Child of Mind: Developmental Science and Everyday Parenting

Reader's Question: Sleep training during the (8 - 11 month) developmental transition

Let's start this week off with a reader's question about something we haven't talked about for a while... sleep!  Yes, we can still address this thorny, ever-morphing issue even though the blog is no longer fully focused on the topic. The question comes from a mother of a 9-month old, but I think we can consider it more broadly to cover any developmental transition period:

My son was sleeping in his crib with very few interruptions until he came down with a bad cold a few weeks back.  I'd trained him using the sleep doula method when he was seven months old.  This involved sleeping on a matress on his bedroom floor for a week and shhh-patting him whenever he awoke during the night.  Anyhow, once he got sick I began to take him out of his crib in the night and take him into my husband's and my bed to sleep.  Now he won't sleep in his crib anymore.  I'd like to try the sleep doula training method again but I've now entered the 9-11 month blackout period.  I'd still be in the room so he'd know I hadn't abandoned him, but I'm worried that it might be damaging to him to see me right there, standing in his room but not responding to his requests to be picked up.

Do you think it would be okay to try this method at this time or should I wait?

So, first off, although the reader is asking about her 9-month old in particular, I think the question can be considered more broadly to cover ANY of the developmental transitions we've talked about on this site. I could have picked from another 4 emails that asked almost the same question (although the particular sleep training methods differed), but were about their 18-month old or 2.5 year old child. So I wanted to mention and review some GENERAL points about transition periods and their impact on sleep training and then get into the specifics of this question.

There are a few, very predictable, developmental transition periods that I've mentioned can be quite problematic for sleep training children. Each of these periods have their own specific character, but what they have in common is that they are developmental transitions during which there are massive reorganizations/changes occurring in multiple domains (cognitive, emotional, social and oftentimes physical). Our approach has been to discourage parents from sleep training during these periods because, no matter what sleep training technique you use, they are less likely to work if the child is adjusting to these huge changes. So, no matter if the child is acquiring object permanence and getting his first real taste of separation anxiety at 8 - 11 months, or is experiencing a burst of language development and understanding social roles at 18 - 21 months, or feeling her first stabs of jealousy at 2.5 years old, or really groc-ing how different people's perceptions can be and feeling the resultant first stings of shame at around 3.5 years old... each of these new stages brings with it a whole lot of upheaval, much of which is related to the social connectedness we have with the ones we love most. Sleep training can be a hard enough battle to win, without stacking the deck against you with all of these new psychological acquisitions added to the mix. So, if there's a way to avoid sleep training during these stages, I've always recommended doing so.

HOWEVER, as we all know, we can have the best-laid plans and then things just don't go our way. Sometimes, like this reader's question typifies, sh*& happens and we find ourselves smack dab in the middle of one of these transitions with little recourse but to forge ahead and try to teach or re-teach our children better sleeping habits. In these cases, my best advice would be: Go for it, try whatever technique you feel will work best for your family, and keep an open mind. The worst that can happen is the child will NOT learn better sleep habits. That sucks, but at LEAST you can feel rest assured that it is NOT your fault. It's not that you didn't learn the most magical, bestest, coolest technique out there to help your kid sleep; it's not that you let her CIO or DIDN'T let her CIO or nursed too much or not enough or that you used the wrong blinds, the wrong music, the wrong pacifier. It's just a sucky developmental period to make these kinds of lessons stick. So I would caution this reader and anyone else trying to forge ahead and sleep train during a sensitive period: it will be hard, possibly harder than if you would have done it earlier or later. And it may not work. BUT! BUT!  Are you all paying attention here? BUT! You are NOT screwing up your child for life if you give it a try. If you feel you must sleep train during a sensitive period, for your sanity, your child's health, whatever, do it and feel no guilt. If it works (after perhaps more work and more time at it) yippee for everyone. If it doesn't work, you have a likely causal explanation and your next plan of action is to wait until this phase runs its course and you can implement the sleep-training method of your choice at that time.

Getting back to the reader's specific concerns about the 9 - 11 month stage, I don't think you will "damage" your child with this sleep training method. Is it ok to try, sure, at least for a couple of days. But because this new stage is all about the child acquiring a more sophisticated understanding of your presence in the world, the same technique that worked at 7 months (before your child really GOT your "permanence" in the world) may simply not work at this stage. The sight of you near, but unattainable, may be too frustrating at this sensitive stage. Sleep training with this "doula" method may just flood your child with too much anxiety, making it difficult to learn any new sleeping skills. But again, I firmly believe you won't damage your child for life if you attempt this method for a few days, even if a few tears are indeed shed (perhaps on both your parts). 

Anyone out there have some supportive words for the original poster of the question? Anyone have great success stories to share from this age? Or how about some words of commiseration... this is a tough age to muddle through (for the whole family).

When Parting May Not Be Such Sweet Sorrow

Wow! That was a lot of guilt purging last week. I hope we're all travelling a little lighter this week if only because we've been reminded that we are not alone in carrying that MOTHER LOAD of guilt. Seriously, thanks for all the sharing. Not only has it been great to hear that we are not alone, but it's been great to get to know you a bit. We aim to please...so the more you tell us, the more you can help shape this site, what gets covered etc. 

In that spirit..
Last week's group carthasis started with Bella's guilt over her departure to Europe, but someone (Paola?) mentioned that she was also interested in the garden variety of separation anxiety.  I thought I"d give a little background into the research on separation anxiety (regular kind) but then leave you with a couple of questions that, to my knowledge, are not so well covered in the research literature. The first is an issue about separation anxiety that I"ve experienced with my son (there we are in the pic in those "all important" early days). I've also heard about it from friends re: their experiences with their own children. Once again, it would be great to hear about your experience...

Here's a quick "Did you know...?" to set it all up (just some highlights mind you, the literature on attachment is MASSIVE).

1. One of the key studies that influenced thinking on human attachment came from a study with monkeys. Infant monkeys were given a choice of a). a surrogate mom made of wire, with a plastic nipple attached that delivered food or b). a similar wire mother with no food access but who was covered in a soft terry cloth. Although they nursed from the wire mom, the monkeys preferred the cloth mum (as in, they spent 17-18 hours a day with the cloth mum versus 1 hour with the wire/nipple one), even more so when food was not at issue but the monkeys were frightened by some foreign object that entered the room. You can read more about the study here. Although this finding came from a study with monkeys and not human babies, it raised the idea that food supply may not be as central to developing an attachment to a caregiver (as previously believed) as comfort and security. 

2. Of course the MAJOR line of research on human attachment came from Mary Ainsworth's work in the lab using something called the "Strange Situation". Basically, moms and infants come to the lab and spend some time in a "waiting room" of sorts (magazines for mom, toys for baby etc.). Over the course of 15 minutes, the people in the room change. At first mom is alone with baby. Then a stranger enters. Mom leaves baby with the stranger. Mom returns, then leaves again. Then the stranger also leaves and baby is alone. Stranger returns, then mom returns. Each of these scenarios last only a very short time; less than a minute to 3 minutes max. The researchers were mostly interested in what happens when mom and baby are reunited. Based on baby's reaction to mom's return, the babies were classified as either a). securely attached, b).avoidant attached or c). anxiously attached. The secure babies (about 65% of the infants tested) got upset when mom left but were comforted and quickly re-assured by mom on her return. In contrast, the avoidant (about 23%) babies were somewhat detached, did not show much emotion, even avoided mom or acted unaffected by her departure and also her return. Interestingly, biological markers (such as heart rate and skin conductance) later showed that these babies were nonetheless in distress. And the anxious babies (about 13%), were VERY upset at mom leaving, seemed upset or even angry on her return and were not easily reassured. 

The argument goes that securely attached babies, confident in a secure base to return to, are more free to explore their environment and therefore to learn. There is evidence that they fare better than avoidant- or anxiously- attached babies on complex problem -solving tasks and that they are generally better adjusted in later childhood and beyond.

3. In case you're freaking out because you don't believe that your child would react like a securely attached baby, here's something to consider. There is evidence that the proportion of babies in the different categories varies across cultures. E.g. supposedly there is a greater proportion of "avoidant" babies in studies with German infants  (although a more recent study with a German sample showed more of a "normal" distribution of babies across the three categories)  and of "anxious" babies in studies with Japanese infants.. Makes sense if you consider that parenting practices and styles definitely differ cross-cuturally, although perhaps less so nowadays what with the whole global village, internet etc. revolution.  In that case, it would be normal, and perhaps highly adaptive, for babies' attachment behaviors to reflect the culture they are being raised to function in.

4. A student of Mary Ainsworth - Mary Main - went on to do pioneering work on adult attachment. She was interested in how your memories regarding attachment with a primary figure when you were a child compared to the type of relationships/attachments that you form as an adult (in friendships but particularly in romantic relationships). Turns out that in ~75% of cases, that early style of attachment stays with you and is similar to the types of relationships/attachments formed in later life. Although, keep in mind that it has also been suggested that certain "buffering" factors can help mediate that connection. So a rough time in childhood does NOT necessarily mean that you are doomed to repeat that pattern as an adult.  

So there you go, some points to ponder. Here's what I'm interested in hearing from you:

My son has been very attached to me, since very early on. At 18 months of age, he would get upset if I left the room to go the bathroom, even if he was in the company of his father or grandparents who he knows very well and loves dearly. A good friend of mine's child went through a phase (granted he was quite young, maybe only 6-7 months or so) where he would get upset when she bent down over the sink to brush her teeth and was momentarily out of his view. Both of these kids improved immensely, but then with no warning would show this intense reaction all over again. No precipitating event, so stressful time, no new baby, move, change of preschool or daycare, illness of loss of a family member etc. Then it would subside, only to return again. And so it went. This summer,at almost 5, my son went to a day camp for the first time (for 2 weeks). He did not know a soul, it was in a location he did not know well, first time taking his own backpack, own lunch etc. But he did not even blink. "See ya Mum". That was it. Ditto the first day of school some weeks later. So we seem to have come out the other side. It's understandable to me that there may be sensitive periods in development when kids are more likely to suddenly seem anxious about separation again, but sometimes he would sail through those sensitive periods without a blip and sometimes not. 

I'm interested to hear from you about "bouts" of separation anxiety. Anyone out there have a child who would "zoom" in and out?  At what ages?  What do/did you attribute it to?

Finally, as a mum of only 1, I"m always interested to know how kids with siblings cope with things. If you have more than 1, are/were your kids similar or different when it comes to separation anxiety?  Also, do you think that how the younger one or ones handled separation from you was different to how their older sibs handled it because they had sibs - read: company - to help tide them over until you returned? 

Send me your thoughts...

--Tracy

Can You Hear That? Listening Study Yields Amazing Insights About Early Human Language

In response to yesterday's blog on clever techniques researchers use to get at the goings on of the infant brain, someone asked if the "habituation technique" I described with looking is also used with listening. If you missed that post, click here for a quick primer. The answer of course is YES!

I was going to post an example of a listening habituation study but if you read yesterday's post, you can probably figure out how that would go. Here, instead, is an example of a listening study using a different listening technique called "conditioned head turning". I wanted to include it because it is one of the more famous studies with mind-blowing findings (if you didn't already hear about it in the media), that have come from infant listening work. I hope you agree that it's incredibly cool!

Check it out:

The Scoop: All babies are born with the capacity to acquire language and which one (or ones) they end up using depends on which one (or ones) they are exposed to. So it's not so surprising that young babies can hear and tell the difference between speech sounds that us old folks can no longer hear e.g. Japanese infants can hear and discriminate between the "r" and "l" sounds in the English language more easily than Japanese adults. Interestingly, the paring down of your sound repertoire to the sounds in your language (s) of exposure happens around 10 months of age, just around the onset of language production. It's as though the brain is honing in on what it will need to find our way in the social world.

In fact, the evidence suggests that this "honing in" may apply to social stimuli in general i.e. not just language. Another study showed that young infants can discriminate between different faces of the same race, a phenomenon that holds for different races; Chinese, Caucasian, African etc. But by 9 months of age, they seem to lose that fine tuned ability and are best at discriminating faces of their own race!  Read: social input goes a long way to influencing our social perception. Here's a link to one of the relevant papers in case you're really curious.

Notice that the speech and face processing narrowing is happening around the same time? Why? Probably because it's more efficient to be finely tuned to the social environment you have to deal with, the one you need to find your way in, to have your needs met in etc.

I don't know about you, but after reading this stuff I usually have two reactions: 1). Wow! Fascinating! and 2). Holy crap it's so much responsibility raising a child. What is he being exposed to?  Do we educate bilingually?  Is he getting multiracial/multicultural input?  Is that necessarily good or bad or something I should worry about at all?  Ughhh!  Then I usually realize that time is marching on and stuff is happening anyway, like it or not. There's only so much we can control...

- Tracy

What's going on in that sweet little head of yours?

Ever look at your baby and wander what the heck is going on in that head? Ever read those articles in magazines or newspapers or hear stuff on the radio about scientific studies on human infants (non-medical) and wonder "How the heck do they know that?".  Can't exactly ask the baby. Heck, they hardly stay awake long enough to find out anything anyway, even if they could talk.

This week I thought I'd take you behind the scenes of infant research to give you a peek into how scientists get inside that head. In a nutshell? They take advantage of the things that babies already like to do such as suck, listen to and look at new things. Looking has probably been explored the most. And dude, you'd be amazed and what we've learned from theses studies.

Looking studies typically use something called "visual habituation". The set-up looks something like this:

 
Mum or dad wears a pair of headphones, so they can't nudge, budge or influence baby's behaviour in any way (like try to make them look especially brilliant- kidding, kidding...). Baby is given something to look at on the screen (image, video etc.). At first the baby is interested and looks intently ("Hey, what's that?!"). But eventually, baby gets bored and starts to look away - "That again, whatever..." We say that the baby has "habituated". Then the display changes and baby sees something new. If they look with renewed interest - "What the...?!" (we call this "dishabituation")- then we know that the baby detected the difference between the old and new thing. That's it.

Ho hum, you say. But get this, sometimes the change between the old and new thing can be VERY subtle (we're talking teeny-weeny). By tweaking these subtle changes - while keeping everything else in the displays the same - we've learned a whole host of things about what 's going on in that noggin'. And we're talking tiny babies (newborns, 1-month olds) right up to toddlers. 

Check out this example: In one study, 6 month olds who were habituated to displays of say 8 black dots on a white screen, looked longer when the display changed to 16 black dots. As the two displays contained the same brightness, density of dots, total area of the dots  (i.e. the amount of black), the researchers concluded that the infants must have detected the difference in number. We're talking 6 month olds here people, they're not counting (at least not the way we do)! Cool huh? 

Infant looking has been used to study everything plus the kitchen sink: we're talking awareness of spatial position, proportion, solidity of objects, understanding gravity, adults' intentions (did they mean to grab that object or just touch it by accident?), discriminating faces of the same race, sensitivity to facial expressions and even to rudimentary addition and subtraction (with some conclusions more hotly debated than others).  And get this: it takes longer for babies of depressed moms to habituate to a happy face compared to babies of non-depressed moms, presumably because it's more novel to them! 

Kinda makes you see that bundle of sweetness in a whole new light doesn't it? So what do you think? Are you surprised by some of these findings? Did you have other ideas about how researchers pried their way into the infant brain?  Wanna know about anything in particular about the baby brain? Send your q's and stay tuned to hear more about ingenious ways of getting at the inner sanctum later this week.

More on perseveration...

Check this out!

 

Are you back? Ok, that was another example of a perseverative or repetitive behaviour from a task you can try at home with your baby. The child watches as you hide an object in one of two identical covered locations. You can create these by just putting two identical covers (cloths?) over two identical cups or other containers. Show the hiding object to your child (something small that will fit in the container), then make sure they are watching while you hide it in one of the cups. Remember to replace the cloth. Repeat this using THE SAME location (location A) a few times. Try 3 or 4 times. Then the next time, hide the object (making sure your child is watching) in the other cup (location B). Replace the cloth cover. What happens? A typical infant of around 9-10 months of age is likely to search for the object in location A again, and not in location B, where they JUST SAW YOU HIDE IT!!   What can they possibly be thinking? You know their eyes work!

This is called the A not B error.  The A not B task was developed by the famous developmental psychologist Jean Piaget. Piaget argued that the tendency to search again at the A location on the first B location trial was related to the infant’s lack of understanding of “object permanence” or the idea that an object continues to exist even when it is out of sight. There has been some debate around why children commit the A not B error. One of the biggies has been that your darling, brilliant angel simply  cannot control the urge to reach at location A, and  instead go with the new information that the object is now at location B.  Sound familiar?  It’s just like on the card-sorting task we talked about earlier this week. The A not B error is usually overcome by 12 months of age.

Try it. You'll see. If you have a 7-10 month old at home, try it now and try again around 12 months of age. You'll be amazed at the difference. And I'd love to hear about it! For more on the practical implications of this stage, in particular, what it might have to do with sleep problems, check out these older posts.

Reader's question: What can we do to maintain good sleep habits during transitions?

Here's an interesting set of questions that resonates with several that I've received. The crux of the concerns revolve around what happens when previously great sleep habits start falling apart during developmental transitions. If the idea is to try to AVOID sleep training during these transitions, what do you do when everything that USED to work doesn't work anymore? There's no magic bullet here, but I'm going to try to address this question in parts so we can think about it more clearly.

Now our Little "J-Bird" is nearly 10 months old.  All the things I read about are happening & are affecting her sleep:  she definitely understands object permanence, she's cutting a 3rd tooth, pulls to stand everywhere & is just about to cruise. And her good sleep habits are starting to fall apart, one by one. 

Here are my questions:
1)  If about 8-11 months is a sleep training "blackout": period, what do I do to MAINTAIN the good habits she's already got?  For example, she consistently wakes to feed once during the night, typically after 7 or even 9 hours of sleep.  She nurses for nearly a full feed, then I rock her for 2 mins TOPS, then it's back into the crib & right to sleep.  This week, though, she has been demanding that I rock her for longer & longer.  A few nights ago, the entire production took 1:40, where it would normally take about 20 mins.  How do I not do any NEW sleep training but avoid letting what good I do have slip away??  Needless to say, I was a WRECK after that 1:40 starting at 2 am & shudder to imagine what will happen if this is a new pattern I must live with for 2 more months.

Unfortunately, I think what most of us do to maintain good habits is keep up the routine we have going, that was working, to the extent that we can. So, same book, songs, bathtime, whatever every night. But as your case easily demonstrates, the same sleep routines can start meaning vastly different things to kids during developmental transitions and so they may stop "working." Recall what I outlined were the main features of this transition: separation distress peaks, object permanence comes on line, and the baby is all about social referencing. So, it's no wonder that your 2 min rocking session has become this protracted experience and you are NOT the only one this has happened to. For so many of us, we would have loved to rock our babies to sleep for years (I would happily do it even now if my 3.5 year olds would let me), but when that peaceful 5 min rocking session turns into a 2-hour battle of wills in the middle of the night... not so much. MANY, many parents report co-sleeping beautifully before this transition and then suddenly, it stops working (Of course, many families co-sleep without any problems for years and years, I'm just referring to those that start having difficulties, and often these difficulties fall around the 9-month mark). And that's because in both the rocking or the co-sleeping case, the baby has some new-found obsessions: to keep you NEAR her (to avoid separations), to LOOK for you constantly (because you being out of sight no longer means you're out of her mind) and to "reference" or check with you that everything is ok, that all is well with the world. So, you may HATE to hear this (and I don't blame you), but there IS no way to maintain EXACTLY the same routine you've establish and NOT sleep train again. Because all that sleep training really entails is CHANGING habits/associations that are linked to sleep. And if rocking now entails lots and lots of pleas to remain with your baby, then it's not working for you anymore (and probably not for her too, because she's probably not happy during those protests).

From my perspective, you are in the middle of this transition and riding it out is one of the only options. It WILL get better, probably in a month at most. Until then, you can do what you've already figured out yourself: (a) resign yourself to rocking for over an hour or more (maybe putting on a good podcast or some good music on for yourself will just help ease the crazies a little for you), (b) try your favourite sleep-training method for 3 days and if you don't see any improvement, go back to (a), or (c) try some gentle night-weaning techniques that may be less aversive to you than outright sleep training. The problem might just go away if she's not waking up to be fed anymore.

2)  What do you think about the idea of scheduled awakenings to eliminate night feedings?  Some of the descriptions of the practice include progressively reducing the amount of time or amount the baby feeds during the night, others do not.  There's even a 1988 study in Pediatrics that (according to the PubMed abstract) found the method to be as effective as controlled crying.  The practice is alluring to me, since any kind of CIO does not work for our family.  However, it seems to be rarely suggested in any sleep books (I think I've read ALL of the "biggies").  The only one that includes it is The SleepEasy Solution, but that's in conjunction with a CIO.

My answer to ALMOST any of these sleep training technique questions is: sure, give it a try. Really. If it feels right to you, if you think you can give it a go for a few days without it driving you or your partner nuts, and if you are at your wits end, then give it a try. Be consistent with it for at least 3 days (outside of transitions, I'd give it a week) and if there's no measurable improvement, you haven't lost much. But I have to interject the final caution: it may not work NOT because it's the wrong technique for your family, but because of the timing. If you DO try it and it DOESN'T work, I'd recommend you give it another go when you're out of the worst of this developmental phase (around 11 or 12 months).

The bottom line is that the end of this blackout period seems really far away to me.  Not only am I terrified that I'll lose the good practices we created when the last sleep window was open, but I also dread continuing the night nursing for at least 2 more months.  I thought I could live with the fractured sleep when I had a 7 month-old, but it now seems to be destroying me.  So, might scheduled awakenings be worth a try?  If so, how do you suggest we implement it?  If not, is there ANYTHING else I can do during this time to get more continuous sleep?  (BTW, J-Bird is breastfed, won't take a bottle & barely takes a sippy cup; I tried dream feeds at about 5 months but they seemed to stimulate her & she fed MORE during the nights I dream fed.)

It ALWAYS seems so far away, doesn't it, the end of these transition periods? I'm in the middle of one now and I'm FREAKING OUT that OMG I have to wait MONTHS for this to taper off (because, dear me, this CANNOT be my boy's new personality. CAN'T. BE.). But it DOES end. That's really all I can tell you. That and try the above suggestions if you're dying and if they don't work, then don't, don't, DON'T give up entirely. Re-try after the transition period. I think this is one of the things that's had the biggest impact on me when I read emails and hear other parents' stories. So many of them tried so very, very hard to implement a sleep-training technique and it didn't work for them so they gave up entirely for the rest of their son or daughter's early childhood. In so many of these cases, I think that if the same  techniques were tried again during a stable developmental window, things COULD HAVE work out.

Of course, I can coulda-shoulda all I want. These kinds of data DON'T exist. So tell me, readers, is there anyone out there who tried sleep training during a transition period, found it difficult or even completely useless, then re-tried during a stable window with success? Can we give this reader at least some rays of hope that her child's hard-won, previously-established sleep habits may return after this phase, even without much sleep training?

Back to 8-11 months for a reader's question

Although I started to write about the 4-month stage transition yesterday, I want to return to the 8-11 month old stage we've already touched on for a reader's question. I've got a few thoughts about the issues she raises and then I'm hoping that the rest of you can chime in with additional suggestions/words of advice/encouragement. I. is a mother of an 11-month old who has had severe reflux problems from birth. She wrote:

"...And then came teething (he got his first tooth at nine and a half months; now he's working on his fourth - it's been non-stop teething for almost two months, which really has not helped the sleep situation) and his first cold, both at the same time. He couldn't sleep at all lying down; he'd choke and wake up. One of us would sleep in the recliner with him, so he could be upright. And by the time he was better, he just would not sleep anywhere else. And he got harder and harder to get to sleep, too; he'd fight it.

Right now, his good nights look like this:

10:00 - Nurse. Asleep by 11:00, in his crib.

12:00 or 1:00 - Wake up. Nurse for 20 minutes, followed by 20 minutes of holding to get into deep sleep before he goes into his crib. (If he's put down before then, he cries and we risk a complete wake-up.)

2:00 or 3:00 - Wake up. Nurse for 20 minutes. Go back to sleep, but only on a person; at this point, he just will not go back to sleep if he's not with a person, so one of us ends up sleeping in the recliner with him.

7:00 - Wake up for the morning.

And on his bad nights, anything can happen - he doesn't go to sleep until 12 or one, then he's up every hour all night long, with an hour and a half in the middle of the night where he's totally awake and ready to party. Or he just won't sleep at all except on a person.

He tends to make up for it by sleeping more in the daytime; after bad nights, he'll get more sleep during the day (always and only on a person, though; I cosleep with him at every nap, because otherwise there is no napping) than he did at night.

It's not really a sleep pattern so much as a sleep dysfunction at this point. We'd cheerfully cosleep with him in the bed if we thought it was safe, but our bed is really high and has no rails, so he'd have to sleep between us, and we're both large people and my partner is a heavy sleeper, so we're a little worried about that. (One possibility would be to get a new bed, or to get bed rails for this one. If that's what it will take, we'll do that.)

Our pediatrician has advised crying it out. But intense, long crying spells tend to lead to reflux episodes, which leads to a) more crying and b) vomiting, and by the time he's soothed, cleaned up, and changed, he's awake, so crying it out seems like a bad idea for him. (Also, I really don't think we can take it; time and again, we've been the parents who caved after a minute of crying. We'd both rather be up all night than let him cry, in all honesty.)

Other people keep telling us that it's the nine-month sleep regression, but - he's eleven months old. It seems like this is more than that.

Any advice would be very, very welcome. I'd especially welcome suggestions for a sleep training method we can use, and some idea of when to start it, and any ideas about what we can do in the meantime."

Oh man... this sounds so hard for everyone: your poor baby and his "growing pains", what with the reflux, teething, and first cold and poor you coping with trying to soothe a baby in pain all the while terribly sleep-deprived . As I see it, there are many parts to this sleeping "question":

1. Reflux problems and the associated sleep situation that requires mom or dad to sleep with the baby upright on a recliner.

2. The child's developmental age.

3. Frequent night wakings, sometimes completely unpredictable.

4. The child being overtired when nights are bad and compensating with longer naps during the day.

5. The desire/need for you guys to co-sleep but the obstacles therein.

6. The need to change the sleeping situation with an appropriate method that works for the whole family.

PHEW!  Did I get it all? It really does seem like some change is required for the whole family to get more rest and feel better. I know there are many parents out there who have dealt with reflux problems and have found various solutions along the way. Given that you've been dealing with reflux problems with your boy since birth, you're probably an expert yourself by now. That's not my area of expertise, so I'm hoping others will join in with their words of wisdom on that front.

So, let me start with #2: Even though he's 11 months, he most certainly still can be in the throes of this developmental transition that starts around 8/9 months. He should be heading out of it soon, and in the next couple of weeks, you can start trying to implement a new plan. IOW, it's good timing to make a change.

#3 and 4 are connected. The frequent night wakings may be in part a function of your child being overtired which, in turn, has an impact on his napping situation, and so on. You may have heard from way too many people that children often have a harder time going down, sleep fitfully, and LESS, when they're overtired. Although Weissbluth seems to suggest that this is a new insight, our grandmothers and nannies have known this forever. My first suggestion to you would be to try to put your baby down "for the night" at an earlier time, especially given how early he still wakes up (7 am). Some kids wake up late (at around 9pm) and so they go to sleep for the night later as well (10 pm or so). This difference in sleep windows is often culturally determined and often reflects a preference for later nights and mornings on the parents' part (as well as the child's). That's all good if the child is getting adequate amounts of sleep. But in your case, that may not be the case given your description. So, my first suggestion would be to try aiming for a significantly earlier bed time, like 7 pm or 8 pm. You probably won't be able to make this change immediately (although it may be worth a try). So, you can gradually inch his bedtime earlier and earlier over the course of a week or two. Although not all babies respond well to this, many do. And counter-intuitively, many babies sleep longer when they're put down earlier.

#5 may be the most straightforward one to tackle. If you and your husband want to co-sleep and you think this will be the best way for all of you to maximize your sleep, then go for it. If you can afford a new, bigger bed that will make everyone more comfortable this may help. Some bed rails may work, but I'd be cautious about how safe they are for wriggling, soon-to-be toddlers. Also, keep in mind that this is a change in your sleeping situation that may last for a long time. If you and your husband like the idea of long-term co-sleeping, great. But if you want to just do it for a month or two to get out of a "bad patch", then you might want to consider what your ideal sleep situation would be instead and work towards that. Your baby is entering a great, relatively stable, resilient stage very soon. This new stage is a window during which you can shift sleep patterns; a lot easier than making changes during the 18-21 month period!

Finally, #6: I'm not big on advising any sleep-training method over another without knowing a family very well. My approach is more along the lines of providing all the possibilities and letting you choose what best fits your parenting style. In our book, I reviewed the main sleep-training methods and the pros and cons of each (it would take pages and pages to do that again here and it probably infringes on some copyright issue or another). You're obviously not into CIO methods, so stay clear of any of those. For the life of me I can't understand why pediatricians advise families to carry out sleep-training methods that go against the parents' own general approach: it's insensitive for one, there's no empirical research to suggest any of the more extreme CIO methods work any better than the more systematic non-CIO method, and the advice is doomed to fail if parents don't feel comfortable following through with the method consistently.  (Gah. I'll get off my soapbox now. Sorry.) More importantly, full-out CIO sounds like it would not be a good thing for your baby, given his serious reflux problems that get exacerbated when he cries a lot. There are gentle, "no cry" techniques that have worked for many families (Pantley is the guru for this approach). These are methods that allow you to gradually change sleep conditions while still providing some level of comfort and support for your baby. There's more graduated methods like Ferber's, that does allow for kids to cry, but for short periods that you can control. Other "controlled crying" approaches suggest allowing the child some fussing and crying before falling asleep, but remaining with him while he does so. And of course there's various co-sleeping arrangements, which the Sears folks have written about extensively.

Can anyone suggest specific methods that have worked for you in a similar situation? Any words of advice for I. on transitioning to a co-sleeping arrangement? What about the problem of reflux and how it fits into solving these sleep problems?

8 - 11 months Part III: Out of sight is no longer out of mind

I wanted to make sure to elaborate on one of the most important cognitive leaps that happen at around 8-9 months because it has such clear implications for sleep training. Remember a couple of posts ago, I mentioned that kids this age become obsessed with searching for objects? That's because babies younger than 8 months don't have the working memory capacity (again, think of working memory as similar to the RAM in a computer) to keep any goal in mind, even a simple one like finding and playing with a toy. BEFORE this age, out of sight is really out of mind. By 6 or 7 months, babies will certainly be aware that a toy or a person has disappeared from view, and they may gaze intently at the place where the disappearance occurred. But only for a few moments. Then their gaze wanders about the room, and before long they forget about the vanished object completely (that's why babies that young are so easy to distract and redirect). This is one of the most surprising and counter-intuitive features of mid-infancy. Hide a treasured toy under a mat—right in front of the baby’s eyes—and your 7-month-old will invariably fail to lift the mat to find it. It’s as if the vanished object has disappeared from existence. Do it over and over, showing the baby that you are hiding the toy they want so much under the mat right in front of their face, and they will repeatedly look around, clueless, when the toy is hidden.  This was basically the classic experiment by the "father" of cognitive developmental psychology, Jean Piaget.  Try it for yourself if you have a baby younger than 8 months... 

Of course, Marc and I had to test our kids when we knew they hadn't reached this stage yet. To give you a sense of what it really looks like, here's a quick clip of one of our boys "failing" the task at 7.5 months old:

Download 7.5 months- OP

    This “cluelessness” about disappearing objects changes between 8 and 9 months when they become capable of keeping the vanished object in mind while they lift whatever it is that’s covered it. Now they know that a vanished object can be retrieved. And that means that a vanished parent can be retrieved too. Before 8 months, if you walked out the door and didn’t come back, there’s a good chance your baby stopped looking for you in less than a minute. But if you try the same disappearing act a month later, your baby will almost certainly do everything in his power to get you back. He will not forget that you’re out there. If he wants you, he will yell, scream, and cry in frustration, knowing that you are accessible and yet stubbornly refusing to reappear. Now you can see why this is such a potentially tough age to sleep train. Once babies basically get the hang of this stage, by around 11-12 months, they've had lots of experience with mom disappearing and then predictably reappearing and the whole goal of bringing mom back is not as compelling anymore.

Cool, huh?

(BTW, you can find tons of youtube videos of kids going through that "object permanence" task. There are way too many grad students in developmental psychology trying it out on their own kids, I suspect.)

8 - 11 months Part II: Reader's question about night weaning & sleep

There are so many fascinating change during this transition period that I could spend 10 posts just going into the emotional and cognitive characteristics of kids this age. But in the interest of also being pragmatic and helpful to the more sleep-deprived, let's talk about B's questions about her 9-month old daughter:

When J [my daughter] was born I quickly realized that she was a better sleeper in her own space.  Due to space limitations in our house, and the assumption that she would have similar sleeping habits to her sister, I set up the co-sleeper next to our bed.  We set up the crib once she became mobile.  She wowed me those first few months by sleeping long stretches (upwards of 7 hours in the 2.5-4 month range).  Nothing like her sister!  She is also able to put herself to sleep with minimal crying - this is after I have nursed her and I lie on my bed next to her crib.  Sometimes I have to pick her up once or twice if she is really mad.  I am not comfortable leaving the room and letting her cry alone.  I hold her when I can, but sometimes she is just so mad/tired she bucks and arches her back and settles more quickly if I just put her down.  She is definitley a tension releaser when she cries.

Since the 4 month mark she has been feeding more at night.  I was expecting this and was prepared for the 4 month sleep regression.  And I realise that now, at 9 months, there is also a sleep regression thing going on.  Due to growth spurts, teething etc. she is nursing more than 3x per night.  I take the short and easy road when she wakes and nurse her back to sleep in our bed, so that everyone gets the most sleep.  Well, most everyone.

The co-sleeping, constant night nursing worked fine for baby #1.  But mama is a little more tired with two children and is ready for more sleep.  We have moved the guest bed downstairs and now [the girls] will each have their own room at the end of next week...  I plan to use the Dr. Jay Gordon method to night wean J.  He doesn't recommend night-weaning until 12 months.  I think it is pointless to night-wean at 9 months due to the sleep regression thing.  I am hoping we can keep up the the "going to sleep by herself as long as mommy is in the room" and then gradually move mommy into the hallway etc.  I am also hoping she will sleep better in her own room because she won't hear us coming into bed etc.

I guess I want to know if there is a BETTER time to night-wean?  Is night-weaning the crux for getting her to sleep through the night?  As I said, I haven't received/read your book yet, so the answer might be in there.  Obviously I would like to night-wean before 12 months, but not if the timing is bad.  Can you offer any advice about the BEST timing for night-weaning given that she will be moving into her own room soon?  Should I night-wean her in my bed first, and then move her into her room?  Should I try a different strategy given her tension-releasing personality?

And if you can tell my why all my friend's babies (same age as J.) are all sleeping through the night I'd love to know!

Let's start with that last HILARIOUS statement. I'm tempted to suggest that all your friends are lying, but of course that's just plain obnoxious of me. But I would wait a week or two and see if that sleep setback that hits most 9-month olds doesn't also hit your friends' kids ;-)

Your instinct is right on. Night weaning at 9 months can be a tough battle. Yes, there IS a better time. The next stable period starts around 12 months. From 12-16 months, kids are much more resilient and weaning can be a much easier process than at 9 months when separation distress is peaking.

To elaborate more on the nature of this transition let's think about what the 9-month old baby is all about: beginning around 8-months old, she is very attentive to adults in her environment, and in particular her mother (poor fathers often take a back seat during this phase). The 9-month old is very attuned to her mother's goals and to where her mother is looking. What does mom see? She's also attuned to mother’s emotional cues, as conveyed by her facial expressions. What does mom think of this situation? What does she want me to do about it? In particular, we see an infant who begins to understand joint attention, who experiences herself as a social partner with her parent, sharing the same perceptions, the same world. Learning to dance a more sophisticated dance with mom and LOVING it when she can demand, and receive, the attention she strives for. So, weaning a baby at this age is likely to feel like a real intrusion to this new-found synchrony and you're likely to hear loud and lasting cries of protest against anything that disrupts this sense of connection that baby now knows can be initiated and maintained by her own actions. 

In terms of whether you should night-wean before you move her to her own room, there's a few ways you can think about it. If you don't mind continuing to lie next to her crib for the next couple of months, and if that's getting you both the most sleep possible, then you could continue that way and then wean her in combination with transitioning her to her own room. If you really want to move her to her own room now, then you can still nurse her in her room each time she wakes up at night. Having said that, this stage might make it tough to change sleeping arrangements like the room in which she's going down for the night. On the other hand, since you say she seems to really like her own space to some degree, maybe it will go smoothly. You could try and see how she copes with it the first couple of days.

In terms of what strategy to use because she's a tension releaser, I'm stumped on that one mainly because I think during these transition stages, some kids can flip from tension releasers to increasers and vice versa. (If you don't know what we're talking about, check out Moxie's compelling distinctions between kids who increase vs release tension when they cry). It's sometimes even hard to define a child based on this dichotomy during these highly sensitive periods because they ALWAYS seem to be increasing in tension to some degree... until they stop. How long and hard does a releaser have to release before he turns into an increaser? I found it impossible to figure this stuff out when my boys were 8-11 months old and again when they reached 18 months. All I knew for sure during those periods was that I was a tension releaser.

Anyone out there night-wean at 9 months? If it went smoothly for you, any words of wisdom for B? Anyone out there night-wean at 12 months? How did it go for you?

8 - 11 months part I: What's happening in the baby's mind

I've had a few questions about this period and how dramatically it effects sleep. Tomorrow, I'll feature one "typical" question about this period and its impact on sleep. But I think it's also important to know the "good news": the cool new skills that are being acquired during this incredible transition stage. You'll probably hear me say this again and again: one of the only things that got me through the roughest of the transition periods in my boys' development was knowing that underlying the crazy sleep disruptions and general neediness were these almost magical changes in the way that kids think and feel about their world, especially their social world.  So here are some of the details about the developmental leaps kids are making around 9 months, taken from our book.

FROM Bed Timing: "Starting at around 8-9 months, babies learn to point, an operation that combines a hand gesture directed at an object with attention to the target of the other person’s gaze. They also learn to look where someone else is pointing, combining their attention to the pointing hand with their attention to objects at some distance out there in the world. Before this, children act like your cat: if you point at something, they look at the tip of your finger, not at the object you were trying to refer to. Pointing doesn’t make sense unless someone is looking where you’re pointing, or you’re looking where someone else is pointing, and it is not until this age that the infant’s working memory can hold onto both parts of this equation. Babies also learn to find objects that are hidden...  The capacity to retrieve hidden objects makes it sensible to search for them, just as the capacity to look where someone is pointing makes it sensible to point... As we will see, the 8-11-month old’s obsession with retrieving hidden objects is fundamental to a major change in social development: the onset of separation distress, based on an obsession with retrieving hidden parents.

Another social habit that emerges at this age is gazing at other people, usually parents, for cues as to the meaning of a situation. This is called "social referencing." The classic experiment to test social referencing involves a piece of apparatus called the visual cliff. This is a plexiglass (see-through) surface that covers an actual cliff—a drop of several feet in a plastic surface, often composed of brightly coloured checks for easy visibility. In the classic experiment (yes, we like to mess with babies), the infant is invited to crawl across the flat, plexiglass surface, which he very often does with little prompting anyway. Then he arrives at the cliff. Although there is no real danger, it appears to the infant that the floor is about to drop away from under him. Should he proceed or not?  Before the baby is 8-9 months, she (at least those who can creep or crawl) usually move blithely across the visual cliff, whether trusting in some divine protection or just plain oblivious. But now, at 8-9 months, they generally stop and look around for their mother. Once they catch sight of her, they look at her facial expression. The experiment is usually designed with instructions for mother to either smile encouragingly or to frown and look discouraging. Before 8 months, babies don't care what their mother's face looks like at that point; they go on their merry way or not. But starting at 8-9 months, infants’ actions depend very much on mother’s expression. If she is smiling, they proceed across the visual cliff. If she is frowning, they stop, and treat the cliff as dangerous. The point of the experiment is to show that the older infant decides whether to cross or not based on the parent’s nonverbal communication. Their interpretation of a situation is completely based on the reaction/signals of their parent." END QUOTE

Does this amaze other people as much as it does the geeky developmental academics?  We completely FREAK OUT about how consistently you can find this new skill at 9 months and how non-existent it is in 7-month olds. This new "social awareness" is linked to the emergence of "separation anxiety or distress" and "stranger anxiety."

The specific implications for changing babies' sleep habits are HUGE...