July 2011, written for our local NCT newsletter
Call me naive, but when I was pregnant, I assumed that cots and prams were things that babies actually used. I realised that sleep deprivation and new parenthood go hand in hand, but I didn't think to question the idea that babies did actually sleep in cots at some point, if not as much as you wanted them to. After all, why else would everybody go out and buy them in readiness for their new babies?
What all the baby books and antenatal classes had failed to mention was that babies exist who when placed in a cot, pram, or indeed anywhere other than the arms one of their parents, instantly scream their lungs out. If we picked our baby up, he was usually happy. If we put him down, he was unhappy. No exceptions, unless I tricked him by feeding him to sleep while we both lay down and then didn't move all night. If at any point I tried to steal away for something like a trip to the bathroom, the crying would start again in a shot. Likewise if he fell asleep in our arms and we waited forever for him to fall into a deep enough sleep, did the arm floppiness test just to be sure, and then attempted to transfer him to his moses basket or cot, then he would awake instantly and we would be back at square one.
So if in these circumstances, you turn to the internet, you will find precisely two pieces of advice, namely to use a sling and to cosleep. We did both of these and they were a reasonable survival strategy in some ways, especially during the first few weeks when babies sleep relatively soundly. They certainly work long term for some people, but didn't for us. I woke the baby up. He woke me up. I like my duvet too much. Also current SIDS guidelines do not recommend cosleeping. Babies grow heavier too and naps in the sling are fine for the first few months, but as I discovered, you don't want a six month old who only naps in his sling. The baby books were resolutely unhelpful too. The only one I could find even mentioning that babies like this was The Fussy Baby Book by Sears. The advice in there also bottled down to those same two suggestions, together with standard tips for settling babies, so was little practical help. However, it did give me some reassurance that I was not the only person in this predicament, that I wasn't doing anything wrong and that babies like this can turn out fine eventually.
Over the next few months, I did discover gradually that there are indeed other things that you can do, some through persistent research and others through dogged trial and error, and it is these that I want to share.
First, you need to rule out silent reflux, the baby equivalent of heartburn. This is often caused by lactose intolerance. Babies with silent reflux generally do not like being horizontal as it is painful for them and hence do not like being put down. There is a lot of information out there on silent reflux, but many health professionals have not heard of it, so check out the symptoms and be prepared to be assertive asking for a trial of meds if you think this may be the problem. Because about a fifth of babies suffer from some degree of silent reflux, the symptoms are often regarded as 'normal' for babies and in the first three months you are likely to be told that your baby has colic even when they clearly don't. Apart from medication, it can help to prop up your baby's moses basket at an angle and to keep them upright after feeds. You can also check if it is a food intolerance by eliminating types of food from your diet if you are breastfeeding (the advice is to only do this under medical supervision), of if you are formula feeding by trying special types of formula.
I would suggest getting your baby checked for tongue tie, which I have heard can sometimes result in symptoms not disimilar to those of silent reflux and is a fairly simple possibility to exclude. You may also want to consider cranial osteopathy . It has no scientific basis that I could discern, and as it did not help us, I don't feel I can personally recommend it, but I have heard reports of it having miracle effects on some babies like this. Be warned though that it is expensive as you will need several sessions.
Once you are sure that the problem is not physical discomfort, there are some other things you can try. The act of being put down can be as unsettling for a baby as actually not being in your arms, so put them down in the same way each time and as gently as possible, warning them in advance using the same words. Sometimes, our son would cry for thirty seconds or so after being put down but then go on and play happily after that. I also found that he got used to being put down in particular locations, so pick a couple of places in your house that you would like to use. A bouncy chair is a good bet as it is fairly vertical and can be moved from room to room. Then when your baby is in a good mood and not hungry or tired, I would try putting them down and singing to them, staying with them the whole time. Once they can cope with that, reduced the singing, and then move further away from him in the room. Eventually experiment with leaving the room - you could try singing when in the next room so they can still hear you. More generally, I think it is important to keep trying to put them down occasionally rather than give up and automatically assume they won't like it, as one day, they will be happy to be put down for short periods.
Unputdownability is in many ways just an extreme sleep problem. So read up early on baby sleep and don't wait too long to deal with it. Essentially you have a baby who is very stressed about something that you can't do anything about. I found it helpful to think of my job as being there for him when he cried (assuming that he was not hungry or in other remediable physical discomfort) rather than being to stop him crying, tears being a way that humans excrete stress hormones. It is easy to get the impression from much of the information on sleep out there that your only options are either not doing anything and enduring the prolonged sleep deprivation, however extreme it is, or to do controlled crying, but there are other approaches which will involve crying but don't involve leaving your baby to cry by themselves and are more gradual. We waited until six months and decided to use a sleep consultant, but in retrospect, I would have started acting a couple of months early as it can take time if you don't want to go for an extreme method.
From a practical perspective, you also need to come to terms with the fact that you will need to let your baby cry for short periods sometimes. Life won't go on as before but you do still need to eat, shower and so on and after the first few months gradually return to some sort of modified normality, and babies need a sane mother more than they need not to cry. Your partner will need to help with nights if you have a baby like this, even if they are working. It is better for you both to be getting six hours sleep each night, than for one of you to be getting four hours a night and the other eight. Those first couple of months, my husband took our baby for a couple of hours in the morning before he went to work. If you are having a bad night, I found it helped a lot to know that at least you will get a couple of hours sleep at the end of it. There are volunteers through the Homestart scheme who can come round to your house for a couple of hours a week to help if you think that might be useful. Get help from family if you can. Sometimes you have to be relaxed and accept that other people won't look after your baby in quite the way that you would like but that it is more important to get a break yourself.
Most new mothers are in survival mode for the first six to eight weeks. You will be in survival mode for the first three to four months instead. This is tough. You will watch your friends with new babies get out and about in ways that you can't as well as get much more sleep. They won't have a clue what you are going through. You will go along to baby groups and be the one with the baby screaming in your arms the entire session. A small number of people will treat you as though you are incompetent at parenting and you will get tired of hearing the same advice again and again from well-meaning parents of easier babies who assume you must be missing something obvious. I had to learn not to make comparisons and found it more helpful to enjoy time spent socialising with other mothers rather than talking about how hard it was, which I tried to save for my husband! I also reminded myself that other people with similiar babies probably wouldn't be managing to get out to the baby groups, so the people that you meet there are self-selecting to some extent. Looking back though, this period was actually relatively short-lived and you can cope fine for a few months without doing anything too ambitious. It seems silly now to think that I was worried that our baby would never manage a car journey without a baby screaming behind me for the entire duration. On the other hand, it is good to push your comfort zone a bit and to get out sometimes when you don't feel like it, as you may be pleasantly surprised with what you can in fact manage. There are hidden positives too. You will have to confront parenting issues about how to balance your needs and your baby's needs much earlier than most parents, and figure out how not to yo-yo between being overly permissive and overly authoritarian, and I hope that I will be a better parent for having decided on my approach here now rather than later.
It does end too. I think for us, it was somewhere between three and four months that things started to get gradually easier during the daytimes and I could for example have a shower in the morning while our baby played in his cot and even sometimes be able to put him down on a play mat on his back for a few minutes. Now at seven months, we do finally use the cot, pushchair and baby monitor that we bought way back when I was pregnant, and we have a baby who sleeps through, is starting to nap in his cot and who sometimes actually doesn't want to be in my arms but out exploring the world.