Sleep Training / Cry it Out (14w5d)

Kieran has never been a good sleeper. Overnight he’s been OK, dependable for the most part with regular wakings that have gotten increasingly longer apart as he’s gotten older. He has been an increasingly early riser though, much to Paul’s annoyance. (I catch Kieran’s overnight wake-ups so Paul can sleep through the night and be able to get up with Kieran in the morning and be with him all day while I’m at work.)

Kieran has always been a crappy napper though. And since I’ve gone back to work, it’s only gotten worse. Most days, he naps once, if at all – or does a couple of 20 minute naps throughout the day which don’t seem to leave him feeling rested. What this leaves us with is a VERY tired baby who is on a downward slide from about 2:30pm on. We were initially aiming for a 7:00pm bedtime, but recently he’s been going to bed earlier and earlier (like 5:30pm) because we can’t keep him up any longer and frankly, wouldn’t want to.

Enter Sleep Training. We’ve just gone along with whatever works up until now because all the books say that before 3-4 months, babies don’t have the physiological maturity to be on a schedule – if they sleep “through the night” before 3 months, it’s the luck of the draw and you have an especially easy baby. (Mind you, “through the night” just means a 5-6 hour stretch before 6 months – which isn’t particularly helpful when that 6 hours starts at 5:30pm.) We’re also fighting against the fact that even though you’d never know it now, Kieran *was* 3 weeks early – and that makes a difference in his growth and maturity for milestone things like this. But Kieran is 3.5 months old now and his lack of naps is really making life difficult – so we’re diving in.

We’ve settled on the methods prescribed by Dr. Marc Weissbluth, author of Healthy Sleep Habits, Happy Child. His technique is usually referred to as “Cry It Out” although he’s the first to say that different babies will respond differently to this. He actually espouses three levels of ‘extinction’: Let Cry, Maybe Cry and No Cry. He recommends ‘Let Cry’ if Mama and Daddy can handle it, as it works the fastest. (Dr. Ferber’s method – commonly referred to as “Ferberizing” – most resembles Dr. Weissbltuh’s ‘Maybe Cry’ option.) Dr. Weissbluth emphasizes that helping our baby to sleep is just like taking care of any of his other needs: we feed him when he’s hungry, change him when he’s dirty, play with him when he’s awake, and help him sleep when he’s tired. That rings true with us.

According to Dr. Weissbluth, at this age, Kieran can’t really handle more than 2 hours or so of wakefulness before he needs to sleep again, preferably for 1-2 hours at a shot. Starting now, and over the next 1-2 months, Kieran will naturally start to develop a mid-morning and afternoon nap: both of which we can and should encourage on Kieran’s personal schedule. The morning nap will develop first, followed by the afternoon one.

Problem is, Kieran doesn’t want to nap. He’d greatly prefer to stay up and play with Daddy. (or look at his toys or listen to us talk… or do anything but sleep.) This has lead to a chronically overtired baby. This starts (and perpetuates) a vicious cycle which has (we believe) caused Kieran’s night-time sleeping to deteriorate. Dr. Weissbluth explains it best: “…When [baby] becomes overtired – from nap deprivation or any other reason – [his] body produces stimulating hormones to fight the fatigue. This chemical stimulation interferes with sleeping well. This is why sleeping well during the day will improve night sleeping and why, conversely, nap deprivation causes night waking.” Kieran has recently been waking up after only 2.5 hours at night after his first big sleep, as opposed to the 4 hours we had a month ago – and his 5:00am wake-up has been pushing closer and closer to 4:30am.

So: this weekend we committed to sleep training – working to put ourselves and Kieran on a schedule for naps and nighttime sleeping as Kieran’s natural nap proclivities emerge. The hardest part of this is putting Kieran down for naps. Regardless of how tired he may be, he doesn’t wanna nap and he protests. Volubly. We are prepared for this though, and will steel ourselves to not go in and get our crying baby for at least 20 minutes, and up to an hour. The hope is that he will cry himself out and actually sleep – well before that hour mark. (Or to put it in a nicer fashion: he’ll learn to self-soothe and put himself to sleep on his own.) So after making sure he’s full and dry: we walk and rock and sing and soothe until he’s drowsy but awake, place him in the crib and then walk out of the room.

So far today, we’ve been lucky: the protest crying has been limited to 7 minutes, and two 4-minute bouts. But, the naps haven’t been great. 45 minutes for the first one, and 55 minutes for the second. A third nap attempt was thwarted after 20 minutes of solid crying/shrieking. We opted to move the operation over to Grampy’s house where we’re having dinner and try again. I’m typing this now from their living room, listening to the crying from the guest room and watching the clock…. We’re approaching 30 minutes or protesting now. (sigh)

Here’s hoping that enforcing naps during the day will help him sleep better at night, which will, in turn, help him nap better. Helping Kieran learn to put himself to sleep will be one of the best things we can teach him, for life. (OK, I think I’ve drunk a little too much of the Kool-Aid.) Paul has his work cut out for him during the day, watching for Kieran’s sleepy signals – before he gets overtired. I have no illusions of who has the much harder job for the next week or two. Paul wins, hands-down.

Brute! (7w)

OMG, it’s not our imagination! In the last 15 days, Kieran has gained 28 ounces – 1.75lb!!! He’s been eating like crazy, and it shows! In the last couple of days, we’re finding that the footie sleepers that fit fine last week are too short now, Kieran is filling them out so well. He’s fine in his newborn-sized onesies, pants and rompers – but he can’t fully stretch out his legs in his footie sleepers anymore! (We can barely strap the newborn sized disposable diapers on him anymore. Same goes with his preemie-sized cloth diapers!)

I weighed him today at the lactation consultant’s office, using their very precise scale. Paul and I are going to try to get his length tonight – I think he’s grown taller too. I can’t believe how BIG he looks now, especially compared to the pics we took in the hospital.

I’m boxing up the stuff that Kieran is outgrowing to give to Paul’s sister, who is due at the end of September. It’s harder than I expected to box up Kieran’s clothes like this. We’re happy that Cassie will get to use them, but folding up our favorite outfits from our son’s first weeks of life… it’s hard to do so immediately after he’s outgrowing them. I’m saving the striped preemie-sized onesie that Kieran wore in the hospital. I don’t know that we’ll save something from each other size… but it’s tempting.

Tonight, I’m continuing to re-do Kieran’s dressers. I was a little over eager with their organization when I filled them up a week before going into the hospital. Makes it kinda hard to know what sizes are what, and makes putting away laundry a PITA. Now that I’m removing nearly all the newborn clothes, it will be easier to get at his various types of clothing in his current size of 0-3 or 3. Stuff that he won’t be wearing for another 4-6 months doesn’t have to be in the dresser yet, methinks.

My little boy is a little brute!! But man, he’s so cute! Paul and I are struck several times a day with just how precious this little guy is. He’s becoming more alert and aware of his surroundings every day – so interacting with him is getting more and more enjoyable. We haven’t had a smile yet, but we’ve had cute grimaces. (A silver lining to the gas that plagues our little man no matter what formula we have him on.)

Kieran is starting to hit some development milestones too – like reaching out for things, grasping and not letting go. He frequently holds on to my shirt or finger while he’s eating. He reaches out for, grasps and pulls off my glasses at least once a day now while we’re playing. (I don’t mind cleaning my glasses when the fingerprints are SO TINY!) He’s able to hold his head up really well – which I think comes directly from his dislike of being burped. I put him on my shoulder so he can rear back his little head and tell me off directly into my face & ear. Good exercise for my little man.

It’s still very much an adventure, but I think Paul and I are doing a pretty good job. Paul is fantastic with Kieran, which makes it a little easier to contemplate going back into the office in three weeks or so.

Follow up on Breastfeeding II (5w5d)

The struggle continues…

My supply continues to dwindle. The herbal supplements don’t seem to help (neither the Mother’s Milk Plus nor the Fenugreek seeds) although I don’t know that I’m taking enough of the Fenugreek seeds because I don’t think I smell like maple syrup.

I’m averaging less and less with the pumping every day. Sometimes I’ll get over an ounce (30ml) combined, but like this morning, I got just over 10ml combined. That is SO frustrating, let me tell you. That’s a lot of time being tied to that pump for so little return. I’m working to increase the number of times I’m pumping though, in the hopes that I can bounce back.

Kieran is basically refusing the breast all the time now. Having to give him thickened feedings because of his acid reflux has necessitated using an even more open bottle nipple, which requires even less effort than a regular bottle nipple for Mr. Lazy Nurser. We give him the occasional un-thickened bottle with the tightest nipple we have just to remind Kieran what it should be like. We can tell that frustrates him. So when he’s offered the breast (even when I’m nearly engorged, so I know he could get a fair feeding outta me) he just fusses and squirms and cries and won’t nurse. We’ve tried giving him a half feeding with a bottle and then offering the breast when he’s not ‘starving’ – but Kieran is convinced that he’s starving until he’s full.

It’s disappointing on several levels.

  • I was SO INCREDIBLY looking forward to nursing Kieran. The bonding, the special time, the perfect nutrition that only I could provide, the easy-clean-up diapers.
  • The Cost. Even using some of the most inexpensive formula we can find (currently Target’s house brand “up & up” Partially Broken Down version) is gonna add around $60-75 a month to our budget that already doesn’t quite cover everything. And as he grows, that figure will only increase. (I can’t imagine if we had to stay on one of the name brands. The Target stuff runs ~$.46/oz whereas the cheapest you’ll find Simalac is ~$.89/oz at Costco or Amazon.)
  • Formula diapers are not as pleasant as BF diapers were. Just sayin’.

On the bright side though, Kieran is gaining weight like a champ. He’s still right at the very bottom of the growth percentage charts – but that mostly has to do with the fact that he was 3 weeks early and such a tiny peanut to start with. ~8lb is teeny for a nearly 6 week old baby. But then again, ~8lb for a nearly three week old baby is still small too. He’s gaining ~1oz a day, which is a very healthy growth rate – so his pediatrician is happy with that.

Truth be told, we’re a little concerned about him gaining weight too fast with the thickened formula – but we’re carefully watching Kieran’s signals and feeding him when he actually tells us he’s hungry, feeding him a set amount (currently 3oz + 1T of oatmeal cereal) and waiting to see if he asks for more 10 minutes later. Sometimes he does (and gets another 1-1.5oz + cereal) and sometimes he doesn’t. The oatmeal cereal added to his formula adds the nutrition/calories equivalent to another ounce of formula. So he’s getting what he needs to grow at the rate that works for him.

I’m bummed that Exclusive breast feeding hasn’t worked out. (Not devastated though, which is a VAST improvement over my mental status for the first 2-3 weeks of this adventure.) But I’ll keep trying with the pump, which we have rented through September and see how it goes. I’m comforted by knowing that any breastmilk Kieran gets is better than none, but that regardless he’s growing well and thriving.

Holding Pattern & Why I LOVE Dr. Schwartz (35w4d)

Fairly boring appointment today. Did the test for Group B Strep, the results of which should be back on Friday. (Most people carry Group B Strep on them with no worries, but if I’m currently carrying it, the baby can get REAL sick if exposed to it during a vaginal birth. Two doses of antibiotics via IV during labor will take care of it if I am positive.)

Amniotic fluid was back up to a 6 today, so that’s good. Little man was happy to show us how well he practices breathing, and had fun kicking the ultrasound transducer. Monitoring was the same as usual, requiring the buzzer to get things going. But once he woke up, he proceeded to kick the contraction monitor pad for about 5 minutes. His heartrate did a scary little deceleration thing a couple of times, but he bounced back quickly – so that’s OK.

Blood pressure was mixed: 164/97. So it was higher than it has been, but the diastolic was under 100, which is good. Dr. Schwartz said he was OK with my BP today, so yay.

Paul and I chatted with Dr. Schwartz about the plans for the rest of this week and next. (We also talked about developing an iPhone app vs a fee-for-service website…) But once we got home, Paul was explaining to his Dad what my status is and kinda had it all wrong. We talked, but Paul was still pretty convinced that he had it right and that the induction wasn’t happening unless it was an absolute emergency. So I e-mailed Dr. Schwartz. Below is the actual e-mail conversation (along with an explanation of what’s up for the next 5 days):

On Jun 16, 2010, at 8:10 PM, Sarah wrote:

Sorry to bug you, but Paul and I seem to have heard completely different things at today’s appointment and I’m hoping you can clear things up.

I’m under the impression that barring any significant change to my condition, you’ll do a Jedi-worthy amniocentesis on Monday morning which will confirm binary-style whether the little man’s lungs have matured enough to be on the outside. If the test comes back with a yes, you’ll have me report to the hospital Monday evening to start the induction. If the amnio comes back saying baby’s lungs aren’t mature yet, we’ll hang out and do another amnio a week later to check lung maturity then.

Paul is under the impression that I’m not being induced until the situation becomes an emergency, and that Monday’s scheduled amnio is just to give us an idea if the baby could handle being outside the womb when that crisis time comes, whenever that is.

So, who’s got it right?


As is probably the case in any disagreements that you and Paul might have, YOU heard correctly and Paul is wrong. Please feel free to refer Paul to this email throughout the rest of your life.


Sent from my iPhone

I LOVE my OB so freaking much. So we’re just hanging out for monitoring on Friday and then the amniocentesis on Monday morning. We’ll have results that afternoon, and either we’ll be at the hospital that evening, or we won’t.

Updating from home… (35w3d)

I was totally expecting to get sent to the hospital today, but I got sent back home! Yay!

Dr. Schwartz re-did the fluid check and is confident he saw 5.5-6 worth of fluid in there. Heck, he even thinks there’s enough that he could do the amnio on Monday. He says he likes a challenge. My BP was fantastic today, with the diastolic under 90!! (I forget, it was 140-something/80-something.)

So I’m home now, gonna go take a nap. Monitoring and Group B Strep test tomorrow. We’ll see how it goes. I’ve got a monitoring appointment on Friday and the amnio scheduled for Monday morning.

Oh, and Dr. Schwartz obliged Paul while he was hunting for fluid and took some measurements. The little man is weighing in at just a tad over 5 pounds right now. Not sure about his length cuz the measurements were kinda all over the place, but the weight is a good estimate at least. Our little bag of sugar! :)