Baby Lily was 5 months old, and she had been waking frequently through the night. Mum was anxious about Lily crying, so as well as feeding Lily 2 large bottles of formula in the night, she was getting up and popping a dummy back in Lily’s mouth as soon as she stirred. Lily had therefore developed a great dependency on the dummy, and was starting to reverse cycle with her milk (not feed well during the day as she was having so much at night), and catnapping was becoming an issue as Lily was needing the dummy to get back into a deep sleep, but was waking fully through her naps hungry as she hadn’t fed well in between.
Overtime as Mum had such a long build up of sleep deprivation, she was starting to feel unable to cope. Mum was stuck in a cycle of not getting into a deep sleep as anxiety over Lily crying started to peak further (compounded by lack of sleep) and she was anticipating Lily stirring and rushed in to prevent any crying as soon as this happened. Mum was also struggling to do her part time work during the day as Lily had no routine and would not sleep for long during the day. It was all getting too much and Maternal Mental Health was called in to help.
Lily’s Mum also found Baby Sleep Consultant, and decided to book in an assessment to help. I completed an assessment of Lily’s sleep, and why this was so difficult for both her and Mum. Both the mental health team and I came to the same conclusion- Mum was struggling with sleep deprivation and anxiety which was compounding each night.
I devised a plan that started with addressing Lily’s sleep environment, and the timing of her naps, so that we could ensure she could get the rest she needed during the day to help with night sleep. We could then tackle a plan Mum was comfortable with for settling Lily without the dummy, and helping her gain her own skills for sleep so both she, and therefore Mum, could get some much needed rest both night and day. Mum had realised that Lily had gotten to a point that she was going to be frustrated at having her dummy taken away, but the only way forward was to remove this prop as it was going to be some time before Lily could find and replace this herself, and Mum needed sleep ASAP. Mum had accepted some crying would be inevitable, but was motivated and prepared with a plan to tackle this, knowing she also had me to support her through and the ground work of environment and routine. Mum decided through understanding of why particular settling methods don’t work, that it would be easier on both Lily and herself to give Lily some space to hone her skills, whilst reassuring Lily that she was still there. Mum also felt she didn’t have the time or energy to commit to a more presence based method that can take longer, and felt Lily’s temperament was also not suited to such a method. Mental health team were in the background, and Mum had support from her partner and family and myself with an unlimited email upgrade. She was ready!
Lily took to settling herself like a little champ! She had the skills there, she just needed an opportunity to use them. Night one after 2 practice times for naps that day, Lily slept 7 hours straight! Mum was ecstatic, and immediately reassured that both she, and Lily could do this. From then on Lily was settling easily in under 10mins, and was barely even grizzling to settle herself, and had gone from waking up to 2 hourly at night for a feed or dummy to 1-2 night wakings. It took a couple of days to iron out feeding by cutting back on night time milk, but within the first 3 days Lily was taking much bigger feeds 3-4 hourly through the day, and was napping a consistent 2 hours easily in the afternoon within 5 days. In the 2 weeks we worked together, Lily even managed a couple of nights where she didn’t wake for a feed at all! Something we don’t expect of a baby until much older.
Mum was thrilled, she was so much more well rested, coping well, and easily doing work at home thanks to Lily napping well and a routine that meant she could quickly read all of Lily’s cues and meet her needs easily. Mum had found that confidence in herself and her parenting of Lily. The biggest bonus of all was that the support nurse who was booked for 3 nights to help Mum get some rest, was no longer needed, and Mum could be discharged from the mental health team, meaning that the nurse could be freed up to go to another family in need.
It is great that in NZ there are avenues of support for Mums who are not coping with the huge challenges of having a baby. With the support of the Maternal Mental Health team this courageous Mum was able to get through her challenges and seek help to get some sleep in order for her to cope. This case study also highlights how a lack of sleep can have a huge impact on the well being of a family, and is not something that should be taken lightly. As sleep consultants we come across situations that are unique particular families. We work with parents that cope quite easily on lack of sleep, and also many that don’t, therefore we have many solutions for sleep that fit with the individual family’s needs. Lily’s Mum needed a fast solution, and we were very successful with this as Mum had the support, recognised her own limitations, and understood her daughter’s temperament. It is quite likely that Lily settled as well as she did because of this, and she may have cried considerably with a different method. Other family’s have the capacity or their own personal philosophies, as well as different troubles for baby and temperament, that calls for different strategies.
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