How we approached the fourth trimester
There is no right or wrong, just what works for your family.
I must preface that my account here is heavily adapted from the advice that a dear friend sent me. I found that I’ve been sharing a lot of her approach with others so I decided to build off her advice.
Mikee and I subscribe to "parent-directed" sleep training (and also in most issues of child rearing). In short, it means that parents tend to know what's best for their kids and therefore they instruct their children in ways that will benefit them in the future. The opposite of this is "child-directed", which assumes that the child knows what he/she needs at the moment and therefore he guides himself. There are, of course, infinite combinations of the two of these. On the west coast, you are far more likely to find child-directed methods. What I have found to be true with Emmy and my friend's children is that babies who follow parent-directed are happier, more adaptable children who sleep longer and sleep better. They understand the structure of their family (they trust their parents as authority figures) and appreciate the boundaries that have been put into place.
Here are some books/tips that worked for us:
Baby Wise We are a baby wise family and we love it- it has been such a gift for us. However, the book is useless. And if you google "baby wise" you will find that it is the hate of all the internet... a few families claimed to be baby wise but instead were simply abusive, and baby wise got the bad rap. I know a few baby wise families and all their kids are happy, healthy and the pride of their pediatricians because of their excellent demeanors and stellar sleep habits. I do recommend this blog and getting a baby wise mentor mom- if you go this route you will have plenty of questions and speed bumps to get over. I am always more than happy to help!
The Baby Whisperer Solves All Your Problems- Baby Wise and Baby Whisperer are extremely similar. I found this book helpful for problem-solving/trouble-shooting with Emmy although… there was little I could do to extend her cat naps, but I liked knowing there were steps I could follow.
Healthy Sleep Habits, Happy Baby- This is actually my favorite sleep book. It's by a dr and he gives you practical applications for so many sleep problems, and he provides different ways of doing it depending on how much you're willing to let the baby cry (so the book is useful regardless of how you approach sleep training). I highly, highly recommend this book for everyone.
Wonder Weeks- This was a great guide with what's going on with her and why it's disrupting her sleep patterns. They also have an app, which I use a lot. Doesn’t work for every baby though.
Sleeping Philosophies - Parent-Directed or Child-Directed?
Sleeping is a skill- it can and needs to be learned. Like any skill, it takes time and sacrifice. I am a huge proponent of good sleep ; the importance of it cannot be underestimated. It allows for more brain development; it helps mom and dad get more sleep and do better at work; it means that your baby is well-rested and therefore better behaved; it makes the lives of secondary care providers (church nursery, nanny, grand parents, etc) so much easier because your child has routine to guide him. As I mentioned, we are a baby wise family, and chose to go with them because it's actually a whole parenting philosophy. While we don't/won't adhere to every single thing, we really like how they approach raising children on a continuum, building on foundations you have laid since birth. If you start reading about baby wise, you will see that "crying it out" or CIO is a big part of it- it's the part that people love to hate. And it's fair to say that there is a lot of misunderstanding about this. We chose to not let our daughter cry until about 4 months old- that is simply our comfort level, some people let them cry sooner and some a little later. Until that point, we respond to each and every whimper with love and compassion. As we learn more about the specific cries of our child at about 4 months old, we provide small, controlled windows of opportunity for them to solve their own problem. [Since we got more comfortable with CIO after Emmy, our comfort level changed to 2 months old when Thomson came along.] We are encouraging, supportive, and ready to step in- and many times we do have to step in and help or comfort or do whatever they need. Anyway- as you get to a point where you're comfortable with a baby crying, we can talk more about this (we do it in small increments, getting longer as needed- there is always a purpose and a plan when we're letting our babies CIO). Our daughter has a pretty amazing sleep pattern and now she goes to bed awake, falls asleep herself and knows exactly what's going to happen in there and when they're coming back out. Emmy started sleeping 8 hours at 6 weeks and by 10 weeks was sleeping 12 hours through the night (with a dreamfeed). Thomson was the same. Personally, the night time sleeping is fantastic but Emmy just has never been a great napper. She has since two months old only, take only 30-45 minute naps throughout the day. We have pretty much tried everything but there was nothing we could do. That being said, she’s healthy, adaptable, and sleeps pretty darn amazing at night. In hindsight, I believe it was because we didn’t do CIO(Cry-it-out) with her for NAPS until much later. We are now experimenting with CIO during nap time with Thomson, and hopefully that will bring in the long naps. Stay tuned! (Skip to the last page to read about CIO experience)
Getting Started
All of this being said... here is how we approach sleeping and eating with a newborn- remember that sleeping and eating are closely related, one will always affect the other:
When both Emmy and Thoms were born, I hoped to nurse right away. It didn't happen. Turns out that I had weird nipple issues that made it difficult for both to nurse. For the first week, I pretty much nurse on demand and try to get life into some bit of normal. You simply don't know what you'll be facing... maybe the baby won't nurse, maybe the baby needs a few days in the NICU, maybe she has her days/nights confused. Those types of things take priority over schedules/routines. Take time to iron out any hiccups along the way. Seeing our lactation consultant was a HUGE help in getting nursing going. Joanna Koch is the BEST in the bay area. $150 for three sessions if your insurance doesn’t cover. Best $150 ever.
Your goal (and it won't be easy, and it won't be accomplished quickly), is to get on a 2-3 hour pattern of sleep, eat, awake. In the early days, the ratio of time you do these things will change as the baby gets older. If you switch this pattern, your baby will become dependent on eating to go to sleep and that will prevent healthy sleep habits in the future.
From DAY ONE work on getting full feedings from your baby. This is really tricky for first time moms who are nursing simply because it's a totally new experience and you're constantly questioning if you have milk and how much they're getting. And it's really hard because the baby is so sleepy that they often drift off while nursing. This is bad for two reasons:
They aren't getting that nutrient rich hind milk, and
They are going to wake up and be hungry earlier than if they had a full feeding. To keep Emmy awake we've used everything from tickling to cold wash cloths. It's hard work to keep them awake through the entire feed (especially since you just want to go to sleep yourself) but it's so important.
Most newborns are super sleepy. It's so, so easy to just let them sleep away on you. And you should- it's such a joy to feel the warmth and weight of your long-awaited newborn. But before you do this, try and keep them awake after they eat, even if just for a few moments (except at night- never keep them awake at night).
We fed on-demand (ideally every 2-3 hours) during the day and night until they got over 10 pounds. Then we wake to feed every 2-3 hours during the day (don't let them sleep longer!!) and then let her wake up herself when she is hungry at night.
If your baby wants to nurse for any reason (hunger, comfort, etc)- do it without apprehension, even before 3 hours!! Emmy would cluster feed a lot when she went through a growth spurt. Number one rule is that if baby is hungry, baby eats, regardless of what the routine says.
**Main Things To Remember With Your Newborn:
Eat, Wake, Sleep every 2-3 hours (try not to switch this, even though the "wake" part is going to be super short/nonexistent some times).
FULL FEEDINGS EVERY TIME.
Sleep Props
I was so opposed to using a swaddle blanket or pacifier because they sleep props; I didn't want my baby to be dependent on something I'd eventually have to away from him or all the nipple-confusion woes. Oh, but I was so foolish! Every baby needs a sleep prop... sleeping is a skill to be learned, and they need help to do it! If the prop is not a sound machine or swaddle blanket or pacifier, it's going to be you. And while that sounds nice and warm and comforting, it's really hard for the baby emotionally when you need to drop the habit. We tried to go prop-free for about one night at the hospital and it was a disaster. She couldn’t sleep for more than 10 minutes at a time. Our favorite swaddle blanket is the halo sleepsack at least in the newborn stage. You will wean them off of this at about 3 months. Emm greatly prefered this paci and also the MAM brand worked well. Pacis got so much bad press in the US when I was growing up, so I thought I'd never use one with my kids. But my pediatrician, dentist, and lactation consultant said it was totally fine, so I got on board. They were life savers those first few months. If you watch your child, he/she will reject the paci by the time he/she is 6 months old. Emmy rejected her paci at 4 months and Thomson at 2 months is already showing signs of rejection. This meant they just kept spitting it out. Believe me, if they want to hold it in, they can and they will. She also dropped the swaddle by 4 months and we transitioned her into a one-size Woolino sleepsack at that point. My favorite sleep sack ever!
Witching hour
Between the hours of 5-7pm, Emmy was e.x.t.r.e.m.e.ly. cranky. Nothing would really pacify her, she wouldn’t take a third nap or napped only for 10-15 minutes. The only thing truly truly worked was to put her in the ergo/boba carrier. It was a pain on our backs but whatever you need to do to keep sane man. It worked. She stopped this behavior after month 4… thank God.
Thomson shows less of this behavior, but I wonder if it’s because we started CIO early.
Sleeping Arrangements
Not sure what you have chosen to do, but here's what we do. During the day, the baby slept in her crib for all naps (unless she's in the car or swing or my arms- it's really hard when they're so young, but I aim for at least one nap a day in the crib for the first 3 months, slowly moving more and more naps to the crib).
When the baby is 1-2 weeks old, sleep training starts to take off.
The routine is eat, wake, sleep.
Keep pushing for full feedings.
Now you build on those two things.
Let me know if you have any questions about how we do it- always more than happy to help! Sometimes it's easier to talk through this type of stuff, too. My main piece of advice... you and spouse/partner/caretaker need to be in agreement about what you want to do. If you two are doing two different things, the baby will be totally confused!!
Sleep Regressions
At specific months, you will start to notice that baby regresses on their sleeping patterns. Instead of sleeping through the night, they start to wake up again. Emmy did this clockwork at 4mo and 9mo. She was developing new skills during that time so it was inevitable. Growth spurts and developmental milestones are tough times but you just gotta power through! The wonderweek app helps warn you in advance. Other things like teething, sickness, environmental change can also affect sleep disruptions. If you can’t quickly pinpoint a root cause of a sleeping disruption, my advice is just let it go and hope it passse in a few days. Just FYI in Emmy’s case, a wet or poopy diaper NEVER affected her sleep! LOL!
Moving past newborn stages...
The short version is after baby gets comfortable with a 3h schedule you start moving towards a 4h schedule. The cues are pretty obvious, they are also awake longer. Emmy started a 4 hour schedule around 5mo and stayed there until we introduced solids. The introduction of solids reduces the need to drink milk and now she is down to one one bottle in the day (11am) and a morning and night nursing session.
Hope this helps- I totally understand if you don't chose our style- every family is different and needs to do what works for them!
Thoughts on Cry-it-out
Like I mentioned before, we were only comfortable doing CIO with Emmy at 4.5 months old. When Thoms came along, we were ready by 3.5 months. Some people do it sooner, some never. It really is a personal preference. So, as we learn about her cries, we provide small, controlled windows of opportunity for them to solve their own problem - in this case, learning to fall asleep by themselves. Constantly remind yourself that you are teaching them a new skill. This is not easy - your heart will wrench, and you may cry along with your baby as well. Here’s how we did it:
Do your usual bedtime or naptime routine (for us it’s bathtime, story time and then prayer time. When older, we added debrief time). While baby is still awake, follow the 4S wind down ritual. Place them in the crib while they’re still awake, and give a gentle rub or pat and tell them why you are doing this and remind them that you love them, and you are just outside. Over time, they get it, communication is so important. They will protest even as you leave the room, but leave anyway. Hell will now break loose as the screams ensue and your heart breaks into a million pieces. Take out your iphone and start timing. Never let your bed cry due to distress(hunger, discomfort etc). Read below for guidance on distinguishing cries.
Distress crying vs Confused crying (from circle of moms)
When your baby is crying, if he is not distressed, his crying will go in "waves". Each wave lasts 30-60 seconds, the wave starts low and gradually increases in volume and intensity, then reduces and stops. There will be a silent pause of 3-5 seconds between each wave. This sort of crying is best described as a confused cry, the baby does not understand what is happening and what they are supposed to do (i.e. go to sleep). If you are not hearing distinct pauses between the waves, then your baby is in distress and should not be left to cry. In your case the distress is probably due to hunger. Yes there are many distress cries but all of them are constant for a few minutes at a time and do not have distinct pauses every 30-60 seconds. Please, anyone leaving your baby to cry, listen to their cries and do not leave them in distress.
For Emmy, we did controlled CIO: (This is more for the weak hearted)
At fixed intervals, go in to calm your baby but at no point actually pick them up. I did a back rub and soothingly told them i am here etc etc. The weaker of the two parents should probably put on headphones or leave the house. The stronger of the two should stay behind to do the controlled comforting. In our case, Mikee did most of the real training while I hid under the covers.
At these time intervals, go in and comfort your baby. Maximum of 30 seconds in comforting. Be calm and confident as you calm your baby. If you are scared or nervous, baby will sense it too. Feel free to also adjust the time intervals depending on your comfort level. The point is to be gradual at first and then consistent. And you want to get to a long enough interval by day 3, that they realize you are not going to break.
Day 1 intervals*: 5 mins, 7 mins, 9 mins, 10 mins, 10 mins etc.(as many as needed, maxing out at 1:30h only because who can tolerate 90 mins of crying! Call it a day and repeat your day 1 interval the next day)
[For reference, on Emmy’s first day she cried 45 mins.]
Day 2 intervals: 7 mins, 9 mins, 10 mins, 10 mins
[For reference, on Emmy’s second day she cried 30 mins.]
Day 3 intervals: 10 min intervals only…
[For reference, on Emmy’s third day she cried 10 mins.]
By Day 4, she was down to just minutes of crying/whining.
By Day 7, she goes down without a peep. :)
Now at any one point, if you break the rules and pick up the baby to calm them down. You might have to restart with Day 1 intervals the next day. It is painful to hear their screams but once they learn to fall asleep themselves, they will be SO MUCH happier. Trust me!
For Thomson, I tried to sleep train him at 3mo but I didn't feel he was ready. When I felt like he was ready at 5mo he was constantly sick because of starting daycare so I waited until he was 7mo.
Thomson’s training went something like this
Night #1 8/2/2015 (40 mins crying)
710 pm nurse but still awake after nursing 730 pm placed in crib and crying started immediately. We went in every 10 minutes to comfort. No more reinserting paci800 pm less crying in crib, intervals between crying start to spread out 810pm mostly asleep
Night #2 8/3/2015 (16 mins crying)
Went down at 7pm after nursing and appeared to be asleep. Woke up at 710pm crying. Mikee went in to comfort. Still crying at 720pm. Mikee went into comfort. 724pm frequency of crying reduced. Prolong periods of silence. Head lying down.726pm last time whining crying Total period 16mins!
Night #3 8/4/2015Nursed at 645pm. Put down in bed at 704pm pretty drowsy but semi awake. About 5-7 mins of occasional whining and movement before sleeping. I call this almost successful sleep training !!!! Tmrw is final test!!!!
Naps at school 8/4/2015Teachers advised to put him down awake. Whined for a little bit and he was asleep. Yay!!! Successful at school too!
Night #4 8/5/2015Nurses at 645pmPut down in bed at 7pm pretty drowsy but awake. 710pm woke up with occasional on and off whining for 5 minutes.
Success!!!
CIO Regression
At a few times in their lives, we have let these habits slip. For example, when Mikee decided he loved the cuddling too much and let her fall asleep in his arms after prayer time. Guess what, we had to train her AGAIN. The same happened when we transitioned her to her twin bed. In order to make the transition smoother, we laid with her in bed for awhile. She got so used to it, she would scream if we left the room. Eventually, we had to CIO with her AGAIN. Each time, just as heartbreaking as before, but always much more rewarding for her. She now goes down without so much as a whimper and is even independent enough to say Good night and ask me to turn off the lights. :)
Remember, asking for help is not a sign of weakness
When our son turned two, his wonderful sleep habits started to take a turn for the worse. We struggled for months before getting help from a sleep consultant. It was a huge help and I couldn’t recommend it more.
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