Wednesday, May 20, 2015

Conquering the 4-Month Sleep Regression: Part 2

*Apologies in advance for the length of this post! I tried to organize the info as best as I could.

When I left you in my last post, I shared how and why the 4-month sleep regression made me crazy. Now I wanted to share the things I tried that worked and didn't work, in the hopes of helping other desperate parents who are currently searching the Internet for a solution to this awful problem.

During the peak of my crazy behavior, I contacted Dr. Weissbluth. You might recognize the name from a popular sleep book, "Healthy Sleep Habits, Happy Child." We happen to belong to his pediatric office, and he offers sleep consultations as a benefit of that. I emailed him, filled out a sleep log for Liam and answered a questionnaire, and we had our consult over the phone a few days later. We were given a very strict set of rules that he promised would result in a sleeping baby in no time. However, the rules were just not something my husband and I were comfortable with. More on that later.

What the "rules" did do is prompt us to examine our current sleep habits. We were pleased to know that some of the rules were ones we were already following, as they made sense for our family. So, let's start with the problem. Liam needed to learn how to get himself back to sleep when he woke up. And he needed to learn how to do that without our help.

After our convo about having too many different plans of attack, we also discovered we were trying to conquer too many problems at once. We were trying to get Liam back in his crib, to get him to self-soothe, to get him out of the swaddle, AND stop relying on the pacifier. And we were trying to have him do all these things at once.

Remember: the changes from the regression are permanent, and they are just as hard on the baby as they are on mom and dad. They don't know why they can't go back to sleep, or how. They want to go back to sleep as much as you want them to. But they need our help in order to sleep without our help. Ya dig?

Our solutions 
Thankfully, we had created some good sleep habits with Liam prior to this regression. In all of my Googling, several of the "steps" to getting babies to sleep better were already things we were doing, so that made us feel like, YAY, we're doing something right. Those things were:
1. Put baby to sleep in his or her own room. This is a hard one to break if you have been sleeping with your baby in the same room. We had Liam sleeping in his Rock 'n Play in our room. After about 8-9 weeks, we felt like it would be better for everyone to be in our own rooms. So, we kept Liam in his Rock 'n Play, but moved it to his room. The transition went smoothly. Of course, I woke frequently and had to check on the baby to make sure he was breathing. (Which I still do, but much less now. :)) In any case, having the baby in his/her own room will likely lead to baby getting some independence, which will help in the long run of this regression.
2. Sleep should be in a dark room. We have black-out shades in Liam's room. But we also had a nightlight. Dr. Weissbluth recommended that the room be pitch black. So we got rid of the night light and even went so far as to put black garbage bags over the windows (under the blackout shades), so that no light crept in. I will say this has helped. We turn on the night light for feedings and to change him, but other than that, the light stays off, and Liam knows it's not time to wake up. (Also note, this has not affected Liam's ability to nap in his stroller or in the car or in other rooms when it can't be pitch black.
2. Use a white noise machine. We did this from day one when we got home from the hospital. It's been a lifesaver. Again, it's another thing that signals sleep to Liam, and comforts him. Don't think this had anything to do with getting over the regression, but it certainly has helped in establishing a sleep routine. Speaking of...
3. Establish a sleep routine. Babies crave routine. It's one of the only things that make sense in their little brains. When they know what to expect, it helps them (and most likely, you too). Our sleep routine starts with a bath. We then do lotion, jammies, a bottle, turn on white noise, put him in his swaddle (now sleep suit), turn off lights, rock for a few minutes, then we lay him down drowsy but awake. Most of the time, he is ready to go in the crib after the lights go out, and actually starts to fuss if we rock him because he just wants to snooze. (Cue tears for this mama who craves her baby snuggles!)
4. Put baby down drowsy but awake. This was something we started doing at around 6 weeks old, to the advice of our pediatrician. This helps instill the ability to have the baby fall asleep on his own. However, as we learned, there is a big difference in the baby knowing how to get TO sleep on his own and how to get BACK to sleep on his own. In any case, if they can do it once, it's likely they can do it again during the night with a little prompting.
So, knowing we were armed with some good sleep habits on our side definitely gave us a leg up on the regression. We continued to push these habits as best we could, even though it was hard at times.

Next, we needed to break some of our bad sleeping habits. 
5. Get an earlier bedtime. Prior to the regression, Liam had a bedtime of 9pm. He was taking 4 naps, with the last one being a short catnap around 6:30pm. We were not keeping him up late because we thought he would sleep later, or anything like that, that's just when he naturally began sleeping for the longest stretches. We learned early on that sleep begets sleep. As babies get older, they need more sleep. So now, the 9-10 hours of nighttime sleep were no longer cutting it--he needed 11-12.
I mentioned rules above that we weren't comfortable with: one of them was to put Liam to bed between 5:30-6PM. Acca-scuse me? Sorry, but as working parents who don't get home until that time, I'm not going to come home from work and only be around to put my baby to bed. We settled on a 7:30pm bedtime, and that has helped IMMENSELY. Some nights it's earlier, some nights it's later depending on the day, but it is always within an hour of that time. If you need help determining when to put your baby to bed, go here and enter your baby's age and wake up time.
6. Limit/Put an End to Sleep Associations. When I was doing all my research, one thing that really resonated with me was about sleep associations. Basically, if your baby NEEDS something in order to fall asleep, that *something* is a sleep association. Not all sleep associations are bad - the white noise machine and a dark room, for example, are good sleep associations. The swaddle, a pacifier, nursing to sleep, rocking to sleep - these are all also sleep associations.  The only time it becomes "bad" is when it disrupting everyone's sleep. 
The other thing that resonated with regard to sleep associations was the idea that in order to see progress with night-wakings, you should start with bedtime, and work up to night wakings. So if you don't want your baby to need/want to nurse to get back to sleep, don't have him fall asleep like that. So while Liam would go down easily, it was with the help of a pacifier and a swaddle. So when he got to the end of a sleep cycle and woke up and realized his paci was gone, he woke up crying and wanted it back. Makes sense, right?

First up was the swaddle. We chose to tackle this association first because at 4 months old and 16 lbs, he was starting to break free on his own anyway. It was only a matter of time before he rolled over in it. Also, we wanted him to be able to self-soothe if he lost his pacifier. But with his hands bound to his sides, it was impossible for him to be able to suck on his fist or hands as a way to get the same effect of the paci. We tried various ways to transition out of the swaddle. One arm or both arms out did not work for us - Liam continued to just flail his arms and hit his own pacifier out of his mouth.

We invested in Merlin's Magic Sleep Suit and a Zippadee-Zip. We tried both of those things at the before the regression and they weren't successful because Liam was just too little. Being that we knew a swaddle worked, we kept going with that until we had this revelation of "duh, he needs his hands to self-soothe." It was a couple weeks later when we tried the Sleep Suit again. Originally, we had been putting him in his crib in his suit, but that was still resulting in him crying after a couple of hours. So one night, we thought to put Liam in the sleep suit in his beloved Rock 'n Play (we'd deal with that later). He looked like a stuffed little sausage in there, but BEHOLD - he slept a solid 5 hour stretch before waking to feed, but then would go right back to sleep again. 

In the travel crib

Next, we needed to ditch the Rock 'n Play. Trust me, I wanted to keep Liam in there, but he is just getting too big, especially in his sleep suit. I began to worry that he would thrash at night and fall out. After about a week of successfully being out of the swaddle and in his sleep suit, we moved him to a Graco Travel Lite Crib, which is basically a smaller version of a Pack 'N Play. (That will likely work, too, we just happened to have one of these at our house because the boy we nanny share with naps in it.) We moved the smaller crib in his room and put him to bed in it. The idea being that maybe this small crib wouldn't feel so big and scary. Success again! We did this for another few days and then one night, decided to try the crib. Perfection: He's been sleeping in his crib, in his sleep suit ever since!

 In the crib

We saved the pacifier for last because we wanted to see if we could avoid having to get rid of the pacifier altogether. Thankfully, we didn't have to. He still goes down with a pacifier, and will *occasionally* wake up and fuss without going back to bed, in which case we go retrieve it for him. But we are happy to do that once a night. When we were having to do it every hour, that was another story. I will say that I also invested in different pacifiers. We were using the Wubbanub pacifiers, but he began pulling them out of his mouth. Plus, the nipple on those is straight. I bought Nuby and MAM pacifiers, which both have more natural shaped nipple, and he keeps them in his mouth much better.

All of this really boils down to sleep training. I always thought that sleep training meant "cry it out" and it doesn't have to. It's just helping your baby learn better sleep habits. It might involve some crying, or some fussing, but it doesn't have to be traumatizing. To take sleep training a step further, our last and final step was combining the following method every night, even (perhaps a better word is especially while) we were trying to correct sleep associations.
7. Let the baby fuss. Part of our issue was that, like any parents, we hated to hear Liam cry or fuss. At the first noise we heard, we were usually up and in his room within a minute. So we -- and really for this one, it was mostly me -- had to at least give him the opportunity to self soothe before we rushed to his aide. 
A pediatrician suggested that the first night of training, you do your nightly routine and put the baby in the crib while he's still awake but drowsy. If he cries, let him do so for five continuous minutes. After five minutes, go in to soothe, but try not to pick him up. Rub his tummy, talk softly, sing, whatever. After 5 minutes, leave again. Let him cry another five minutes, go back this until he falls asleep.

However, since Liam went down easily and it was more about the night wakings for us, we applied the same method but in the middle of the night. The first night, we only go into his room if he fussed for five straight minutes without being able to soothe himself. We'd go in, give back pacifier, or rub his belly. We did not pick him up unless he was screaming. The second night the interval for going in to soothe is 10 minutes. The third night the interval is 15 minutes. Of course, if Liam was not going back down easily or seemed truly upset, we always checked basic needs (poopy diaper, is he hot/cold, etc) before determining how we would deal with the wakeup.

Liam also was still waking for at least one nighttime feeding. I am totally fine nursing Liam in the middle of the night if he's truly hungry. The problem was, I couldn't tell if he was hungry, and thus would end up nursing him often during the regression because I knew it would get him to calm down (and I was introducing a new sleep association).

To battle this, I looked at our feeding log and determined when a "normal" feeding time was: usually between 2:30-3:30AM. When he woke up during the night and it was NOT during this timeframe, I would not feed him. If he did cry during his normal feeding time, I'd feed him and then put him back to sleep drowsy but awake. Try to have this be the only time you pick him up. If that's not possible for you, do your best to ONLY feed him during his feeding time. Eventually, Liam learned that crying wouldn't automatically mean he got to nurse. His overnight wakeups eventually consolidated to be during this "feeding time" and now, he RARELY wakes for this feeding anymore.

The results

I am happy to report that as of May 1, Liam is sleeping ALL NIGHT LONG. He will occasionally wake up once to eat, but most nights, has been sleeping through until it's time to get up for the day.

In retrospect

In the end, I just had to let go and realize that Liam is a baby. He's doing the best he can, and so are we. We can't *make* him do things - but we can give him the tools he needs and help teach him how so that he eventually gets the idea.

I'm really proud of my husband and I, and of Liam. Literally every time Liam wakes in the middle of the nigh and fusses, I feel such pride when I see him just go back to sleep, on his own, with no assistance. We were able to teach him that, to give him the tools he needed to sleep and let him figure out what to do from there.

I also learned that I can't control everything. That sometimes there  isn't a prescriptive answer. I think perhaps this was my first lesson in realizing that as a parent, I have to let Liam learn, succeed, fail and struggle. I have to let him learn how to do something by himself when all I really want to do is fix it, or do it for him. I know that I could go into his room at his first peep and rock him to sleep, or give his paci right away, but that doesn't help anyone.

If you've tried all of this and nothing works, have hope. Most people say the four-month sleep regression lasts 2-4 weeks. Perhaps your baby just needs time. My baby’s problems may have worked themselves on their own, regardless of us trying the above. But for my own sanity, having a plan gave me hope that the issue could be solved with some intervention on our parts.

Ultimately,  you should do what you are comfortable with and what works for your family. Yes, the changes from the regression are a good time to introduce good sleeping habits, and a good time to sleep train, but that doesn't mean you have to. Sometimes you just gotta follow the "whatever works" method.

Anyone have any other tips that helped them through? I'd love to hear them!

Monday, May 18, 2015

Liam {5 Months Old}


We don't have a wellness checkup appointment this month, but by our at-home calculations, Liam weighs 17lbs and is 25.5-26 inches long. 

Your eyes are brown around the pupil and the outer parts are hazel/green. Time will tell.
You still have a full head of brown locks, including a wispy, randomly long strand on the right side that I find endearing. Your eyebrows look red sometimes...fingers crossed that's not going anywhere.

  • Peekaboo 
  • Looking at yourself in the mirror
  • Putting everything in your mouth - toys, feet, mom/dad's hands...literally eveything
  • Your latest noise is an interesting bird-like "caw" (see video)
  • You love being naked
  • Still fascinated with Addy
  • You love making body contact while eating - holding hands, hands on chest...anything works!
  • Your favorite toys are Sophie, your bear with different textures, your soft Very Hungry Caterpillar book and you're still all about the Jumparoo. Daddy is a fun toy, too!

  • Being sick (even though you are still in pretty good spirits!)
  • Coming in from being outside
  • Getting out of the bath
New Milestones/Skills
  • You can hold your own bottle
  • You finally belly laughed! Still aren't doing it very often but it is the sweetest sound! (see video)
  • You're so close to sitting on your own, and can do so for short bursts of time
  • You respond to your name
  • You've officially "found" your feet and are obsessed with them
  • You can put your pacifier back in your mouth (woohoo!)
  • You not only roll over, you push off  your arms when you're on your belly
  • Your search to see where mom and dad are
  • You pull everything - mainly my hair and jewelry 

You're still exclusively breastfed. You eat 5-6x day, and have 5-6oz per feeding. We are looking forward to starting solids at 6 months!

Now that we have gotten through the God Awful sleep regression, you're sleeping 11-12 hours per night in your crib. You go to sleep around 7:30pm most nights, and get up between 6:30 and 7:30am. SOMETIMES you wake for a night feeding, but not often. 

  • First cold: Officially the worst thing ever as a parent to see your baby sick! :(
  • First time on the "El"
  • First baseball game

As always, every month is better than the last. Watching you grow and discover is our favorite thing. You are the most curious, sweetest, happiest, most chill child ever, and though I hate the expression, we truly are so blessed.


Wednesday, May 13, 2015

Conquering the 4-Month Sleep Regression: Part 1

As I've alluded to, April was a rough month in our house, namely because no one was getting much sleep.

We returned home from Easter weekend in Iowa when Liam started having sleep issues. Wouldn't sleep in his crib anymore, wouldn't sleep unswaddled anymore, was waking up a lot. We chalked it up to having his routine messed up when we traveled, and the fact that we allowed him to sleep in his beloved Rock 'N Play while we were there.

After a few nights, it became clear this was more than just re-adjusting to our schedule. This kid was just not sleeping anymore, and it was getting worse. I'd heard about the 4-month sleep regression and started to look into it more. Sure enough, he had all of the "symptoms." (Read more about it here at one of my favorite sleep resources.)

We rode it out for awhile - maybe a week or so - just to see if it would just go away without much intervention from us. Some babies go through it and you'd never know. Other babies get it bad for a few days.

But Liam struggled for 4 weeks. FOUR WEEKS.

Every night, we'd put him down at 9pm, swaddled in his crib (as we did prior to the regression). And every night, around 11pm, he'd wake up screaming. We'd soothe him, put him back in crib and he'd start wailing again. We'd eventually put him back in his Rock 'N Play. But even there, he'd only sleep for 1-2 hours before waking up crying again. He was waking up after every sleep cycle (45-50 minutes) some nights. He slept better as a newborn. I usually ended up nursing him because I knew it would get him back to sleep (ignoring the fact that I was introducing another sleep association.)

It got to the point where I was so ridden with anxiety. I'd go to bed anxious and fearful every night because I didn't know how long I would get to sleep, or how many times I'd have to wake up. When I heard Liam on the monitor, my heart would start pounding, and I'd just hold my breath, hoping he would go back to sleep.

Not every night was terrible. But I'd say on average, for those 4 weeks, Liam was waking up about an average of 6 times each night. Now, I know that many babies out there wake up this often and more, even babies older than Liam. But you have to understand - our little man was sleeping 9pm-5am, eating, and going back to sleep until 7:30am. I realize now we were lucky!

Being that I - we - were desperate for sleep, I spent hours on end researching the topic of sleep. Have you ever read that article by the mom who read every sleep book, and she basically concludes that all of the advice contradicts each other? That was me.  Every day I came home with a new solution. I bought memberships to sleep sites. I scheduled consultations with sleep experts. I bought gimmicky items guaranteed to make my baby sleep better. I bought e-books.

I. Was. Crazy. At one point, I seriously considered if this obsession with sleep was post-partum depression manifesting itself in a new way.

One night I'd be ready to have him Cry It Out, the next night I thought better of it. Next night let's try no swaddle, now let's try one arm out of the swaddle, fuck it let's go back to full swaddle. He's not getting a paci tonight, he's only getting a paci when he wakes up, but not when he falls asleep. Today we'll try schedule A, and next we'll go to schedule B. Tonight it's the sleep suit, tomorrow it's the Zippadee Dee sack. The problem is this, not actually it's that, so we have to do this...this was my brain for 4 weeks! It was maddening.

As a confused, sleep-deprived, new parent, I desperately needed explanations for Liam's behavior. I wouldn't even consider the possibility that his "behavior" was because Liam is just a little baby! I wanted to find an answer, a solution, an easy fix that would not only help us all sleep better. But also because as a parent, I just wanted understand what the hell was going on. I can see now that it was because, on some level, I believed that with understanding comes control. "If I know what it is, I can do something about it."

But trying too hard to understand can backfire, too. I got mad at my husband because on his night to get up with Liam, I felt he was neglecting Liam by letting him cry, and told him, "That's not what we agreed to." He explained he had no idea what we "agreed to" because my plan of attack was different every day.

So that was it. I needed to turn off the faucet of information. I needed to stop Googling. Stop buying e-books. Stop requesting sleep consultations. We needed to take what we knew about OUR son, about OUR family, about OUR beliefs, OUR goals for sleeping, and come up with a plan.

The one thing we knew for a fact, despite all of the conflicting information out there, was that the answer to getting through the sleep regression successfully was teaching Liam how to self-soothe in order to get himself back to sleep. How we did that was the question.

In my next post, I'll share what finally worked for our family in getting Liam to start sleeping again!