The sleep book review edition

I have written several posts about my sleep struggles. Well, not technically my sleep struggles — my sleep would be awesome if I could get any — but my struggles with getting my baby boy to sleep. Or more precisely, to fall asleep and stay asleep. You can find my sleep deprived rants  intelligent analysis here (in French), here and here (in French).

This is not a new issue for me. My interest — some would call it an obsession — with good sleep goes back to my oldest child. Or, more precisely, was caused by my oldest child but didn’t gel until I had my second child. See, my firstborn was sleeping 8 hours at night by 3 weeks and 12 hours by 6 weeks. Uninterrupted. And she also had long naps during the day. It’s hilarious when I think about it: this child would go down for the night at 8 pm and sleep until 8 am. Then she would go back down for her morning nap at 9 am and sleep until 11. Then she’d be down around 1 pm until 3 pm and would often have an evening nap around 5 pm for an hour or so. Then she’d be down for the night at 8 pm. This “sleep routine” was well established by her 2-month mark. What’s hilarious is that I — 22 year-old omniscient me — thought (a) this was normal, and (b) I was doing something right that other struggling parents were obviously not doing.

(As an aside I would like to add this word of warning to young parents with easy babies. I have eaten back every single critical word I ever said about other parents. Even those I said in my head. If you have easy, manageable children take this advice — especially if you are hoping to have more — offer a word of deepest gratitude to God and Shut Up. If you don’t, the aforementioned God will “bless” you with babies/children exhibiting every single trait you ever criticized in other people’s kids and you will be plagued by an ever-present urge to call them and grovel at their feet begging for forgiveness. Take it from me.)

When my second child came along a year later he was immediately different. For one, he did not like being left alone in a bassinet. When at age 3 weeks he did  not sleep through the night, I wondered “What is wrong with that child?” (ha ha ha ha ha ha ha ha ha *cough* *wheeze*). By 7 months of age, he was still waking-up to nurse every hour. I was fried and I read Ferber’s Solve your Child’s Sleep Problems. We ferberized our son and it worked, more or less, like the book said it would.

But the Ferber method was not only difficult for me as a parent, it just didn’t work with my next dreadful sleeper (in the person of my fourth child). She was nearly a year old when we started implementing the 5-10-15 method (also know as gradual extinction) and she cried, and cried, and cried, and cried…. for 10 hours a night, for a full month. Oh, she would occasionally stop for 30 minutes and rest a little. But otherwise, she cried. And we gave-up.  Eventually I weaned her and she stopped waking-up to nurse. But that premature weaning weighted heavily on me. I wanted to understand why some of my children were such lousy sleepers and what I could do to help them before getting to a point of desperation where I had to let my babies cry their hearts out. I didn’t want to have to choose between nursing or sleep. I was thinking in terms of the ecosystem of the family. It didn’t make sense to me that the need for rest, comfort and sustenance in mother and baby should be mutually exclusive. Yet, in my case they were.

I read Tracy Hogg’s Secrets of the Baby Whisperer but her antiquated approach to breastfeeding turned me off and made me wonder what else in her approach might not be, let’s say, based on sound science. If you want to learn more about her E.A.Z.Y. method start by reading the comments section. You will notice that the reviews split between 5 stars and 1 star: very little middle ground reviews. My warning would be that if your child does not respond well to being put on a schedule (some do, some don’t), you can ruin several months of your baby’s babyhood trying to fit a square peg in a round hole. This doesn’t make for good memories.

When my sixth child was born, I quickly noticed that she was showing the tell tale signs of being a lousy sleeper: brown hair and brown eyes (yes, this is how it goes in my family: brown eyes = lousy sleeper, blue eyes = self-soothing baby. It splits evenly between the 8 and even alternates.) Someone recommended Harvey Karp’s Happiest Baby on the Block and by far this book has been one of the most helpful I have read. It comes with some mild words of warning, most notably that the book is infuriatingly repetitive. It could have been published as a pamphlet. Also, I would like to see some scientific evidence related to that “calming reflex” and that “fourth trimester”: because something seems to work doesn’t mean that it has to be “trademarked” into some pseudo-medical concept. Finally, I would take the claim that his method solves colic with a boulder-sized grain of salt. That being said, his time-tested method of swaddling, white noise and rythmic motions will result in a calmer, more settled infant. This book — and a few Aiden & Anais swaddling blankets — is my go-to baby shower gift. It is better read before the baby comes along. Despite what the book claims, I would set the best-before date on this method at 6 weeks meaning that after 6 weeks, it may not help you as much as it would have before. My 3 year-old was swaddled well into her 5th month and my twins at 3 months will still moro-reflex-themselves silly if left unswaddled.

My 3-year-old is showing how to be the "Happiest Baby on the Block": swaddled and sucking.

All this being said, Happiest Baby on the Block says little about sleep problems and what to do when they occur past the 4th month. Someone gave me Marc Weissbluth Healthy Sleep Habits Happy Child and I bought Healthy Sleep Habits Happy Twins (essentially the same book with more emphasis on scheduled awakenings). If you want to learn more about the science of sleep and its importance, this is the book for you. In a nutshell, his approach to sleep is that “sleep begets sleep” and that a well-rested child will naturally sleep better at night and during the day. It can be a dry read if you are as severely sleep-deprived as I am but the summary at the end of each chapter is enough to get you going. While Weissbluth’s method is not a straight-up Cry-it-Out approach, it can get to that if you let it.

All these books have helped me better understand my babies’ sleep. Each book describes at length how its method will help your baby sleep better. Each book has testimonies from parents whose children used to wake-up every 10 minutes and went-on on sleep 12 hours!! In a row!! Without waking-up!! Ever again!! But none of the books  has a decent troubleshooting section.  For instance, Weissbluth claims that if you put your baby to bed drowsy but awake at the right time (ei, before he gets overtired and cranky) he will quietly settle into sleep. When I put my son in bed drowsy but awake after the first signs of drowsyness, he wakes right up and freaks out. Now what? That doesn’t seem to exist in Weissbluth’s method: I must have missed the signs of drowsyness and waited too long. So I try again with shorter intervals of wakefulness. Still no success. Now what? Troubleshooting may suggest that the method in question is not a slam-dunk, and this may not be on any parenting book author’s wish list. But it would be nice to understand why some kids just don’t get it.

In the end, if my experience with 8 newborns has shown me anything it’s that some babies are able to fall asleep and stay asleep unassisted and others aren’t. Among those who are unable to fall or stay asleep unassisted you will find different degrees and variations of difficulty. For instance, my son can’t fall asleep on his own during the day but has no problem at night and overnight. It is possible to turn a good sleeper into a bad one through bad sleep hygiene (for instance if baby is constantly being woken-up or unable to nap adequately) and it is possible to turn a moderately bad sleeper into a moderately good one. Really lousy sleepers from hell and colicky babies are just that and your best bet is to aim at survival. That’s why Karp and Weissbluth are my favorite books: they propose to instill a good sleep hygiene through gentle repetition of time-tested routines. But if your child does not respond to the approach by sleeping like an angel, you can still keep those routines going without loosing your mind. Not so much with Ferber’s gradual extinction or Hogg’s Pick-up/Put down.

For my twins, I have adopted my own set of sleep principles. My approach has two pillars. The first one is survival: I need well-rested happy babies and this means that they must have naps during the day. At their age, we are still looking at 3 naps a day or more if they are very short. The second pillar is enjoyment: these are my twins. Having twins is a unique life experience and I’ll be damned if I waste it in a constant struggle with my flesh and blood. I have every intention to have wonderful — if blurry — memories of my twins’ infancy: raising twins is too tiring not to make the most out of every smile.

In order to give Lucas the rest he needs during the day, I have resorted to the swing, which I used to not-so-lovingly call the neglect-o-matic.  I only put Lucas in the swing for his naps. I nurse him, swaddle him and put him in the swing with white noise. He can sleep 2-3 hours like this. You may wonder, as I do, how the heck I will wean him from the swing. The truth is I have no clue. I’m trying to address this issue in steps and right now I am getting him in the habit of sleeping a couple hours in the morning and a couple hours in the afternoon and an hour or so in the evening. When his body is used to sleeping, I figure that being drowsy and falling asleep will come naturally and we can transition to sleep out of the swing. I’ll write a post when we get there. At night, he can usually fall asleep on his own in bed so I cultivate this ability like a delicate flower. I figure that he has the ability to fall asleep on his own and will eventually apply it to his daytime naps as well.

As far as night sleep goes, once again, the two pillars. Survival means that if Lucas needs to finish the night in bed with us, so be it. That’s what David did and our early morning cuddles are some of my fondest memories. Survival also means that I will  not spend a night awake listening to my baby cry. If I’m going to be awake, it will be drowsy with a nursing child. Ève is starting to sleep through the night (from 7:30 pm until 4-5ish) so the days when I’m up every hour with one or the other will be soon over. I know that to a parent of a singleton, waking-up to nurse every 3 hour sounds like a nightmare but to a parent of twins, it sounds like a trip to paradise: I haven’t slept 3 hours in a row since mid-August (I’m writing this in January).

In conclusion, Solve your Child’s Sleep Problems and Healthy Sleep Habits, Happy Child are the best resources in terms of understanding the science, physiology and importance of sleep to overall health. However, if you are not willing to let your child “cry it out”, just skip that part of the book. To establish gentle sleep routines and help your child sleep better — undertanding that “better” is only relative to your baseline and may mean going from no sleep to 2 hours — Healthy Sleep Habits, Happy Child and Happiest Baby on the Block are your best bet. They are a nice complement to each other. If you have no problems letting your child cry it out, save your money and don’t buy any books: both Weissbluth and Ferber agree that no harm will come to your child from crying it out assuming they are not hungry, sick or in pain. Just close the door and walk away.

I may be getting too old for this but I’m done pretending that I don’t care about my babies.

Put down the book and pick-up the baby

I am so exhausted! Fatigue oozes from every pore of my body.

Nights were getting better but they took a turn for the worst. Then the babies got sick. Sick infant twins is an extreme sport. Over a period of 2 or 3 weeks, I went from high-functioning-tired to what’s-mah-name- tired.  I sit down to nurse the babies. I look at the feed-and-sleep log and try to remember who should get the breast and who should get the bottle. The squiggles on the page make no sense. I read the words carefully. I understand the words but I don’t understand how they fit together. Why was I looking at the notebook again?

The twins are screaming. I know I should sit down to nurse them but I can’t. My back hurts too much from sitting in odd positions for so long. Three months of bad posture, following three months of late multiple pregnancy, added to almost a year of no exercise have taken their toll. My muscles are stiff. Who was that person who ran a half-marathon three months before she got pregnant? She was running 10km 3 times a week? She was fit, she was driven. I’m just a soggy mess of back aches and sore legs.  I’m 20 pounds overweight but I just ate 6 pieces of peppermint bark and half a bag of truffles. It’s not even good but I couldn’t stop.

I cry a little because I don’t want to nurse again but eventually I sit down, calm down and do what I have to do. The last step in a long walk of things I have to do. I don’t do anything that I don’t have to do. Except maybe writing. When I write, I feel like I should do something else. Something that feels like a chore. So I write as I try to soothe Lucas to sleep. A little cheat. I am emotionally exhausted from the endless stream of competing demands. They say that the caregiver needs care too but this couldn’t possibly be when people will go hungry or the toilet will walk away? The caregiver can only take care of herself once everybody has been taken care of. And my job is never, ever, done. Sometimes I feel like God has “blessed” me with a large family and left me for dead.

“It’s me, it’s me, it’s me O Lord, standing in need of prayer…”

Two weeks ago, I decided to see if I could encourage my body to produce more milk. Enough to feed both babies. I read Making More Milk (which I highly recommend whether or not you have milk supply issues, just to understand the milk-making process. A miracle, really, just like the rest of the baby-making business). I learned that a baby’s breast milk intake peaks at 6 weeks and remains the same until the baby starts solids at around 6 months of age. So when a supplementing mother like me finds herself increasing the supplement, it’s not because the baby needs more milk, it’s because the mother is producing less breast milk. All of a sudden, I was staring down the end of breastfeeding my twins and that wasn’t on.

I’m just so tired of bottles. Tired of washing bottles and prepping bottles and boiling water and cooling water and making sure there is enough formula. I hate it. It stinks. It makes my babies stink. The other evening, I was too tired to prep the night bottles so I went to bed without  bottles. The babies were hungry, they spent the night nursing on not enough milk. They were fussy and impatient. I was sore and exhausted. It never occurred to me to get the bottles already: 5 minutes of pain for 2-3 hours of sleep. Instead, I decided to nurse around the clock for a couple of days to see if my milk production would increase. It did, but not enough. Lucas and Eve had just started sleeping longer stretches at night: up to 8 hours for Lucas and 6 for Eve. It stopped. I managed to get their supplement down to 3-4 oz a day but it wasn’t enough. The babies went from being content and engaging to fussy and demanding.  3 or 4 days became 5 then 7. I couldn’t accept that my body was not able to feed my babies. And the more tired I became, the more frustrated the babies were on the breast. When I smashed my van’s rear-view mirror out of sheer inattentiveness, my husband sat me down and said: “The twins need more food and you need more sleep.” I increased their supplement to 6 oz a day each and we seem to be on the mend. But the babies have not resumed sleeping longer stretches at night.

I stop at the Tim Hortons’ Drive-Thru to buy snacks for the children. The girl at the other end of the mic is asking me a question on one side, my daughter is giving me ordering instructions on the other. The words come-in through my right and left ears and crash in my brain. It’s like they’re both speaking Finnish or something. I am tired and confused.

The battle has now moved from making more milk to straightening out Lucas’ sleep patterns. Why do I  need a fight to keep me going? Is it because it keeps me awake? Lucas is a cat-napper who is unable to self-soothe. He falls asleep being held or nursed or rocked and if transferred to a bed, will wake-up at the end of his 30-minute sleep cycle. In my state of sleepless stupor, I seem to have lost my main coping skill, that is my perspective. I am locked in a battle to the death with my son: he will fall asleep on his own, in his bed, and stay asleep. It’s not that I mind holding him now. But I have vivid memories of other children waking me up every 2 hours for 12, 18 months, to nurse or have their soother replaced. I am determined not to go there with twins. I cannot take one more day of sleep deprivation, let alone 1 year!

I re-read Healthy Sleep Habits, Happy Child and ordered its companion Healthy Sleep Habits, Happy Twins. I read excerpts from The No-Cry Sleep Solution. I re-re-re-read  Happiest Baby on the Block. Expect a book review post coming soon.

My son is swaddled and soothed and put in bed drowsy but awake after short intervals of wakefulness. And yet, he will not fall asleep or stay asleep during the day. When I started having anxiety attacks at the sound of his cry, I knew that things had to change. Lucas is not a difficult baby. He just wants to be held. He is happy and engaging. He just wants to be held. Yes, he is far more demanding than Eve. But that’s because Eve is not a normal baby. Eve is more like an ornament: her day is structured around periods of eating followed by periods of smiling/cuteness and long periods of sleeping, repeated over a 24 h period. She’s a Little Flower, he’s a Teddy Bear.

At this point, I think I know what I need to do. I am a mother of 8. I need to put down the books and pick-up the baby. The rest will sort itself out.