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When CIO Is Not An Option: The Tension Increaser

When CIO Is Not An Option: The Tension Increaser

By Amalah

Hi!

I love your column, and I have a six-month old daughter that is giving me sleep grief right now. She had been waking twice a night for months, including the dread four month sleep regression, but two weeks before she turned six months she started waking up more. Sometimes four or five times a night. And, playing my tiny violin, my husband works 100+ hours a week (yay residency), so I am butt tired.

So I thought I had everything figured out: she goes down awake (wide awake, not drowsy), in a sleep sack, in a crib that is safe and boring, white noise, blackout shades, same darn routine every time. But someone suggested that I had to feed her at least 20 minutes before put down, that I probably had a feed – sleep association. So I tried that last night, and she only woke up three times.

Here’s the deal, though. I can predict whether or not she will go to sleep on her own by whether or not she cries. If I put her down and she is happy, she will go to sleep on her own. If she starts crying, however, she cries and cries and cries and cries and sometimes barfs. This is whether or not I am in the room. Total tension increaser. The only thing that turns off the crying is nursing or going out of the room and turning on the light.

So, how can I reduce night wakings caused by a feed-sleep association with a tension increaser since cry it out doesn’t work? Also, I have tried 10 minute checks, five minute checks, standing by the bed, sitting by the bed. If she can’t see me she is upset. If she can see that I’m not picking her up she is incensed.

HELP!

For everyone playing alone at home, go read the inimitable, original, momblogosphere-breaking posts on Ask Moxie about tension increasers and tension decreasers, and why it’s important to understand which “type” of baby you have before implementing any sort of sleep training program. For a tension increaser, ANY cry- or fuss-it-out method, will be a stressful disaster of fail. For a tension decreaser, rushing to comfort or intervene at the first sounds of crying/fussing will really, truly only make things worse.

It’s a personality trait, really — I was a baby who needed to fuss a little before settling down on my own, and now I am an adult who sometimes deals with stress by “having a good cry” over a sad movie. I tear up during sad commercials, the emotion passes, and I feel fine. My tension decreases if I let myself FEEL my feelings of sadness/anxiety/panic rather than fight them.

A tension increaser would be the opposite. They find crying to be unbearably stressful, and have trouble stopping the tears once they start. Crying over a sad movie can morph into crying over something in real life and 20 minutes later they’re just crying and panicking about everything. Afterwards, they feel exhausted and drained. They need to take a proactive approach to dealing with stress/sadness/fear BEFORE it hits their eye sockets.

My children are fellow tension decreasers, across the board, though my youngest kept me pretty confused for the first eight months or so. He very much needed a gradual extinction method to keep his crying from building into hysterics, but I never had to deal with a baby who would get so worked up he’d vomit or take 45 minutes post-cry to calm down.

(I just basically admitted that I have no personal experience with this topic and therefore have no business writing a completely useless column about it, but oh well. LOOK AT ME TYPING ANYWAY!)

So the best path to good sleep with a tension increaser is do. Whatever. You need to do. To keep the crying from starting. Hold her, rock her, comfort her. You’re gonna want to chuck the Ferber book and check out The No-Cry Sleep Solution.

But sleep crutches! Food-sleep associations! If I go in and nurse her a million times a night I’m going to be nursing her a million times a night until kindergarten!

I know, I know. But the rules are different for YOUR baby. For YOUR baby, by NOT doing all the things that make her incensed, and by doing the things she NEEDS in order to go to bed HAPPY, you will gradually decrease her overall tension and anxiety. And that will lead to better, less interrupted sleep. Eventually. In theory.

As Madga (aka Ask Moxie) put it so well in the posts I linked to, this is about accepting your baby’s unique personality and setting your expectations accordingly. Don’t do things that lead to crying at bedtime, even just a little. If she starts crying, pick her up before it escalates. Get her happy, try again.

(You didn’t mention her schedule and what time you’re putting her down, but if she’s getting harder to keep happy at bedtime that COULD mean she’s overtired and bedtime is set too late.)

If you find that the feeding-20-minutes-before-bed thing continues to cut down on the number of night wakings, that’s great! Just make the next 20 minutes as pleasant and calming and happy-making as possible. Read a book, sing some songs, give her a lavender bath.  Try a musical crib soother instead of a “boring crib” and see if that helps with the transition into bed.

The night wakings could be from SO MANY THINGS, not just a food/sleep association. Growth and developmental spurts, teething, separation anxiety, etc. Fallout from the sleep regression and the failed attempts at sleep training. Again, IN THEORY, if you make keeping her happy at bedtime your 100% top focus/priority, her sleep patterns might improve on their own as her tension levels stay low. Don’t fight the night wakings, just get in, get her happy, get out.

Photo source: Photodune.net

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Comments

  • Alyssa

    I just want to add that she could genuinely be hungry or thirsty at night and that is why she is waking. (I know that sucks to think about) My 2 oldest didn’t sleep through the night until just past a year and even now they still wake up for drinks (at 2 yrs & 4 yrs). If I leave water in their room, I don’t hear from them, but if I forget, they wake up for real. I have to drink 2-3 times a night myself or I wake up painfully dehydrated.

    So if she’s co-ordinated enough, maybe a sippy of water in her bed? If she likes to play to sleep maybe a couple safe toys or books.

  • Thank you for this post

    My first baby was the same way.  CIO would not work for us because that little boy really liked (and still does!) to eat.  Although I wouldn’t let him nurse all the way to sleep at his night wakings, I would nurse him to calm him down, even if it was only for a little and then he would be relaxed enough to sleep.  Now a toddler, the very occasional night wakings are dealt with by tucking him in and sitting next to him until he is calm enough to go back to sleep on his own.  Last thing to add, my baby took a little over a year to consistently sleep through the night (the 5am waking took forever! to get rid of).  But you know what?  He needed to eat during the one waking.  When I accepted this and realized that baby sleep is all just stages, it was when we found a sleep routine that worked for us.  This is a stage in life and it will get better!  Promise! 

  • Anna

    Have you considered reflux? Some babies with the condition can be really uncomfortable lying down straight after a feed – might be why the 20 minute break works so well? Once we figured out our second had this issue we started keeping him upright after each feed, including night feeds that we kept to a minimum and things improved quite a bit!

  • Anna

    Trying again after a comment submitted too quickly: Have you considered reflux? Some babies with the condition can be really uncomfortable lying down straight after a feed – might be why the 20 minute break works so well? Once we figured out our second had this issue we started keeping him upright after each feed, including night feeds that we kept to a minimum and things improved quite a bit!

  • Life-Changing

    HOLY S*IT. This is it, the answer to all my burning late-night questions. I can’t believe that in all my internet searches, I never ran across this concept of tension-increasers / tension-decreasers. I have a classic tension-increaser (who doesn’t cry to the point of throwing up, but will cry hysterically and increasing over HOURS). This is life-changing. 

    Thank you Amalah!

    • Melissa

      Oh my GOD here too! Except… does this still apply to a 33 month old? My daughter used to go to bed drowsy and happy and easy but lately clings to us and cries and if we dare to walk away from her before she deems it time and has started working herself into such a fit that she pukes. Frankly, I’d rather rock her for 20 extra minutes than clean up puke at 2am. But I always feel so guilty that I’m creating bad sleep habits. Now at least I think I have a light at the end of tunnel and we can try an earlier bedtime but rest assured that if it takes a little longer, it’s at least justified 🙂 

      • Kate

        Yes, as Amy said it’s a personality trait that follows us throughout our lives. My oldest is a decreaser and it only took 2 days to sleep train for a grand total of about 30 min. Today at almost 7 he’s exactly the same; when he’s upset he’ll go up to his room to have a little cry and then he’s calm.

         My daughter took forever to figure out a sleep solution because she’s a tension increaser. I spent a lot of time sitting in the glider in the nursery while she putzed around in her crib before finally falling asleep. We had better and worse periods but just before she was 2 she was waking up screaming multiple times a night and I’d have to stay with her until she fell back asleep. Then we stayed at my mom’s house for vacation and they had to share a room and suddenly she was fine because she wasn’t alone. Now she’s 4.5 and still won’t go to sleep without someone else in the room but as long as she’s not alone she’s fine. She’s also still prone to hysterics so if she starts crying you have to nip it in the bud because 9/10 times she will wind up hyperventilating if you don’t.

  • MJH

    I don’t know what I think. I do know that my kid was the same way. If we laid her down and she didn’t cry, she’d put herself to sleep. If we laid her down and she start crying…well, I didn’t know what would happen! I really don’t know how you would even make sure you had a happy baby at bedtime. That’s not something I could guarantee. Lying her down in the crib would sometimes be the thing that would make her unhappy.

    Anyway, we decided to CIO. And she worked herself up into a lather the first few nights. But then she’d go to sleep! And this wasn’t oh a little fussing to get settled. This was full-on angry crying. The kind that isn’t fun to hear. How long, LW, did you let her cry? Was it hours? 5 minutes? 25 minutes? We were fortunate that our crier didn’t cry for more than probably 20 minutes at most, so much less stressful than some CIO stories. I just want to make sure you’re giving it the full chance!

    Anyway, after a few nights she caught on and that worked and she’s been sleeping through the night ever since. But there’s no way I could’ve diagnosed her as an increaser/decreaser. Maybe? Both? 

  • Elizabeth

    Can you gradually replace the nursing with something comforting but not as awesome as nursing? For my son it was rocking in the rocking chair (which was a total pita, but worked after about a week). For my daughter firm (not hard but so she could feel it) pats on the back/diaper (she was over a year then and likes to sleep on her stomach) work. They wouldn’t cry because I was there but it wasn’t as exciting as getting to nurse so eventually they decided to sleep instead.

    • Ros

      For my daughter, the rocking chair worked WONDERS but only if it was her dad (if it’s mama, boob is an option and why is it not in her mouth *crisis*). And then, after her dad had mostly taken that over for a while, I started being able to rock her without nursing her. Gradually altering expectations, basically.

  • Ros

    No actual suggestions for the situation at hand, but a word to say about the whole ‘if you comfort them to sleep you’ll still be boob-ing them in the middle of the night in kindergarten!’ BS that freaks people out. 

    Look: my baby was the type of baby who needed to touch someone. At. All. Times. She’d sleep on me, or on her dad, or curled up in my bed against my stomach, but if I rolled over and didn’t keep a hand on her while she was sleeping? Bam. Awake within 20 minutes. So, we co-slept, and boob-ed a lot at 2am, and despaired of ever having a life. 

    And, at a year old almost to the day, she suddenly learned to sleep without needing to be touched. We moved her to her own bedroom, and (miraculously), she started sleeping through the night (12 hours straight!!) within 2 weeks. 

    So, general advice: do what works, regain sanity, try something else. If sleeping NOW is making NOW something you can deal with, then maybe try that for a while and proceed to try again in a month or two. Do what you gotta do – you’re not gonna irreperably ruin anything. 

  • Pingback: Is Your Baby/Kid a Tension Increaser or Tension Decreaser? | Far Out City()

  • Jeannie

    I just want to second Ros’ comment — I had tension increaser, one who didn’t sleep through the night until he was 2.5. And what worked was making him happy, because then he would sleep. A lot. And so I slept. A lot. And for us that meant co-sleeping, which wasn’t my first choice but meant that both of us were sleeping, so … had to be done.

    And as for setting up bad habits? Well, he’s nine now, and doesn’t need adults or cuddling or any other sleep aid. And weaning him off those things was easy once he was ready. Anyone who tells you that you will irreparably harm your kid by X or Y sleep aid is wrong. She will get there when she gets there, and in the meantime, do what you can to maximize sleep — hers and yours.

  • K

    Jeannie and Ro again. We ended up co-sleeping. And you know what? It’s a great example of something we just thought we would never do, but it was what got us through that first year. And I learned a lot about sleep and babies, when I stopped trying to get my baby to sleep and just followed his lead a little more. And when we were all feeling like it wasn’t working anymore, we switched tactics and things took time but the adjustment was much easier a little later. The biggest mistake I made with our kid was to try to “make” him sleep on a certain schedule or a certain way. Instead I tried to meet him halfway until he was a little older and easier to deal with. And for awhile, I just needed to accept that while I would have loved to not get up 3 times a night with a six through nine month old, it was just a phase (a long one) but just doing what worked made it much easier and eventually everything worked out. We have a 3, almost 4 year old who never gets out of his bed at night and sleeps well. But you better believe everyone was like “sleep crutch” and “you will never get him out of your bed!!” – dude, we totally did. At one year he peacefully and mostly without protest slept in his crib. He just needed to be a little more ready. So. Do what Amy says. Get that baby happy. And if that doesn’t work, just get ready to adjust your own expectations of what under a year old sleep looks like.

  • Allison

    Dude, call grandma over for an afternoon of baby snuggles and take a nap! I found that if bedtime is crap and you feel like crap, the best thing to do is find time for a nap before you explode. And if the house gets a little messy in this sleep deprived fog you are living in, just embrace it. (Ain’t nobody got time for that!)

  • MR

    Where was all this information when my first was a baby?! Even reading this brief description it is obvious that she was/is a tension increaser. I wish I had known that, although honestly CIO was our only option since she was also an AWFUL sleeper and I was SOOOOO sleep deprived I was literally going crazy. We had tried cosleeping (my preference actually), but she kept kicking my cesarean scar and talked in her sleep so much that I didn’t get any sleep. But CIO was awful for all of us, and now I know why. She is 7 now and this still applies to her. Now I’m off to read more about this!

  • Maddy

    Your daughter sounds a bit like my son, definitely the getting so worked up crying that he would vomit, last thing you need!
    Two suggestions from the no cry sleep solution that I found useful were introducing a cuddly/lovey toy and making the cot as comfortable as possible and a fun place to be, which at first meant spending some time playing in there with him and lots of toys etc in the daytime. He is mostly sleeping through now at 16 months but it was a gradual process, and the most improvement came when I stopped breast feeding him at night a bit after 12 months, at first he wanted formula somewhere between 3 and 5 but this eventually stopped too. Hang in there, it will get better! (and don’t feel bad about all the people who will tell you that their babies are sleeping through already and to just let him cry, they are all different)

  • Myriam

    I coslept with my 2nd daughter for 7 months, nursing on demand, several times a night. But by that point, she wasn’t sleeping well anymore. She would fuss and nurse and cry and nurse all night long. She was ready for her own bed, but had no idea how to fall asleep on her own. Even nap were on me, or in the carrier or stroller. I’m no good with long-drawn out method, I lack the consistency needed. So we went with a 5-10-15 method (www.sleepyplanet.com). She did cry for longer than 10 minutes and it did escalate to vomiting (she tends to stop swallowing her spit when crying, then gags on said spit…). But the method explained how to deal with in, and with 3 nights, she had stopped the “escalading” part of the crying, and was fussing for a few minutes before falling asleep. I think a CIO method “can work” with some tension increaser, but probably not all. And I would definitely suggest finding a method you are comfortable with, reading the book cover to cover and apply the method exactly as described, to maximize your chances of success. For us, there was no “doing what works”, because nothing worked anymore…

    • Myriam

      We kept night feeding until 14 months, but used the dreamfeed method (twice a night until 10 months, then once a night until 14 months).

  • S

    Another vote for consider reflux. My son could not cry it out, it just made it worse. You mentioned being in the light. My daughter falls asleep with the light on. She now can tell us she is afraid of the dark. A nightlight doesn’t cut it. She is still particular about a specific routine, blanket etc.

  • Lise

    Our third is a tension increaser while our first two were tension decreasers and as you can imagine we basically feel like first-time parents all over again! It got particularly awful around 6-7 months. She was waking up every 4 hours to nurse and I was losing my mind. My husband started giving her 4 oz of formula at midnight and boom. She’d sleep until 8 am. It was incredible. INCREDIBLE. 

    This is the first time I’m regularly supplementing. I did a year of breastfeeding only with my first two. I know there’s a ton of debate about supplementing undermining your milk supply, and it’s totally worth checking out, but for a baby who’s waking up that frequently to nurse (and a mom losing that much sleep) I would try sending her off with a full belly one night and see what happens. And FWIW now my daughter’s at 9 months and weaning OFF the nightly bottle of formula – between me getting more rest and upping her solids intake, she’s getting enough without supplementing. 

    I hope you figure something out! Mama has to SLEEP (and baby, too).

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  • Letter Writer

    Hi all! Letter writer here. 

    So I am a total tension increaser, haha! Funny how I never thought about that. I hardly ever cry, but when I do it is epic, I hyperventilate, and I have a really hard time stopping. And I’m a grown up!

    Things have gotten better since I wrote that letter, and we are back to two or three wake ups to eat, AND she stopped being hysterical when she woke up. I still don’t understand why she doesn’t seem to sleep more than 5 hours at a time, but it’s where we are at, and I can’t handle screaming in the middle of the night.

    I did do a lot of work to make bedtime extra snuggly and fun – I read Sleepless in America between posting this and getting the response – and it was really helpful. It talked a lot about the need to help your child feel safe, calm and relaxed before bedtime. Duh!

    I don’t know what to do about the night feedings – I don’t mind two, but three feels painful. I think it’s all in my head. I am trying to nap more, though, and my mom comes over once a week now to give me a break. So all told, things are looking up!

    Thanks again, Amalah, and everyone who responded.
    🙂

  • Janna

    We would nurse/feed my daughter until she was very sleepy and put her in her crib… and she would nod off and sleep through the night. We never tried to insert the 20 mins of awake time and never had a problem with sleeping until 2 1/2 and her crib side came down. Now she likes to come into our room at 4:30 in the morning to see what she’s missing!

  • Melissa

    My 2nd was not a sleeper either. She’s 7 now and she still isn’t. What worked for us was giving her something else to do when she woke that didn’t involve us. We hung one of those crib rail aquarium things that plays music and the little fish kind of move around. She figured that out very quickly and we would hear it go off 4-5 times a night but it gave her something to do and it wasn’t long before we didn’t have to go in at all. She used that thing until she was about 4 attached to her bed. To this day, at 7.5 she still wakes up for a long stretch every night so we decided not to fight it and she has books or headphones and music and it just lets her reset for her second period of sleep. I think maybe some people are just not solid sleepers so you do what you have to do that equals momma-sleep. Best of luck to you!