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【转】西尔斯博士(Dr. Sears)关于宝宝睡觉问题的几篇文章
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发表时间:2011-06-04
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前面与JMs分享了《西尔斯的亲密育儿百科》(The Baby Book)的部分内容,以及比较有名的Sleep Training的办法,下面就将我看到Dr. Sears关于宝宝睡觉及断夜奶的几篇文章转贴这里与新妈妈们分享啊,均来自Dr. Sears的官方网站(http://www.askdrsears.com/)。

●8 Infant Sleep Facts Every Parent Should Know
●6 Ways to Help a High Need Baby Go To Sleep and Stay Asleep
●31 Ways to Get Your Baby to Go To Sleep and Stay Asleep Easier
●Sleep-training – Not For Breastfeeding Mothers
●Night Weaning: 12 Alternatives For The All-night Nurser

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8 INFANT SLEEP FACTS EVERY PARENT SHOULD KNOW

In order to better understand the how-to's of getting you and your baby to enjoy going to sleep and staying asleep, here are some important principles of sleep that every new parent needs to understand.

1. How you sleep. After dressing or undressing for bed, most adults help themselves relax for sleep by performing various bedtime rituals: reading, listening to music, watching TV, or having sex. As you drift into sleep, your higher brain centers begin to rest; enabling you to enter the stage of deep sleep called "non-REM" (non-rapid eye movement -- NREM), or deep sleep (also called quiet sleep). Your mind and body are quietest during this stage of sleep. Your body is still, your breathing is shallow and regular, your muscles are loose, and you're really "zonked." After about an hour and a half in this quiet sleep stage, your brain begins to "wake up" and start working, which brings you out of your deep sleep and into light sleep or active sleep, called rapid eye movement or "REM" sleep. During this stage of sleep your eyes actually move under your eyelids as your brain exercises. You dream and stir, turn over, and may even adjust the covers without fully awakening. It is during this sleep stage that you may fully awaken to go to the bathroom, then return to bed and fall back into a deep sleep. These alternating cycles of light and deep sleep continue every couple hours throughout the night, so that a typical adult may spend an average of six hours in quiet sleep and two hours in active sleep. Thus, you do not sleep deeply all night, even though you may feel as though you do.

2. How babies enter sleep. You're rocking, walking, or nursing your baby and her eyelids droop as she begins to nod off in your arms. Her eyes close completely, but her eyelids continue to flutter and her breathing is still irregular. Her hands and limbs are flexed, and she may startle, twitch, and show fleeting smiles, called "sleep grins." She may even continue a flutter-like sucking. Just as you bend over to deposit your "sleeping" baby in her crib so you can creep quietly away, she awakens and cries. That's because she wasn't fully asleep. She was still in the state of light sleep when you put her down. Now try your proven bedtime ritual again, but continue this ritual longer (about twenty more minutes). You will notice that baby's grimaces and twitches stop; her breathing becomes more regular and shallow, her muscles completely relax. Her fisted hands unfold and her arms and limbs dangle weightlessly. Martha and I call this "limp-limb" sign of deep sleep. Baby is now in a deeper sleep, allowing you to put her down and sneak away, breathing a satisfying sigh of relief that baby is finally resting comfortably.
NIGHTTIME PARENTING LESSON #1:
Babies need to be parented to sleep, not just put to sleep. Some babies can be put down while drowsy yet still awake and drift

others need parental help by being rocked or nursed to sleep.

The reason is that while adults can usually go directly into the state of deep sleep, infants in the early months enter sleep through an initial period of light sleep. After twenty minutes or more they gradually enter deep sleep, from which they are not so easily aroused. As you probably know from experience, if you try to rush your baby to bed while she is still in the initial light sleep period, she will usually awaken. Many parents tell me: "My baby has to be fully asleep before I can put her down." In later months, some babies can enter deep sleep more quickly, bypassing the lengthy light sleep stage. Learn to recognize your baby's sleep stages. Wait until your baby is in a deep sleep stage before transitioning her from one sleeping place to another, such as from your bed to a crib or from carseat to bed or crib.

3. Babies have shorter sleep cycles than you do. Stand adoringly next to your sleeping baby and watch him sleep. About an hour after he goes to sleep, he begins to squirm, he tosses a bit, his eyelids flutter, his face muscles grimace, he breathes irregularly, and his muscles tighten. He is reentering the phase of light sleep. The time of moving from deep to light sleep is a vulnerable period during which many babies will awaken if any upsetting or uncomfortable stimulus, such as hunger, occurs. If the baby does not awaken, he will drift through this light sleep period over the next ten minutes, and descend back into deep sleep. Adult sleep cycles (going from light to deep sleep, and then back to light sleep) lasts an average of 90 minutes. Infants' sleep cycles are shorter, lasting 50 to 60 minutes, so they experience a vulnerable period for nightwaking around every hour or even less. As your baby enters this light sleep, if you lay a comforting hand on your baby's back, sing a soothing lullaby, or just be there next to baby if he is in your bed; you can help him get through this light sleep period without waking.

NIGHTTIME PARENTING LESSON #2:
Some babies need help getting back to sleep.

Some "resettlers" or "self-soothers" can go through this vulnerable period without completely awakening, and if they do wake up, they can ease themselves back into a deep sleep. Other babies need a helping hand, voice, or breast to resettle back into deep sleep. From these unique differences in sleep cycle design, we learn that one of the goals of nighttime parenting is to create a sleeping environment that helps baby go through this vulnerable period of nightwaking and reenter deep sleep without waking up.

4. Babies don't sleep as deeply as you do. Not only do babies take longer to go to sleep and have more frequent vulnerable periods for nightwaking; they have twice as much active, or lighter, sleep as adults. At first glance, this hardly seems fair to parents tired from daylong baby care. Yet, if you consider the developmental principle that babies sleep the way they do -- or don't -- for a vital reason, it may be easier for you to understand your baby's nighttime needs and develop a nighttime parenting style that helps rather than harms your baby's natural sleep rhythms. Here's where I'm at odds with modern sleep trainers who advise a variety of gadgets and techniques designed to help baby sleep more deeply through the night -- for a price, and perhaps at a risk.

5. Nightwaking has survival benefits. In the first few months, babies' needs are the highest, but their ability to communicate their needs is the lowest. Suppose a baby slept deeply most of the night. Some basic needs would go unfulfilled. Tiny babies have tiny tummies, and mother's milk is digested very rapidly. If a baby's stimulus for hunger could not easily arouse her, this would not be good for baby's survival. If baby's nose was stuffed and she could not breathe, or was cold and needed warmth, and her sleep state was so deep that she could not communicate her needs, her survival would be jeopardized.

One thing we have learned during our years in pediatrics is that babies do what they do because they're designed that way. In the case of infant sleep, research suggests that active sleep protects babies. Suppose your baby sleeps like an adult, meaning predominantly deep sleep. Sounds wonderful! For you, perhaps, but not for baby. Suppose baby had a need for warmth, food, or even unobstructed air, but because he was sleeping so deeply he couldn't arouse to recognize and act on these needs. Baby's well being could be threatened. It appears that babies come wired with sleep patterns that enable them to awaken in response to circumstances that threaten their well being. We believe, and research supports, that frequent stages of active (REM) sleep serve the best physiologic interest of babies during the early months, when their well being is most threatened.

NIGHTTIME PARENTING LESSON #3:
Encouraging a baby to sleep too deeply, too soon, may not be in the best survival or developmental interest of the baby. This is why new parents, vulnerable to sleep trainers' claims of getting their baby to sleep through the night, should not feel pressured to get their baby to sleep too long, too deeply, too soon.

6. Nightwaking has developmental benefits. Sleep researchers believe that babies sleep "smarter" than adults do. They theorize that light sleep helps the brain develop because the brain doesn't rest during REM sleep. In fact, blood flow to the brain nearly doubles during REM sleep. (This increased blood flow is particularly evident in the area of the brain that automatically controls breathing.) During REM sleep the body increases its manufacture of certain nerve proteins, the building blocks of the brain. Learning is also thought to occur during the active stage of sleep. The brain may use this time to process information acquired while awake, storing what is beneficial to the individual and discarding what is not. Some sleep researchers believe that REM sleeps acts to auto-stimulate the developing brain, providing beneficial imagery that promotes mental development. During the light sleep stage, the higher centers of the brain keep operating, yet during deep sleep these higher brain centers shut off and the baby functions on her lower brain centers. It is possible that during this stage of rapid brain growth (babies' brains grow to nearly seventy percent of adult volume during the first two years) the brain needs to continue functioning during sleep in order to develop. It is interesting to note that premature babies spend even more of their sleep time (approximately 90 percent) in REM sleep, perhaps to accelerate their brain growth. As you can see, the period of life when humans sleep the most and the brain is developing the most rapidly is also the time when they have the most active sleep. One day as I was explaining the theory that light sleep helps babies' brains develop, a tired mother of a wakeful infant chuckled and said, "If that's true, my baby's going to be very smart."

7. As they grow, babies achieve sleep maturity. "Okay," you say, "I understand this developmental design, but when will my baby sleep through the night?" The age at which babies settle – meaning they go to sleep easily and stay asleep varies widely among babies. Some babies go to sleep easily, but don't stay asleep. Others go to sleep with difficulty but will stay asleep. Other exhausting babies neither want to go to sleep nor stay asleep.

In the first three months, tiny babies seldom sleep for more than four-hour stretches without needing a feeding. Tiny babies have tiny tummies. Yet, they usually sleep a total of 14-18 hours a day. From three to six months, most babies begin to settle. They are awake for longer stretches during the day and some may sleep five-hour stretches at night. Between three to six months, expect one or two nightwakings. You will also see the period of deep sleep lengthen. The vulnerable periods for nightwaking decrease and babies are able to enter deep sleep more quickly. This is called sleep maturity.

NIGHTTIME PARENTING LESSON #4:
An important fact for you to remember is that your baby's sleep habits are more a reflection of your baby's temperament rather than your style of nighttime parenting. And keep in mind that other parents usually exaggerate how long their baby sleeps, as if this were a badge of good parenting, which it isn't. It's not your fault baby wakes up.

8. Babies still wake up. When babies mature into these adult-like sleep patterns varies among babies. Yet, even though babies achieve this sleep maturity some time during the last half of the first year, many still wake up. The reason? Painful stimuli, such as colds and teething pain, become more frequent. Major developmental milestones, such as sitting, crawling, and walking, drive babies to "practice" their new developmental skills in their sleep. Then between one and two years of age, when baby begins to sleep through the above-mentioned wake-up stimuli, other causes of nightwaking occur, such as separation anxiety and nightmares.

Even though you understand why babies are prone to nightwaking, you realize it's still important for parents and babies to get a restful night's sleep, otherwise, baby, the parents, and their relationship won't thrive.

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6 WAYS TO HELP A HIGH NEED BABY GO TO SLEEP AND STAY ASLEEP

High need babies not only need help falling asleep, they often need help staying asleep. Here are ways to keep them asleep so that you can stay asleep, too.

1. Sleep where baby sleeps best. Every mom, dad, and baby must work out and keep evaluating what sleeping arrangement will get everyone a restful night's sleep most of the time. Some high need babies seem to have a critical distance for contented sleeping. For some, sleeping too far away from their parents gives them an acute case of nighttime separation anxiety, causing them to awaken frequently. Other babies get hyperstimulated by sleeping too close to the parents, and awaken frequently there. Parents also vary in the amount of nighttime attachment that gives them the most restful night's sleep. Some mothers do not sleep well with their babies too far away from them, some fathers do not sleep well with their infants too close, and sometimes both parents are very anxious about one extreme or the other.

When baby sleeps too close to me he fusses. When he sleeps too far from me he fusses. I keep experimenting with different sleeping distances, and it changes from week to week.

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There came a point where exhaustion overwhelmed me. Our other two children had slept with us as babies, but I was afraid to put our 3-pound, 13-ounce premature baby in bed with me. I feared I'd fall asleep and my breast would smother her. Her nose was the size of my pinky finger. But one night after weeks of walking the floor with a crying baby, I snuggled her in bed with me and figured one night without bottles or breast pumping would be okay. We were there for seven hours. It was heaven! From then on we went to bed together, and we slept! She would nurse frequently during the night, but she never cried. This was the beginning of our sharing sleep together. I was amazed at her needs for physical closeness to me, despite the fact that she'd spent most of her short life alone in ICU. I embraced this need with joy. Those primal instincts are not easily squelched. I began to see her high need personality as a positive sign; looking on the bright side, high need babies have finely tuned survival instincts.

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I resisted any idea of sleeping with my baby until one night I thought, "Well, we slept together for nine months and it didn't kill either of us. Defying everything I had been told, and following my instincts I took her to bed with me.

2. Vary your nighttime response. Whether nightwaking is the result of a need or a habit is a judgment call, and a difficult one. Babies would claim they need comfort; sleep trainers claim it's a habit. The goal of nighttime parenting is to make it more attractive for baby to stay asleep than to wake up.

For example, if every time the older baby awakens you "reward" the awakening, you set yourself up for many more wakeful nights. Yet, it's a natural maternal instinct, especially for a breastfeeding first-time mother, to rush to comfort a toddler back to sleep using his favorite pacifier. Suppose each time you awakened, your favorite person instantly rewarded you with your favorite treat. How motivated would you be to stay asleep?

At the other extreme is playing deaf to all nightwaking to "let baby cry it out" and "break the nightwaking habit." This is common advice given by sleep trainers and well-meaning friends who are not there at 3 a.m. and who have no connection to the baby who is awakening. Few mothers are able to be insensitive to their baby's nighttime needs, and besides, most high need babies will outlast any scheme to let them cry it out. They just keep on crying. They don't learn to put themselves back to sleep. They just get angry and frightened.

It helps to have a variety of ways to comfort nightwakers, so baby learns that nighttime needs can be filled, many different ways. Develop a large repertoire of nighttime responses depending on the age of your baby:

●feeding (a newborn needs to be fed; a one-year-old probably doesn't)
●sucking
●tummy-patting
●singing a lullaby
●rocking
●snuggling
●reassuring voices

For nighttime sanity's sake, it's helpful for mother and father to share night-comforting. You'll appreciate one another rather than resent one another.

We took shifts during the nighttime hours. I would get up and nurse her or I'd just pull her next to me in bed. If she wouldn't fall asleep, Michael would walk with her or we would just both get up together. Sometimes we'd watch this hilarious 3 a.m. television show. If Michael was walking with her then I'd get some letters written or do some reading, and make it productive time instead of just feeling frustrated that it was a waste.

Realistically, high need babies are notoriously resistant to most nighttime tricks, especially the popular sleep training strategies which are just modern versions of the ancient cry-it-out method. As described on page these babies have a strong mindset. They want what they want, and any alternative is met with a wailing protest. If babies awaken expecting their mother's breasts but get a plastic plug instead, most babies will indignantly protest your trick to the entire neighborhood.

Keep in mind that your goal is to condition your child to sleep, not awaken. Try to meet his nighttime needs in a relaxed and boring fashion. Give him a sense that nighttime is different from day, and we don't usually play in the middle of the night. It's not that you don't meet your baby's needs at night, but you recognize that the main need at this time is for sleep and a well-rested mother in the morning. Once again, what helps to keep you calm so you can truly help baby be calm is to let go of the expectation that you should be getting an uninterrupted stretch of sleep.

3. Time your response and be boring. Keep working at your cry response until you find the one that resettles your baby the fastest and disturbs your rest the least. Some mothers find a quick response works best; they know from experience that those first sounds will escalate into a family-arousing wail if ignored. At the first whimper, you immediately comfort your baby by letting him suck, tummy-patting, holding, rocking, singing softly, hand on tummy putting pressure to make baby feel held and warm, rock the cradle, whatever works before baby completely awakens -- and you completely awaken. If baby is in bed next to you, try hugging him in close to you in the teddy bear snuggle. Bottle babies may settle if you help them find a thumb or pacifier. Sometimes just helping an older baby find a better sleep position works. Many mothers find this quick response works best for high need babies because you get to them before they get revved up to a full awakening, from which it will take longer for both you and baby to resettle. This approach works best if baby is nearby or in your bed rather than in his own room, unless you have a very sensitive monitor and sleep with one ear awake.

Other mothers find the slow response works better. If you don't rush in to comfort baby at the first whimper, baby may not awaken fully and will drift back into deep sleep without intervention or baby may awaken and resettle herself back to sleep without your help. Babies with easier temperaments and older babies are more likely to resettle themselves.

There are risks and benefits to both approaches. Responding too quickly may reward the baby for waking and short-circuit his developing ability to self-comfort. Responding too slowly allows baby to fully awaken and become frightened or angry at the slow response. This will make it more difficult to settle baby and yourself back to sleep. Somewhere between these extremes is the right response for your family, and it may change at each stage of baby's development.

When comforting a nightwaker, try not to reinforce the waking. If you rush in and scoop up baby with a panicky voice and tense arms, you convey that there really is something to be scared about at night. Instead, be quiet, calm, soothing while you give an "It's okay to sleep" message.

4. Detect irritants that could cause restlessness. Remember, many high need babies are hypersensitive to noise and uncomfortable irritants. While most infants are not awakened by these stimuli, supersensitive babies are. As much as you can, minimize noises that startle and bodily discomforts that irritate. This requires putting on your detective cap, analyzing your baby's sleeping environment and, as much as possible, removing any stimuli that could awaken baby. Use the following checklist as your guide.

●Stuffy noses. Plugged noses awaken tiny babies. Babies under six months don't readily switch to mouth-breathing if their noses are plugged. Keep baby's sleeping environment as free of nasal irritants as possible: cigarette smoke, animal dander, mother's perfume or hairspray, dust from stuffed animals, etc. Clues that a nighttime, stuffy nose is the problem include: persistent restlessness; noisy, throaty breathing; and difficult nursing at night. In addition to removing possible nasal irritants, "hose your baby's nose" using over-the-counter salt-water nose drops and an infant nasal suction bulb.
●Irritating sleepwear. Some babies cannot settle in synthetic sleepwear. Change to 100 percent cotton clothing to see if your baby sleeps better.
●Environmental irritants. The same things that can cause a stuffy nose (see above) can also cause a general irritability at night. If you've ever experienced a tickle far back on your palate that you can't get to, you'll have some idea what an internal irritation can do to disturb baby's sleep. This irritation may be present at other times besides sleep time, but baby won't usually notice it in his busy waking hours. Like teething pains, physical discomfort is so much worse at night because there is no distraction from it.
●Dietary sensitivities. Hypersensitive babies may have food intolerance's. Like environmental irritants, certain foods in baby's diet (and your diet while you are breastfeeding) can cause internal irritation.

●I want to thank you for your sensitivity and intuition as Ian's doctor. When I brought him into you I was "beside myself," "at the end of my rope." He wasn't sleeping at all during the day or at night. At night it was the worst. From 8:00 p.m. till 2:00 a.m. he would wrench up, pull his knees up to his chest and scream. It was impossible to calm him, hold him, or even nurse him. I tried everything; swinging, rocking, walking and sleeping with him. The list is endless. I refused to believe he was colicky. I explained to you what he did and you said it sounded like something external rather than internal.

●I thought about what you said and thought the only time he is content is when we change him and he has no clothes on. I realized I was putting him in 100% polyester nightgowns in the evenings when he was the worst. He was totally miserable. During the day he was usually in something 50/50 cotton/polyester and was less miserable.

●So I came home and put him in 100% cotton diapers, cotton clothes, cotton blanket, and cotton bedding. I couldn't believe it! I had a new baby in my arms. He was totally calm and content. He even started cooing and smiling and seemed happy. It seemed too good to be true, but the next day he even took several naps! Just like a real baby!

●He is finally out of his misery. I am so glad we didn't just write it off as a colicky baby. I can now enjoy my baby. He is now a happy, content, cooing, and smiling baby!
●Tummy trouble. Hypersensitive babies often have hypersensitive intestines. Like environmental irritants, certain foods in baby's diet (and your diet while you are breastfeeding) can cause internal irritation somewhere in baby's body. If you've ever experienced a tickle far back on your palate that you can't get to, you'll have some idea what an internal irritation can do to disturb a baby's sleep. This irritation may be present at other times besides sleep time, but baby won't usually notice it in his busy waking hours. Like teething pains, nighttime discomfort is so much worse at night because there is no distraction from it.
●Startling noises: oil squeaky cribs, warn older siblings not to slam doors, remove noisy clocks, etc. Sounds that are sudden, loud, and unfamiliar awaken these babies. Other sounds may settle them.

When our first baby woke up wet during the night, I would take her into the changing room, turn the lights on, take off her wet diaper, cleanse her, and put a new diaper on. By that time she was totally awake and I had to nurse her back to sleep. With our second baby, a friend of mine convinced me I didn't have to change a baby's diaper during the nighttime. Initially, I was afraid it would leak all over the place and the whole bed would get wet, but here's what I did. I covered his bottom with a zinc oxide barrier cream, put three cloth diapers on him, and sometimes even used a diaper cover. When he woke up at night I didn't change him. I just pulled him next to me and nursed him. I did everything I could to keep it quiet and dark and not to stimulate him anymore by getting up and changing his diaper.

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I wrapped him in a nice warm blanket so that only his head poked out right before I nursed him to sleep in the rocker. Then when I go to put him down he still feels warm and secure. It worked. I took that a step further and put flannel sheets on our king-size bed so that the sheets wouldn't be so cold so as to wake Philip up during his nighttime sleep.

5. All-night nursing. In my practice, some mothers relate that their high need babies and toddlers do seem to nurse a lot at night. How you approach this depends on how old the baby is and whether or not you are actually waking up feeling sufficiently rested First refer to the section on "Medical Causes for Nightwaking." A baby of any age deserves to have his nightwaking investigated for medical and physical causes. Younger babies almost always have legitimate problems (even to our adult minds) which cause waking, and they sleep much better once these problems are addressed.

We have found in our own experience with several of our babies that as they became toddlers the amount of nightwaking Martha was able to handle changed. This was especially true with our last several toddlers, due to increased stress in our lives (and probably the fact that Martha was getting older). When Erin was a bit past two, Martha began setting limits on night nursing because she was pregnant. She literally could not stand lengthy feedings, especially at night, so she'd let Erin nurse for 2-3 minutes and then ask her to stop (Erin was not always willing), and Martha cuddled her up close. What saved the situation was that Martha discovered that Erin would relax if she could put her hand on Martha's breast. In fact, she fell asleep faster doing this than if she were allowed to keep sucking. Martha also discovered that Erin relaxed off to sleep much more quickly when Martha was able to stay peaceful herself.

6. Just say no! When our Matthew was two, Martha felt desperate for sleep if awakened more than two times. I would wake up to hear a dialogue like "Nee" (his word for nurse)..."No"..."Nee!"..."No!"..."Nee!!" "No, not now, in the morning. Mommy's sleeping. You sleep, too." A firm but calm, peaceful voice almost always did the trick. You can manage to stay peaceful in this situation when you know you are not damaging your very secure, attachment-parented child.

When Stephen was at this age (20-22 months), he was typically nursing twice at night, occasionally three times, and Martha was fine with this. Actually, she found it enjoyable. But he hit a stage where he started waking 4 and 5 times and Martha tried the calm, peaceful "No" dialogue. Every child is different, and Stephen wasn't buying it. So we devised the plan we wrote of in THE BABY BOOK. Martha would nurse Stephen the first two times he woke. Then if it was still a long time till morning, I would pick him up and walk with him the next time. He cried, but it did not escalate to panic, and I lasted him out. After nearly an hour he fell back to sleep in my arms and I laid him back down next to a sleeping Martha. After 3 or 4 nights (with less and less crying), he stopped the frequent waking, and all was well again. And stayed well. He learned what our limits were!

In some families with different temperaments and levels of ability to cope, we have learned that this "cry-it-out-in-Dad's-arms" advice may not work. One mom had this to say:

I would suggest that a toddler waking frequently at night to nurse will not do well crying it out in Dad's arms. What he may need is to learn to sleep alone on a separate mattress or with a sibling, because the proximity to mom is stimulating the waking. It's time for a positive weaning from the family bed (see p. ), not a negative you're-stuck-with-Dad experience.

We have learned that the "just say no" approach also isn't right for all toddlers. I was on a talk show once giving this suggestion to a caller who had a sixteen-month-old waking 2-5 times at night. ("Mommy and Daddy go night-night, baby go night-night, and nummies go night-night.") A week later I got a letter from a mother who had identified with the caller's situation and had tried out the advice herself. She was amazed at how well it seemed to be working and wrote to thank me. However, a few weeks later she called Martha, very confused because everything had deteriorated. Her sixteen-month-old who had actually managed to sleep for nine hours with one or two brief wakings of a few seconds without breastfeeding, was now a very clingy, weepy child by day. She wondered if it was connected to the night situation. Martha helped her understand how to "read" her child to assess results of any technique. She included the insight that radio talk shows can not allow for a complete exploration of problems and solutions (especially when the adviser is male and the show's host is male!) Her thank-you letter (addressed to Martha this time) said, "You really helped me put it all into perspective! I've been a much more "go with the flow" and intuitive parent. Not letting my daughter breastfeed at all during the night was clearly too much for her to handle right now." In my defense, I didn't mean to imply that she not nurse her baby at all at night, but I guess that's what came across. I guess I'll never know what happened with the caller's baby.

Since our youngest child is ours by adoption, and since she was no longer breastfeeding when she was a toddler, Martha had to learn a new way to deal with Lauren when she woke at night. Thankfully, she was usually a "good sleeper;" yet there were times when she would wake and think it was time to play, or times that she was sick and couldn't get back to sleep. Martha, by now an expert on not having nighttime expectations (we'll discuss daytime expectations in the "Mother Burnout" chapter!) would simply get up with her and take her down to the living room where no one else would be disturbed. She'd rock Lauren or let her play in the dark while Martha would lie on the couch and rest.

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31 WAYS TO GET YOUR BABY TO GO TO SLEEP AND STAY ASLEEP EASIER

Over the years of putting our own children to sleep and keeping them asleep, and counseling thousands of other moms and dads on various styles of nighttime parenting, here are some time-tested, proven attitudes and techniques. Most of these are applicable to infants and toddlers of all ages.

NIGHTIME PARENTING DECISIONS

●Develop a realistic attitude about nighttime parenting. Sleeping, like eating, is not a state you can force a baby into. Best you can do is to create a secure environment that allows sleep to overtake your baby. A realistic long- term goal is to help your baby develop a healthy attitude about sleep: that sleep is a pleasant state to enter and a secure state to remain in. Many sleep problems in older children and adults stem from children growing up with an unhealthy attitude about sleep—that sleep was not a pleasant state to enter and was a fearful state to remain in. Just as daytime parenting is a long-term investment, so is nighttime parenting. Teach your baby a restful attitude about sleep when they are young and both you and your children will sleep better when they are older.

●Beware of sleep trainers. Ever since parenting books found their way into the nursery, sleep trainers have touted magic formulas promising to get babies to sleep through the night – for a price and at a risk. Most of these sleep-training techniques are just variations of the old cry-it-out method. And technology has found its way into nighttime babycare by providing tired parents with a variety of sleep-inducing gadgets designed to lull a baby off to sleep alone in her crib: oscillating cradles, crib vibrators that mimic a car ride, and teddy bears that "breathe." All promise to fill in for parents on night duty. Be discerning about using someone else's method to get your baby to sleep. Before trying any sleep-inducing program, you be the judge. Run these schemes through your inner sensitivity before trying them on your baby, especially if they involve leaving your baby alone to cry. Does this advice sound sensible? Does it fit your baby's temperament? Does it feel right to you?

●If your current daytime or nighttime routine is not working for you, think about what changes you can make in yourself and your lifestyle that will make it easier for you to meet your baby's needs. This is a better approach than immediately trying to change your baby. After all, you can control your own reactions to a situation. You can't control how your baby reacts. Use discernment about advice that promises a sleep-through-the-night more convenient baby, as these programs involve the risk of creating a distance between you and your baby and undermining the mutual trust between parent and child. On the surface, baby training sounds so liberating, but it's a short-term gain for a long-term loss. You lose the opportunity to get to know and become an expert in your baby. Baby loses the opportunity to build trust in his caregiving environment. You cease to value your own biological cues, your judgment, and instead follow the message of someone who has no biological attachment, nor investment, in your infant.

●Especially in the first six months, avoid sleep trainers who advise you to let your baby "cry-it-out." Only you can know what "it" is and how to respond appropriately to your baby. Using the rigid, insensitive "let-him-cry-it-out" method has several problems. First, it will undermine the trust your baby has for nighttime comfort. Second, it will prevent you from working at a style of nighttime parenting until you find the one that works best for you and your family and third, it may keep you and your doctor from uncovering hidden medical causes of nightwaking. Nightfeedings are normal; frequent, painful nightwaking is not. (See related lessons: Hidden Medical Causes of Nightwaking, Letting baby "cry it out" yes, no?, and 4 Possible Hidden Causes of Colic.

●Stay flexible. No single approach will work with all babies all the time or even all the time with the same baby. Don't persist with a failing experiment. If the "sleep program" isn't working for your family, drop it. Develop a nighttime parenting style that works for you. Babies have different nighttime temperaments and families have varied lifestyles. Keep working at a style of nighttime parenting that fits the temperament of your baby and your own lifestyle. If it's working, stick with it. If it's not, be open to trying other nighttime parenting styles. And, be prepared for one style of nighttime parenting to work at one stage of an infant's life, yet need a change as she enters another stage. Be open to trying different nighttime approaches. Follow your heart rather than some stranger's sleep-training advice, and you and your baby will eventually work out the right nighttime parenting style for your family.

●Decide where baby sleeps best. There is no right or wrong place for babies to sleep. Wherever all family members sleep the best is the right arrangement for you and your baby. Some babies sleep best in their own crib in their own room, some sleep better in their own bassinet or crib in the parents' bedroom, other babies sleep best snuggled right next to mommy in the parents' bed. Many parents prefer a co-sleeper arrangement. Realistically, most parents use various sleeping arrangements at various stages during the infant's first two years. Be open to changing styles as baby's developmental needs and your family situation changes.

CONDITIONING BABY TO FALL ASLEEP

●Sleep is not a state you can force your baby into. Sleep must naturally overtake your baby. Your nighttime parenting role is to set the conditions that make sleep attractive and to present cues that suggest to baby that sleep is expected. Try the following sleep tight tips, which may vary at different stages in your baby's development. What doesn't work one week may work the next.

●Get baby used to a variety of sleep associations. The way an infant goes to sleep at night is the way she expects to go back to sleep when she awakens. So, if your infant is always rocked or nursed to sleep, she will expect to be rocked or nursed back to sleep. Sometimes nurse her off to sleep, sometimes rock her off to sleep, sometimes sing her off to sleep, and sometimes use tape recordings; and switch off with your spouse on putting her to bed. There are two schools of thought on the best way to put babies to sleep: the parent-soothing method and the self-soothing method. Both have advantages and possible disadvantages.

1.Parent-soothing method. When baby is ready to sleep, a parent or other caregiver helps baby make a comfortable transition from being awake to falling asleep, usually by nursing, rocking, singing, or whatever comforting techniques work.

●Advantages:
 Baby learns a healthy sleep attitude – that sleep is a pleasant state to enter and a secure state to remain in.
 Creates fond memories about being parented to sleep.
 Builds parent-infant trust

●So-called "Disadvantages": Because of the concept of sleep associations, baby learns to rely on an outside prop to get to sleep, so—as the theory goes—when baby awakens he will expect help to get back to sleep. This may exhaust the parents.

2.Self-soothing method: Baby is put down awake and goes to sleep by himself. Parents offer intermittent comforting, but are not there when baby drifts off to sleep.

●So-called "Advantages": If baby learns to go to sleep by himself, he may be better able to put himself back to sleep without parental help, because he doesn't associate going to sleep with parents comforting. May be tough on baby, but eventually less exhausting for parents.

●Disadvantages:
 Involves a few nights of let-baby-cry-it-out
 Risks baby losing trust
 Seldom works for high-need babies with persistent personalities
 Overlooks medical reasons for nightwaking
 Risks parents becoming less sensitive to baby's cries

★Remember, in working out your own parenting-to-sleep techniques and rituals, be sensitive to the nighttime needs of your individual baby and remember your ultimate goal: to create a healthy sleep attitude in your baby and to get all family members a restful night's sleep.

●Daytime mellowing. A peaceful daytime is likely to lead to a restful night. The more attached you are to your baby during the day and the more baby is held and calmed during the day, the more likely this peacefulness is to carry through into the night. If your baby has a restless night, take inventory of unsettling circumstances that may occur during the day: Are you too busy? Are the daycare and the daycare provider the right match for your baby? Does your baby spend a lot of time being held and in-arms by a nurturant caregiver, or is he more of a "crib baby" during the day? We have noticed babies who are carried in baby slings for several hours a day settle better at night. Babywearing mellows the infant during the day, behavior that carries over into restfulness at night.

●Set predictable and consistent nap routines. Pick out the times of the day that you are most tired, for example 11:00 a.m. and 4:00 p.m. Lie down with your baby at these times every day for about a week to get your baby used to a daytime nap routine. This also sets you up to get some much-needed daytime rest rather than be tempted to "finally get something done" while baby is napping. Babies who have consistent nap routines during the day are more likely to sleep longer stretches at night.

●Consistent bedtimes and rituals. Babies who enjoy consistent bedtimes and familiar going-to-sleep rituals usually go to sleep easier and stay asleep longer. Yet, because of modern lifestyles, consistent and early bedtimes are not as common, or realistic, as they used to be. Busy two- income parents often don't get home until six or seven o'clock in the evening, so it's common for older babies and toddlers to procrastinate the bedtime ritual. This is prime time with their parents and they are going to milk it for all they can get. In some families, a later afternoon nap and a later bedtime is more practical. Familiar bedtime rituals set the baby up for sleep. The sequence of a warm bath, rocking, nursing, lullabies, etc. set the baby up to feel that sleep is expected to follow. Capitalize on a principle of early infant development: patterns of association. Baby's developing brain is like a computer, storing thousands of sequences that become patterns. When baby clicks into the early part of the bedtime ritual, he is programmed for the whole pattern that results in drifting off to sleep.

●Calming down. Give baby a warm bath followed by a soothing massage to relax tense muscles and busy minds. Be careful, though, because this will stimulate some babies.

●Tank up your baby during the day. Babies need to learn that daytime is for eating and nighttime is mostly for sleeping. Some older babies and toddlers are so busy playing during the day that they forget to eat and make up for it during the night by waking frequently to feed. To reverse this habit, feed your baby at least every three hours during the day to cluster the baby's feedings during the waking hours. Upon baby's first night waking, attempt a full feeding, otherwise some babies, especially breastfed infants, get in the habit of nibbling all night.

TRANSITIONING TECHNIQUES

●Many infants need help making the transition from being awake to falling asleep, which is really a prolongation of the bedtime ritual that conditions baby that sleep is expected to soon follow.

●Nursing down. Nestle next to your baby and breastfeed or bottlefeed him off to sleep. The smooth continuum from warm bath, to warm arms, to warm breast, to warm bed is a recipe for sleep to soon follow.

●Fathering down. Place baby in the neck nestle position (nestle baby's head against the front of your neck with your chin against the top of baby's head. The vibration of the deeper male voice lulls baby to sleep) and rock your baby to sleep. If baby doesn't drift off to sleep while rocking, lie down with your baby, still in the neck nestle position, and let baby temporarily fall asleep draped over your chest. Once baby is asleep, ease the sleeping baby into his bed and sneak away.

●Rocking or walking down. Try rocking baby to sleep in a bedside rocking chair, or walk with baby, patting her back and singing or praying.

●Nestling down. For some babies, the standard fall-to-sleep techniques are not enough. Baby just doesn't want to be put down to sleep alone. After rocking or feeding baby to sleep in your arms, lie down with your sleeping baby next to you and nestle close to her until she is sound asleep. We call this the "teddy- bear snuggle."

●Wearing down. Some babies are so revved up during the day that they have trouble winding down at night. Place your baby in a baby sling and wear her around the house for a half-hour or so before the designated bedtime. When she is fully asleep (see limp-limb sign) in the sling, ease her out of the sling onto her bed. For babies who are used to nursing off to sleep in a mother's arms, fathers can wear their baby down to sleep and give mother a break.

●Wearing down is particularly useful for the reluctant napper. When baby falls asleep in the sling, snuggled with his tummy against your chest or draped over your chest once you lie down, you both can take a much-needed nap.

●Swinging down. Wind-up swings for winding down babies are a boon to parents who have neither the time, energy or creativity to muster up rituals of their own. Tired parents will pay anything for a good night's sleep. Once in a while a moving plastic seat may be more sleep inducing than a familiar pair of arms. Sometimes high-need babies associate a parent's body with play and stimulation and will not drift off to sleep in a human swing. For them the mechanical one is less stimulating, if not downright boring, and therefore can be a useful part of a sleep-ritual repertoire. Yet remember, high-need babies are notoriously resistant to mechanical mother substitutes and will usually protest anything less than the real mom. Before you actually spend money on a swing, you might want to borrow one for a week or two to see if the spell of the swing will last. You may discover that you are uncomfortable with mechanical mothering and decide to get more creative. Still, swings have their moments.

●Driving down. If you've tried all the above transitioning techniques and baby still resists falling asleep, place baby in a carseat and drive around until she falls asleep. When you return home and baby is in a deep sleep, carry the carseat (with the sleeping baby) into your bedroom and let baby remain in the carseat until the first nightwaking. If she is in a deep sleep (witness the limp-limb sign – hands unclenched, arms dangling loosely at her side, facial muscles still), you may be able to ease her out of the carseat into her own bed.

●Mechanical mothers. Gadgets to put and keep baby asleep are becoming big business. Tired parents pay high prices for a good night's sleep. It's all right to use these as relief when the main comforter wears out, but a steady diet of these artificial sleep inducers may be unhealthy. We remember a newspaper article extolling the sleep-tight virtues of a teddy bear, with a tape player in his stuffing that sings or makes breathing sounds. Baby can snuggle up to the singing, breathing, synthetic bear. Personally, we are not keen on our babies going to sleep to someone else's canned voice. Why not use the real parent?

STAY ASLEEP TECHNIQUES

●Now that you've learned all the tricks of the nighttime trade to get your baby to sleep, here are some ways to keep your baby asleep. Because of the characteristics of babies' sleep cycles and easy arousability from sleep, you will notice that we purposely omit what we call the "harden your heart" method: put your baby down to sleep awake in a crib in his own room, put cotton in your ears, and let him cry himself to sleep. When he awakens, don't go into him. He will soon learn to put himself to sleep and back to sleep. We believe that this method is unsafe, runs the risk of baby losing trust, and, for infants with persistent personalities, doesn't work. Try these tips to help your baby sleep increasingly longer stretches at night.

●Dress for the occasion. Try various ways of swaddling your baby at night. In the early months, many babies like to "sleep tight," securely swaddled in a cotton baby blanket. Older infants like to sleep "loose," and may sleep longer stretches with loose coverings that allow them more freedom of movement. Oftentimes, dressing a baby loosely during the day, but swaddling him at night, conditions the baby to associate sleep with swaddling. A baby who gets too hot or too cold may become restless. Adjust the layering according to the temperature of the room and the sleep habits of your baby. Allergy-prone babies sleep better in 100 percent cotton sleepwear.

●Quiet in the bedroom. Since most babies can block out disturbing noise, you don't have to create a noiseless sleeping environment, yet some babies startle and awaken easily with sudden noises. For these babies, oil the joints and springs of a squeaky crib, put out the dog before he barks and turn the ringer off on the phone.

●Darkness in the bedroom. Use opaque shades to block out the light, which may get you an extra hour of sleep if you have one of those little roosters who awakens to the first ray of sunlight entering the bedroom.

●Sounds to sleep by. Repetitive, nearly monotonous sounds that lull baby to sleep are known as white noise, such as the sounds of a fan, air conditioner, or even tape recordings of womb sounds or vacuum cleaner sounds. Also, try running water from a nearby faucet or shower, a bubbling fish tank, a loudly ticking clock, or a metronome set at sixty beats a minute. (These can all be tape-recorded.) Try music to sleep by, such as tape recordings of waterfalls or ocean sounds, or a medley of easy-listening lullabies on a continuous-play tape recorder. These sleep-inducing sounds remind baby of the sounds she was used to hearing in the womb. (See 11 Ways to Soothe Fussy Babies for more sleep-inducing tips.)

●Music to sleep by. Try a continuous-play tape recording of your baby's favorite lullabies, so when she awakens she can resettle herself to the familiar sleep-inducing sound of the tape-recording. You can make a medley of your own lullabies that have been proven sleep-inducers.

●Leave a little bit of mother behind. If you have a separation-sensitive baby, leave a breast pad in the cradle, or play a continuous tape recording of yourself singing a bedtime lullaby.

●A full tummy (but not too full). While stuffing baby with a glob of cereal before bedtime seldom works, it may be worth a try. A tablespoon or two given to a baby over six months of age may get you an extra hour or two. Tiny babies have tiny tummies, a bit bigger than the size of their fist. So, your baby's digestive system was designed for small, frequent feedings, which is why, in the early months, babies feed at least every 3 to 4 hours at night and more often during the day. (See Foods for Sleep)

●Lessen physical discomforts.

1) Clear the nose. In the early months, babies need clear nasal passages to breathe. Later they can alternatively breathe through their mouth if their nose is blocked. Bedroom inhalant allergies are a common cause of stuffy noses and consequent nightwaking. Dust-free your baby's bedroom as much as possible. (Remove fuzzy blankets, down comforters, dust-collecting fuzzy toys, etc.) If your baby is particularly allergy-prone, a HEPA-type air filter will help. As an added nighttime perk, the "white noise" from the hum of the air filter may help baby stay asleep.

2) Relieve teething pain. Even though you may not yet be able to feel baby's teeth, teething discomfort may start as early as three months and continue off and on all the way through the two-year molars. A wet bedsheet under baby's head, a drool rash on the cheeks and chin, swollen and tender gums, and a slight fever are telltale clues that teething is the nighttime culprit. What to do? With your doctor's permission, give appropriate doses of acetaminophen just before parenting your baby to sleep and again in four hours if baby awakens.

3) Change wet or soiled diapers. Some babies are bothered by wet diapers at night, most are not. If your baby sleeps through wet diapers, there is no need to awaken her for a change – unless you're treating a persistent diaper rash. Nighttime bowel movements necessitate a change. Here's a nighttime changing tip: If possible, change the diapers just before a feeding, as baby is likely to fall asleep during or after feeding. Some breastfed babies, however, have a bowel movement during or immediately after a feeding and will need changing again. If you are using cloth diapers, putting two or three diapers on your baby before bedtime will decrease the sensation of wetness.

4) Remove irritating sleepwear. Some babies cannot settle in synthetic sleepwear. A mother in our practice went through our whole checklist of nightwaking causes until she discovered her baby was sensitive to polyester sleepers. Once she changed to 100 percent cotton clothing, her baby slept better. Besides being restless, some babies show skin allergies to new clothing, detergents and fabric softeners by breaking out in a rash.

5) Remove airborne irritants. Environmental irritants may cause congested breathing passages and awaken baby. Common household examples are cigarette smoke, baby powder, paint fumes, hair spray, animal dander (keep animals out of an allergic child's bedroom), plants, clothing (especially wool), stuffed animals, dust from a bed canopy, feather pillows, blankets, and fuzzy toys that collect lint and dust. If your baby consistently awakens with a stuffy nose, suspect irritants or allergens in the bedroom.
●A warm bed. Placing a warm baby onto cold sheets can cause trouble. Especially in cold weather, use flannel sheets or place a warm towel on the sheets to warm them, and remove it before placing baby on the warmed sheets.

●Create the right bedroom temperature and humidity. A consistent bedroom temperature of around 70 degrees F is preferable. Also, a relative humidity of around 50 percent is most conducive to sleep. Dry air may leave baby with a stuffy nose that awakens him. Yet, too high a humidity fosters allergy-producing molds. A warm-mist vaporizer in your baby's sleeping area helps maintain an adequate and consistent relative humidity, especially with central heating during the winter months. (And, the "white noise" of a consistent hum may help baby stay asleep.)

WHAT TO DO WHEN BABY AWAKENSWHAT TO DO WHEN BABY AWAKENS When your baby awakens, develop a nighttime parenting approach that respects your baby's need for nighttime trust and comfort, in addition to the need for baby and parents to quickly get back to sleep. While some babies are self-soothers, being able to resettle easily and quickly without outside help, others (especially those high-need babies with more persistent personalities) need a helping hand (or breast, or whatever tool you can muster up at 3:00 a.m.). Try these back-to-sleep comforters:

●Laying on of hands. Determine what your baby's nighttime temperament is. Is your baby a born self-soother who awakens, whimpers, squirms, and then resettles by herself? Or is your baby, if not promptly attended to, one whose cries escalate and becomes angry and difficult to resettle? If you can get to your baby quickly before she completely awakens, you may be able to resettle her back to sleep with a firm laying on of hands. To add the finishing touch, pat your baby's back or bottom rhythmically to match your heartbeat. Remove your hands gradually – first one and then the other – easing the pressure slowly so as not to startle baby awake. Sometimes fathers, perhaps because they have larger hands, are more successful in this hands-on ritual.

●Honor your partner with his share of nighttime parenting. It's important for babies to get used to father's way of comforting and being put to sleep (and back to sleep) in father's arms, otherwise mothers burn out. A father's participation in nighttime parenting is especially important for the breastfeeding infant who assumes the luxury that "mom's diner" is open all night.

●Detect hidden medical causes of nightwaking. If you've tried all these techniques and your infant is still waking up frequently – and painfully – suspect there may be an underlying medical problem contributing to your baby's nightwaking. (See Hidden Causes of Nightwaking) One of the most common hidden medical causes of nightwaking (and colicky behavior) in babies is a condition known as gastroesophageal reflux (GER). Due to a weakness of a circular band of muscle where the esophagus joins the stomach, irritating stomach acids are regurgitated into baby's esophagus, causing pain like adults would call heartburn. Clues that your baby may be suffering from GER are: painful bursts of nightwaking fussiness, particularly after eating; frequent spitting up (although not all babies with GER spit up regularly); frequent bouts of colicky, abdominal pain; frequent bouts of unexplained wheezing; and hearing throaty sounds after feeding. Another hidden medical cause of nightwaking is allergies to formula or dairy products, either in milk-based formulas or in dairy products in a breastfeeding mother's diet. Clues that milk allergies may be causing nightwaking (and colicky behavior) are bloating, diarrhea and a red rash around baby's anus, in addition to many of the signs described above under GER. If your baby is not only waking up frequently, but waking up "in pain," discuss these two medical possibilities with your doctor, since both can be diagnosed and treated, giving everyone in the family a more peaceful night's sleep.

●The above tools not only help your short-term goal of getting your baby to sleep, but, more importantly, create a healthy sleep attitude that lasts a lifetime. A baby who enjoys this style of nighttime parenting learns that sleep is a pleasant state to enter and a secure state to remain in. Therein lies the key to nighttime parenting.

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SLEEP-TRAINING – NOT FOR BREASTFEEDING MOTHERS

Ever since parenting books found their way into bedrooms, authors have touted magical formulas promising to get babies to sleep through the night and follow a more convenient schedule. While babies have a lot of wonderful attributes, convenience is not one of them. Beware of using someone else's training method to get your baby to sleep or get your baby on a predictable schedule. Most of these methods are variations of the tired old theme of letting baby cry it out. Before trying anyone else's method, run it through your intuitive wisdom. Does this advice sound sensible? Does it fit your baby's temperament? Does it feel right to you?

With most of these baby-training regimens you run the risk of becoming desensitized to the cues of your infant, especially when it comes to letting baby cry it out. Instead of helping you to figure out what baby's signals mean, these training methods tell you to ignore them. Neither you nor your baby learn anything good from this.

If your current daytime or nighttime routine is not working for you, think about what changes you can make in yourself and your lifestyle that will make it easier for you to meet your baby's needs. This is a better approach than immediately trying to change your baby. After all, you can control your own reactions to a situation. You can't control how your baby reacts. Use discernment about advice that promises a sleep-through-the-night more convenient baby, as these programs involve the risk of creating a distance between you and your baby and undermining the mutual trust between parent and child. On the surface, baby training sounds so liberating, but it's a short-term gain for a long-term loss. You lose the opportunity to know and become an expert in your baby. Baby loses the opportunity to build trust in his caregiving environment. You cease to value your own biological cues and judgment and follow the advice of someone who has no biological attachment, nor investment, in your infant.

Clicking into the cry-it-out method also keeps you from continuing to search for medical or physical causes of nightwaking, such as GER and food allergies. Nightfeedings is normal; frequent nightwaking is not.

Stay flexible. No single approach will work with all babies all the time, or even all the time with the same baby. Don't persist with a failing experiment. If the "sleep program" isn't working for your family, drop it.

Follow your heart rather than some stranger's sleep-training advice, and you and your baby will eventually work out the right nighttime parenting style for your family.

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NIGHT WEANING: 12 ALTERNATIVES FOR THE ALL-NIGHT NURSER

Frequent night nursing is characteristic of high-need children. It's like going to their favorite restaurant. The ambiance is peaceful, the server is familiar, the cuisine is superb, and they love the management. Who can blame the all-night gourmet? Try these suggestions for dealing with all-night nursing:

1. What's the problem?
How much of a "problem" is the frequent night nursing? This stage of high level night nurturing will pass. Both you and your baby will someday sleep through the night. Yet, if you are sleep deprived to the degree that you are barely functioning the next day, you resent your nighttime parenting style (and your baby), and the rest of your family relationships are deteriorating, you need to make some changes in your nighttime feeding schedule.

A parenting principle we learned many kids ago is: IF YOU RESENT IT, CHANGE IT!

Even if you can't get your baby to sleep through the whole night, you can help him cut back on nighttime nursing, making the situation more tolerable for you. Here's how:

2. Tank your baby up during the day
Toddlers love to breastfeed, yet they are often so busy during the day that they forget to nurse, or mom is so busy that she forgets to nurse. But at night, there you are, only an inch away, and baby wants to make up for missed daytime nursings. (This is a common scenario when a breastfeeding mother returns to work outside the home.) Finding more time to nurse during the day may make the breast less attractive at night.

3. Increase daytime touch
Wear your baby in a sling and give your baby more touch time during the day. It's easy when babies get older to greatly decrease the amount of touching time without realizing it. All-night nursing can sometimes be a baby's signal reminding mothers not to rush their baby into dependence. In developing a healthy independence, a child leaves and comes back; lets go and clings, step by step until she is going out more than she is coming back. Many mothers have noted that babies and toddlers show an increased need for nursing and holding time right before undertaking a new stage of development, such as crawling or walking.

4. Awaken baby for a full feeding just before you go to bed
Rather than going off to sleep only to be wakened an hour or two later, get in a feeding when you retire for the night. This way, your sleep will be disturbed one less time, and you'll (hopefully) get a longer stretch of sleep.

5. Get baby used to other "nursings."
Try wearing him down to sleep in a baby sling. After baby is fed, but not yet asleep, wear him in a baby sling around the house or around the block. When he's in a deep sleep, ease him onto your bed and extricate yourself from the sling. This is a good way for dad to take over part of the bedtime routine. Eventually, your baby will associate father's arms with falling asleep, and he'll be willing to accept comfort from dad in the middle of the night as an alternative to nursing. Other ways to ease your baby into sleep without nursing him include patting or rubbing his back, singing and rocking, or even dancing in the dark to some tunes you like or lullabies you croon.

6. Make the breast less available
Once your baby has nursed to sleep, use your finger to detach him from the breast. Then pull your nightgown over your breast and sleep covered up. A baby who can't find the nipple quickly may just fall back to sleep. If you can stay awake long enough to put the breast away, he may not latch on again so soon.

7. Just say no!
When our son, Matthew, was two, Martha felt desperate for sleep if awakened more than two times. I would wake up to hear a dialogue like "Nee" (his word for nurse)…"No!"… "Nee!"… "No!"… "Nee!"… "No, not now. In the morning. Mommy's sleeping. You sleep, too." A firm but calm, peaceful voice almost always did the trick. You can manage to stay peaceful in this situation when you know you are not damaging your very secure, attachment- parented child.

8. "Nummies go night-night."
Now the marketing begins. Around eighteen months, your child has the capacity to understand simple sentences. Program your toddler not to expect to be nursed when she awakens, such as "We'll nurse again when Mr. Sun comes up." When you nurse her to sleep (or have the first or second night nursing) the last thing she should hear is "Mommy go night-night, Daddy go night-night, baby go night-night, and nummies go night- night" (or whatever she dubs her favorite pacifiers). When she wakes during the night the first thing she should hear is a gentle reminder, "Nummies are night- night. Baby go night-night, too." This program may require a week or two of repetition. Soon she will get the message that daytime is for feeding and nighttime is for sleeping. If "nummies" stay night-night, baby will too -- at least till dawn.

9. Offer a sub
High-need babies are not easily fooled; they don't readily accept substitutes. Yet, it's worth a try. Remember, nursing does not always mean breastfeeding. Honor your husband with his share of "night nursing" so your toddler does not always expect to be comforted by nummies. This gives dad a chance to develop creative nighttime fathering skills and the child a chance to expand her acceptance of nighttime comforters.

Martha notes: "One of the ways we have survived toddler's who wants to nurse frequently during the night was for me to temporarily go off "night call." Bill would wear Stephen down in a baby sling, so he got used to Bill's way of putting him to sleep. When he woke up, Bill would again provide the comfort he needed by rocking and holding him in a neck nestle position, using the warm fuzzy and singing a lullaby. Babies may initially protest when offered father instead of mother, but remember, crying and fussing in the arms of a loving parent is not the same as "crying it out." Dads, realize that you have to remain calm and patient during these nighttime fathering challenges. You owe it to both mother and baby not to become rattled or angry when your baby resists the comfort you offer.

Try this weaning-to-father arrangement on a weekend, or another time when your husband can look forward to two or three nights when he doesn't have to go to work the next day. You will probably have to sell him on this technique, yet we have personally tried it and it does work. Be sure to use these night-weaning tactics only when baby is old enough and your gut feeling tells you that your baby is nursing at night out of habit and not out of need."

10. Increase the sleeping distance between you
If the above suggestions do not entice your persistent night nurser to cut back, yet you still feel you must encourage him to do so, try another sleeping arrangement. Try putting him in a bedside co-sleeper® bassinet, on a mattress or futon at the foot of your bed, or even sleeping in another room with a sibling. Dad or mom can lie down beside baby to comfort him if he awakens. Mom can even nurse, if necessary and then sneak back to her own bed if continued closeness seems to encourage continued waking.

11. Sleep in another room
If your baby persists in wanting to nurse all night, relocate "Mom's All-Night Diner" to another room and let baby sleep next to dad for a few nights. He may wake less often when the breast is not so available and when he does wake, he will learn to accept comfort from dad.

12. Let baby be the barometer
When trying any behavior-changing technique on a child, don't persist with a bad experiment. Use your baby's daytime behavior as a barometer of whether your change in nighttime parenting style is working. If after several nights of working on night weaning your baby is her same self during the day then persist with your gradual night weaning. If, however, she becomes more clingy, whiny, or distant, take this as a clue to slow down your rate of night weaning.

Babies will wean and someday they will sleep through the night. This high maintenance stage of nighttime parenting will pass. The time in your arms, at your breast, and in your bed is a relatively short while in the life of a baby, yet the memories of love and availability last forever.

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