Aug 6, 2012

How Do I Get My Baby To Sleep Through The Night?

Category: Sleeping Problems
Posted By: Lizzie

Question: We have a 9-month-old son who has never slept well and we are now at breaking point.  My partner and myself do not instinctively feel that the ‘cry it out’ method is the right thing to do and probably follow attachment theory more.  My son started life with a very difficult 35 hour labour, breach and induced, only to be whipped out with an emergency c-section. He then had "colic" for 3 months, screaming all evening but generally sleeping well after midnight. Once he grew out of the colic he started waking up frequently at night, sometimes up to 15 times and often awake for 2 hour periods through the night.

We have always rocked/soothed him to sleep, he has never been a self soother and I have breast fed him, sometimes regularly at night but now down to only once or twice and not at all in the day. He appears wound up and unhappy at night but very bonnie in the day. I am now feeling utterly despairing...most people say we should be doing controlled crying but i cannot believe there is not another way. We cannot sustain it as it is, we both work part time and are totally and utterly shattered. Not sure what I am hoping for, just some advice I suppose. Thank you, Lizzie

 

Answer: Oh dear Lizzie, I’m sorry you are at your wit's end.  It’s a terribly difficult time.  After nine months without enough sleep no one has the capacity to cope any longer… and yet somehow your sleep deprived brain has to come up with a solution to a really difficult problem.

I completely understand that you don’t want to use a controlled crying solution and its great that you are leaning towards attachment parenting, I think it’s a lovely way to bring up children.  There are a few traps that it is important not to fall into, however, and the first is the belief that attachment parenting means just giving in to your child.  It is really important to give your child supportive routines, even at this stage, and to make sure everyone in your family gets enough sleep.

It sounds like your family had a difficult start, a breach birth and a 35 hour labour is exhausting for you and your son, and at the end of having worked so hard to have ended up with a cesarean is terribly unfair.  This difficult start seems to have had an effect and the colic period was the longer end of normal and must have been extremely hard on the whole family.  These circumstances would have made it impossible for you to just slip easily into a routine and nights started out and remain fraught in one way or another.

Luckily your son is now old enough to learn to sleep more easily and it is possible to help him to manage this without crying.  Helping your son to learn to sleep using a no-cry method is much slower than using a controlled crying programme, but much less traumatic for everyone.  The first thing that you and your partner will need to do is find a way to manage your own anxiety and worry over the lack of sleep and the upset state of your son at night.  It is important to find real confidence in your capacity to help your son to sleep and to fix the difficulty that you are in.  If you feel able to do this yourself then that is great.  Read up on a couple of no-cry methods (suggestions below) and get started. If you don’t feel confident and are feeling very run-down and exhausted then you might want to enlist the support of a professional of some kind to give you the confidence that you can manage a programme and make it work (again suggestions below).

The next thing to do is work out a programme that you feel comfortable with.  I would read up on ‘sleep associations’ which help you think about what your baby associates with going to sleep and what are sustainable sleep associations that you can encourage in your child.  For example if your son associates being rocked with getting to sleep then you may find yourself having to get up every time he stirs to rock him back to sleep once again.

It is really important to find a routine that works.  Having a warm bath before bed raises melatonin levels (melatonin is naturally occurring hormone that helps to regulate sleep).  It is also helpful to have a period of calm before bed that helps to reduce all hormones that may interfere with sleep such as adrenalin and cortisol.  These are both produced to manage, among other things, excitement and stress and so activities that excite your son, even lovely ones where he giggles as he his chased around for example, should be avoided for a period of time before bed.  Light levels also affect melatonin production so bright lights should be avoided during the bedtime routine.

The next thing to do is start a programme of slightly reduced input in your son’s sleep over a long period of time.  For example in the first week you may need to be very close to your son in order to help him sleep without crying.  If you have been feeding him to sleep then the first step would be to hold and rock him rather than feed him.  It sounds as though you are no longer feeding him to sleep so if you have been holding and rocking him then you could try lying down next to him and stroking him or rocking him slightly from side to side.  As a first step you need to find whatever is the minimum intervention you can have without him crying in distress.  You continue with this for at least four days, completely consistent in your routine.  After four or five days, if he is very relaxed with the new routine, you can then move to the next step.  If you have been lying with him and rocking him you can move to stroking him, from stroking him you could move off the bed and continue to stroke him.  When the next step has been achieved without any anxiety being shown by your son at night, hopefully another 4-5 days, you can then move on to the next step.  Now perhaps you could sit next to the bed and sing or sooth him without touching him.  And so it goes on until slowly you move further away until you are able to sit by the door, in the doorway and eventually outside the door!

I’m sorry if that sounds like an awful lot of work… it is!  It is not at all for the faint hearted.  Its not a lot different in many aspects to a controlled crying technique, but it is longer because you need to move more slowly to find a pace that does not cause your baby to cry in distress.  It does take a lot of stamina on your part, it requires very slowly re-training your baby’s instinctive survival systems.  But once you have done it everyone, including your son, will be happier for it.

Bear in mind that there will also be temporary set-backs such as illnesses, holidays or other such things that necessarily break the slow, steady routine you are building.  Expect a set-back after such things and then continue back to whichever step is necessary and continue on once again.

If you decide that you would like some professional help or support then you can look for the help of a child psychotherapist either in person or over the phone.  I can also highly recommend Millpond Sleep Clinic although you will have to be clear that you are not willing to let your child cry at all.  William Sears and Elizabeth Pantley are the two best known authors on attachment parenting and no-cry sleep solutions, but I think that Tracey Hogg’s book is a little more middle-line and a very good option.

I really wish you well with your journey.  I hope that it all goes smoothly for you.

Ryan



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