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Wednesday, 23 November 2011

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The Internet at times seems to have two distinct camps - the "expect them to sleep 12 hours" side, and the "it's normal for babies to only nap for half an hour, never want to be put down/sleep on a chest and wake every hour at night" side.

I (as usual) don't fit in either.

I often read from other mothers that very broken sleep must be normal, because their baby does it - some babies, even teeny weeny ones just don't need sleep!  If mums have had several children and some slept great, others not - this reinforces the belief it is personality; and in the past I would have agreed.  We call these babies "spirited" or "high needs", Sears writes a whole chunk about them here; and I think his descriptions are fantastic; but I think we can break it down even further and am not convinced personality is the whole explanation.  Yes babies are meant to be held close on a chest - does this mean that it's therefore normal they never want to lay down?  Babies are meant to sleep next to mum, but did cave woman sleep standing up?

Partly I think this has arisen as direct opposition to the "expecting 12 hours sleep camp", IE embracing baby's cues and being responsive.  But for me responsive parenting can also include exploring if there is a reason baby may be struggling to relax, if the parents feel that's something they need to explore.  That is not the same as suggesting not addressing the reason will lead to "bad sleep habits" or a baby that never sleeps better, babies change a lot as their brains and bodies grow.  Some will naturally iron things out as they mature going into the second half of the first year, some may be nearer 3 or 4 and some may continue to struggle to get to sleep/rise early, although the signs may become more subtle as sleep requirements reduce.

I'm not talking about training them to sleep, leaving them to cry or enforcing strict routines - but really watching baby's body language and cues to see if this is normal personality stuff, or, if he is desperately trying to convey something with constant waking and/or an intense need to suck.

Many parents I have discussed this with are those who have posted seeking advice - and they've mentioned replies are often to co-sleep, sling wear etc; but as they pointed out, what if they're already doing all that and still feel they have an issue?  Some say mum shouldn't ever expect a good chunk of sleep, that this is parenting and again I agree that there will be times baby is fussy and unsettled at night, certainly it's normal for babies to nightfeed - but does that mean therefore that it's typical for a baby to never be settled and sleep for longer than an hour or so?

With a first baby this may be easier, mum can nap when baby naps, head off to bed with baby at 6pm should she fancy - but throw 2,3,4,5 or more other children in to the mix, and/or work outside the home - and things can be very different, some mums are so exhausted they can barely function.

Whilst reassuring mums things are normal can be helpful, and there is a wide range of normal, there is also a range of what parents can cope with -  some may stop co-sleeping/breastfeeding/responsive parenting in a bid to save their own sanity or because their gut instinct is something isn't right, yet they have no idea what.  Whether these "work" in terms of changing behaviour or not is irrelevant, the impact to baby can be significant.

I'm of the belief there can be several reasons for consistently very disturbed sleep patterns or indeed a spirited/high needs infant, none of which involve bad habits, breastfeeding to sleep or baby needing to sleep in a cot to (say it with me) create positive sleep associations.  My feeling is that frequent wakers seek comfort, not that they wake due to a habit or reliance on said comfort to remain asleep; but what I want to focus on today, because it's a matter close to my own heart is the Duracell Bunny Babies (DBB).

How do you know if you have one of these?

Generally if the comment: "just go with the flow, babies will always sleep when they're tired" makes you laugh out loud, it's a pretty good indication; well they might, but no longer than 35/40 minutes in one nap (consistently), even if exhausted.  In exchange they might take lots and lots of little naps, day and night - or may stay awake for most of the day from a very young age and then wake frequently at night too.

The reality is that some babies do not sleep well despite being tired.  Nope, Nada no way - DBB are called such because they rarely seem to run out of energy!

DBB's according to Sears are:
"HYPERACTIVE"
"This feature of high need babies, and its cousin hypertonic, are directly related to the quality of intensity. Hypertonic refers to muscles that are frequently tensed and ready to go, tight and waiting to explode into action. The muscles and mind of high need children are seldom relaxed or still. "Even as a newborn, I could feel the wiry in him," one mother related
."
Whilst many would recognise this in a toddler, being "tense and tight" are not characteristics we typically link with the label hyperactivity.  I like "hyper switched on/hyper alert", as I feel it's more descriptive.  Their muscles are often frequently tensed and tight - their muscles and minds do seldom relax, but is this always easy to recognise this in a baby?  I've put together some of the indicators I think define a DBB.:

Signs of a DBB:

  • Baby appears very physically strong - many comment they head their head very early, sometimes from birth.  When they arch and push with their legs they feel strong and many are very early movers.  This is not related to size - baby may appear unusually strong for age/size.
  • Baby is very alert from a very young age - being "very alert" is very difficult to describe, but many mums of DBB comment how alert their baby is (and often others have too) they are often described as "very switched on".
  • They don't show tired cues - whereas when a typical baby starts to become tired, they slow down start to relax and show tired cues; the DBB is opposite.  They flip from awake to asleep without the relaxing/showing cues/unwinding.  One minute they can be playing happily, the next rubbing their eyes (an overtired cue) and if you have a tool like feeding to sleep/pram at this point, will typically suddenly zonk for a power-nap. Many DBB in my experience use either feeding/motion to sleep - not through habit but because it assists relaxation, they tend to be like marmite when it comes to  prams/carseats/motion, and either love or hate it.
  • Hyper when overtired - some have a slightly longer window of doing the stage above than others, some flip straight to the almost hyperactive behaviour a very overtired baby displays.  They may struggle to keep still, fidget, fuss and cry a "tired cry".  Some resume play seemingly full of energy again although they may be short tempered or as one mum described "manic" flipping from laughing to crying in quick succession.  The parent ultimately feels the baby is tired yet wont sleep!
  • Struggle to stay asleep - all babies have periods of unsettled sleep, for DBB's it's consistent and persistent month after month and comes with other signs here (as mentioned above babies can have unusually disturbed sleep for other reasons).  Baby may show signs of exhaustion with purple/blue bags appearing under eyes (whilst this may be a sign of food intolerance, lack of sleep will give you them too!) yet still no longer naps or stretches appear.  In fact often the more tired a DBB becomes, it seems the less they sleep!
  • Co-sleeping makes no difference - baby still consistently wakes 1-2 hourly, it's likely to be more bearable but DBB's may want to be awake and playing in the middle of the night, regardless of where they are.  Others have an intense sucking need and are described as "Velcro babies who would stay permanently attached given a choice."
  • Constantly moving - sit and watch a DBB and you will note they never keep still, even when tired  they do not relax.  A leg may be bouncing, an arm wiggling - but they're in some way always constantly on the move when not asleep.
  • Mum feels baby is tired - some mums will acknowledge their baby isn't sleeping the huge stretches many mainstream books state they will, but that they are happy, settled and content with the sleep they are receiving.  Others though have a gut feeling their baby is just not getting enough sleep and desperately want to help them sleep better.
  • Baby is very sensitive to mum's emotions - something I've noticed is that if you take an already tense baby, and you add a tense/frustrated mum, a lot of DBB's will become even more tense/unsettled and will struggle even more to settle; for some even just laying there willing baby to sleep seems to be enough to unsettle them!  If you're beginning to feel this way & are holding baby "change of arms" can help IE passing to partner can work, if no spare arms available laying down next to them on your bed or suchlike can be an alternative.  If you're "sleep willing", try and do some relaxation/breathing exercises yourself (great to teach DBB if they're still struggling in toddler hood too) to clear your mind and truly relax yourself, and you can sometimes be amazed how quickly this will help baby to settle too.  If all else fails taking a shower with baby is something many mums comment can be a good stress buster if home alone.
  • May cry before sleep or upon waking - especially if tired, some DBB can seem prone to almost needing to cry to settle and again when waking ie they wake fussy and grumpy not happy and well rested.  Parents sometimes say he cries whether I'm holding him or not so I may as well put him down, but crying in arms is very different to crying alone.
Identifying why your baby is struggling to relax is perhaps the hardest piece of the puzzle because it can be several causes or just one, so finding someone to help work through things can be difficult; reasons can range from an undiagnosed tongue tie, food sensitivities, cranial or structural discomfort from birth and so on.  Something I believe can help these babies in the meantime is.....wait for it......*whispers* a rough sleep routine *sharp intake of breath".

Before you hit close hear me out!

Just because baby doesn't show sleep cues, doesn't mean they don't have a window of time in which it is easier for them to settle to sleep.  Some studies have suggested when a baby becomes overtired their bodies produce adrenalin and other "stay awake" chemicals, which is why they can appear to become suddenly energetic.

My own Duracell bunny had a predictable wake up time - OK so it was 5am, but it was predictable.  By playing with the gap from wake up to sleep, rather than watching her cues - I found trying to assist sleep at a particular time had more success than others; with the highest success rate before she showed any sleepy cues at all (the window was so small from this to overtired, she didn't get the "wind down" time she needed).  I started with the morning nap and then worked my way through the day, once I had a rough idea of times I then adjusted accordingly this based on how well she had napped earlier.

Of course the easiest way to do this with a younger baby is sling wearing - most sleep in a sling so they are "in position" for when they start to become tired.  Contact and movement can help many DBB's relax (some resist contact and the sling and arch away) and with many carriers a small adjustment can be made to manoeuvre material, and help cut out visual stimulation for baby (which some DBB seem to really need).  Some slightly older babies seem to prefer a back ride to a front carry; resting their head sideways on the wearers's back to nod off.

If this isn't possible/doesn't work/baby is older and wants to be down playing -  you can try putting baby in the sling at what you've worked out as the "optimum times".  Despite what any book tells you this will be variable for each baby. As an example when my daughter was taking three naps, she needed to be relaxed and ready to sleep two hours after she woke for the first sleep, despite books etc saying she should have a longer gap for her age.  

Clock watching is a total pain - if you have a baby that is happy without, I wouldn't recommend it to anyone!  But if you're struggling it's something you can try and which may help a little..

The last thing I would add is that the DBB can easily seem to get stuck in a cycle when overtired, the less sleep they get, the more frequently they wake.

Something that can sometimes help is "sleep cramming", which is doing anything and everything that works to maximise sleep for a day or two IE laying down with them when they nap, feeding them back off if they stir (and you're breastfeeding) long walks in the sling/pram.  Sometimes helping them catch up during the day can pay dividends at night/early morning wake up time - but with some it can be easier said than done.  White noise, reducing stimulation eg colours, sounds etc can also help "switch off", whilst I would never endorse baby napping in a dark quiet space as important (it's oftenblooming inconvenient)- for some DBB in my experience it does make a big difference; in my daughter even encouraging her to turn and face the wall instead of gazing around her room had a dramatic effect.

Above all remember your baby is not waking to manipulate you or because of anything you have (or haven't) done.   They're not trying to be spirited, or "high needs", or challenging, or whichever term you prefer to use,    in fact they're just as bewildered as you (if not more so).  Instead of being left to cry or trained, these babies in fact need more understanding and sensitivity than your average bear; whilst I've met many mothers who have regretted not responding more, I'm yet to meet one who wishes they had responded less - regardless of what the mainstream books say.

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