Tuesday, June 06, 2006

Sleep Training + Schedules - NPR Report on Pediatrics Study

I heard this report as I was driving home from work and of course listened with great interest. Sleep is a pet issue of mine. I know sleep training is as combustible as politics and religion topics wise. Everyone has an opinion about the cause of troubled sleep and you can't win either way. I've tried the "natural mothering - attachment parenting - co-sleeping" approach with Elliot and the "strict schedule" approach with Asher. Neither of my kids were great sleepers in their first 2 years.

I've known a few babies that have slept well alone since birth. I know it happens. But they're freaks of nature, robot babies. Even before I heard the results of the study I thought, it doesn't make a difference, it's just a fact that babies will wake up multiple times during the night and destroy your sanity and your life no matter what.

Ferber vs. Sears vs. Weissbluth
The Ferber way is totally crazy making. Everyone seemed to tell us this was the only way to go. Our pediatrician. Friends. Family. Short term pain for long term gain. We tried "crying it out" and couldn't handle it after two nights of crying, going in to pat him every 10 minutes (Elliot was 18 months at the time). We gave up. Then we were Sears / Panter "No cry sleep solution" subscribers for a while, but when that dragged on for nearly a year without significant levels improved sleep for any of us, we had to try extreme measures after Asher was born. The Weissbluth healthy sleep habits book which advocates early bedtimes really saved our lives. Downside is that everyone thinks you're a sleep nazi and you can't go out at night as a family anymore. "What?! Your kids go to bed at 6pm?" I got my life back. It was heaven. I didn't care. Now I've relaxed, but I actually think we should go back to earlier bedtimes (elliot goes down at 8 and asher at 7) because the night ritual seems to be taking longer lately.

Elliot had no schedule, he slept with us, nursed on demand and it was fine when he was really little, but after 2 years, it wasn't working for any of us. He wouldn't go to sleep without me, bedtime took 2 or 3 hours. If he woke up and I wasn't there he'd freak out. I was completely chained to him, I had to sleep with him to get him to go to sleep. I was so resentful after a while. Ever since we did the Weissbluth sleep training and early bed time with him at age 3 (6pm), he's been a great sleeper. The biggest thing I learned from sleep training is that if you're firm, in control and you expect them to sleep, that positive thinking goes a long way.

Asher actually has always been a great napper. He's been on a schedule since he was 7 weeks old. I still put him down at 1pm, leave and he's out (nearly 100% of the time). Before we addressed the recurrent ear infections, Asher slept through the night only a handful of times. Now that he's older and isn't dealing with ear infections, he's sleeping better but tends to complain about going to sleep ("I'm hungry"-- "I need water" -- "Medicine"). Then he wakes up at 2am or 3 or 4. We move him into our bed and he sleeps for the rest of the night. Still not perfect. We'll have to wean him out of our bed when we move back into our house.

New Advice for Sleep Deprived Parents
by Allison Aubrey
June 5, 2006

Research published Monday offers some of the first strong evidence-based advice on what approach is best at getting a baby to sleep through the night.

What some baby experts offer up in opinion and theory, psychologist Ian St. James-Roberts has put to the test. In his latest research, published Monday in the journal Pediatrics, he recruited three groups of moms-to-be.

The first group was made up of women in Europe and the United States who were aligned with a natural-mothering network: They held their newborns 15 to 16 hours per day, breast-fed on demand, and co-slept with their babies.

The second group, in London, was much more structured in its approach to baby care, setting up schedules for feeding and naps. Overall, the London parents had about 50 percent less contact with the babies than the "natural-network" moms.

The third group, made up of moms in Copenhagen, Denmark, split the difference between the two more extreme approaches. They carried their babies a lot during the day, but typically did not sleep with them.

The researchers compared the habits of all the babies throughout the first 12 weeks of life, and then again at 10 months.

St. James-Roberts says that neither of the extreme methods proved better than the other, although they produced different outcomes with different costs and benefits.

The advantage of the "natural-mothering" technique was that the babies fussed much less in the early weeks of life. They cried half as much as the London babies who had less physical contact. But the drawback is that the "natural-mothering" babies did not sleep well at night. And by 10 months, they were waking and crying much more than the London babies.

The Copenhagen babies, whose parents were taking the moderate approach, fared very well. As a group, they cried little after the first six weeks of life. By three months, their results were similar to the London babies -- they were settled well at night.

St James-Roberts says that some infants -- ones evenly distributed through all three groups -- suffered bouts of colicky crying. He says that this suggests there is a biological nature to colic that parents can't control.

"That's an important message for parents," St. James-Roberts says. "It's not their fault. Within the normal range of baby care, it doesn't make very much difference to these colicky crying bouts."

But when it comes to establishing solid sleep habits, St James-Roberts says that parents can make their mark. Six weeks seems to be the age at which there's a real advantage to putting a baby down and taking a middle ground between the "natural moms" and the "London moms."

"Move over to something that is setting more limits and introducing more routines and that will then help babies learn to sleep through the night from about 12 weeks onward," he advises.



Allie said...

When people find out how early our kids go to bed, at first they think we are kind of strange, then I think they realize that we have the whole evening alone together in a quiet house, and they get jealous. :)

Our kids go to bed at 7. With our older son, we had some real struggles with bed time after he moved out of his crib. We let him cry more than I would have liked, it was awful, but he's a good sleeper now.

Our younger son has always been a good sleeper. After lunch, he used to run to his room and try to climb into his crib. At two and a half, he still takes 2 hour naps in the afternoon. We just moved him out of the crib, and he goes to bed really well, we read a story and say goodnight, and he is out. In the morning he calls for us and waits in his bed for us to come open his door (even though he could open the door himself if he wanted to).

The only thing we have done with him that makes me nervous, is that we still let him have his pacifier at night. Our older son never cared about pacifiers, but #2 loves his and he sleeps so well that I'm nervous about taking it away.

Nothing in parenting is easy.

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