Is Your Baby Overtired?

"I don't let my child's naps hinder
me from doing my grocery shopping!"

Sleep is under-emphasized in our society.  We burn the candle at both ends.  We work weekends.  Yet our kids are important to us, too, so we tote them around, taking them with us to Wal-mart at all times of the day and night and bringing them along to parties.  The general consensus is that you've got a "good sleeper" if your kid will crash anywhere.

The problem with this is the quality of sleep.  In a nutshell, sleep is a complicated state that occurs best when it's the right time.  Fluctuating hormones cause us all to enter sleep states and wake states throughout a 24 hour period (see the Napping Window).  It is possible to put a child to sleep during a wake state (although it will probably take a long time!) but because of the increased cortisol hormone, the sleep will not be as deep and the sleep period will probably be short.

All of that to say that, after 4 months of age, a routine helps to train a child's body when it's time to sleep. 

Just as important as the timing is the place.  Although she looks completely zonked, a soft blanket and a shopping cart are no substitute for her bed.  You're familiar with sleep cycles, right?  Fall asleep, get deeper into sleep, cycle up to a lighter sleep state, and then without waking, go back into a deeper sleep.  Many cycles per night.  The reason that still, quiet sleep is the most restorative is because the motion and the noise hinder getting into that deep sleep state.  Her mind is not able to rest.

I don't want to make anyone mad, but I do think that parents are sadly unaware of some facts about their child's sleep.  First of all, some things I've heard parents say.

•  My child just isn't the type to conform to a sleep routine.
•  My child doesn't need as much sleep as other children.
•  Our family is on the go.  It's best if our child just gets used to it now!

If you've found yourself thinking or saying something like this before, please consider some of these symptoms of over tiredness in babies and young children.

•  Waking grumpy vs. happy
•  Unable to play happily by themselves during their wake time

He crashed.  Kinda funny, but
really just kinda sad.

•  Unexplained fussing
•  Yawning or rubbing eyes a lot
•  Fidgety or spazzy
•  Easily startled
•  Irregular sleep patterns
•  Fights naps and/or bedtime
•  Random unexplained night wakings

•  Complains of headache or stomach ache
•  Seemingly not tired when you know they should be
•  Waking within minutes after being put down for a nap
•  Crashing randomly

Imagine what it feels like when you haven't gotten enough sleep.  Miserable, right?  What's work like the day after you haven't gotten enough sleep?  I'll skip to the chase because I think you get my drift.  A bad attitude and a hard-to-pin-down schedule today are the least of your concerns when your child is sleep deprived.  Weissbluth writes, "Small but constant deficits in sleep over time tend to have escalating and perhaps long-term effects on brain function."  Not to mention the affect sleep has on health.  Some long-term affects of a child who does not get healthy sleep can be decreased mental focus, insomnia, ADD and ADHD.  People take medicine and suffer from these ailments that might have never occurred had they been getting enough sleep.

Eliminating a child's sleep deficit is not easy, but anything you can do to help your child get more sleep (the right kind of sleep... still, quiet, consolidated, and regular) will benefit their health and development.  If you want to get started, you know the book I'll recommend.  I love to talk about this stuff (can you tell?) so please let me know if I can be of any support.

Declan's First Visit to the Chiropractor

I took Declan to his first appointment with Dr. Adams, a local chiropractor who also has a degree in Pediatrics, this morning.  I got a lot of encouragement from my friends for looking into alternate treatment for him.  Some people were confused.  I think that, despite how awesome and practical the work that chiropractors do, it is really, really misunderstood.  Somebody needs to promote them.  I'm doing my part!

The reason I am having Declan see a chiropractor is mostly for treatment of his acid reflux, but I also know that keeping his spine in alignment will "fix" or prevent other problems that we may never even know about.  The list of ailments that preventing vertebral sublaxation can prevent is extensive.  Common things that you might take your child (or yourself) to the doctor for, like ear infections, unexplained crying, growing pains, poor concentration, allergic reactions, digestive problems, etc. are very successfully treated by a chiropractor.  I learned a new term today... (did you see me use it in a sentence? (c;)

vertebral sublaxation

"A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity."

Thanks, Wikipedia.

So I learned a lot.  I wish I had taken notes!  He asked me a lot of questions, then examined him with a thermo-sensor thingie.  Declan wiggled too much to get a good shot, but he got a good look at his neck vertebra and could see some sublaxation there, including a big bad one up by his head.  He adjusted him.  Declan cried a little on the first adjustment.  Dr. Adams said it wasn't supposed to hurt, but it must have been a pretty sore spot. 

He showed me on a model how Declan's esophagus might be being squeezed when his head is turned to one side.  That explains why Declan prefers nursing from one side as opposed to the other.  He also held him upside down by his feet (!!!) and then let go of one leg.  He said he was checking to see if Declan's head would turn the opposite way.  He tested both legs and it only worked on one side.  So there must have been something else out. 

He also told me that the Prevacid that Declan is on (which neutralizes the stomach acid) might be causing more harm than good.  I told him about how sometimes Declan was still spitting up when it was time for his next feeding, sometimes 3 or 4 hours after his last meal.  This confused me a lot because I know that babies' stomachs should be empty 2 hours after their last meal, especially with breast milk (it is very quickly and easily digested).  The Prevacid might actually be causing that problem because it is inhibiting the acid from digesting the food.  (A while back our pediatrician wanted to put Declan on a medicine that would speed digestion.  I didn't do it because I read on the Internet that it was a dangerous medicine.  Black-labeled by the FDA!).  So he would have been on 2 medicines and one of them would just be to "fix" the problem that the other one was causing!

Dr. Adams could not tell me to take Declan off of the Prevacid, but he did say that it might be hard to tell if the adjustments were working if his symptoms were masked.  It's my goal to get him off of the medicine, anyway, so I'm going for it! 

Before our visit was over, he had the receptionist take a picture of him and Declan.  This is cute and sentimental and all, but he also does it to track visual progress of his patients.  He actually asked me to bring in 50-100 pictures of Declan from birth to present in order to examine trends in his posture and how he holds his head.  He said he might be able to decipher if his sublaxation is a result of birth trauma.  So I have a fun project ahead for Thursday!  Dr. Adams also had me bring in Declan's carseat and he showed me some problem areas on it and told me what I can do to make it better for Declan's spine.  Awesome!

After the adjustments, the doctor said it's not uncommon for babies to take a 4-5 hour nap, or have a big diaper, haha.  Well, he just woke up from his 45 minute nap, so much for that.  Anyway, we have a follow-up on Thursday and he might get examined and adjusted again.  I should add that the examinations and consultation on kids is free, so if you're in the area and are curious about seeing if your child might benefit from a chiropractor (I tend to believe it's great for overall wellness, not just for treating problems), it couldn't hurt to check it out!  The adjustment cost was $50.  Financially, it was an easy decision for us (his Prevacid costs $60 a month!).  A small price to pay for my son's health, especially when it's medicine-free (no negative side affects!), and it allows for his body to heal itself.  I'll be making appointments for Ryan and I, too (c:

Giving Him the First Year, My Practice of Mothering

Click to read others' practices in Sarah's Practices of Parenting Carnival on Monday, February 6.

Sarah at Emerging Mummy asked her readers to share their practices of mothering.  She has a really awesome series on her own practices.  I loved the idea, but I didn't think I would submit anything myself.  It came to me today.  Ryan, my husband, was reminding me of a principle my great-grandmother talked to him about over Christmas: give them the first year.  My great-grandmother (My 7 1/2 month old son Declan's great-great at 89 years old!) was a little bit of an entrepreneur.  She had consignment shops, a house cleaning service, and she was involved at church over the years.  When she was a young mother, though, she put these things on hold to focus on her babies. 

I think about this principle whenever I feel outside pressure to compromise Declan's schedule.  For our family, giving him the first year translates to staying home a lot.  Babies need more sleep than most people (Americans?) think.  His feeding, nap, and bedtime routines are very important to me in order to maintain his comfort and sense of security.  I want to rock him in his nursery and for him to be able to sleep in his own bed, still and quiet and clean in a fresh diaper with his blanket and his white noise; I want him to know where he is when he wakes; I want him to know that I'll come to him with big smiles when he finishes a good nap.  These things are his to rely on and he can feel that all is safe and normal.

There are things that Ryan and I miss out on because of our dedication (some may call it obsession) to our son's routine.  We do make allowances for specific occasions and on Sundays for church (our service meets in the evening).  Although it would be nice to have more flexibility to run errands, have dinner parties with friends, or do other evening church functions, we believe we are doing something more important.  I don't know many other people with young babies that give up their pre-baby lifestyle.  I understand that decision and sadly I think it's a strong aspect of Western culture, but I can't honestly say I support it (even though it's none of my business).  My husband and I believe that through this temporary sacrifice (which, let's face it, is just the beginning -- you're a parent by the way!), he will grow into a healthier, happier, smarter, and self-controlled child.

Studying His Sleep

Declan has been asleep for 2 1/2 hours for his 2nd "morning" nap (which has now spilled over to afternoon) now.  Considering 98% of his naps are 30-40 minutes long (I think with only one other exception) - this is weird!  A part of me wonders if he's okay (I have checked on him twice in the last 30 minutes) but he's fine - still breathing!  He's going to be one happy - and hungry - kid when he wakes up, which I'm looking forward to... I miss him!

I've been keeping a sleep log for him since August 10th when I started enforcing naps every 2 hours, and I have used part of the time he's been asleep today to put it in a spreadsheet.  Looking at it all together has helped me to see patterns emerge, and also to help me see how we've improved - little by little - over the past 20 days.

There hasn't been a drastic change, but the biggest thing I am able to see is his natural sleep rhythm.

Wake Up:  7:00 - 8:00am
Morning Nap #1: 9:00am (average duration 75 minutes, most often 1 hour though)
Morning Nap #2:  12:00pm (average duration 50 minutes, most often 30 minutes).  On day 16 he slept for 2 1/2 hours and today (Day 22) he is going on 3 hours for this nap.  Weird.
Afternoon Nap #1: 3:00pm (average duration 50 minutes, but most often 30 minutes).
Afternoon Nap #2: 5:20pm (average duration 35 minutes, most often 30). 
Evening Nap: 7:30pm (average duration 50 minutes, most often 45).
Bedtime: 10:30pm
Night Wake Ups: If his bedtime is between 9 and 10, he will usually wake up twice (around 1am and again at around 5:30am).  If his bedtime is between 10 and 11, he'll just wake up once (around 4 or 5am).  If his bedtime is after 11, he'll wake up around 3:30am and have a rough morning - probably waking again before morning wake up and maybe sleeping fitfully.

There have been a couple of wonderful nights that stand out.  On Day 15 he went to bed at 10:30 and slept until 7:30am (!!!), and on Day 20, he went to bed at 9:30 and slept until 5:00am.  Day 15 though had only one morning nap, and I think we swaddled him and gave him formula that night.  He was probably fussy a lot and hard to deal with that day.  Day 20 was much more ideal - he took 4 of the naps and was much happier in his waking time.

I can't believe he is still asleep for his nap.  When I go in to check on him, he has had his eyes open a couple of times, looking around quietly, but will shut them back again and fall back to sleep.  Maybe he's having a growth spurt???  He will have been asleep for 4 hours pretty soon.  I often worry when he does have abnormally long sleep, thinking I have bundled him too warm or that he will have trouble sleeping tonight.  But I remind myself that sleep is important and sometimes difficult to get, so I let him be and it has always made for a happy waker... I can't wait to play with him when he gets up!

A few quick things we've learned to help him sleep:
• Start the soothing routine 1 to 2 hours after previous wake up
• Have a pacifier handy
• Swaddling
• Rocking
• Singing (the same song or two every time)
• Letting him cry for up to 30 minutes and checking on him every 10.  If he's still awake and crying after 30, I assess if he's hungry again and if not I rock him some more
• Soothe until he's drowsy - not asleep - and put him in bed.  This used to work with no crying, but he has started to figure out our plan and fights it... hence the addition of the "let cry" method into our routine
• Giving him a few ounces of warm formula (helps him to sleep longer... sometimes)
• Daddy magic - Ryan sings to him and holds him tight while rocking and swaddling.
• Taking him for walks or swimming in the evening to wear him out.  Also making him use his muscles like with tummy time or moving his arms and legs and other exercises to physically wear him out.

He was even smaller once - proof that he won't be little forever!

Putting him to bed is not my favorite thing - it's usually a struggle and I just want one thing to work every time so I don't have to think about it so much!  But when I'm rocking him and waiting for those little eyes to go from wide-awake to half-shut, I try to just imagine him getting bigger and not being able to hold him.  Thanks to moms who have gone before me and advised not to take this time for granted, I snuggle him closer and enjoy where we're at right now.

Saying Goodbye for a While

This week I hugged Whitney and her family goodbye for a little while.  Whitney and I were friends in high school and were college roommates all 3 years (even though everyone said we'd get tired of each other).  We were in each others' weddings (us: June 2009, them: January 2010), and we were watching a movie at her house the night she told me that she might be pregnant.  Even though it was (what we thought of as) bad timing for both of us, we joked about going through that next stage in life together, too.  Little did either of us know or expect that about a month after that night I would be texting her with the news that it was happening.

Now we have our boys, Declan and Micah, 5 weeks apart.  It would be too perfect for them to grow together and have each other to play with, though.  Whitney and her husband have moved to another city in another state for at least a year, and who knows after that?  At least our parents still live 10 minutes apart and we can meet up when we're visiting them for the holidays.  I'll miss you, Roomie, and I hope that Micah and Declan can play together in the future!