Sleep Training: A Literature Review

A friend recently texted me: "Do you have your baby on a sleep schedule?"

Ha! She had no idea what she was getting into by asking me this question.

I'm not one of those moms who Does Things That Work. So, this is not a blog with Answers! However, I thought I'd piece together information I wish I'd had before my baby was born. Plus, it's a huge part of my life lately so it's all I have to write about. :)

I've collected a small library of sleep books and somehow managed to read them in the midst of my zombie brain! Here I offer a comprehensive literature review.

Babywise:
Get it together, baby. You eat, play, and sleep when I say so, and always in that order. You will cry as much as you need to get on my schedule. Soothing is for the weak.
                  Me: Um, I feel sick reading this. Don't make me do this!
                  Babywise moms: Sure, enjoy your moral high ground. We're going to enjoy our twelve hours of sleep.
                  *What I found useful: Coralie is definitely happier with a routine.

Dr. Sears:
You are cruel, Babywise, and you will ruin your baby forever. Instead, why not let her sleep in your bed and breastfeed whenever she wants to? DON'T YOU LOVE YOUR BABY?? Sleep is for the weak.
                  Me: Yes! I am an Attachment Parent! Oh God, I'm so tired.
                  Coralie: It's 4am! Let's play!! Hi-ya! Hi-ya!
                  *What helped: at least somebody is in favor of soothing a crying baby.

Dr. Ferber:
So this thing called scientific research says...(zzzzz). Don't be cruel. Let your baby cry in small, increasing increments. It's the humane thing to do. But you need to "give your baby the opportunity to fall asleep on her own"!
                 Me: This is code for: "Listen to her scream her heart out until you cry into your husband's T-shirt."
                 *What I liked: we tried his method for bedtime at 3 months old, and it made a big difference. Coralie goes down easily most nights now.

Secrets of the Baby Whisperer:
I am the nanny you wish you were. Follow my program and it will be E-A-S-Y! Eat, awake, sleep, time for yourself! Get the routine down and she'll start falling asleep on her own.
                 Coralie: What's wrong with you? I'm not hungry and now I'm not sleepy. I sleep for 45 minutes no matter what you say, thank you very much.
                *What helped: lots of specifics on how to care for a baby in general.

Sleeping Through the Night:
If bedtime is your enemy, this book is for you. It will guide you through every detail. Then, once your baby can fall asleep on her own, the book says she'll sleep through the night when she's ready.
                Coralie: Haha! That's a good one! Hahaha!
                *What helped: acknowledging that sleep training may not work until 5 months. Things really are much different at 5 months.

The No-Cry Sleep Solution:
Get out your pencils, people. We're making charts and graphs and a few Venn diagrams while we're at it. If we track your baby's every move, maybe we'll figure out when she wants to sleep. Or maybe if you just soothe her and feed her enough she'll grow out of it.
                Coralie: WAAAAAAAAAAAAA!

This leads us to our winner. Ladies and gentlemen, I present Dr. Weissbluth's Healthy Sleep Habits, Happy Child. I resisted this book for a long time because I knew he was a cry-it-out advocate. However, this is apparently the book Coralie read cover-to-cover, because so far he has been right about EVERYTHING.

Things he taught me that were helpful:
1. Two words: avoid overtiredness. Put that baby down sooner than you think!
2. You can try all that no-cry stuff, but it won't work for everyone. Some babies really just need to cry it out.
3. Forget "dream feeding." "How would you like it if I woke you out of a deep sleep and fed you when you weren't hungry?"
4. Cluster-feeding and solid foods don't help babies sleep longer.

HOWEVER, the downsides are that I felt like a slave to her naps and I became OBSESSED with sleep. I worried that if she didn't sleep enough her cognitive development would suffer and blah blah blah...can't a new mom get a break?


What We Did:

For the first three months, we soothed like crazy and prayed that Coralie would figure sleep out on her own. She didn't.
Then, we established a nighttime routine and bedtime. Still, she cried and we soothed for hours.
Then, we tried Ferber's method for bedtime. It took a while, but she did start falling asleep on her own. It was excruciating to hear her cry. I sat and stared at the wall and hated myself.
Still, naps were short and she woke a lot at night. I followed Weissbluth and put her down every 1-2 hours.
Now, her naps have finally become more normal. Sometimes we soothe her if she wakes up quickly, and she might go back to sleep a while longer.
She still woke up several times at night though. So, dear reader, we did it. We let her cry.

I am no longer judgmental about people who let their babies cry. We are not cruel people. We are desperate people.

I was starting to have crazy thoughts. Thoughts like, "Maybe I should have a heart attack so I can go to the hospital and get some rest for a few days."

And I have to say, so far it is helping. She gets up less, and I am in better spirits.  She wakes up smiling and laughing and seems no worse for wear. She is a joy! 

If you made it to the end of this post, I adore you. You clearly care about me a lot. :)








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Things I Have Learned Since Becoming a Mother (all three-ish months of it)

All night your moth-breath 
Flickers among the flat pink roses. 
I wake to listen: A far sea moves in my ear.

One cry, and I stumble from bed, cow-heavy and floral 
In my Victorian nightgown. Your mouth opens clean as a cat's. 
The window square 

Whitens and swallows its dull stars. And now you try 
Your handful of notes; 
The clear vowels rise like balloons. 

-Sylvia Plath


"Morning Song" doesn't seem like such a sad poem anymore. She's struggling, and tired, but her disconnectedness starts to improve and her tone softens by the end. She ends with balloons, for goodness' sake. Good for her.
 
I can understand the strangeness she describes. Everything feels new and strange. My body feels strange. Normal society looks different. How does everyone else run errands and talk to each other and accomplish things?

If you expect it to be beautiful and easy, you're in for a rough time. If you expect it to be a rough time, it's beautiful and wonderful, and it's also a rough time.

Single parents are other-worldly super-human beings who deserve our reverence. And paid days off.

Sometimes breastfeeding doesn't help the baby weight.

That first moment of seeing my baby really is as close as I've come to seeing God.

The idea that life is a gift feels more real to me now. It's a gift, but it's not a gift you just unwrap and smile at.  It's fought for. That whole birth thing takes you to the brink of your mortality, the trembling point where life could begin or end. I realized we have all fought hard to be here...HARD.

I can pray for our long, happy, healthy lives every day. But life is not in my control. It's only because of God that I get to exist at all, and to have the opportunity to hold this baby.

There is an underground war going on about infant sleep. There are basically two sides: those who believe in "sleep training" (often known as crying it out), and those who think you're a terrible person if you let your baby cry it out. The sheer vastness of books and blogs and opinions on sleep is overwhelming. The more I read, the more confused I get.

Or maybe I'm just confused because I'm sleep-deprived. OH RIGHT, we're all sleep-deprived. That's why everyone's fighting the underground war!

I went back to work because I had to, but I stayed back to work because I love it. Doing therapy makes me feel more whole. I'm afraid to admit that I might not be cut out to be a stay-at-home mom.

Babies need dialectical behavior therapy just like all of us. For example, some things will calm her down when she's at a 5 on the Richter Scale that won't calm her when she's at a 10. At a 5, I might swaddle and shush and sing or whatever. At a 10, only the boob will do.

Another example: we all benefit from accepting the co-existence of contradictions. She can be tired and wound up. Breastfeeding is wonderful and difficult. She is the most amazing thing in the universe and I love her more than I could imagine, and could someone else please take her for a bit?

As Ti would say, "Be there for the experience of it." And just look at that little face.

My Birth Story

During the course of my pregnancy, I must have read/watched/listened to hundreds of birth stories. I couldn't get enough of them. I am endlessly fascinated by the powerful, raw, life-changing process of birth, and I felt like each story helped me manage my expectations. I thought I'd write mine down too, in case there is anyone like me out there wanting to know the gory details.

I was six days past my due date, and I wasn't feeling much of anything.  I could tell the baby was very low, and moving a little less, but I wasn't feeling any contractions. The best secret I can conjure up to inducing labor is watching Jon Stewart. Also, a wintry mix storming in the night before Jason had two tests to take.  At 11:15 PM in the middle of The Daily Show, I felt a pop and my water broke. EVERYWHERE. I called our midwives, who confirmed my suspicion there was some meconium in it, so we started packing up and getting ready to head to the birth center.  (We chose to deliver in a free-standing birth center 40 miles from our home--that's how much I don't like/don't trust hospitals.)  My adrenaline was sky-high...I was shaking, my mind was racing...it was one of those rare moments in life where time seemed to collapse into that single moment, and I knew I had to dive head-first into whatever lay ahead of me.

In the end, here are the main points I learned from all those birth stories:
1) Birth is different for everyone.
2) It's a journey you have with yourself.
3) There are ALWAYS unexpected things that happen.

Some people slowly ease into labor. They have contractions that start off mildly, have time to get used to the sensations, and feel a steady progression over hours or even days. I expected that to be my experience. WRONG. Not me! It's more accurate to say I was FEROCIOUSLY ATTACKED by labor.  The 45-minute drive to the birth center was somewhat tolerable (bless Jason for getting us there in the middle of sleet and snow); I listened to my hypnobabies podcast and timed my contractions with my handy iphone app (like the good student that I am!). The midwife checked me when we got there, and I was 2 centimeters dilated, 90% effaced and the baby was at -1. I was glad I knew that didn't necessarily mean anything about how long I would be having this battle, because after that, my contractions took off like a steamroller and dragged me along behind them. They were only a few minutes apart and lasting 60-90 seconds.

The hardest part at this stage was this strange, sharp, fierce pain in my back and low abdomen that didn't go away between contractions. I expected to have at least some breaks between contractions. Literally NO ONE had described this awful pain! I told the midwife, and she wasn't surprised. "It might be the position the baby's in, or it might be your anatomy..." something about my pubic bone being really low...in any case, I took that to mean it wasn't going away. That pain made it so that I couldn't relax into the contraction like all my books had advised. I felt like I was hanging on for dear life. Nothing eased it.  The only position that was even remotely tolerable was to be on my hands and knees, so I would do that and rock back and forth and moan and just keep telling myself, Maybe I'm having a fast labor...maybe I'm having a fast labor...

The birth center was a wonderful environment.  They left me alone when I wanted, and came in when I needed. I could move around, walk, shift positions, turn the lights low. I felt like I was going to puke, so the midwife put a little peppermint oil in a basin for me, which helped. I turned on a playlist of soft music I'd listened to every night before bed for years, and that also helped some. I kept thinking, I don't know how people do this in a hospital! If I were strapped to a bed, poked and prodded, fluorescent lights and beeping machines everywhere, I don't think I could cope. At one point, I asked the staff, "Please, does anybody have any suggestions??" and they showed me a few things: pushing my hips together during a contraction felt pretty good.  Eventually I asked if I could get in their tub.  The midwife said they usually wait until four centimeters, because it can slow things down, but I clearly needed it.

Getting in the tub helped a little, if only for a change of sensation. My arms and legs were also getting tired from holding myself up, which was worrying me (I knew maternal exhaustion was the most common reason for a hospital transfer). The water helped with that.  Once I got in, the midwife asked to check me again. She could tell with her special midwife tricks that I had progressed pretty far--and lo and behold, I was 7-8 centimeters! I was in transition--after only three hours! "Oh thank God. Oh thank God," I panted.  She went to get a few things ready, and by the time she got back, I felt the unmistakeable urge to push.

I can see how vulnerable any woman is at this point the energies and words of those around her. I felt completely out of control and lost in self-doubt. I kept asking, "Are you sure this is going okay? That I'm in the right position? That she's in the right position?" If someone had seemed concerned and told me I needed a C-section, I would have believed them. I'm glad I knew that self-doubt is normal and a good sign that the labor is almost over. I'm even more glad that everyone around me was so calm, confident, and encouraging. "Yes, yes!" they all said, "Your body knows what to do. You know what to do. If you want to push, then push!" I would whimper, "I can't do this!" and Jason would answer, "You ARE doing it!!"

The midwife talked me through the pushing stage beautifully. "At the peak of each contraction you'll feel the urge to push," she said, "and the first thing you'll notice is that it feels like she's coming out your butt." Ha, yes! That's exactly what it felt like! Luckily I did get longer breaks between pushing contractions, during which I would pant and moan and curse and maybe cry, but crying took too much energy. I kept thinking, Some people say you go kind of numb during pushing or that it feels like a relief...nope! Not me either! I started off on my knees, then moved to squatting on my feet per one midwife's suggestion. Jason sat just outside the tub. When I felt a contraction coming, I'd reach up and grab his hands. He'd hold me up and I'd use the counter-pressure to help me push. I kept thinking, God, I love how strong he is. I feel like we're doing this together.

I'd been warned about the "ring of fire" when the baby starts to crown. Yep, that's an accurate description. My favorite moment: at one point I asked the room, "Is there ANY way to make it burn less??" The midwife paused and answered, "Just to push her out."  It's such a weird feeling, knowing you have to make things worse for yourself before they get better.

I pushed for maybe an hour. As she was coming out, no one touched me, they just shined a flashlight on her and talked me through it. After her shoulders were out, they told me to reach down and grab her. I grabbed my own baby! I brought her out of the water, and she screamed immediately. Her eyes were open. I could tell she was healthy and strong. At that point, everyone sprang into action. They got her cord unwrapped from around her neck and had me hold her correctly. I stared at her and kissed her and told her how well she had done, and that it was over. I heard Jason crying softly. I felt almost too overwhelmed to even cry.

They got me out of the pool and put us both in the queen-sized bed. She latched on and starting sucking immediately--a huge relief. But after the placenta was out, things got a little scary for me. I started losing a lot of blood. When I tried to get up, I almost fainted and my blood pressure was very low. One of the midwives wanted to give me cytotec, which really scared me--I had heard horror stories. Bless her though, she patiently answered my questions and laid out my options. "You can have cytotec, a shot of pitocin, or we can send you to the hospital for a transfusion." "Cytotec it is!" I finally answered.

No one ever told me about the horrible part where they push on your uterus over and over to check things out. That was INCREDIBLY painful. Even worse, huge clots were coming out, which scared me. They felt half as big as the baby was.  After a while of some seriously agonizing manhandling, I finally had a crying spell. I was just so overwhelmed and scared and tired and hurting. After two liters of I.V. fluids, I finally started to feel more stable and the bleeding improved.  All the while, the baby did great. I focused on how perfect she was and said my mantra/prayer: "I am safe; I am healthy; I am loved; I am protected."

She was born at 5:10 AM. At 2:30 PM, they let us go home (though I would have liked to stay longer, I must admit!). Recovery has been slow for me; that first week it was hard to get out of bed. I was anemic and felt weak and very tired. Now, I'm slowly feeling improvement. Reconnecting with the medical world (read: going to the pediatrician) was upsetting, and made me appreciate the birth center all the more. I love how non-traumatic the whole experience was for her. No one took her away from me. No one handled her impersonally. Nothing interrupted our bonding. 

If anybody out there wants to do the natural labor thing, here are my suggestions:
1) Read Natural Childbirth the Bradley Way by Susan McCutcheon. We didn't really use all the coaching stuff, but the breadth of information was very helpful.
2) Also read Ina May's Guide to Childbirth by Ina May Gaskin. It's mind-blowing.
3) I watched "The Business of Being Born" over and over.
4) Get in touch with your higher power and surrender. :)


Now Coralie and I spend our days learning together, with me periodically overtaken by waves of gratitude for how beautiful and healthy she is. I am also extremely thankful for my village of help: Jason, our moms, friends and family have been amazing. I don't know how I could do it without them.    

Countdown

Here we are, Coralie, with five weeks left before your due date. You're moving like crazy. You've got a little foot planted way over on my right side that you like to stretch out and let me tickle.

I started feeling you move at 19 weeks.  It felt like a little fish bumping up against my insides.  At 23 weeks, I had some gelato that got you excited, and Jason was able to feel you move. He cried. It was one of those perfect moments.

That second trimester I worked a ton of hours, I exercised...I felt like I could handle anything. Now, I'm using my coping skills to get through the workday.  I'm feeling easily fatigued and quiet inside.

I'm grateful for a sense of rightness and readiness. As weird as it sounds, I feel like I've been waiting for you for a long, long time. We all can't wait to meet each other. As far as I can tell, you are just plain excited to be alive. You remind me how amazing life is.   

I've become a little obsessed with how much I want us all to live long, happy, healthy lives.  I ask God for that constantly, and thank God for every day I have with Jason and you and our families and friends.

God is caring for us so beautifully. I haven't always been able to feel that like I do now, and I am thankful.

God, therapy, and mommyhood

Hello again, blog! Time flies! I can't believe how long it's been since my last post. I apologize for neglecting you. Maybe it's true what they say, that contentment is bad for creativity. No, I think I've just been busy.

One thing has happened: there's a little human being in my belly. How crazy is that? I can already feel her fluttering around in there. She's been very good to me so far. I haven't felt that different, except for tiredness. So. Tired.

I notice it most at work. I feel more impatient, like I have less to give emotionally. I worry I may have lost a few people as a result. I try to tell myself that God is giving me what I can handle for the day, and the people who need me. The thing is, I don't have a job where I can have occasional checked-out, tired days. I've had those jobs before, where you can coast through sometimes and stare into space. That's about what I feel like doing. Well, what I really feel like doing is taking naps and picking flowers. Is that so wrong?

I feel I need to be "on" most of the time as a therapist. After all, that's what I would want from a therapist. People are making time and spending more than they want to see me.  And when I'm able to be, I'm frequently, almost daily, in awe of the inspiring, profound, thought-provoking, sacred, crazy and even fun! moments that happen. Other days, I don't have it in me and just want people to be okay, fast.

I work for an organization that promotes "faith-integrated counseling." We used to be "pastoral counseling." At first, I was worried my personal beliefs would clash. I'm not sure I can be any authority on helping people get to know God. I'm realizing, though, that the joke is on me--I'm the one getting to know God better. I turn to God more and more for guidance (not to mention soothing--plenty of sessions I need to do some deep breathing and say a little prayer!). Sometimes I feel like God says stuff to me through my clients. I don't know why some people get better and others don't...I think it's often in God's hands.

Being pregnant has a way of turning my mind to God, too. Who understands such a miracle? With both work and baby, all I can do is show up and, as Ti would say, "open myself to something greater."

   

On Planning a Wedding

As we sat together looking at our wedding pictures, Jason turned to me and said, "That was really fun. Let's do it again." "Yes!" I said, "Do you think anyone would notice if we sent out invitations again saying, 'Hey everybody, we're getting married, come to our wedding...'?"

Lots of people talk about how stressful it is to plan a wedding...how wrapped up in materialism and meaningless traditions...so expensive it could be a down payment on a house...a huge industry preying on women's ideals. Well yeah. So. I used to think those things too, but in the end it didn't feel that way.

I loved it all. I learned a lot about myself, about Jason, about covenants and family. I think I'll have some friends getting married in the next couple years, and if I could pass along any lessons learned, I would have a few:

-Do it. Yes, it's expensive, and a lot of work, and it can be stressful negotiating family stuff. But creating such a transcendent moment is worth everything. To be surrounded by as many loved ones as possible, celebrating hope and love and commitment, is one of those sublime memories that will stay with me forever. You never know what will happen with houses or anything else you can spend money on...but that experience is irreplaceable.

-More than just that night, the process of clarifying our intentions was incredibly meaningful. Our pastor asked us, "What is it exactly that you want to promise to each other?" Answering that question was a dynamic process that put us in touch with something sacred and wise and creative in each other.

I've had a couple friends lose relationships recently, either through death or another's trouble with commitment and intimacy. It used to feel overwhelming to me to think about a lifetime commitment. Who knows what can happen in a lifetime? How can I promise that? But I am reminded that we are really only borrowing our loved ones for as long as the Universe allows us to have them. Why not fully BE THERE while you can? I dearly hope it's a very long time. I no longer understand viewing marriage as a huge, lumbering sacrifice of the self. It's precisely because we can't predict what will happen in a lifetime, or how long that lifetime may be, that I want to wholeheartedly commit to being there heart and soul. It feels good to have that intention, because each moment, and its intention, are all we really have.

My Sister's Toast

We did it! We got married!

It was a truly magical night, full of hope, love, an amazing community and pure joy. One of the best moments that I will remember forever was my sister's toast. When she got up to speak, the whole room was enthralled, with everyone hushing and then laughing and then hushing and then crying. She inspired everyone sitting there with us, taking part in our commitment. I wanted to share it with the world.

Hi there- For those of you who don't know me. I'm Nicole. Robin's sister. I've always been Robin's one and only sister and Thank God for that .... Because she's an incredible person and I am really glad to have that special "in" -- to get on the list of people who are lucky enough to know her big heart and insightful, courageous spirit. To get invited to this party. So, I'll just start this by gushing - Rockin' Robo Robin I LOVE YOU.

For those of you who just started listening... Hi, I'm Nicole. Jason's sister-in-law. I've been Jason's one and only sister in law for about an hour … And so far he's an incredible person -- kind and courageous and funny PLUS I get to send him texts with random medical questions - like why does my stomach growl and do you think I'll lose my injured toe nail (Here's a pic)?? So 5' 17" Jason "Chance" Chancer (man who loves nick names) You have officially earned another one … You are Uncle Jason to those little flower girls over there. (Ella stood on a chair and just BEAMED.) And we are lucky to have you as part of our family.

Robin and Jason care about family. I've seen it in the way they love on my kids. I've seen it in they way they brought our two families together. We've all seen it in things like the blessing of the rings. We each have a part in this marriage - in supporting and loving you two amazing people as you promise to love and support each other most of all.

Robin has mentioned at least 4 times over the last year how much it means to her when people are genuinely excited for them and their engagement. As she told clients, friends, or just wore a veil around Las Vegas… people have sincerely wished her and Jason well and been excited for them. I've seen this touch your heart deeply because family and community matter to you both so much…

But it also struck me...

No matter what we see happening around us in the world, there's something sacred about marriage … two amazing people, who are awesome on their own, team up and promise to love each other unconditionally for their entire lives … and we all feel a sense of Hope; Some sense that this is what life's all about.

Robin and Jason - your marriage is more than just a ceremony. You are the hope of the world. :)

So, since we all have so much riding on this sucker, I (as your matron of honor… AKA Lead Bridesmaid) have a little pep talk for you before the game clock starts.

Be grateful. Love is a gift. Treat each other like the person you are hoping to marry soon rather than the person you are now stuck with. Robin is a gift. Jason is a gift. Remember you don't owe each other anything. Let each touch, smile, word, and dish washed be an unexpected gift.

Let it go. Whatever is bugging you about the other one… LET IT GO. Quickly. Decide to love them more than that thing that bugs you. Let it go.

Hang on. Whatever it is you love about each other… there will be days it is not true. Robin will not be beautiful or kind or well-spoken, Jason will not be funny or brave or intelligent… these times might be short but it will be long enough to make you question everything. So hang on. Dig in - To loving the deepest, most epic and personal parts of each other. The parts you cannot list or recite. The parts that defy explanation because they are the core of him or her. Love that part on the hard days.

Share everything with each other. Protect each other. Love each other. Never give up. Never put anything or anyone above your marriage.

We believe in you. We are so excited for you! We support and love you both. We've blessed and warmed those rings… now, love the heck out of each other.