Showing posts with label Breastfeeing Toddler. Show all posts
Showing posts with label Breastfeeing Toddler. Show all posts

Saturday, June 23, 2007

Surviving the Toddler Years


by Naomi Aldort

Many attachment parents call me in bewilderment when their child's behavior or development does not meet their expectations. "I did everything right for her!" says a young mother, "She was born peacefully, I carried her all the time, and she is still nursing and sleeping with us. Now that she is two years old, I am just not sure what to expect, or how to deal with her many needs." Some parents have specific questions about eating, sharing, cooperation and developmental stages. Others simply aren't sure how much to limit, and how much freedom to provide. These issues can indeed be perplexing. We have no role models to follow, as most of us are not following in our parents’ footsteps.

We all love our children and want the best for them. We want to follow our hearts, our intuition, and most of all, our children's cues. At times, our own childhood may make it difficult for us. Even the best and most loving parents sometimes respond to their children in a less then loving and kind way. This often stems from past hurts being restimulated by the child. How can we learn to care for our children in a loving way, without the interference of our own past painful memories?

Attachment parenting is the shortest route to knowing a child's needs, and trusting and responding to their cues is the best way to avoid mingling our own issues with their care. Yet even then, we sometimes miss. It is relatively easy to trust a baby: nurse, change, burp, rock, sleep. As the little newcomer starts acquiring physical independence, things may flow just as easily, or she may take a direction that bewilders us, and we are not sure what to allow and what to restrict.

Toddlers need our leadership. They need clear, gentle guidance as well as our support and our "vote of confidence". The beauty of being a leader is that the best way to lead is actually to follow.

When a young mother consulted me on how to stop her 2-year-old son from throwing his spoon and fork on the floor after each meal, I asked her how she was feeling about his behavior. She said she had been grinding her teeth with anger and frustration while trying to prevent him from developing bad table manners. But as she listened to her own inner conversation, she was able to separate her emotional reactions from the real needs of her child. She remembered the pain of feeling "used" as though she was the "slave" in her family. She recalled having to do chores she hated to do, and being scolded and shamed when she didn't do them well enough. She also remembered the pain inflicted on her if she acted with childlike freedom, and the inner fear that prevented her from being fully curious and vivacious as she grew up.

As she realized that her negative reaction to her son’s behavior was based on her own past hurts, she could see what was really going on for him: he wasn't exhibiting "bad table manners"; he was a young scientist, experimenting with gravity. When she was able to see things from her son’s point of view, she could then marvel at and enjoy his experiments as well as his other creative ideas. She could then play with him: she picked up the silverware, handed it back, and he dropped it again and again. They could both laugh at this, because she was going with, and not against, his need.

Not surprisingly, the "throwing spoon and fork on the floor" game disappeared by itself as her little boy became interested in other things and activities. His general behavior improved, and his mother’s ability to enjoy him grew by leaps and bounds. She learned to see her son as an individual with his own perspective and his own motives. Every stage in a child's life is there for a purpose. If we can respect and respond to their needs fully during each stage of life, they can be done with that stage and move on.

Empowering responsibility

My son Oliver, at age 2, was sitting in my lap to be read to. As soon as he was done with one book, he wanted another. I kissed him and said: "Put this book back in its place and bring whatever you want to read". This was no difficult task, and he did so with a smile on his face. Oliver's days are full of small and achievable tasks. Shoes come off when we enter the house. Then they go in the entry closet. Each toy is put away before choosing another one. Their father and I help, as needed, to keep things joyful and accomplishable.

Sometimes the mess is too overwhelming and I end up doing much of it by myself. My commitment to order, self-discipline, and responsibility is being modeled with, or without, my children’s participation. Watching me clean up the food that spilled on the floor, or voluntarily helping me with this task (at his request), are much better teaching tools for Oliver than being coerced to do it by himself before he is truly ready for that stage. Similarly, my gentle tone of voice, and my generosity and kindness in responding to his needs teach him what a million words would fail to convey.

By age 3, Oliver was asking me to clean up if food fell off the plate. He already cared. Yet my other children did not internalize that attitude until much later. Each child has a different built-in time-table of development. In a relationship built upon attachment, children internalize all the nuances of our ways of being, because they trust us. When we are self-disciplined, they follow our lead. When they experience our kindness and gratitude toward them, they become kind themselves, and when they watch our cooperation with each other and with them, they learn to cooperate.

Some people may say "No, my child doesn't seem to learn". In answer, I can assure them that he may not have learned yet, and he will. When he is full-size, he will be close to behaving like an adult. He may not live up to all of his parents’ expectations, instead he will live up to his own: to grow, to fulfill himself, to belong and to contribute. He will be uniquely himself.

A parent may have a "spirited" child, or may see her child as "different, not like others". Each child is indeed unique. A parent can be attached, meet a child’s needs, be kind and loving, and still have unexpected difficulties. Some children simply have an unusual "blueprint of being". In such situations, parents may need help to learn to recognize the needs of their child. Children communicate in ways that are not always clear to parents. Although learning the special language of one’s child is easiest through attachment parenting, even then we can sometimes lose sight of the child’s inner reality.

Saying "yes" most of the time builds trust and cooperation

When a child becomes demanding, whiny, or less responsive, she is most likely feeling frustrated by unmet needs. The child's tolerance to frustration and to "not getting her way", has a lot to do with the degree to which she feels that life generally flows with, and not against, her needs. We need to say "yes" to our children's needs as much as possible, and when that is not possible, we can still say "yes" to their feelings.

To respect and meet their needs is the best way to assure happy and cooperative children. Play and experimentation are the "job descriptions" of a toddler, and he needs our vote of confidence in him. Making a sculpture out of mashed potatoes harms no one, is low-cost, and cleanable. Running away from us at bedtime is an invitation for play, and taking apart an old phone is a learning adventure. Most no’s can turn into yes’s easily: "Yes, you like to cut books, here is a magazine you can cut."; "I see you are making a lake out of your juice. Here, let me move your project to the sink."; "Yes, you love to paint on the wall, here is a big sheet of paper." and "Yes, you can play with the phone." (I unplugged it).

When it is painless, safe, and simple to clean, we can be leaders by providing tools and by removing obstacles. Doing so helps the child feel worthy and helps her to trust our leadership, guidance, and intentions. She then responds to our leadership, not out of fear or intimidation, but simply because she wants to respond to us as lovingly as we have responded to her.

Providing leadership in tough moments

A three-year-old girl had a swim in Mom's arms, which she greatly enjoyed. When she was finished with swimming, she asked to be dressed and to play on the grass. As soon as she was out and dressed, she started whining, "Mom, I want to go home now". Her mother told her that it was her brother's turn to swim, and that when he was done in 5 or10 minutes, they would go home.

The little girl was adamant: "NOW!" she screamed. "I want to go home NOW!". This mother wanted to meet the needs of both children. She validated her daughter’s feelings while touching her gently: "You want to go home now, and we are not going yet. You are sad and crying." The little girl asked once more to go home and met with her mother's validation, but not with any change of plans. Once her need for empathy was fulfilled, she stopped crying and played happily the rest of the time.

For many parents, the story is reversed: a child does not want to leave. The challenge is the same, however. The child wants something that is not possible, will be at the expense of another child, is unhealthful, or is otherwise not available. Parents may feel anxious to supply everything the child asks for, and can experience panic in the face of an upset or crying child. Being on our child's side does not always mean it is possible to give them their wish. Most verbal youngsters are able to handle the simple limits of reality as long as we show them that we genuinely care and understand their feelings.

When will they learn to "behave"?

Parental expectations may be the greatest obstacle to a child's development and a prime cause of difficulties. Children are doing their absolute best to learn, to imitate our modeling, and to please us. We can trust them and guide them based on their readiness. They have a huge job ahead of them: becoming adults. They are in a rush and going as fast as they possibly can. Indicating to a child a need to grow even faster, can only lead to failure experiences and low self-esteem.

What leads most often to difficulty are the common parenting techniques of punishment, including threats, deprivations, time-outs, bribes, insults, shouting, scolding, inducement of guilt, and other attempts at controlling the child. The best thing we can do as parents to ensure that our children will grow into compassionate, communicative, responsible, caring and considerate adults is to treat them with those same qualities, and then trust them to model our behavior at their own pace.

Nursing on demand, holding, responding to cries, and co-sleeping form only a part of attachment parenting. A child will speak in a gentle tone if he hears his parents speaking kindly to him, and to others. He is likely to keep things neat if he has experienced others’ commitment to their surroundings. He will learn to share from being shared with, and from being respected when he is not ready to share. He will learn to say "thank you" by receiving and observing many expressions of gratitude. The only way to know when to expect the development of certain behaviors is by observation of the child. In the meantime, parents can lead not by controlling or instructing, but rather by example and clear, gentle guidance.

Here is a "declaration of complete confidence in children":

  1. Adult-like behavior matures by the time we are adults.

  2. No expectations means no disappointments for us, and no damaging pressures for our children.

  3. Children respond best to modeling and leadership, not control.

  4. Trust... and wait.

  5. Choose between your momentary convenience and your long-term goal for your child's sense of self.

  6. Enjoy your child for who he is, not for who you would like him to be - he will never be this age again.

  7. Distinguish between your emotional needs and what your child feels and needs. Act toward your child in harmony with her needs; take care of your emotional needs elsewhere.

  8. Celebrate your child's uniqueness as well as your own.

Monday, November 13, 2006

Sleep Advice / Night Weaning

Changing The Sleep Pattern In The Family Bed

By Dr Jay Gordon

I can only imagine a mom and dad who are as tired as anyone can be, eager to see this article on sleep, and finding that we had made it unavailable for a little while!

We had to do that because I didn't write the article clearly enough and need to clarify some very important facts.

It would be hard to find as strong a proponent of the family bed as I am. Yet, I have received email commenting that there were sections of this "plan" which were easy to misinterpret as being just another angle on "sleep training" for young babies. It is not meant to be that. Not even close to an endorsement of the benefits of getting your baby to "soothe herself to sleep" during the first year.

Here's what I really want to do: I want to offer an alternative to Ferber and Weisbluth and the Whisperer. I never want to see my ideas applied to a four month old or even a seven month old baby. As a matter of fact, I am not too excited about pushing any baby around at night but I know that sometimes it will be done and I'd like to offer a gentle, supported plan for after the first year.

Before I go any further, let me express my overriding concern. Babies do better when we answer all their questions as best we can and meet their needs as best we can.


Most of the families I have taken care of in my pediatric practice sleep in a family bed.

Their babies tend to breastfeed for more than one year and they don't sleep through the night any better than most of us would if we napped and cuddled within inches of the best restaurant in town and knew it was open 24 hours a day.

This arrangement is not just adequate and tolerable, but actually feels easier to moms who can just roll over, nurse a while and fall back to sleep with their babies rather having to get out of bed to nurse or, alternatively, refuse to nurse and get their babies back to sleep some other way.

Lots of parents continue this pattern through the first year and well into the second and beyond, but some get tired of it -- or just plain tired -- after a while and are looking for a way to change things. Saddest of all, some moms and dads think that total weaning from breastfeeding is the best way to get more sleep. They choose not to look into nighttime weaning as a good option instead.

There are dozens of confusing books and magazine articles implying that there can be some quick and easy way to get your baby to sleep or to not nurse through the night. I have yet to read one which told parents the complete truth: It's not easy, it's rarely quick and it's usually a little loud and heartbreaking for a few nights . . . or more. I have seen too many families needing help and getting offered choices they didn't like at all.

I have a better alternative to completely weaning or to letting the baby cry it out. Babies wake up for the optimal interaction with their moms, breastfeeding back to sleep. If we offer them a little less than that for a few nights and then a little less and still less in the ensuing nights, gentle behavior modification will lead them to realize that it might not be "worth it" to knock on the door of a closed restaurant, so to speak.

I don't recommend any forced sleep changes during the first year of life. Probably the only exception to this would be an emergency involving a nursing mom's health. There are many suggestions in books and magazines for pushing "sleeping through the night" during a baby's early months or during the first year. I don't think this is the best thing to do and I am quite sure that the earlier a baby gets "non-response" from parents, the more likely he is to close down at least a little.

Don't get me wrong. I love the family bed, child-led weaning and cuddling all through the first, second, third year or more if it's working well and if the family is doing well. Don't let anyone convince you that this is a harmful choice or that there will be "no way" to get him out of your bed if you don't do it now. Don't believe anyone who says that babies who cuddle and nurse all night long "never" learn to self soothe or become independent. This is simply not true but it sells books and the myths stay in our culture.

Some moms just don't want to do this after some months or years and there should be a third choice to the dichotomy of crying it out or giving in to all-night nursing. Again, I support the family bed and frequent night nursing for a long time and even attempt to pull some parents along "just a little farther," but I often have to switch tacks and support and help families with difficult choices.

Here's what I recommend for older babies:

Choose the most valuable seven hours of sleep for yourselves. I personally prefer 11p.m. through 6 a.m. but you might have a slightly different idea.

Change the rules during those hours and be comfortable that a "well-built" family bed baby's personality can withstand this rule changing and the mild inconsistency of getting everything he wants all the time . . .oops, almost all the time. That's the word we want to show this baby. The word "almost." If only we could explain to him that "tired moms and dads take their children to the park a little less and that children of well-rested parents get to go the zoo and for hikes a lot more than children of exhausted parents." If that explanation only made sense to kids somewhere before the third birthday (and it doesn't!) they would simply roll over, say, "See you in the morning," and let us get the sleep we want.

I try to do this in three- and four-night intervals.

I'm assuming that you have a wonderfully healthy 12-, 15-, 20- or 30-month old baby who still loves to wake up every 2 to 4 hours to cuddle, eat or . . . whatever. I'm assuming that you have thought this through, decided you want to make changes and alerted the neighbors that it might be a little noisy for a week or so.

I'm assuming that both parents agree -- or almost agree -- that this is the best thing to do. And, most important assumption of all, you are willing to go "in a straight line" to the goal of seven straight hours of sleep.

The reason for that last statement: If your baby learns that crying, squirming and fussing (euphemisms, let's just say "crying" . . . sorry) for an hour will get him fed you will set yourself back quite a bit. This is the best program I have seen but it's far from easy. And now, to say it again, I really like what you've been doing. Cuddling, nursing, hugging through the night. Don't change this with my program or any other if you're happy doing what you're doing. But . . .

The First Three Nights

At any time before 11 p.m. (including 10:58) nurse to sleep, cuddle and nurse when he wakes up and nurse him back to sleep, but stop offering nursing to sleep as the solution to waking after 11 p.m.. Instead…..

When your baby awakens at midnight or any other time after 11 p.m., hug him, nurse him for a short time but make sure he does not fall asleep on the breast and put him down awake. Rub and pat and cuddle a little until he falls asleep but don't put him back on the breast (or give him a bottle if that's what you've been doing). He must fall asleep with your comfort beside him, but not having to nurse to feel comforted enough to drift off.

Now, he will tell you that he is angry and intensely dislikes this new routine. I believe him. He will also try to tell you that he's scared. I believe he's angry, but a baby who's had hundreds of nights in a row of cuddling is not scared of falling asleep with your hand on his back and your voice in his ear. Angry, yes. Scared, no, not really.

During these first three nights, repeat this pattern only after he has slept. He might sleep for fifteen minutes or he might sleep for four hours, but he has to go to sleep and reawaken to get cuddled and fed again.

These will be hard nights.

You may have decided you're really not ready to do this. That's OK. Stop and start over again in a few months if you like. Choosing the right time is crucial and many people choose a time suggested or pushed by friends, doctors or in-laws. This doesn't work as well.

Is it better to do this in the family bed, a crib in the same room or using a crib in another room? I prefer to continue the family bed even though it might seem harder at first, but it has always seemed harder to me to be putting a baby in and out of a crib. However, a crib or toddler bed in your room may be what works best for you. Another option is to expand your bed's limits by placing another mattress against your mattress. A bit more space for each family member may help to solve some of the sleep issues. My least favorite choice is a crib or bed in a separate bedroom.

Again, during these first three nights, between 11 p.m. and 6 a.m., cuddle and feed short, put him down awake, rub, pat, talk until he falls asleep and repeat this cycle only after he's slept and reawakened. At 6:01 a.m., do whatever you have been doing as a morning routine ignoring the previous seven hours' patterns. Many babies will roll over, nurse and cuddle back to sleep and give you an extra hour or so. Some won't.

For me, one of the most reassuring parts of this "sleep plan" is seeing that babies wake up fine, happy and grudge-free about the change in the rules. You'll see what I mean, even if the first few minutes of the morning are not exactly as they've always been.

The Second Three Nights

Again, the nursing to sleep stops at 11 p.m. When he wakes up, hug him and cuddle him for a few minutes, but do not feed him, put him down awake. Putting him down awake is a crucial part of this whole endeavor because it really does teach him to fall asleep with a little less contact and then a little less. Not feeding is the big change during these three nights. One-year-old babies can easily go for those seven hours (or more) with no calories. They like to get fed a little through the night, but physiologically and nutritionally, this is not a long time to go without food.

If I could wake my wife a few times each night, ask her to squeeze me a little fresh orange juice (my favorite drink) and rub my back while I drank it, I wouldn't choose to voluntarily give up this routine. My wife might have some different ideas and get tired of the pattern quickly. Babies rarely give up their favorite patterns and things -- day or night-- without balking and crying.

I really don't like listening to babies cry. I actually hate listening to babies cry. Unlike them, though, we adults can truly understand the implications of lack of sleep for a family of three, four or more people. Sleep patterns sometimes have to be changed. The incredible safety and reassurance the family bed has provided, and continues to provide, supplies the best context and location for these changes.

During these second three nights, some babies will cry and protest for ten minutes at a time and some will go for an hour or more. Your toddler is aware that you are right beside him, offering comfort and soothing. It just isn't the mode of comfort he wants at the moment. It is hard to listen to him fuss, but it will work. I believe that a well-loved baby, after a year or more in the family bed, will be the ultimate beneficiary of his parents getting more sleep. Not coincidentally, the parents benefit "big time," too.

"Yes, for the past many months we have enjoyed voting "1 to 2" -- non-democratically -- in favor of . . . the baby. 'Anyone want to get up all night, feed and walk the baby and be really tired all day and the next day too?' Well, the vote is 1 to 2 in favor of the baby."

Now, what we're saying is, we will sometimes be voting two to one in favor of the baby's family. This "baby's family" concept may be abhorrent to he who considers himself the King of England, or Emperor of the Whole World, but our knowing he has that feeling of power allows us to confidently demote the dictator to a majority-respecting member of the family. His family.

By the end of the sixth night, your baby is going back to sleep without being nursed or fed. He's going back to sleep after a nice hug, a cuddle and with your hand on his back and your words in his ear.

If, at any point this is feeling "wrong" to you, stop, wait some months and start over. Don't go against your "gut instincts" which tell you that this is the wrong time to get longer sleep intervals from your baby. Your instincts are better than any sleep-modification program ever written.

The Next Four Nights

Nights seven, eight, nine and ten. Don't pick him up, don't hug him. When he awakens after 11 p.m., talk to him, touch him, talk some more, but don't pick him up. Rub and pat only. No feeding either, obviously. He will fall back to sleep. Repeat the rubbing and talking when he reawakens. By the end of the ninth night, he will be falling back to sleep, albeit reluctantly for some babies and toddlers, with only a rub and a soothing voice.

After

After these first ten nights, continue to cuddle and feed to sleep if you like and he wants to, but do nothing when he wakes up except to touch a little and talk to him briefly. This may continue for another three or four nights but occasionally keeps going for another week or more. Then . . . it stops. He has learned that he is just as well-loved, gets virtually everything he needs and wants all day, but must give seven hours per night back to his parents and family.

What happens if you travel, he gets sick or some other circumstance demands a return to more nighttime interaction? Nothing. You do what you need to do (cuddle, nurse, walk, in the middle of the night, as many times as you need to) and then spend a night or two or three getting back to the new pattern the family has established.

By the way, pay the baby. Make sure that he really does get a lot of the benefit of your getting a good night's sleep. Go to the park more often. Do all those things with him you said you'd do if he ever let you sleep longer. Explain it to him as you're doing it. He'll understand in an ever increasing way and will be OK with all this.