Will my baby ever sleep through the night?
December 27, 2008 by Dr. Heather
Filed under Babies, Sleep
Oh, what Susanna would give...
OH! NO! What have I done? We only did Scream It Out that one terrible night (usually it is Fuss It Out; and a few times of Cry It Out); but Did I scar my baby? We have friends and family that did various versions of CIO (the moronic –in my humble opinion–Babywise, the classic Ferber, and contemporary Weissbluth, author of Healthy Sleep Habits, Happy Child) and they are thoughtful, enlightened, kind, rested people in good marriages with well-adjusted beautiful kids! Are they wrong? And all those books say that CIO will not hurt your baby, and that it will help in the long run because the baby won’t be sleep-deprived, and more able to engage with life! But by crying, do they mean screaming in terror for two hours??
Susanna’s baby was born at 27 weeks’ gestation, so he was quite premature. But she and her partner are exhausted, and fear they’ve scarred their baby for life. Here’s my response to her:
Susanna — your little guy is still so very young — especially because of his super-preemie status — that you can’t really expect much from him yet, in terms of sleep. I know that developmentally you say he’s on track in other areas, but that doesn’t mean he’s caught up in EVERY area. So you’re still dealing with a very young baby, in terms of sleep expectations.
I have a major beef with so many of the “baby sleep” books, because they set us up to believe that an infant’s inherent sleep patterns can truly be majorly altered by the external environment — US. And that if the baby isn’t sleeping like x, y and z by a certain age…well, that’s our failure in parenting. THESE BOOKS ARE LARGELY BASED ON THE CLINICAL EXPERIENCE OF SLEEP-DYSFUNCTION SPECIALISTS, who mainly see very disturbed children and families…people with severe problems. Then their findings are extended into the “normal” population, in error. The other “faction” in the baby sleep department is the AP group, who don’t take into account the needs of babies who have differing sensory needs (or parents who have a need for some sleep). ;}….just IMHO.
I really want you to get away from the notion that there is ONE RIGHT WAY to be doing this, lest you screw him up permanently. Rather, have a long-term vision of what your ultimate sleep goals are for him, and then take mini-steps in that general direction, WHEN YOU CAN. If backsliding occurs, so be it. Try to be as “zen” as possible about all of this. It will work itself out, and it will be a surprise to everyone involved how, and when it does. You cannot control much of this situation, beyond providing him with the “Good Enough” environment that you already are.
So that means all you can do is COPE, for the time being. I hope he’s getting a bottle? So that someone else can feed him, and you get a break? Sit down with your partner and make a plan; a schedule. Who will take which nights. The other person is “off” on certain nights, and gets to sleep (with earplugs on!!), go out, whatever. Or perhaps one of you might take him the first 2-3 hour shift of the evening, and then switch. Whatever works for you both. And it also includes calling in extra help, even if it’s paid help, even if that means just once a month, so the two of you can get out and just be together, without him, to recharge your batteries. He’ll be just fine.
And yes, it is my observation that preemies tend to be a bit hypersensitive to stimuli and have more difficulty with regulation. It’s all about neurological development. “Regulation” is a very complicated, advanced process, and one that requires lots of time for higher-level systems to mature. So again, it’s about providing that “Good Enough” environment so that his own miraculous internal development can take place at it’s own pace. It is fascinating to watch over time. You might even look back at video of him (if you have it) from just a few weeks ago, and you’ll see how much his movement and other developmental milestones have progressed, just naturally. The same will happen for sleep.
Keep giving him the message that nighttime is for sleep, but until he really gets that, all you can do is hang out with him as you are, at night. Don’t keep looking at the clock, saying “Man, it’s 10:30 pm already. He should be asleep! What are we doing wrong!” Just take a deep breath, get some extra support, trade off, and know that this to shall pass. (easy for me to say, i know, but i have been there, with all 3 kids…..!)
I hope Susanna will keep us posted. Does anyone else have suggestions for her? And don’t forget to read this post on another baby’s sleep (or lack thereof).
I remember doing CIO with our first–I think we cried almost as much as he did. But there came a time when we knew he needed to sleep as much as we did! I don’t remember much about it (he is 9 now!), but I don’t think we did any permanent damage. :0) I can’t remember doing it with number two, but it’s possible that we did. CIO was a topic of heated discussion (much like the family bed and breastfeeding) on the birth club board I frequented at Babycenter.com. What I learned there was to listen to the moms who had already been through CIO because they KNEW what it was like. Those of us who had firstborns could only read about it first.
Just my two cents on bedtime: I scoffed at the experts that suggested a bedtime routine. I mean, how can you expect to do the same things in the same order EVERY night??? But we tried it anyway. I left out the bath, figuring I didn’t want to make a good night’s sleep dependent on something we might want to do at another time of day or might have to leave out if we were away from home. But we worked in feeding and snuggling and singing and rocking. And by gosh over time, it made ALL the difference! The rocking was our final piece of the evening, and we used it wherever we were, even if we had to rock without a chair. They came to know that rocking came before sleeping. As they got older, I worried about the feeding part, even though I tried not to nurse them to sleep after 6 months or so (didn’t always succeed either!). But somehow we found a natural break in the pattern, dropped the feeding and never looked back.
I now have a 6.5 and a 9-year-old who have gone to bed without a major fuss for most of their lives. We also are lucky that past the age of 3, both have routinely slept through the night with only a very few exceptions. My friends have freaked out before when I told them that our kids are in bed by 8:30! A friend of mine used to let her kids that were 5 and 2 stay up until 10:00 or later, partly because dad worked and didn’t get to see them until 6:00. But they were tired, the kids were tired, and they never got any time alone. As kindergarten approached, she decided to change their bedtime to 8:00 and I never saw a happier mommy! :0)
I watch the people on SuperNanny and thank my lucky stars that I stumbled onto the right approach early! I think all you can do is gather all the ideas, pick what you think works best for you, try it and be willing to adapt when your child’s routine inevitably changes.
Hi Dr. Heather, I just wanted to touch base on what you said about preemies. I have two of them, and I can say FOR CERTAIN that I had worse sleep issues with my firstborn, who was born just shy of 30 weeks. She also was caught up in most every way (other than crawling-12 months, and walking-15 months). She did not sleep well until she was over a year old. She still wakes often during the night and has even started sleepwalking. She turned 10 years old yesterday.
My son, who was born at 33 weeks didn’t have trouble sleeping. He has congenital heart defects which caused him to have little or no energy, so all he really wanted to do was sleep. BUT, he was so, so small that the doctor’s insisted he be fed every three hours, round the clock until his first heart surgery. It was either that or tube feeds, which we wanted to avoid. So, this is where the taking shifts thing comes in. Starting at 9:00 PM, my husband and I would take turns. If I did 9:00, he did midnight, then I did 3:00 AM. The next night, we switched. It was hard. Really hard. But, we did it until he was 13 months old.
I think that age is a factor for sure. I think preemies have a harder time with everything!
HI MOMO:
I recently saw a study that evaluated preemies in the NICU. They found that the babies would sort of “flail about” until a part of their body met up with the side of the isolette. As soon as there was that physical sense of containment, the babies’ heart rate went down, body movements got more smooth and controlled — basically, signs of regulation improved. Ergo — preemies need more swaddling/holding etc. It helps their immature systems of regulation.
It’s also interesting in relation to the discussion we’ve been having about Attachment Parenting, and why I’m a little reluctant to be a full-on supporter of that approach (much after 6-9 months of age or so). As you had said, “kangaroo care” is helpful for preemies, who need that extra body contact to help support their immature neurological systems. But over time, they develop the capacity to regulate themselves a lot better. Our parenting approach has to continually change and develop as our babies change and develop.
Have a great new year!!
In defense of at least some preemies, I have to offer this comparison. My daughter, now 4.5, was born at 34 weeks, but was the size of a 32-weeker. She was a crappy sleeper. She took a looooooong time to learn to sleep any decent stretch, and of course you know those stretches were all during the day. I always wrote all of her sleep troubles off to her being a 3.5 pound preemie because, as Momo Fali points out, preemies have a harder time at everything.
However, I just had my son the first week of October (full-term, nearly 7 pounds), and he is nearly the same as my daughter. He is also a nightowl and he’s still only sporadically sleeping more than a 4-hour stretch, which he only does once a day. As a matter of fact, he’s an absolutely average baby in every way, except he’s a crappy sleeper. This leads me to believe that, at least in this family, this is just their personalities and that no matter how many babies I have at any gestational age, they will all be crappy sleepers. Period.
For the record, my daughter does sleep through the night on a regular basis these days. Rather well, in fact, so it does get better. I’m counting on it for this baby and biding my time. It’s hard when you’re in the trenches of that first year (and you’ve really got to give preemies at least a whole year), but the sleep stuff generally improves over time.
Thanks, Dr. Heather, for the ABCs of sleep post. I sent it to my husband so we could commiserate and feel reassured we were doing all right.
hi Dr. Heather! Thanks for your follow-up on my situation! The study you cited in the NICU makes a lot of sense, as babies born so early are expecting to find themselves in a womb, not in a big open isolette. Your interpretation of the study seems to suggest that you think preemies– even after they come to term– are fundamentally different from other babies of the same adjusted age. Is that true? How and Why do you think they are different? My son and I are in a moms group with other babies all born around my son’s due date, and he behaves exactly like them (within a wide range of personality types, of course). A few of them have a harder time winding down at night than he does (can you imagine?!), and a few have an easier time. The neonatologists and pediatricians we’ve seen have said that we should treat him like a “normal” baby of his adjusted age, which is 8 months (true age is 11 months), but your opinion seems to differ.
thanks,
Susanna
Hi again! I wrote about this more on my blog
http://ifindmyselfamother.wordpress.com/
thanks!
Susanna
Hi, I also have a 7-month-old and I just did the sleep training with the Sleep Easy Solutions book. It has been a great experience! We actually bedshared for a bit, but it became very taxing in the evenings, as he could not go to sleep without me. He now sleeps longer and better and gets himself to sleep. We are now working on naps. Interestingly enough, he used to nap so much better next to a parent, but now he sleeps better if he gets himself to sleep. I think seven months was the perfect time for us to transition him to his crib and help him learn to sleep on his own.
I wrote about this on my personal blog.
http://www.ilovemonsters.blogspot.com/
It’s long winded–amazing how much new moms can blather on about sleep! It’s fascinating, if you’re one of us.
I heard about your blog on Mainstream Parenting Resources. I also have a new blog with some other folks called Rational Moms.
http://www.rationalmoms.com/
I’m very interested this whole AP thing–I have some major issues with Sears. So I was looking at your articles on this in preparation for my own post.
Thanks for the great blog.