woensdag 16 maart 2016

Successful sleep training: how we changed my baby's bad sleep habit

For the past six months, I had been suffering from anger, frustration and mild depression. I didn't feel like a mother but more like a slave as I accompanied my baby for his sleep 24/7. Every nap or sleep took about 1,5 hours before he fell asleep and then he slept lightly, waking up easily. I would lie next to him in our bed, putting pacifier in his mouth every 2 minutes and waiting for him to close his eyes. Despite my great effort, he slept only 11-12 hours on average and was still rubbing his eyes when he was awake. As a result, I didn't quite enjoy being a mother and lamented the lack of joy and freedom in my current life. My baby was tired all day long (and so was I) and he cried more than 5 hours a day. Of course there were better days, but towards the end of the 5th month the situation has worsened. He seemed to have stomach ache constantly and we landed in a vicious circle of bad sleep and no play. As the main caretaker of my baby and his milk dispenser, I couldn't take a break or regain my strength. Worrying about his well being and mine, I also lost my sense of balance. It was time to reach for help...I could not do this any longer.

Many experts came, a physiotherapist, a childcare nurse from the children's bureau, and a speech therapist. I was also referred to a pediatrician in the hospital, to who I complained about the frequent tummy ache and more than 7 times breastfeeding per day. The pediatrician immediately decided that the baby should stay in the hospital for close observation on the same day. This decision took me by surprise, as it implied that we'd have to stay overnight in the hospital for several days. I wanted a medical examination of his bowel system or allergy tests but they refused to do that. The pediatrician said that most colic babies' sleep problems are caused by behavior rather than illnesses. Thus they would observe his behavior before taking any further action. Reluctantly, I agreed to staying in the hospital. Turns out, it was the best decision ever.

The reason why I was reluctant to staying in the hospital was because of the hospital's method of solving the sleep problems. They used the Ferber cry-it-out method and strict day schedules. These principles were counter to my belief that we should not let babies cry as doing so could be psychologically and emotionally damaging. Babies cry as a means to communicate with adults. I had been applying Dr. Sears' attachment parenting with co-sleeping and plenty of affection. Also, I didn't feed on schedule but on demand. The doctor gave us the following day schedule:

6-7am breastfeeding --> playing together/cuddles---> playing alone (in the box)
9-10am fruit --> playing together/cuddles---> playing alone (on the floor)
12-1pm breastfeeding --> playing together/cuddles---> playing alone
14:30pm snack (porridge/bread crush/rice waffle) --> playing together/cuddles---> playing alone
17-18pm dinner --> playing together/cuddles---> playing alone--> bathing or other bed rituals-->breast milk as dessert --> bedtime
22-23pm top-up breastfeeding when waking up

The key was to observe the baby closely and to put him in bed when he shows tiredness signals. It was confusing for me because my baby sometimes shows tired signals not long (an hour orso) after he woke up from a nap but he was apparently not tired enough to sleep again. He did 2 naps in the day and refused to take a third nap, even though he was very tired and cranky in the late afternoon.
So when he was tired enough, I put him down in bed, said "time to sleep. Mama will be back when you wake up" + pats and pacifier, and I went away.
Obviously the poor baby started crying as soon as I left. He wasn't used to sleep in his own bed, and alone. Next instruction given by the doctor was to let him cry for 7 minutes before going to soothe him. When he calmed down, I would leave the room and let him cry another 7 minutes. This went on for 3x 7 minutes and I would pick him up when he cried for another 7 minutes. When he cried 4x 7 minutes, I was supposed to pick him up and end the attempt to sleep. I would play with him until he showed tiredness signals again.
So the soothing ritual is the following:
  1. 3x 7 minutes crying; 4x 7 minutes crying during daytime. whining is not considered as crying
  2. patting and shshing every 7 minute without picking the baby up
  3. when the baby calms down or otherwise after 5 minutes, leave the room
  4. on the third attempt, pick the baby up, soothe him and put him back in bed
  5. after that, end the sleep moment and play until the baby shows tiredness.
On the first day in the hospital, my baby cried for more than 40 minutes before falling asleep. He woke up frequently during the night. I wasn't allowed to be with him. We also used this opportunity to wean off night feeding. Two birds one stone! I went home and my mom stayed overnight in the hospital. The next day, he wasn't all too happy to see me when I showed up in the morning. At that time I thought that he must be angry that I let him cry alone all night ("oh no, is he emotionally damaged now?")
On the second day, he cried less (3 times) during the night and didn't eat until the next morning. He was happy to see me in the morning and seemed well rested!
On the third/fourth day, he cried 2 times during the night and slept for long stretches. He also cried less than 30 minutes for nap times.
The nurses told me they saw an improvement in his behavior and that he often talked to himself in the early morning around 5. Later on I found out what they considered as talking was more like asking for a change of diaper ("eek, mama, please get rid of this big poopoo in my diaper").
Since he was in the hospital, he has been consistently sleeping on his tummy. I believe this change in sleep position plays an important role in the success of the sleep training. He probably sleeps more soundly on his tummy. Until now he wasn't able to because he couldn't roll to his tummy until recently. Also because of fear of SIDS, we didn't allow him to sleep on his tummy before. He also has formed the habit of pooping in the early morning (5-6:30am?). Sometimes he wakes up in the night and cries when he can't poop.
Furthermore, it remained tricky to get the timing of putting him to bed right. Sometimes my baby showed tired signals but cried his balls out if I put him to bed accordingly. And if he went to bed too late, he would be overtired and therefore had a hard time falling asleep.One evening in the hospital, something went wrong with the dinner, and we had to wait 1,5 hours for his solid foods to arrive. In the end he was awake for more than 5 hours and was too furious to fall asleep. The nurses couldn't calm him down and told me to take him out for a short walk before trying to get him to sleep again.

I could not believe this strictly scheduled cry-it-out sleep method worked!!! It wouldn't have succeeded had I been doing the crying-it-out method at home. My husband and I are both softies and can't stand the crying of our baby for too long. And I would still be feeding him 2x at night, simply out of habit. after staying 4 days in the hospital, he no longer eats during the night and is able to sleep for more than 5 hours!!!! It was like a miracle to me. I could sleep longer than 2 hours at night and finally had energy to play with him during the day. He no longer struggles and pushes at the breast (I guess the tummy ache came from over-frequent feeding). I don't think he is much happier than before, but he doesn't seem to have any visible psychological or emotional damage either. In any case, I am a much happier mommy. I feel like this is what being a mother should feel like, happy to play with my baby and also have time to do my own things. I imaginatively waved goodbye to the slave-me who walked around in pajama all day with heavy eye bags and who had to suppress hurting my baby all the time because of frustration.

The Ferber method seems to work for my baby, who probably is one of those babies who needs to cry himself to sleep. The isolation of baby from his mother in the hospital helped to wean off night feeding. This observation/sleep training at the hospital not only helped me to structure my baby's routine, it also showed that my baby has no serious medical problems. For other desperate mothers out there, please have a try of this method or ask for professionals to help you!!! Do not turn down a method even if it is opposite to what you believe. Try everything if you are really hopeless, haha. I'm so grateful that someone was there to take care of my baby and give me advice. My happy motherhood starts now...

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