All about sleeping through the night..

I am wondering how many parents are like us, for the past half a year, the number one baby topic we key into search engines is always "baby sleeping through the night". I believe nighttime waking is one of the most common dilemmas for us parents.

I said goodbye to uninterrupted beauty sleep ever since Renzo was born. Though I have been trying extremely hard to establish a daily bedtime routine for Renzo, he was only doing relatively well during his 4th month. And by "relatively well", I meant only a good 4-5 hour sleep after his shower time. I would still have to carry and cuddle him to sleep after his midnight feed. Then the 5th and 6th months were just nightmares to me as I was overwhelmed with his occasional 7 - 9 times of wakeups, meaning I need to creep to his cot almost every hour at night (that's no joke because I really had to pick him up and rock him or feed him water before he could sleep back again). He had never ever slept through the night for the past 6 months+, not even a single night!

Look at our beautiful record on this little boy's sleeping pattern:
Month 00 (Aug 09)
- Longest sleep after shower: 3 hours+
- Number of feeds during midnight: 3
- Carry to sleep in wee hours: Yes

Month 01 (Sep 09)
- Longest sleep after shower: 3 hours+
- Number of feeds during midnight: 3
- Carry to sleep in wee hours: Yes

Month 02 (Oct 09)
- Longest sleep after shower: 3 hours+
- Number of feeds during midnight: 2
- Carry to sleep in wee hours: Yes

Month 03 (Nov 09)
- Longest sleep after shower: 4 hours+
- Number of feeds during midnight: 2
- Carry to sleep in wee hours: Yes

Month 04 (Dec 09)
- Longest sleep after shower: 4-5 hours+
- Number of feeds during midnight: 1
- Carry to sleep in wee hours: Yes

Month 05 (Jan 10)
- Longest sleep after shower: 6-8 hours+
- Number of feeds during midnight: 1 and down to 0 from Jan 13 onwards
- Carry to sleep in wee hours: Stopped from Jan 04 onwards
- Number of times wakeup and drink water: 7-9 times

Month 06 (Feb 10)
- Longest sleep after shower: 8-10 hours+
- Number of feeds during midnight: 0
- Number of times wakeup and drink water: 7-9 times

You can see around Jan to Feb this year, he started to form this pattern that he will keep waking up at anytime after his last feed, although no more night feeding is a remarkable milestone achieved. After ruling out teething pain, soiled diaper, hunger etc, I decided to start training him and change his habit, because the fact that he's been behaving this way for more than a month, and the thought that it might even take me years to correct him if I let him continue this way, really horrified me.

So, the training started on Feb 24. I am never an advocate of the famous Ferber's Cry-it-out method, but there are a few variations and I must say some tips are really helpful.

In a nutshell, there are a few things I followed that seemed to solve the problem:
1. Never pick him up from his cot when he's tossing and turning around.
- Challenging, because sometimes he wiggles as he needs to burp, so I have to make sure I burp him well before putting him to bed. But at least I am happy to find out that my cuddling triggered him to wake up so often in the past.

2. Put him into his cot while he's drowsy and let him sleep on his own.
- He's quite good at playing on his own till he falls asleep, but a lot of times he will cry and scream, and since I cannot pick him up, I give him water instead (which is not something very right, and might become habitual).

3. Do not feed him.
- Well I don't feed him milk, but I am still giving him water. This might be the reason why he is still waking up, as cuddling, feeding or talking to him might prompt him to wake up each night for such attention. But letting him cry his eyes out is still something I am not in favour of, especially during middle of the night.

4. Give him a few fussy minutes before responding to him.
- Sometimes we are lucky enough that he can struggle back to sleep on his own.

I thought about blogging on this topic last week, but decided to monitor him for a longer period of time in order to prove that I've found the cause and my solution is really working.

We have not achieved the ideal result yet, but at least we can see some improvement there as nowadays he awakens about 2-5 times, and we are keeping our fingers crossed that things will only get better and better..

(just for records, both picture here were taken in January 2010)

The 3 P's of Parenting Renzo...

So we are into the third week after Renzo's birth, but I can't say that Feli and I have quite settled into parenting life yet (despite that fact that my mother-in-law flew in from China just to help us along for this few months). Late night feedings that can be as torturous as you might have heard from other parents, earth splitting havoc during water baths, diaper changing that seems to threaten your limited supply... But it is through all that I have come to establish the three Ps of parenting... well... at least in Renzo's case... Fully understand the three Ps, taking care of Renzo will be a lot lack hectic... or so i hope..=P

The first P... PEE

During the earlier days of Renzo's life, he didn't really pee much... In fact on the first 2 days at home, he only peed twice... Imagine that when we checked on his diaper, it was clean... puzzling... and to make matters worse, on the 3rd day... his diaper had pee with blood stains (OMG)... It was during consultation with our pediatrician, Dr Ong Eng Keow, did we confirm that they were 'crystals' passed out by Renzo that could indicate dehydration.

So mastering the understanding of your baby's pee would increase your understanding of your baby's hydration condition... =P

Clear Urine - Normal health condition

Yellow/Orange Urine - Indication of dehydration

Cloudy Urine - May indicate blood traces in urine

The second P... POOP

Renzo has been a little Poopersaurus recently, though we didn't need to change his diapers for poops until the third day we brought him home. On his record day, he needed 6 diaper changes due to pooping (and that didn't include the bathe change and his pee changes). His poop started out greenish and more runny and we believe it was because of the breastfeeding early on, but have recently taken on a slightly more yellowish shade since we switched to formula milk as recommended by our PD due to his high jaundice level during breastfeeding.

Breastfed infants are more likely to poop than formula-fed infants, mostly due to the fact that breast milk is more easily digested (so breastfed infants are less likely to be constipated). The excretory take on a more seedy appearance and is more runny and yellowish (like mustard...ewww). Formula-fed infants produces more poop in a session (they poop less daily though) and the excretory are usually firmer and are dark-yellow-to-green in colour. The three colours that should alert you to contact your PD are: red (signaling fresh blood), black (not including the first few days as the black maybe due to the meconium that fills the intestines before birth), or white (which may be due to bile system problems).

The third P... PUKE

Renzo feeds in multiple small meals and will go for a short naps before waking up hungry again (as opposed to other infants who can down 90ml in one sitting and sleep for 3 hours). Problem is, if we try to feed him in excessive quantities, his body will reject and he will puke them out. Well, technically it should be a spit up actually (puking is usually referring to projectile vomitting and usually through the nose as well, which Renzo has only twice or so thus far). To lessen his spit ups, what Feli would normally do is to sit Renzo in an upright position to burp him... and meehhh, the little guy sounds like an adult when he burps (cute~!).

Anyway, spit ups are nothing more than a mess during the earlier weeks of infancy and rarely causes chokes, coughs or pain. But in the event that your baby spits up large amounts of milk, spits up green or brown liquids or isn't gaining weight, you may want to contact your PD.

Lastly, should you experience anything like in this video below... kindly sign your kid up for civil defense... the fire department may require his talents...=P

Total breastfeeding, not as easy as expected

It's been about 20 days after we brought Renzo home from hospital. Life has been changed completely. I've cried a few times in front of Win and my sister, really that's something I totally did not expect because I thought I am not that emotional. But seeing baby not having good feed or sleep at times, and me not even able to hold a proper conversation with Win as usual just drives me crazy (yes I have to truly admit that having no private time with Win is something I could not accept the most).. And there are just so many new challenges everyday. The topic we struggled on the most so far is:

Total breastfeeding vs. Formula milk

I do not remember since when I became an advocate of total breastfeeding, when the nurse at Thomson Medical Center asked me right before my delivery, "Do you want to breastfeed your baby?", "Yes, I want to TOTAL BREASTFEED him!!"I answered her proudly with full confidence. During our 2 days stay in hospital, Renzo was brought to us every 2-3 hours and I just let him latch on for 15 minutes each side. I do not know what happened to him after each feeding when he was brought back to the nursery room, I was only sure that he has not been given any formula milk or water at all. And that made me believe that he will be able to survive the same way once we are home. And end up I tried breastfeeding him for a total of 5 days before we brought him back to TMC for the first review. And during these 5 days, he barely peed, and only pooped once but his stool was dark green color, which supposed to be his meconium. Am I worried? Yes definitely!! But I still insisted on total breastfeeding despite that my mother, my sister and my father all commented that I should give Renzo some water and formula milk. Win being the super supportive kind always, left the decision to me as he believes that I am the mother and all my decisions are for our baby's own good.

But eventually, I gave up when Dr Ong said that Renzo needs to be admitted for phototherapy due to high jaundice level, and it could be caused by not enough breast milk. We left him in TMC for 2 days and everytime I called up the nurse to check on his status, I heard that he's been taking 70-90ml of formula milk and peed and pooped well, suddenly I got this feeling that I should not be so stubborn, and I quickly discussed with Win about whether to continue with total breastfeeding. Obviously, I do not have too much a choice, I used my Avent breast pump every few hours but can barely express out 20-40ml from both sides, which is definitely not going to be enough for our poor little boy. Again, Win gave me his full support, we both understand how precious breast milk is for baby, but now first thing first, we got to make sure he has enough milk before we even talk about the nutritional value of the milk.

So right after we brought Renzo back home again, we started to give him Mamex Gold infant formula, the same one he had during his hospital stay. And just my 2 cents to new parents:

1. Give yourself 3 days, monitor your baby closely. If your milk supply has not came in, think about it seriously. How do you know if your baby is having enough breast milk? It is never easy to gauge, but check and make sure he has 6-7 wet nappy everyday. I checked on internet and some people said first few days baby will not pee that often, I do not know how true it is, but if he does not pee, he could be dehydrated and your breast milk is definitely not enough..

2. If your baby's pee is dark yellowish color, be careful.. And even worse, if you see some pinkish spot in his pee, be extra careful. Dr Ong said it is kind of "crystal" that passed out from baby's body, but it could be a sign of severe dehydration also..

3. Believe it or not, baby born before 40 weeks really have higher chance of getting jaundice and if you do not have enough breast milk, it is going to worsen the situation. Supplementing him with formula milk really somehow helps in clearing the jaundice..

4. Now you might say if you give your baby formula milk, he might have nipple confusion and refuses to latch on as it is easier to drink from bottle teat. Err who said that? Must be internet again but in actual fact, it really depends on individual baby. Renzo never refuses anything, maybe he's simply hungry..

5. If you are someone like me, who did not hire a confinement lady, and have to take care of baby day and night almost on my own (Win needs to work and I am trying my best not to wake him up at night, my mother needs to cook for us during day time so I need to let her rest well at night), most probably you will not produce enough milk due to lack of rest. So don't be so stubborn like me, everyone wants to give their baby the best but if that means you have to starve your baby, then nobody wants that to happen, so don't blame yourself for not being able to make total breastfeeding successful. The more you stress yourself, the less milk you can produce..

Now I am only able to give my poor little boy about 40-60ml of my expressed milk everyday. If we ever have our 2nd baby Chan, I am sure I will try breastfeeding again but before that, I will talk to a lactation consultant and many other successful breastfeeding mothers to gain more experience.