Stories and thoughts from day to day life in the Bullard Family

Infant Reflux or Classic Colic? August 8, 2011

Filed under: Gabriel Stories — parentsong @ 10:51 pm
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Once we were a few weeks into G’s life, we realized this baby was not going to be easy. He fussed and cried for most of the day and night. Once he calmed down at night, things got slightly easier. I still had trouble doing anything out of the house. I had to take him grocery shopping and occasionally to outings for our older child, B. I was known at the grocery store as the lady with the crying baby. Seriously. But I learned ways of calming him, mostly by holding him and keeping him happily fed. The problem was that he would spit up if I fed him too much. He pulled in his legs and squirmed through every nursing. He seemed as though he was in pain.

After we passed the 6-week mark, the time when babies generally calm down, I began to think we need an intervention. I had tried everything on my own that I could think of and had read about, but nothing seemed to work. After G’s 2 month check-up, we put him on Zantac. Our neighbor also had both of her children on this medication as infants and said it was “like magic.” Several other mothers told me they had their children on it, too. I was reluctant, but wanted to help my baby. After two weeks on the medicine, he seemed the same. Maybe he was a little more calm, but it was hard to say that it was the medication. It could have just been our perception- that’s how subtle it was.

I called the pediatrician to see if we could try Prilosec, a stronger medication for blocking acid reflux. Since this medication works in a different way, one would expect to see some change when transition from one to the next. We saw no difference, but gradually, G seemed to be calming (but still very subtle changes). Was it the medication? The pediatrician warned us not to stop the medication until he was sitting up on his own and more mobile. The reasoning was that people think that when the medicine starts working, you don’t need it anymore and that reflux tends to be less of a problem when babies are more vertical (i.e., sitting up on their own).

Around three months, we still weren’t convinced that G was suffering from acid reflux. He still spit up after almost every meal and I was still feeding him in small doses frequently through the day and night. He was still crying, but not quite as much. After about 4 weeks on Prilosec, we decided to stop the medicine, AMA (against medical advice). We gradually decreased the dose. We noticed G started having digested spit up: the kind with the little white bits in it. Up until now, he only spit up pure breast milk. Now that the acid was actually digesting his food, it changed a bit. He did not become more fussy, but continued on his normal curve toward improving.

How can you know if your baby is suffering from acid reflux or colic? Unless tests are performed, which they are generally not in this country, one can never really know. It is just treated with medicine (hence so many babies taking the medication). The more I learned about colic, the more I felt that this was G’s situation, especially since the medication did not make a huge difference. We also intuitively felt that it was more likely colic. I remember several times with my first child that people told me to trust the “mother instinct.” I could only trust my instinct after several weeks of carefully watching my son and learning about colic and acid reflux.

At the time, it felt like it would never end. I thought we would be stuck with a very difficult baby, but that is not the case now. Now we are just catching up on sleep, er, sort of.


Book Review: Solve Your Child’s Sleep Problems July 15, 2011

Filed under: Book Review — parentsong @ 1:00 pm
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Solve Your Child’s Sleep Problems by Richard Ferber

There are a million reviews on this book on-line. You are reading my review, and so I will to my best to make it worth your while.

First of all, Dr. Ferber is famous for the so-called “cry-it-out” method of sleep training. Well, unless you have a baby who is calm, able to fall asleep relatively easily on his or her own, or you are a really super awesome parent who can time everything perfectly and catch all your baby’s cues, then there will likely be some crying when teaching the baby to sleep on his or her own. Now, for the review:

The book is broken into four parts. In the preface, Dr. Ferber indicates how the reader should use the book. This is very helpful and will make using the book more effective.

Part 1:

It is important to read the first section: it tells the reader how to tell if your child has a sleep problem, how sleep works, and how to help your child develop good sleep practices.

Part 2:

The second section is where Ferber creates his legacy. This section introduces “sleep associations” and how they impact the child’s ability to sleep. The reason a child cannot go to sleep on his or her own is because he or she associates rocking, nursing / bottles, holding, cuddling, etc. with falling asleep. The child is unable to go to sleep or go back to sleep without the assist of the parent. Ferber calls his method for solving this problem the “progressive-waiting approach.” This method requires the parent to put the child down awake (and sleepy) and wait progressively longer before going in to check on the child.

Ferber provides a detailed, step-by-step approach for using this method. He considers the fact that many parents will have a hard time listening to their child cry and is quite open about how the whole situation will happen in reality. It is not necessarily smooth sailing after a few nights of doing this. Other issues may be involved, such as the procedure itself, scheduling, anxiety, or medical issues. The author does a good job for addressing the “but my child is like this” stance and really provides solutions for almost any imaginable situation. Along with sleep associations, Ferber goes into setting limits, night feeding, nighttime fears, and colic and other medical causes that impede sleep.

Part 3:

The third section goes into schedules and sleep rhythm disturbances. The author discusses biological sleep rhythms and schedule “disorders.” Sleep phases refer to the typical times of day or night that sleep or sleepiness happens. Solutions are offered for correcting unhealthy or irregular sleep phases in all ages. Sleep phase issues are further discussed to include problems such as waking too early, long middle-of-the-night wakings, and nap problems. This section is very helpful for seeing how sleep fits in the big picture and how one thing affects another.

Parts 4 and 5:

The fourth and fifth sections address interruptions during sleep such as nightmares, bedwetting, head banging, partial waking, snoring, sleep apnea, and narcolepsy. This section only useful for these specific problems and can come in handy should they arise.

My take on the book:

For our first child, this book was a life-saver. We had tried several different approaches (Pantley’s No-Cry Sleep Solution, Dr. Sears’ sleeping advice, and Tracy Hogg’s approach) to no avail. Our daughter was around 9 months when we “broke down” and used the progressive-waiting approach. We made a chart for timing that spanned over a seven-day period. It took about four or five days to our daughter to learn to go to sleep on her own. More on this process in another post. Thanks to this book, our 2 ½ year-old is a fantastic sleeper. Naps didn’t work out so well until she was over 2 years old, but at least we had our evenings back. That made everyone happier.

What I really like about this book is that it is pretty straight-forward. Ferber presents the method and gives loads of background information so that the reader can make informed choices regarding this approach. He also gives a few options for modifying the technique to meet the parent’s needs. He gives practical advice concerning parenting issues around sleep. It is not a strict “do it this way or your child will fail” book. This approach also fits nicely with other non-sleep issue parenting approaches. For example, if you only have an issue getting the baby to bed and to sleep on his or her own, then you only need to use the progressive-waiting approach (unlike the 12-hour-sleep approaches that require the baby be on a specific schedule).

The part on colic is not helpful at all. If you have a colicky baby, I highly recommend Your Fussy Baby.

If you are a responsible and loving parent, I do not find this approach to be cruel my any stretch of the imagination, but it isn’t soft and fluffy. As with any sleep training approach, it really depends on the child and the parents and the relationship. All involved parties need to be “ready.”  There will be crying, but that is not necessarily a bad thing as long as it is controlled and your baby’s needs are met (fed, dry, comfortable, etc.).


Book Review: Sleeping Through the Night June 30, 2011

Filed under: Book Review — parentsong @ 11:33 pm
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Sleeping Through the Night by Jodi Mindell*

The book covers everything about infant sleep behavior. The tone of the book is quite conversational. No references to studies or even a bibliography here.

It is not a method book, per se, though the author seems to be presenting a gradual extinction method. This method is rather simplistic and is likely to leave a parent wondering what went wrong if the baby is mildly challenging. The basic approach here is to let the baby “cry it out.” She illustrates with stories of babies crying so hard they vomit. And she tells the reader how to set up the bed so that when the baby does vomit, the sheets can quickly be changed. Hmmm, not very practical advice for sleep training if you ask me.

The author refers to “sleep associations” that make or break your baby’s ability to go to sleep, which is the same idea that Ferber’s method is built on. I think sleep associations are questionable to begin with. But this author takes it one step further by identifying “negative” and “positive” sleep associations, which is not one of Ferber’s ideas. It may be one of her own or something she picked up from training as a psychologist. Negative sleep associations are identified as the parent or anything that will not be present when the baby wakes (such as a music box or pacifier). Positive sleep associations are the presentation of the room as the child falls asleep (a cuddly toy in a dark room). I have not read this anywhere else and I’m not sure about it because it can become rather ambiguous, depending on how one views positive or negative associations.

The author gives advice of what do in certain situations, such as the child jumping out of the crib, teething, setting limits, moving, traveling, etc. Everything in this book seems to get equal attention. All aspects of sleep, from birth to adulthood, are covered in a paragraph or two each. In this way, everything is sort of glossed over. This seems to make it is more of an “introduction” to sleep. The book will likely train parents more than children (such as if the parent is truly interfering with the child’s ability to sleep).

In all honesty, I did not even want to spend the time reviewing this book. I suppose it is because I have read some very helpful books on sleep and this one offers no new information. I also did not like how the information was presented. For me, I need to know why certain things work and why they do not. I like for the author to have some philosophical background so that I know where they are coming from. This book feels very empty to me, as though the author has never actually had to teach a child to sleep.

*I realize this review is quite biased and less objective than I like reviews to be; my apologies.


Singing to an Infant: Lullabies June 25, 2011

Filed under: Songs — parentsong @ 11:32 pm
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Lullabies have been the muse that lures babes to sleep for, well, a very very long time. It is quite natural to sing to a baby. Almost every culture has some form of a lullaby. Lullabies help promote sleep, increase bonding, boost confidence and trust (part of the rhythm, something to anticipate or something expected), and can be soothing to a restless babe.

With our daughter, we sang spirituals and an English song called Ten Green Bottles. It was difficult to sing to Gabriel in the early months because he was colicky and the only thing that soothed him was shhhhing. Now that he isn’t crying all the time, I have been using lullabies to soothe him during his bedtime routine and prepare him for that wonderful slumber. This also helps me keep the routine straight. This way, even if it gets a little off track, I can keep the same basic rhythm leading to bedtime because it is guided by song. This doesn’t exactly put him to sleep every time, but it is a start!

Here is the rhythm I use for now (at 4 months):

      1. Short song to announce bath time (I wrote).
      2. After bath, during massage and dressing I sing All the Pretty Little Horses. I usually end up improvising some and changing words until we are finished.
      3. During his bottle, which is the only time I don’t nurse him, I sing Edelweiss. It’s not a typical lullaby, but it is very soothing and lovely to hum.
      4. After he has finished eating, I rock him and walk around singing the spirituals. Usually Swing Low, Sweet Chariot or Goin’ Down That Lonesome Road, residuals from when we sang Briony to sleep. If it goes on longer, I bust out the Ten Green Bottles.

Since using these songs, I am better able to keep a consistent routine. This is part of our sleep plan and part of our colic recovery. More on that in other posts.


Singing to an Infant: Spirituals June 16, 2011

Filed under: Songs — parentsong @ 9:24 am
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When our first child was born, my husband and I had just quit the choir.We were still in choral music mode and much of what we sang to her was from our choir repertoire.

Interestingly, this tended to be spirituals. Nothing felt better while walking a little baby around, dead tired and completely out of our depths, than a little Swing Low, Sweet Chariot or Going Down That Lonesome Road.

There is something about the Spiritual that embraces the feeling of having all your resources taken from you, yet wanting nothing more than to press on. Ah, parenting. The music is simply beautiful. Lilting melodies, repetitive strains, and if you have someone to sing with you, the potential for some fantastic harmonies.

Spirituals were often used as codes by slaves who were trying to reach freedom. This is not to imply that I feel parenting is anything one needs to escape or that it is like being a slave (well, maybe it is a little like being a voluntary slave). I’m simply focusing on the music here. The inspiration and motivation embedded in the music lives on through these songs, and I can feel it whenever I sing it. Hopefully, our baby can feel it, too.


Recovering from Colic June 14, 2011

Filed under: Gabriel Stories,Parenting — parentsong @ 9:30 pm
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Peaceful napping, mostly when not in a crib

I think the “worst” is over. Though, apparently, when raising children, things don’t get harder or easier, they just change. While there are many challenges of parenting I expect, things such as sleep deprivation and having to eat standing up or use only one hand for everything because the baby cannot be set down, there are some things that I do not like to be challenged by. Having a baby spitting up constantly and crying for many hours of the day is not fun. I just wanted to get through it. And we have. Now, we have a very happy, alert, spunky 3 ½ month old.

The problem now is that sleep is still a major issue. I have many books on sleep in infants and I understand how it works. Weissbluth is the only author I have read that acknowledges the effect colic has on the infant developing healthy sleeping habits. I believe that parents can really make or break a child’s ability to sleep well.

Happy most of the time, now!

I want to help our child learn to sleep. He currently wakes every 30 to 45 minutes from a nap and every hour to three hours in the night. This says to me that he cannot make it through natural arousals that occur in all sleep. We adults have learned how to stay asleep through having to move or adjust in our sleep. We don’t wake up full of vigor in the middle of the night because we were uncomfortable or had an itch or heard a car door shut. We mostly remain unconscious of it and carry on sleeping. By 12 to 16 weeks, infants have the ability to do the same thing. Hmmm, I guess we are dealing with a habit at this point.

While I am not quite ready to jump into hard-core sleep training just yet, we are devising a sort of plan to assist our child in getting the gist of sleeping. I’ll lay it out in another post, and hopefully report great things as time goes on.


Book Review: Healthy Sleep Habits, Happy Child June 13, 2011

Filed under: Book Review — parentsong @ 8:53 am
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Healthy Sleep Habits, Happy Child by Marc Weissbluth

A thorough book on infant and child sleep written by a pediatrician and father of four.  The book is broken into three sections: 1) How children sleep, 2) How parents can help their children establish healthy sleep habits, and 3) Other sleep disturbances and concerns.

The first section describes healthy sleep, disturbed sleep, sleep problems, and common myths. Five elements of healthy sleep are introduced here and reiterated several times throughout the book. The reader cannot forget this point, as Weissbluth uses this as a building block for how the infant can develop healthy sleep habits; all five must be in place. This section also outlines strategies for getting the infant or young child to sleep. These include soothing methods and sleep methods. The sleep methods include “no cry,” “maybe cry,” and “let cry.” He goes into detail of what these methods look like theoretically and anecdotally.

Like many other sleep solution books, the author gives what he considers to be the ideal and healthy sleep schedule. However, he does not say that it is critical to follow this schedule if you want your child to sleep. He gives many alternative solutions and variations of the sleep schedule, keeping the needs of the family in mind. He gives proposed solutions for almost any kind of problem that could come out of a sleep schedule. Prevention, treatment and action plans are offered as concrete guidance for different sleep issues.

This book also covers the extremely fussy baby, or colic. There is an entire chapter dedicated to it. This information is basically reprinted in Weissbluth’s other book, “Your Fussy Baby.”

The second section focuses on what sleep looks like at different developmental stages. So, for infants aged 0-3 or 4 months, sleep patterns are broken down by week. He also takes into consideration the colicky baby who is not likely to follow this pattern. Months 5-12, 13-36, preschool children, and school-age and adolescents are covered. The author explains what is healthy for that age range, what is “average,” and how the parent can help the child to achieve optimum sleep habits.

The third section discusses other sleep problems and concerns, such as sleep walking, nightmares, bedwetting, the arrival of a new sibling, moving from a crib to a bed, travel, illness, and several other situations that might effect sleep habits. This section is helpful in that it provides enough information of how the issue might disturb sleep, but does not go in to the issue itself. For example, eczema might disrupt sleep because the child may be itching in the night and unable to sleep.

The information in the book is based on research. Studies abound to support suggested sleep methods and he also uses anecdotal evidence collected from his years as a pediatrician. There is almost everything one would need to know about infant and child sleep in this book. The methods for getting the child to sleep are a little weak and is not a focal point in the book. Some step-by-step instructions exist to teach parents how to train the child to stay in his or her crib or recognize when the child is getting sleepy or when he or she is over-tired.

My take on the book:

Weissbluth seems to be trying to provide information, not counsel on how to actually get the child to sleep. I find this helpful, because I can then make an informed decision of how I want to “parent” my child in this area, whether it be co-sleeping or having the child in his own crib and using the “let cry” method of sleep training. The instruction to actually getting your child to sleep is not very clear and I would not feel confident using these techniques with my child. However, it is very informative and educational. I feel like I really understand our son’s sleeping better, though he isn’t actually sleeping all that well. I know we have work to do, but when we do start “training,” it will be much easier because we will not be fighting his biological sleep rhythms.

For specific sleep training techniques, I would recommend the following books:

For the “let cry” or “maybe cry” method, try “Solve Your Child’s Sleep Problem” by Richard Ferber.

For “no cry” try “The No-Cry Sleep Solution” by Elizabeth Pantley or a number of books by Dr. Sears, such as “Nighttime Parenting” and “The Baby Sleep Book.”