Wednesday, September 10, 2014

Sleep Training - What Works

As we celebrate 6 months of E the one E I haven't dropped ba-dum-tss here at Headbath, I'd like to revisit the topic of her sleep. I jokingly refer to our efforts at training her to fall asleep (see here, here, and here, in chronological order) as our life's greatest achievement. 

But babies are drunk little monkeys anyway.

What Works


In the three months since we started sleep training with E, I've found the following tricks to be very helpful in getting her to sleep and stay asleep.
  1. An unchanging place to nap - same room and same surface.
    She still sleeps in our bedroom but I shifted her napping spot from the family bed to the crib after she turned 5-months old. We took a trip to Kerala and when we got back, I wanted to see if she'd accept the crib and she did - no fuss!
    For a while she napped in her crib but slept at night in the family bed. However, since she turned 6-months old, she sleeps in her crib even at night. We had no transition troubles on either occasion. 
  2. darkened bedroom - this is a very strong cue to sleep.
    Drawing the curtains is a part of our nap time routine; I'm usually carrying her when I do this. Likewise, when I go in to pick her up after she wakes up from her nap, I draw the curtains open while she's looking at me from her crib.
  3. Quiet voice before naps and bright, cheery voice after naps.
    We need to do everything we can to help baby understand that not only is sleep about to follow, but that we expect her to fall asleep soon.
  4. Clean diaper.
    You try falling asleep in wet undies.
  5. Appropriate clothing - E changes into full-sleeve top and full-length pants before all sleep.
    In The No-Cry Sleep SolutionElizabeth Pantley points out that, sometimes, babies wake up mid-nap because their bare skin touches a part of the bed that hasn't been warmed by their bodies.
    E doesn't mind her hands and feet getting cold but is quite sensitive with regard to her arms and legs. The upside to a pre-nap wardrobe change is that it is also a powerful cue to sleep for her.
  6. A full stomach.
    Nursing in a darkened room just before a nap helps E wind down without any distractions. We have an adirondack chair in our bedroom that I now only use to nurse her before a nap. For all feeding that happens outside of nap time, I use other rooms and seating arrangements. 
  7. Cuddles and kisses.
    The final step in our sleep routine involves me holding E and whispering, "Mummy loves you. It's time to rest now. I'll come get you in <insert sleep duration> hours. Sleep well, my angel." This is interspersed with as many kisses as my sleepy little baby will allow.
  8. Putting baby down, switching the monitor on, and walking out only to return after the stipulated time.
    We have a highly useful baby monitor to help us hear and see her. As soon as I leave the room, I switch it on to monitor her d-oh. Fortunately, E's temperament is such that she doesn't cry when she wakes up. So the monitor is highly useful for me to see when she's awake and playing happily by herself in her crib to go fetch her.
  9. Temperature between 22ºC and 26ºC. This may or may not be just my personal preferred temperature of slumber. I think it's inhuman for anyone to sleep in a room that's outside this temperature range.
    I don't use a white noise machine but I leave the ceiling fans on in our room. The one furthest from her is at speed setting 2, while the other is set at 1.
  10. Fill awake time with lots of natural light, fresh air, and activity. Make sure the difference between nap time and play time is like night and day.
However, I think the most important lesson from the last three months has been to let E figure out her sleep problem and fix it herself. Some days she coos and gurgles for a while before she falls asleep while on others she wakes up 30 minutes into her nap. In both cases, I give her 30 minutes to kick around and go back to sleep. If she doesn't, I fetch her and keep her awake till her next nap unless it's bedtime in which case I just monitor her remotely till she falls asleep.

If she starts crying which is so rare, I check the monitor. If she is in discomfort usually because she has rolled over or has a stuffy nose, I go in silently, fix the issue, and get out - no eye contact. At the start of sleep training, she had a distinct fussy cry. It took me 3 weeks to realise that she wasn't crying for me but was trying to figure out how to fall asleep by herself. Nowadays if she cries fussily, I do not go in to pick her up until the prescribed sleep time is over This happened for two days at bedtime after we got back from holiday in August but not even once since

Of the two books I read on baby sleep, Healthy Sleep Habits, Happy Child by Marc Weissbluth, M.D., was the most informative and useful enlightening. Three months into applying my learnings with E, I have a calm, well-rested child. The title of the book says it all.

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