Update: 17 months

I haven't been updating this blog, and I fear that I'm kinda done with it.  I no longer need it, since MCAD isn't defining Cupcake's life the way I feared it would.  Our life situation has changed, with moving, I'm going back to work, etc.   Though I want to throw out the occasional update, because I've noticed people who google MCADD end up here, so I want to put out good vibes on the Internet.

Cupcake is now 17 months and she's walking, climbing, and starting to talk.  She plays with crayons, blocks and looooves reading books. Also, her latest obsession is babying her stuffed animals, she holds them, tries to feed them and walks them on her doll stroller.  It melts my heart.

She's also doing great health-wise.  At her 15 month check-up, she was at the 98% percentile for height, and over the charts for weight.  Because of that, we have been officially switched to low-fat (2%) dairy products.  We talked with our nutritionist, and we are on a heart-healthy diet, but  without any major restrictions beyond that.

Nutrition-wise, we have a little foodie.  Cupcake will try all sorts of new foods, and seems to have few texture problems.  Risottos, fish, soups, chicken, veggies, grilled meals, sandwiches, fruits, tacos, Thai, etc, she'll eat all of it.  Great for us, since we can cook one meal for the whole family.  We still stick by the old staples that she loves for snacks and lunch: bananas, blueberries, oranges, low-fat Greek yogurt, pita bread, turkey sandwiches on whole-wheat bread, cooked carrots, peas and bell peppers, chicken.  But she's cool when we want to try something else for dinner.  She's getting more opinionated about not wanting to sit on her high chair, but we're letting table manners slide.  It's more important that she eat a proper diet and develop varied taste buds.

On the breastfeeding front, we weaned at 16 months !  It was easier and harder than I was expecting, though one thing is for sure, it was the best thing for our family.  Cupcake now drinks cow's milk from a bottle.  We weren't able to transition her to a sippy cup, and thinking more about it, with her feeding requirements, we need her to still take a bottle at night.

We are still not taking L-carnitine.  Cupcake hated the taste (would violently reject it), and we had decided with our previous doctor to only take it when she was sick.  We've moved and have a new specialist in Texas, and on our first appointment he did full blood work.  Her numbers came out good (though she still has the genetic mutation for MCAD), so we concluded that she doesn't need any carnitine supplements.

We've made it 17 months without any ER visits or metabolic crises.  Luckily, Cupcake seems to have a tough immune system, and has managed to stay away from major illnesses.  To this day she's never had the stomach flu, RSV, or coxsackie, and for that, we're very grateful.  We take her out everywhere.  She's been in the NY subway several times, and goes to her fair share or playdates, library story times, grocery stores, etc.   We even took her abroad (more on that later).  We haven't done anything particular to protect her from germs, and we've been lucky that she's responded well.

Last month, we had our first ear infection.  Went to the doctor, who prescribed antibiotics, and commended us for catching it so early.  Nice.  She was on antibiotics for 10 days, and it was uneventful.  Her medicine tasted like bubble gum and she loved it; she'd even ask for more.   During this time, she didn't develop any major fevers, or have any appetite problems, so her MCAD was a non-issue.  Thank Dog.

Also, we have started part-time daycare.  The goal is to have her go full time eventually, but baby steps.  My main concern was how seriously they would take her feeding requirements (since MCAD sounds made up when you try to explain it, doesn't it?), and though the daycare was very accommodating and understanding, it took a few tries for all of us to be on the same page.  I had the daycare menu approved by our nutritionist.  The next issue is that in the toddler classroom, they expect kids to self feed.  Cupcake has been refusing to, so they have to spoon feed her.   I'm hoping she'll get the hang  of self-feeding soon, but currently our main concern is that she eat regularly.  It's one of those MCAD concessions, I guess.  We also send a banana daily in her bag in case she doesn't like the menu.  So far, they've had to give it to her a few times.

It's been quite a transition. Cucpake cried the first couple of weeks during drop-off   It broke my heart, but I knew it was a good place (I had personal references and just got a good vibe from the teachers). By now, 6 weeks into it, she's fine when we arrive, and is well rested and happy when I pick her up.  This decision has been good for our family, and she's learning new skills and socializing very well.   She's had a couple of colds and the aforementioned ear infection since she started, but that seems to be par with the course.

Her current sleep arrangement is a full-sized futon mattress in her bedroom floor, Montessori style.  This way, we can lay down next to her to help her fall asleep without braking our backs.  It's an in-between to co-sleeping. At night, we transitioned slowly to less feedings by gradually adding water to her bottles.  Cupcake has been cleared to go 8 hours at night without food, so we give her only water if she wakes before the 8 hour mark.  After the 8 hour mark, we give her some milk diluted with water.  The theory is that the water satisfies the sleep association and thirst, while slowly retraining the body's hunger cues.  I think this is why she STTNs some nights, but who knows for sure? 

When she's sick, we go ahead and give her some milk in her nighttime bottles, just to be on the safe side.

One last thing, Cupcake went on her first international trip to a South America!  The flight was exhausting (toddlers don't like staying on their seat), but she did very well during the actual stay.  We were visiting family, so we had lots of extra hands to keep her entertained and active.  Our concern was food, as lots of people get food poisoning when visiting South American countries.  It's just a fact, no judgment here.   We were extra careful to keep her away from uncooked foods, and poor Cupcake missed out on amazing tropical fruit and fresh fish.   Instead, she ate lots of chicken soups, cooked veggies, mostly homemade stuff, and what do you know, she never got sick.  I was still breastfeeding her then, so we knew that no matter what she'd have a calorie source at hand.  I'm really glad we were nursing, as there were many times we found ourselves with weird schedules because of all the family obligations, and I was able to keep her fed every 3 hours, no matter where we were (house, beach, park, car, etc).

Ok, this was way longer than I intended, but its been a while. 

On having a constant snacker

I've made a great discovery these last few weeks that hopefully should help us deal with the days better.  Turns out that Cupcake is much more of a snacker than I ever imagined, and needs less naps.

In fact, it seems that half the time she looked tired and I thought she needed to nap, she was actually hungry.  I began to realize that she was tired but not actually going to sleep, and if I gave her food/breast milk, she'd perk right up.

So we've been doing a new experiment.  Cupcake is down to two naps, at noon and at 5 pm.  If she seems to be tired earlier than that, I try to feed her first.  If she's still tired after getting the blood sugar rush, then she's probably having a sleepy day.

It's a curious thing, and probably related to her MCAD.  When she's hungry, and her blood sugar goes down, she seems to crash more than other babies.  She whine, gets cranky, tired, rubs her eyes, is pretty much insufferable.   But once I give her food her entire demeanor changes.  She smiles, the color comes back to her face (I hadn't even noticed she was looking pale!), her energy comes back, and her entire demeanor improves.  It's such a change, and pretty remarkable.

It makes me wonder how many times I've tried to put her down for naps and she fought them, when she was actually only hungry.

Does your kid need to snack constantly?  Could it be FOD related, or is it just common infant behavior?  What are easy healthy snack ideas?

Sleep Chronicles

It's been a busy last few weeks, both in Cupcake's life and in ours.  The main issue with Cupcake is a bizarro sleep regression that I'm having a hard time dealing with.  Please forgive the dangling preposition, my mommy brain isn't functioning very well.  Sleep deprivation is a b-ch.

Life before baby

Life after baby

 I also seem unable to organize my thoughts into a standard essay-style blog entry, so maybe I'll just try to touch the highlights of what's going on with us.

- We tried a form of modified sleep training.  Basically, my arms gave out and I just couldn't rock her anymore for as long as she needed.  The new plan was to rock her for 5 - 10 minutes (which seems reasonable, since she is, after all, a baby), then set he down on her crib.  At this point, if she cries, just sing to her and pat her and reassure her that I'm there.  She cried, and wailed, and looked very angry, but never more than 15-20 minutes.  I would stay in the room with her, not wanting the issue of sleeping of her own to get confused with separation anxiety. 

It worked, I admit.  Hearing her cry felt terrible, but she would fall asleep, and stay asleep for an hour.  Then proceeded to be in a wonderful mood the rest of the day.  I had feared that she'd hate me for doing this to her, but a baby's short term memory is bliss.  Mostly, I felt like I had no choice, since I couldn't rock her.

- I'm not sure how I feel about crying to sleep, even though we had to do it.  It seemed to me that Cupcake started waking up from naps mid cry, as opposed to the cooing she used to do.  Am I projecting?  Probably.  Reminds me of Dr Horrible's Sing Along Blog, when Captain Hammer is frozen mid song, and when he unfreezes he finished the note where he left off.  Yes, I just compared my 10 month old's napping pattern to Dr. Horrible, what of it?  In any case, even though my arms were finally getting rest, I wasn't fully convinced that this was the best approach for us.  A week and half later, she was still crying 10 minutes per nap.  Is that normal?  Shouldn't she be happily self soothing by now?

- She's learned to stand on her crib.  She's known how to pull up for long time, but she finally figured out how to go from laying down to sitting, and from there the rest is easy.  So now, I can't even let her cry as an option, because as soon as I put her down on the crib, she immediately sits and stands.  It's so quick, I could blink and I'd miss it.

Which leaves me with some options, rock her to sleep until she's really good and zonked out.  Which.... no, this is what got us in this predicament.  My arms can't rock a 22 lb baby.  Not gonna happen.   Or I could take her out to nap on the stroller.  Or I could just leave her to cry and figure it out for herself.

I've tried to let her fuss it out, and it's just not working.  She cried, gets completely red and snot nosed, and just doesn't let down.  At what point do I throw in the towel?  So far I'm stopping the torture after 20 minutes, I just assume she wasn't tired and we can try for a nap again later.

- Have I mentioned that she's just kinda not sleeping during the day but stays in a great mood?  She looks exhausted, will fall asleep within 30 seconds of me rocking her, and wakes as soon as I put her on the crib.  But once I pick her up she's all smiles, plays well on her own, and largely shows no signs of being tired or overtired.  I'm trying to remind myself that at this age many babies only need one nap, so as long as she gets one nap in there, it's all good.  She'll fall asleep when she's tired enough, right?

- The sleep training has had one awesomely positive side effect.  Cupcake now sleeps on her stroller again.  After a 5 month stroller strike, she now will happily zonk out in her umbrella stroller, her neck bending to utterly uncomfortable looking positions.   Freedom.   I can now leave the house without worrying about coming back home for naps or risk total breakdown while out.  Is it related to the sleep training, or simply a developmental phase?

- Could she possibly be transitioning to one nap?  And if so, she's gone from 3 naps to 1 in a matter of weeks.  Not sure how to handle this.

- Now with the the crib standing, she's back to waking up 4+ times a night.  We'd managed to cut it to 2, by letting her fuss it out for a few nights.  We're regressing.  And the worse thing is that Cupcake seems to be sitting up in her sleep, and then her body wakes her up.  None of us, baby included, are happy with this situation, but are at a loss on what to do.  The night we let her sort it out herself, she just cried while standing for a half hour.  I was so exhausted I let her, but we share a room, so this just wont work.  Should we set up an air mattress in the living room?  Would that work better?

I'm having a some tough weeks, where I feel like I'm doing it all wrong.  She doesn't sleep well, and it feels like a direct reflection of my love and parenting abilities.  It's hard to convince me otherwise. 

Re-reading The No Cry Sleep Solution

A friend gave me Elizabeth Pantley's The No Cry Sleep Solution when we went through our 4 month sleep regression.  I read it along with Ferber's "Solving Your Child's Sleep Problems", and Weissbluth's "Healthy Sleep Habits, Happy Child."  Of the there, Pantley's words and advice were the most relatable, and I liked her gentle parenting approach to a baby's nighttime needs.  Overall, I highly recommend it.

I've written about my opinions on Ferber (liked the theories and research, not so much the CIO methodology), and Weissbluth (hated his close minded one-size-fits-all admonishments), but I realized that I've never blogged about the No Cry Sleep Solution.  Probably because I was actively taking advice from the book, so it felt like it deserved several pages of analysis and thought.

Well, I'm ready now.  If I am to be honest with myself, Cupcake never recovered from the 4 month sleep regression.  She has some good days and some bad days, but the good days are still only 4-5 hours of sleep a night, and on the bad days she needs to nurse every 2 hours (she doesn't have nighttime needs beyond food, it seems).  The bad times are not too terrible, compared to some other stories I've heard, but still, I'm getting worn out.

I want to respond to my child's needs, and if she needs to eat at night, then she shall have milk.  However, I also want to help her self soothe to the best of her abilities.  Nothing wrong with gently directing the child towards more sleep independence, right?

Over the next few weeks/days I plan on going over the book again, and hopefully writing about our experiences with it.  What worked for us, what didn't, and what things don't work because we might just have totally unrealistic expectations.

On weaning

Man, I think I'm gonna have to make an appointment with our Metabolic doctor soon, because Cupcake is showing sings of weaning.   At the ripe old age of 9 months.  

I'm having very conflicted feelings about this, which I'm sure it's normal.

Currently we nurse at 9 am (wake up time). 12:30 or1pm, 4pm, 7pm and 9:30pm (bedtime), 12:30 pm, (dream feed)  4:30 ish (if she only wakes up once a night, which... riiiight... it's the best case scenario).

(As an aside, I'd like to share that technically, Cupcake can go longer between feeds - we're at 8 hours overnight- and doesn't metabolically need the midnight feed.  But we do it anyway, because otherwise she'd wake up at 2am, just as I am reaching my own REM sleep.  We have to work together, child.   But even though medically she could sleep longer, she seems to still get hungry during the night, after about 5 hours.  You can't convince me that MCAD is unrelated to to appetite.  I was told that the only issue with her MCAD is to feed her, so if she's hungry, homegirl is getting milk.  Hopefully this will sort itself out as she gets older.)

Aside over.  

So we've been having lots of trouble with the bedtime feed.   Cupcake is tired, fussy, and my letdown is super slow at the end of the day.  Also, and this might be the biggest factor, she usually has dinner with us at about 8 pm.  I'm beginning to think that milk at 7, solids at 8, and then again milk at 9:30... maybe not such a good idea.  By the time bedtime comes along she's probably not that hungry.  She'll usually eat, but more and more often she likes to be at the boob, but gets frustrated after a few minutes.  We go on with the routine and read books instead, and she doesn't seem too upset about it.  Seriously, sometimes she skips her bedtime milk,  which I thought was supposed to be the sacred one.

I'm thinking of combining the 4 pm and 7 pm nursing sessions.   As it is, the 4 pm is a complicated one too.  The way her naps work, I end up combining her 4 pm milk with her solid lunch sometimes.  And as we are usually out at the park at this time, she doesn't seem to interested in breastfeeding.   So maybe I'll just do one nursing session at about 5:30 or 6 pm, so that by the time bedtime comes along she'll actually hungry.

We'll see.  I'm hoping that in response to this adjusted feeding schedule, her naps will reorganize as well, and she'll go into two longer naps, instead of the current three.

Next week there's a La Leche League meeting.  I'll be curious what they have to say about it.  I'm fine with weaning.  Though I love breastfeeding, I'm not particularly interested in extended nursing.  I mean, if Cupcake has a hard time letting go, I'll keep giving her the boob as long as needed, but I have a feeling that won't be THAT long.  She likes real food way too much.

What's our bedtime routine?

The bedtime routine is one of the few things we feel in total control of as parents.   We chose it, altered in response to Cupcake's preferences, adjusted things that worked better logistically, and have arrived in a routine that we all enjoy.  Cupcake is happy, we have activities to do with her, and most importantly, she goes to sleep very quickly at night.  (Does she stay asleep? No, she still nurses at night, but one issue at a time, right?

We start some time between 9 - 9:30 pm.  And yes, that's late compared  to other kids in the US, but she wakes for the day at 9:00 am, so it's a non issue,  she's getting all the sleep she needs.   So depending on how tired she is, we either try to hold her over until 9, or sometimes we are having such good family time that next thing we know its 9:30 already and it's time to get her in her bath.

First bath, always with her dad.  This is their special  time to bond and play.

Next dry off and, put on diaper, and have baby massage with lotion.  I used to do this, but now Nate has been giving her the massage  more and more often. That way I can be cleaning or cooking for longer. Then she puts on pajamas.

At this point Nate will take her to the kitchen clock and tell her what time it is.   This is my sign that they're done,and I nurse her in the couch.  She has milk, sometimes lots, though lately she doesn't seem as hungry at night.

Then we read two books.  All three of us.  Sometimes only one of us will read if the other is busy, but it's such a fun family activity, we try to do it together.  We used to skip the book sometimes when she seemed way too tired, but now we have to read it.   Then about a month ago seemed to be sleep nursing and we made the misguided decision to go ahead and take her to bed, and he screamed bloody murder, and was not content until we read two book.  Yes, two.  It's pretty cute, she likes turning the pages, and has books that are obviously her favorite.

When the books are over, I give her a goodnight kiss and she goes to our  room with her dad.  He rocks her on a yoga ball (still), and she's out within 5 minutes. He sets her down on her crib, she turns to sleep on her side, and by 10 pm-ish we are done.

It's been really great.   She really knows the routine by now, and we've been able to leave her for the evening with my mom, who followed the sequence to a T and said Cupcake zonked out with no problem.

It's curious how she seems to get that it's time to sleep.  She's energetic and awake in the bath, then gets tired and cranky during pajama time, is about to pass out during milk, but wakes completely for the books.  We used to worry about the books taking her out of the tired zone, but it seems the exhaust the last bit of energy she has left, so by the time we're done with them she's ready for sleep.

Next goal, establish a nap time system that's as effective.

Stuffy Noses

It's normal, right? The stuffy nose issue?  Because right now we have the stuffy nose that will not go away. 

Some days it's better than others.  Today, for example, it's like a dripping faucet and it's all I can do to catch the snot bubbles are they explode out of her nose.  Then again, yesterday she was pretty good and we were able to attend a wedding reception.  I'm not too concerned over the ramifications of another mild cold, since Cupcake has proven to have an awesome immune system and doesn't seem too upset or debilitated by it.  The only aspect that really affects her is sleeping.  It seems the stuffy nose doesn't let her nap well, which results in having a cranky baby that seems always a little tired.

Actually, today I've tried an experiment.  After having two weeks of stuffy noses and nap-time being all over the place, I'm trying to figure out if she's cranky because she's not getting enough sleep, or if she's achy/sore, and that is causing her to both be cranky and unable to sleep.  It's a cause and effect issue, ya know?  So I've given her some Motrin this afternoon, and she's down for a nap, so far over a half hour.  I don't like medicating my child for no reason, but seriously, if she doesn't get some good naps in there, she'll be in no condition to fight whatever is causing her runny nose.  Medicine is your friend, I really believe that.  Additionally, Motrin isn't a sleep inducer, merely a pain reliever, so it wouldn't help her sleep on its own.

No fevers, though, so there's no concern of an MCADD crisis.  Just good ol' traditional stuffies.  It's still clear and runny, which makes me think it's not a cold... allergies maybe?  I've also heard some kids get stuffy noses when they're teething.  And if she's working on a tooth (it'd be the top one), it would explain soooo much.

Lots of little things

It's been a weird week, with all the rain and us having the slight sniffles.  It's just enough to keep us home bound, only venturing nearby in the neighborhood and going a bit stir crazy.   I have nothing specific to write about; just wanted to do a general state of the union.

- On Wednesday we went a baby sing-along in a neighborhood cafe, and Cupcake LOVED it.  A few weeks ago we'd gone to check out a music "class" for babies (I have an entire rant on classes for 6 month olds, but I'll save that for another day), and she was wholly uninterested.  So we went to this sing along as a lark, since it was raining and it was only 2 blocks away.  Cupcake was mesmerized by the songs the entire 40 minutes, and I got to chat with some friends that had gone too.  Win-win for everyone.

- We've been battling the mildest and stubbornest of colds since last week.  It's just a stuffy now, that will. not. go. away.  Aaaargh!  Cupcake seems to be dealing fine with it, her mood is unaffected.  But it's messing up her sleep, since the stuffy nose will wake her up, and force her to spit out her pacifier.   All the wonderful progress we'd made a couple of weeks ago with her 1.5 hour naps?  Pretty much gone.  At this point we're back to rocking her to sleep.  I mean, anything to get the rest her body needs.

- I might be over-dramatic, but I went ahead and called her metabolic doctor for advice on what to do.  That's why they're there, right?  They told me to not worry about it if she didn't have a fever, but IF she got a fever, her new L-Carnitine dosage is 2.5 ml three times a day.  Man, I'm glad she doesn't take it everyday, or we'd be going through it like crazy.  They also reassured me that as long as she eats something every 2.5 hours, her sugar levels should be fine.  And yes, a snack of solid food does count.

- We've been having crazy naps all week because of the stuffy nose.  It seems the discomfort wakes up Cupcake before her sleep cycle is finished, so she's been waking up cranky yet unwilling to go down again.  I've been rocking her a lot, and it really feels like her sleep is regressing.  Isn't there supposed to be an 8 month sleep regression?  I really hope this is it.

- Cupcake is standing like crazy.  No longer happy just chilling on her butt, she must now stand at all time or else.  Which results in me having to be behind her at all times, because ma'lady hasn't figure out how to fall gracefully yet.  We've gotten her foam tiles for the floor (about time), and they look wonderful, but still, must watch her closely.  I have a feeling we're gonna skip crawling altogether, she's seriously ready for walking.  Any minute now....

- We might be working on another tooth.  There's nothing visible on her gum, but she's drooling like crazy.  Will it appear soon?  It'd be lovely if it could explain why she's having such disturbed sleep.

New Schedule

I'm trying to figure out a new schedule for Cupcake, and I'm still hesitant to try it out.  I'm not sure why.  

She's fine, we're fine, let's not rock the boat, right?  Except that now she's sleeping longer naps (finally!  hour long naps!), and because of solids we need longer time between feeds.  I'm trying to not interfere with her breast milk intake, so I'm not feeding her food less than an hour before she's due to nurse.  This, of course, presents it's own set of logistical problems, because she'll oversleep, or we have plans out of the house, etc etc.  If my entire life was only about her food and sleep we'd be fine, but as I've discussed a couple of days ago, I need some other distractions in my life. 

Thankfully, her MCAD hasn't presented itself in a dramatic way, so we can be a bit more flexible now with her feeds.  We can go 6 hours without food, which gives a gigantic leeway throughout the day, and it's a bit overwhelming to have such freedom.  I'm realizing now that many of our early schedule/parental decisions were based on her medical condition.  I'm also realizing that we set up a day schedule about 5 months ago and haven't updated it too drastically.   It's time.

For starters, she's waking up earlier now.  Her nighttime sleep is now about 10pm - 9 am.(not straight through).   I'm thinking of going 3.5 hours between daytime feeds instead of every 3 hours, and I'm hoping that the extra half hour will give us more breathing room between nursing sessions.

I'm also torn because I always wanted to be one of those attachment parents who feed on demand (it's the best for milk supply, right?), but when we got the MCAD diagnosis we had to change our plans.  Not that you can't feed on demand with an FOD, but the practical implications were too much for me.  In order to make sure she wasn't going longer than 3 hours throughout the day (we'd been told 3 -4 hours, and we decided with our metabolic doctor to do 3 during the day and 4 at night), I would have to keep track of every time she was eating.  It was so stressful to have to worry of when she ate last, where the notebook was, had it been too long, not long enough, finally I just decided to set up a schedule and stick to it.  It was the best decision we could have made.  We had regular nursing sessions, I knew what to expect, and I wasn't constantly concerned that she would go into fasting mode.  However, now that she's 7 months old I can actually feed on demand, since the threat of fasting isn't as imminent, but I fear that I won't recognize her hunger signs and I'd be overwhelmed by deciphering is she's hungry, tired, bored, achy, etc.

So.... I'm gonna run through some options and see if they logistically work.

9 am wake up ... 9:30 milk  ... 10:30 food ... 10:45-11:00 am nap (wake up at noon?)  ... 1pm milk ... 2pm food  ...  2:30 nap (wake up at 3:30?) ... 4:30 milk  ...6 pm nap (wake at 7pm?) mmmm... usually she nurses at 9:30, but that would be 4.5 hours from her last session, and though that's acceptable by MCAD standards, I don't think it's gonna work for for her.     

9am wake up ....  Milk between 9 am - 10 am based on hunger cues  ... 10:30 am food  ... 11:00am nap (wake up 12?)  1:00 milk  1:30 food   2:30 nap (wake up 3:30?)  nurse 5 pm  6 pm nap 8:30 milk? .... won't work, it's not her bedtime.

I'm gonna try working back from her bedtime.

9:30-10  pm last milk.....   7 pm milk   6 - 7 pm last nap.  3:30 pm milk  nap 2:30-3 pm   12 noon milk  9-10 food.... this looks all scrambled, but to put it in order:

wake up: 9 ish.   

Milk: 9-9:30am   

Nap: 11 - 12  

Milk: 12 noon   

Food: 1 pm   

Nap: 2:30-3:30pm   

Milk: 3:30pm   

Food: 4 pm  

Nap: 6-7 pm  

Milk: 7 pm  

Food Snack: 8:30pm    

Last Milk Feed: 9:45pm

Bed: 10 pm

Dream Feed Milk: 12midnight

Milk: 6am

I realize that the 6 hour span between midnight and 6 am is a bit of a joke at the moment, but that's what we're aiming for.  Let's give this slightly modified schedule a try... since it's based on the natural schedule she seems to be taking.  We shall see how it works.

Sleep regression

I'm at the end of my rope.  I just can't be an effective night-time parent.  From everything I've heard of how motherhood changes you, I guess I was expecting that my body would go through some chemical adjustment that would let me be sleep deprived but still functional.

No such luck.  I still struggle at night, and if I don't get 7 hours of sleep I'm an emotional mess.  When I was pregnant we were aware of these issues.  Nate is a total superhero who can function on 4 hours of sleep, then go to work, come home and fix all the door hinges and still have energy to listen to me go on about my day.  So before Cupcake came into this world we agreed that he would be on night duty, while I was in day duty.  At the time we imagined him resettling cupcake a couple of times a night and maybe giving her bottled breast milk.  Meanwhile I could sleep and not get migraines. 

Then reality hit.  Cupcake needed to feed around the clock, so I was just breastfeeding her around the clock.  And because I was feeding so often, I couldn't really get enough pumped reserves, which meant I wasn't getting a break at night.  And so on, and so on.  All of the sudden our nighttime plan wasn't really working.

Before I ever thought of having children, I remember talking to a couple of women with babies who said that after giving birth your relationship to sleep changes.  You no longer *need* as much sleep, your needs just shift naturally.

This is not biologically true, in my experience.  I still need sleep to function as a sane productive person.  And after almost 7 months of getting up during the night no matter what, my body is giving up.  It's done.  Finito.

Last night Cupcake woke up and cried for about an hour and a half.  We have no idea what was actually wrong with her.  Teething?  Growth spurt?  Allergies?  Cold?  Gassy?  Digestive issues?  Separation anxiety?  She'd cry, and our usual system of patting her wouldn't work, so Nate would pick her up, and she'd calm down, then the second he'd try to lay her down on her crib she would start the crying again.

After 45 minutes of this he also gave up (I had thrown in the towel a long time ago and told him I was fine with just letting her cry).  And we did what I swore I'd never do, attempt to let my baby cry herself to sleep.  We were there, next to her, and Nate had his hand on her chest, but still.... I can't believe I was ok with it.  I was just sooooo tired.

She whined and moaned for about 20 minutes, then it looked like she was going to sleep, then she started to cry loudly, went back to sort of sleeping and then she started screaming hysterically at about the 35 minute mark.  And my husband is much more sensitive than I am, because he just couldn't take it.  I ended up feeding her at that point and she zonked out (and stayed asleep for over 4 hours!).  Too little too late though.  And I honestly don't think feeding her at the beginning would have helped, she'd just eaten an hour and half before, she wouldn't have been hungry at the beginning.  After the hour and half, then yes, totally legitimately  hungry.

I don't know what to do.  I don't want to keep co-sleeping.  I was happy with it before, but now she likes to stick her hand in my mouth as she drifts off to sleep and it just hurts. The crib next to our bed was working, but now she doesn't seem to be ok with it.   I don't have the stamina to get up at night, but I don't agree philosophically with CIO as a means to self sooth.  I'm at an impasse.

This little 18 lb princess is kicking my a$$.  Though she didn't seem happy with last night's fiasco either, at least she had the decency to wake up cranky and not well rested.  I know, I know, it wasn't pleasant to deal with her in that mood, but I think I would have been really annoyed if after such a horrible night she was all smiles as if this was the most natural thing in the world.  The fact that she didn't enjoy it either gives me hope that this is not the "new normal."

I have faith that at some point this will all sort itself naturally.  After all, my parents never sleep trained me, and at some point I learned to sleep through the night.  And I've never met a teenager that needs to be rocked to bed, so it does stop.  Just... when?  How much longer will this go on?

Today's musing

There's a tenuous five minute period, when the baby falls asleep on her crib, I take my hand off her chest (she likes to hold my hand to fall asleep), I gently step back to leave the room, slowly humming softer.  During this window, if someone drops a pin two blocks away, she will hear it.

Once this magical time is over, a marching band can be tuning up outside her window and she will sleep through it.

How does that work?

On getting more hours of sleep

Last night she slept for 5.5 hours!  Or rather, we also got 5.5 hours of sleep.  Now that the doctors have cleared us for 5 hours, we seem to be having trouble getting Cupcake to also want to sleep for that long.  And we haven't pushed too much on it because she's been teething, then had a stuffy nose, and then had to adjust to having grandma visit for a few days.

That last one was a particular adjustment, as we took the opportunity to go out for three nights in a row and have my mom put Cupcake to sleep.  During those evenings, she drank from my pumped reserves, so it seemed cruel to keep her from getting the boob in the middle of the night if that's what she actually needed.

Also, I have no idea how much she nurses each sitting.  Really, I have no idea.  I left my mom with 4 oz bottles, but I don't know if that was enough or not.  So if she woke up at night, I fed her.

Last night, for some inexplicable reason, she slept for 5.5 hours, and then another 4 after nursing.  Could she just be maturing in her sleep patterns?  She's done something similar 4 times since we got the approval from her doctor.  I don't want to jinx it by being excited, but I totally am.  Excited, that is.  I know with MCADD and sleep the first year is the hardest, and we are over halfway through.

Telling a 6 month old baby to cry it out so they can learn to fall asleep by themselves feels misguided. 

What's next, telling Cupcake to change her own diaper?  I wipe her butt after every bowel movement, and gently put her butt paste to prevent diaper rash.  Do I do this lovingly? Yes.  Do I find it gross and smelly?  Of course, I mean, have you ever changed a baby's diaper after they've had bananas or sweet potatoes?

But it would seem ludicrous to leave the little baby to cry until they learn to change the diaper themselves.  So why do we do it with sleep?

I know it's probably a bad analogy, because potty training does happen, and for many it's a frustrating and complex process.  But that's when they are older,  when they understand the concept of what they're doing.  And the current thought is to let the kid lead their potty training process, to make sure they are committed and ready.

Why isn't sleeping handled the same way?

I know, the easy answer is that wiping Cupcake's butt takes me all of 3 minutes, and thanks to disposable wipes and diaper genies we are hardly in contact with the actual poop.  While waking in the middle of the night is exhausting, debilitating and affects the whole family's sense of well being.

But to the baby it's all the same.  They're not doing it to annoy us.  This isn't a competition over who's in control.  Because we both are.  I am the mother and as such am in "control" of my child, in that she eats, has a roof over her head, and doesn't fall out the window.  My child is in control because most of her needs are immediate, and basic.  Actually, I don't think Cupcake is in actual control of anything here, she's just trying to figure out how to exist.

And unfortunately for me and Nate, sometimes those struggles happen at 3 am.

To supplement with formula, or not? That is the question

I've been having some serious thoughts of adding formula to Cupcake's diet.  Which is difficult for me, because I've been staunchly against it. The La Leche League people really did a number on me.

The thing is, a few days ago she had her first bottle of formula ever, and the world didn't collapse like I expected it to. I've run out of pumped reserves.  I'm at a loss.  My milk supply has stabilized to the point that the only times I have extra milk to spare is in the middle of the night.  So a couple of nights per week, I get up after Cupcake's 2 am and 6 am feeds and pump the other side.  Not a sustainable system, I know.

We've managed to only consume what I was storing until the last migraine.  (I should share at this point that my migraine medication is not compatible with breastfeeding.  So for 12 hours, I have to give Cupcake bottles, while I pump-n-dump.)  So the other day, when I was feeling like doodoo and had to take my meds, we had no choice but to give Cupcake some of the emergency formula we had stashed around. 

To my utter surprise, I was okay with this decision.  I think it's because I made it to to 6 months exclusively breastfeeding.  And a pat in the back to me, it was no easy task.  I am so glad we struggled through it, as it's been an incredibly rewarding experience.  At this point the weaning process has already started, because she's exploring solids.  So while I want to keep breastfeeding for a year, the idea of giving her formula here and there doesn't feel as tragic. 

Lo and behold, Cupcake took it with no problem.  I'm lucky that if  I'm gonna have an FOD child, at least she's one of those kids that seems to eat whatever is in front of her.  And heartily.  Formula, bottled breast milk, mashed bananas, pureed veggies, they are all good. 

So now I'm at the weird place where I'm wondering if we should start giving her a bottle of formula for her 3 am feed. It would be easier for all of us to just give her a dream-feed bottle while she's still in her crib. (Yes, her oral hygiene be damn*d, at this point we have more important metabolic things to worry about.)  And it would take some of the pressure away from me, as Nate could give her milk half the nights.

I struggle with this, because I know that giving formula on a regular basis can affect my milk supply.   And I love breastfeeding.  I really do.  I cherish being able to provide for my own kid, and feel very lucky that we were successful with it.  What if I end up compromising my supply?  What if she ends up weaning to formula against my wishes?

I don't want to sabotage my breastfeeding.  I also need a break. Then again, it's only a few more months until she's drinking cow's milk, so maybe I should just tough it out for 5 more months.  I have a feeling that I'm going to go back and forth with this, and by the time I make a decision, it'll be almost the 1 year mark and it will be a non-issue.  Or so I hope, at least.

Dropping the 4th nap

I feel so silly that it didn't occur to us sooner, but dropping the 4th nap has made our nighttime routine so much better!  She used to have a nap about 2 - 1.5 hours before her final bedtime.  We needed it, without it she would get overtired and she was just very unhappy during her bath and nighttime routine.  But then when she turned about 5 months we began to have problems going to bed at night (it would take about 40 minutes).  And waking through the night too, but I now realize that those are probably unrelated.

And after reading/skimming through 3 different sleep books, and talking to some fellow moms, I began to realize that Cupcake probably wasn't very sleepy at the end of the day.  She was tired, because she'd been "up" for 12 hours, but she wasn't "sleepy" because it had only been 1.5 hours since she woke up from her last nap.  And this was a problem.  So we dropped the last nap, and moved her 3rd nap to about an hour later.  Ha ha, I say this as if she actually follows her baby-led nap schedule, but at least now I have a better idea of what I'm aiming for.

The first couple of days it was tough to keep her up at the end of the day, since she was getting fussy.  But she quickly got used to the idea.  Now she takes her  last nap at 6 pm, wakes at 7 pm and is up until she goes to bed between 9:30 - 10 pm.  She's great at her bath, super active, and as we dry her, do massage and put on pajamas, she gets a bit cranky, so I nurse her.  She's happy again, and we read a couple of books.  And by the time the books are done she's pretty tired, and it's been taking Nate no longer than 10 minutes or so to put her to bed.  It's lovely.  No crying, minimal fussing, and by 10 she's usually out and we have 2 whole hours to ourselves to spend together.  Yes, we're night owls, I don't even get tired before 11:30 and if I try to go to bed before midnight I just sit awake for a long long time. 

I'm just glad we realized that her sleep needs were shifting.  And thanks to all our sleep info, I feel like we are a bit more in control of her naps.  Right now, for example, she's napping in her crib again, after pretty much refusing to do it for a week there.  It's so nice to have some time off.

6 month MCADD appointment

I'm not a fan of doctors offices, in particular with specialists that tend to overreact and make my life dramatic.  But I couldn't be happier with Cupcake's metabolic team at Mt Sinai, though.  They are easy going, warm, and very reassuring. 

Cupcake is 6 months now, and she went for her mid-year appointment.  She's doing great!  No metabolic crisis so far (which we don't know if it's because she's asymptomatic, or because we've been diligent with her feedings; in either case, yay!!).  She weighs almost 18 lbs, and is tall for her age.  Which is unrelated to MCADD, but it's reassuring to know that she's growing rapidly.  Then the doctor played with Cupcake a bit, to get a sense if she could respond, babble, sit on her own, had a good grip, etc.  And of course she can do all those things!  So to our immense relief, they decided they didn't need blood samples.  Cupcake is hitting her physical milestones well, and is fat and growing, so there's no point in getting a metabolic breakdown at this point.

Also, we've been cleared to have her go 5 HOURS without feeding.  And another hour every month until we hit the 8 hour mark.  Our doctors here don't feel comfortable having her go longer than 8 hours until she's about two, mostly because her initial C8/C10 numbers as a newborn were really high (or was it low? whatever it was, it was not the desired amount, lol).  So now we have the luxury of sleeping one whole hour longer, and a baby that probably will not cooperate.  Whatever, I'm just excited to join the throng of parents that can complain about normal night wakings. And isn't 5-6 hours technically considered sleeping through the night?  Music to my ears.

The older cupcake gets, the less MCADD scares me.  She's 6 months now, she's eating solids and still breastfeeding wonderfully.  Her body is strong, and she's getting more and more antibodies as she's exposed to the world.  She's up to date with her vaccines.  She'll have stronger defenses to fight disease.  I know that with an FOD you're never out of the woods, but as she gets bigger and older it feels much more manageable.  My heart goes out to all my fellow mamas that had to take their weeks-old babies to the ER.  It must be very scary and you have my utmost admiration.

So now we are diving into solid foods, and our doctor told us not stress over it too much.  Keep nursing Cupcake at our normal times, and she will naturally take less milk as she eats more food.  It's easy during the day, when we can observe if anything is different.  The danger is at night, when we wouldn't notice if she's lethargic because she's sleeping, and we are too tired.  We were even told to not worry about her diet too much at this point, since she'll still be nursing and getting all her proteins from me.  We'll go back to see them in 3-4 months, once Cupcake starts taking protein and her eating habits shift to solid food.  At that point, we'll meet with a nutritionist to give us some tips.  But even then, it seems that as long as she's not fasting, MCADD doesn't require a strict diet.  Just make sure it's low fat, but that's what ALL of us should be eating anyway.

Sleep issues II - reading Weissbluth

Since cupcake started having nighttime issues, I'm becoming well versed on sleep literature.  Something I thought I'd never do.  I really dislike parenting books, specially those that offer a one-size-fits-all solution to your "problems."

Another friend gave me the Weissbluth book, Healthy Sleep Habits: Happy child.  She didn't recommend it, she just gave me three parenting books because she now has two kids and she is DONE, and she will never need these books again.  Works for me.  I have no issue in reading these book so long as I don't actually have to pay for them.

My apologies if the Weissbluth method worked for you, but I hated everything about this book.  He is the type of author that makes me hate parenting gurus: sarcastic, condescending, alarmist, and narrow minded.  In contrast to the new Ferber book, which allows for different parenting styles, Weissbluth declares one solution, and goes so far as to admonish those parents who don't follow his directives.

For starters, he states that bad sleeping habits in infancy can result in a lifetime of stress, mental problems, ADD, etc.  Seriously?  I know for a fact that my parents weren't very consistent with my sleep schedule as a baby, and so far my only big problem is that I like to read to sleep.  Big whoopdee deal.  Also, his advice is to put the child to sleep earlier and earlier.  Well, its 7 pm now, and my Cupcake is taking a nap, like she always does.  She'll be up for another 3 hours playing with her dad (who's just getting home from work), and then will be down at 10.  No, I will not put her to bed at 6:30. Yes, I want to sleep, but I also want us to have time as a family.  You see, we wanted to have kids, and thus we want to spend time with them.  I understand that it's  late bedtime, but that concept is such a cultural one.  What to do you care if Cupcake goes to bed a 10, if she then wakes up at 9 am.  And to further suggest that a parent is keeping their baby up late at night in order to avoid spending time with the other parent is preposterous.  And beside the point, really.  Because I do want to spend time with my husband.  But if I didn't, that's neither here nor there.

Furthermore, she has MCAD.  She needs to eat every certain number of hours.  So shut your holier than thou trap about how feeding during the night can have terrible long term consequences.  If I wanted a guilt trip, I could just call my grandmother.

Ugh.  I got so annoyed trying to read this book.  I just totally vented into the Internet.  We'll keep our sleep problems, Mr W, regardless of what you think.  We''ll mess her up, maybe as bad as my parents did to me.  Somehow, despite not having a regular nap schedule, or going through rigorous sleep training as a baby, I managed to have a happy, fulfilling and successful life.  How do you explain that?

Sleep issues, reading Ferber

So against everything I believed, I've been reading the Ferber book, Solve Your Child's Sleep Problems.  A friend loaned it to me with glowing recommendations, after I confided in her how Cupcake has been waking up so many times at night.   She told me that she was adamantly against CIO (Cry It Out) too, but after actually reading the book, it's much different than the media makes it out to be, and she's been happy with the results.

That's a good recommendation as any, and while I was skeptical, there's no harm in reading a borrowed book.  I can read about how to solve sleep problems while in bed, right?  There's no irony there whatsoever.

It's strange, I was expecting to hate everything about Richard Ferber, but so far I'm just really interested in the entire theory of sleep patterns and how they mature and change as the baby gets older.  It really explains why Cupcake was such a great sleeper when she was younger, and how physiologically her body is changing and causing sleep disturbances.  I like the fact that he's an actual doctor citing her sleep research, and giving actual statistics and data.  One of the things I find frustrating about Parenting books is that they pretend to give you an overall parenting philosophy.   I mean, who are these authors?  Unless they have the credentials to back themselves up, then they are just citing circumstantial evidence and preaching it as facts.

One of the things I liked about Ferber is that he doesn't preach a parenting philosophy.  He shares his sleep research, gives his take on what patterns are emerging in a child's sleep and then gives his recommendation on a potential solution to the "problem."  He also explains which sleep behaviors are normal, which are "normal" but don't have to be, and which can be a cause of concern where parents should begin to look for underlying causes.  He has no opinions on feeding schedules, discipline issues, daytime parenting.. blah blah, he's merely interested in sleep and its patterns.  That's nice.

I'm still not sold on CIO as a viable solution for us.  But reading Ferber's book is making me realize that we have "sleep associations" for Cupcake.  And the rocking her to sleep thing had been working great so far, but it might be keeping her from settling back to sleep at night, now that her body has matured and stays longer times in the light sleep phase.  So we need to create a new sleep association that she can replicate on her own.

So far, we are going to transition slowly.  Rock her for shorter amounts of time, and then set her down when she's drowsy, and then patting her and singing.  There might be some crying, but we need to be there for her.  I can't just leave her on her own, not deliberately if I'm up for dealing with her.  (I've left her to cry before, but that's been on particularly hectic afternoons where I just couldn't handle her anymore and needed some time to regroup.  I can't see myself leaving her to cry alone as a methodology.  Not yet, at least).  Hopefully, this will help her fall asleep without needing to be rocked, so when she wakes at night, she can resettle without our help.  A girl can wish.

I should add that I've been reading the new edition of the Ferber book.  It's my understanding that the original 1985 version was much harsher and dogmatic.  In fact, he has an entire chapter in this book devoted to "explaining" himself and how his ideas were misunderstood.  The new edition is much warmer and caring, emphasizing a loving night time routine and a need for the baby to feel constantly loved and reassured by their parents.  It is also incredibly open to co-sleeping, bed sharing and all styles of parenting.  The book explains how to apply new sleep associations for every family arrangement, which is refreshing.  I don't like being told what to do, but I appreciate someone giving me the tools to apply my own solutions.

Who would've thought I'd be okay with Ferber?   More on our sleeping saga as it progresses.

Sleep problems

They say that whatever sleep "technique" you are using is alright if it works for you.  And every baby has a different temperament, and every family has different style.  That's why I've always been wary of all the literature out there to sleep train.  Oh, and the MCADD, which means that we still have to feed at night.

But whatever we are doing is not working for us right now.  What to do?  Have we taught her really bad sleeping habits?  (On that note, is it possible to treat an FOD baby to the  "normal" sleep training techniques?  We have to feed her on regular intervals.)

She used to sleep fine, waking up a couple of times a night when she was due for a feed.  It's like her internal clock knew to expect the next meal.  But this last couple of week have been bad.  She keeps randomly waking up, we adjust her paci, sometimes that's not enough and I have to feed her.

In a couple of weeks, we'll be meeting with her Metabolic Specialist, and they should be giving us the go-ahead to go 5 hours between feeds (and in another month 6, then 7, then 8!!!).  But I can't help but think that it sounds like a bit of a joke.  Riiiight.... She won't sleep 5 hours in a row...  We haven't had to wake her to eat in a while.  Since we stopped setting the alarm a couple of months ago, we've let her hunger cues wake us.  Usually it's every 4 hours at night.  It's been 4.5 or even 5 a few times, but not usually.  And the last couple of weeks, it's been every 2-3 hours.

She also was sick last week.  Is that why her sleep patterns are still messed up?  Is this a temporary issue until her body completely rids itself of all traces of the virus?

Or, the more typical culprit, is it a growth spurt?  I know there's supposed to be one at around 6 months.  It would explain why she's nursing sooooo much at night. It would also mean it's temporary, which would be wonderful

Or maybe we need to go back to co-sleeping.  Or move the crib to her own area of the room.  I don't like this second option because we still have to nurse twice a night, and I'd rather not have to *get up* for that.  But I'm not too excited to bed share again, I've enjoyed these last few weeks where we sprawl and take over our mattress.

I don't like second guessing so much.  Ha ha, I better get used to it, it's part of this whole parenting gig, right?
We are thinking of trying the No Cry Sleep Solution, from the Baby Whisperer books, as soon as Cupcake and I make it to the library.

Will that even work with an FOD kid?  I fear that Cupcake will wake up, we will get her back asleep, only to have to wake her after an hour and half to feed.  Something about that feels very counterproductive.  More on this as it progresses.

Sleep training an MCAD baby?

MCAD and sleeping through the night don't go hand in hand.  So while many fellow moms are debating their parenting philosophies regarding nighttime, we are secure in knowing we are not going to get a full night sleep for many months.  Whether Cupcake wants to or not.

It's surprisingly freeing, and we also figured we wouldn't have to deal with sleep training.  After all, the ultimate goal in all the techniques is getting the baby to sleep through the night uninterrupted, so it didn't apply to us.

And yet....

Originally we had to set the alarm and dream feed Cupcake, as she would sleep the whole night with no problems.  Back in those first three months we though we had the best baby EV-ER, and we would curse the MCADD that wouldn't let us sleep.  Then the 4 month sleep regression happened, and she started waking up a couple of times a night before the alarm clock.  This was fine, as it felt much more natural to feed an awake and hungry baby than a sleeping one.  But waking 2 times a night begat 3 times a night, and before we knew it, she was waking 4+ times and I was feeding her every time.

It made sense to nurse her for every night waking.  Firstly, its the fastest way to get her back asleep.  But mostly it was a way to make sure she wasn't fasting at any point in the night.  However, this system is not sustainable, and even the most dedicated of moms needs to get sleep once in a while.  We had to figure out a way to get her back to the 4 hour nighttime schedule.

We started our own version of sleep training.  No crying, lots of rocking and soothing, and eventually, at just about the 4 hour mark, we'd feed.  The idea is that she'll be actually hungrier then and eat more, which will hold her over for another 4 hours.  I just can't have her lightly grazing every night, it's too much for me and I end up being a snappy mom the next day from sleep deprivation.

It's not a fool proof system.  One of the nights we managed to soothe her back to sleep at 4:30 am, only to find her asleep at 6 am when she was due to eat.  Which then gets us in the never-wake-a-sleeping baby conundrum.   So... should I feed her at 4:30 have her graze every 2-3 hours (and she'll eat when she's awake, yay), or try to get her in a schedule but have to make sure I'm setting the alarm?  I like the stability of her eating on a schedule at night; I don't have to worry about tracking when she ate last, which is hard to do when one is half asleep.

The books don't have answers.  There doesn't seem to be any advice out there for this type of situation.  So we soldier on, doing our modified sleep training, and as we rock her, we imagine the Rocky theme in the background.  Actually, I have sung her to Rocky music to sleep before. She seems to like it.