Sleep Training- A Response

I have a good friend that is embroiled in sleep-training her little one. We had our fair share of sleep-training with both Henry and Silas (who were difficult in different ways) and I've managed to become somewhat of an expert on some different techniques for the grueling process. Lots of people don't agree with any version of sleep training but we do. JT and I believe that you're teaching a child how to sleep well for the rest of their lives. Tammy posted some sleep training questions and i thought i would use this post to provide my answers to them. For the record there are two sleep books i would absolutely read: The first is Weissbluth's Healthy Sleep Habits Happy Child and if you happen to have a non-colicky baby the book 12 Hours Sleep in 12 Weeks.

1. Do we set up our pre-training “bedtime” environment? Do we turn on white noise, let her turn on her crib aquarium, leave music playing, dim lights? Or is now the time to simplify our sleep “crutches”? (we left our set-up the same)

You need a routine for bedtime. It can be very simple. If you already have one continue to do it. If you want to inject one additional thing (i think the white noise would be great especially given question 7) but i wouldn't add any additional steps before you actually put her down to sleep.

2. What if she poops/pees?
I thought she had pooped one night so I changed her. It turned out to just be pee, but it probably was good to wake her up a smidge after the feeding anyway.

If she poops you need to change her. No worries if it's just a wet diaper. It's nice not to have to change her but if you do you do and it's not a deal breaker. Unless you have reason to suspect she's got a dirty diaper after you feed her, i would change her before you feed her so that she's already drowsy and ready to go back to sleep after you feed her.

3. What about naps? Do we do sleep training for her daytime naps? We can NEVER get her to take naps. Still completely unresolved.

If she's having a hard time with naps you will most likely want to sleep train her with naps as well. Speaking from personal experience, i would wait to work on naps until you've got the nighttime ironed out pretty well. Weissbluth offers sleep research to indicate that daytime and nighttime sleep are neurologically different. Therefore using sleep training techniques at night and not during the day isn't actually confusing. Based on some of the same research though, daytime sleep is more difficult to "train." Ideally you will be healthy and have some good nighttime sleep under your belt before you attempt nap training. You must read the Weissbluth book before you get started because you will have many questions about how to do this.

4. Does the method recommend that you go completely cold turkey with no feeding at night? Or do you ease into sleeping through the night?

I've actually not read Ferber's book so i can't attest to his method. Depending on the age of the child and if there are any weight gain issues i think it's a choice about what strategy works best regarding night-time feedings. My personal preference and what i think is easiest to implement is to follow the steps that are outlined in the 12 weeks book and that i shorthanded below to lengthen the times between nighttime feedings and then work on phasing them out all together.

5. How to extend the period of time between feedings? What if she falls sleep during these nighttime feedings?

The 12 hours sleep in 12 weeks book offers step by step guidance for how to lengthen the time between nighttime feedings and eventually work on phasing them out all together. First she tells you to keep a log for a few days of at what times she's eating now and for how long. Then you work on a two-pronged strategy to lengthen the time between the feedings and shorten the feedings until you've eliminated each one.

From your post i think she's eating twice a night roughly around 1 am and 4 am. You set those as your new goalposts and you never feed her earlier than that. If she wakes up earlier you use your toolbox (could be letting her cry, giving her a pacifier, patting her, etc.-- see the book for a complete discussion of different techniques), to get her to the goalposts you set. The idea is to always move the ball forward and not let them creep backwards. If she wakes up and eats at 1:30 am tomorrow that becomes your new goalpost. Basically the idea is if she did it once she can do it again.

You also note how long she's eating. If she eats for 15 minutes at each feeding you start there. Every few days you reduce the amount of time by 2-3 minutes. If at any point she eats for less than that (and doesn't wake up with some gentle prodding) that's your new "time limit." There's something i'm forgetting about the order with which you phase out the feedings. So you're just going to have to read the book!

6. Is it ok if they fall asleep while you’re nursing them, then you wake them back up when they’re in the crib?

Weissbluth argues that it's fine if they fall asleep while they're nursing. It's a normal response to a totally soothing and relaxing ritual. You don't have to undergo any shock treatments to fully wake them up while putting them in the crib. Just lay them down normally so if they wake up they wake up but you're not setting out to arouse them from their peaceful slumber.

7. Should we be “extra quiet” in the rest of the house? We live in a small 1 bedroom floor-thru apartment, and I know Sadie sleeps at daycare when there are toddlers screaming about. So, should we get her to sleep with our standard-noise-level, or do we just need to learn to turn our standard-noise-level down? (we put headphones on to watch tv and tip-toed around the house)

No, you shouldn't be extra quiet. I would recommend the white noise machine (or waves or any other kind of soothing sound machine) to give her some buffer but she needs to be used to sleeping with normal night noises. This will help in the long-run if you ever want her to be able to sleep if it's not perfectly quiet. This won't help if you want to have friends over, and it also won't help if she's at camp sharing bunkbeds and the crickets are too loud.

Finally-- in addition to telling you that you really need to read the books, i'm also going to suggest that you try moving Sadie's bedtime up by 15 minutes and see what happens. Especially if she's struggling with naps i have a feeling she's overtired which makes getting them to sleep that much harder. Reach Weissbluth and we'll talk some more.

Finally, finally from one parent that has gone through this to another: this is hard. It's hard because it's terrible to hear your baby cry, it's terrible to know that the situation before wasn't good and there's no going back, but to not be able to see clear to the other side. It's terrible because as you noted, all the crying and the not knowing and the wondering and the questions sets you on edge, and your partner on edge. Call for support when you need it, read some books so that you've got an expert weighing in with the advantages of a good sleeper, and take breaks from the sleep training. You can take turns walking around the block or running to the drugstore just to get some distance from the crying.


tammy said...

hi Tamra,
This is incredibly helpful and we have picked up both books (and promise to read them - well, some of them). We greatly appreciate all of your guidance and advice and will keep you posted on Sadie's progress.
Love and Hugs,
-Tammy (and Andrew and Sadie)

Anonymous said...

Hi Tamra, Wow, i never knew this was such a science. wish I had had this info when our boys were little,(I think). Anyway, thanks, it is very interesting.How young is this baby? Sheree/Oma