Behavioural & Cognitive-Behavioural Psychology

Sleep update

 

Have now added a bed time story to the routine! After the Bath, Change of clothes (was supposed to be a massage here as well but he was usually bit too tired, screamy and wanting a feed at this point) and Feed elements of the current routine.

The first few nights the LL fell asleep as usual during the bedtime feed. However, rather than putting him into his cot asleep (well, he does wake up a bit when moved into the cot) we now read him a story (Goodnight Moon, at the moment). At first he woke up very annoyed and crying, but now he sits and looks and touches on the book calmly. We then put him into bed awake and let him fall asleep. It takes him a while and sometimes with a bit of crying, but he eventually falls asleep without feeding. If he cries we go into the room to comfort him, he stops, then we go back out again and leave him to keep trying.

Next step – Try this for naps! I’ve been trying to read LL a story before day time naps (the Hungry Caterpillar) as well. Unfortunately we are still doing rock yourself to sleep in the buggy for day time naps. But – at least he is sleeping. One step at a time, and he still feels very little, getting on for 5 months.

Day Time Schedules

Thinking more about him sleeping through the night, I was thinking about schedules. ???????????????????????????????

I’m attempting a better day time schedule (maybe this will positively impact on night time?). So far we don’t really have one. This is terrible I know because in my work I am all about behavioural interventions and working with people to log their activities and create meaningful activities and some structure to their day. In my depression related work with adults this can be fundamental and people often see an increase in mood with an increase in meaningful activities, good self care and better sleep at night. At the moment with LL we just do what I think he wants to do when he wants to do it. It’s probably an extension of the feeding and sleeping on demand that was present from birth. But now I’m wondering if the lack of structure and routine is just not very containing or predictable for him, or for me. Naps and feeds then get thrown off and can occur at any time. He doesn’t know what to expect and neither do I.

In another attempt to break the eat-sleep association, I’m trying to not feed before naps and instead to do a feed, wake (inc. play/activities/baby classes etc) and then sleep kind of structure. I just need to work out how long each cycle should be. Some say 3, some say 4 hours at this stage (e.g. Baby Whisperer; LL is 4.5 months). The eat-sleep association just kind of arose because it was difficult to get LL off to sleep initially and that seemed to work. Rocking him while singing row your boat also seemed to work for day time naps and although I knew that in the long term these methods might not be great because he was reliant on my rocking or feeding, I didn’t mind because at least he was getting some sleep and not cyring about being tired. I thought – well I’ll just have to make changes to any habits later on because at this point (first few weeks/months) any sleep is better than no sleep, and I don’t care how we achieve it! And the longer the sleep, the better.

Ok so plan for next few weeks is to start more of a day time routine! Consistency and predictability is really important.

When will he sleep through the night?

So we are still getting up a few times a night for feeds.

The Little Lovely (LL) seems to wake up around 1am, 3:30/4am and then about 6:30am. Apparently 6:30am is classed as morning and doesn’t count as a night awakening. Well it does in my book because it’s still the middle of the night and too early for me. He goes to bed around 8pm so can now go a good 5 hours before waking which is great compared to the earlier months and weeks when I was getting up every 2 hours to feed him and it was horrible. I think I must have adapted to disturbed sleep and little sleep. I wonder if my sleep cycle has adapted so that the times LL wakes up actually coincide with the end of a sleep cycle? I have no idea if that’s possible.

What’s the research on this? (note to self – look into this)

So now I’m wondering if he should be sleeping without so many feeds and if I should be doing something about this – or if he is still too young. I don’t mind the first feed at 1am because he has had a good stretch of sleep. But is the next feed necessary? Should we just put up with it until he’s weaned or should we spend a few screamy nights of breaking the eat/sleep association)? Yaaay says LL’s father, to the latter idea. But what if he is genuinely hungry?

A quick look at the internet says that LL might be a “habitual waker” because he tends to wake at the same time every night. Apparently if he was going through a growth spurt and needed the food he would be waking at random times. We briefly attempted not feeding him during one waking the other night and all that happened was he cried at us and refused to be soothed or settled by cuddles, rocking or any other soothing and only calmed once he was fed.

Maybe I can try a briefer feed and slowly cut down on the length/time of feed to change the association between eating and sleeping  (I have to suckle in order to fall asleep, otherwise I can’t do it alone).Although I’m not sure if a graded approach will work because I would still be feeding him to sleep, plus I’m very tired at 4am and might dose off and lose track of how long it’s been or it might work somewhat but take some time. And dosing off while nursing (both of us) is probably contributing to the issue.

I’ve found this:

PANTLEY’S GENTLE REMOVAL PLAN (See here)

More on how Pantley developed The No-Cry Sleep Solution and her research methods

from what I understand, this involves:

  • Feeding baby when awake but rather than letting him fall asleep during the feed and whilst sucking, wait until he is relaxed and sleepy, then remove the breast/bottle just before falling asleep.
  • If baby starts to look for the breast/bottle and tries to continue sucking then try to hold his mouth closed gently by putting a finger under his chin or some light pressure on the chin just below his lips (hmm, sounds easier said than done). You can rock the baby or say comforting words while doing this.
  • If this doesn’t go down well then give the bottle/breast again and repeat the process until he falls asleep without sucking.
  • When removing the breast/bottle, do this for about 10-60 seconds and count while you do this
  • Repeat each night until baby can fall asleep on own and does not frequently wake at night.
  • Work on this technique at bedtime, in particular the initial falling asleep as baby will probably want to fall asleep the same way for the rest of the night following any further awakenings.
  • Once night time use of this method is achieved then it can also be used for naps.
  • It could take several days or longer to break the association but you should eventually see a reduction in night awakenings

…… well we’ll see how well that goes down!

(see Pantley’s book if you are interested in more – I haven’t read it, just found the information above from general sleep and baby forum reading online)

The other option is just to not nurse LL to sleep in the first place and to break the association, or develop a new association there. We should try reading a book or singing a lullaby or something immediately before sleep.

  • Rather than feeding him in the bedroom right before he falls asleep maybe I’ll feed him in the living room with a dim light – then take him into the bedroom for a story or another quiet activity immediately prior to sleep.
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