Mahalo to Jill and the gang at KITV!

Despite awakening at 4 am with bloodshot eyes from an allergy attack (perfect for HDTV, right?) — I was psyched to head down to KITV yesterday morning to talk story with the gang about parenting. So mahalo to Jill Kuramoto for inviting me, and a big aloha to Mahealani Richardson, Moanike’ala Nabarro, and Yasmin Dar for making me feel so at home in the studio. Looking forward to seeing you all again next month!

Here’s the link: Dr. Heather on KITV — January 17, 2012

Aloha,

Dr. Heather
The BabyShrink

Sometimes I need a good cry before a nap, too.

One of the most primitive, innate reactions any mom has is to comfort her crying child. But as we’ve talked about here before, many babies can tolerate — and thrive — with some crying, when their parents thoughtfully decide why and when that might be necessary.

That’s why articles like this leave me mystified — especially when they come from one of my shrink colleagues.  Her bottom line is that CIO is dangerous. She trots out all the old arguments, hailing the Dr. Sears “science” behind her claims, and providing one of the most common misinterpretations of infant research. She makes the mistake that clinical research findings about abused and maltreated babies — babies who were pervasively denied their needs over the long-term — should be applied to NORMAL babies in NORMAL families.

The fact is, there is no evidence whatsoever that occasional CIO in typically developing babies causes any damage. PERIOD.

More importantly, there IS evidence that severely sleep-deprived mothers are at much higher risk of developing an already common –and dangerous — condition: postpartum depression. And PPD certainly CAN lead to long-term damage to both baby — and the entire family. CIO is a method that, when implemented thoughtfully, can often lead to improved sleep (and health and happiness) for everyone.

Firebombs like those thrown in the Psychology Today article only make the burden heavier on moms. What a shame.

Aloha as always,

Dr. Heather
The BabyShrink

PS: Wow, what a response! After commenting here, please also see the comments developing over at the Fussy Baby Site.

Ah, sweet sleep

kids sleep better. They’ve all evolved into being better sleepers over time.

That’s why I’m so interested in the line of research discussed in this study. Penn State scientists found — despite common parenting advice — that parents’ EMOTIONAL response to their children at bedtime was much more successful than any specific behavioral “trick” in getting children to sleep.

As a shrink, I tell parents that babies absorb their emotional messages. Parents are often surprised when I tell them that even the youngest babies sense their emotions — but it’s true.

In the shrinking world, we’ve been struggling internally for years over the predominant theoretical orientation — Behaviorism, and its spin-offs — and the power it holds over the way we do our work. Those of us who work with very young children understand that simple behavioral and operant conditioning simply doesn’t apply with the little ones. That’s why “Ferberizing” and related approaches are often ineffective.  FIRST, babies need to feel emotionally (and physically) safe. Other learning can proceed from there. But sleep is an inherently scary proposition, and often triggers resistance and regression in children. It’s a weird and scary thing to transition into a sleep state.

So the fundamental message of this research at Penn State is both obvious to me — and very reassuring — as an Early Childhood specialist. I’m eager to see what else they discover in this line of inquiry, and I’ll be sure to share it with you.

Here’s a link to some of my “getting to sleep” advice. What’s yours?

Aloha,

Dr. Heather
The BabyShrink

I’m blogging for mental health today — but not in way you might expect. Mental health isn’t just some esoteric list of psychiatric diagnoses. It starts with simple — but critically important — things. These include the support of loved ones, meaningful work and relationships, and enough resources to have a little fun. On the top of that list, though, is getting adequate SLEEP. Having young children is the quickest way to ruin in the sleep department (and I speak from vast experience). Here’s a quick tip on tackling the sleep issue for toddlers (and by extension, YOU):

Dear Dr. Heather,

My 2 year old started climbing out of the crib a few weeks ago. We transitioned her to a toddler bed and she continues to wake up around 2 am to play! And doesn’t go back to bed until after 4 am. I’ve tried cutting her nap, which resulted in a miserable little girl in the afternoon and still waking in the middle night. I know allow her to nap for an hour and she’s still up and playing at 2 am. Her bed time is around 8:30pm every night. Help!

Holly

You KNOW she's tired.

It was 2 pm, and my toddler STILL hadn’t gone down for her nap. Routines were followed, milk was drunk, and the house was quiet (no small feat around here, I assure you). She was rubbing her eyes, complaining — but plowing ahead. Throwing her little arms in the air, she was chanting, “Up! Up!”

Some of you are pretty mellow about your toddler’s nap schedule. But I’m the type who has to have “mellow” beaten into me with the stick of experience. “Toddlers are supposed to nap. Go to sleep, toddler of mine.”

Not always that easy, is it? Turns out, none of my 4 babies ever read the Weissbluth or Ferber books, and they totally failed the “How Many Hours Per Day Babies Need To Sleep” test. They didn’t follow those rules, and I was left fretting that something was wrong (and trying to soothe an overtired baby).

But guess what? I’m up at 3 am writing this post. Why? I can’t sleep. I did my nighty-night routine, but my BabyShrink work beckoned me from bed. Your baby has important work to do, too. Sometimes, it’s more important than sleep.

But what does a poor parent do with an obviously sleepy (but not napping) toddler?

Here on my 4th baby, I’ve discovered some important truths about nap schedules:

* The best-followed routine doesn’t always work. Sometimes a nap simply isn’t in the cards.

* Yes, an over-tired toddler sometimes means a cranky and difficult afternoon. But often, your toddler can rally and make the most out of the day.

* Toddlers are notoriously wacky about following nap schedules — some more than others. Focus on nighttime sleep, and an earlier bedtime when there’s no nap.

* Some parents attempt to hang on to that second nap for too long. If she used to be a good napper and now isn’t, experiment with dropping the nap.

* Yes, I know: Sleep is important to a baby’s brain. But as with food, parents need to focus on the overall amount, over time. A bad day ( or week) of sleep isn’t going to do any lasting damage (except to us).

Now it’s off to bed for me. If you’re still awake, go and read more about your toddler’s sleep challenges here.

Aloha,

Dr. Heather
The BabyShrink

Reader Allie emailed me a couple of questions about her 15-month-old Jack*.

Not so cute at 3 am

He was an otherwise healthy boy who simply stopped sleeping a few weeks ago

And Jack’s Dad wasn’t so hip on it either. He was of the belief that “tough love” was in order (as was Jack’s pediatrician), and again in desperation, Allie tried it with Jack. After three hours of crying (and barfing all over himself and his crib), Allie had enough. No “CIO” for this baby.

After weeks of this, poor Allie was totally blotto from the accumulated sleep deprivation. My emailed suggestions didn’t seem to get to the heart of the problem, and so I asked for more information. Turns out that Mom and Dad were having relationship difficulties on top of everything, and they just couldn’t agree on how to handle the nighttime sleep issue. They had just started couple’s therapy, and although the therapist was helpful to them, there was no time to focus on the problems with Jack. Plus, the therapist wasn’t a specialist in babies and young children.

I suggested a Parent Coaching session, so that I could see Allie for myself, get to know her a bit, and have some time to get into the nitty gritty of Jack’s situation. We spent an hour on Skype, going over Jack’s temperament and personality, as well as options Allie hadn’t thought of yet. I gave her detailed information on what is “normal”, sleep-wise, as well as developmentally, for a child Jack’s age. This helped decrease her fear that something was really “wrong” with Jack. Also, Allie was upset that Dad wasn’t seeing things exactly the same as she was. I carefully side-stepped the relationship issues, focusing on helping Allie to understand that different parental attitudes CAN WORK with children. We created a plan that both parents could agree on, with the goal of helping EVERYONE get better sleep.

The “nuts and bolts” of the plan weren’t anything fancy or unusual. But the fact that we had the time to really put our heads together to make a plan — a plan that would work for Mom, Dad, AND Jack — made it simple, but powerfully effective. And although I’m not necessarily against CIO in every case, I knew it was off the table for this family — so we worked out a different plan. I was excited to receive an emailed update from Allie this weekend, letting me know that Jack was back to his old good-sleeping self (and more importantly, so was SHE).

If you can relate just a little too well to Allie, you’ve come to the right place. I’m including a link to one of my most popular Sleep posts here, to get you started. If my sleep posts aren’t enough, shoot me an email (BabyShrink@gmail.com) or hit the “Parent Coaching Packages” button up on the top of the page to complete the form. I’ll be happy to chat or Skype with you, too, to help you FINALLY get some sleep!

Aloha,

Dr. Heather
The BabyShrink

*Allie asked me to keep her name, and that of her child, private — these aren’t their real names. But their experiences are real.

YES!!!

Going the “babywearing” route — responding to every need — wasn’t working — it was making things worse. So I undertook the most rigorous “Sleep Training” program I’ve tried yet. And it worked.

Now, I’m not advocating that you try Sleep Training — and by that, I mean some variation on the “Let Them Cry Longer Than You Normally Would” theme. No, please don’t take this as something I’m necessarily advising you to do. Just hear me out for a minute:

Some babies do very well with “babywearing” and co-sleeping. Mine don’t. They either get all aggravated with the extra body contact — they want to be “free” — or think sleeping with Mommy and Daddy means fun playtime all night long. It seems they want to sleep in their cribs, because they’re wonderfully well-adjusted (and much more well-rested when they finally “get it”), but they need help in “getting it”.

So I used my Shrink’s Crystal Ball and devised a perfect sleep plan just for her that worked immediately. Hah! I wish. No, seriously, I thought about her specific age (7 months), her temperament (loud and excitable, but resilient and forgiving), and our family’s needs (3 older kids who need to have a reasonably quiet house at night plus 2 working parents), and went from there. It was 6-ish weeks, with 2 or 3 of them being fairly challenging, but I am happy to say that the plan has worked fabulously well. Miss Nighttime Partier is now sleeping 10-11 hours at night.

This combination: Your baby’s age, temperament, plus your family’s needs, all get put into my formula for improving any parenting problem with your baby — not just sleep. It’s a personalized approach that goes way beyond a checklist that you might find in a parenting magazine. It’s developed for you and your family. That’s the basis for my Parent Coaching service that I’m preparing to offer online, and I’m really excited to be able to help families far beyond my little island home out here in the Pacific.

So stay tuned for more details on BabyShrink Parent Coaching, and in the meantime, comment or email me for more specifics on your little nighttime partier.

Aloha,

Dr. Heather
The BabyShrink

Super Cute, and Super Challenging

So to you fellow parents of 9 to 12-month-old babies out there: I know it can be a challenging, difficult stage. Your little bug seems content to scramble around the house one minute, then wails in panic the next. What used to be stable sleep habits are now in a shambles. Feeding –and nursing — has become an unpredictable struggle — and separations are exceptionally difficult. And forget diaper changes! What a wrestling match! Immmobility is the enemy to her now — being restrained in any way is bound to be a fight. High chairs, strollers and car seats are demon baby torture devices. They keep her from exploring her brave new world.

What to do? Re-think your daily tasks with this knowledge in mind. Everything will take a little longer, as your baby goes through this unpredictable (but temporary) stage. Some days she may need you constantly. But don’t worry — when you’ve finally reached the end of your rope with your little Clingon, she’ll start to feel “refueled”, and venture out again — allowing you to catch up on that laundry and email. And make sure you get some help with nighttime wakenings — you’ll need extra rest too, since you’re up again with a fussy baby — but don’t forget to reinforce the sleep routines that have worked well in the past. She’ll eventually remember what her job is, at night — and now that her memory is better, she can hold on to her internal image of you a bit longer, giving her some comfort, despite being away from you to sleep. Feel some reassurance knowing that the earlier — and stronger — your baby shows separation anxiety, the sooner it resolves. Lots of parental support and understanding help her get through this challenging — but remarkable — stage.

Dr. Campos was generous and encouraging in my BabyShrink book-writing project, and I had a blast geeking out with him, picking his brain about the amazing new developmental capacities in normal 9-month-old babies. What a great experience! Now, please excuse me — I’ve got a 9-month-old baby clinging to my leg.

Aloha,

Dr. Heather
The BabyShrink

It's so hard to walk away from that face!

Regarding 9-12 month old babies:

We understand that the older infant finds it painful to be separated from beloved persons. We grant him the right to protest. At the same time this pain, this discomfort, is something he can learn to tolerate if it is not excessive. We need to help him manage small amounts of discomfort and frustration. If we are too quick to offer our reassuring presence, he doesn’t need to develop his own tolerance. How do we know how much he can tolerate? By testing a bit of the limits of his tolerance as they become known to us. The point at which protesting and complaining crying turn into an urgent or terrified summons is the point where most of us would feel he needs us and we would go to him. This is real anxiety and he needs our reassurance. But we need not regard all crying of the older infant and young child as being of the same order. At this age, in contrast to the period of early infancy, the baby can manage small amounts of anxiety or discomforts by himself….As far as possible we should try to reassure the child in his own bed. Picking him up, rocking him, is usually not necessary and seems indicated only when the baby is unusually distressed by anxiety or illness.

From The Magic Years, pages 74-75.

If you like Selma, Click on “The Quotable Parent” down and to the right for more juicy tidbits, or just buy the paperback — I promise it will end up heavily read, re-read, mashed and dog-eared, like mine. I’m clinging tightly to Selma these days (and nights), as Baby #4 has proved to be exceptionally gifted in protesting loudly, and waking up her siblings. But we are making progress, and so will you. Hang in there!

Aloha,

Dr. Heather
The BabyShrink

Sure, she sleeps OK in the stroller.

But Tough Love is rough on me — and on the family. A fussing (or screaming) baby feels like a constant reminder of some kind of parental inadequacy, and is really grating on the nerves. Not to mention the fact that it often happens at ridiculous hours of the night when most other babies are surely sleeping soundly. And forget sleep for poor mom. I’m a zombie.

But persist I must. I won’t give in to an 18-pound 8-month old, no matter how cute she is (in the daytime, at least). It will be worth it in the end.

Here are my tips for getting through this rough time, if you’re going through Sleep Training:

Make sure you and your partner are on the same page. There’s nothing worse than arguing about sleep training techniques at 2 am, standing outside the door of a screaming baby. Agree ahead of time — or don’t attempt it.

Prepare the older kids for nighttime noise. I tell my lightest sleeper that he may hear the baby fussing at night. “But you’re a big boy and can roll over and go to sleep. Soon we’ll all get better sleep.”

Use a little reverse psychology on yourself. (You’re so sleep deprived it just might work!) Instead of preparing for a night of sleep, prepare for a night of watching “guilty pleasure” TV, listening to great music from your (childless) past, or even folding laundry. Fooling yourself into thinking you don’t really need to sleep somehow makes it less painful to be up at weird hours.

Take a deep breath, have a zen moment, do some mindfulness meditation, yoga, or pray – pick your version of expressing gratitude and relaxation. Having a non-sleeping, screaming baby at 2 am is really hard. But in the scope of things, not really that big of a deal. A few moments recalling the years when we feared we couldn’t get pregnant, or thinking of friends who have a baby who’s quite ill, and others who have God forbid lost a child, and I’m ready to get through another tough night of sleep training. Having a healthy, happy, non-sleeping baby is a high-class problem we’re blessed to have, quite honestly.

I’ve written other posts about getting through the sleep deprivation aspect of this, but let me also mention our friend caffeine here. Don’t overdo it. At my peak, I have a mug of java in the morning, some iced tea at lunch, and another cup of coffee around 2. That’s 3 servings a day. Any more and I get frazzled and nutty — and no more awake than if I had stayed with the 3 servings. Studies say that some coffee is fine for most of us, but too much will definitely make you feel worse.

Sleep Training eventually works — I’m writing this now as the baby sleeps nicely in her crib. Get through the rough nights and I promise things will improve!

Aloha,

Dr. Heather
The BabyShrink