Baby Shrink asked me these questions, and they made me realize I haven’t truly fleshed out our situation. First, I will show you The Wedge. You can laugh; you should laugh; we laugh. But let me explain before you report me to CPS.
It’s for reflux. The idea is that if the baby is diagonal instead of horizontal, there won’t be as much reflux, the esophagus will have more of a break and not get as irritated. It isn’t one of those things babies need; it just helps make them more comfortable, if they do have reflux. It is mainly intended for younger infants (under 5 months I guess?), and we were told by the OT that made it for him that “we would know” when “he didn’t need it anymore.” ha. We don’t know, and He doesn’t need it, but he likes it, and naturally has come to depend on it, and the swaddle, to go to sleep. The swaddle is another thing we are mysteriously supposed to know when to stop using and that he is mysteriously supposed to stop wanting. We have tried sporadically taking the wedge and/or swaddle away in different combinations and circumstances. All of these attempts end in misery. We came very close to having a Christmas miracle, for on Christmas night we made the most progress sans swaddle OR wedge than we have ever before: A. slept for two one-hour stretches with neither crutch. He slept sweetly with his hands floating around his head and his legs still in their bent position, as though he were still in the wedge. But then he kept waking through the night, upset, and Wifey eventually put the wedge back in.
So, now for Baby Shrink’s questions:
Does he associate his crib with the crying episodes?
I don’t think so. He is a pretty good napper during the day. We look for tiredness cues and then put him in his crib (in the wedge) and let him suck on our finger for a minute or two. We used to switch the finger out with the paci, but now he doesn’t want the paci, and is fine when we take our finger out when he is still awake. Sometimes he fusses for a minute, but then goes to sleep. Often when he wakes after 30 minutes to 1 hour, he sings and chats with his mobile. Other times, he cries and we go get him.
Then when it comes to bed time, does it help to stay in the room with him until he’s asleep?
Not really. At bed time, he is clearly tired but he gets hyper, and when we stay with him he kicks his legs and laughs and screeches and when we don’t take him out he cries. He doesn’t stop crying, and it escalates in severity, to the point where he is hot and truly distraught and he seems in real distress. All while we are standing right there, soothing, singing, shushing, stroking his head, offering our finger, in all different combinations. I also gently blow on his face to cool him, which calms him momentarily.
What happens if you sit next to the crib with your arm through the slats, patting him? Talking to him? Does that ever work?
Those things do work to calm him momentarily, but do not get him to sleep. See above.
What if his Dad puts him down?
No Dad, but we’ll assume you mean Mommy. Same thing as when I, Mama, put him down.
What if you hold him until he’s asleep (or almost asleep) and then transfer him to his crib?
Works well for naps, does not work at bedtime. If he is sound asleep in my arms, he will stay asleep transfered to the crib. To get him sound asleep, even in my arms, at bedtime, is the hard part. He is hyper. Even after I’ve nursed him. Not hyper-sad; actually, he’s usually hyper-happy at night, doing all of his tricks, showing off how not-tired he is. All the while, intermittently fussing, screaming, yawning, rubbing his eyes. Oh no no wait! Look! Kicking! Smiling! Laughing! We can even listen to your music, Mama! I am so awake! Yawn. Fuss. Eyes drooping.
I can hear your next question! Earlier bedtime? Why yes, we’ve tried that! As early as 6pm. We’ve also tried 6:30, 7, 7:30, all the way to 11:30.
What about a binkie/lovey?
We have no qualms about pacis; but he doesn’t want them anymore. Aren’t we supposed to worry about the baby suffocating on a lovey? He can’t cuddle with his pink monkey in his bed anyway, because he is strapped down to a giant foam spaceship. By choice.
And let me also explain how smart and wonderful he is! He is developmentally right on cue, except for social interaction, which was described by his doctors as advanced. He has been teething for over four months but has still not yet broken a tooth. He nurses well, and eats solids precariously. He is held often, cuddled, danced with, worn rarely, rests calmly, rolls around, sits pensively, jumps in his jumper, strolls in his stroller, reads books with studied interest, concentrates on his toys, the whole gamut of baby activities.
I now also realize I should describe what has been “working.” Not working, really, more like “happening.” We hang out for hours with a manic, fussy but determined, sleep-deprived infant (whose mood vacillates wildly between two vastly different poles) until 11pm-ish, when he eventually gives into exhaustion and falls asleep nursing. All previous nursing-to-sleep attempts were met with screeching and fussing and singing and crying. Not sleeping. I guess I could call this “working” (or at least, working for him– we, on the other hand, would love to have a quiet evening together!) but the reason I would hesitate is that he often seems sleepy during the day, even with good naps.
Sorry for my assumption about “Dad”.
~~OK, good info. So far so good. Sounds like you are doing what you can. Don’t panic. There is good reason to hold on to hope that he will outgrow these things. High-energy kids like this often seem to start out with a low threshold to sensory input, which makes them nuts at first, until their little brains develop more “filters” to screen out the input. (And then they often become very bright little monkeys later on…curious, interested in the world and people, etc.) My oldest started out that way and didn’t sleep through the night reliably until she was 4. Now she sleeps like a log. On the other hand, our youngest was a lousy sleeper until he was 12-13 months — then becoming the champion of the group. So you never know.
Another question: What was the original reason for referral to the OT? And what is the current course of services for the OT, and what is the OT’s thinking about sensory issues, sleep, etc?
Thanks for your quick reply, Baby Shrink!
about the OT: The reason for referral was reflux. Or rather, Reflux. Current course of services is that they have no concerns about him and therefore there are no services; his reflux is managed with Prevacid. We think it is improving over time?? But maybe that’s just because we know it is supposed to be improving over time? We never spoke with an OT about sleep issues, as that wasn’t a concern at the time.
Again, he puts himself to sleep fine for naps. Usually. Presently, he is not putting himself to sleep for a nap. He is alternately singing and screeching. Now sucking on Wifey’s finger. Now she’s singing. Now he’s laughing. Anyway.
A. was born at 27.5 weeks gestation. He was put through the whole barrage of physical/sensory/developmental testing at his 6 month follow-up, and was deemed Healthy and Normal. All head, chest, heart ultrasounds normal at birth and at discharge.
That said, I have heard from unscientific sources that former preemies have a hard time self-regulating. Is that true? If so, Why? What is going on with that?
Are you going to be my magical baby fairy?
I love his giant foam spaceship.
And don’t feel weird about it. The strangest crib-addition I ever saw was when my Aunt Mary fitted the tops of her twins’ cribs with screen-door lids that latched down. They were tiny escape artists, and it was the only thing that she could come up with that kept them in their cribs. She always fretted that if Child Services had seen their room, they would have been in foster care faster than you could blink. But they’re now happy, healthy sophomores in college. And someday Mister Finn will be, too! Then HE’ll know what it’s like to have a noisy roomate.
oh my god, Lee, Wifey and I are laughing uncontrollably.
“Magical Baby Fairy” — as if! I wish. All I can really say here is that your little guy is still so very young — especially because of his super-preemie status — that you can’t really expect much from him yet, in terms of sleep. I know that developmentally he’s on track in other areas, but that doesn’t mean he’s caught up in EVERY area. So you’re still dealing with a very young baby, in terms of sleep expectations.
I have a major beef with so many of the “baby sleep” books, because they set us up to believe that an infant’s inherent sleep patterns can truly be majorly altered by the external environment — US. And that if the baby isn’t sleeping like x, y and z by a certain age…well, that’s our failure in parenting. THESE BOOKS ARE LARGELY BASED ON THE CLINICAL EXPERIENCE OF SLEEP-DYSFUNCTION SPECIALISTS, who mainly see very disturbed children and families…people with severe problems. Then their findings are extended into the “normal” population, in error. The other “faction” in the baby sleep department is the AP group, who don’t take into account the needs of babies who have differing sensory needs (or parents who have a need for some sleep). ;}….just IMHO.
I really want you to get away from the notion that there is ONE RIGHT WAY to be doing this, lest you screw him up permanently. Rather, have a long-term vision of what your ultimate sleep goals are for him, and then take mini-steps in that general direction, WHEN YOU CAN. If backsliding occurs, so be it. Try to be as “zen” as possible about all of this. It will work itself out, and it will be a surprise to everyone involved how, and when it does. You cannot control much of this situation, beyond providing him with the “Good Enough” environment that you already are.
So that means all you can do is COPE, for the time being. I hope he’s getting a bottle? So that someone else can feed him, and you get a break? Sit down with your partner and make a plan; a schedule. Who will take which nights. The other person is “off” on certain nights, and gets to sleep (with earplugs on!!), go out, whatever. Or perhaps one of you might take him the first 2-3 hour shift of the evening, and then switch. Whatever works for you both. And it also includes calling in extra help, even if it’s paid help, even if that means just once a month, so the two of you can get out and just be together, without him, to recharge your batteries. He’ll be just fine.
And yes, it is my observation that preemies tend to be a bit hypersensitive to stimuli and have more difficulty with regulation. It’s all about neurological development. “Regulation” is a very complicated, advanced process, and one that requires lots of time for higher-level systems to mature. So again, it’s about providing that “Good Enough” environment so that his own miraculous internal development can take place at it’s own pace. It is fascinating to watch over time. You might even look back at video of him (if you have it) from just a few weeks ago, and you’ll see how much his movement and other developmental milestones have progressed, just naturally. The same will happen for sleep.
Keep giving him the message that nighttime is for sleep, but until he really gets that, all you can do is hang out with him as you are, at night. Don’t keep looking at the clock, saying “Man, it’s 10:30 pm already. He should be asleep! What are we doing wrong!” Just take a deep breath, get some extra support, trade off, and know that this to shall pass. (easy for me to say, i know, but i have been there, with all 3 kids…..)
@ Baby Shrink: thank you again for your comments. They are encouraging, and your take on things sits well with me. You mentioned A. being too young for sleep expectations; and I probably should have made clearer that he is 7.5 months adjusted age, yet his “real age” is 10.5 months. Does this change your estimation about his age appropriateness?
Re swaddling, DS1 was swaddled until he was over 2yrs. DS2 has never wanted/needed swaddling, though I did it a bit in hospital to keep him warm because he was naked til the day we went home.
Hello, I just came across your blog and want to offer some encouragement. My son is 15.5 months now and, although he was not a preemie, he suffered from reflux that we treated with both zantac and prevacid until just over 12 months. We also tried a wedge and the Amby bed, and we swaddled him until around nine months I wanna say. Anyway, he was a HORRIBLE sleeper and I just about went nuts from sleep deprivation that escalated into insomnia/anxiety. He’s always been a good napper, like yours, but he woke every hour or two at night until about 8-9 months. I read every book, too, and was not going to resort to CIO. In the end, we ended up doing some combo of all of it, including some crying that worked for a couple weeks at a time, until the next illness or tooth. So where’s the hope in all this, you might be wondering? Our guy essentially outgrew the reflux around a year (which most do), and his food sensitivities diminished (have you cut dairy out of your diet since your bfeeding? I had a lot of success with this.) A little after a year, he went from rarely sleeping longer than 2-3 hours at a stretch, to being able to sleep 6-8 hours at a time (he’s slept through on a handful of occasions). At 15 months, I confidently feel that when he cries in the night it’s not because he’s petrified or in pain, but because he’s pissed off that he can’t have my company or boob. And he still gets a feeding if it’s after 3 or 4am. But I’m ready to cut this out too, so we’re working on it. and by working on it I mean Dad, without the milk, has to go in to soothe, and after that we let him cry. Comforting by the non-nursing parent is one of the techniques we’ve had the most luck with. Of course baby wants the boob, but at least they’re getting second best (no offense to other mama:)). I don’t know if you’ve noticed, but there’s not much reference to sleep habits of reflux babies in the sleep books. I found this very frustrating because I always felt like I was doing something wrong, but now I know that it was as I suspected, that he woke all the time because he was uncomfortable. Our guy had lots of painful nightcrying until 8-9ish months. So I don’t know if this helps or not, but I think you might have some relief in the near future, as your son gets closer to a year (not sure how being a preemie plays into this). I hope he outgrows the reflux and you all get some rest soon. My sympathies… it’s SO hard. Good luck, and Happy New Year!
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