Tuesday 6 October 2015

Gentle Sleep: Finding Balance & Perspective

Sleep. The topic that has consumed my every waking and sleeping (or not sleeping) thought for months. How long should she sleep? How should I get her to sleep? How many naps should she be having? Why does she fight sleep? It's literally all I think and talk about. But apparently I'm not alone. Every new or veteran mother I know or speak to seems obsessed with my daughter's sleep too: 'She is STILL waking in the night to feed?'; 'Is she self-soothing yet?'; 'Have you stopped nursing her to sleep yet?'

Where did this obsession with another child's sleep come from? 



The first three months weren't too problematic in the sleep department for us; Freya would sleep most of the day, anywhere and anytime and during the night, she would wake twice for a feed and go straight back to sleep. We could let her sleep in the living room with the TV on relatively loud, she would fall asleep in her pram or rocker when she was tired and actually I can honestly say I never felt sleep deprived at all. Then something changed. Suddenly, our sleep-anywhere-and-anytime baby turned into a total party animal- she wanted to stay up raving all day and night (not sure where she got that from!) and even when her eyes were red raw with exhaustion, she would scream and fight sleep whenever we tried to put her down. We had hit the so-called '4 month sleep regression.'

Having entered motherhood without any idea of how babies work or reading any books on 'what to expect AFTER the birth', it didn't even occur to me that I'd have to figure all this sleep stuff out. I just figured she would sleep when she was tired. What a school-girl error that was  (current me is laughing and pointing at pre baby me.) So as the 'regression' struck, I embarked on a one-woman crusade to figure out what the hell was up with my insomniac daughter's massive sleep issues and become an expert on the biology of baby sleep.

At this point, my first major lesson was learned. At about the time the problems started, Freya had come to the end of the 'fourth trimester' where babies basically do just sleep whenever they want, and had entered 'real infancy.' Apparently at this point, a baby's sleep cycles becomes more like an adult's and according to Ockwell-Smith (The Gentle Sleep Book) looks like this: "stage 1, a drowsy or very light sleep; stage 2, early sleep, muscles relax; stage 3, deep sleep, heart rate slows, body temperature drops and then REM, body immobile and brain highly active." This cycle happens in 45 minute blocks where baby essentially wakes up and starts the cycle again. Bloody hell- so this was why she was waking so frequently all of a sudden. It's flippin' science. Her brain was working in a totally new way when it came to sleep.
         But this didn't help when it came to her staying awake all day and how at nighttime, despite our meticulous bedtime routine, she would scream the house down, often falling asleep on my shoulder out of sheer exhaustion from crying. Not only this, but I consistently had to nurse her to sleep in my bed, followed by the use of the controversial pacifier (which, as it turns out, is a huge player in the reduction of SIDS) and then I would have to transfer her to her bedside crib- all the things people would tell me I should never ever do. I was exhausted and after weeks and week of dreading bedtime and feeling guilt over how we did it (based on the fact society was telling me I was doing it all wrong) I felt like I needed to do something: anything.

I would ask everyone I met how they got their baby to sleep and each had a different way. But one thing that kept on popping up was CIO or the 'Cry It Out' method (also known as the 'Extinction Method.') It sounded horrendous- a method whereby you check all of babies basic needs are met (fed, clean nappy, comfortable temperature etc) and once they were all OK, you leave them in their cot and walk away. Now if baby cries, you ignore them. You IGNORE them. You let them cry and cry and cry until they are so tired and exhausted from the screaming they give up asking for your attention (which is their biological response to extreme and continued stress- stop crying to preserve energy. Survival mode.) You do this for hours and hours and days and days and eventually, you have a baby who 'self-soothes' and 'sleeps through the night.' Brutal. Now when I learned about this method, I was shocked to see how many people on the internet and how many 'sleep experts' condoned and even suggested it. But I was even more surprised when my Health Visitor told me I needed to do it. In fact, in her words: 'You walk away and you let her cry. If you really must you pop back in fifteen minutes, but you don't talk to her or engage with her- you pick her up, check she is OK and then put her back in the cot and leave. If you keep picking her up and responding to her cries, she will start to manipulate you.' (Manipulate me?But she is a matter of weeks old?) My heart sank. My Health Visitor was telling me I needed to use this method and actually insinuated I would be doing wrong by her if I didn't. I was totally conflicted.



I began reading into the method and in my sleep deprived haze, I started to make plans to use CIO to train my tiny baby to go to sleep. Friends who have done it told me it was the hardest thing they ever did, but that baby now slept like an angel and I wanted a piece of that pie. Knowing how important sleep is for their development, I decided I needed to get started. But at this point, Freya's screaming was becoming painful and after several trips to the hospital and paediatrician, it came to light that Freya had a terrible intolerance to dairy. Her reflux, eczema and crying were all related to an allergy to cows milk protein. I was put on a dairy exclusion diet and as if by magic, her nightly colicky-screaming stopped. All those times I was told she just had normal colic, she was actually in genuine discomfort and pain. Imagine if I had let her 'Cry It Out'- ignoring her cries for help, her need for love and her pleas for me to take away her pain?

Thankfully, we never got as far as trying CIO which I thank the Universe for every day. But despite the end of her excruciating bedtime crying sessions, we still found ourselves with a string of 'bad' sleep associations. She HAD to nurse to sleep and when she woke in the night, she HAD to nurse again for comfort. She needed white noise to drown out the street sounds and black out blinds to block out the light, she would fall asleep nursing in my arms and without realising it, we had begun bed-sharing for about half of the night's sleep. At around 4am every morning, I would sleepily pull her across from her side-car crib and let her fall asleep nursing (following important safety guides which are generally only recommended for breast fed babies and parents who don't drink, smoke, take drugs or sleep heavily) and we would always wake at 9am. Five whole hours of sleep to end our 12-14 hours stretch.

But I became embarrassed to talk about our sleep situation which people were still totally obsessed with, including me. I felt like I couldn't tell people that we co-slept and nursed to sleep and shock horror, that it totally worked for us and we all got excellent sleep despite it being broken with up to three or four night wakings. When she started to stir and moan in the night, a quick half-asleep nurse and we were all snoring again. So why was something that was giving us such good sleep also the thing that I worried about 24/7 and wanted to hide from friends? My mum co-slept with me as a baby and toddler while my Dad was away on various detachments in the RAF and I turned out perfectly fine?! I am fiercly independent. Why was I ashamed?


It was at this point that a Facebook parenting group friend pointed me in the direction of 'The Gentle Sleep Book' by Sarah Ockwell-Smith. The connotations of the title made me feel like this was something that would suit me, but I'd heard so many people scoff at the idea of 'gentle, no cry sleep solutions' and criticise 'attachment parenting.' As soon as I received the book, my attitude towards sleep completely changed. I was utterly reassured by everything she wrote; it was like taking a huge sigh of relief. Freya's sleep and what we were doing was totally normal and natural. This book was a life-changer for us.

In her forward, Ockwell-Smith writes: 'Much of what has been circulated in the parenting world on child sleep seems to be founded on parental convenience, rather than biology or science, and it's about time that changed.' Why is this? It is the Western world that has become obsessed with babies sleeping through the night and becoming independent sleepers to suit their routines and busy lifestyle choices. The rest of the world don't deal with the same obsession with sleep- instead co-sleeping, extended nursing, nursing to sleep and baby wearing are the norm and in line with the biology of the human infant. Born the most vulnerable of all the world's species, human babies NEED their mother to respond to their every need at any time of the day or night and in order to become 'independent' they must first learn to become 'dependent'. Therefore, nursing on demand and to sleep (my biggest insecurity) and co-sleeping (whether in a crib in the same room or in the same bed) is totally how nature intended. This was a break-through realisation for me and changed my attitude towards my parenting choices with regards to sleep.

Our expectations of children's sleep is based more on cultural norms than their natural sleeping patterns. Professor Margot Sunderland, when talking about the effects of Western expectations on a mother's psychological health (including how it is a huge contributing factor towards post-natal depression, something I have first hand experience in), says: "Babies are awful sleepers. When we accept this, maybe we will stop seeing a wakeful baby as a parental failure and instead as entirely normal." Babies and toddlers waking through the night, where it is not necessarily convenient if parents are working, is normal. This fact alone made me feel like, actually, I wasn't failing and my baby isn't broken. Letting a child 'Cry It Out' goes against their every biological need and increasingly, child psychology and behaviour experts are calling for the method to be removed from medical rhetoric because of the neurological harm it can cause in the long term.

At this point it's important to note that I will not be including any of the latest medical articles or studies that warn against the method or preach about how what we are doing is the safest thing (I'm not THAT Mum)- every mother is entitled to do what they feel is best for their family and I know using this method has meant for thousands of happy families and well-slept children which is so important. However, Professor James J. McKenna of the Mother-Baby Sleep Laboratory at The University of Notre Dam (the lead specialist in this field) has some wonderful advise and facts against CIO, in favour of co-sleeping and nursing to sleep, and the positive effects it has on the health of both mother and baby, which you can read here. Co-sleeping can often be the solution to these 'sleep issues' (which sometimes aren't actually 'issues' at all!) and where the UK suggests co-sleeping until 6 months, most other countries including the USA advise 12 months + in the same room. This is not least because of biological necessity- being close to the mother regulates breathing and heart beat, therefore reducing the risk of SIDS dramatically. What the media don't report in their scare mongering over cosleeping and SIDS is that 9/10 infant deaths involving cosleeping were because the mother and/or father were heavily under the influence of drugs and/or alcohol.



So after six months of utter obsession, I can proudly and confidently say that we are a co-sleeping (meaning in the same room and often bed-sharing), nursing to sleep family with a happy, safe and secure baby. Despite the fact she absolutely will not fall asleep day or night without help (which I now know is her disposition and NOT my failings), she goes to sleep at my breast- or bottle with her Dad-like clock-work, she wakes at 11pm and 3am every night for a five minute feed and we very rarely feel sleep deprived. Sometimes she will wake once at 5am after ten solid hours or sleep, sometimes we will have a bad night and she will wake far more than that, but half the time we don't even realise as I pop her dummy in and she settles back down (although this last fortnight she seems to be uninterested and seems to be weaning herself off it.) More often than not, just my proximity helps her to go back to sleep or 'self-settle' (which many suggest is actually an arbitrary notion, as to 'self-settle' babies would have to have the ability to regulate their own emotions which is a skill learned much later in childhood. If a baby 'self-settles', it is more that likely that their parents have been blessed with an unusually good sleeper or potentially that they have been subject to sleep training and- as some experts suggest- have learned not to ask for help anymore as nobody comes which personally makes me really sad.) Because she is now in her 'SleepyHead' pod- THE best baby purchase we ever made and if only we had done it from the start-we hardly have to wake to respond to her needs and every morning, I roll over to see her beautiful face smiling up at me, well rested and cooing with happiness that she is with her Mummy and Daddy.

 For all my worrying about Freya becoming 'too attached' or dependent on me, extensive studies have proven that co-sleeping babies are often more independent and confident children because they grew up feeling totally safe and secure. If and when this arrangement stops working for us, we will revisit sleep with some of the gentle suggestions we have researched but for now, we will be happy with how it is working for us and I for one have stopped stressing over what the implications might be in the future and just enjoying what is working for us now. I'm certain this realisation had helped me overcome PND.

Oh and for those worrying about the affects of co-sleeping on your sex life, it's far more fun figuring out other places to have 'adult time' than boring old bed! In that department, we are better than we have ever been, I am happy to report.