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“The Only Sleep Method You’ll Need for Your Baby.” by Dr. Dina Kulik, wife, mother, pediatrician

Posted July 15, 2014

(Published in Huffington Post Living, July 15, 2014)

"My oldest son wasn't a natural sleeper. I had been taught in my pediatric residency that newborns should sleep 18-22 hours a day. As I had planned on studying for my pediatric board exams throughout my brief maternity leave, I was counting on this dedicated sleep time while I could focus on my studying. He turned out to be a pitiful sleeper, requiring my constant rocking and feeding to get him to sleep, only to wake right back up when I lay him down. Thus began the constant cycle of feeding him in a carrier and pacing around my apartment with a stack of cue cards to keep him asleep while I tried desperately to study. So much for a relaxing and fruitful maternity leave.

When he turned four months old I was at my wit's end. I was exhausted and stressed that I wasn't accomplishing much on the studying front. I read five different parenting books to ascertain the best method of sleep training and dove in. One week I tried the classic Ferber method -- soothing him every five minutes in increasing duration. This failed pitifully, as every time I left the room he lost his mind. Next, the Pick Up-Put Down method -- even harder, as it seemed to be a huge tease for him. I tried the Shush-Pat method, where I stood over him and pat him back to sooth him to sleep. He thought I must have been kidding and wailed for hours.

On the verge of having a mental breakdown (truly), at my husband's suggestion I tried the dreaded Cry-It-Out Method. This was truly a last resort for me. It didn't make me comfortable. To this day I cannot stand hearing my kids cry and usually rush in to "save them" within moments of crying unless my husband holds me back. But he insisted and the sleep training needed to be done. I was going back to work in one short month and was exhausted. I started resenting my son and I wasn't enjoying our one-on-one time together as I had dreamed.

And so began our new bedtime routine with bath and stories, feeding and putting him down with soft white noise in his room. For three nights we put him down, on his own in his crib by 7 p.m. and left him in his crib till 7 a.m. save for a brief dream feed, preempting crying by sneaking into his room and feeding without waiting for him to cry.

The first night he cried three hours. Three hours! I thought my heart would stop. I left the house, literally. I went to stay at a friend's house and pumped there. My husband offered a dream feed of pumped milk. The second night was a huge improvement, at a mere one hour and 45 min of crying. The third night -- 2 minutes of crying! It was a huge success and has lasted till this day with only a few bumps in the road with illnesses and teething. It was horrible, the hardest part of parenting I've endured so far in my four years as a mom, but it was a means to an end.

Since this time we have sleep trained my younger son in exactly the same way -- with cry-it-out. The longest he cried was almost three hours. Lessening to an hour the second night and no crying the third night. I plan to train my next son the same way once he is four months old next April. I have suggested the same training method to over 1,000 parents so far in my practice, with the same results in 100 per cent of cases -- 12 hours of uninterrupted sleep for babies and parents. Two babies failed to train successfully in the first month, and after one week we resigned to trying again the following month. One month later these babies trained in two nights. Perhaps they weren't ready yet the first time, but it worked magically the second time around.

I have heard much controversy about the Cry-It-Out Method over the years. Mostly I hear that leaving your baby to cry leads to psychological damage for life. While I understand this argument and this makes theoretical sense to me, I have not noticed this to be the case. Once my kids (and countless others) are sleep trained, I find them happier and more relaxed. Parents uniformly tell me that their child changed dramatically for the better once they were sleeping through the night. Not to mention how much happier and more at ease parents are when they too can sleep. A well-rested parent is a more engaged parent, who is much better able to parent with love and patience. This is of obvious benefit to the child.

There is evidence that babies benefit greatly from predictable routines and long stretches of consolidated sleep. Emotional intelligence and cognition are enhanced (despite these first few hard nights). Babies are happier, more alert and more engaged if sleeping well. In addition, learning to sooth oneself is a life skill that will last a lifetime. I find that waiting till the baby is older leads to more difficulty with sleep training, as then the baby is more mobile and verbal. Hearing your baby call 'mama, dada', only makes this more difficult.

If you are a parent and in the uncomfortable situation of having a baby who is not interested in sleeping long periods at night, I suggest speaking to your physician about the options, including Cry-It-Out. I promise, you will not regret it!"

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Filed under: Sleep and sleep training


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Guilt. A Wasted Emotion?

Posted July 3, 2014

"I already know I've done all the wrong things" said Rebecca on the phone told me this week.  "I've nursed her to sleep since she was born, sometimes I let her nap in my arms and I know I've caused all the problems she is having now.  Plus, I'm alrady feeling really guilty about returning to work at the end of my mat leave.  I just feel like I've messed up.  Can you help?"

It seems true that for many women - perhaps particularly true for new mothers - guilt can be an ever-present cloud hanging overhead.  I'm well aware that I was plagued with feelings of guilt sometimes when my children were young.  Was i spending enough time with them?  I should not have gotten SO upset with the temper tantrum yesterday.  Why do I sometimes just need to get away from my kids?  Shame on me for wishing I could just go off to work like my husband.  I kept searching for confirmation that I was a good mother. 

My husband - and I bet yours - doesn't seem to feel guilty - at least not often and never for long.  What's that about?

Several years ago I was leading a daytime parenting group in Calgary.  Two dads were in the group and about 10 mothers.  GUILT was the topic that day because it had been mentioned often in past weeks.  During a heartfelt discussion, we all realized that, surprisingly,  the two at-home dads and one mother said guilt was really not a problem for them.  I asked one dad how he handles times when he felt he could have done something better or his daughter was upset, etc.  He said "If I've done something wrong that I could fix or do over, I would.  If I've hurt someone's feelings, I would apologise.  Otherwise, it's just gone. (he made a gesture like tossing something over his shoulder.)  Personally, he said kindly, I think guilt is a wasted emotion." 

This was an eye-opener for me.  I decided then and there that I needed to be more dad-like with some of my parenting.  (I've probably succeeded with this about 50% of the time).

In the end, I reminded Rebecca that all the way along in her job as a new parent, she has done the very best she could with the information at hand, taking account of her physical stamina at the time (especially when sleep-deprived), her baby's personality and her strong desire to be the best mom to her baby that she possibly could.  Sometimes that meant nursing to sleep, holding for a nap or bringing her baby into her bed, temporarily.  There are ways to change those habits once she feels ready, but in the meantime, if she feels guilt over doing her best, then she's most likely been holding herself to too high a standard.  Time to let herself off the hook and remind herself that she knows more than she thinks she does and she is the best mom for her baby.

I try to follow my own advice, but it's a challenge sometimes.  My mind tries to return to all the "should-have's," without my permission.  But remembering that days' discussion helps me -figuratively - toss guilt over my shoulder and be a little more dad-like in my thinking.

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Filed under: Interesting Parenting Matters


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Take a Look at Your Backyard!

Posted June 3, 2014

One of the very best learning environments for your young child is your back yard.  For so much of the year the weather in Calgary eaves this educational laboratory covered in snow - so I feel really excited about the opportunities you can now make available for your toddler. 

If you've been reading my blog for a while you already know that I am not a fan of 'parents as playmates' and this goes for backyard play as well.  Leave your back door open and your child may wander out, curiously, just to see if she can.  "You going outside?"  you can ask.  "OK." you say, because you've already applied outside,  the same sort of childproofing standards you use inside your house. 

But a perfectly safe back yard can also be a boring place to play so let's see how we can maximize the experience.

Consider stocking your yard with the following:

  • A hose which you set on the lowest trickle
  • Dirt with which to make mud, using the hose
  • A real set of hand garden tools - not plastic - ones that look just like the ones you use.  A trowel, a claw and gloves.
  • Some blocks of wood or small logs which can be moved from one place to another
  • Some sand in a pile (to discover the difference between sand, dirt and mud)
  • At least one large Tonka-type dump truck - it can stay out even in the rain so that cleaning up isn't onerous. 
  • A fly swatter
  • A paint brush and clean paint can (ask at a paint store) to 'paint' the garage with
  • A plastic basin
  • At least one all-weather doll
  • Some river rocks

If you have an older child, what worked well for him last year?  Pass on your or your child's clever ideas!  Please leave your comments on my Facebook page (Raymond Parenting News)

PS If you are worried about your child being unsupervised in your yard, do some surrepticious surveilance from a window or be outside with your nose in a book so your child can lose herself in her work. (related article)

I hope you enjoy your summer.

I'll be away this summer from time to time, so if you are needing a consultation on sleep or another parenting matter, use this link to see my appointment calendar and Book Now.

Prefer an email consultation?  Book Now. (available throughout the summer)

Kitty 

 

 

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Filed under: Play


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Parental Characteristics Can Influence a Child’s Ability to Become a Good Sleeper

Posted April 24, 2014

At last, research on sleep disorders  in infants and children is gaining the attention it deserves.  For the past 30 years problems with sleep for the youngest of the population, have been on the increase.  Primarily the two sleep disorders which accurately describe pediatric sleep issues that are precursurs to insomnia are 1) night wakenings and 2) sleep onset problems.

Among the factors often associated with pediatric sleep issues (birth weight under 2500 grams, low Apgar score, long delivery, etc.) some parental characteristics are appearing to be a major influence in a child's ability to master good sleep.  Following is a direct quote from the research of Dr. Evelyn Touchette.  This article, titled "Factors Associated with Sleep Problems in Early Childhood", appeared in the most recent Encyclopedia on Early Childhood Development publication:

"Parent characteristics also influence the establishment of consolidated sleep insofar as they are associated with certain bedtime habits or practices.  Anxious, over-protective or depressive mothers, or mothers who experienced insecurity in their attachment history, are more likely to have children with sleep problems compared to other mothers. For example, studies have shown that depression in mothers affects children's sleep consolidation.  This relationahip may be attributable to a modification of maternal behaviors (over-protection) hindering the child's learning of independent sleep habits.  Maternal age and education however, show little effect on sleep consolidation in children aged 0 to 4 years.  Mothers who work outside the home reported that their children's sleep is more fragmented than that of children whose mothers are at home.  However, family structure seems to have little effect on the development of a consolidated sleep-wake rhythm in young children."

In my monthly Sleep Class and in my work with parents by telephone, I sometimes find a definitive range of reactions when I've finished talking about the extinction method of sleep training (ranks highest in research for good outcome).  Some women respond with words like "OK. I got it.  Thanks." or "That's what I thought, I just needed to know it was OK."  Many dads respond the same way.  After asking a few questions about details, they are ready to go. 

But some mothers begin to tear up at the thought of their baby going to bed awake and without help, to fall asleep.  I can clearly see the pain on their faces and in their hearts and I understand how difficult sleep training will be for them.  And of course (according to my observation) women do not tend to sleep as deeply or easily as men do (!!) so it's more likely to be the mom who has had the monitor on her side of the bed and wakes up often to check.  I was one of those moms and if you'd asked me, I'd have answered "Well someone has to be on duty and it won't be my husband!"

And that is a major point.  Its almost as if a baby can sense that both his parents are not feeling the same amount of confidence in his ability to do his normal protesting (crying) as he learns over the next three nights how to design and practice his self-calming skills.  Maybe he isn't getting the unquestioned leadership he needs to see himself through this new learning.  Or, he gets mixed messages about the new plan. 

I want to talk to dads and moms who are already sure of themselves but just don't know the mechanics of sleep training and what to expect as they proceed.  And I want to speak with parents who feel that their own anxiety or attachment issues or doubts of any kind might interfere with their baby or toddler's ability to learn good sleep skills. I can help identify post-partum depression, in case it exists, and together we can work through some of the issues that might be holding parents back from accomplishing this major parenting responsibility.

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Filed under: Sleep and sleep training


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