Wednesday, December 15, 2010

Nighttime Harmony With Your Baby

It's 3:00am and while the rest of the world is in a peaceful slumber you are... not. You are up, half dressed, pacing vigorously up and down the hallway with a crying baby in your arms. Your hair is in your eyes, which are bloodshot, dry, and burning. As your body aches with fatigue and your nipples throb, your heart aches more for the sadness pouring out of this little extension of yourself. You are hearing all of those advice-givers in your head telling you that, "You will spoil him if you hold him too much." "If you don't leave him in his crib, he will never learn to sleep through the night." "If you pick him up every time he cries he will only cry more." You are just reaching a new level of desperation in your fatigue when your pacing lands you in the doorway to your bedroom. Your eyes fall on your partner who is in perfect sync with the rest of the world, sleeping peacefully. That's it. You put the baby alarm right in front of his face and say, "Your turn!" as you walk out of the room for a breather.
I am going to give you the secret to sleeping through the night: don't have a baby! Parenting is a 24-hour job. Their needs don't stop just because the sun goes down. We've all been there. Everyone who has ever had a baby has been there. And in our zeal to be the best parent we can be, combined with the exhaustion a new mother faces, we try to impose all these ideas of what nighttime should be on ourselves: the pictures of a baby sleeping soundly in a perfectly designed crib in a perfectly outfitted nursery, your mother-in-law telling you the only way to get any sleep is to let her "cry it out," maybe even your pediatrician warning you that whatever you do- don't bring baby in to your bed." It is so important to enter parenthood and approach nighttime with appropriate expectations. And I'm sorry if I'm the one breaking it to you but newborns are not supposed to sleep through the night.
So what's wrong these adorable little poop machines? Why don't they sleep at night? I'm sorry to have to say this but it's partly mom's fault. Throughout 9 months of pregnancy, baby comes into existence and consciousness under these circumstances: rocked and swayed and soothed with voices all day, still, quiet and bored all night. Mom is up moving, walking, turning and talking all day long. It's like rocking baby in a rocking chair while singing a lullaby. Then nighttime rolls around and mom lays still and silent in bed. Most mothers will attest to the fact that by the end of pregnancy, sleep is nearly impossible because come night time, baby is bouncing all around in there, wide awake.
A baby is born with a couple pressing tasks. First, sucker grown-ups into a euphoric state of love assuring they will meet your needs (attachment). Second, gain weight. The process of attachment (primary emotional, psychological, and social developmental task at birth) is so important that it cannot take half the day off (12 -20 hours is the amount of sleep a newborn needs). Even gaining weight (primary physical developmental task at birth) is tied in to attachment. To really thrive and put on those healthy rolls a newborn needs to eat every 2-(max) 4 hours. This is because babies have tiny stomachs. They can only hold and digest a few ounces as newborns. So you fill them to the brim, and then a couple hours later they are again on E, ready for more. Stretching the time between feedings doesn't expand the size of their stomachs; it just forces them to sit longer in a state of hunger. Needing to eat is not a behavioral issue, it is a physical one. As much as your baby loves you and wants you to be rested, she cannot change her capacity to digest. As she grows, her stomach grows, and so will the time between feedings. Lastly, babies just have shorter sleep cycles. It is believed to be a protective mechanism to wake up their systems and make sure they keep firing (breathing, pumping, digesting, etc.).
So what's a new family to do? Well the first step in creating a peaceful night for your family is to change the goal for nighttime from sleeping through the night to HARMONY. Nighttime harmony is priceless. It is the experience of being peacefully in sync with your baby throughout the night. It is the difference between fighting against your baby in a battle for sleep and being connected with your baby for the mutual goal of rest.
The primary tenant of nighttime harmony is to do what feels right for you and baby. Listen to your innate wisdom as a parent. Tune in to your baby and do what feels right. This could take some soul searching. It involves examining your preconceived notions of what should be. Reach inside and pull out all your assumptions. Where did they come from? Try them on. Does it feel like a good fit? Look into the eyes of your baby and tap into that maternal wisdom. If it feels right, keep it. Integrate it into your new idea of nighttime with your baby. If it doesn't feel quite right, toss it. You can respect the people who give you advice while at the same time recognizing that their advice doesn't fit your baby or your family.
Let's start with the 'where' of sleeping arrangements with baby. That image of the perfectly decorated nursery is a nice one but when it comes to actually sleeping, you have to be a little creative, open-minded, and accepting of whatever arrangement gives everyone the most sleep. Co-sleeping is something that most mother's come to unintentionally, out of a desperate need for more sleep. After waking up, walking down the hall, picking up baby, nursing while sitting up in the rocking chair, and putting baby back to bed you think, "I'll just pick him up and bring him to my bed and nurse him there. That way I can lay down." You fall asleep nursing and realize, "Oh my god, I just slept 4 hours!" The reason co-sleeping works so well is because baby is getting all the things that makes him thrive: skin-to-skin contact, milk, mom's breathing regulates his own, mom's heartbeat is a soothing reminder of the womb, and mom's chest even regulates baby's temperature. And while baby is in heaven, so is mom.
You do your job of meeting your baby's needs while laying and resting effortlessly in bed- talk about harmony. Breastfeeding in bed requires some new positions but they are totally worth mastering. The side-laying position is the classic co-sleeping arrangement. Lay on your side (you can put a pillow behind your back) and lay baby on his side, mouth to nipple. You can rest his head on your arm or not. Dads are sometimes unsure of how they will fair in this arrangement. Assure your partner that a happy, rested mama means a happier wife. Some dads end up spending the first month or so on the couch (my husband made a bed on the floor next to us) but a new baby takes work and sacrifice from both parents. Dad has to do his part too. As far as sex goes (while this is certainly not the priority immediately post baby), be creative! The bed is not the only place for erotic fun. Don't worry, your baby will NOT want to sleep with you forever (despite what some advice-givers will tell you).
Research shows that when mom's co-sleep with baby, they are so sharply attuned to baby that amazing things happen. If baby moves his head back, mom moves her head forward. If baby scoots down, mom scoots down. It is actually an amazing testament to the connection between mom and baby. Mothers accommodate baby's position all night long. And the slightest wiggle or disturbance on the part of the baby results in a hovering, awake mother. This is not true however, of fathers. Since fathers don't get to spend 9 months tuning in to baby, they are not attuned to baby while sleeping in this special way. That's why baby should sleep between mom and the end of the bed. You should know that research absolutely supports the safety of co-sleeping (refer to Attachment Parenting International and Dr. Sears). That said there are some guidelines to maximize the safety of this sleeping arrangement.
1. No big comforters on mom or baby.
2. Make sure there is some kind of a bed rail or place the mattress on the floor to prevent the baby from falling off the bed.
3. No siblings in bed with baby.
4. No co-sleeping if mom or dad has consumed any alcohol or medication.
5. Put baby to sleep on their back.
To cosleep actually means to sleep in close proximity with baby. What I described above is technically referred to as bed-sharing. But co-sleeping can take other forms. Consider using a co-sleeper. You can buy a "co-sleeper" (Babies R Us) or side-car your crib as a toddler bed to accomplish the same goal. Baby will have her own designated space but be within arm's reach. This means you can hear every breath and all you have to do is open your eyes to see her little chest moving up and down. You can pull her close for nursing and slide back her back over to sleep. Personally, this arrangement is ideal for me. I find that this provides the perfect balance whereby I can get the best sleep. If baby is in a different room I can't sleep. I worry about them and have to get up constantly to meet their needs. If baby is in my bed all night, I feel like I am "on the clock" and have trouble reaching the deepest stages of sleep. But with baby co-sleeping right next to me I can lay right next to him, nose to nose, all night long, pulling him over for breastfeeding periods and sliding him back when I want some serious sleep. I encourage you to find the arrangement that works best for you. Every baby is different. Every mother is different. Every family is different. Do what works best for you and your baby.
How do you get baby to sleep to begin with? Start by winding baby down with a nighttime routine. Incorporating a bath and massage is a great way to wind down for the night. Try to stick with the same routine every night but do what works best for you baby and your family and be flexible with phases, issues, or changing needs. Try swaddling. Some babies find peace in being tightly wrapped, mimicking the feeling inside the womb. Wearing down baby in a sling is a great way to ease baby to sleep. Babywearing incorporates swaddling and mimics the womb, provides rocking, skin-to-skin contact, baby is soothed by the sound of your heartbeat and the boom of your voice. Breastfeed while babywearing to release all those feel good hormones and fill baby's tummy for a long stretch of sleep. Vacuum the house to add white noise and that pretty much utilizes the full arsenal. It is good to have a nighttime "time" to keep in mind in your nighttime routine. This time should not be a strict bedtime as you might have with an older child but a general guideline for putting the world to sleep: turn off the lights, don't speak using high-pitch tones, no more games or playful engagement. Embrace the transition and send the message that the daytime has ended and nighttime is here.
While always being able to meet all the needs of your baby is ideal, parents are human beings. We need sleep. If the goal is to be the best parent you can be, then sleep for you is going to need to be in that equation. It is hard to balance the needs of your baby with your needs. This will be a balance you will work on daily for the rest of your life. Especially if you have a high needs baby, you have to give yourself permission to get the fuel you need to keep taking good care of that baby. Sometimes this might mean calling daddy up from the batter's box (giving daddy and baby time to establish their connection is good for both daddy and baby), giving a trusted family member a shift, or leaving baby in the crib. I am not a fan of scheduling babies (because what that usually really means is putting baby on your schedule) but there are some situations when a schedule is what's best for baby and family. One example of this is with multiples. To ensure every baby gets all the milk and sleep they need, schedules are sometimes necessary. Doing what's best for your baby and your family is the moral of this story. Sometimes doing what's best for you is what's best for baby in the long run.
Misconceptions about babies and sleep:
If you don't put baby to bed while he is still awake, he will never learn to fall asleep on his own. The logic behind this is that if you put baby to sleep while he is still awake, he will learn to self-soothe. This idea came out of the big push for independence along with bottle-feeding. Babies are dependent- they're supposed to be! If you look at the entire lifespan of a human being, they only need you for such a short period of time. If you allow them to be dependent while it's appropriate, they will establish security and feel safe and confident enough to be independent. Developmental psychologists throughout history agree that the first task of infancy is establishing trust in caregivers and the world. Once this is firmly established they can move into to establishing independence.
If you pick up a baby when she is crying, you are teaching her to cry. The logic behind this is that you are rewarding the behavior thereby reinforcing it. This is taken from a very basic principle of learning psychology first studied with lab rats and frequently used with dogs. Babies are not dogs. As much as you may love your pet- it is not the same. There are far more dynamics at play with a baby than a simple behavior/reward model covers. Research has shown us that the opposite is actually true. The "cry it out" method unfolds like this: baby communicates a need, no response, baby cries, no response, baby eventually gives up and learns that they their communication is not effective, caregivers are not there for them, their needs may not be met, and the world is not a safe place, baby stops crying. Now try this on for size: baby communicates a need caregiver responds sensitively (in an appropriate and timely manner) baby learns that communication is effective, caregivers are present and attentive, needs will be met, the world is a safe place, baby does not need to cry.
Co-sleeping increases the risk of SIDS. Research shows that the opposite is true. When babies sleep next to an attached caregiver there are several factors at play working to protect babies against SIDS.
· Mother is tuned into baby for signs of distress.
· Baby mirrors mother's steady and rhythmic breathing ("reminds" baby to breath).
· Baby mirrors mother's steady and rhythmic heart rate.
· The sucking from frequent breastfeeding increases brain activity and fluid production, increases the flow and efficiency of all baby's systems.
· Skin-to-skin contact increases the level of feel-good hormones and decreases the level of stress hormones.
· Mother's chest actually regulates baby's temperature. If baby's temperature rises, mother's temperature lowers. If baby's temperature lowers, mother's temperature raises and she expels heat from her chest to warm baby.
Once you bring a baby into your bed, you will never get them out. Ridiculous. As discussed above, a baby is dependent as an infant. Allow them a time of dependence! You will not have a 30-year-old in your bed. The more you give them what they need to feel secure as infants, the more safe, secure, and confident they will feel to be more independent than their prematurely pushed counterparts. If you are worried about it, you can use a transitional strategy. Baby sleeps with you while they are breastfeeding during the night. You can then put their bed right next to yours (like an extension of your bed). You can then move their bed to the foot of your bed.
Lastly, move their bed into their room. Include them in the process of selecting a bed and bedding and make it fun and positive. On a personal note, my first born son slept in our room when he was a baby. Even after he was done breastfeeding at night, my husband liked him in our room. Since he worked all day, he valued the closeness having him with us at night provided. As his second birthday approached, we asked him what he wanted and he said, a big boy bed! He got a bed for his second birthday and other than an occasional night when he was really sick, we never saw him at night again. We provided him with security and allowed him to take the lead in establishing his independence. We now have a son full of love, inner peace, and independence.
Babies need a strict bed time. I am an advocate of teaching your children to listen to their bodies. Babies are born with an amazing mind-body connection. If nothing else, they know when they are hungry and tired. Strictly scheduling babies can disrupt this connection. Instead of telling your child to clean their plate, ask them to close their eyes and listen to their tummies. "Is your body telling you you are hungry?" The same is true for sleep. As children get older nighttime can become a power struggle between parent and child. Instead, encourage children to listen to their bodies, hear the signs of sleepiness, and respect them. Have a good nighttime routine and keep moving in the direction of bed (upstairs, bathroom, bedroom, bed, etc.). Try sending the message that the world is going to sleep: go outside to see the darkness, say good night to the sun, hello to the moon and stars, turn off the lights, turn down your voices, take a bath, have a massage, go to bed, read some stories, night-night.

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