Monday, December 29, 2008

Hibernation Issues in Wombats

Elijah is now almost 5 months old. I know. I can't believe it either. And ever since he was 3 months, the first question anyone asked us was "And how is he sleeping? Is he sleeping through the night? IS HE?!!!!"

I don't know why sleeping through the night is the ultimate measure of how good an infant is. It seems that if the baby IS sleeping through the night, people are satisfied with his progress in life; if he is not, they give you a ton of advice, hoping, apparently, to help you progress his current station. I wonder at what point sleeping through the night no longer becomes a yardstick for your accomplishments - 1 year? 2 years? In a way, I wish it lasted into adulthood - darn it, if judged by sleeping through the night, I should have multiple awards. I can sleep with the best of them; always could. And there wasn't even any place to mention it on my college application (although it's not too late to list it on my resume).

Anyway, at our last pediatrician visit, the doctor asked if Elijah is sleeping through the night, and, upon hearing that he wakes up 2-4 times, told us to research baby sleep issues. Specifically, he told us to read "Healthy Sleep Habits, Happy Child" by Dr. Marc Weissbluth. I read the book, and thought I'd expand my thoughts on it here.

Dr. Weissbluth presents results of studies of sleep in babies, and then uses those results to propose some sleep training methods for your child, who is behind in his sleep progress (obviously. Otherwise, why would you be reading his book?). The research is interesting and useful; the methods are interesting and scary. Research first:

1. 5 Elements of Healthy Sleep:

  • Sleep duration: naps should be at least 45 minutes; night sleep is best uninterrupted. Night waking usually disappears around 9 months.
  • Naps are important: 3 naps up to 9 months, then 2 naps (morning and afternoon) until 12-21 years and 1 nap until 3-4 years of age.
  • Sleep consolidation
  • Sleep schedule
  • Sleep regularity
2. Sleep is controlled by 2 biological mechanisms, which do not always talk to each other:
  • Homeostatic sleep control: a biological system that tries to restore sleep when any sleep is missing. It is involuntary, and controls sleep much in the way that our bodies control their temperature.
  • Circadian timing system: switches specific genes on and off in response to the light/dark cycles. This molecular clock is set by sunlight (although it seems to be set to a 25-hour cycle rather then our 24-hour day).
3. Biological Rhythms control sleep:
  • Sleep/wake rhythm emerges immediately after birth
  • Body temperature rhythm (temperature rises during the day and drops at night)
  • Cortisol peaks in early morning and has lowest concentration levels around midnight (develops by 3-6 months)
  • Melatonin surges at night and helps support the sleep/wake rhythms (completely controlled by the pineal gland by about 6 months). It is produced by human brain starting around 3-4 months of age and both induces drowsiness and relaxes the smooth muscles encircling the gut
4. Good sleep is important
  • Night sleep, daytime sleep and daytime wakefulness have rhythms that are partially independent of each other. Before 4 months, they are not in synchrony with each other at all. This means that the sleep rhythm can be in "deep sleep" stage, while wake rhythm is in "alert" stage instead of "drowsy". So the kid can be completely exhausted, yet wired and unable to fall asleep.
  • Naps differ in quality by the time of day. Morning naps provide more REM sleep, while afternoon naps provide more deep sleep.
  • Naps dramatically reduce levels of cortisol (stress hormone) present in the body.
  • After 4 months, naps should be 45 minutes to 1 hour to let the body relax. 30 minute naps do not do the trick.
  • Most common sleep-deprivation complaints are headaches and stomachaches. If you are experiencing either, try sleeping better.
Now the scary part. From this research, the Doctor concludes that sleep is obviously extremely important (no disagreement there), and that therefore you must make your child sleep NO MATTER WHAT. We must stop at nothing to make him sleep!! And the best way to do that is to leave him crying so he learns to fall asleep on his own. In fact, the Doctor goes as far in his book as to suggest that if you should turn off your baby monitor for the entire night; that if your kid throws up while crying for you, you should not clean him up until morning, and that if he falls down while trying to get you, just let him stay as he falls. That'll teach him not to try it next time!

On top of that, the author adopts a condescending tone and frequently makes interesting passive-aggressive comments about the rest of the family of the sleepless child. Here are my 2 all-time favorite passages from the book:

"Practical Point: A parent who keeps a baby up past his natural time to sleep may be using this play time with the child to avoid unpleasant private time with the other parent." A practical point indeed! Let's make the parent not only exhausted, but also paranoid! Why is my husband so happy to be playing with our son in the evenings?! I used to think it was because he misses him all day, but now I suspect it's due to his secret hatred of me!! It's all clear now!!!!

"Why Can't I Let My Baby Cry? I enjoy my baby's company too much at night. This may be because you are not a good sleeper yourself." Yes, this makes sense. Not only is your child a failure in the making, you yourself are also a ruinous sleeper. Right. This guy could make a second career as a motivational speaker in addition to his pediatrics practice.

It's pretty amazing how often looking at lots of data results in your losing all common sense. There really should be rehabilitation programs for these people.

Anyhow, I am trying a slightly earlier bedtime with our little Wombat. And I'm trying to normalize his naps somewhat. But overall, he can keep waking up through the night for now. Beware of white coats bearing research, to paraphrase Warren Buffet. :)


Cecilia Newell said...

Bah! to your pediatrician. I also agree that the sleep training mentioned in this book is quite scary. I can't imagine a parent really doing this, but I do know a few families who have recommended it to us, stating that it worked for them. I just wonder if it really teaches the child to self-soothe or really have the opposite effect of causing them to lose trust in the parents and hope of relief!

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