Monday, November 24, 2014

Sleeping training and schedules with a breastfed baby

The words "sleep training" are all a frazzled mother needs to hear to bring on a case of night terrors. We all want our babies to sleep peacefully through the night like little adults, but we don't want to teach them. Much like toilet training - we wish they would just finally use the bathroom like big kids, but who wants to mop up the accidents? Yet, we've all got to do it one way or another, unless you give birth to an angel who sleeps through the night since being a newborn.

First I must mention a few key points:
  • Maybe the most obvious one, every baby is different. The sleep tactics that work for your friend's baby may not work as well for your baby. And formula-fed infants may sleep differently than your breastfed baby.
  • A sleep problem is only a problem if it's a problem for you. Your baby is fine and is probably getting enough sleep the way he/she is. You only need to sleep train if it bothers you.
  • Babies who sleep through the night from day one - sounds like a dream, doesn't it? Well, if you are a full-time working mom and need to pump more than once a day, you probably want your baby to nurse at night to maintain a good milk supply. Which brings me to my next point:
  • Nighttime breastfeeding is SO good for your milk supply. This is because the level of milk-producing hormone prolactin is much higher at night and you want to take advantage of that.
  • What I found - and this is by no means a scientific, proven theory - is that mothers whose babies sleep through the night very early on stop breastfreeding earlier than mothers whose babies nurse throughout the night. That's just what I noticed among friends and family.
  • If you want to sleep train, you and your spouse have to be 100% committed to doing it right. You can't chicken out mid-way. If you don't feel ready, wait. 
  • The term "sleeping through the night" (or STTN) has a wide definition. It can mean anywhere from 5-7 hours in a shot, to sleeping 12 hours straight. So take it with a grain of salt.
  • Sleep training technically shouldn't be tried until a baby is four months old. However, that's precisely the time their sleep becomes all wacky anyway, so I wouldn't bother until about 6-7 months. Also that's when babies are distracted by daytime feedings, so they cash in on the calories they could get in the peace of night. Don't deprive them!
  • Normal napping ensures good night sleep. If don't let your baby nap, thinking they'll be "good and tired at night" you'r just setting yourself up for an overtired baby.
  • Follow established sleeping guidelines to know approximately how much sleep your baby needs at night. For example, a one year old shouldn't really be sleeping from 11pm to 8am and having random naps (though this schedule works great for a much younger baby!). 
There are basically two schools of thought regarding sleep training: (1) methods that involve letting a baby cry it out (CIO), or (2) gentle, no-crying sleep solutions. The first has been popularized by Richard Ferber, the second by Elizabeth Pantley. It's really up to you to decide which to use. The first is much, much quicker, but it can be pretty heartbreaking to let your baby cry when you know that a quick feeding will heal all. It's almost always effective and working after a 3-5 days. The second method is long drawn-out process that involves keeping sleeping logs and gently getting your child to sleep through the night, and it can take several weeks to months to achieve STTN.

I'll admit, I bought Elizabeth Pantley's book and found it really enjoyable, as a book. I learned a lot about baby's sleep habits and things like that, but I did not find the ideas implementable. For one, I work so I'm not with Sam all day and can't keep track of all his naps and stuff. Besides, the book kind of relied on the fact that the reader's baby is having normal, long naps each day. Sam took 3-4 smaller naps each day at that point.

Also, I have to say that I don't mind a little seemingly harsh training if the results are effective and if they would help both Sam and I sleep better. So I looked into Ferber's theory and found it pretty simple. I would have to let Sam cry for small increments of time before going in to calm him down and increase those amounts each time.

At the time of training, Sam was about 8 months old. Each night, I would nurse him before bed and then put him (awake) into his crib. He would cry a few minutes later. I'd go in and reassure him. Come out. Cry. Go back in. Usually I'd just rub his back till he fell asleep. Eventually he fell asleep. He'd wake up 2 hours later or less, and I knew he wasn't hungry since he just ate, but I still fed him. He wouldn't even nurse for that long (proof that he wasn't really that hungry). I know some of you might argue that he needed the comfort and all that, and maybe that's true. But he definitely got comfort from all the other breastfeeding times that he didn't absolutely require it every two-three hours at night.

After so many nights of broken up, choppy sleep, I decided we had to train him and we'd do it gently. No cold turkey for me. So I decided to go with reasonable chunks of time, which was 4 hours. If Sam woke up before 4 hours since his last feed I'd let him first cry for a minute or two to see if he actually needed me or would go back to sleep on his own. If his crying persisted, I'd go in after five minutes and then pat him and reassure him and help him find his pacifier. I walked out. If he went back to crying, I'd wait 7 minutes before going back in. Then 15 minutes. I never had to go back in more than 3 times. By the fourth night, he fell asleep for the night on his own without crying. And if it was four hours or more since his last feed, I'd just nurse him back to sleep like I've always done.

You know what? When he put himself to sleep he slept much, much better! He would sleep for longer chunks of time. We used this method to eliminate the 2-3 AM feeding which I really felt was unnecessary since he ate a lot at the 11-12 feeding (right before I went to bed).

So if you're feeling brave and or if you've had it with the incessant feedings and comforting in the middle of the night, try this. You have nothing to lose. Just give it your all. This won't work if your husband feels bad and will sneak into baby while you're chewing your nails in the other room during a crying bout. Both of you should follow the plan you create (e.g. creating a time limit, such as four hours, and using Ferber's method for when your baby wakes up earlier than that).

A baby who sleeps well at night wakes up HAPPY.

Let me know what works for you and what doesn't!

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