Boston Children’s Hospital Sleep Center Visit

I’ve hit a new level of crazy when it comes to sleep issues guys. A few months back in October I had reached my breaking point with Caleb, and also Julian, but really Caleb was the driving force behind my craziness. He was waking up 2-3 times a night and taking tiny, short naps through the day and becoming a HOT, hot mess by 5pm. Enough was enough so I made the decision to set up an appointment for him at Boston Children’s Hospital Sleep Center to see what the experts had to say about our situation.

Yes, I realize there are sleep consultants out there but I wasn’t willing to pay $$$$ for a random stranger to come tell me what I need to do and then leave. I also realize there are tons of online sleep courses but again, they’re $$$ and I didn’t trust myself to follow through the advice if I didn’t agree with it or like it.

The thing is, I feel like I’ve done my research. On top of incessant googling for sleep training and sleep schedules, I read and re-read my bible when it comes to sleep, Healthy Sleep Habits, Happy Child by Dr. Marc Weissbluth. Its a super informative science based book all about baby sleep that I downloaded to my phone at the height of Julian not sleeping around 5 months. This book is not for the faint of heart but if you are a sleep deprived and sleep obsessed parent like me you will devour it like I did. I knew I had to do some sort of sleep training with Caleb but I was nervous and unsure if it was even going to work since we had to sleep train Julian and he’s 3 and still waking up at night often!

Our appointment came up at the end of October. I dropped Julian off at his grandma’s and made my way down to Waltham to a Boston Children’s location in the pouring rain with Caleb. The Sleep Center was founded by Dr. Richard Ferber of Ferber method fame, for those who know about sleep training methods. So I already felt like I was in good hands. Bonus – I pulled up to the garage and a parking attendant showed me right to the bottom, front row parking spaces they reserve for caretakers with babies. Sweet.

The appointment was eye opening and although we still have work to do I’ve seen improvement in Cabe’s sleep, especially with naps. The appointment was with a nurse practitioner who was gentle mannered and SUPER thorough. She ended up talking to me for an entire hour after giving Caleb a quick exam and downloading a full health history on him from me. Part of me was feeling guilty I was taking my healthy son to a sleep appointment in the neurology department of Children’s Hospital when they were likely seeing patients with much greater needs than us, but the NP assured me they see lots of cases just like mine.

Here are a few things that I took away from our meeting.

–Age Appropriate Total Sleep Need

My biggest takeaway and surprise was that I was expecting way too much total sleep from him in a day. I was expecting him to do 12 hours at night and another 2 hours during the day for naps which totals 14 hours of sleep. She informed me that babies Caleb’s age (almost 9 months at the time) only need about 12 hours max total sleep, nights and days combined. I was shocked! This was not anywhere near what I had been reading in various articles and books. All this time I was so concerned with him being over tired and he was really probably not tired enough for all the sleep I was trying to get him.

–Daily schedule vs Wake times

Another helpful takeaway was the nurse practitioner having me set a daily sleep and wake schedule for Caleb vs going off time awake. I had been doing a routine of about 3 hours wake time, so no matter what time he woke up, ~3 hours later he’d be going back down for a nap, then ~3 hours after that another nap, then bedtime around 7. Sometimes if he was super fussy and only taken short naps it’d be more like 6 or 630. Our days were all over the place and I never knew how to plan anything in them. If it sounds like a hot mess to you then you’re right.

Instead, the NP had me set a daily wake time where no matter what, whether he was awake or sleeping, he was getting up for the day at that time. She suggested 630am for us but truthfully it’s been closer to 645-7 because he seems to naturally be doing that and I also cant seem to get myself out of bed before then (I am still waking up at night with one or both kids). Then no matter what, 10am comes along and he’s going down for a nap and I’m waking him after 60 minutes. Same at 2pm although this time he can sleep 1.5 hours max. Then she suggested a bedtime of 830 pm. That would get us the recommended 12 hours of sleep total. To be honest he’s actually going to bed more like 745 at the latest because he just cannot hang much longer. But even with my personal tweaks things are still a LOT better and our days are so much more predictable, which is a relief to me!

–Night weaning

As far as waking at night is concerned she suggested that physically he was ready to drop his feeds at night and set me up with a plan to wean him from these night time feeds but I haven’t done it yet. She told me it was OK to get him settled on his schedule first and he may even start to sleep better at night because of it, otherwise I could eventually work on night weaning using the plan.

Guys, it’s probably against what’s best for both of us in the long run but I haven’t brought myself to do it yet. He still eats ravenously at night even though he’s eating 3 full meals a day plus a snack or two,  I just feel in my heart he still needs those night time feeds. At least til he’s closer to 12 months. I would prefer he only get up once a night to eat though and he’s been doing twice lately which tells me that second time, though he is eating actively, is probably not really necessary.

–Confidence to use some form of extinction for sleep training 9 month old

My last biggest learning and maybe the most important to me was the nurse practitioner’s blessing to use extinction or gradual extinction to sleep train. Extinction, otherwise known as Cry it Out, is fiercly debated in parenting groups with some people claiming its akin to child abuse and others saying there’s basically no other way to sleep train than cry it out. After weeks of trying all the gentler methods we ended up using full extinction on Julian at 5.5 months old while keeping 1-2 night feeds and it was the only thing that made him stop waking up every 90 minutes. It was TORTURE to listen to and I won’t even tell you how long that little boy cried the first couple nights but I will tell you it eventually did work. Even though I was still getting up with him, that extra sleep we both started getting was amazing and so needed and I just don’t think it would have happened otherwise.

For me the dark side of using extinction is the extreme anxiety it causes me to hear my babies cry and know that the best thing for them is not for me to go in and try to feed and comfort them. As I mentioned, Julian screamed and cried for hours and hours the first few nights we did it with him and we had to keep going back to sleep training him every few weeks or so due to his persistent and stubborn personality type. So when it came time to consider sleep training a much milder baby, Caleb, I was so torn and instantly anxious at just the thought. Hearing a medical professional tell me extinction for a 9 month old was their recommended and safe plan of action for me and my baby made me feel so much better. I knew in my heart that’s what I had to do but hearing it come from the NP made me confident.

This post is hugely long and long overdue at that, but I definitely wanted to recap it in case it could help anyone else out.

Xoxo

Liz

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