Getting Baby to Sleep By Any Means

As with anything new, putting a baby down to sleep often requires a lot of experimentation. And sometimes, when we're sleep deprived, we don't always come up with the best ideas.

"The world is a fascinating place, and most children would rather be awake than go to sleep," says Glenna Winnie, M.D., a sleep specialist at the Pediatric Sleep Center in Purcellville, VA. "They often fight to stay awake when they should be sleeping, and therefore become excessively tired, have behavior problems, or become excessively active due to sleep deprivation."

Necessity is the mother of invention, as parents whose babies awaken the moment their head hits the crib will tell you. But maybe you're one of the lucky ones and haven't had to drive Baby, strapped in the car seat, from one side of town to the other. If not, take comfort in the following stories of trial and error.

Although parents may often go to great lengths to get their child to fall asleep and stay asleep, parents have to be sure that safety is paramount. "Always be sure that there is no chance that your child could get injured or suffocate. Always stay with your child if you have him sleeping anywhere that is not in a crib or his bed, and be sure to keep all choking hazards far out of your child's reach," counsels Jodi Mindell, Ph.D., Associate Director of the Sleep Center at the Children's Hospital of Philadelphia and author of Sleeping Through the Night.

Most bedtime routines include reading to the child. Unfortunately, this did nothing to put Nicole and Jason Hunter's 20-month-old, "the lightest sleeper on the planet," to sleep. "Isabel engaged in the children's books we read to her, and they kept her from sleeping," Jason says.

So he started reading some history books to her. "Max Hastings' Armageddon was very effective," says Jason, a history major, of the British historian's 640-page volume on the final collapse of the Third Reich. "If I read it out loud, slowly and methodically, she would go to sleep."

Eventually, Isabel started referring to all her daddy's books as "Max Hastings."

"A lot of people think kids set their own sleep schedule," Dr. Winnie says. "But parents need to set limits. It takes time for a child -- and an adult -- to wind down at night, to prepare for bed. The bedtime routine should be short -- 15 to 30 minutes -- and end with the child in bed and lights out. Consistency is the most loving thing to do for your child."

Plenty of babies fall asleep in car seats, while being driven around. Not wanting to get in their car every naptime, Kathy and Bill Guerry came upon a simple solution.

"We used to put the baby in the car seat and put the seat on top of the dryer while it was running," Kathy says. "It worked pretty well until one time when the baby had fallen asleep and then the buzzer went off at the end of the cycle. We had to start all over again."

"The American Academy of Pediatrics does not encourage actions like swaddling or rocking because they become a sleep association," says Sanjeev Kothare, M.D., director of the Center for Pediatric Sleep Disorders. "It takes about two weeks to retrain a baby to be a good sleeper." This process, Dr. Kothare explains, involves cutting back on a child's sleep by about an hour and then putting the baby in the crib, responding to them every five minutes, then extending it, to every 10 minutes and 15 minutes.

"Never leave your baby alone if she is sleeping anywhere than in her crib. Her car seat could easily fall off the dryer," Dr. Mindell advises.

Raquel Avila and Simon Fraser had twice the work putting their infant twins to sleep.

"Ava and Maddy were born at 35 weeks, weighing just 4 pounds," Raquel says. Premature babies often take extra time to catch up to developmental milestones, and that includes sleeping through the night. Maddy, in particular, had trouble sleeping. She would sleep only in her car seat.

"We strapped her in and brought the car seat to bed with us, so we could rock her to sleep between us," Raquel says.

From then on, they relied on the car seat and even put it in the crib with the baby in it. "I think she needed to feel warm and cozy, like she was in the womb," Raquel adds.

"Premature babies have immature sleep centers and may take longer than their full-term counterparts to learn to sleep," Dr. Kothare explains. "If they are very premature, they may have physiological reasons for not sleeping well, and if they have stayed in the NICU, they may have emotional aspects to their sleep problems."

"There are some concerns about breathing when a baby sleeps in a car seat, so be sure to check your baby's positioning with your doctor. Also, be sure that the car seat cannot tip over or that she can reach anything if your baby sleeps in a car seat," Dr. Mindell advises.

While other children are cuddling their security blankets, baby Sophia needed another tactile source of comfort.

"Sophia would go to sleep only if she played with my hair," says Miriam Mathers, of her daughter. "So I would sit on the floor with my head against the bars [of her crib]. Luckily, I had longish hair; otherwise it would have been awkward."

"The big, important thing when it comes to kids is sleep onset association. We all have a set of conditions under which we feel comfortable to go to sleep," Dr. Winnie says. "Children learn to expect those conditions that are present at sleep onset and often become dependent on them for sleep after awakening during the night."

Sophia needed to stroke her mother's hair between the ages of one and two. Then one day, both she and her mom stopped cold turkey.

When baby number two came for Maria Vasilakis-McGlynn and her husband, Chris, a new life-saving product came on the market: the Bibfeeder. This special bib features straps that hold a bottle on the baby's chest.

Maria kept baby Eleni and her older brother in bouncy seats next to her bed and "as soon as I heard a sound, I would reach over with one hand and place the nipple in a mouth. After a while, they knew how to search for the nipple themselves," McGlynn says, giddy over how much sleep she saved.

Eventually, her children transitioned to the crib, but basically Eleni used the Bibfeeder "from the day (she came) home from the hospital to the day she could hold the bottle by herself."

"Children should not be nursed to sleep, or drink from bottles," Dr. Winnie says. "There are medical problems associated with drinking when you are in bed, including gastroesophageal reflux and cavities."

"Our oldest son slept with five pacifiers. If one was missing, there was a real drama," Herman Garcia says. "He would have one in his mouth, one in each hand, and the other two available to rub against his face."

If the baby stirred during the night, he would feel around for the pacifiers, and if they weren't there, "there was a big drama." This only happened when he slept in the crib. He napped fairly easily elsewhere.

"I do remember a couple of late night outings to the pharmacy during vacations to buy more when we had forgotten or lost them," Herman says.

"This is a great example of an unusual sleep onset association," Dr. Winnie says. "I would suggest that the family provide a little pile of pacifiers in the corner of the crib, so if the child loses one, he could reach over and find one easily, and therefore return to sleep himself."

Gloria Juliana didn't have trouble putting her baby to sleep, but he would wake up a few times in the night demanding his bottle.

"We decided to put a few bottles in the crib, so that he could find them himself," Gloria says. "We put five or six bottles, filled with juice or water."

When the bottles were empty, they would go flying out of the crib. "He would throw them out!" says Gloria, who found them lying on the floor.

Although it worked for the Julianas, pediatricians advise against babies drinking in bed. "It is best not to leave bottles in the crib, especially if they're filled with juice. There is a good chance that your baby will develop dental caries, or cavities," Dr. Mindell warns. "Even water in large amounts is not good for babies."

Moving babies to a new sleeping situation can sometimes mess them up. That's what happened with Amy Giles's second baby, who slept well as an infant in her bassinet, but had trouble adjusting to a crib.

"Julia refused to let me leave her bedroom. She wouldn't fall asleep unless I was in the room," says Amy. a mother of two. "I figured at some point I would be able to slip out of the room, so I would lie down on the floor next to her crib."

When she was almost certain the baby was asleep, Amy would crawl on her belly to leave the room. (Her husband took turns with her, and did the same.) "You'd think we were trying to escape a hostage situation! Sometimes she would fall asleep thinking I was still there. Other times, she would lift the bumper, see me trying to escape and start howling. And then I'd start the whole process again."

Things were at their worst when Julia was 15 to 18 months old. There were many nights that Amy gave up and fell asleep on her bedroom carpet. "Thankfully, we spent the extra money on the carpet and it was extra plush."

Eventually, Amy and Pat realized they weren't doing their baby any favors and turned to gentle Ferberizing. '

"Once she learned to fall asleep on her own, she did much better through the night," Amy says. "We realized that we needed to teach her how to sleep."

"If you change your routine at the beginning of the night, you can retrain your child," Dr. Winnie says. "It's the first time going to sleep that's important. We all have sleep cycles, but we're able to put ourselves back to sleep. Babies who do that are called self-soothers."

Sejun Ra found a way to stay fit and put his baby to sleep. "Haeli was very difficult to put down, so I tried many things -- singing, walking, swaying -- but the only thing that would work was an up-and-down motion," he says. "I would do squats and lunges for about 30 minutes while holding Haeli."

Sejun began using only his arms, but that got really tiring, so he started the lunges and squats. "At first, I couldn't do more than five minutes, but after a few months, my legs were really strong and I would normally do 30 minutes. It worked every time!"

Sejun and his wife, Jinhee, even had a name for it: "the sumo," after the motions sumo wrestlers make at the beginning of a match.

"I didn't have to do it every night, but at least twice a week, it was a necessary regimen," Sejun says. "I think with some fine-tuning it may work with every baby."

"Motions while sleeping are associations and should not be encouraged," Dr. Kothare says. "It is unclear why vertical motion is preferred by the brain."

Kristin and Mike Zangrilli used a birthing ball to bounce baby Annabelle all over their apartment to keep her asleep during her nap.

"I was at a friend's place, visiting her and her newborn baby. Because of limited places to sit, one of us ended up on the ball. It seemed to calm the baby," Kristin says. "We tried it with our baby, shortly after bring her home and it worked. The more you bounce, the more it would calm the baby."

For the baby's first four months, Kristin and her husband would bounce for up to half an hour and have a conversation with their family, watch the news, and so forth.

"We all used the ball-- my husband, my mom and dad, everyone," Kristin adds.

"It was crucial! It was an integral part to the newborn ecosystem," says Mike, who needed it all the more because he didn't have the "magic breasts." It worked better if they made a shushing noise in the baby's ear, and also, "the higher you bounced, the calmer the baby."

Each of us has a set of circumstance under which we can fall asleep at night, called sleep onset associations. If we wake for any reason (normal or abnormal), we have to re-establish those sleep onset associations to fall back to sleep.

Those conditions are usually quite specific, like having a pillow in a certain position, stroking Mom's hair, having five pacifiers, or rubbing the edge of a beloved blanket between two fingers. Sometimes those conditions include drinking a bottle, or being rocked by Mom. The key to sleeping through the night is to help a baby or child develop a set of sleep onset associations that the child can establish themselves, without parental intervention; then, when the child awakens in the night, the child can re-establish those conditions and fall back to sleep.

That is why, by about four months of age, a baby should be put down to fall asleep alone, when the baby is drowsy but not yet asleep, so the baby can learn to fall asleep without help from someone else. By this age, feeding should be separated from sleep onset by at least a few minutes; as the baby gets older, finish feeding 15 to 30 minutes before putting the child down.

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