Wednesday, December 16, 2009

Improving Night-time Sleep

Little Missy is 20 months and still nurses at least once overnight, so take this with a grain of salt, but she's never been a great sleeper, so we've had to do a lot to get her sleeping for longer stretches over the past year and a half or so...

From birth, she always slept better when she was swaddled. So we swore by the Kiddopotamus SwaddleMe blankets. We started out with the small size, then moved up to the Large size eventually, although by that point, I think she always slept with her arms out of the swaddle blanket. So it was really just wrapping her body snuggly that seemed to help. We tried to wean her off the swaddle several times, but didn't succeed until around 9 months.

We learned early on that Little Missy was a light sleeper, so we moved her into her own room where it was quieter than our bedroom around 6 or 7 weeks. Before then, we would often wake her when we came to bed or when I would cough or something in my sleep. She slept marginally better in the crib in her room than in the cradle next to my bed, although it did mean I had to schlep down the hall several times a night. We tried cosleeping some, but she isn't really a snuggler, so it never worked well for us at all.

She slept pretty good for a couple of weeks after we moved her to her crib, but that was short-lived. So then I read The No Cry Sleep Solution, by Elizabeth Pantley, and we implemented some simple strategies from there as well as some we may have made up on our own. We blacked our her windows and turned off the nightlight to make it really dark in her room. We started playing repetitive wave sounds on the alarm clock in her room, then later on an iPod set to repeat, once we realized she would wake up the moment the waves would stop on the alarm clock (after 2 hours). We also introduced a "lovey" for her to sleep with, and I held the lovey between us whenever we would nurse to get her used to it. (Her lovey is an Angel Dear blankie and we now have 5 identical ones that we cycle through.)

We also started trying different techniques to get her to put her to sleep drowsy but not asleep. We bounced her on a yoga ball to help get her to sleep and as she got older, sometimes my husband could bounce her on the ball to get her to sleep in the middle of the night without nursing. I followed the NCSS method for popping her off the breast right before she fell sound asleep, and would lay her in her crib very drowsy. It took a while before she really started falling asleep on her own though after I laid her down. And although we still always nurse before I put her down, she is usually quite awake now when I lay in her in her crib and she falls asleep on her own without crying.

Once we tackled falling asleep on her own without nursing all the way to sleep, we tried to stretch out the time period between night-time nursing sessions. What I started doing was a time limit where I would only nurse her if it had been 2 hours since she last nursed. If she woke before then, my husband or I would comfort her and do whatever else we could to get her back to sleep. She would cry some, but we were there with her, and she would fall asleep pretty quickly. Little by little we extended the time period, from 2 hours to 3 hours to 4 hours. Then I started saying, if she wakes before midnight we'll do something other than nurse to get her to sleep. Then I moved that to 1am, 2am, etc. We definitely had setbacks, but we always try to follow this pattern to get back on track and now she sleeps from 8:30pm to 4-5am (give or take), then nurses, and goes back to sleep until 7-8am. But it took a LOT of work to get us to this point. And it wasn't until around 10 months to a year that we had any real improvements.

During these non-nursing wakes up we followed the NCSS method of doing less and less to get her back to sleep. We used to have to bounce her on a yoga/pilates ball or rock her if we weren't nursing, then we could just hold her still using the Dr. Sears suggestion of putting her down in the crib and laying our hands on her (not like forcefully pressing down on her, but holding her still). Eventually we could get her back to sleep with just a few pats on the back, and now if my daughter wakes up earlier than normal, I walk in and tell her "It's still night-night time. Lay back down," and she is usually asleep again almost immediately. The less and less interaction you have, the less and less motivation they have to wake up and need attention. I've heard some recommend methods of refusing to say anything at all or refusing to touch the baby, but I have never gone that far, because it just seems too harsh.

Once we started getting Little Missy to fall sleep without nursing, I found that if I waited a couple of minutes when she woke up my daughter would fall back asleep on her own. In the NCSS, Pantley explains that babies have periods of wakefulness while they sleep and can whimper, fuss, or even cry in their sleep. So I would wait until I was sure my daughter was really awake before going in her room. I wouldn't wait if she was hysterical crying, only if it was just a quiet little cries to see if it was the equivalent of talking in her sleep or if she was really awake.

We didn't start seeing much improvement in her sleep patterns until around 10 months, but by 14 months, she was down to nursing just once a night on most nights, which she is still doing now at 20 months. We still have sleep issues that result from teething, growth spurts, illness, traveling, or other interruptions (like my mom visiting from out of town last week), but overall, things are much better, and it doesn't take long to get back on track when we do have a setback.

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