Sleep Training: the SleepEasy Solution

Good morning!

People are always commenting on how happy Benjamin seems to be.  Family, friends, and strangers alike tell us that they're amazed he's constantly smiling, laughing, and observing the world around him.  It's true, he rarely cries unless he has a good reason to (teething, very overtired, bored/frustrated), and on a day to day basis I would guess he cries a total of about 10 minutes, on a bad day up to 20 minutes.  I fully admit that one aspect of this is pure luck.  We have a very good baby - a truly easy baby.  But I've also been fortunate to have the ability to take my education and experience as a Pediatric Nurse Practitioner and put it to use to teach Benji how to be a happy baby.  In our case, sleep has been the most important aspect of ensuring his easygoing nature.

I wake up HAPPY!

Since the beginning we've been blessed with a good sleeper overall.  From the start (well after the first 2-3 weeks in reality), Benjamin seemed to understand the difference between day and night, and while he woke every 2-3 hours to eat around the clock, he was kind enough to go "right" back to sleep (within about 15 minutes) after overnight after feedings.  Of course there were exceptions to this trend, and there were a handful of nights where we both cried in exhaustion, but when comparing his sleep patterns to those of most of my patients, I knew we were lucky when it came to sleep.

Babies all naturally go through growth spurts with fairly predictable patterns.  Ahead of time, I knew that these growth spurt weeks would be the hardest on me physically, mentally, and emotionally, because in all likelihood he would need to nurse every 1-3 hours instead of his typical 3 hour routine.  And sure enough, at 2-3 weeks, 6 weeks, and just shy of 4 months we hit those dreaded growth spurts, and they were trying.  I am very against co-sleeping for safety reasons, so it was constant back and forth between our bedroom and his.  Benji moved from our room to his crib in the nursery at 4 weeks old so as to establish a healthy sleeping environment early on, which I do attribute to his excellent sleeping habits.  We depended on swaddling until about 4 months, and used a zipadee zip to transition him to a sleep sack between 4 and 5 months old.  He'll sleep wearing anything now.

The 4 month growth spurt/sleep regression was almost our undoing.  I would still argue this was harder than the newborn period in some ways.  Ben would awaken every 1-3 hours and absolutely nothing but nursing would soothe him.  I became a human pacifier - he has never taken to an actual pacifier and no amount of coaxing and pleading could convince him to give it a try.  If I attempted to put him down in his crib asleep, he woke right up crying.  We were both completely miserable, and because I was acting as a human pacifier Tom was unable to do much to help.  He needed to be nursed to sleep for naps as well during this period.  I tried the swing, the car, the bouncer, the rock n' play, rocking and singing... anything and everything we could think of!  I finally gave in to co-sleeping for a night or two which resulted in better sleep for Benji, but still virtually no sleep for me because I couldn't allow myself to relax enough to fall asleep.  And my typically cheerful baby was still content while awake, but he looked a little dazed and stopped smiling at anything and everything.

So I started researching sleep training and quickly identified a method that I liked called the SleepEasy Solution.  I downloaded and read that entire book within a 24 hour period, and it was the most wonderful resource for sleep I have come across (personally or professionally).  Yes, this is a modified cry it out version, which is controversial.  It was so instrumental in turning our lives around within about 4 days that I felt compelled to share the basics with you, but this is by no means enough information to completely skip the book....spend the $10, it is worth every penny!

Sleep Environment: create an ideal and consistent place for sleep.  For us, that meant adopting most, but not all, of the recommendations made by the authors.  Ben sleeps in his crib, with a small (breathable!) lovey, is placed on his back awake, has a loud white noise machine, and the lights are turned off.  Because he rolls over on his own he flips to his belly within about a minute of putting him down but (for SIDS safety) we always put him down on his back.

Sleep Schedule: we started sleep training around 4.5 months old, likely just below 15lbs.  The book outlined that a baby at this age and weight needs a total of about 15 hours of sleep per 24 hours.  He should sleep 11-12 hours overnight and 3-4 hours daytime.  Naps were to be spaced starting 2 hours after waking for the day, 2.5 hours between the end of nap 1 and 2 (and 2 and 3), and awake at least 1.5 hours before bedtime.  Feeding schedules are incorporated, as is bedtime routine (and mini bedtime routine for naps).  Our schedule continues to follow this pattern (although some days he takes two longer naps) and looks like this:

• 7am wake up
• 9am nap 1 (typically lasting 1-1.5 hours)
• 1pm nap 2 (typically lasting 1-1.5 hours)
• 5pm nap 3 (typically lasting 0.5-1 hours)
• 7:30pm bedtime  

Check Ins: this is the "cry it out" portion of sleep training that a lot of mom's are unable to stomach, and I can't blame them because my heart breaks when I hear my little man crying.  Professionally I have been in support of cry it out, a baby must learn to self soothe and it is the parent's responsibility to teach their child to sleep.  But most parents don't believe me or understand the importance of this when I explain, and months (or years) later ask in desperation how to correct bad sleep habits that have been in place since early infanthood.  It is possible to do, but more difficult, and sooner or later you do need to teach your child how to sleep.  Night one will be the hardest, night two a bit easier, and by night three or four you'll be done with the hard stuff, I promise.

A timer/stopwatch is seriously important to this step.  I found that 20 seconds of crying felt like 5 minutes, so I needed a reality check here.  If your baby begins crying start a timer for 5 minutes, and prepare to be in agonizing emotional pain (sorry mama).  If your baby is still crying after 5 minutes go into the room, do not touch them, but in a soothing voice reassure that you love them and it is time for sleep, and get back out of the room within 30 seconds.  The book goes into detail as to why this specific method is really important, and it made so much sense to me (think of touching as teasing them that you'll revert back to old and overall ineffective soothing methods).  In effect you are encouraging them to attempt, and eventually rely on self soothing instead of parental soothing to produce sleep.  After the first check in reset your timer for 10 minutes and repeat.  If needed, reset for another 10 minutes and so on.  

Our experience was great.  The longest Benji ever cried was the first night and maxed out at 17 (horrible) minutes before he learned to suck on his hand and fell back asleep all on his own.  Subsequent wake ups that night he cried for a few minutes (longest was 11 minutes) and then soothed himself with his hand and went back to sleep again.  In the morning when he woke up and started fussing I went in to him and he beamed up with me with a huge smile and squealed, at which point a promptly burst into tears in relief that my baby didn't hate me.  As mentioned, the next night went better, and the third night he put his hand in his mouth the second I put him down and never cried - seriously. 

Falling asleep all on my own

Overnight Feedings/Weaning: most babies are still waking up to eat overnight at 4+ months.  As long as they weigh at minimum 14 pounds (ideally 15) they don't NEED to eat, but awaken out of habit.  This being said, you should clear this with your pediatric provider before weaning all overnight feeds.  Because we went from nearly hourly awakenings to sleep training, I had to take an educated guess of how often he was eating vs. comfort nursing.  The book explains how to properly dreamfeed rather than allowing the baby to awaken and control their nursing patterns.  I decided to dreamfeed at 10pm, 1am, and 4:30am to start.  I set alarms and woke myself up and crept into his room to dreamfeed at those times, and timed how long he ate for over the course of the next few days.  If Benji awoke before I was to feed him, I would allow him to self soothe back to sleep (doing check ins if necessary) and make sure he was asleep for 10 minutes before I would go in to dreamfeed, so the timing wasn't always perfect, but very close.  After determining his patterns, I shortened the time he ate at the 1am feeding by 1-2 minutes every night until it was gone.  Then I did the same for the 4:30am feed.  I still dreamfeed at 10pm to date, but that's for me - both to keep my milk supply up (he has had some weight gain issues unrelated to sleep training), and I admit I love the cuddling before I go to bed.  Technically I could pump at 10pm and he could wean off of this feed too, and I will eventually.....

So there you have it.  The basics of sleep training using the SleepEasy Solution.  I've heard varying statistics on the effectiveness of sleep training, and ultimately it does not work for all babies.  But it does work for most.  And the benefits of having a well rested baby and parents are astounding.  Benjamin is hitting milestones at a faster rate now, he is ALWAYS happy, and he can be flexible with sleep when needed because he is an expert at self soothing now.  There will be set backs when traveling, teething, going through a growth spurt, or illness, but existing on little sleep is now our exception instead of our norm.