Tuesday, April 21, 2009

Problem Solving - Toddler Sleep and Bottle Rejection

This happened a few weeks back, but I wanted to write about it. I had a couple moments of motherhood where I tried something new to fix a problem and it worked!

Problem One- Toddler Fighting Bedtime:
Ever since Harper was about to arrive, Z's sleep has become a problem. He started fussing about going to bed and waking up at night. He hasn't done that since....man, I don't even remember... it's been a long time. We chalked it up to anxiety about the change with the baby and just kept at our usual routine. Then he started to climb out of his crib. Darn. The problem became a little more challenging when we had to physically put him back in bed. Thankfully, John usually handled this since I wasn't in a position to be lifting a toddler (pre and post delivery). So, the problems have continued. Some nights John would have to put him back in bed 6-8 times with Z throwing a major fit the entire time. And that crafty little guy eeked out more and more concessions at bedtime... this book, that light, check the door, doggies barking, drink, etc. Finally, I had the idea that the core of the issue was that he wanted more time with us. Instead of letting him watch some TV while John and I did other things before bedtime, we started sitting down with him and reading books or some other activity BEFORE the bedtime routine starts. Not only is it nice family time, it mellows him out and he is less whiny about starting the bedtime routine. The first night we tried this, it worked like a charm. We put him in bed, said goodnight, and that was it! Of course, now we have to be consistent about doing it, which can be hard at the end of the day when you would rather veg with the TV on. But, dang, I was so excited my idea worked!
P.S. Z is doing great in his toddler bed. We are trying to enforce the stay in bed rule. (I say try because we're struggling with enforcement in the morning when he very quietly gets up and starts to play in his room.) He is doing pretty well with it and hasn't had a lot of get out of bed moments when we put him down at night and at nap time. Overall, he seems really comfortable in his new bed and seems proud of his big-boy-ness. Yeah! And I thought it was going to be a nightmare. (Sheepish grin)

Problem Two- Breastfed Baby Rejecting Bottle:
I started Harper on the bottle when she was about a week old. We had no problems until week 3. There were 5 or 6 days of pretty frustrating feedings, including one my Mom handled like a champ where she screamed A LOT. It did start to get better (we didn't change anything like nipples or bottles or time of day), but Harper is still pretty finicky about it. She isn't screaming full out anymore, but we definitely have to coax and soothe to get her to do it. She'll do the first ounce or so fine, and then she starts to push it around with her tongue and sometimes fuss. So, it takes forever to get her to take it (not even all of it) and then she gets to bed later and then she's fussier, and then she is super tired for her 10pm feeding. So, one night she was fussy and flailing with the bottle, so I decided to swaddle her and then try again. It worked! She calmed down and even got a little sleepy and then finished the rest without a problem. Since this is the bedtime feed, I don't have to worry about her falling asleep right after the feeding. And my swaddle is loose enough around the middle I could sit her up to get a burp. I don't have to use this technique every time, but I'm sure glad I have something when we need it.
P.S. Another thing I tried for this was when she started rolling it around with her tongue like she was confused about what to do with it, I would switch and give her a pacifier. When she started going with that, I would switch to the bottle again. It worked pretty well (although not every time) and sometimes got her going again. I think I haven't used this one as much because I'm not sure if I'm just confusing her more with the different nipples. Anyway, I mention it as just another thing to try.

Sunday, April 19, 2009

When Did That Happen?

Something about my little baby boy getting into a real bed makes me suddenly sad. We bought the bed and assembled it, moved out the crib and sold it all in one day. In less than 6 hours. I thought I was ready for it until I started crying when the adorable little couple drove off with my Baby Z's crib in their truck.

Before:


After:


Just another way our little boy is growing up.



Saturday, April 18, 2009

Crying It Out - Revisited

I've been thinking and reading about crying it out lately. I keep expecting to have some of that with Harper as the newborn sleepiness wears off. I thought I would write some thoughts on it for myself and for those with new and not-so-new babies. Some of this is based on going through it once already (see Strategies for Crying It Out)and there are some things I would do differently.

1. Start As You Mean To Go: This is from Tracy Hogg's Baby Whisperer book. Her whole point is to make things easier for you and your baby by starting from the beginning with how you want things to be later. If you don't want to rock your baby to sleep at 3 months, then don't start with it at 3 days. It's easy to think there will be some age when you will feel more comfortable not rocking the baby and listening to him cry, but the truth is that changing later will be hard on you and on the baby. I would add to that that if you think hearing a newborn cry is rough, wait until you hear a 3-month-old cry. They just get better and better at tugging on your heart strings.

2. It's Not Too Late To Start: Having said number one above, I also have to say that it's never too late. Babies are far more resilient than we are, so chances are good that it will be much harder on you than on them to make a change when you decide to do it. If you're frustrated or unhappy with where you are now- change it! Don't convince yourself it's just a phase and things will change. Babies/Children need to learn how to sleep. Sleep training is a skill they will carry for years; just ask around and you'll hear of 2, 3, 4 year-olds who still get up in the middle of the night. Our bodies establish little clocks for our sleeping. If you're always getting up at night, your body will start to expect it.

3. Are You Really Ready?: Don't start it until you are 110% committed and your spouse (especially your spouse!) and other caretakers are too. You could work tirelessly to get them sleeping at night only to sabotage it by continuing the old routine during the day. As long as the baby is getting the old routine at any point, he will continue to expect it at other points. Don't confuse the baby by doing it half-heartedly.

4. Remember the Big Picture: This is part of number 3. If you keep in mind the big picture that you are doing what is best for your baby and your family in the long run, you'll be less likely to crumble in the moment. Write down why you are doing it on an index card. Tape the index card to the door of the nursery, carry one in your pocket, tape it to the mirror. Repeat it like a mantra when you're in tears because your baby is in tears. Also, remember that letting your baby cry will not scar the baby emotionally, psychologically, physically. Your baby does not think you're a bad Mom. Your baby will not remember that you let him cry when he is an adult in psychotherapy. (Now, I am very confident in these statements based on my worldview. Others may not agree and, if so, will have a much harder time with a crying-it-out scenario. This blog is probably not for them.)

5. Make A Plan: Decide ahead of time how you will approach the situation and go over it with others who can help reinforce the plan (especially a spouse).
METHOD: Will you wait a certain amount of time before going in to soothe the baby? Will you use the pacifier? If you're working on putting them down to sleep, I suggest reading this very helpful post based on Tracy Hogg's newest book: Sleep Training - Four S's
There are those that swear by the Ferber method which uses a ramping up approach where you start with 5 minutes crying and then progress to 15 minutes. I think this is probably successful in the sense that it is a ramping up that parents can handle. That is extremely important because the parents need to stick with it. Now, for me, I found that I had to go whole hog. The minute I cracked and went in to Baby Z it only made things worse and started the clock all over. In a way, it tells the baby, "If I cry long enough, she'll come back. So, I'll keep crying." That said, I would just recommend you develop a plan and then stick with it. As long as your consistently working toward them falling asleep on their own (whether gradually or abruptly) then you'll get there; it is just a matter of how long it will take.
DISTRACTION: Part of your plan should include what you will be doing while the crying is going on. You must do something to keep yourself occupied and distracted. Go outside, put in earplugs, listen to music, organize the junk drawer. Whatever it takes. If your spouse is stronger, let him stay in the house while you go out for a walk. Or, go outside yourself (assuming you can hear enough to know if there is danger - choking, gagging, earthquake, fire. Smile.) One distraction that worked for me was writing about the process. Writing for my blog was accountability and catharsis all in one. A phone call to a friend (who is supportive and understanding, obviously) is also a good distraction.
TIMING: Decide when to start your plan. Perhaps you'll need to clear the calendar so the baby can sleep at home. Maybe you want to include the weekend so your spouse can help (or perhaps you need to avoid it because your spouse will weaken your resolve). Maybe you need to do it on the days when you don't have other caregivers. I would recommend giving yourself three days to work on it (See number 6 below).

6. Stick With It. Stick With It. Again, Stick With It: Rome was not built in a day. Sleep was not conjured in 2 nap times. I always prepared myself for 3-4 days of hard work. It takes time and repetition for a baby to learn something new. You can't expect to change something in one nap and see immediate results.

7. If You Cave In, Don't Give Up: I wrote this with baby number one and I'm so glad to see that. I struggled more with expecting perfection with my first. I though that if I messed up the game was over; there was no going back. Again, babies are resilient. If you don't stick with the plan, dust yourself off and start again at the next nap. Listening to a baby cry is extremely difficult. It is one of the most grating and stressful sounds on the earth (literally- there was a study on it). So give yourself a break and then get back on that horse.

Wednesday, April 15, 2009

Quick Question and Answer

I just had a recent new visitor to the blog who had a question:

I have one huge question.. What do I do when my baby who is 9 weeks old won't stay awake after feeding.. He is bottle feeding and some days he is dead weight after a feeding no matter how hard I try. Any advice??

I assume you've tried all the standard methods to keep him awake like taking off his clothes, using cold water on their face or feet (I often use a wet wipe), putting them on the ground so they aren't as cozy, etc. Oh, have you tried a bath? That would probably keep him awake after a feeding. Usually this is the sort of thing you do to wake them up in order to eat. I don't think it is AS critical to keep them up after they eat. As long as it is not a regular habit (every feeding), I would try your best and then just put the baby to bed.

The goal is to establish a pattern of eat, awake, sleep. I'm sure there are lots of reasons behind that pattern (see BabyWise book), but an obvious one to me is that they are not becoming dependent on the bottle or breast to go to sleep. Going from awake (or drowsy) to sleep helps them learn how to put themselves to sleep. It also helps you make sure they get a full feeding and don't fall asleep in the middle of it.

So, first, if it is not a regular thing, as in every feeding or most feedings:
If you can see a pattern to when he is very sleepy, try to anticipate it and put him down to nap earlier before that feeding. Or even let him sleep a little longer before the next feeding (not more than 30 minutes). How long of a nap is he getting for each feeding? A good nap for this age could range from 1 1/2 hours to 2 hours (assuming about a 3 hour routine). So, one option is to put him down earlier if he isn't getting 2 hours nap already.

If it is more regular (pretty much every feeding) where he falls asleep right after the bottle:
Are you waking him up for most feedings? You may need to go to a 3 1/2 to 4 hour feeding routine. The caveat to that is that he is already sleeping at least 4-5 hours at night, that is, he is only getting one middle of the night feeding. So for us that means Harper eats at 10:30pm and then 4am and then 7am -wake up. If he's not doing that yet, then I would start pushing him to drop one of the middle of the night feedings (that means you have to let him cry and perhaps use the pacifier to get him to go back to sleep). If he sleeps longer stretches at night he may not be so sleepy during the day.

I would definitely push for the one middle-of-the-night feeding before switching to the 4 hour cycle. However, I do think it's okay to go to 4 hours before you drop that second middle-of-the-night feeding. I think the BabyWise book says that this transition to 4 hours and the sleeping all the way through the night happen around the same time. If you're having a hard time keeping the baby awake for pretty much every feeding, I would look to expanding the feeding increment to 3 1/2 to 4 hours. And make sure the baby is getting a solid 2 to 2 1/2 hours nap. Be sure to watch for those sleepy cues (the stare, the yawn, the fussing not immediately following eating) and get the baby to bed when he needs to go. If he gets more rest at each nap, he will probably be less likely to go straight to "dead weight" sleep after a feeding.

I hope this helps. Remember, the bottom line is that parent-directed feeding means you watch your baby and decide what your baby needs. Something I'm doing better with on baby number two is that I'm not as worried about anomalies in the routine because I know in the big picture they don't matter. So, do your best and then try to relax and enjoy!

Tuesday, April 14, 2009

Words, words, words: Update

It's been a while since I posted about Z and his expressive speech delay. He's been going to group speech "play group" for 8 weeks now and it's been beyond fantastic. In general, having a place to go and play twice a week in a structured, active environment has been really good for all of us. Z gets to do things like sing songs (well, listen for now), paint, glue, etc. that we don't do at home. And I get some time to sit (without trying to keep a toddler busy) while feeding Harper and watching his class. I can really see God's plan in the whole thing.

Z is doing really, really well with his words and talking. He is putting sentences together and surprising me every day with a new word or two. It is SO great to have him be able to communicate. He is less frustrated and even when he does start to whine we can usually focus him on using some words to tell us what he wants.

I love hearing Z talk and tell us about what he sees and learns. I love words and it is so special to see this part of Z's development. Perhaps it is even more special because it came late. It's also encouraging because we get more feedback on what he understands. I was telling him not to poke people or animals with a turkey baster (shaped like an elephant with a long blue trunk) he likes to carry around. I went through people and things and asked if it was okay to poke: Can you poke Mama?....No...Dada....No...Harper...No....Snickers (Grammy's dog)...No...etc. Then, a few minutes later, I heard him going through the whole routine. Dada? No poke. Sickers? Nope. Gammy? Poke? No. It was awesome! I love hearing him process things.

So, as it goes with kids when they're learning to talk, there has to be a funny story or two. So far the best one is when John was leaving for work and he asked Z: "Can you say goodbye to me?" And Z said: "Goodbye me."

Friday, April 3, 2009

Decisions Are The Worst

I've been reading a really good blog recently: Chronicles of a Babywise Mom. Unlike me, she has used the Babywise approach past the sleeping through the night phase. I got the Babywise II book but, honestly, only used some of it. Now, I've started reading it again and I could kick myself! There are so many things I could have done to make life easier now. I must go out and get Toddlerwise now.

I realize that I have opened up too wide the freedoms Z has. Babywise and Toddlerwise talk about the funnel of freedom and how you limit freedoms to a child until they show the maturity/capability to handle them. For example, you wouldn't let a 10-month old play with the remote, even though at the time they are doing no harm. He doesn't know how to change the channels and he hasn't started banging it on the coffee table. However, one day he will start that behavior and it will no longer be okay to touch the remote. So, it is better to restrict it from the beginning than to suddenly have to pull back a behavior that was previously okay.

I have to admit I didn't do a good job at that. When thinking through my strategies for baby "proofing," that is, what I wanted to be off-limits in the house, I failed to think through what it would look like for Z to do something similar when he was older. I didn't limit certain behavior early because the effects were minimal. Then, later, when Z became more developed and creative, I realized I should have never let him play with such-and-such. I also tended to think that a restriction at 10 months was going to be a restriction forever so I would hesitate to limit him. Instead, I should have been thinking that, for that time, Z wasn't able to handle something, but later he might, and at that time I could give him that freedom.

Let me give a practical and more personal example. When Z was around two years old I started to let him eat snacks in the living room. He did a pretty good job of being careful, but he was physically not coordinated enough to keep from spilling fairly regularly. Besides that he also gets extremely transfixed by the TV (like his Mom) and becomes so unaware that he spills and doesn't even realize it. It wasn't until I was pushed to an extreme (mashed Crispix all over living room) that I pulled back the freedom and made him eat snacks at the dinner table again.

Another good point from Toddlerwise, summarized by Chronicles of Babywise Mom was that when toddlers have too many choices behavioral problems ensue. Giving them too many choices pushes them beyond their developmental capability. It also gives them the feeling that they have more control than they do. After reading this I wrote a list of the times I give Z the opportunity to make a choice. I guess I had heard that a good way to keep a toddler from tantrums was to give them some choices. This is probably true, but if you go over board they start to expect it and then throw tantrums when they don't get the choice. Backfire. When I looked at my list I realized that I was, in a sense, negotiating with Z all day long. This cereal or that. This shirt or that. Even by asking him if he wanted to go to the park is misleading. I had already decided we would go to the park, so there is no point asking him his opinion. Then I'm stuck in a negotiation, convincing him it will be fun, etc.

Holy cow! The lightbulb has really gone on! Now I'm more aware throughout the day about how I tell Z what to do. Probably 95% of the time I phrase it like a question. Even when I say the command outright, I can't stop myself from saying, "okay?" on the end. Urgh. This is going to take some serious retraining- and I'm talking about me, not Z. I also realize how often I let Z pick what he is going to do rather than direct him. Just in one day, after reading that blog entry, I started telling Z what he was going to do next rather than just letting him decide (when we have free time usually because I'm feeding Harper). I picked the snack and set up an activity. I was amazed how well he responded! I was expecting tantrums or at least protest, but he just went along. (Boy, you know you've let the discipline go if you are surprised when your child obeys you. Sigh.) He actually really enjoyed it. Gosh, this all seems so obvious now, but, oh well, it's more important what you do once you know than what you didn't do when you didn't know.

Like I said, in that one day where I changed my approach and started directing rather than just sitting back, there was an improvement in Z's behavior. And, well, don't get me wrong. I still had to do a lot of disciplining. Perhaps more. But it was my attitude and mentality that was better. I felt like I was the leader/manager/parent. I wasn't the victim, waiting to see what my toddler would inflict. This is very similar to how I felt when Z was 10 weeks old and I was wound tight at every nap wondering if Z would sleep or not. My Babywise mentor came over to help and we worked through an approach to help Z sleep and help me keep sane. Once I had a plan for how to handle Z's crying, I was a new person. His crying hadn't changed one bit but I had changed. I can never say enough about having a plan.

Wow. I feel like I'm actually trying to be a parent again after many months of just trying to get by. It's not an excuse, but being pregnant (1st and 3rd trimesters) was pretty tough while parenting a two year-old. However, it probably just cracked the veneer of my parenting, and showed where things were already barely holding together under the surface. When I had energy to entertain and cajole Z, things were easier. It wasn't that he was better behaved; I was just better able to extract the good behavior. I'm thankful for the gentle way God is showing me this now, when I'm ready to handle it.

That felt good to get all of those thoughts down. Naptime is almost over. I only slept 15 minutes because Z has been waking up regularly during his naps (and sometimes at night too); I'll save that for another blog. But really, I couldn't go back to sleep because I have all these thoughts running through my head. And that is the main reason I started a blog in the first place. So, thanks for listening.

Thursday, April 2, 2009

Sleep: Yeah! Bottle: Boo

Last night Harper dropped the late night feeding without any special help from me. Even though I vowed to let her cry for the past few days, she only woke up at the 3/3:30am time which is when I wanted her to wake up. Then she was waking up around 6:30am, close enough to our 7am wake up time that I just used the pacifier and rocked her a little to get her as close as I could to 7am. Then, today, for the first time, I woke up when she did (6:55am) and fed her right away! I'm so thankful we've reached this milestone and I'm even more thankful I didn't have to push too hard to get there. Praise God! It's amazing what 5 hours of continuous sleep can do.

On the down side, it appears Harper is rejecting the bottle. She just started getting really finicky about it and last night she firmly let us know that she was not happy about the bottle. She really doesn't cry much and last night every time we tried with the bottle she gave us her loudest protest to date and looked downright angry! Just to be sure it wasn't gas, I offered her the breast and, lo and behold, she had no problems with that. Doh!

So everything I've read about this problem says to just keep at it. Have someone besides me offer the bottle. Don't give in and feed with the breast (okay, okay, I know). Urgh. It's tough to keep at it for the 7pm feeding when we're also trying to get Z in bed. And then she doesn't eat enough so she doesn't sleep well from 8pm to 10pm. This seriously impedes John and my down-time at night. Sigh. But, again, we have to sacrifice the now for the good of the later. I can't imagine life without being able to give Harper a bottle. That is not even an option.

I'm thankful for God's timing on this that I'm getting a little more sleep so I'm better able to cope with a setback like bottle rejection. Gotta just hang in there!