Friday, October 31, 2008

Ferber Sleep Training

This is a long post. If you don’t have a young baby or a reason to care about sleep training, just enjoy the pictures...

Dorian has always been a good sleeper. I mean, I did my share of walking him around the living room in the middle of the night for the first several weeks. But around the time he was 6 weeks old, he began sleeping a consolidated 12 hours each night (and by “consolidated,” I mean that he woke up every 3 to 6 hours to eat, but always fell back asleep immediately, without me wearing any further tracks in the living room carpet). However, a few weeks ago, he started waking up more often in the night, like every 1 or 2 hours, and crying until I either fed him or rocked him back to sleep. I knew it was time for some sleep training. I had been reading Healthy Sleep Habits, Happy Child, by Dr. Marc Weissbluth. My short review of this book is that I learned a lot of valuable things from it, but from a practical standpoint it is very poorly written and the jewels of wisdom get easily lost in Dr. Weissbluth’s repetitive, indirect writing style. So, to save you the trouble of reading the book, here is what I learned from it:

• Sleep is very important for a baby’s development. Overtired babies (and children) are cranky, and they don’t learn as well as well-rested babies.

• A young baby (younger than about 4-5 months) will generally be happiest if he is awake for only 1-2 hours at a time. If a baby is fussy and has been fed and changed, check the clock–he probably just needs to sleep.

• Around 6 weeks of age, a baby’s sleep will start organizing itself into longer periods of night sleep and shorter periods of daytime sleep.

• Sleep begets sleep–meaning, a baby who is well-rested will be able to sleep better than one who is not. So the idea of keeping a baby up during the day in order to have him sleep at night is actually counter-productive.

• Babies need to learn to fall asleep on their own, because otherwise, when they wake up in the middle of the night (which we all naturally do, several times a night), you will have to get up to put them back to sleep. Even if you don’t mind doing this, it is fragmenting the baby’s sleep, and is ultimately not healthy for them.

• There are a few different methods of sleep training, including “extinction” (letting your baby cry without any consoling) and other more gradual methods. Every baby and every family is different, and you have to decide what will work for you. In my opinion, Dr. Weissbluth did not do a great job of explaining these methods.

Then I read Dr. Richard Ferber’s Solve Your Child’s Sleep Problems. Now, Richard Ferber gets a bad rap. He wrote this book in 1985, and since then there have been a lot of people who have criticized him for advocating a cry-it-out method. But here’s the thing: Richard Ferber doesn’t say to just let them cry! Dr. Weissbluth actually advocated the “extinction” method over any other, saying that it will work the fastest, even if it is the hardest. I tried it. Dorian cried for an hour and a half before falling asleep, and guess what? I couldn’t do it anymore. I couldn’t face another hour of crying, so I picked him up the next time he cried, and put off sleep training another couple of weeks. So I don’t really know if extinction works. But what did work, like magic, was Dr. Ferber’s method. All you have to do is, after a nice bedtime routine (pajamas, story, song, kiss), put him in his bed awake, and leave the room. He will cry. After 5 minutes, you can go in and comfort him (but don’t pick him up), and then leave for 10 minutes, and then 15. After that you can check on him every 15 minutes. I admit, this is still a little hard, when you know that you could just fix everything by picking him up. But it’s so much easier than just letting him cry. Anyway, the second night, you increase the intervals to 10, 15, and 20 minutes, and so on, each night after that. You do the same thing for naps. Ferber says it shouldn’t take longer than a week. For us, it took one night. One hour of crying. I still feel like some kind of magic has occurred when I kiss him, tell him I love him, lay him down in the crib, leave the room, and he is asleep within 2 or 5 or 10 minutes. But that is how it happens, every time. And even when it takes him a little longer to fall asleep, he usually just fusses a little bit, and hardly ever cries. He is so happy to see me in the morning after a good night’s sleep (12-13 hours), and his naps are also longer now (he has settled into a schedule of 3 naps, usually totaling around 4 hours of daytime sleep), so he wakes up happy instead of cranky. Before I started the sleep training, I wondered: should I keep swaddling him before I put him to bed? I was worried that if he associated being swaddled with falling asleep, he would not be able to fall back asleep if he wiggled out of his blanket (which he does with some regularity). But I decided to keep swaddling him, until one day for his nap, Russell tried putting him down without being swaddled, and it worked. That was easy. Now we swaddle him, or not, depending on the temperature of his room. I also wondered if I should keep feeding him during the night, because isn’t the goal of this sleep training to get him to sleep through the whole night? I decided to take a gradual approach. For now, if he wakes up and it has been at least 3-4 hours since he last ate, and he doesn’t seem to be self-soothing, I will feed him, and we will work on stretching the times between feedings each night. If he doesn’t wean himself off these nightly feedings by the time he gets teeth, though, then I will take a more assertive approach. In the meantime, at least he is sleeping much better between the feedings, and I feel really good about what we have accomplished! Confession: I rocked him to sleep this morning when he woke up too soon. He seemed to be in some teething distress and I couldn’t resist. I do love holding that little guy. Fortunately, naptime went fine, so I don’t think occasional indulgence will ruin him...


Ashley said...

Wow, I'm impressed. Isn't it a nice feeling knowing they can put themselves to sleep? We did really good with Lincoln for a few months but recently he has just liked to scream. I hope we can get back to the stage you are at!

Kelley said...

YAY! Sleep is a wonderful thing for all involved - moms, dads, and babies.

When Ben was a baby I read "On Becoming Babywise." It introduced the concept of a rough schedule of eat-play-sleep. It made a great deal of sense, and I've used it successfully with my last two babies. Too bad I didn't know about it sooner. Anyway, I love that I can put Rachel in bed for her naps and she puts herself to sleep. Life with four kids would be too chaotic if I was having to rock her to sleep every time she needed a nap.

Dorian definitely looks like a Hopper. He is so cute and so happy. :)

Jenny said...

Thanks for all the info. I was just reading about the Ferber method a few days ago because I am having the same problem. I don't remember it being such an issue with my other two kids. I have just been hesitant to let him cry because he does wake up the other kids, but I think we all are just going to have to tough it out.
Super cute pictures. Dorian really does look like a happy little baby.

Katie said...

I will tell you--extinction doesn't work in apartments. We had neighbors that got super annoyed with Caleb crying in the night and would call us when he cried longer than, oh, a minute. It was so awful. He was waking up 10 times a night to play with me, knowing that I would come in quickly. what happens with Dorian when he wakes in the night, and you think he's not hungry? Do you let him cry then?

bonnie jack said...

Ya, that has happened a few times. If he wakes up and it has only been 2 hours (or, during the first part of the night, if it has been less than 5 or 6 hours, because I know he can go that long), then I let him cry himself back to sleep.

Last night was his best night yet--he slept from 8 p.m. to 5 a.m. So I'm hoping that starts to become the norm. :)

Man, I would go crazy with neighbors like that.

the lunch lady said...

wow!!!! way to go mom!! (and dorian, of course!)

Elizabeth said...

I'm super impressed. I hope I can remember your words of wisdom when I actually need them! (Russ usually sleeps through the night --I'm really proud; he's only 29.) Dorian is super super super cute!!

quiltgirl said...

isn't my nephew the cutest baby ever? Landon has been my easiest baby for sleeping... becasue i read Dr. Weissbluth's book. He screams sometimes when we start walking to his room if he knows it's nap/bed time but as soon as i lay him in his bed, he grabs the corner of his blankie and rubs with his right hand and goes for the thumb with his left. he never sucks his thumb anywhere but in bed. That's good, i guess, except wehn i want him to suck it at church.

Becky said...

Nice job, Bonnie! I have to say, I HATED sleep-training, but I firmly believe in it. It's so much better in the long run if kids know how to fall asleep on their own. I even had 2 or 3 year olds who would come to me at 8pm and tell me, "Mom, I'm tired. Can I go to sleep?" It's wonderful when they learn to listen to their own cues and actually LIKE to sleep! But teaching them that is really hard. I remember with Evan, when we first started the process, I had to put him to bed and leave the house. Somehow, Vince could deal with it a lot better than me! :)

Anonymous said...

Hey, your blog was so helpful b/c I am dealing with the same issues. Our baby is four months old and we are 5 nights into sleep training. she is getting much better and at naps we can put her down awake. the issue is that we put her to bed at 7, and she has been waking up at 11/12 and will not put herself back to sleep. before we started training she would usually go to 1 or 2 and sometimes later, so we don't think she's hungry. so my husband sleep trains her at 11/12, it takes about 1.5 hours. then some nights she's woken up between 2 and 4, at which point i feed her. my question is like yours-- if this is basically behavioral training, and i make her cry at 11 but feed her at 2--- she can't distiguish, so should i not be feeding her at 2?! also, we're a bit baffled at the early 11/12 waking that won't go away... anyone have theories on that?!

bonnie jack said...

anonymous--i'll do another blog post to see if any of my readers have any advice!

Anonymous said...

oh, bon. He is just so cute.
Funny, but I just made an association with letting your child work out his sleep and teaching our kids agency. It must be how Heavenly Father feels. He knows he can pick us up and we'll be better--for a while. But he also knows it is better for us to work through it and so lets us suffer to grow.
I dunno, strange connection.
Also, I loved being able to put my boys to bed, go to a movie, and then wake them up to nurse when I got home. Because I knew they'd go back to sleep, I wasn't worried about waking them. I got to have that little indulgence. So, go ahead and rock him when you want. He knows how to sleep now.
(I'm not really anonymous, I just don't have an account!)

Randy Macchi said...

We did the same thing for Will and it didn't take quite a week for it to work. It really was a miracle!

maryk said...

hi, waas just wondering, if you're swaddling, how does he self-soothe? i'm swaddling still, and want to sleep train, but have been wondering this same thing. ??

bonnie jack said...

maryk, i wish i had a good answer to your question. unfortunately, i am still swaddling my son who is now 8 months old. it is getting sort of difficult because he can wiggle his way out of the swaddle, but he has learned to depend on being swaddled as his method of being soothed. so, i think maybe i did it wrong. i did let him sleep without being swaddled for a few weeks, but when i went back to it his sleep quality and length was so much better that i just stuck with it. have you started sleep training yet?

Marci said...

Hi, I found your blog through Google. How old was Dorian when you started sleep training? Our son is three months old. He has slept 7-9 hours a night since he was 4 weeks old (with swaddle and us soothing him to sleep and he sleeps in the car seat), and then in the last two weeks has started waking for a feeding once a night.

I spoke with the pediatrician about the wakings, and he suggested we try a little "Ferber light" let him go 30-45 min total crying. The trouble is, I am not sure how we can only approach it half-heartedly. It sort of seems all or nothing. And---because of his age, I worry about the feeding issue. As a prior commenter said, sometimes he wakes and you feed, sometimes you don't? How have you gotten that to work?

We tried it last night...when we put him down at 8:15 he actually went to sleep without any crying...for three hours. Amazing. He woke at 11:15 and I fed him because we started this whole thing earlier than usual and he was rooting. He stopped crying after about 9 minutes and slept for 2 hours. Great. Then it all went south. He woke at 2:30, we did not feed him, it took almost an hour for him to stop crying and he slept for 30 minutes. Then, since it had been 5 hours since his last feeding I fed him again and he laid awake for almost an hour (no crying) but then again slept for only thirty minutes. At this point it was 6:00am so we just got up and fed him and started our day.

Sorry, this is the longest post ever but we are debating whether to try again tonight (and today with naps), or to abandon ship and try at 4 months instead. Trying to deal with the transition out of the car seat, the soothing, and interpret when to feed is really hard!

Thanks for any advice and again sorry for the marathon post...sleep deprived!

Marci said...

P.S. I agree with your view of Healthy Sleep Habits Happy Child. Tons of good little nuggets, but the information was unorganized, repetitive and confusing. I found myself re-reading sections over and over and not knowing what he really recommended! Ferber is much more organized and easy to follow.

bonnie jack said...

My baby was exactly 4 months old when I did the sleep training. I think you just have to trust your intuition on whether or not your baby is ready earlier.

As for whether it is "all or nothing," I kind of took a halfway approach, in two ways. I still swaddled him, which didn't really allow him to fully learn to self soothe, and I still fed him when he woke at night. That worked well for a while, because I didn't feel like he was quite old enough to force the sleeping through the night, and he settled into a pattern of only eating twice a night, which wasn't too bad.

But...I'm not sure this was the right approach. My baby is now almost 9 months old and, though he can fall asleep on his own, he is still not sleeping through the night, and we have failed in several attempts to get him to sleep well without being swaddled. I am actually, this very week, "redoing" his sleep training in an effort to get him to sleep through the night, because I know he's old enough. So for the last 2 nights, I have not been feeding him when he wakes up, but have been checking on him in 15 minute intervals until he falls back asleep. It seems to be going well, but I know better than to declare victory after only two nights.

And I am still swaddling him. I have very mixed feelings about the swaddling. It helps him sleep so well that I think it is really good for him to be swaddled. But it becomes a problem when he wiggles out of his blanket in the middle of the night and cannot get back to sleep until I come wrap him back up. So I am not sure what to do about that.

So...I wish I had more helpful advice for you. I am not sure whether you should take a gradual approach--i.e. transition out of the carseat first, then do sleep training, but still allow him to eat once or twice a night, then try to wean him off night feedings...OR just do it all at once, which might seem harsh, but might be easier in the long run. Good luck. I'd love to hear how it goes for you.

Marci said...

Thanks for the quick response, Bonnie! Even though he is only three months, he seems to be responding (i.e. self-soothing) as he has shown he can fall asleep on his own. However, I agree, all at once is hard and last night I struggled with "he's hungry, I need to feed him!" and had many feelings of guilt when we didn't. We are so anxious to get him out of the car seat but it seems the car seat/swaddle combo keeps him from waking himself up...we're convinced last night he woke 4 times b/c of the absence of the car seat more than anything else! I think I will continue the feedings for now. I'll let you know how it goes, and thanks for your advice. Best of luck with your little cutie!

Anonymous said...

Thank you so much for this really helpful post! After nearly four months of total exhaustion, I'm reading Dr Ferber's book. I'm absolutely chomping at the bit to get started -- but I've had the same questions you've had: What to do about night feedings and swaddling?

My son is just about four months old and his sleeping patterns are getting worse, not better. He can't fall asleep without breastfeeding and I think the feedings are starting to cause more night wakings -- whether because his diaper is soaked or because he has to burp.

I think you've convinced me to get rid of the swaddling, but I still am not sure what to do about the night feedings... If I'm reading it right, Dr Ferber recommends that babies who have come to rely on night feedings not be asked to go cold turkey, but that you spread out the time between feedings.

I'm not sure how all of these different factors will interact and whether my husband and I will have the willpower to remain consistent in the face of our baby's screams... I'll report back.