Ask Moxie

Q&A: Baby food sensitivities

Sarah has a question that's beyond me, so I hope there's someone out there who can unravel it for her:

"I just wanted to ask you about my son's sleep problems. He's now nearly 11 months old, and he's suffered from gas pains since he was born. I hoped when he was first born that he would start to grow out of it at 6 weeks, as everyone told me he would, but he didn't. If anything, it intensified. He exhibited the classic signs of colic - drawing his knees up and crying. This would happen exactly two hours after he ate (he is formula fed - I tried breastfeeding but after three bouts of mastitis, flat nipples and chronic thrush I gave it up for a bad job), then he would sleep until his next feed. He would then be happy for two hours, then the colicky symptoms then sleep etc etc. As he grew older, at around 6-8 months, he started crying in his sleep at night then waking up screaming and impossible to console. I did think that perhaps he was having nightmares, but my mother in law assured me that he was too young for nightmares, and on the nights he stayed with her he would do this and then burp or pass wind then go back to sleep, so she assumed it was a gas pain problem. Over time, I see now that she is correct in this - when he does it now, I pick him up and generally he burps and then is calm for a couple of hours.

We discovered over the course of time that elevating his legs seems to alleviate the pain. As a result of his frequent wakings and the need to elevate his legs, we've ended up co-sleeping rather than pogoing out of bed every couple of hours to sort him out. I did think that he would grow out of this at 8 months when his digestive system matured, but it still persists. Even eating solids hasn't solved the problem. I suspect the problem may be yeast related - he had problems with this from the breastfeeding days, and he had the last white patches in his mouth at about 7 months. He also has a persistent diaper rash that doesn't clear up with zinc oxide. I haven't tried thrush creams on it yet, but that will be my next port of call. He's eating half a pot of probiotic yogurt a day to try to combat this, but it doesn't seem to be having any effect. As yet, the health professionals seem unconcerned (however, we do live in the UK where extensive testing for digestive abnormalities doesn't happen due to the constraints on the national health system), but since it seems to have not abated at all, I'm starting to get quite concerned about him. He also has a slight wheeze which intensifies when he eats a new food. In case you were thinking it may be milk related, I've tried him on hydrolised protein formulas and lactase drops and these had no effect either. I recently switched him to iron fortified follow on milk and the wind seemed to get a bit worse.

Do you have any ideas on this? I'm at my wits end, having not slept for more than three hours at a stretch for nearly a year...

My gut reaction is that it's definitely dairy related and that she needs to take him off dairy completely, make sure there's no wheat in his diet, and be aggressive about treating the yeast. But I don't really know where to start on that if he's taking probiotics already.

Is there anyone with more experience with food sensitivities, dairy intolerance, celiac, or yeast issues who could offer some thoughts?

Talk about the 9-month sleep regression

I had a request to put up a post where you guys could talk about how you're dealing with or not dealing well with the 9-month sleep regression.

To recap, this is the period encompassing the developmental leap at week 37 and the one at week 46. Very very often there's also some teething mixed in there, and learning to crawl and/or pull up and/or cruise and/or walk.

Which means you've got a brain working on developmental stuff that won't let the kid sleep, a brain and body working on movement that won't let the kid sleep, and maybe some random shooting or throbbing gum and jaw pain in there, too.

In other words, you're going to have to accept that the kid just can't sleep straight through until some of this is over with.

(We haven't even mentioned how this sleep regression can affect other stuff, too, like naps and mood and clinginess and what they'll eat and won't eat. Some kids who keep sleeping at night just wig out during the day--that's their particular reaction to the developmental spurts.)

Which means your plan shifts from Get Kid To Stay Asleep to Maximize Sleep For Everyone Else. This is not the time to pretend you know what's going on or that you have it all under control. This is not the time to say "your job is this and mine is that." It's the time to divide up the schedule so everyone gets 5 hours at a stretch if possible. If one of you has to go to sleep at 8 pm and take the 8-1 shift so the other has the 1-6 shift, do it.

Here are the important things to remember: Lots of us have been through it. You will get through it. There is nothing inherently wrong with your child--this is normal. Hideous and demoralizing, but normal. You're doing a good job.

Now, commiserators?

Q&A: apartment living with a baby

Laura writes:

"I love your site and check it daily; you are a guru to me, as you are to many!

I wonder if you have advice to offer about living in small spaces with a baby. Ours is four months old; we live in San Francisco. Our apartment is tiny, and his crib is in our room. We're about to start sleep-training,
and wonder if it's possible to do in a small apartment, with neighbors close by, but we're desperate for more sleep.

I'm also suffering a lot of guilt over not being able to provide a separate room for my child (the apartment is so small that we can't even partition a room with screens, or move our bed into a living room). We
can't afford to move, and Bay Area home prices are so high that we'll never be able to purchase a home. Yet most of my friends have nurseries for their babies, and almost every book I read assumes that the reader has a separate room for the baby. I feel very guilty as a result: will he resent us someday? will he be okay if he doesn't have his own room? Any words of wisdom?"

Thanks. I actually prefer charismatic leader, but guru will do just fine*.

First off, do not sleep train until your son is past the four-month-sleep regression. That regression sucks so much anyway that adding sleep training into it (which is going to suck 40 times more than it normally would if you do it in the middle of a sleep regression) will make you all long for the sweet release of hospitalization. So hold on 'til he's past the 19-week spurt to train, at which point you may not need to train anyway. (The irony--it's the regression that makes you want to train him, but the regression that makes training largely futile. Then once it's no longer futile, he'll sleep better on his own.)

Did we mention that four months sucks in general?

But on to the space question. I think you have two choices: Stay where you are, or move someplace where you can have more room. Either way you gain something, and either way you give something up.

Honestly, I don't think there's any way to know whether he'll resent you for it until he's grown up. I suspect that how he feels about how he grew up will have more to do with his relationship to you and your husband than to the specifics of how much space you had.

I know adults who adored growing up in NYC. (FWIW, the NYC one-bedroom long-term solution seems to be to move the kid into the bedroom and have the parents sleep on a Murphy bed or pullout in the living room.) They feel like having all the of the cool stuff in the city was the best way to grow up, and feel sorry for kids who grew up with more space but less stimulation. The two women I know who grew up in NYC and hated it also had major family issues, so it doesn't surprise me that they have bad feeling about their growing-up years.

I know adults who adored growing up in the suburbs, or small towns, and the country. Big yards and forts and running around the neighborhood. But you know what they talk about when they talk about the way they grew up? What they did with their families and friends. It's the relationships that made their childhoods happy, and those relationships made the settings good for them.

So I think your decision to stay or go is going to have to be informed by other things, like what makes you feel comfortable (Would living in a crowded space stress you out? Would living outside a city enervate you?), whether you want to live closer or farther from your families, and whether you want to have more children or not. (From my observation, being an only is much more "normal" in cities than in other areas where most families have 2+ kids.)

If you're happy with yourselves and your marriage and your family and your son, he'll be fine growing up wherever you land.

Data points, people?

* I'm kidding, obviously. I'm so boringly normal. I have the same problems you guys do, and many others I hope you never experience. At this point writing the blog is just what I do, and I wish I had time to do more for you guys.

Sleep posts

You know what I think is funny about the comments on sleep posts here?

That different posts totally bring out commenters with different situations. Some posts draw tons of "try co-sleeping!" comments. Some draw "read Pantley!" comments. Some draw "read Ferber!" comments. Some draw "do CIO!" comments.

Which just goes to show you (or me, at least), that there is no one right answer for everyone. I've been fumbling toward trying to find some classification system so that we could make some kind of checklist and you could observe different aspects of your kid and then know which "method" (can you really call anything that makes you cry at 3 am a method?). Wouldn't that be awesome? Observe and answer these 50 questions about your kid, and then you'll know exactly how to proceed. (The "tension increaser" vs. "tension decreaser" observation was the first step in my plan for a taxonomy of sleep personalities and issues.)

Unfortunately, all we have to go on now is trying to figure out exactly what the problem is (going to sleep initially? staying asleep? nursing at night? waking early? all of the above?) and then trying different things to fix it until you either find something that works or pack the kid off to boarding school.

Remember that there are tons of things to try before you resort to doing something that isn't in your comfort zone (I'd put co-sleeping and true CIO--letting the child cry alone until s/he falls asleep no matter how long it takes--in those category of things that people might not be comfortable with). The Ferber method (not that he made it up, of course, but no one's great-great-great-great-great-great grandma wrote a book about it) of allowing the baby to cry for short chunks of time and then going in to check and make contact is one of them. In fact, the surefire way to tell if your baby is a tension decreaser who needs to cry some to fall asleep is to walk out and let the baby cry for 5-10 minutes and see what happens. That sounds a lot like Ferber to me. (If the baby starts to lose steam and quiet down, you've got a tension decreaser.)

If you've got the baby in the same room with one of you, try switching who the baby's with. A baby who nurses all night on mom might sleep the whole night through with dad. If the baby's in the same room, try switching the baby to a different room. Or vice versa.

In other words, if the pattern is bad, figure out exactly what part is bad, and try changing the structure of it. Sometimes just small changes will break the pattern.

The other thing that's really important to know is that no matter what you do, it's not going to stick. If you sleep train, you'll have to do it again, after sleep regressions and big teething spurts. If you co-sleep, you'll have to re-evaluate every time your kid goes through some developmental spurt and starts kicking you in the kidneys all night. So don't feel too smug or too desperate, because there's always someone better off and worse off than you are right now.

Anyone want to post something that either helped or hurt your kid's sleep that surprised you?

I'll go first.

Son #1: Went through a phase around the age of 2 in which he'd go to sleep just fine, but would then wake up screaming an hour later. It took a few weeks, but eventually we figured out that he was having heartburn/indigestion from eating tomato products at dinner! We put the kibosh on all tomatoes after 3 pm, and he stopped waking that first night.

Son #2: Wanted to nurse all night long with me. I went to sleep out on the couch and left him sleeping with his dad and he slept the whole night through. Occam's Razor in action: if I was there, he'd nurse; if I was gone, he wouldn't.

Now you go.

Sooo tired...

So I'm not doing well at getting to sleep by 10 or 10:30 at all. I just have so much to do, and my cycles seem to be off. I could totally fall asleep at 7 pm, but then get a second wind when I have all that stuff to do later on, so I end up staying up until midnight (or later!) and then I'm a wreck in the morning.

It doesn't help that the little one isn't falling asleep until 9:30 some days(!) and then he wakes up at 6:15. (Yes, I've tried taking away the nap, and it does nothing except make it worse for everyone.)

But I read this and realized I'm not the only one: One-third of workers catching zzz's on job. Holy crap, people--you can sleep at work?! If 1/3 of workers are actually falling asleep at work, how many of us are just tired?

And I guess I shouldn't feel so bad, since the average wake-up time is 5:35 am. That's just brutal.

I should also feel lucky, because once I finally do go to sleep I have no problems falling asleep and staying asleep (cats notwithstanding). I know some of you are having problems with that, though, so I thought those of us who sleep well could share with those of you who don't.

My top tips for sleep:

1. Don't have kids or pets. (Ha! OK, I know it's not really funny, but at least it reinforces the point that it's really not your fault.)

2. T-Tapp. Honestly, they should put me on the payroll at this point, but that was the first thing I noticed. Within two days of starting T-Tapp I was falling asleep and staying asleep. It helps your lymphatic system and your hormones, and somewhere in there it becomes easier to sleep.

3. Magnesium. It helps your body relax, and shortages can increase anxiety. Some people do foot soaks in warm water and magnesium oil a couple times a week. Others just take a calcium-magnesium supplement about 20 minutes before they go to bed.

4. Omega 3s and B vitamins. Help with the hormonal balance and decrease stress, so you can fall asleep.

5. Water! If you find that you end up in that half-sleep state in which you're asleep but it's not restful, you may be dehydrated. Drink some more water for a few days in a row and see if that helps.

6. Actually go to bed. That episode of Lost will still be on your DVR tomorrow.

Anyone else?

Q&A: rocking baby to sleep

Eric writes:

"I have been pouring over various entries in your blog for a while now and decided to ask you a few questions.  Based on different books (Ferber, Weissbluth, etc.) and doctor recommendations, my wife and I tried CIO and it was miserable...for us and our son.  It didn't feel right and we were reassured when we read your thoughts on babies who increase tension by crying.

We have found some success by rocking our son to sleep though it often seems to take ages for him to fall asleep.  This might seem ridiculous, but one question is about how to get our son into the crib without waking him once he does happen to fall asleep.  On several occasions, he has fallen asleep in our arms by rocking him to sleep but awakens as soon as we set him down in his crib.  Do you know of a successful way to put him in the crib without waking him up?  Also, what is your stance on rocking him to sleep?  I know that you suggest rocking as a way of calming a baby who increases tension through crying, but should we be letting him fully fall asleep in our arms?  The problem is that if we don't let him fall asleep in our arms and we attempt to soothe him while he is lying in the crib, it takes a much longer time and he seems to be more restless. 

We are experiencing other sleeping problems (night wakenings), but would really like to try to first tackle the issue of getting him to fall asleep without the nightly battle that it always has been.  I am not sure if his age would vary your response, but he is approximately 4.5 months old right now.  He was born approximately 3 weeks early due to my wife's development of HELLP Syndrome. 

Exhausted and eagerly awaiting your response,
Eric"

Ooh. Three things I hate combined into one post:

1) HELLP Syndrome. For those of you who don't know it, it's like turbo-ultra-mega preeclampsia, and is very serious. If the baby doesn't come out, the mother can seize and then her organs shut down and she dies. I'm glad Eric's wife and the baby came out of it healthy. We should all keep a close watch on our blodd pressure and the protein in our urine while pregnant.

2) The 4-month sleep regression. It just sucks. There's no way around it. 4.5 months minus 3 weeks puts Eric's baby smack in the middle of it. It's so so hard for babies to sleep at this age.

3) The cultural expectation that a baby that young should be able to go down awake and that if the baby can't it's something the parents are doing wrong.

Yeah, there are things you could be doing to screw up your kid's sleep. Some of them are obvious, like playing loud music at 10 pm in the same room your baby's in, or snorting coke while you're breastfeeding. Some of them are not so obvious, like drinking coffee in the morning while nursing(caffeine has a half-life of 96 hours in a baby's system--go figure--but it doesn't seem to affect some babies at all) or putting a kid in pajamas that make him/her too hot and sweaty all night.

But aside from a really small group of things, there's not much you can do to change the way your baby sleeps. It's largely a function of personality and age. If Eric's baby needs to be rocked to sleep, that's the way the kid is. It doesn't mean that he'll be like that forever, or even a month from now. Just that it's what's working now. By Any Means Necessary to get everyone as much sleep as possible.

So I think rocking your kid to sleep is fine, as is putting your baby in the swing, or nursing to sleep, or using a pacifier, or having the baby go to sleep with a comfort object or white noise machine or anything else people use. (If you use a comfort object, make sure you have a spare in case something happens to the primary one, or you're screwed.) You child will not need that thing forever, and you'll probably have a good instinct about when you can switch that thing out of the routine. At the very least, you'll do better making sleep changes in your child if you have some sleep under your belt, so think of it as strategic pacing.

But. If it takes forever to rock to sleep, I'd look and see if there's something else that might work better. Eric and his wife tried CIO so they know that doesn't work for their son. (In contrast, my second son didn't want to nurse or rock down, so I tried letting him cry and he fell right to sleep after a few minutes. Stunned me, since my first son would escalate if I let him cry for more than half a minute.) Maybe swaddling would work, or something else. I wouldn't be afraid to try other things, because they just might stumble onto something that will work faster than the rocking. Or maybe not, and the rocking is as good as it gets at this stage.

It's just awful staring down the barrel of a long, long bedtime routine (those of us in the 3-year-old sleep regression can sympathize). You're finally at the end of the day, and you know you're still facing an hour of getting the kid to sleep. No way around it but through it, but it still just makes you want to cry, and ask for your money back.

How many of us have suffered through the problem of getting the kid to sleep but then not being able to put the baby down into the crib?! It's the bloody hangnail of the first year of parenting. I've head suggestions of putting a heating pad/hot water bottle in the crib to leave it warm, then moving it right before you put the baby down, but I didn't have enough hands to do that. You can let the baby sleep for 20 minutes to get deep into the sleep cycle before putting him down (and then let all the blood rush back into your arms) and that might help. I've also heard that in Australia they don't have this problem because they all put their babies down to sleep on sheepskins, and the sheepskin magically keeps them asleep. Honeslty, I can't remember if I came up with anything good at that age because I was so sleep deprived that not much stuck from that phase.

So, can anyone solve the problem of putting the baby down into the crib and keeping the baby asleep? If you can patent it, you'll make mountains of money.

And if anyone else wants to sympathize or complain, please feel free.

 

The 2 1/2-3 year sleep regression

Can we just talk about this sleep regression?

I talk a lot here about the 4-month sleep regression (when you feel bewildered and bleak), the 8-9-month sleep regression (when you feel defeated and hopeless), and the 18-month sleep regression (when you feel insulted and irate). But I haven't talked much about the 3-year sleep regression. We're in the middle of it here (although he won't be 3 until May), so i thought maybe some of you would like to complain along with me.

The other sleep regressions seem to be characterized by frequent wakings throughout the night, but this 3-year one seems to be all about not going to sleep at bedtime. When he first goes into his bed at 8, and is still awake at 9:45, it starts to piss me off. There's only so much water a kid can drink, the monster-scarer is in full effect, the temperature is fine, and no you cannot come out and read with me. And, what's more, your brother needs to stay asleep so he won't be tired for school tomorrow.

Honestly, at this point I don't even care if the little one actually goes to sleep, I just want him to be quiet so he won't wake up his brother. (The progressive lowering of standards also seems to be characteristic of the 3-year sleep regression.)

What I've finally come to is that I can provide him the opportunity to sleep, but cannot make him do it. We have a temporary peace with his staying in his bed quietly (so he doesn't wake his brother) and my not caring if he's asleep or not. I definitely don't think it's something he's doing on purpose. I think it's the same thing that happens at the other sleep regressions--the kids are working on something mentally or developmentally, and their bodies and minds just simply can't sleep right then.

This too shall pass.

Anyone else want to complain about the 3-year sleep regression? (And, moms of older kids, is there one coming at 6 years?)

Q&A; Rolling over in sleep...ACK!

I love it when readers answer their own questions. Nancy writes:

"File this under "don't brag about how your baby sleeps 11-12 hour per night" as it will come back to haunt you!  We sleep trained our 6 month old son with excellent results about 6 weeks ago and have had mostly amazing sleep-filled nights ever since (with the exception of a couple of teething incidents).  Last night at 1 am, he decided to roll over for the first time in his crib.  As he found himself on his belly, he immediately started screaming.  My husband flipped him over and was able to quickly get him back to sleep only to have him do the same thing again about an hour later.  This waking was much more involved and required about two hours of rocking, feeding, shushing to get him back to sleep.  He has very strong legs but his arms haven't quite caught up yet, and rolling over has been a pipe dream of his for the last month or so.  Any ideas about how to help him get through this? Is the prescription just lots of tummy time so he can master this milestone during the day?"

You've got it. He's more wakeful in general because he's working on the rolling over, and the only way around rolling over is through it.

There's no way to force a kid to get through physical milestones (hearing stories about someone "teaching" their kid to walk always makes me laugh), but the more a child can work on the skills the sooner s/he'll get good at them. So tummy time is exactly the prescription to end your nighttime wakeups.

Once he can roll over easily on his own, he'll stop waking himself up by rolling, and he'll also stop being up and cranky and needing to be soothed so much, because that part of his brain will be able to relax again.

You'll probably have to sleep train him all over again after this is over (the dirty little secret of sleep training), but depending on how old he is when he gets through this, you might be in the middle of the 8-9-month sleep regression. Which is one of the worst times to try to change your child's sleep, and will make you really frustrated. So I'm hoping he comes through it more quickly and you can get on a more even keel first, but if you end up with this movement leap transitioning into the developmental stuff of 8-9 months, just know that it won't last forever, and he will sleep all night again eventually.

Oh, and here's a good point to mention that although we're all told to make sure our kids sleep on their backs, once they can roll onto their stomachs we can let them keep sleeping that way (if they will).

Comments on rolling? Milestones? The upcoming weekend? Which of the new toys are still in favor and which ones have already been ignored?

Help for parents of early wakers?

I've been getting several emails from parents who have toddlers waking up really early (like 5 am). The kids are obviously still tired, but can't get back to sleep or stay asleep. Then they're cranky for the rest of the day.

I'm sure many of us have gone through this on limited occasions (it happened in my house yesterday, which is why I didn't post and was foggy at work all day), but having it happen morning after morning would be truly demoralizing.

Here are the things I've suggested:

• Blackout shades on the windows. You can buy actual blackout shades, or you can buy blackout material at a fabric store, or even just heavy drapery cloth and make your own.
• Mess around with bedtime. Sometimes it seems like the kids are just in the wrong place in the sleep cycle, and that's why they wake up. So switching the starting sleep time around might alleviate the problem. (I also think it may be sort of the same effect whacking the side of the TV has to get it to stop fuzzing out, but that's just me.) As counter-intuitive as it sounds, I'd start with bumping the bedtime earlier, unless you've already got a 7 pm bedtime, in which I'd try 8 pm. (FWIW, it seems to me just from hearing people talk that most kids have a sleep-time sweet spot between 7 and 8 pm, so if you're totally up in the air I'd start with 7 and see where it gets you.)
• Check out the naps. How old is your kid? Most kids older than 18 months are down to one nap a day, in the early afternoon. If your toddler is still taking two naps, the early waking might be part of trying to drop the second nap. Messing around with that might give you some more information.
• Look at what your kid's eating. I think diet problems (including bad reactions to artificial things or acids, and reflux) usually manifest themselves earlier in the night (waking up screaming an hour after going to bed is a classic sign of reflux or too much acid, for example). But you never know. Anything that's causing stress on a kid's system can make the difference between being able to go back to sleep after the slight arousal of finishing one sleep cycle, and if they're having a tummy problem of any sort, that could do it.
• "Psychological" causes. I didn't know what else to call it, but some kids go through a monster phase, when they wake up and are scared of random things or of monsters or of being alone. You could definitely try some kind of monster-scarer or other comfort object (I think you'll have better success with something you get specifically to scare away the bad things than just trying to use an old comfort object) and explain that it will help them get back to sleep in the middle of the night and keep them safe.

But if none of this is working, what do you guys recommend? Like everything else in parenting, you could just wait it out. But if your child is desperately tired, and you can barely function at work, you need to  get everyone sleeping longer ASAP.

Does anyone want to offer solutions, suggestions, anecdotes, or commiseration?

Q&A: crib mattresses

Merry Christmas to those who celebrate it!

Speaking of a sleeping baby, Kristen writes:

"What are your thoughts about the flame retardants in crib mattresses?  Should we be concerned about the chemicals in our mattress and our baby's mattress?  I was looking into getting a rubber mattress but I can't get any solid non-bias information."

I can't imagine that those flame retardants can be good for anyone, least of all babies*. If you can afford it, I'd definitely look into an all-natural (rubber or organic cotton) mattress for your child's bed.

However, the price difference is enormous between a regular mattress and an all-natural one. I'm about to switch my younger son from his crib into a twin-sized bed, and the gap between What I Can Afford For a Mattress and the price of an organic cotton mattress is truly insurmountable. (Unless there's some organic cotton mattress company who'd like to send me a twin-sized one to review for this site.)

I'm going to try to mitigate some of the effects of the toxic traditional mattress by putting down a wool blanket under the mattress pad (yes, they make wool mattress pads, but those are expensive, and my mother has wool blankets aplenty to give me), which will also provide some waterproofing as we head into nighttime potty training. (Of course this is no help for kids who are allergic to wool.) I'm also going to hope that the pillow acts as a buffer between any fumes and his nose.

Anyone else have anything on crib mattresses?

* Hey, if your baby doesn't sleep all that well, at least that's one good thing about it--they're not breathing in all the crib mattress fumes as much as the better-sleeping babies are. Come on, you knew you could get some snark here on Christmas Day.