Wednesday, May 31, 2006

The Hard Line on Sleep

Two reviews appeared in Slate today on the new and revised edition of Richard Ferber's Solve Your Child's Sleep Problems. (You can read them here and here).

Now I haven't read this book and happily fall into the class of parents that doesn't need to. But in reading the reviews it occurred to me that we had pretty much taken the Ferber line with our babies anyway. That line is this: let them cry. The book is then about various strategies for parents to use to achieve this. As one reviewer, Emily Bazelon, wrote: "his parenting book is read and reread in our house, because we rely on Ferber for backbone." She goes on:

Ferber's method rests upon the sensible idea that children have to learn to go to sleep by themselves. To do that, they need a set of "sleep associations" that don't require your presence, which means at bedtime no nursing, rocking, back rubbing, or singing to your baby. Ferber provides a vivid analogy for adults: "Think again about having to sleep without your pillow," he writes. "You would no doubt curse your bad back and your doctor vehemently. … The only way you would learn to fall asleep without your pillow would be to actually practice doing so." So it also goes for a baby who since birth has been nursed to sleep and is now going off the boob. She needs to practice and that means some crying—and not crying followed by a guilt-ridden rush to make the wailing stop. When parents cave, "their child only learns that he must cry longer to get what he wants." According to Ferber, your impulse to give unconditional comfort is misguided, and maybe you'll even be able to conquer it. "Once you understand that your child's need is simply to learn a new way to fall asleep (whether it is what he wants or not) it is easier for you to see that this need is met," Ferber says.

This highlights the issue. The theory is simple: if you make a big deal about bedtime and associate it with things that require your attention then that is what will happen. Bedtime is a first hit at independence and, of course, it is a rare baby that doesn't react to that very fact. After all, from their perspective they are the centre of the universe and everything else about their lives at the time is reinforcing that belief.

It is implementation that is hard. This is especially the case for first time parents. And what you need to do it is support.

That is what happened to us. Our first child spent the first six weeks of her life not sleeping. We were getting four hour breaks at best. I was hallicinating. (I saw a horse running on the freeway and still remember it vividly!) We took her over to a friend's place. They had more children. We put her down and they stopped us from going in. 30 minutes later she was asleep.

That night we implemented the hard line. Through the baby monitor was screaming. My partner said that she "couldn't stand listening to it any more." So I went to the monitor and turned it off. "Problem solved." 10 minutes later we determined with our ears to the door she was asleep. 4 hours later we didn't get her. She screamed and then went back to sleep. 8 hours later we woke up, panicked, ran to her room and she was lying there happily smiling at us.

We never had another problem night from her again. And when I say never, I mean never. She would go down at 6:30 and stay there until 6:30am. 12 hours per night without fail. Now it wasn't just the hard line that allowed this but also the fact that we made sure she wasn't hungry by engaging in a 'feeding frenzy' between 4pm and 6pm. But with that mix we definitely got results.

So how did all this knowledge translate to our second child. There, it was a hard line pretty much from the start. And the result was 8+ hours sleeps at night at 4 weeks. Alas, however, our cockiness stuffed it up again when we put him on solids at 4 months (that was the recommended date way back then in 2001) and got over-enthusiastic about it. He had stomach cramps, had to be taken off food and didn't sleep through properly again until 10 months.

Sleep performance does to a large extent depend upon the child. Child No.1 was well suited to it. She ate like a big that meant she could eat enough before bed. She also is a great sleeper. To this day (she is now 7) we can move her around in her sleep without her noticing.

On the other hand, Child No.2 would throw up feeds all the time and was a light sleeper. He also doesn't need as much sleep. To this day, he bounds up out of bed at 5am ready to go. He is the ultimate in morning people even before it is officially morning! Compared with Child No.1 who thinks that morning is an afront to her rights and grumps for a good hour, our son is disturbingly happy and cheery at sunrise.

Finally, on to Child No.3. We had a hard line from the start (partly because we didn't realise the old baby monitor wasn't working too well and so we got our 'spine' for free; we didn't know she was crying!). But nothing we would count as sleeping through until 10 months. This is because our daughter reached a compromise solution. She wanted 5 minutes of our time sometime between midnight and 2am for a feed and that was it. We hardly felt it and when it comes down to it we effectly got 90% of the Ferber-type independence anyway.

Nowadays when she wakes up at the crack of dawn she is greeted first by our son who, let's face it, is the right person for the job. That buys us extra sleep time.

In conclusion, the Ferber approach has lots of merits but it is implementation that you have to concentrate on. Absent that the defective baby monitor will work wonders.