Pacifiers -- blessing or curse? 

I am unapologetically a huge proponent of pacifiers.

Some breastfeeding support folks argue that pacifiers interfere with a good latch, and that pacifiers shouldn't be introduced until six weeks of age, or not at all. But no one argues that you shouldn't offer a clean pinky to suck on. And why wouldn't that interfere with a good latch just as much? 

Moreover, evidence-based research doesn't support the idea that pacifiers interfere with breastfeeding. Babies know the difference between what we call "non-nutritive sucking" and feeding. When I was a NICU nurse, I read academic articles that showed that pacifier useactually helped premature babies prepare for breastfeeding. 

This double-blind meta-analysis (the most rigorous form of research) of 1302 infants found no difference in breastfeeding duration between babies who took a pacifier and those who did not. The study's authors concluded, "This meta-analysis shows that pacifier use does not decrease breastfeeding duration in full-term infants. The new evidence contradicts current WHO (World Health Organization) recommendations, however, which are based on less rigorous studies.8,9,13,14 The AAP (American Academy of Pediatrics) now recommends that pacifier use be implemented after breastfeeding is established.4 Based on the evidence, we think mothers who are motivated to breastfeed their infants should be allowed to make their own decisions regarding pacifier use, and pacifier use should not be discouraged."

Moreover, the AAP actually recommends the use of pacifiers as a way to decrease the incidence of SIDS. Dr. Harvey Karp recommends sucking as one of his "5 S's" as a way to soothe a newborn to sleep. 

Anectdotally, as a parent and as a healthcare professional, I have never understand why one would offer breastfeeding when a baby wants to suck for comfort, not hunger. We wouldn't offer formula to a baby who wasn't hungry. Why would we offer breastmilk, then, when a breastfed baby isn't hungry? 

As a baby grows older, out of the newborn stage, I recommend that pacifiers be restricted to times that a baby is tired or fussy. Babies use their mouths to explore the world, and that should be encouraged. They also need their mouths to coo and babble as the earliest stage of language development. But when it is time to sleep, pacifiers can be a wonderful tool.

That said, if pacifiers start to become more of a blessing than a curse, it's fine to eliminate them. Some babies love pacifiers but can't keep them from falling out of their mouths, and then cry for them to be replaced. If this happens to your baby multiple times a night, the pacifier may not be worth the inconvenience. In that case, I would recommend offering the pacifier once at bedtime but not replacing it, especially if your baby is no longer in your bedroom. Tugging gently on the pacifier once it's in your baby's mouth can strengthen the suction so it's less likely to fall out.

By six months, babies no longer have a biological need for sucking, but many still enjoy it for comfort. It's up to you if you want to eliminate it then or wait longer. 

Both of my children used pacifiers. My older daughter used it until about four months old, and then gradually transitioned to sucking her thumb. She didn't stop sucking her thumb until five and a half years old and the weaning process required a full-scale assault. I wished many times that she used a pacifier instead -- it would have been so much easier to stop pacifier use than to stop using a thumb that was always with her!

My little one used a pacifier until age 3. It was an amazing help for her in sleeping through the night at ten weeks old. We kept her pacifiers -- a lot of them -- in the crib and car seat, only. Only once she was climbing in and out of the crib, and then transitioned to a toddler bed, did more frequent pacifier use become an issue since she was able to reach them whenver she wanted. 

At age three, on the dentist's advice, we picked out a reward for giving up the pacifier -- she chose an Elmo doll -- and on the day she was ready, she threw the pacifiers in the trash and got her Elmo. Of course, a few minutes later, she changed her mind and wanted to throw Elmo in the trash and have her pacifiers back. But I held the boundary. At bedtime that night, I rubbed her back while she cried. I didn't try to plead or explain or convince her that her grief was wrong. And after about ten minutes, she fell asleep. The next night, she cried even less. And by the third night, we were done. She continued to speak fondly of her "pacis" for months to come but she never cried for them again. 

I'm so glad that she was able to have the comfort of sucking when she needed it, and that she was able to partner in the process of giving them up. So to those who would argue that if you give a pacifier, it'll be hard to get rid of them -- no, I don't agree. 

My girls preferred different kinds of pacifiers. One like the Phillips Avent pacifier while another preferred the Nuk. For each, I bought a few different options to see which they liked best. Oh, and each breastfed past a year, despite pacifier use and taking a bottle while I was at work. 

So I recommend stocking up on a few different options and experimenting. Offer the breast or bottle first, if you think your baby is hungry. But if she's crying and pushing it out of her mouth, or if it's been less than 90 minutes and you're confident that she had a good feeding, try swaddling her or popping her in the baby carrier and offering a clean pacifier. She might just need some non-nutritive sucking to soothe herself to sleep. Rest assured, when the time comes that you need to wean her off it, you'll be able to manage it.

For more help with soothing your baby to sleep, or getting him to sleep all night, schedule a free chat with me and get your family sleep you deserve. 

Newborns are hard. Really, really hard. And those early days seem to last forever. Sometimes they do last for months, if you have a colicky or overtired baby, or one with medical issues. 

And it's remarkably easy to forget how hard it was, once we are out of those dark days.

I just went back and read my personal blog from the early days with my older daughter. I had forgotten how miserable I was. And how guilty I felt as a result. Guilty that I wasn't treasuring every moment. 

"I'm not enjoying my life today. I feel guilty that I'm not appreciating C more. This morning, I laid her on the changing table and saw her sweet little face grinning up at me through my tears.

This made me feel terrible. Poor thing doesn't even realize that I'm upset.

Yesterday I accidentally woke her up while I was documenting her Baby Whispered status... and we've been off track ever since. And so now I feel like a baby sleep failure, on top of everything else.

And oh, sidebar, the pacifier: what a double edged sword. It helps her calm down so much and often soothes her to sleep. Until she loses it or spits it out... and immediately decides she wants it back. And so... Mommy goes to and fro, sticking the damn thing back in. Sometimes I don't give it to her... and then she cries, because she needs its magical soothing powers to calm herself down. I'm so frustrated!"

You are not alone if you are miserable, too. So many other women feel the same way. And our culture puts trememendous pressure on us to bounce back immediately, to fit into our pre-pregnancy jeans on our way home from the hospital, to have a spottless home and baked goods for our guests who want to see the new baby, to breastfeed effortlessly and painlessly -- after all, it's "natural," right?

I promise you, you will feel better. But possibly not right away. And if your baby or babies are not sleeping well, it may take quite a while. I know I never feel good when I am sleep deprived, and I know I'm not alone. 

A cruel truth of sleep training is that is requires a reservoir of strength you may not feel you have. It generally gets harder before it gets easier. It's hard to believe that it will ever get better, especially when you are already exhausted and unable to think logically. When you are tired, it's also all the more agonizing to listen to your overtired baby cry. You just want that heartbreaking noise to stop. You just want to go to sleep yourself, as soon as humanly possibly. You don't care what you have to do to make it happen. Unfortunately, the shortcuts you take often make the overtiredness all the worse in the long run. 

I wish we lived in a culture that valued vulnerability more. And supported new parents more. That told us it is okay to feel tired and hormonal and weepy. That we are beautiful in our milk-stained overstretched t-shirts and bagging yoga pants. We have created (or supported) new life. We are miraculous!

Brene Brown says, "Vulnerability is about showing up and being seen. It’s tough to do that when we’re terrified about what people might see or think. When we’re fueled by the fear of what other people think or that gremlin that’s constantly whispering 'You’re not good enough' in our ear, it’s tough to show up...

Vulnerability is the birthplace of love, belonging, joy, courage, empathy, and creativity. It is the source of hope, empathy, accountability, and authenticity. If we want greater clarity in our purpose or deeper and more meaningful spiritual lives, vulnerability is the path.”

(You should totally watch her excellent Ted talk on vulnerability here -- it can be watched while nursing or rocking a tired baby. But don't watch it if adding one more thing to your day will stress you out!)

The thing about being vulnerable and real about where you are right now is that it allows people to love you. Perfection is admirable but not loveable. When we show people our weaknesses and our needs, we invite them into our hearts. We let them love us. And if there was ever a time where you deserve support, it's when you have a new (or not so new) baby at home. People want to help. They just don't know how. 

So let them in. Invite them into your heart. And ask for very specific help. They don't see the unmet need. You give them a beautiful gift when you show it to them. 

This was hard for me, too. Reading back over my blog, I see that I asked one of my closest friends if she would spend a night with me and do just one four-hour stretch with my daughter in the evening while I slept. This friend never went to bed early, but still, I felt like I was asking her for an unforgiveably huge favor. It was deeply painful to ask. But I did anyway.  (At that point, C was waking every three hours to feed, and it took about an hour to feed her and get her back to sleep.)

"I asked SL last week if she would come over and stay the night to do a late night feeding, back when I was desperate (well, more desperate) for sleep. We hadn't seen her since the birth, six weeks prior. Amazingly, she agreed!

So last night SL left work on time (for once!) and we had a lovely time catching up. At about 8 pm, I started to yawn. And when my friend asked if I wanted to go to bed, I realized I did. Even though I felt guilty to desert her.

Of course, C was resisting sleep, so it took a while... I didn't want to go to bed until she was down. But I finally gave up and went to bed anyway.

Well, my little Super Baby finally went to sleep and didn't wake up again to eat until four hours after the previous feeding, at midnight, then went back to sleep... for five and a half hours!

Could this be the light at the end of the tunnel???

My friend brought her to me shortly before 6 am. At that point I had been asleep more than nine hours! Of course, I had woken up multiple times to look at the clock and notice my engorged breasts and wonder how things were going... with gratitude in my heart.

After the 6 am feeding, C went back to sleep and slept another three and a half hours! I slept three of them, then got up to have a little time with my friend.

So not counting that one feeding at 6 am, and the little wake-ups here and there, I slept twelve hours!!!"

In this case, what I needed was someone to take that early evening shift. If you are still in the early days of infancy, you might need this too. It's perfectly acceptable to ask someone if they will sit with your baby from 8 pm to 12 am. The worst they can do is say no. And believe me, it's deeply uncomfortable for me to ask people for favors, and risk them saying no. In my crazy little head, that "no" takes on all sorts of meanings, like that they don't love me. Which is not rational, but that's a story for another day. 

Anyway, try to remind your rational self that the worst thing that can happen if someone says no to you is an uncomfortable feeling. And Brooke Castillo at the Life Coach School reminds us that uncomfortable feelings are not dangerous. They are just a vibration in our body, caused by our thoughts. And we can choose to change our thoughts. So instead of thinking, "she said no because she doesn't really care about me," or even, "she said no because I'm an unacceptable human being," we can choose to think, "she said no because she doesn't have the capacity to help right now, which is about her, not me. I'm glad she felt safe enough to be honest with me. I will think about who else I can ask."

Don't be afraid to seek support from folks you don't know as well. Other moms may not be able to pitch in at night, but maybe your neighbor or co-worker or friendly acquaintance from your religious community would love to pitch in. If you are in a community like Single Mothers by Choice, there are likely members out there who would love  to pitch in as they wait for their own turn at parenthood.  Post to your local group as well as to the national organization and let folks know you need help. Remember, you are giving a gift by asking -- it helps build friendships and community. 

Even if you don't need physical help, please let folks know when you are struggling. It doesn't mean you can't be there for them but sometimes, sharing your vulnerability is a beautiful gift. If you are overwhelmed by sadness or anxiety, or have thoughts of hurting yourself or your baby, please seek professional help immediately. It doesn't mean anything about you. It's not your fault. It's your hormones. 

If you are ready to sleep train, ask for emotional support. Ask a friend or family member if you can call them to vent or cry. Ask them -- ahead of time -- to please support you by not offering advice or feedback. Just keep on reminding you that you are doing great, that your baby is crying because she's overtired and not because she feels abandoned. They need to remind you that she is going to feel so much better when she is getting the sleep she needs. I promise you it's true!

This is a big part of the work I do for tired parents. It's hard to have confidence that you are doing the right thing when both you and your child are exhausted. After we create a sleep plan together, my role is to troubleshoot but mostly, to cheer parents on. To tell them they are doing great. Over and over and over again. If you find someone who can help you stay consistent, you will  see results. 

If you're interested in getting support from me, let's schedule a free chat and help your family get the sleep you deserve. Remember, there is no shame in needing support. We all do. It's a beautiful thing. 

​

Twins. Double trouble but triple the joy? 

I haven't been lucky enough to experience multiples personally (though I was hoping for them with my firstborn!) . But I've recently had the pleasure of working with two sets of twins and I'd like to share a few tips for all those tired families of twins and higher-order multiples.

1. Identical twins typically have similar sleep needs, while fraternal twins are more likely to have different sets of sleep needs. In a separate blog post, I'll talk about how to address these different sets of needs.
   
   
2. Unless you are able to provide separate bedrooms for each twin long-term, it's usually best to sleep train them in the same room. 
   
   Yes, this means that they will likely wake each other up. In the beginning. Eventually, they will learn to sleep through each other's noise. This is an important key to success with twins. Unfortunately, there's no easy way to get there. You just have to get through it.
   
   
3. White noise can really help with covering some of the noise though. My absolute favorite white noise is the HomeMedics White Noise Sound Machine. It's considerably louder, cheaper, and more lightweight than the Marpac or the Dohm. It also allows you to use batteries if you are traveling and there's not a handy outlet nearby. We've even used ours in a tent!
   
   
4. Each twin should have her own crib once she is able to move around, if not before. It's best to have the cribs as far apart as is safely possible. This makes them less likely to disturb each other.
   
   
5. Blackout shades during naps and nighttime sleep are especially important when working with twins. We want to make sleepy cues super obvious. 
   
   
6. Consistency, as always, is key. Whatever approach you take to sleep training, you need to do it exactly the same for each twin. 
   
   
7. Both twins need to be on the same schedule, for the sanity of the parents. Otherwise you will never leave the house!
   
   If you can't get them into bed at exactly the same time, it should be within 30 minutes of each other. It is okay if one twin goes to bed a bit earlier than he might otherwise need. If he's not tired, he can rest or play quietly in his crib until he gets sleepy. If he's crying in the crib, he's tired! It does not mean that he feels like he's in baby jail -- these are thoughts we adults assign to our babies. So please don't feel guilty about putting your twin to bed at a time you fear is not ideal.
   
   
8. Feed both twins at the same time, or as close as possible, unless one twin is ready to skip night feedings. This will help their sleep schedules sync up. At night, if both babies need feedings, when one baby wakes up, wake the other for a feeding too. I highly recommend the My Brest Friend Nursing Pillow for Twins, whether you are breast or bottle feeding. Feeding both babies at the same time can save you a lot of time. 
   
   If your babies were in the NICU and come home on a schedule, consider keeping them on that schedule. It can also save you a lot of time and effort in the long run.
   
   
9. Many twins are born small and need extra attention paid to feedings and weight gain. By nine months adjusted, though, most babies are ready to be night weaned unless your pediatrician still has concerns about weight gain. In the long run, night weaning makes for higher quality sleep and thus, happier babies. 
   
   It's up to you to decide how to night wean. Some folks prefer a more gradual approach, slowly decreasing the volume or length of feedings, while others prefer to go cold turkey so that the change happens faster. Either way will work, as long as you are consistent in your approach. 
   
   
10. When you are feeling guilty that one twin has to wait her turn for attention, or otherwise has her needs compromised, remember that there are many gifts to being a twin. Just like with disparate-age siblings! 
    
    Learning to take turns, to share, and to wait are all valuable life lessons. And many twins grow up to have an unbelievably close bond as adults. I lived with one set of twins as an adult, and I was envious of the closeness they enjoyed. 
    
    Being a twin (or higher order multiple) is a rare and special gift! With better sleep, you'll be able to appreciate your unique gift all the more.
    
    

For help with sleep training twins, or any other child, schedule a free chat with me and get your questions answered.