Friday, May 28, 2010

Sleep Training I - Sears

Method : Sears - Attachment Parenting

Expert(s)
William Sears, M.D and Martha Sears, R.N. with Robert Sears, M.D. and James Sears, M.D
- William and Martha Sears have 8 children
- Dr. Sears was trained at Harvard Medical School's Children's Hospital, Boston and Toronto's Hospital for Sick Children, Associate Clinical Professor of Pediatrics at the University of California, Irvine. Practiced Pediatrics for more than 30 years
- Martha Sears is a Registered Nurse, works as parenting and breastfeeding consultant in the Sears Family Pediatric Practice
-Robert Sears, M.D., a board certified pediatrician, degree from Georgetown Uni and trained in Children's Hospital LA.
- James Sears, M.D. a board certified pediatrician, degree from St. Louis Uni. Medical School, trained in Tod's Children's Hospital in Youngstown, Ohio.
More info: William Sears (Wiki.)  ,  AskDrSears  , Dr. Sears Official Website

How To Get Your Baby to Sleep [pg. 312, Chapter 15, The Baby Book]

A) Step One: Give your Baby the Best Sleep Start

* Develop a Nighttime-Parenting Mind-Set
"The nighttime mind-set we want to steer you away from is that getting your baby to sleep through the night requires a list of gadgets and insensitive techniques that 'break' baby of night waking. This is a short term gain and possibly a long term loss. In breaking baby's night waking, you may also break other, more fragile connections with your baby."
- "Do you look at night as a time of relief from the constant attachment of baby during the day?"
-"Is 'sleeping through the night' at the top of your parent-achievement list?"
-"And if you are not rewarded with a perfect sleeper, have you failed Parenting 101?"
If you answer 'Yes' to the three questions, consider another approach.......

* Develop a Nighttime-Parenting Style that Works for You
"Because babies have varied temperaments, and families have varied life-styles, there is no right way to get a baby to sleep - only the right attitude about sleep."
"Good sleepers are partly born, party made, never forced."
- "Be open to trying different nighttime approaches to see which one fits the sleep temperament of your baby and your life-style and sleep habits."

* The Attachment Style of Nighttime Parenting
"The approach ...that usually works for most families is the attachment style of nighttime parenting."
"The two elements of this style are (1) organizing and mellowing your baby's temperament during the day (2) sleeping close to your baby at night."
How: Feeding on demand/cue promotes better sleep at night, wear baby during the day, sharing sleep with baby highly recommended.

B) Step Two: Condition Your Baby to Sleep
"Your role is to set the conditions that make sleep attractive and to present cues that suggest to baby that sleep is expected."
"Which sleep tips work depends on your baby's temperament and stage of development. What doesn't work tonight may work next week."
"We omit.. 'harden your heart' method: 'Put your baby to down to sleep awake in a crib in her own room and let her cry herself to sleep so that she gets used to falling asleep by herself and won't always need to rely on you to get her back to sleep...."
- "We believe that in the first 6 months, this method is unwise; you run the risk of losing your baby's trust, you may become insensitive to your baby's cries, and in the case of infants with persistent personalities, it usually doesn't work.."
How: 
a) Make sure daytime is peaceful
b) Set consistent nap routines
c) Set consistent bedtimes
d) Enjoy predictable bedtime rituals - warm bath, rocking, nursing, lullabies - capitalize on patterns of association
e) Calm your baby down - A soothing massage or a warm bath
f) Wear your baby down - Wear baby in a sling, walk around till she sleeps, put her down with the sling as blanket.
g) Nurse your baby down - Breastfeed to sleep
h) Father  your baby down - Father nurse baby to sleep through 'neck nestle' technique
i) Rock your baby down
j) Create a bed on wheels - Drive baby in car seat till she/he falls asleep

C) Step Three : Lessen Conditions that Cause Night Waking
"While some night waking is inevitable and the result of the temperament and developmental stage of your baby, there are many causes of disturbed sleep over which you do have some control."
Physical Causes 
- Teething pain, Wet/Soiled Diapers, Irritating Sleepwear, Hunger, Stuffy Nose, Baby too hot or cold
Environmental Causes
-Fluctuating temperature and humidity, Airborne irritants, A cold bed, Unfamiliar sounds
Medical Causes
- Gastroesophageal reflux, Colds, Ear Infections, Fever, Allergies, Pinworms, Urinary tract infections..

Others:
Developmental Causes
-"Expect the previous steady sleeper to begin night waking while going through a major developmental milestone e.g. walking, sitting up alone, crawling..."
-"Separation anxiety is another developmental reason for night waking.

Emotional Causes
-"Expect more night waking when your family's usual routines are upset.."
-"Expect sleep disturbances when ..there's separation, divorce, family strife and hospitalization.."
- "If you and your baby have a close attachment, expect her to share your emotions. If you are upset,depressed, or wakeful yourself, expect similar emotional and sleep disturbances in your baby.."

Pros-Cons/Testimonials
Since I myself am pro-Sears method, I will give my two cents worth on the pros and cons.
Pros
- I don't have to go against my natural instincts when I respond to my baby's cries
- I enjoy the closeness with my babies
- I understand my children's sleep patterns better
- From observing my eldest daughter, she fared well, grew up to be independent and when she was 2 and a half years old, she happily slept in her own bed, own room
- Personally, I feel responding to my baby's cries at night reinforces their trust in me.

Cons
- It may be a bit tiring waking up at night.
- For those with office hours (8 - 5pm), disruption in sleep can affect work performance.
- Some of the steps are not practical e.g. driving baby around to sleep.
- Parents have to do more to put baby to sleep.
More:  
 
Personal Opinion: As I said, I am pro-attachment parenting. At the same time, I have provided links for those who feel differently just so we can see two sides of a coin. Some claim that it spoils the child, parents become too permissive so the children do what they want. I like it because this method of parenting takes into consideration babies'/ children's stage of development and emphasizes parent-child bonding. However, it doesn't mean I follow everything to the T. I am also a firm parent and I do not tolerate disrespect, ill-discipline, selfishness and rudeness. When necessary, I will mete out appropriate disciplinary actions based on the misbehaviour involved. Therefore, as I have said before and will continue saying, we as parents must know our own children and judge for ourselves what works/doesn't work. In everything, strike a healthy balance!

Carpe Diem, ladies!
Becky

15 comments:

Ss said...

Waking up middle of the night definitely is not easy. Parent's age might be one of the reason. I remember I was 25 yrs old when my daughter was born. My aunty who was 40 plus yrs old also has her 1st child 9 months earlier than me. We both face the same thing, waking up middle of the night to breastfeed our baby. Her feedback, after she woke up to feed her baby, is very difficult for her to go back to sleep. She'll be awake and sometimes she'll go online for a while, read books till she feel sleepy, then she sleep again. Fortunately, she's not working, so she still can sleep in the morning. As for me, straight after breastfeeding or to pump the breastmilk, I can continue my sweet sleep straight away. So, we are thinking maybe age is the reason. But bare in mind, to wake up middle of the night for the infant, the most is 1 yr or maybe 2 yrs (don't think will last till 2 yrs).

Mad About Writing said...

Ya Ss, same here for me. By 11 months after weaning my daughter off, she slept through the night.. Ahh.. sweet sleep for me!!

laifchan said...

well , i have a colleague who's daughter is 2+ and still waking up every 2 hrs for milk at night! Somehow, she doesn't seem to take so much during the day. Some people have explained that the child has developed a sleep association (read habit) of relying on drinking milk to fall back asleep at night.

I think its hard to predict' when every child will 'naturally' sleep thru the night, from my limited observation looks like its usually by 2. Becky, you actually had to decide to night-wean R at 11 mths right?

Personally, I think the principles of AP are great, i wish I could practice more of it in the ideal situation, I mean which mother doesn't want to connect with her child all the time or enjoys letting the baby cry?

But, I think that we shouldn't feel guilty that we're bad parents if we have to use other methods to help our baby sleep, wean-off breastmilk etc when we think the time is right but the baby is does not seem naturally 'ready' yet. However, I do think that 'training' the baby as early as 2-3 mths is a bit too drastic.

For practical reasons, after 6 mths (starting semi-solids) baby much less 'nocturnal' and a bit more secure in terms of attachment (i hope:) seems like a more comfortable starting point to help the baby learn to fall asleep on their own gradually.

This link offers practical tips on the 'hows'. Basically, it gives the option of cry-it-out and the no-cry-it out way depending on your baby's temperament, parents co-sleeping or not etc:

http://www.babysleepsite.com/sleep-training/sleep-training-from-no-cry-to-cry-series-part-2/

As for my 8 mth old, we've gradually gotten him to learn to fall asleep while he's drowsy in his own cot (last breast-feed about an hour before but awake after that). Of course he protested initially (cried for almost an hour 3 weeks ago but now its less than 5 minutes)

He still wakes up 1-2 times (including the early morn feed at6-7am). The first time he wakes close to midnight, he gets a bottle of expressed milk (more full, with the breast, he's so cozy he sleeps of before he's really full and wakes up more often). After that. its the breast.

laifchan said...

just watched the sear's method video becky's link.

Interesting to note that actually the proponents of AP are not so different from what we're practicing now. It's supposedly no cry it out method ie gentle, gradual but at the end of the day, like my hubby commented, whether the baby cries or not depends on the baby!

Mad About Writing said...

Perhaps the owner of the Baby Sleep Site is combining a little of everything through her research? A bit of AP, a bit of this and that...etc?

Hmm.. I think I should highlight that the Sears do not advocate "Sleep train" (There's a footnote in the book: BEWARE OF SLEEP TRAINERS).. they call it sleep inducers, instead.

Mad About Writing said...

I just read through "When Attachment parenting isn't right...." by Shepherd. Gee, this mother sounds angry! Raving mad!

I don't know how far other AP proponents actually go to say "if one doesn't do whatever a child wants, it makes one a bad parent" as claimed by this angry mother. It sounds a bit extreme and subjective since no one is rebutting her at the same time.

My view on this matter is 1)parent-child attachment is very important
2) It doesn't mean parents should be permissive, allowing the child to do whatever he/she wants-- that's spoiling the child-BIG TIME!
3)While parents take child's needs into consideration, a parent shouldn't let a child 'dictate' how things should run e.g. don't want to do homework, fine. Don't want to eat dinner, fine. Want to watch all the TV you want, fine.. things will get a bit out of hand.

The other two AP mums I know of are also super strict with their children though they wore their babies on slings, breastfed on demand, wake up at nights to feed..etc. But if their now grown children do not toe the line, the mummies do not play the fool with them.

Ss said...

I have a friend who feed the baby water instead of milk when the baby woke up middle of the night. This is so that the baby will not get hungry at night and slowly will not get up too often at night. But I don't know how long she did that and whether it works or not. I only know when she start doing that, she was busy to change the diapers at night.

laifchan said...

yeah, we were considering the water substitute but haven't got down to it yet.

looking at my boy, maybe we can wait and see whether he still needs the 2-3 am feed by 1 yr.

at first, i was edgy bout co-sleeping in same bed, till when?
but now, i've sorta gotten used to it.

i guess when he sleeps better, we sleep better. aniway, its onli for the 2nd half of the nite after his first awakening from his cot , something we can live with.

Delighted said...

My oldest is 12, 2nd is turning 11 and last child is turning 4...I always tell people that I haven't slept soundly for 13 years (during the birth of my 1st child i didn't sleep throughout the whole night while I was pregnant with her). My oldest sleep walks when she is really anxious about school or activities and will talk in the middle of the night. My son is the most sound sleeper but once in a blue moon, he will have problems sleeping. The youngest is the one who keeps me up most of the nights.

I think it takes some getting used to waking up and being disrupted in sleep.

Take heart mommies, it will have an end. Just enjoy the moments with your children and remember, there is light at the end of the tunnel.

Mad About Writing said...

Hear, Hear! Thank you Delighted.. Always nice to read words of encouragement to keep us going.

Sometimes, trying to get everything right 'by the book/expert/theory' can make a mama feel "What am I doing wrong!!!??" sob, sob, sob... :D

Mad About Writing said...

by the way, u said your oldest sleep walks... does that pose any danger in anyway? i read of people who sleep walk and end up in unsafe places e.g. outside their homes, on a road..etc

Ss said...

ya, would really love to hear about sleep walk. talking in sleep, very common but sleep walk, i only hear it before but never heard of anyone i know having this problem. Delighted, are you scared or worry when you know your child sleep walk?

Delighted said...

Becky n Ss, my eldest used to sleep walk and sleep talk a lot. It was usually when she was anxious about a school event. The first time she slept walked, she went to the toilet, took out a spray bottle of dettol and came out and sat on the piano bench. I told her it's sleep time and not cleaning time so she had to go back to bed.

I'm a light sleeper most of the time so any type of noise, I'll wake up and check.

Her sleep talking is actually more scary than her sleep walking....imagine hearing someone scream out or talk loudly in the middle of the night. It takes her longer to stop talking than walking.

One way to stop a child from hurting themselves is to keep something in front of the doorway. They have this big fire engine toy which I use to keep the door ajar and then I would place a toy that makes noise or has a bell on it so when they come out, I'll know someone is coming out of the bedroom.

One window is left opened during the night but the curtains closed so it deters them from easy access out the window, in case.

She used to sleep walk when she was 6, 7, 8 and now maybe once a year, she'll sleep walk.

I always pray for them before they sleep and in the prayer, I pray that what is tomorrow's worry or anxiety is tomorrow's. Today is over and any sins we haven't confessed, we should do so, so we can sleep in peace. I also pray for the next day that as we wake up, the first thoughts we have are of God.

That usually helps my daughter to calm down and not think of what is ahead but focus on a night's peaceful rest.

BTW, when I was younger, I used to sleep walk also. By my late 20's I would have just dramatic dreams that a few times I woke up with tears rolling down my face and/or great fears (demonic battles in my dreams).

My husband still talks in his sleep sometimes. It's done in foochow mostly...hehehe.

So from me, my daughter got the sleep walking and from her father, she got the sleep talking...what a humourous family hey?

Hope that helps!

Mad About Writing said...

Sleep talking in foochow! Hahaha...

I wonder if such a thing is hereditary?
Or perhaps when there is a family history of such 'habits' the children are more inclined to have it?

Do you still sleep walk? Is it something one can grow out of?

Delighted said...

Becky, I don't sleep walk anymore. It only happens during those years of puberty.

I am in general a light sleeper.