Gentle Sleep Training, or Why Parent-Child Attachment is Bigger than I Thought

We are on our 3rd night of sleeping training tonight.  I never thought I would be one of those mamas who blogged about such topics.  As I explained in a previous post, we fall for the most part within the camp of attachment parenting, in which sleep training is considered somewhat anathema.  Before little Bean was born, I pictured myself rocking and nursing her off to sleep cozily each night, with the intervals between waking/nursing sessions gradually and comfortably growing longer as her feeding and sleeping cycles matured.  With many babies, this is definitely the case, and those mothers probably think I'm crazy and hard-hearted.  I would have thought so of myself not too long ago. This is one of the many areas where motherhood is humbling me.

This last week, things came to a head. For the last few months, nursing has no longer been a reliable tool to get Bean to sleep.  We've resorted to doing all naps in the baby carrier, which is handy when traveling but inconvenient during a normal day at home, especially if you would like to lie down and rest yourself.  At night, Bean goes to bed at all hours and wakes up at all hours.  And as much as I have loved cuddling with her at night, I think I am ready for co-sleeping to come to an end.  She is very cuddly, but also very much of a bed hog.  Additionally, she sometimes rolls off the bed (don't worry, the mattress is on the floor) and finds herself in strange places of the room.  We've been dealing with culture shock for the last 6 months as we simultaneously try to handle sleep deprivation.  We are grumpy, our marital communication and soul care are going down the drain, and it is simply not sustainable. 

I decided to do sleep training at 3:00 am one morning last weekend, in the city of Athens where we are taking a vacation.  Anyone who knows about sleep training will tell you not to do it while traveling, and I would generally agree with them.  But that night, I knew it couldn't wait.  I was walking around the living room for 2 1/2 hours with Bean in a baby carrier, since she had already nursed approximately 1,0001 times that night and couldn't stay asleep for (it seemed) more than 5 minutes. She couldn't even sleep in the carrier, and she was miserable.  For the first time, I realized deep down that learning to sleep well in a bed was actually a gift to her as much as it was a break for me.  She needed it, too.

While the No-Cry Sleep Solution is a fabulous book on gentle sleep shaping that I would recommend as a sleep tool for all new parents, its strategies have not worked for us.  We needed something more direct.  My plan for the last couple months has been to use Dr. Jay Gordon's gentle method of night weaning at the age of 12 months, before I move her to her own sleeping space.  However, rather than do night weaning  in the family bed (his recommendation) we decided this week to bite the bullet and do night weaning now at 10 1/2 months, and at the same time that we transitioned her to a pack n' play.  We made this decision out of our knowledge of her, and our knowledge of our own limits.  Refusing her milk in the big bed, in our experience, results in a wrestling contest with her jumping on me, crawling around the bed and ramming her head into my chest.  We knew that she would vehemently resist both of these changes (no milk, no family bed), and it just seemed kinder on all of us to do them at the same time, like pulling off a band-aid.  Within minutes, I bought "Good Night, Sleep Tight" on Amazon Kindle, and we were in action the next night.

The method we chose does involve some crying, but it never leaves the child to cry by themselves.  I don't think I would have had the heart to do it any earlier than now, since hearing my baby cry does something terrible to my insides.  But the purpose of this approach is to help your baby accept your soothing touch from the sides of their bed, as you gradually fade away your involvement over the course of a couple weeks.  Even though they are mad, they know that you are there.

Can I make a confession?  In my deepest of hearts, I didn't think (still kinda don't think) that sleep training will work with our baby.  I have often had visions of her, 18 years old and going off to college, still waking up 8-10 times at night.  We have tried alternatives to co-sleeping or night nursing before, but only for short periods of time.  They have always resulted in me saying "It's not worth it; I'll nurse her".   Plus, part of me really mourns this transition; it's taken until now for me to really feel that this is the best thing for our family.  It probably took this crisis point to make me accept that... plus the realization that she is old enough now to handle some frustration without damaging her trust in me.  I will miss those sweet baby cuddles, but I will get my fill of them during the day.

Here is what happened our first night (Monday the 15th):

6:15pm After a bedtime routine (dinner, change diaper and PJ's, book, song, nurse, lights off with white noise), I said "Good Night!" and put the Bean in the pack n' play.  We started early so she wouldn't be overtired, especially since naps had been terrible that day as usual.  At first, she played for a few minutes, then made a noise as if to say "OK, I'm done; get me out of here".  When she realized I wasn't getting her out, she quickly became furious.  For 45 minutes she screamed at me while I patted her head, gave her a blanket and told her it would be okay.  It was terrible.  I questioned my sanity and ethics as a mother; I wondered whether I really wanted this to turn into a contest of wills.  She wailed and reached for me, signing "milk".  As an SLP I was amused but distraught; she hadn't used that sign consistently since she was 7 months old- pulling it out now, really??!? Finally, since she was hysterical, I picked her up to calm her before setting her back down.  She took a minute to calm but started over again as I lay her back down, at which point I quickly offered her (for the 10th time) her sippy cup of water.  She gulped it and passed out at about 7pm, hugging her cup like a teddy bear.  The night had only just begun.

9pm I gave Bean a dreamfeed to make myself feel a little better about denying milk the rest of the night, then went to bed on the couch while Kevin took the first shift of the night in the bedroom.

11:15 pm I woke up to hear horrible screaming from the other room.  It went on and on, stopping occasionally for 15 minutes or so before starting again, for TWO WHOLE HOURS.  This is a parent's nightmare.  I did expect such behavior from my persistent daughter, but...I couldn't help thinking... what if she keeps going like this all week?  I was supposed to be sleeping but instead started internet researching the limits of crying during sleep training, whether this was normal or whether we should call it quits. I was a mess.  This research, which came out this year, did make me feel a little better.  While the researchers don't recommend unlimited, unattended cry-it-out, they do demonstrate that children receiving sleep training with our method  (called "camping out" in the child's room) or with Ferber's system of periodic checks, show no psychological difference in the long-term to children who have not had sleep training.

2:30am My shift started, right as Bean woke again.  I hugged Kevin as we passed in the hall, hanging on for dear life.  He whispered, "She really does go back to sleep".  I went in and my baby was reaching and wailing for me.  I put on an extra T-shirt so I wouldn't accidentally nurse her in my oblivious exhaustion.  I picked her up for a big hug and whispered "I love you very much", then put her back in her bed.  She cried for only about 5 minutes more before collapsing and going to sleep.

2:30-6am A haze of wake-ups, me patting her and saying "It's okay", and her going back to sleep for brief periods before waking again, usually right as I was drifting off.  I start to think that this will never end.  I get so tired that all I can do is mumble at her words that I hope are comforting.  My bed is level with hers, so she pushes toward me through the mesh walls of the pack n' play, bleating feebly.  I feel guilty.  At about 4:30 onward she seems thirsty and gulps water from a cup.  I, on the other hand, am so full of milk that I worry about mastitis and go to pump in the living room, trying not to wake Kevin up.  By six am she is waking every 5 minutes, so I decide that it is time to be morning! I wait until she is sleeping, then turn on the light and announce "Good Morning!"

All day long, I am shot since I only had one or two hours (max) of sleep.  But baby Bean is her happy self, and doesn't seem clingy (Oh good- at least she's not visibly emotionally damaged).  We are doing a lot of baby wearing on this trip, so she gets lots of cuddles during the day as we explore historical sites.

On the second night, I go through the bedtime routine and place Bean in her crib, steeling myself for the worst.  She gives me a mad cry for less than a minute, then rolls over and goes to sleep.  Is it really that easy?  That night she wakes up a handful of times for Kevin and another handful during my shift, and each time goes back to sleep quickly as we pat the bed and say "It's okay baby, lie down and sleep".  By 5 am I think she's ready for the day (okay, so I realize later that was a mistake) but for the most part, night #2 was surprisingly un-traumatic.  The dramatic difference with the first night is overwhelming. 

As we head into night #3 (tonight), I am very hopeful.  I just emerged from Bean's room, where I placed her in the crib and watched her roll over and settle without a single protest.  She took about 15 minutes to drop off to sleep, since she had taken a late nap during the day.  A week ago, if this had happened, she would have been bouncing around despite my attempts to nurse her to sleep.  Now that she is learning to settle on her own, I feel like the world is opening up to me.  Let's pray that this starts to result in longer stretches of sleep, reasonable wake-up times, and naps... there's a lot of work ahead, but this is a huge step for us.

A few days ago I stumbled across this post on another mommy's blog, where she shares about her process of guilt doing sleep training as an attachment parenting mom.  I really appreciate her wisdom (thank you, anonymous mother of Finn).  I have truly felt that co-sleeping helped my daughter's attachment to me, but parent-child attachment is so much more than co-sleeping.  After all these months, I don't feel bad that Bean will be sleeping within arm's reach of me (we're not quite ready to put her in her own room) while I get to cuddle again with my husband. 

I am realizing that in my zeal to be a responsive, loving mother, I bought too much into categorical answers and definitions in my brain ("Attachment parents don't sleep train".  "Letting your baby cry at bedtime is damaging", etc.)  instead of truly looking at MY daughter and what her needs are at different developmental stages.  When she was a newborn, she was exceptionally fussy, reflux-y, and difficult to soothe (my own mother, who has three children, described her later as crying more than any baby she had ever seen).  I feel she really needed us nearby during those first few months.  But now she is blossoming into an incredible, confident, loving little girl.  Attachment to us is very important, but it's time for her to step out a little more on her own in the area of sleep, just around the time that she is getting ready to take those first physical steps in the world. 

Snot suckers and chicken soup

It’s 7:15 am, and I am awake by myself once again.  For the last few days, the Bean and I have been sick.    It started, as far as I can tell, from a low-grade baby ear infection that caused us all to lose some sleep.  I started sniffling- the beginnings of a cold.  Before I knew it, things had spun out of control with alarm clocks beeping at all hours for antibiotic drops and nasal spray, me nodding off in language class every morning, head congestion that wouldn’t let me rest, a snotty baby that woke me up every time I started drifting off, and way too much infant ibuprofen and Tylenol being spouted all over the place. 

Last night at 3 am, as the Bean snorted and cried, the Daddy and I finally remembered to pull out THE SNOT-SUCKER!  Why did we not think of it before?  The highly-reviewed, albeit somewhat gross, nasal aspirator given to us by my new sister-in-law.  Within a few minutes, the Bean was protesting wildly as we put a plastic tube in her nose and pulled out all her yucky boogies.  It took some time to settle after that, but she has slept better than she has all week.  And, much to my surprise, she went to sleep without much need for nursing- she just wanted to be snuggled close.   

My body, on the other hand, took the opportunity available for a good solid chunk of sleep and decided to present me, for the rest of the night, with a persistent hacking cough and multiple trips to the restroom.  It seems that either I or the Bean gets to sleep.  You can’t win them all.

I read this article online this morning, while I was very much awake and wondering how many years have been removed from my life expectancy in the last ten months.  Apparently, the 8 hour sleep gold-standard is somewhat of a myth, in that it’s more important to get pockets of quality sleep throughout the day than it is to get a long, unbroken chunk.  This is good news to me; naps are not just a cheap substitute for night sleep.  Add to this, the research` that co-sleeping moms do wake more frequently but also get better quality sleep overall than those whose babies sleep in separate rooms.  

I am feeling better about my life this morning as I drink my tea. My plan today is a pediatrician visit, lots of rehydration for me and baby, and a drop in to our kind neighbor who sent her grandson over with a boiling hot pot of chicken soup the other day.  But mostly importantly, even more important than that lacto-fermented salsa I’ve been waiting to make?  I am getting a nap!

The Land of Nod, that Once I Knew

It’s 5:15 am, and I can hear the call to prayer echoing outside my windows, a block down the street.  It has become the rhythm of my daily life, the markers of my day and the lullaby to which my baby falls asleep every night.

Sleep.  The reason I am awake at 5:15 a.m. is because my daughter is not a big fan of sleep.  I have been up since approximately 2 a.m.  At that time I was far too groggy to look at a clock.  Now, I am far too awake, after 2 ½ hours of cycling between being climbed on by a giggling baby, nursing a cranky one, crying, and whispering back and forth with my husband as we devise useless strategies to convince the Bean that it is the middle of the night.  On her own, at 4:30 am, she drifted off and I came out to the living room to enjoy some peaceful snacking and reading in the eerie silence of the early morning.

At almost ten months, the Bean still wakes numerous times at night and usually accepts only nursing when she wakes.  We have tried having her in our bed and beside our bed.  We have tried walking, bottle feeding, bouncing, wearing in the carrier, singing.  We have put on white noise, tried to establish a bedtime routine, provided her with a lovey.  Yet it would seem that Bean hasn’t read any of the books on baby sleep.  At hours that all decent people are blissfully snoozing, she is up eating or practicing her dance moves while sitting on mommy’s head.  It makes it rather hard to feel rested, frankly.  

I think I have become an expert in baby sleep strategies, in the sense that I have read numerous articles and a few books on the matter.  I could tell you about the spectrum of approaches, ranging from the hard-core cry-it-out (CIO) methods by extinction—in which baby is put in a room and the door is kept shut until morning—to “attachment parenting” methods, in which wakeful babies are seen as a developmentally normal phenomenon and their needs are attended to by both parents, usually in the same room and often the same bed.  I could tell you about the options in-between, such as Ferber’s “graduated extinction” approach (parents coming in to soothe at gradually increasing intervals) or attended CIO methods, made popular by the book “Good Night Sleep Tight”, in which parents sit next to their babies while they cry and move their chair slowly toward the door and out of the room over the course of time.

Before we actually had a living, breathing baby, I would have told you that I was absolutely horrified at the thought of cry-it-out methods that leave baby alone.  As a speech pathologist I really value early communication, and crying is the earliest form of it.  I would have said that were most definitely in the attachment parenting camp but that we were not averse to letting our baby cry sometimes as long as we were there by her side.  As Dr. Sears puts it in “The Baby Sleep Book”, would you toilet train your child by locking them in the bathroom until they figure out how to use the toilet?  Babies are biologically primed to be wakeful because they need to eat and be close to their mothers, and their lighter sleeping patterns are a protective mechanism against SIDS.  (See resources below)

At almost ten months in, I completely understand why people let their babies cry-it-out.  Sleep deprivation is terrible.  It turns normally sane people into a cranky, non-functional mess.  Add to the sleep deprivation a host of other factors we’ve faced this first year—an international move with accompanying jet lag, setting up a new home, learning a new language- and it’s not a pretty picture.   

Let me tell a few things about our daughter.  I am rather impressed and awestruck by her resistance to sleep.  

Here is the approximate timeline of our sleep journey:

Up until 4-6 weeks old: The Bean, like every newborn, slept constantly.  We were setting an alarm to wake us all up for feedings.  We spoke highly of her amazing ability to sleep.  We spoke too soon.

6 weeks to 2 months old:  She was diagnosed and had surgery for a tongue tie, explaining why nursing had been living heck, and why she felt the need to eat c-o-n-s-t-a-n-t-l-y.  Around this age, she began fighting any and every attempt to convince her to take naps or to sleep at night.  While other newborns were snoozing peacefully in their car seats or strollers, we were walking/feeding/babywearing/snuggling/screaming for up to an hour or more for every nap.  She did love breastfeeding, and I still obsessively fed her at every opportunity because I worried about her weight gain.  I bought the book “No Cry Sleep Solution” to try to help us all, and started un-latching her at the end of nursing sessions before she was completely asleep.

3-4 months old: Screaming from sun-up to sundown, and several night wakings with screaming, too.  I started a serious elimination diet, and finally found out that eggs in my diet were causing the reflux.  I also started having low milk supply from the previous tongue tie, and added in multiple pumping sessions to my day.  The three month growth spurt hit, and the Bean continued the frequent small feedings necessitated by reflux and habituated from tongue tie.  She wanted to spend all night latched on to me nursing in bed.  I cried and complained and shouted at her and Kevin; he attempted to soothe her in my place, but she wouldn’t take anything else.  She also began refusing to let her dad put her down for naps, maybe because of the extra need for milk from the growth spurt.  She did take nice, long, regular naps after I nursed her down.

4 months: We moved overseas.  For a month, I was a walking zombie- doing Arabic language lessons in the morning, and up all night long with a hungry, jet-lagged baby.  Naps went hay-wire again.  My milk supply probably did, too.  After agonizing a little bit and looking at the research, we experimented for a couple weeks putting her to sleep on her stomach.  Nothing doing.

5 months: We tried having Kevin take over some of the night feedings, but I couldn’t keep up with the pumping.  Sometimes, she cried even with the bottle.  After one night where she hard-screamed for an hour with dad, I nursed her back to sleep and we gave up that plan.  

6 months: Bean started learning how to roll over and go to sleep on her own a little better after nursing. I tried putting her in a pack-n-play by the bed at night, but I missed having her in our bed and she didn’t wake any less.  I was pulling her into bed to nurse and then putting her back in the pack-n-play again afterwards.  How do other moms have the energy for this?  I was worried about dropping her in my exhaustion!  Enough of that.

7 months: Visited the States for my brother’s wedding, traveling alone with the Bean.  More jet-lag.  Not the time to try anything new with sleep.

8 months: She was still swaddled.  With great effort, and several nights where we thought she would never fall asleep, we weaned her off the swaddle.  Naps started going even more hay-wire, and bedtime started varying widely.  I would nurse her with her white noise and lovey in a dark room, and she would pop up like a jack-in-the-box to practice her new-found motor skills.

9 months: Naps all over the place.  Sometimes one, sometimes two—at all hours of the day.  I gave up trying to do a bedtime routine because I never knew when she was actually going to fall asleep.  Finally sleeping a little better at night once she went down (up 3-4 times to cuddle and briefly nurse, then back to sleep… with co-sleeping this was not too difficult).

9.5 months: Waking up all night again.  The Bean got an ear infection along with teething.  As new developmental milestones loomed, she started implementing an exercise work-out routine in the bed from around 2-5 a.m. with my body and head as an exercise mat.  She was (and is) going through a big separation anxiety stage and wants mom all the time, day and night.  She still seemed hungry a few times per night but also nursed frequently for comfort.  I have noticed she is able to self-soothe sometimes upon waking, if tired enough.  One night, I attempted a night weaning session where I held her in my arms for half an hour…an hour… an hour and a half…while she cried in my arms and I finally gave up and nursed her back down.  

However, I have a confession to make.  Despite all of this, I kind of love our co-sleeping, attachment-parenting style.  I think it suits her high-needs temperament, and it suits us.  Sleeping next to the Bean for so many months, and nursing her on demand, I feel that I know her really well by now.  I know what all of her wiggles and sighs mean, when she is likely to re-settle and when she is going to cry out for me.  I know when she is really hungry and when she just wants to be close.  I love the little sigh of relief that she gives when I am nearby and she knows she is about to get milk.  I hate the desperate cry she gives when it is withheld.  I know that she longs for mommy in this stage of her life.  I know that she is an active, inquisitive little one who has a hard time settling and organizing herself to sleep without a lot of help.  I know that she has a history of needing milk frequently, and that she and I have a long-standing habit of going to breastfeeding first to solve all problems.  I know that there have been a lot of transitions in her first year of life, and that we provide the consistency that keeps her feeling safe.  I love smelling her nearby and hearing her breathing, monitoring her from inches away in the bed.  When I put her in the pack-n-play, I lean over constantly to check on her because I am so used to having her near.  One of my favorite experiences of the day is to hold her close, as her sucking slows and her breathing becomes deep in the entry to sleep.

As an added bonus, nursing so frequently will probably keep me from getting pregnant again anytime soon.  And that, considering our current situation, is a very welcome relief.

I have learned a whole lot in the last ten months about sacrificial love.  I hope I’ve also instilled trust in my daughter that I will always be there for her when she needs me, to the best of my ability, her whole life long.  As she grows into the ability to separate a little more from me, I trust that she will do so with security because of the precious foundation we’ve built this first year.  As we eventually transition her away from nursing and co-sleeping, I feel that I will know her well enough to know when she is truly ready.  I can already see her beginning to blossom into a little girl of warmth and vitality, and I know that each cuddle has not been in vain.

Despite my tiredness, I know that in the long scheme of things, this stage of life is short-lived.  So, our coping strategy for now is for my husband to take the Bean for an hour or so every morning while I get some extra sleep.  If I am lucky enough to get her to take an afternoon nap, the Bean and I sleep together when I get home from language class.  I try to go to bed early at night.  In a couple months, after she turns a year old and her diet expands even more, I am planning to re-try night weaning.   

Until then, cleaning the house may just have to wait.

Some resources I have found helpful on baby sleep and night nursing:

Books:

“The Baby Book” and “The Baby Sleep Book” by Dr. Sears

“The No-Cry Sleep Solution” by Elizabeth Pantley

Information on night nursing and its relation to breastfeeding:

http://www.askdrsears.com/topics/feeding-infants-toddlers/10-tips-night-feedings

http://kellymom.com/parenting/nighttime/weaning-night/

Benefits to co-sleeping:

http://www.attachmentparenting.org/support/articles/artbenefitscosleep.php

http://www.askdrsears.com/topics/sleep-problems/scientific-benefits-co-sleeping

http://www.phdinparenting.com/2009/01/09/cosleeping-benefits/#.UGquMIGqgRE

http://naturalparentsnetwork.com/five-benefits-cosleeping/

http://img2.timg.co.il/forums/1_147673444.pdf

The case against Cry-It-Out (CIO) sleep training methods

http://www.ahaparenting.com/ages-stages/newborns/case-against-ferber-sleep

Steps towards joy

Six months ago, our family moved to the Middle East, lending a new meaning to the word “trekker” for me.

Noun: trekker  tre-ku(r)

1. A traveller who makes a long arduous journey (as hiking through mountainous country)

Parenting the Bean has been a journey.  Maybe in retrospect, many years down the line, it won’t seem as arduous as it has in the last ten months.  But long, arduous journeys are often the most rewarding.  Dr. Jay Gordon, one of my attachment-parenting gurus, wrote that parenting a baby is like opening your own flower shop.  For the first year, you are waking up early to go to the market, working long hours during the day, and worrying at night.  Maybe other people in your life think you are crazy for putting in this investment, but by the end of the first year you have a beautiful pay-off.  

http://drjaygordon.com/attachment/flowershop.html

I hope his words are true, because these first ten months have been quite a trek.

Now that we are learning a new language and starting again in a new culture, we are truly a Trekker family in yet another way.  The road to learning Arabic is long; some say that from English to Arabic mastery takes at least eight years.  The definition of language “fluency” is particularly slippery, but even so, it’s quite a complex language and cultural scene. Actually, to be honest though, my more recent concerns have been far more mundane.

Yesterday’s checklist:

•  Function on little sleep. 
• Stay AWAKE during language class. 
• Find time for language review while mashing up chicken liver for a hungry Bean. 
• Remember to communicate nicely with my husband  (or to apologize when I don’t)
• Make a grocery list, and try to find out where to buy the things on my list
• Look at the dishes in the sink and think about doing them
• Remember to keep in communication with Jesus, the One who I have a crazy-enough love for that I would follow him here, to this beautiful, unknown-to-me land where all that was familiar is no longer in view.  Find snatches of time to receive his grace when I am fighting a cold, dealing with a teething baby, and generally feel overwhelmed by life.

The journey starts small, with the little things.  Trekking is an act of discipline, of focus on the destination.  Both with parenting and language/cultural adjustment, we have to believe, like Jesus, that the joy set before us is worth it.  

Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us,  fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross, scorning its shame, and sat down at the right hand of the throne of God.  Consider him who endured such opposition from sinners, so that you will not grow weary and lose heart. (Hebrews 12:1-3)

In the meantime, my next steps are to catch a nap and clean up those dishes.