Three Baby Sleep Case Studies
Posted: Aug 08 2014
- No cry sleep training
Many parents think any form of sleep training involves shutting a helpless baby in a room alone to cry it out no matter how young. Besides this being wildly inappropriate for a young baby, it simply isn’t an option for many parents with a different parenting philosophy to that. No cry sleep training is a different approach, we incorporate all the same elements of any traditional based sleep training but don’t leave baby alone to cry.
Baby Anna was 9 months old when mum booked a consult with our team, she was not getting more than 1.5-2 hours’ sleep in a row at night, and Anna was looking to be fed back to sleep after every wake up. While this style of parenting suits many people, Mum was going back to work part time in a month and needed some more night sleep to concentrate in the day, and felt Anna was suffering from lack of sleep and becoming quite clingy and grumpy.
We looked at Anna’s sleep environment and suggested a change from sheets to a sleeping bag as Anna was probably waking cold some of the time. We had her diet assessed by Megan from Nourished Nutrition who quickly discovered Anna was a fussy eater and not consuming a lot of protein which is often the way with all night snack feeding. Megan changed Anna’s diet and added in some sleep supporting food groups too.
Anna’s naps were suffering as a result of her over tiredness and she was going to bed over tired, we brought her bed time forward until her naps repaired themselves, and mum decided on no cry sleep training to teach Anna to self-settle.
Mum was under no illusions that Anna would not cry, but felt staying in the room and emotionally and physically supporting Anna was the right thing to do as she learn ’t to go to sleep without the aid of a breastfeed.
There was 55 minutes of intermittent grizzling and crying on night one, with mum lying Anna down 23 times, and singing her favourite nursery rhyme about 50 times! Anna eventually lay herself down, with mum right by the cot and mums hand through the bar’s, she drifted off to sleep after opening her eyes 3-4 times to check mum was still there.
Mum left the room 20 minutes after Anna was asleep to ensure she was in a deep sleep.That night Anna slept 6 hours instead of 2, and had 2 feeds from midnight-7am instead of 6 overnight.
Over the next 2 weeks mum gradually withdrew her presence and assistance from the bed time ritual until all Anna needed was a kiss and song, and she lay herself down and went to sleep. Mum’s perseverance, patience and consistency is what taught Anna to go to sleep on her own.
- Quick and Effective
Here at Baby Sleep Consultant we do not judge and we believe no mum should be judged until you have walked a mile in her shoes! This next case study is one of those stories where you need to know the back ground to understand why this mum chose fast and effective sleep training.
Baby Joshua was 6 months when we visited his mum, he was a thriving baby who was gaining weight steadily and meeting all milestones. He was however not sleeping well! He needed to be rocked to sleep, and weighing in at 9kg this was becoming increasingly difficult for mum. It was taking 40-90 minutes at night after every wake up to rock Joshua back to sleep, and he would then wake again 2-3 hours later for the process to begin again. Over the day he was doing some classic cat napping of 45 minutes and only getting 3 quick naps a day.
Mum had 2 other children who were at school and kindy, being the third Joshua had a lot of his naps in the push chair or car on the go, mum was busy!
As soon as we started talking I could see that mum was at her wits end, she broke down when she spoke of her other 2 children and her husband, exhaustion was taking its toll (as it does!) and she felt she was snappy, and grumpy at her children, failing them as their mother and her marriage was on rocky ground as both her and her husband were not coping with the severely broken sleep.
Mum felt the exhaustion was causing some post natal depression, and her Dr suggested she get the sleep sorted before trying medication.
I really felt for this mum as she was trying to please everyone and at the bottom of that priority list was herself. Her little boy was absolutely delightful and eating solids and gaining weight, he did not need to be waking excessively at night to feed, and neurologically at 6 months he could easily learn to self-settle.
After weighing up her options mum chose extinction which is more commonly referred to as cry it out.
We reviewed Joshua’s routine and his sleep association, mum bought him a new small comforter to be his new sleep aid, and we added some white noise to the mix to help him sleep. We bought his bed time forward as he too was over tired, and mum made the decision to move Joshua to his own room.
We decided to reduce his night feeds to 2 a night, and then re-assess in a week. On night 3 Joshua sleep all night with no feeds! Clearly he was not hungry!
Mum was thrilled as none of thought it would work this quickly, Joshua clearly was ready to go to sleep on his own!
Mum felt empowered that she had made the right decision for her family and her mental health, she said there is no way she had the mental energy to be consistent with an in the room technique, and she knew something needed to change and fast.
- New-born not sleeping
Baby Michelle was 6 weeks when I visited her in her own home. Mum felt she had colic and could not be settled to sleep in the evening before 11pm (4 hours of crying on and off from 7pm). Mum was trying lots of things I recommend for a new-born, she had a great swaddle (miracle blanket and aden and Anais muslins), and she was using white noise.
Mum was very concerned with ensuring Michelle went into her bed awake and put herself to sleep so she didn’t develop any “bad” habits.
By the time I arrived I felt Michelle was so over tired we just needed her to have a sleep before we could even begin to worry about bad habits.
I swaddled Michelle which turned out to be a lot firmer than mum was doing and sent her for a walk with dad in the push chair to get a quick and effective nap under way so our day didn’t start off to badly.
After showing Mum some different swaddling techniques she realised Michelle had been busting lose so often not because she didn’t like the swaddle but simple because it was too lose.
The white noise mum was trying was on her iphone and also just not loud enough to be effective.
Later that day when settling Michelle with a better swaddle and some louder white noise (thanks baby shusher!) Mum also realised she was trying to put Michelle down too awake.
At 6 weeks baby Michelle really had no ability to self-settle and needed some help from mum before she could even begin to learn to self-settle, no point trying to make her run before she could walk!
So I showed mum how in her arms she could use techniques to get Michelle really drowsy but not asleep, then transferring her to the cot and carrying on with some hands on settling to ensure she fell asleep quickly and stayed asleep.
The evening crying was quickly resolved, as baby Michelle was over tired and hungry in the evening hence the screaming. An over tired baby doesn’t feed well, and a hungry baby doesn’t sleep well!
We made sure Michelle took another nap before the evening routine kicked in, and I explained that a 7pm bed time was too late for Michelle who was already tired by 5.30pm! We bought her bath forward to 5.45pm instead of 6.30pm, and I showed mum how to swaddle Michelle then feed her in the evening so she was calm, and fed well before getting over tired. This also meant that baby Michelle got drowsy on the breast (which is totally fine at this time of day at this age!) and was then burped and placed into bed 80% asleep.
This was a lot less stressful than trying to ensure baby Michelle self-settled in her bed which usually resulted in a few hours of crying.
Over the next 6 weeks mum worked on getting Michelle down less and less drowsy, and by 12 weeks most of Michelle’s naps she went down awake and self-settled, but mum new if she had to help her – the hands on techniques still worked and didn’t create and “bad habits”.