The Sleep Survival Zone

Dear Amy,

This first time mom needs help undoing some bad sleep habits that I admittedly let my four month old son develop.

My son had all sorts of stomach issues when he was born. We finally got a diagnosis of bad reflux and lactose sensitivity, but it was a lot if trial and error to get there. He is now on Zantac and special formula and gaining weight like a champ. He also is now (mostly) sleeping through the night. But prior to figuring out what was wrong, he was up every one and a half to two hours at night and would only do 15-20 minute catnaps during the day.

I have a very fast paced, demanding career which I love, but the office doesn’t fall under FMLA requirements and I only got 6 weeks of unpaid maternity leave. And my husband left with the military the day before I went back to work. So starting at 6 weeks, and dealing with all these stomach issues, I was doing it by myself while working and was willing to do ANYTHING to get this kid to sleep more than 60 minutes at a time.

So now, at 4 months, he is very dependent on a bottle to fall asleep (but refuses every pacifier ever created), and won’t sleep anywhere except in my arms or in the rock and play with the vibration on. And has a hard time staying asleep unless I keep pushing the button to keep the vibration on. I’m trying to transition him into the pack and play but it’s been awful. I’ve inclined the mattress, I’ve stuck a vibration thingy on the side of the mattress, I’ve given him the bottle while laying in the pack and play, I’ve set him in there after he’s asleep (never stays asleep longer than 20 minutes). I’ve tried being in his sight, out of his sight, white noise, nightlights, total darkness, swaddling…..Nothing works. I’ve also tried cry it out (which I hate), but after 15 minutes and him working himself up to heart wrenching wails, I just can’t do it. He just can’t self soothe.

He’s about to outgrow the rock and play and I’m about to put him into daycare two days a week because of current relative babysitting issues (which is a different can of worms entirely). I have to get this munchkin to sleep! Help!  (Update from Editor: The Rock-n-Play and other bouncers and sleepers with over 10 degrees in incline are not approved as safe for sleeping.)

Desperate FTM

Okay, here’s what I want you to do:

RELAX.

I doubt there’s a four month old out there who isn’t still reliant on some kind of sleep association/crutch (or two, or four). I always think of the first three months with a newborn are a solid “do whatever it takes” survival zone. Baby only wants to be held, co-sleep, sleep in a swing or carseat, nurse/bottle-feed to sleep, use your knuckle as a pacifier all night, FINE. DO IT.

(Within reason, of course. I don’t care how much better some newborns sleep on their tummies or nestled among a sea of pillows or on the couch…that’s all patently, hugely unsafe. We’re talking common-sense concessions here.)

And then yes, around 12 weeks old I think you can start getting serious about creating more of a nap/sleep schedule and consistent routine. But understand that for most babies, it’s NOT going to be an overnight transition where they’re just like, “okay cool, a crib, I guess I sleep here now zzzz.” And that it’s NOT a sign that you’re doing all the things wrong and/or have irrevocably ruined your child’s chance at healthy sleep habits.

There’s ALSO this little thing called the four-month sleep regression, where any good habits you maybe managed to establish in the earlier weeks tend to go completely out the window. Which is why I personally don’t recommend (or see much point to) trying to formally sleep train before six months. Ride out the regression at around three/four months, focus on mapping out a good daytime sleep schedule (the 2/3/4 schedule works well at this age), and more or less keep doing whatever you need to do to ensure maximum sleep at night.

Since your son has reflux, he’s going to be super-resistant to lying on his back in a crib, even at an incline. It’s going to more uncomfortable for him that the “average” infant (who will still put up a good fight about it as well), which is another reason I suggest tabling your concerns for a couple more months. At six months (around the time when he’ll be ready for solids), his esophagus will be better developed so you’ll likely see a marked improvement in the tummy/reflux department. Which means you’ll see a marked improvement in his ability to tolerate a different sleeping arrangement. Not necessarily his WILLINGNESS, but he’ll at least be physically ready, and you can embark on a GENTLE sleep training regimen. (I DO NOT recommend straight-up CIO. A gradual “fuss it out” extinction method like Ferber will get the job done without thoroughly traumatizing everybody involved.) But know that some reflux babies really can’t sleep on their backs until 7/8 months, so keep your expectations reasonable.

As the Rock-n-Play will pose a serious safety concern for him, I definitely can’t recommend that you use it past the age/weight guidelines. Which means you might end up having to hold him or co-cleep (SAFELY) until his reflux issues improve a bit more and you are ready to give sleep-training (again, NOT CIO) a try. And cut yourself some slack about it. Reflux babies have different sleep needs than what all the baby books describe. It is what it is, you do whatever you have to do. (Update from Editor: The Rock-n-Play and other bouncers and sleepers with over 10 degrees in incline are not approved as safe for sleeping.)

(As an aside, I haven’t examined a recent/new model Pack-n-Play, but on the one I had, the standard mattress was admittedly pretty uncomfortable. I’d use it in a pinch for naps or travel but I don’t think I could’ve expected my babies to be happy sleeping there full-time without a serious mattress upgrade. If you’ve already bought a better mattress for it, great! Ignore me.)

As for the daycare concerns…honestly daycare was a damn Christmas MIRACLE when it came to my oldest son’s sleep habits. He was 12 weeks old and had been (mostly) sleeping through the night for about a month, but his nap schedule was a hot mess and as time went on I could see our awesome nights of sleep going increasingly AWOL because he was so overtired. Daycare got him on the 2/3/4 nap schedule so freaking fast I couldn’t believe it. I followed their lead the first weekend at home and it was like…oh. Wow. Look at that. NAPS ARE A THING THAT CAN HAPPEN.

So again: Relax. Relax relax relax. Your baby isn’t broken, he’s just still really tiny. Enjoy him.