Q&A: all kinds of toddler sleep stuff

Part 1 of the "Preventing PPD" series goes up this afternoon.

K writes:

"i don't really know if this is actually one question or rather a series of small questions. let me fill you in on what's going on and you can decide yourself.

so the little lady is now 13.5 months old and today i reached that point where i am so tired i am trying to not throw up. so that's when i know it is time to write for help.

the sleeping was bad before [2-3 wakings at night] and then just before the holiday it got really bad [5-6 wakings at night] and now we are back to something like 4 wake-ups.

the evenings go like this: dinner at 6, a bit of calm play, tooth brushing, bath, pyjamas, then breastfeeding and quietly saying goodnight to the parked cars and the houseboats outside the window. at 8 dad takes over at puts her to sleep [in her own bed in her own room]. she sleeps well until about 12, when i go in and breastfeed her in the extra bed in her room where i sleep most nights. if i am lucky she falls back asleep until two where we either repeat or i take her to her daddy and breastfeed her to sleep there. he then takes her for the rest of the night while i go back to her room for some sleep. otherwise she just stays in the extra bed with me and wakes up every two hours or so, wanting to breastfeed. until about 8 or 9 where she wakes up properly. and the day circus begins.

when she wakes up it is often crying or moaning. and sometimes [like last night] she simply doesn't really get comfortable again but rolls around and headbutts me. for 3 hours. and then she falls asleep again towards the morning. if i try and put her in her bed during this, she tends to headbutt the bed instead and much rending of clothes and wailing ensues.

she has just recently begun taking a non drip sippy cup [she never took the bottle or pacifier] so we try and give her milk or water when she wakes up. about half the time however though, if i try and give her water she gets very angry and nothing but breastfeeding will stop her from going berserk. so i often cave in and feed her again.

every once in awhile she skips the 12 o'clock wake up and sleeps straight to 2. this makes me think that we have got that end of the night down OK and we should just deal with the post 2 am chaos.

she is great at taking naps but only if she is walked around in the buggy [so i don't get any naps]. if she got what she wanted she'd sleep for 2 hours in the am and another 2 in the afternoon. this is no surprise, i mean i would LOVE a 4 hour nap myself :)

she is in daycare 2 days a week and the rest of the time we tag team... she is not starved for my attention :)

i am still breastfeeding 3-4 times a day, my goal was to make it past the 12 months mark but beyond that i have no plan, i would love to night wean her, and then let her breastfeed during the day until she self weans - would it be easier to totally wean her? and how exactly does one go about weaning anyway?

when she wakes at night we have been experimenting with a, giving her milk in the sippy or b. water [which makes her quite irate] if we give her milk are we just starting another bad habit?

is she simply not tired enough at night, should i move her to one nap after lunch?

she essentially co-sleeps the majority of the night, should we stop that?

i cant help the sinking feeling that i may have made a mistake to be so laid back with the feed on demand and the co-sleeping. i see the bottle fed CIO kids around me all sleep way better. i don't want to think that the stern people were right but i am not sure where to go from here. part of me just thinks that she happens to be a very attention happy and social girl and that she simply needs more cuddling than most... but if that was true then what we are doing now should make her a happy sleeper. and she is not a happy sleeper."

Wow, that's a lot of stuff to sort out.

First of all, I want to say that I think this is totally "normal" behavior, and that there's definitely a subset of co-sleeping night-nursing kids who are still in this pattern at 13 months. And none of their parents are happy, and they all doubt themselves and wonder why their kid doesn't sleep more like the co-sleeping, night-nursing kids who only wake up once a night, or the CIO'd kids who sleep straight through. But the fact of the matter is that in the big sleeping discussions, it's usually the parents who have easy sleepers who do most of the talking, and the ones with more difficult sleepers usually sit quietly in the corner feeling bad about themselves.

Did I mention that it's probably just your kid's personality? And that even if you'd done CIO you might still have a kid who kept waking, only instead of nursing every two hours you'd be re-CIO-ing every other month. And maybe your next baby will sleep all the way through from month 3, and it's only the luck of the draw that you got your daughter first.

So just let go of any doubts about what you've done, because you did what you needed to do for you and for her at the time.

Now, let's talk about the naps. She's right in the age at which babies consolidate to one nap. You can tell she's ready to go to one nap if she's really resisting the early nap or having a hard time going down then. I'd watch her for a few days and see if she's still tired at her normal first nap time, or if she seems like she could hold out for another few hours. If she starts going down for her first nap later than she did previously, eventually it will just turn into her only nap. If you genuinely think she isn't tired enough, you might want to try running her around more in the morning (it's too bad you can't rent a 3-year-old or a large dog to run her ragged for an hour or two).

On to the nighttime sleep. Before I made any moves, I'd go over her and your diet with a finetooth comb to see if there's anything either of you are eating that could be causing her to wake so often. You might want to try going off dairy and/or soy for a week to see if it makes any difference. See if there are any nights she doesn't wake up and if those nights have anything in common. If this turns out to be as simple as a sensitivity to some food one of you is eating then you're home-free and can skip the rest of this post.

And it can be something really small and stupid, too: We hit a stretch at one point during which El Chico was waking every hour or so, but only on some nights. After a few weeks of thinking I was going to lose my mind, my husband cracked the code. On nights that El Chico was eating French fries, he woke up. It turned out the cooked tomato in the ketchup was too acidic and was giving him reflux. Once we limited cooked tomato consumption to before 1 pm, he slept fine.

If you've gone through all the foods you're both eating, think about nightweaning. I think you can nightwean her while still co-sleeping without completely weaning her. In fact, I think it would be tougher on both of you to wean completely than just to nightwean.

Dr. Jay Gordon used to have a nightweaning plan for co-sleeping toddlers up on his website that was gangbusters. It's not on the site anymore, but is still in his book Good Nights (about co-sleeping). Chris reports that it is still on the site, right here, so feel free to ignore my paraphrase and read the source. Several of my friends used it successfully when their kids were in the 14-17-month age range. It was a ten day plan, and is easier if you have a partner who can take over some of the comforting duties while you're doing the plan. It's been awhile, but this is what I remember of the plan:

Pick a 7-hour stretch of the night that is most useful for you (the suggestion is 11-6, but pick whatever's good for you). Before your start time and after your end time, you can nurse as much as you'd like. You'll end up weaning during the 7-hour stretch you choose. Before you start the plan, talk to your baby about how you're not going to nurse anymore during the night, but can nurse again when the sun comes out. You might want to do the discussing prep for several days before you start. Once you start the plan, do your last feed of the night right before your cut-off time (10:40 if your cut-off time is 11, for example.)

Nights 1-3, whenever she wakes you can nurse her, but do not let her fall asleep nursing. The idea is to stop the habit of needing to have a nipple in her mouth to fall asleep in the middle of the night. This probably isn't going to be easy. One method I've heard that seems to work is to nurse until she's drowsy, then pull out and roll so your back is to her and she can hug you. These first three nights won't be easy, so you probably want Night 1 to be a night when you and your partner don't have to go to work the next day. You both can comfort her to sleep any way you want, as long as the nipple isn't in her mouth when she falls asleep.

Dr. Gordon pointed out (when this plan was up on his website) that your baby might be really angry and cry. The crying will be out of anger, though, not fear. A baby who's slept with her parents for over a year (Dr. Gordon cautions parents not to use this plan on a baby under a year) and is still in bed with her parents is not afraid--she's angry that she's not being nursed to sleep. Anger will pass, and isn't going to hurt her the way fear would. You're probably dealing with her anger during the daytime hours over things like not being able to pull out the cat's fur or drink the bubble liquid, so this is no different.

Nights 4-6, whenever she wakes up you can use any comforting method to get her back to sleep as long as you don't nurse. Cuddling, rocking, singing, walking, etc. Your partner is going to get a work-out for the first day or two of this phase, but this is the moneymaker of the whole plan.

Nights 7-10, whenever she wakes up you can soothe her, but don't pick her up. You can cuddle or sing or "shhh" or rub her back or whatever soothes her, just don't pick her up.

This is all supposed to be gentle, so if she really freaks out about it, pull back and try again in another week or two, but bear in mind that she's not going to like not falling asleep nursing so she's going to be angry for the first few nights anyway. By night 10 she may still wake up occasionally in the middle of the night, but she will be out of the habit of nursing whenever she wakes up. Eventually she'll start waking up later and later or just not at all.

I think you'll have an easier time only changing one thing at a time, so don't try to nightwean and stop co-sleeping at the same time. And don't try to wean all at once. That's a recipe for a stressed-out kid and mastitis and/or depression (from the sudden hormone drop) for you.

I woudn't give her milk in the middle of the night. If you do the 10-night plan, you shouldn't need it, and if you decide not to do the 10-night plan I think giving milk will put you in the same bind you're in now. In general I think people (including kids) should have water available to them in the middle of the night, because sometimes a person just gets thirsty, but I wouldn't try to do a direct breast-to-water swapout. Part of our nighttime routine became filling the water sippy and leaving it beside El Chico's bed, so if you want her to have water at hand you could try that.

If you do nothing at all she will eventually grow out of this (no one has to take their mother along to college, after all). But it sounds like it's really time for you to get more than a few hours of sleep in a row, so don't feel bad about nightweaning, and don't feel bad about what you've done so far. You have to stay true to the kind of parent you want to be and do what makes you comfortable. So no second-guessing and no regrets. I hope the nightweaning goes smoothly and easily, and you get some more sleep.