Friday, 24 January 2020

sleeping through the night at 8 weeks : it happened again

today i'm sharing our tips on how we got our baby girl to sleep through the night at 8 weeks old. i thought it was a coincidence that our son was a good sleeper, and he slept through the night from about 12 weeks, but now i'm not so sure it's a coincidence. and just in case it's not, i want to share what we did, what we read, things that helped us, in case some tidbit here makes all the difference for you.

sleep is SO important, for all the family, and when you're both not getting enough, it's really, really tough.

i wish that this blog post could be a formula for success for everyone, but unfortunately i can't guarantee that if you do everything we did that you'll have a sleeping baby. each baby is different, as is each parent and home. i can only share things that i know have helped us establish good sleep. i am not a sleep expert, and i'm not a doctor. these are just things i've spotted that we do differently from other people, and they may be a factor in the sleeping, or they may not.

so let's start with a couple of important pieces of information...

firstly, what do i mean by sleeping through the night? everyone has a slightly different definition of it, and i simply mean that the baby is sleeping whilst we are sleeping, between about 10pm and 6am.

secondly, both our children had breastfeeding jaundice, which made them extra sleepy for the first couple of weeks of their life. this meant that they had to be woken up for every feed, instead of waking themselves, so this enabled me to set the pace of their feeding more easily in those initial weeks.

now let's break it down...

the feeding cycle

one of the things we learnt early on with our son, was that in the neonatal unit at the Belgian hospital in which he was born, ALL the babies are on a 3 or 4 hour feeding cycle. demand feeding wasn't really an option, i had to be there to wake him, change him and then feed him before he feel asleep again, and he was really only awake for about an hour at a time.

this meant that he was never overly hungry. it meant he rarely cried. it meant he was always fed enough to sleep well. i guess if in those first couple of days you let them sleep too long, then you could end up in a hunger cycle that would be hard to get out of.

i used to set a timer for 4 hours in those early days and nights, and make sure to wake baby when the timer went off. the timer indicated the beginning of one feeding session to the next - so for example i would feed at 4am, 8am, 12midday, 4pm, 8pm, midnight, etc. in the neonates, we started on a 3hr feed cycle and then went to a 4hr cycle, because he was smaller to begin with, but with our daughter we did 4 hourly to begin, and 3 hrs when we were treating her jaundice for a few weeks.

after a couple of weeks, as they got more alert, they were awake more often, or waking for feeds themselves. at that point with both my children, at about 3-4weeks, i switched to demand feeding in the day time, especially as both of them did spit up a lot, and our daughter even did a round of projectile vomiting! that way, feeding more like every 2 hours was a little easier for them, and made sure they kept it down.

don't overstimulate

the next 'secret' is that babies often look fully awake and then fall straight back to sleep. sometimes our daughter would even cry really loudly for a few short cries - it sounded like she was having a nightmare - and then go straight back into a deep sleep.

the key to the secret seems to be to resist the temptation to play with them or stimulate them. just let them be, and see if they don't put themselves back to sleep. most sleep therapists would say that the skill of being able to put themselves back to sleep is the key part of getting them to sleep through the night. and to do that they need to be able to practice in those early days when they're sleepy.

what we do is let our daughter make a few noises, and we only pick her up when it's consistent.

we also don't overstimulate in the day time, she's 3 months old and she doesn't do classes or too many outings, about all she can manage is to kick on her mat and attempt to grab her rattle, then she'll get annoyed and want less stimulation, so we pop her in her moses basket. it's ok to let them lie in a basket not doing too much, not looking at anything, i believe that in those times they're being allowed to figure out how to use their muscles and keep their brain calm in idle moments. and they're also figuring out that it's ok to be by themselves.

more sleep equals more sleep

we've always been sure that the whole idea of keeping them more awake in the day so they sleep at night is a myth, that actually you want to encourage sleep in the day, and that actually helps them sleep better at night.

sometimes it's imperative to force sleep by driving them around in a car seat or putting them in a baby carrier or wrap. that's what we did when our son was out of routine and we needed him to sleep more so that he would sleep more, and it's always worked.

if you're not sure how much sleep your child should be getting, you can check the Gina Ford book The Contented Little Baby Book (UK/US) - i found this a really helpful guide for how much sleep and how many minutes of breastfeeding, etc, was normal or appropriate for each age. i didn't and don't follow it word for word, but it's really helped us keep moving forward and find patterns.

swaddle, swaddle, swaddle

one of the things we also do is to swaddle in the first few months, because it mimics the feeling of the baby being back inside mummies tummy, all warm and tightly held. if you're not sure how to swaddle, you just need a 120x120cm muslin (like these ones - UK/US), and then to wrap them like a burrito (like in this Youtube video). it's important to do it safely.

a couple of other things we make sure to get right about their sleep environment:
  • not too many layers
  • wearing only 100% cotton to sleep in 
  • in a sleep suit, so there's nothing pulling on their tummy and no socks can fall off
  • in a sleep sack when they're too big for the swaddle
  • covered with a heavy cellular blanket over the swaddle in the winter months, and a lighter cellular blanket for the summer
  • safe - see The Lullaby Trust
  • their nappy/diaper isn't too tight (we usually use the size up for night time), and is fresh on before nighttime
  • the room they're sleeping in isn't too hot or too cold, we keep our house at 18.5c (65f)

avoid sleep associations

this is a really difficult one, and our boy got addicted to being bounced to sleep in the Ergobaby for a long time, and we had to wean him off of it at 18 months (read how we sleep trained him at 18 months here). it will be interesting to see how we handle sleep regressions and periods of sickness this time, because that's how we ended up with that situation with our boy. it's no bad thing to want to cuddle them to sleep when they're unwell, but it was tricky to get out of that cycle.

there are a couple of sleep associations we did avoid that can be tricky to get rid of. but the main one i hear problems with is using a dummy/pacifier - we just never used one, we just let our children be loud, which was not very well looked at by people around us in Belgium who all had one when my son was little. i think this is a bit of a cultural/family thing, but i do know that some kids wake up if they fall out of their mouths and parents have to go in to put it back, causing sleep disturbances

we sometimes feed to sleep, but not always, so it's not a requirement for sleep. i think this all stems back to the first point, of not feeding every time they cry and find other ways to settle them first. we also keep our baby in a separate moses basket and then in their own crib, rather than in our bed. our children, and we, just prefer to sleep that way, we don't really have anything against co-sleeping as such, as it's worked brilliantly for some people we know.

we tried to get our son to enjoy listening to music to relax and sleep and always played him Ed Sheeran. but he never needed it to sleep, or even really associated it with sleep - though it would've been nice to just play some Ed and have him fall to sleep!

one really positive sleep association is darkness - our daughter will sleep so long as it's really dark, it's how she knows it's nighttime. it's quite easy to provide darkness with blackout blinds during the summer months too. but it does mean that our son sleeps better in the winter than the summer, he basically hibernates and still takes a 2 hour nap in the winter at the age of almost 4.

some people swear by a bedtime routine, but we've never done a strict bedtime routine of bath, pyjamas, books, prayers, etc, because we knew we'd be travelling a lot with our son, and we wanted it to be easy for him to sleep anywhere and at different times. so instead, the only solid thing in the routine when they're little is that they're in their room and it's dark. we do incorporate the other things a lot of the time, but we're not strict on it, and we haven't found they really need it to relax before bed, until they're about 18months old when it gets a bit more important to teach them how to do that.

putting them down partially asleep

one of the things we learned from Gina Ford was the importance of putting baby down to sleep when they're half asleep, half awake.

with our son, we got to the point of having to make sure he was fast asleep before we put him down, and with our daughter i'm trying to put her down when she's just fallen asleep, and then letting her drift herself off to sleep again. she will usually put out a couple of loud cries and then fall asleep.

during the night however, i used to put her down when she was pretty awake. i would change her, nurse her til she didn't want any more, burp her for 5 minutes and then put her down, however awake or asleep she was. then i switched off the light. if she cried, i picked her up and fed her again and then put her down again. i repeated until she made no noise when i put her down. it’s tiring, but eventually she got the gist that being awake at night isn't something we do. i didn't talk to her, didn't play, kept the lights low. so by 8 weeks old, she was sleeping through.

take care of yourself mama!

so much of the time, sleep is related to how much they've fed, and how well they've fed. so i want to dial in on that a bit more, and give you my top tips for making sure baby is well fed. if you want to read more, check out my blog post about increasing breast milk supply.

- ditch dairy.
this has been a key thing for so many people i know, so it's worth giving it a shot if you're struggling. i restrict my dairy heavily, i might eat a tiny bit of butter on toast once in a while, and when i go out i might end up eating a little cream in a sauce or something. but i keep dairy-free ice cream and cream and milk in the house - i did this before i had kids to clear my acne (i still only get a spot when i eat dairy, otherwise my face is clear!). check this article out for more info on cows milk protein allergy in babies.

- increase fats and galactogogues.
making sure that you have a really rich diet is so important, you can't expect to make great milk if you're eating nutrient-poor foods, or not getting enough calories. i make a huge batch of cookies each week and eat two each day, full of coconut oil, oats, eggs, and other milk-enhancing foods. i usually have porridge and fruits for breakfast, eggs for lunch and fish for dinner. and i eat a LOT.  you need to keep yourself nourished. one of my favourite books for post-partum health is The First Forty Days (UK/US) - it teaches you why and how to get the vitamins in and looks at traditional cultural ways of doing so.

- feed for long enough!
one thing most people say about me is that i feed for way too long, or my kids are slow. but it's an intentional thing to make sure they're getting the fatty milk that comes at the end of finishing one side. if they get one whole boob, rather than two halves, they sleep loads because they're getting all the nutrients! so make sure you finish one breast before starting on the next!

if baby is fussy at the breast, you need to be the one to keep latching them back on. that happened a lot in the early days, and it's physically exhausting getting them to keep latching on again, but it's so worth it. feeds took 45minutes-1 hour to begin with, and now at 3 months she's taking 20-30minutes for a good feed. make sure you plan the time into you day for this, and relax into it (you want to make sure you also get a good let down or two).

- keep them upright
with both my babies, i kept them upright a lot after feeds, to burp but also to prevent them spitting out too much milk and help them digest. i try to keep my baby upright on my chest for 30minutes after a feed, so sometimes i put her in the Cuddlebug wrap so i can do other things too! the need for keeping her upright disappeared at about 10-12weeks as her digestive system matured.

- make sure you've had plenty of rest
i've said it before, and i'll say it again. babies always copy your emotions, so if mama is grumpy, they're grumpy, if mama is happy, they're happy, etc. so if i'm tired and stressed, what do you think baby is going to be? i make sure to do VERY little during the day, i maybe spend about an hour cleaning each day, and a lot of the rest of the time i'm doing something relaxing, meditative and peaceful - which for me is faith journaling, baking and watching a lot of Gilmore Girls.

dream feeding is the best

our daughter just turned 3 months old, and with that, she had her first dream feed. she'd fallen asleep at 8:30 and i could tell she was in a deep sleep for the night, and as my breasts were still a little full (i hand expressed for a second to check how full they were) i decided to try and dream feed her at 11pm as i went to bed as she still hadn't stirred. and she did it! it takes a while to dream feed, because you pick them up asleep and get them to latch and they keep falling asleep! but twenty minutes later she was done and had emptied them, and then slept all the way through until 7am! so she almost slept 11hrs! she's now been doing this for the last week, and so essentially she's sleeping a whole twelve hours in the night with no wake-ups.

i dreamfed my son for months and months, because it kept my milk supply up, but also allowed him that deep rest throughout the night.

for the first 3 months, she would wake for a feed at 10:30. and i can guarantee that if she doesn't have that dreamfeed she'll be up at 3am hungry for milk, at least until she starts solids.

i know this is a lot of information, so thank you so much for reading, and please do get in touch if you have any questions or comments. and please let me know if any of these things work for you!

i honestly don't want to sound at all preachy or like we have it all figured out. we don't. we've been really blessed with good sleepers. but like i said at the start, i wanted to share what we do because people are always so surprised by how well our kids sleep and they want to know the why, so here it is. plus also, if for some reason we have another child, i'll have all those notes of what we did to look back on!

Saturday, 26 October 2019

she's here! our labour story...

hey all! our daughter has arrived, and we are so thrilled with our gorgeous girl.

today i want to share our labour story with you all, because firstly this blog is somewhat of a diary for me, and i want to remember all the details, and secondly, because i know that i like to read other peoples stories, so perhaps you'd like to know mine... i will hold nothing back, so if you don't like all the gross, gory bits, stop reading now!!

firstly, let's talk about why i had an induced labour. if you're new here, you may not know that i have type 1 diabetes, which although it was very well controlled throughout the pregnancy, they still like to induce early due to the likelihood of a larger baby and need for a c-section if the baby went to 40 weeks. but, for my good sugar level control they scheduled me in for 39 weeks as she wasn't measuring as too big on the scan.

so the day came when i was to be induced, they had actually called a couple of days early to say that the ward was less busy than normal, could i come in earlier than planned? and of course, i said yes...

We arrived for the induction at the labour ward. The induction room at our hospital had 4 beds in it, each with a separate curtain for privacy. However each space was pretty small, just about enough space to sit on a ball if you wanted, and enough space for your bags and a chair for the birthing partner to sit in. One of the hardest parts about induction is being confined in this space waiting for something to happen.

After a little intro into what induction would entail, and what options/routes it could take, i was put on monitoring to check my baby's heartbeat and my contractions. it turned out that i was already having some small contractions, but nothing major. they also did an internal exam to see if i was dilated already, and i was about 1-2cm.

because of the mild dilation and contractions, they decided to give me a 6hr pessary instead of the 24hr. so that was put in at about midday - quite an uncomfortable process as it has to go in a very exact place in your cervix... so for me there was quite a bit of wiggling and shoving and manoeuvring around to get it in the right place. but it was worth the discomfort to make sure it did its job properly.

then i was immediately placed on more monitoring to check it started to do something straight away. when that was confirmed i was allowed off the monitoring, and they told me to get up and about and go for a walk to "get things going".

i walked with Pete over to the hospital shop to get sandwiches and ate them outside on a bench. on the way over there i wasn't really feeling anything, but then by the time we sat to eat the sandwiches i was feeling regular pains, not too strong, but definitely present.

by this time the contractions were fairly thick and fast - it's a strange sort of muscle memory, and it made me feel really emotional, recalling the last time, thinking of the pain to come, as well as the joy, and really feeling like "ok, we're gonna have this baby soon!"

i needed to go back to my bed, and sit, so we found a ball and sat on that - the ball was lovely in those early stage pains, because you can change your position easily to relieve pressure, and it's easy to sit on and lean on the bed too. i loved the ball and was so grateful there was one available.

i was put on more monitoring, and the contractions were already at 4 every 10 minutes. the midwives were impressed!

we waited. waited on monitoring for half the time to check the frequency didn't get too strong too fast. and then we ate some dinner. the thing about induction is that it brings on the contractions, but that doesn't always mean something is happening... so you can contract without any dilation, without any shortening/ripening of the cervix. at least that's my understanding, as well as my experience.

i had an internal exam,. they concluded that there was some small thinning of the cervix but not more dilation, eg not enough to break the waters (which was the next step). but as i was contracting still 4/5 in 10 i was told to wait longer,. the midwife suggested i do a sidewards wiggle walk up the hospital stairwell. which i did, another 3/4hrs seemed daunting in that tiny space, and any distraction was welcome.

i felt really low for half an hour - the idea of more contractions without progress was frustrating - i wanted to meet my girl! and i knew that every hour of contractions was tiring me out for the main event. i had so badly wanted to do this labour faster and without any pain relief... i cried. and then realised that my mood was affecting my contractions, and decided to be determined and positive again. it's crazy how quickly my attitude change affected my contractions.

i was put on more monitoring, which showed that the contractions were getting stronger. i was really having to breathe through them at this point.

i had another internal exam, and they decided that i was just about dilated enough (about 3cm) to break my waters.

my waters were broken. perhaps the most uncomfortable thing ever! it takes a while to find and hook cervix with finger first, and the first student midwife's fingers were too little for my long body, so i had to have it done twice. i was also refusing any sort of pain relief at this point, although it had been offered to me. but oh my goodness, it was a horrid feeling, on top of breathing through the contractions. but after many minutes of wiggling around the midwife hooked it, then used the giant crochet hook to break it. my water came leaking out everywhere, lots and lots.

i was moved straight to the delivery room.

which was good, because the contractions got wayyyyy worse!

i decided that an epidural was needed, as my body was too tired from all the contractions and lack of progression earlier in the labour. and i knew that if it was going to take much longer that i would need some intervention. also, my legs were starting to shake, and i could barely hold myself up on the ball or on my feet. the only other option was the bed, and i know that lying down was far more uncomfortable. i also knew that it would take an hour or so for the anaesthetist to be available, so i wanted to get ahead.

whilst i waited for the anaesthetist, the midwives put a canula in my wrist - i still have bruising from a couple of failed attempts. i tried also to eat some toast, because you aren't allowed to eat with an epidural in.

the anaesthetist arrived to administer the epidural. it's a really tricky procedure, requiring exact position for placement, so i had to sit on the edge of the bed, squeezing my husband's hands whilst i stayed as still as i could during contractions whilst she administered it. i kept repeating "the pain will be over soon" and then finally by about 3:15am it started to work and i felt that warming numbness pass down my legs, not quite to the end of my toes.

i had another internal check, and i was declared 4cm dilated, and officially in active labour. i was still having the same amount of contractions, but i wasn't able to feel them!!

i had on and off sleep, realisitcally i was dozing, and probably only slept for about 10 minutes at a time. i was having checks done every 30minutes, on my sugar levels, my blood pressure and to check the epidural wasn't spreading with a cold spray. i could also top up the epidural every half an hour, so i did that when i needed to.

one thing that really surprised me about the hospital was the permanent 1to1 midwife care during active labour. literally no-one left my side. and then every hour my midwife would get another midwife to double check the baby heartbeats, to make sure they weren't missing anything.

we were both so happy to be able to sleep a little. it had been quite an intense day.

the thing is, last time with my son, i had an epidural because it was the only form of pain relief my Belgian hospital offered, so i knew i could trust that it would work, and i knew how it worked. and even though i'd really wanted to labour naturally, i knew with the facilities available to me and the fact that the induction had been relatively slow, that i just didn't have the stamina or strength.

another internal exam - and this time i was fully dilated! they said it so casually, i was like hold on what?! then standard practice with an epidural is to wait for another hour before you begin the pushing, just to make sure your body is ready, as you can't usually feel that pushing urge.

handover to new shift staff and meet new midwives that will birth our girl. we were also asked if a 1st year Junior doctor could watch the birth, and we agreed - it was his second week of the course and he needed to tick the box 'watch a baby being born', and so it was really cool to be the first birth he would ever witness.

we commenced pushing. it is so weird pushing with an epidural, as you can easily put all the force into the wrong place, and so you really need guidance as to if you're doing it right. they did keep saying that i was doing really well, but it went on for a long time...

as pushing gets stronger, babies heart rate is dropping with contractions as my O2 levels drop, this is usual but midwife decides to review with a doctor.

reviewed by Junior doctor who passes case to obstetrician. they consider the positioning of the head might not be where it needs to be to crown. they have a feel for where babies head lies. apparently i kept almost crowning and then she would slip straight back up.

the obstetrician says to keep going for half an hour and we will review then, as i was pushing so well.

obstetrician asks for review from consultant as baby is not birthing as quickly as expected (later our diabetic consultant suggested that the labour could/should have been allowed to continue naturally and this might be as a result of diabetic bias amongst the team at the time).

the consultant reviews and determines exact baby positioning, suggests an episiotomy and forceps in the labour room will be enough to deliver baby imminently.

obstetrician prepares for this by wearing scrubs and cleaning herself. a baby resuscitation cart is wheeled into the room in place of the cot in case of complications, along with a neonatal paediatrician. i was feeling overwhelmed by all the movements around me, without anyone really asking permission, or feeling like things had been explained adequately. i cried the second i saw the resus cart arrive, it felt all too similar to the birth of my son.

pulled with forceps, quite easily, and had the midwives pull my legs back to get the shoulders out, she arrives! she was immediately placed on my chest, vernex, blood and all. thankfully she needs no help from the paediatrician, she cries a little, seems to be very well and also very large! the cord was left for a time to drain, as the placenta was born, and then we breastfed pretty much straight away (whilst i was being stitched back up).

i was kept on a drip for 4 hours in the room - oxytocin (to stop further bleeding - i'd lost 500ml in the process, which is on the border of concern - and contract my uterus further) and sodium lactate (keep my fluids and electrolytes up). during which time she was weighed - a glorious 9lb 1oz, or 4150g - the midwife wrote up my notes, we called our family to tell them the good news, and we took lots of pictures of her cute little cheeks...

then i was moved to another ward for recovery, blood pressure checks and catheter removal checks (pee twice) post-epidural.

checks on our girl the following day, we discovered a broken collar bone (clavicle), and severe tongue tie, otherwise all well. we went for an X-ray to confirm the clavicle. and the physio was booked for the following week. apparently should heal itself within a week! newborns have really quick healing rates usually. we went home that evening, 36 hrs after she was born.

however, when my milk came in, i got a low grade flu/fever, i was shakey, had a high blood pressure, and my temperature elevated. it went away with breastfeeding. i was sent in to the hospital for review, and they sent me home with antibiotics as a precaution (the blood test results showed i had an infection). i felt better about 36 hrs later after starting the antibiotics.

then, a couple days later, at our next midwife appointment, we spotted she was getting jaundiced, and so we ended up spending two nights in the hospital having blue light phototherapy, and now we are finally home and i'm sat here again, engorged breasts, slightly yellow baby, still with a tongue tie (that hopefully will be fixed next Tuesday) and needing much more sleep than i got at my second stay in the hospital...

birth is different for everyone, but that's my story. please ask questions if  you have them, either here in the comments, or via DM on my Insta (@thealissaevelyn). i hope you found that interesting!

Friday, 13 September 2019

what's in my hospital bag? preparing for our baby girl

hey all, today i'm sharing my packing list for my hospital bag. i'm prepared for a long stay in hospital, because of my diabetes and the fact that last time i had a preemie at 35 weeks... so it might be more than a person really needs, but i'm prepared for a few nights stay and a baby in neonatal care with the amount i have!

hospital bag checklist

for baby:
a pack of size 1 nappies (we use Bambo Nature - UK/US)
biodegradable/compostable nappy bags (UK/US)
wet wipes (we love Water Wipes because they are just water and grapefruit extract - UK/US)
changing mat
clothes for baby, inc. socks, hat & scratch mitts
baby blanket
muslins & swaddle cloth
nappy change cream (Weleda is our fave - UK/US)

for mama:
slippers & socks
breastfeeding bra (i love the iLoveSIA ones via Amazon - UK/US)
3 tshirts (easy to breastfeed in and good for photos)
yoga trousers
large black panties
maternity pads
breast pads
water spray
giant water bottle, with sports cap or straw
fennel tea bags (my favourite is the Three Fennel by Pukka - UK/US)
2 bottles of energy drink
antibacterial hand gel
my expert midwife spritz for bitz (UK/US)
toiletries bag: body wash for sensitive skin, facial wipes, toothbrush, toothpaste, deodorant, hairbands, earplugs
birth notes & birthplan

for my backpack:
spare charger
medical supplies
lip balm
music, hypnobirthing, tens machine, birthing ball, swimwear for birth pool - or other additional birth aids you need - i'm not taking anything other than my phone with a playlist ready to go!

also, read my living life with a newborn blog, which has so much useful info in, i would really recommend reading it, it's so juicy!

please note: i receive a small % of commission from anything bought via any amazon links above. it doesn’t cost you any more, but is a little way that you help this blog keep on going.