggressive for a non-aggressive approach because if I'm forcing her to stop sucking, why not just cry-it-out and save myself the months of training? Does he have a reason for it?

I'm actually not against crying-it-out, or sleep training, or any technique, whatever feels right and works for the family. Just want to make sure I don't alienate anyone unintentionally :)!

Kat said...

I read that entire post and it makes perfect sense from a psychological leve. I wish you much internal fortitude trying to impliment that. I hope the results will be worth it!!

Amberism said...

How was the race?

Claudia said...

Hey there...long time lurker here. We dont know each other, but we have a common friend - Jessica Douglas, and I found your site through hers.

We were pregnant at the same time, and my daughter is now nearly four months. You will never know how much I have enjoyed keeping up with your site! So much of pregnancy and early parenthood is so difficult and lonely, and it helps much to hear what other people are going through and techniques they've tried...

As for your sleep training, I thought now would be the time for me to chime in with what we did. I know for sure that some things work for one kid but not for others, but maybe you'll find something useful here. She gets herself to sleep pretty consistently now (I know Im going to ginx it by writing that!!!) and this is what we did.

Step 1: Get her to sleep in your arms with a pacifier, and wait for the pacifier to fall out, then transfer to crib, and tiptoe very quietly out the door.
Step 2: Rock in arms, then yank out the pacifier when she slows down the sucking, rock a few more minutes, then transfer, tiptoe, etc. (this sounds like the "no cry" book, but I didnt do any holding of her mouth shut. If she woke up Id just put the paci back and start over)
Step 3: Rock in arms just until she had sleepy eyes and was still sucking, transfer, tiptoe, etc.

It seems like a big jump to go from step 2 to 3, and it was, but it was awhile where we were taking out the pacifier before she was asleep. So she learned to sleep without it. Then we basically swapped being in my arms for the paci, and she was okay with that. Now we dont even have to tiptoe out the door, and she'll get sleepy eyes just with the routine of swaddling and rocking, so the whole process is less than five minutes.

The key to all of this is a tight swaddle. I dont know how we are going to get past that one. The latest big sleep challenge is to get her to sleep for more than 45 minutes during the day! (and take just 2-3 long naps and not 5 short ones!)

If you want to read more of our adventures:

Good Luck!


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