You are here

The 3 AM Wake Up Call

When I brought my firstborn, Matilda, home from the hospital weighing just 5 pounds, 7 ounces, demanding to be fed every hour and a half, and consuming so little at a time I could barely get the other cup on my nursing bra unhooked before she was full, it seemed I'd never sleep a full night again. But somehow she evolved into an 8 p.m. to 8 a.m. snoozer at about 5 months of age, and I became as smug as a mom could get.

I was in for a rude awakening, however, when Matilda learned a few months later to pull herself up to a standing position. Suddenly I was living with a human jack-in-the-box, who popped to standing whenever I put her down in her crib. Unfortunately, she hadn't mastered how to sit from this position, so bedtime  -- and suddenly, night wakings as well  -- became an endless cycle of tuck in, pop up, tuck in, pop up, until Matilda wore herself out or I gently held her down and rubbed her back. My nights of uninterrupted slumber appeared to be over.

Two more kids later, I've learned that this experience was far from unique  -- even the best sleepers resume night wakings at times. "The second half of the first year can present some real nighttime challenges  -- from teething to motor milestones to overnight guests  -- and if you're really lucky, everything will occur at once," says psychotherapist and sleep coach Jennifer Waldburger, co-author of The Sleepeasy Solution. "You can't avoid the disruptions, but they don't have to become catastrophes either."

In other words, you will sleep again. According to Waldburger, soothing one's self to sleep is like riding a bicycle  -- you never forget how. Here's how you can get your baby back to her bedtime routine.

Culprit #1: Teething trouble

Maddie Zeis was a dream sleeper  -- eight uninterrupted hours a night since she was 2 months old  -- until she hit about 8 months and began waking up crying repeatedly throughout the night. It would go on for a few nights, stop just as suddenly, and then occur again a few weeks later. Her puzzled parents eventually caught on to the fact that after a few nights of upheaval, a new tooth would soon appear. A sister recommended Humphrey's Teething Pellets No. 3, a homeopathic product, and soon Maddie was back to her usual state of all-night slumber. Now her mom reaches for this gum soother whenever she suspects a tooth is trying to rear its pearly head. (Want to give it a try? Ask your doctor first, but you can find it at Amazon.com

Teething seems to get most of the blame for nighttime upheaval. The catch is, teething is a process that goes on for so long (beginning between 5 and 9 months and continuing until about the second birthday) and the symptoms are so wide-ranging, it's hard to tell if it's truly the cause. Drooling, for instance, may get more severe when a tooth is about to erupt but is not a symptom by itself. Other possible signs  -- a low-grade fever, crankiness, a rash around the mouth (a side effect of the drool), looser than usual stools  -- may also be due to an actual illness.

What you need to know: "The only time teething should truly interrupt a baby's sleep is that acute 24- to 72-hour period before the tip of the tooth cuts through the gum; once it's through, the pain turns off, and you can jump right back into your routine," notes Waldburger.

To prepare for and minimize the disruption, familiarize yourself with the usual course of teeth arrivals, watch for more severe than usual symptoms (i.e., crankiness or gnawing on fingers), and keep an eye out for redder than usual, swollen gums (you may even be able to glimpse a bit of white just underneath). Then administer a doctor-approved dose of either acetaminophen or ibuprofen (the latter relieves pain a bit longer so it's ideal for nighttime) before putting your baby to bed and another in the middle of the night if she wakes up in distress when the first dose wears off, recommends Waldburger. Of course, the usual remedies of teething rings, frozen washcloths, and topical teething gels may also work if your baby finds them soothing during the day, but they're not as likely to provide the longer-term relief if you're in need of a serious block of shut-eye during the night (and who isn't?).

Babytalk contributing editor Stephanie Wood is a mother of three in Blauvelt, New York.

Culprit #2: Going mobile

Aime Rose Greenlee, 10 months, loves to crawl and cruise. So much so, in fact, that she has begun waking at 3:15 a.m. every night, wailing to be freed from the crib. And she makes it clear it's not a hug or a kiss she's looking for. "She resists any attempts at rocking or snuggling when we first arrive in her room," notes her mom, Jessica Greenlee of Las Vegas. "Usually the only thing I can do is bring her into our bed." There Aime Rose sits in the middle of the mattress between her parents with her favorite doll and tries to relax, which can take up to an hour. When she lies down and starts to snuggle, her mom knows she can successfully deposit Aime Rose back in her crib.

"Accomplishing a big physical feat  -- crawling, pulling up, walking  -- is like winning the baby lottery," notes Waldburger. "They're so excited they just want to practice, practice, practice." In fact, if your baby accomplishes large motor milestones (rolling over, crawling, cruising) on the early side in general, you may be all too familiar with sleep issues. These active, curious babies tend to have more alert personalities and that can translate to difficulty winding down, too, notes Kim West, a pediatric sleep therapist in Annapolis, Maryland, and author of the book Good Night, Sleep Tight. That means it's up to you to figure out how to push your child's off button.

For starters, give your newly mobile marauder plenty of time to practice his skills during the day: Show a stander how to sit back down by gently bending his knees from the back. Then when he calls for you to help him at night, you can "just pat the mattress and say 'lie back down, honey,'" West notes. "Reassure him, but do as little for him as possible. Otherwise you'll end up in a power struggle."

Waldburger also recommends playing lots of games that introduce the concept of object permanence at this stage such as peekaboo, jack-in-the-box, or hide-and-seek. "Becoming independent may also make your baby anxious, and sleep can become a separation issue," she explains. "Practice leaving and returning during the day, always telling him where you're headed: 'I'm going to the bathroom and will be right back.' " It's also a good idea to play with your baby in his bedroom during the day, Waldburger adds, so he realizes the bedroom doesn't always mean separation.

Because all this activity is also going to wear out your intrepid explorer, try not to let him get overtired, or you'll be in bigger trouble. Worn-out bodies produce cortisol, a stress hormone akin to caffeine, which makes it harder for your baby to go to sleep and stay asleep. Stick to the usual nap routine and an early bedtime, which Waldburger recommends should be between 7 and 8 p.m. for babies between 6 months and 2 years of age.

Culprit #3: Life, interrupted

When 12-month-old Tess Curtis moved with her family from San Francisco to Brooklyn, New York, she took full advantage of her mom and dad's wishy-washiness when she woke at night. "Tess was always a light sleeper, and she seemed to know that her dad would cave in, worrying that she wasn't warm enough or her pacifier had fallen out of the crib," notes her mom, Christina. "Meanwhile, I've always been a big fan of Ferber, but Tess seemed to have more energy than her older brother when it came to fighting back." By the time the family finally got settled in Brooklyn, after a few weeks of visiting friends while their furniture traveled across the country, any semblance of routine was out the window.

Whether you're moving, taking a long-awaited vacation, or still under the same roof but with company residing there, too, your little one knows well that something has changed. Your mission in any case: Try to keep as much as possible the same. Bring familiar bedding, from favorite little blankies (for older babies) to unwashed crib sheets so the scent of home still lingers, suggests Waldburger. If you're in the habit of darkening your baby's room, do so in a hotel, too. When you first arrive at your destination, spend some time playing in the room where your baby will be sleeping so it's familiar when the lights go out. And when it comes to routine, try to stick with it, including putting him down awake if that's what he's accustomed to. "Avoid letting your baby get overtired on vacation," West also cautions. Let him nap wherever you happen to be so he gets the shut-eye he needs.

If you're dealing with company in your own home, there's a good chance Grandma, Aunt Brittany, or your BFF from college will be hankering to take over the tuck-in. And you'll be more than thrilled to hand Junior over. But you both should control your urges, at least for the first night or two. The excitement of having someone new to play with is enough at first, and too much change can leave your baby too wound up to settle down. Compromise by letting your visitor give the bath, then you follow through with the rest of the routine. In two or three nights, when the company is less of a novelty, Grandma or your girlfriend can relieve you at bedtime with less chance of your baby overreacting.

As for the Curtis family, Mom finally cracked down and Tess wised up. "At first we worried about her adjustment to her new home, but then we realized it was ridiculous how much we were getting up with her," Christina notes. "We turned on the air conditioner for helpful white noise, covered the window with a black cloth, put a bunch of pacifiers in the crib, closed the door, and told ourselves we wouldn't go back unless she was really in distress. Within a week she was sleeping all night again."

Culprit #4: Feeling not so groovy

Kyndal Collins slept though the night from 8 weeks on, except when she got a cold, which could be counted on to wake her up like clockwork. "We can always plan on her waking up the first night she develops a stuffy nose," says her mom, Jennifer Collins of Americus, Kansas. "I think she realizes she can't breathe through her nose and it scares her." Her mom hit upon a combination of a vaporizer, a dose of doctor-approved infant Tylenol Cold medicine, and a little nostril-tingling menthol rub (Vicks) for her chest, and Kyndal was soon sleeping all night again.

It may be those reopened nostrils, or just the magic of that same runny-nose routine each time that soothes little Kyndal's aches and anxieties. You know how it is when you're sick as a grown-up: You can't get comfortable and wish your mom would show up with whatever childhood cure she had up her sleeve. "Of course you should rock and soothe your sick baby," agrees West. "Do whatever you need to get her through the bug and help her sleep  -- sick children need that. But resume your normal routine as soon as she's better."

For most illnesses, that should be quick; an over-the counter infant pain medicine (given in consultation with your pediatrician) can lower a fever or reduce ear pain enough to help your baby sleep. An antibiotic should start to work in 24 hours, and by 48 hours your baby should be pain-free. And most stomach viruses run their course in about 24 hours, which means your baby should be able to sleep even if her appetite is not up to par.

If you don't want to leave her alone, but also would prefer she not get in the habit of sleeping in your bed, lay down in her room next to the crib for a little while until you're sure she's sleeping soundly again. "As soon as you have a 24-hour period with less severe symptoms, get right back to that routine," Waldburger recommends.

Whatever the reason for your baby's recent nighttime demands, try to keep in mind West's "three-night rule." That's just about how long it takes to create a new routine, she notes. So whatever you're doing for that amount of time is likely to become a tougher habit to break after that point. Of course, the flip side is that should also be all the time it takes to get with the right program again, too.

Tags: 

comments