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Chapter One: E.A.S.Y. Isn't Necessarily Easy (But It Works!)
Getting Your Baby on a Structured Routine
The Gift of E.A.S.Y.
You probably have a routine in the morning. You get up at roughly the same time, maybe you shower first or have your coffee, or perhaps you immediately hop on the treadmill or take your pup out for a brisk walk. Whatever you do, it's probably pretty much the same every morning. If by chance something interrupts that routine, it can throw off your whole day. And I'll bet there are other routines in your day as well. You're used to having your dinnertime at a certain hour. You probably have particular rituals at the end of the day, too, like spooning with your favorite pillow (or partner!) in anticipation of a good night's sleep. But let's say your dinner hour changes or you have to sleep in a bed away from home. Isn't it unsettling and don't you feel disoriented when you wake?
Naturally, people vary in their need for structure. At one end of the continuum are those whose entire days are predictable. At the other end are free spirits who tend to fly by the seat of their pants. But even "flyers" usually have some sort of dependable rituals during their day. Why? Because human beings, like most animals, thrive when they know how and when their needs are going to be met and know what's coming next. We all like some degree of certainty in our lives.
Well, so do babies and young children. When a new mum brings her baby home from the hospital, I suggest a structured routine straightaway. I call it "E.A.S.Y.," an acronym that stands for a predictable sequence of events that pretty much mirrors how adults live their lives, albeit in shorter chunks: Eat, have some Activity, and go to Sleep, which leaves a bit of time for You. It is not a schedule, because you cannot fit a baby into a clock. It's a routine that gives the day structure and makes family life consistent, which is important because all of us, children and adults, as well as babies and toddlers, thrive on predictability. Everyone benefits: Baby knows what's coming next. Siblings, if there are any, get more time with Mum and Dad -- and they get to have less harried parents who have time for themselves as well.
I was actually doing E.A.S.Y. long before I named it. When I first started caring for newborns and young babies more than twenty years ago, a structured routine just seemed to make sense. Babies need us to show them the ropes -- and to keep it up. The most effective learning comes with repetition. I also explained the importance of a structured routine to the parents I worked with, so that they could carry on after I'd left. I cautioned them to always make sure that their baby had some kind of activity after a feed instead of going right to sleep, so that their little one wouldn't associate eating with sleeping. Because "my" babies' lives were so predictable and calm, most of them were good eaters, they learned to play independently for increasingly longer periods, and they could get themselves to sleep without sucking on a bottle or breast or being rocked by their parents. As many of those babies grew into toddlers and preschoolers, I stayed in touch with their parents, who informed me that not only were their children thriving in their daily routines, they were also confident in themselves and trusted that their parents would be there if they needed them. The parents themselves learned early on to tune in to their child's cues by carefully observing their body language and listening to their cries. Because they could "read" their child, they felt better equipped to deal with any bumps in the road.
By the time I was ready to write my first book, my coauthor and I came up with "E.A.S.Y.," a simple acronym designed to help parents remember the order of my structured routine. Eat, activity, sleep -- it's the natural course of life -- and then, as a bonus, time for you. With E.A.S.Y., you don't follow the baby; you take charge. You observe him carefully, tune in to his cues, but you take the lead, gently encouraging him to follow what you know will make him thrive: eating, appropriate levels of activity, and a good sleep afterward. You are your baby's guide. You set the pace.
E.A.S.Y. gives parents, especially first-timers, the confidence to know that they understand their baby, because they more quickly learn to distinguish their baby's cries. As one mum wrote to me, "My husband and I and our six-month-old, Lily, are considered an enigma among my peers in our childbirth education class due to our sleep-filled nights and very pleasant baby." She goes on to say that they put Lily on E.A.S.Y. when she was ten weeks old. As a result, Mum says, "We understand her cues and have a routine -- not a schedule -- that makes our life predictable, manageable, and fun."
I've seen it time and again. Parents who establish my E.A.S.Y. routine quickly get better at figuring out what their baby needs and wants at a particular time of day. Let's say you've fed your infant (the E), and she's been up for fifteen minutes (the A -- activity), and then she starts to get a bit fussy. Chances are, she's ready for sleep (the S). Conversely, if she's been napping for an hour (S), while you (the Y) hopefully have been stealing a little downtime for yourself, when she wakes, there's no guesswork involved. Even if she's not crying (if she's under six weeks, though, she probably is), it's a pretty safe bet that she's hungry. And so the E.A.S.Y. cycle begins again.
Write It Down!
Parents who actually chart their baby's day by writing everything down have less trouble sticking to a routine or establishing it for the first time. They also are better observers. Writing things down, even though it seems tedious at the moment (goodness knows, you have lots of other things to do!), will give you a much better perspective. You'll see patterns more readily, and see how sleep and eating and activity are interrelated. On days that your baby feeds better, I'd just bet that he's less cranky during his awake time and sleeps better, too.
When E.A.S.Y. Seems Hard
In preparing to write this book, I pored over the case files of thousands of babies I've worked with, as well as questions I received from parents who have recently contacted me via phone, email, or through my website. My goal was to identify the stumbling blocks that typically occur when well-meaning and committed parents try to establish a structured routine. Most parents' queries are not about routines. Instead, their questions tend to focus on one of the letters of E.A.S.Y. They might ask, "Why are my baby's feeds so short?" (the E), "Why is he cranky and uninterested in his toys?" (the A), or "Why does she wake up several times during the night?" (the S). In this book I deal with a whole range of questions like those and offer lots of suggestions for dealing with specific problems -- all of chapters 3 and 4 are devoted to eating issues, and chapters 5 through 7 to sleep. But we also have to look at how the three areas are interrelated, which is what this chapter is about. Eating affects sleep and activity; activity affects eating and sleeping; sleep affects activity and eating -- and all of them will naturally affect you. Without a predictable routine, everything in a baby's life can go haywire -- sometimes all at once. The solution is almost always E.A.S.Y.
Parents tell me, though, that E.A.S.Y. isn't necessarily easy. Here's a portion of a letter from Cathy, mother of one-month-old Carl and twenty-two-month-old Natalie. It captures the confusion and several of the difficulties parents seem to experience:
My older daughter, Natalie, sleeps very well (seven to seven, puts herself to sleep, naps well). I can't remember how we got her there and need some sample routines to use as guidance for Carl, starting now and covering the next several months. He is breast-fed and I fear I inadvertently keep nursing him to sleep, and I sometimes confuse tired/hungry/gas pain. I need to have a general structure to follow to help me keep track of where I should be with him, since his sister demands a lot of attention when she is awake! Tracy's [first] book talks in general terms about amounts of time on E/A/S, but I'm finding it difficult to relate that to the hours in the day and night.
Cathy was ahead of the game in one respect. She at least realized that her problem was inconsistency and her inability to read Carl's cues. She suspected, quite accurately, that the solution is a routine. And like many parents who have read about E.A.S.Y., all she needed was a bit of reassurance and further clarification. It didn't take her long to get on track after we spoke, as Carl was only a month old, young enough to adapt quickly to a new routine. Also, when I found out he weighed seven pounds at birth, I knew he wouldn't have any trouble going two-and-a-half to three hours between feeds (more on that later). As soon as Mum had her son on E.A.S.Y., she was better able to anticipate his needs. (See a sample routine for a four-week-old on page 25.)
All babies thrive on routine, but some adapt more rapidly and readily than others because of their basic temperament. Cathy's first child, Natalie, who is now a toddler, was an extremely easygoing and adaptable infant -- I call them Angel babies. That would explain why Natalie napped and slept so well and also why Cathy can't remember how she got her there. But little Carl was a more sensitive type of child, what I call a Touchy baby, who even at a month old could be thrown off by a too bright light or Mum holding his head slightly lower than usual when she fed him. As I detail in chapter 2, temperament affects how a baby reacts to virtually everything in his life. Some babies need a little more quiet while they're eating, less stimulating activities, or a darker room to sleep in. Otherwise, they become overstimulated and will resist a routine.
With babies under four months old, problems also can occur because the parents don't realize that E.A.S.Y. has to be adapted to accommodate a special birth condition, like prematurity (see sidebar, page 27) or jaundice (sidebar, page 28), or their particular infant's weight (pages 27-29). Also, some parents misunderstand how to apply E.A.S.Y. For instance, they take "every three hours" literally and wonder how their baby will ever learn to sleep through the night if they wake her for feeds and what kind of activity should be done in the middle of the night. (None -- you let them sleep; see sidebar, page 19.)
Parents also have problems with E.A.S.Y. when they think "schedule" and focus more on reading the clock than reading their babies' signals. A structured routine is not the same thing as a schedule. This bears repeating: You can't fit a baby into a clock. If you do, then both mother and baby become frustrated. Merle, a mother from Oklahoma, wrote to me in desperation after she had "tried unsuccessfully to do the E.A.S.Y. schedule." Straightaway, my antenna went up because Merle used the word schedule, which I never do. "It seems every day we are at a different time schedule," she wrote. "I know I am doing something wrong, but what?"
A structured routine is not the same thing as a schedule. A schedule is about time slots whereas E.A.S.Y. is about keeping up the same daily pattern -- eating, activity, and sleeping -- and repeating that pattern every day. We're not trying to control children, we're guiding them. The way humans learn -- or other species, for that matter -- is by doing something over and over, which is what a structured routine reinforces.
Like Merle, some parents misinterpret what I mean by "routine," often because they tend to live by schedules themselves. So, when I write down a suggested three-hour routine for a baby who's under four months -- say 7, 10, 1, 4, 7, and 10 -- a schedule-driven mum sees the time slots as written in stone. She panics because one day her baby naps at 10:15 and the next day at 10:30. But you can't put a baby on a clock, especially in the first six weeks. Sometimes you'll have a day when you're on track and everything goes smoothly and other days not. If you're busy watching the clock, instead of your baby, you'll miss important signals (like the first yawn in a six-week-old or eye-rubbing in a six-month-old, which means that your little one is getting sleepy -- more on the sleep window, page 181). Then you have an overtired baby on your hands who can't get himself to sleep and who of course resists the routine, because it goes against his physical needs.
The most important aspect of E.A.S.Y. is to read your child's signs -- of hunger, of fatigue, of overstimulation -- which is more important than any time slot. So if one day, he's hungry a little earlier, or seems tired before it's "time" to put him down, don't let the clock threaten you. Let your common sense take over. And believe me, ducky, the better you get at interpreting your baby's cries and body language, the better you'll be at guiding him and at clearing whatever obstacles get in the way.
Getting Started: Guidelines for Different Ages
Establishing a routine for the first time gets a bit harder as the baby grows, especially if you've never had structure. And because my first book concentrates mainly on the first four months of E.A.S.Y., some parents of older children find themselves at sea. At least half of my queries come from parents who have either tried another, less structured method, such as "on demand" feeding, or followed a different type of routine and found it lacking. Then they discover E.A.S.Y., and they wonder how to get started.
E.A.S.Y. is different with older babies, and on pages 39-46, I lay out a day-by-day plan that works with babies four months or older. Granted, babies' challenges don't necessarily fall into neat categories. As I explained in the Introduction, I have found that certain concerns seem to crop up in particular age groupings. In this review of E.A.S.Y., I will focus on:
Birth to six weeks
Six weeks to four months
Four to six months
Six to nine months
Nine months and beyond
I will offer you an overall description of each stage, plus a list of the most common complaints and their probable causes. Even where the complaints seem to center on a feeding or sleeping issue, at least part of the solution always involves establishing a structured routine if you don't have one, or tweaking the routine your baby is already on. The numbers in parentheses in the "probable cause" column indicate the pages in other chapters where you'll find more detailed explanations about what to do (so as not to repeat the information).
No matter how old your baby is, it's a good idea to read through all the sections, because as I will remind you repeatedly, you can't base strategies solely on age. Children, like grownups, are individuals. With a six-month-old baby, we sometimes see the same issues that crop up with a three-month-old baby, especially if the child has never had a routine. (Besides, if I don't constantly reinforce this point, I'll get letters from parents when this book is published, saying, "But my baby is four months old and she's not doing what you described...")
The First Six Weeks: Adjustment Time
The first six weeks is the ideal time to start E.A.S.Y., which generally starts out as a three-hour plan. Your baby eats, plays after his feeds, you then set the scene for good napping. You rest while he rests, and when he wakes up, the cycle starts again. But the first six weeks is also a time of huge adjustment. Your baby once lived in a cozy, climate-controlled place where he ate twenty-four/seven and dined in the seclusion of your uterus, and now he's been thrust into a noisy home with people bustling about. He is expected to get his nourishment from a nipple -- yours or a bottle's. Life is dramatically different for you, too. Especially if you're a first-timer, you are often just as confused as Baby! And if it's your second or third baby, you probably have his siblings underfoot, complaining about that crying blob who's suddenly monopolizing everyone's time.
The baby doesn't have much control over anything at this point except his mouth, which he uses to suckle and to communicate. His existence is all about eating and suckling and crying. Crying is his voice, his only voice. The average baby cries somewhere between one and five hours out of twenty-four. And to most new parents, every minute feels like five. (I know, because I've asked parents to close their eyes while I played a two-minute tape of a crying baby. Then I asked them how long they thought they had been listening. The majority thought it was two to three times longer!)
We should never ignore a baby's cries or, in my opinion, let him cry it out! Instead, we always have to try to figure out what he's telling us. When the parents of young infants have problems with E.A.S.Y. it's usually because they're misreading their baby's cries. It's understandable: Here's this little stranger in your midst whose only language is crying, a lingo you don't speak. It's hard for you -- a foreigner -- to understand what he means at first.
Crying often peaks at six weeks, by which time observant parents have usually learned the language. Paying close attention to the baby's movement, they often act before the crying starts. But they also know what a hungry cry sounds like -- a slight cough-like noise in the back of the throat, short to begin with and then as a more steady waa, waa, waa rhythm -- compared to an overtired cry, which begins with three short wails, followed by a hard cry, then two short breaths and a longer, even louder cry. They also know their particular baby -- after all, some are less vocal about their hunger than others. While some infants only fuss slightly and "root" or curl the sides of their tongue, others become absolutely frantic with the first hunger pang.
If you put your baby on E.A.S.Y. straightaway, I guarantee you'll learn her cues more quickly and be better able to determine why she's crying. Looking at your daily chart will help. Let's say, for instance, that she fed at 7 A.M. If she starts crying ten or fifteen minutes afterward, and you can't calm her down, you can be fairly certain it's not hunger. More likely, it's a digestive issue (see pages 109-115), and you know you have to do something that will calm her -- not give her more food, which would only make her more uncomfortable. On page 26, you will find the common complaints.
E.A.S.Y. by the Pound
When the parent of a baby under six weeks has trouble with E.A.S.Y. I ask: Did you have a full-term pregnancy? Even if she says "yes," I ask: What was your baby's birthweight? E.A.S.Y. was designed for an average weight newborn -- 61/2 to eight pounds -- babies who generally can last three hours between feeds. If your baby weighs more or less, we have to adjust accordingly. As the "E.A.S.Y. by the Pound" chart on page 29 indicates, with an average-weight baby, feeds generally last twenty-five to forty minutes (depending on whether they're breast- or bottle-fed and whether the baby chows down or grazes at a more leisurely pace). Activity time (which includes a nappy change) is thirty to forty-five minutes. Sleep, allowing fifteen minutes or so for the baby to drop off, is 11�2 to two hours. Such a baby would be fed at, say, 7, 10, 1, 4, and 7 during the day, as well as 9 and 11 in the evening (a strategy that helps eliminate the 2 A.M. feed; see "Tanking Up," pages 93 and 195). These are suggested times only. If your baby wakes up for his lunchtime feed at 12:30 instead of 1:00, feed him.
Babies who weigh more than average at birth -- say eight to ten pounds -- often feed a little more efficiently and take in more food at each feed. There's more weight on them, but you'd still keep them on the above three-hour routine. Age and weight are different things -- a baby may weigh eight pounds or more, but developmentally he's still a newborn who needs to eat every three hours. I love to work with those babies, because I can get them to sleep longer stretches at night within the first two weeks.
However, some babies, because they're either premature or just smaller babies, weigh less at birth. They're not ready for the three-hour E.A.S.Y. plan. When parents bring them home from the hospital and try to put them on an E.A.S.Y. routine, the usual complaint is, "I can't get her to do even twenty minutes of activity time" or "She falls asleep during feeds." They want to know how to keep her awake. Simple. You don't -- at least not for activities. If you do, you'll overstimulate her, and she'll start to cry. As soon as you calm her down, she'll probably be hungry again, because she's been crying, which uses up energy. And then you'll be utterly confused about her cries. Is she hungry? Tired? Gassy?
At night, smaller babies can only last four hours max at first, so they generally have to feed at least two times a night in the first six weeks. But if they go only three hours at a time, that's okay, too. They need the food. The fact is, you want little babies to eat and sleep a lot in the beginning, because you want them to get fat. Think of baby pigs who eat, snort 'round a bit, and then go back to sleep. All baby animals do that, because they need to gain weight and conserve energy.
If your baby is less than 61�2 pounds, put her on a two-hour eating schedule at first: Feed for thirty or forty minutes, reduce the activity time to only five or ten minutes, and then let her go to sleep for an hour and half. When she's up, don't expect her to coo and goo at you -- and keep stimulation to a minimum. By being fed every two hours and getting the sleep time she needs to grow, she will definitely gain weight. As your baby starts to put weight on, she will probably last longer between feeds, and you'll be able to keep her up a little longer, gradually extending her activity time. Where she could only sustain ten minutes up when she was first born, when she's 61�2 pounds, she can stay up for twenty minutes and by seven pounds as long as forty-five minutes. While she's putting on the weight, you'll gradually lengthen the two-hour routine, so that by 61�2 or seven pounds, she'll be on the three-hour E.A.S.Y. plan.
Six Weeks to Four Months: Unexpected Wake-Ups
Compared to the first six weeks at home -- the classic postpartum period -- during the next 21�2 months or so, everyone starts to be on a more even keel. You're more confident, and, we hope, a little less harried. Your baby has put some weight on -- even low-weight babies have often caught up by now -- and is less likely to fall asleep during her feeds. Her feeds are still every three hours during the day, stretching a bit longer, though, as we get closer to the four-month mark (at which point they'll be every four hours; see the next section, page 33). She is able to sustain longer activity periods and is probably sleeping for longer stretches at night, too, say from 11 P.M. to 5 or 6 A.M. Her crying, which probably peaked around six weeks, now slowly starts to decline somewhat over the next 21�2 months.
Here are the complaints I generally hear at this stage:
I can't get my baby to sleep more than three or four hours during the night.
My baby was sleeping for five or six hours during the night, but now she's waking up more frequently, but always at different times.
I can't get my baby to nap for more than 1�2 hour or 45 minutes.
My baby wakes up at the same hour every night but never takes more than a few ounces when I try to feed him.
She may not be getting enough food during the day, and you also might need to "tank her up" before bedtime (pages 93-94 and 195).
Your baby is probably having a growth spurt (115-119 and 197-199) and needs more food during the day.
You're probably misreading his cues and either not getting him to bed when he first shows signs of fatigue (181), or you're going in too soon when he first stirs, which doesn't give him a chance to go back to sleep on his own (189-190).
Habitual waking is almost never about hunger. Your baby is probably waking out of habit (191-192).
As you can see, the problem that usually presents in babies this age is a sudden, inexplicable (to the parents, at least) departure from the "S" part of their routine. Day and night sleeping can be erratic and trying -- especially if a baby isn't on a structured routine. The parents wonder if they'll ever get any sleep themselves. Some night waking is naturally due to hunger -- babies wake up when their tummies are empty -- but that's not always the case. Depending on what the parents do in response to their baby's night waking and nap problems, their well-intentioned actions can lay the seeds of accidental parenting.
Say your baby awoke one night and you calmed her by giving her your breast or a bottle. It worked like a charm, and so now you think, Mmmm, this is a good strategy. Your baby liked it, too. But you're inadvertently teaching her that she needs to suckle in order to get back to sleep. Believe me, when she is six months old, much heavier, and still wants to feed several times a night, you're going to regret that quick fix. (You're lucky if you catch it by then -- I've counseled several parents whose babies are nearly two, and they're still waking up several times a night for a comforting nip at Mum's breast!)
Four to Six Months: "4/4" and the Beginnings of Accidental Parenting
Your baby's awareness is heightened now, and she interacts more with the world around her than she did a few months ago. Remember that babies develop from the head down, gaining control first over their mouths, then the neck and spine, arms and hands, and, finally, legs and feet (see sidebar, page 22). At this stage, your baby can hold up her head easily and is beginning to grasp at things. She is learning to, or already can, roll over. She can sit up fairly straight with your help, so her perspective is changing, too. She's more aware of patterns and routine. She has grown increasingly better at distinguishing where sounds come from and figuring out cause and effect, so she's much more engaged with toys that move and react to her touch. She has a better memory, too.
Because of these strides in development, your baby's daily routine naturally has to change, too -- hence, my "4/4" rule of thumb, which stands for "four months/four-hour E.A.S.Y." Most babies are ready at this point to switch from a three- to four-hour routine. It makes sense: Your baby can play for increasingly longer periods during the day and sleep longer stretches at night. Whereas she used to wake up in the morning because she wanted a feed, most of the time now she wakes because of habit -- her own internal clock -- and not necessarily hunger. Left on their own, many babies wake somewhere between 4 and 6 A.M., talk to themselves and play a bit, and then go back to sleep. That is, if their parents don't rush in, which is how accidental parenting usually starts.
Your baby is probably a more efficient eater, too, so draining a bottle or breast may take only around twenty to thirty minutes. Including a diaper change, then, the E is forty-five minutes at most. But the A is different: Now she can stay up a lot longer, typically another hour and thirty minutes at four months, two hours by six. Many kids have a two-hour nap in the morning, but even if your baby wakes up after 11�2 hours, she can usually stay up the extra half hour while you're getting her ready for her next feed. Around two or two-thirty, she'll want another nap, usually 11�2 hours long.
On the next page is a side-by-side glance to show how E.A.S.Y. changes when your baby is four months old. You can cut one feed because she's taking in more at each feed, consolidate three naps into two naps (keeping the late afternoon catnap in either case), and thereby extend your baby's waking hours. (If you have trouble getting your baby to transition from a three- to a four-hour routine, you'll find a detailed plan for this transition on pages 39-46.)
The above are ideal days. Your baby won't necessarily conform exactly to these times. Her routine can be affected by weight -- a smaller baby might only be able to do a 31�2-hour routine at four months but will usually catch up by five, or, at most, six months -- and temperamental differences, as some babies are better sleepers than others and some take less time to chow down. Your child might even veer from her own schedule fifteen minutes here and there. One day she'll have a shorter nap in the morning and a longer one in the afternoon, or she'll alternate between the two. The important consideration is that you stick to the eat/activity/sleep pattern (now at four-hour intervals).
Not surprisingly, many of the complaints that I hear most often at this stage have to do with problems in the routine:
My baby finishes her feeds so quickly, I'm afraid she's not getting enough to eat. It also throws off her routine.
My baby never eats or sleeps at the same time.
My baby is still waking up frequently every night, and I never know whether or not to feed him.
My baby makes it through the night but wakes up at five and wants to play.
I can't get my baby to nap for more than a half hour or forty-five minutes -- or she refuses to nap at all.
The E may not be a problem at all -- some babies are quite efficient eaters by now. As I explained above, you may be trying to keep your child on an E.A.S.Y. plan meant for a younger child -- every three hours instead of four (see pages 39-46 to learn how to make the transition).
Some variation in your daily routine is normal. But if he's snacking and catnapping -- both the result of accidental parenting -- he's never getting a good meal or a good sleep. He needs to be on a structured routine suitable for a four-month-old (pages 39-46).
If it's erratic waking, he's hungry and needs more food during the day (195-200); if it's habitual waking, you have accidentally reinforced a bad habit (pages 191-192). You also might have him on a three- instead of four-hour routine.
You might be responding too early to his normal early morning sounds and have inadvertently taught him that it's a good idea to wake up so early (pages 189-190).
She may be overstimulated before naptime (pages 249-252), or this is the result of a lack of, or improper, routine (pages 224-230) -- or both.
In addition to the above, we also see a continuation of challenges that weren't dealt with earlier. Those seeds of accidental parenting planted earlier now begin to flower in the form of both eating and sleeping problems (so don't forget to read the previous section, "Six Weeks to Four Months," if you've skipped it). The parents find themselves faced with multiple problems and can't see clearly through the chaos. In some cases, it's because they didn't tailor E.A.S.Y. to their child's more advanced development. They didn't realize that they had to go from feeding every three hours to every four, that wake-up times are longer, or that naps are just as important as nighttime sleep. In others, it's because of the parents' inconsistency. They've gathered conflicting advice from books, friends, from the internet or the telly and have been trying this strategy or that, constantly changing the rules on their baby, hoping that something will work. Additionally, Mum may have returned to work full- or part-time (see page 32). That and other types of household change can disrupt a baby's routine. Whatever the circumstances, the problem is usually worse at this age because it has been going on longer and, in many cases, because the baby has never been on a routine at all. Indeed, I always ask parents of children four months (and older) one key question: Has your baby ever been on a structured routine? If the answer is "no," or even "she once was," I tell them that they have to begin with E.A.S.Y. At the end of this chapter, pages 39-46, I give you a step-by-step plan for helping your baby make that transition.
Six to Nine Months: Riding Out the Inconsistencies
The E.A.S.Y. plan is a different ball game now, although we're still looking at a four-hour routine -- and I hear many of the same problems I see in slightly younger babies. But by six months, there's a major growth spurt, too. It's the prime time to introduce solid food, and, by seven months or so, to cut out the dream feed (page 123). Mealtimes are a little longer -- and a lot messier -- as your baby gets to try a whole new way of eating. Parents have lots of questions and concerns about solid food intake (which I answer in chapter 4). You can't blame them: In the beginning, babies are like eating machines, but at around eight months your baby's metabolism starts to change. She often becomes leaner, losing her baby fat, which has been put on to give her the strength to move around. At this stage it's more important to gauge her diet by quality not quantity.
Now, too, the early evening catnap disappears, and most babies are down to two naps a day -- ideally, each one lasting one to two hours. Napping is not a favorite pastime of babies at this stage. As one mum of a seven-month-old put it, "I think it is because Seth is aware of the world now, and can move around more so he doesn't want to sleep. He wants to see everything!" True enough, as physical development now takes center stage. Your baby can hold himself upright -- by eight months he'll be able to sit on his own -- and he is becoming more coordinated as well. He'll be a lot more independent, especially if you've nurtured this skill by allowing him to play on his own.
The common complaints at this stage are pretty much the same as we saw at four to six months -- except of course, habits are more deeply entrenched and a bit harder to change. Eating issues and sleep disturbances that could be tweaked in a few days at earlier stages now can be very intractable, but never impossible to correct. Now problems are just going to take a little longer to solve.
Otherwise, the biggest issue that crops up at this point is inconsistency. Some days your baby will take a long nap in the morning, -month-old put it, "I think it is because Seth is aware of the world now, and can move around more so he doesn't want to sleep. He wants to see everything!" True enough, as physical development now takes center stage. Your baby can hold himself upright -- by eight months he'll be able to sit on his own -- and he is becoming more coordinated as well. He'll be a lot more independent, especially if you've nurtured this skill by allowing him to play on his own.
The common complaints at this stage are pretty much the same as we saw at four to six months -- except of course, habits are more deeply entrenched and a bit harder to change. Eating issues and sleep disturbances that could be tweaked in a few days at earlier stages now can be very intractable, but never impossible to correct. Now problems are just going to take a little longer to solve.
Otherwise, the biggest issue that crops up at this point is inconsistency. Some days your baby will take a long nap in the morning, other days it happens in the afternoon, and still other days it seems he's decided to drop one of his naps altogether. One day she'll eat with gusto, and the next she'd rather skip meals. Some mums roll with these ups and downs, and others want to tear their hair out. The key to survival is twofold: If he doesn't stick to a routine, at least you can. Also, you have to remember that truism of parenting: Just when you think you've got it, everything changes (see chapter 10). As the mother of a seven-month-old (who'd had her baby on E.A.S.Y. from the time she brought him home from the hospital) remarked, "The one thing I have learned is that practically every baby who is on this routine is different -- you really do just have to do what suits you both."
When I read some postings on my website, it's quite clear to me that one mum's nightmare often seems like an ideal situation to another. On one of the E.A.S.Y. message boards, a Canadian mother was complaining because her eight-month-old daughter had "gone way off." She explained that the little girl wakes at 7, breast-feeds, eats cereal and fruit at 8, has a bottle at 11 and sleeps until 1:30, at which time she eats vegetables and fruits. She has a bottle at 3:30, eats dinner (cereal, veggies, and fruit) at 5:30, a final bottle at 7:30, and goes to sleep at about 8:30. The mother's problem: Her baby was taking only one nap a day. "I have lost control of the situation," she exclaims and begs other mothers on the site, "I need some help over here!!!!"
I had to read that posting twice because, for the life of me, I couldn't see a problem. Yes, her baby was getting older, able to stay awake for longer periods. But she was eating well and sleeping a solid 101�2 hours a night and taking a 21�2-hour nap during the day. I thought to myself, Some mums would give their hind teeth to be in your shoes. The fact is, because babies nine months and older can stay up for longer stretches without sleeping, it is possible for them to start skipping the morning nap altogether and take one long nap in the afternoon -- for as long as three hours. They eat, play, eat again, play some more, and then go to sleep. In other words, "E.AS.Y." becomes "E.A.E.A.S.Y." Dropping a nap can be a momentary glitch, or it can mean that your baby might be able to get by on one nap a day. If your baby seems grumpy on only one nap, you can introduce another nap or extend too-short naps by using the P.U./P.D. (pages 249-252).
I also get a lot of queries on my website from parents of babies this age who have tried E.A.S.Y. or another type of routine when their child was younger. This is the age that they decide to try again. Here is a typical posting:
When my baby was 2 months, I tried to put her on E.A.S.Y., but the sleep part was so difficult, and the nursing was so often I gave up. Now that she is older I would like to try it again, but I would like to see sample schedules of other babies too.
Just for fun, I looked on the website for postings of mothers with babies between six and nine months old to compare their E.A.S.Y. routines. Putting them side by side, a surprisingly similar pattern emerges that looks pretty much like this:
7 Wake up and feed
9 or 9:30 Morning nap
11:15 Breast or bottle (the snack)
1 Lunch (solids)
2 or 2:30 Afternoon nap
4 Breast or bottle (snack)
5:30 or 6 Dinner (solids)
7 Activity, including bath and then the nighttime routine, which consists of a bottle or breast, book, and tuck in
While the above is typical, there are of course many variations on that theme: Some babies are still getting up at 5 at this age, having a pacifier or an extra bottle. Some nap far less than the ideal hour and a half or two, or take only one nap, which can make the "A" period that follows a very cranky and trying affair for their parents. And, sadly, some children are still waking several times a night, even at this age. So it's not just the daytime we have to look at. As I will keep drumming into your head, E.A.S.Y. is not about time slots.
E.A.S.Y. after Nine Months
Sometime between nine months and a year, your baby will be able to go five hours between feeds. He'll be eating three meals a day, just like everyone else in the family, and have two snacks to tide him over. He can be on the go for 21�2 to three hours, and, usually around eighteen months -- earlier in some children, later in others -- get by on one big nap in the afternoon. We're not technically following E.A.S.Y. at this point, more likely he's on E.A.E.A.S.Y., but it's still a structured routine. Every day may not be exactly the same, but the elements of predictability and repetition are still there.
Starting E.A.S.Y. at Four Months or Older
If your baby is four months or older, and she's never had a routine, it's time to put her on one. The process is different from that of younger babies for three important reasons:
�1. It's a four-hour routine. Sometimes parents don't realize they have to adjust the routine to their child's more advanced development. Their baby is eating more efficiently and sustaining ever-increasing periods of activity but they're still feeding her every three hours -- in effect, they're trying to turn back the clock. For example, Diane and Bob's six-month-old Harry was suddenly starting to wake at night, seemingly hungry. Well-meaning parents that they are, they fed him at night. And knowing he needed more food during the day, instead of feeding him every four hours, they started feeding him every three hours as they had done when he was younger, reasoning, quite correctly, that he was having a growth spurt. But that's a solution for a three-month-old, not a six-month-old, who should be eating every four hours and sleeping through the night. (They need to feed him more at each feed, which I explain in chapter 3, pages 120-122.)
�2. We use my "pick-up/put-down method" (P.U./P.D.) to make changes. With babies over four months old, sleep difficulties are invariably part of the reason why it's impossible to sustain a daily routine, if not the entire problem. This is when I introduce beleaguered and skeptical parents to P.U./P.D., a technique I rarely advise for younger babies (a detailed description of this key sleep strategy is the subject of chapter 6).
�3. Establishing a structured routine over four months is almost always complicated by accidental parenting. Because parents have already tried other methods, or a medley of methods, their baby is confused. And in most cases, the baby has already gotten into a bad habit, such as falling asleep on the breast or waking repeatedly during the night. Therefore, putting an older baby on E.A.S.Y. invariably involves more commitment and work, a bit of sacrifice, and a great deal of consistency. Bear in mind that it took at least four months for those bad habits to develop. It won't take nearly that long to get rid of them if you stick with the plan. The older the baby, obviously, the harder it will be to change his routine, especially if he's still waking at night and is not used to any type of structure in his day.
Because babies are individuals, and because what happens inside each of their homes is different, too, I need to find out exactly what the parents have been doing so that I can tailor my strategies accordingly. If you've read thus far, you should already be anticipating the kinds of questions I'd ask parents whose baby has never had a routine:
Regarding the E: How often are you feeding your baby? How long are his feeds? How many ounces of formula or breast milk is he eating during the day? If he's close to the six-month mark, have you also introduced solid food? Although it's only a guideline, see how your baby measures up on the "E.A.S.Y. by the Pound" (page 29) and "Feeding 101" (page 95) charts. If he's eating every three hours or less, that's inappropriate for a four-months or older child. If his feeds are too short, he might be a snacker; if too long, he may be using you as a pacifier. Also, babies who aren't on a routine by four months often eat too little during the day and get up at night for additional feeds. Particularly if they're over six months, they often need more sustenance than a liquid diet provides. You might want to read chapter 3 as well before introducing E.A.S.Y.
Regarding the A: Is he more alert than ever? Is he starting to roll over? What kinds of activities does your child do during the day -- play on a mat, attend a Mommy and Me group, sit in front of the TV? It's sometimes harder to establish a schedule with a more active baby, especially if he's never had one. You also have to make sure that you're not doing too much with your baby, which would make it hard for him to calm down for naps and bedtime and disrupt his eating as well.
Regarding the S: Is he sleeping through at least six hours in the night -- which he should be by four months -- or does he still wake for a feed? What time does he get up in the morning, and do you go right in to him or allow him to play independently in his crib? Does he nap well, and for how long? Do you put him in his crib for naps, or do you just allow him to get exhausted and sleep wherever he passes out? The S questions help gauge whether you've been allowing your baby to learn how to self-soothe and get to sleep on his own, whether you've taken charge of his sleeping, or let him lead you. The latter, obviously, leads to problems.
Regarding the Y: Have you been under more stress than usual? Have you been ill? Depressed? Do you have support from your partner, your family, your friends? It takes stamina and dedication to establish a routine if your life has been chaotic. If you're not up to speed, make sure that you nurture your adult needs first. It's almost impossible to minister to a baby, if it feels like you need to be taken care of. If you don't have support, get some. Having someone else by your side to give you a break is great, but even a shoulder to cry on is better than nothing.
The thing to keep in mind when introducing a routine for the first time is that there are rarely overnight miracles -- three days, a week, even two, but never overnight. When ushering in any new regime to a baby of any age, you're going to get resistance. I've counseled enough parents to know that some of you out there really do expect magic. You may say you want your baby on the E.A.S.Y. routine, but to do so, you have to take certain actions. You have to be the monitor and guide, at least until your baby gets on track. Especially if your baby hasn't ever had a routine, you may have to forfeit something for a few weeks -- your own time. Many parents resist that notion, like the mum who assured me she'd "do anything" to get her baby on E.A.S.Y., all the while firing off a barrage of questions: "Do I have to stay home every day in order to get him on a routine? Or can I go out with him and have him take naps in the car seat? If I have to stay home, will I ever get out of the house with my son? Please help me."
Have some perspective, luv! Once your baby gets used to the E.A.S.Y. routine, you don't have to feel like a prisoner. Fit your errands into your baby's time. You might feed the baby and then his A time will be riding in the car with you and doing errands. Or you might do a feed and activity at home, and let your baby sleep in the car seat or stroller. (Your baby may not nap as long, though, if he's the type who wakes up when the car engine turns off; more about routine busters on page 179.)
However, when you're first trying to establish a routine, the ideal would be for you and your partner to stay at home for a fortnight (two weeks) to give your child a chance to get used to a new routine, a week at the least. You must make the time to make the change. During this critical introductory phase, see to it that his feeds, his activities, and his sleep times happen in a familiar environment. Just two weeks, mind you, not the rest of your life. Yes, you might have to put up with a little extra crankiness, even crying, while your baby adjusts to the change. The first few days will be especially tough because you've already programmed this baby in a different way and now you have to undo the old patterns. But if you hang in there, E.A.S.Y. will work. Like the old saying goes, "It works if you work it."
Think of it this way: When you first go on holiday, you're not in holiday mode. It takes a few days for you to switch gears, leaving thoughts of your job and other responsibilities behind. It's the same for babies. Their minds are fixed on the old regime. When you try to change things, your baby is going to say (with his cries), "What the hell are you doing? We don't do it this way! I'm screaming as loud as I can, but you're not listening!"
The good news is that babies' memories are relatively small. If you're as consistent with the new way as you have been with the old, he'll eventually get used to it. And after a few really tough days or weeks, you'll find that it is better -- no more erratic feeds, no waking up in the middle of the night, no frustrating days when you don't understand what he wants.
I always suggest that parents set aside at least five days to introduce E.A.S.Y. (see sidebar below for age-specific estimates). One of them should take the week off if possible. As you read through the plan, you might be surprised to see that I tell you to follow the suggested times pretty rigidly, whereas I have repeatedly told you not to go by a clock. For the purpose of this retraining period only, you have to be somewhat of a clock-watcher and far more inflexible than I would usually recommend. Once your baby is on a structured routine, it won't matter if you veer half an hour one way or the other. But at first, try to stick to the times I advise.
Days One and Two. Don't intervene at this point; just observe for two solid days. Pay attention to everything. Reread the questions I ask (page 41), and try to analyze the effects of having no routine. Make note of feeding times, length of naps, bedtimes, and so on.
On the evening of Day Two, in preparation for Day Three, you must go to sleep when your baby does, and do the same thing each successive night as well. You're going to need to be rested to withstand the next few days (or longer). Ideally, since you're planning to stay at home for this week, you can also nap when he naps. Most things in your life can be put off for a bit. You might be in for a rough few days, but they will be worth how smashing your baby and you will feel when he's on a routine.
Day Three: The day officially starts at 7 A.M. If he's asleep, wake him -- even if he usually sleeps 'til 9. If your child gets up at 5, do P.U./P.D. (pages 221-224) to try to get him back to sleep. If he's used to rising so early, and especially if you normally take him out and play with him at that hour, he's going to protest. You might end up doing P.U./P.D. for an hour or more, because he's adamant about getting up. Do not take him into your bed, a mistake a lot of parents make when their babies wake so early.
Take him out of his crib and feed him. Follow this with an activity time. A four-month-old can usually sustain 11�4- to 11�2-hour play period; a six-month-old, as long as two hours; a nine-month-old, two to three hours. Your child should be somewhere in that range. Some parents insist, "My baby won't stay up that long," and to them I say, do whatever you can to keep her up -- a fan dance if necessary. Sing songs, make funny faces, keep her upright with lots of whistles and bangs.
Following the four-hour E.A.S.Y. routine on page 34, start to put your baby down for her morning nap around twenty minutes before you actually want her to sleep, say around 8:15. If you're unbelievably fortunate and have an adaptable baby, she'll do the usual twenty minutes of settling in and then nap for an hour and a half or two. However, most babies who have never had a routine resist going down, so you will have to do P.U./P.D. to send her off to sleep. If you're committed and you're doing it correctly -- putting her back down the second she stops fussing -- after twenty to forty minutes she'll eventually go to sleep. Yes, some babies take longer; I myself have had to do it for an hour or hour and a half, using up almost all the baby's "S" time. But remember that old saying, "It's darkest just before the dawn." The method takes resolve and patience and a bit of faith as well: It does work.
If you've had to do P.U./P.D., expect her to stay asleep for only forty minutes (remember you've spent almost that much time getting her down). If she wakes up earlier, go back in and do P.U./P.D. You might think this is crazy. If she's had forty minutes' sleep and nap time is supposed to be 11�2 hours, you might have to spend forty minutes getting her back to sleep and then she has only ten minutes left. Trust me: You're changing her routine and this is how you do it. Even if she's slept for only ten minutes, wake her up at 11 in time for her feed, so you don't get off track.
After you feed her, do an activity, and, again, go into her room at around 12:40, twenty minutes before it's time for her 1 p.m. nap. This time, it might only take her twenty minutes to get to sleep. If she doesn't sleep at least an hour and a quarter, do P.U./P.D. again. She also might sleep longer, but be sure to wake her up by 3 when it's time for the E.
The day will be pretty exhausting for both of you. So she might be extra tired in the afternoon. After she has a feed and does an activity, watch for signs of sleepiness. If she's yawning, let her have a forty-minute catnap somewhere between 5 and 6. If not and she's playing happily, put her to bed at 6 or 6:30, instead of 7. If she wakes up at 9, do P.U./P.D. again. Give her a dream feed between 10 and 11 (dream-feeding is explained in great detail on pages 93-94 and 195-196).
There's a good chance she'll get up at 1 or 2 A.M. You do P.U./P.D. again. You could be there for an hour and a half, just to get her to sleep for three hours straight. Do it all night if you have to, until 7 a.m., at which point you're into Day Four.
Day Four. Even if she's sleeping at 7, and you're utterly exhausted, wake her up.
You will go through the same process as on Day Three, but now instead of P.U./P.D. taking forty-five minutes or an hour, it will probably take only a half hour. She probably will sleep longer, too. We're aiming for naps of an hour and a half each at least. But use your judgment. If she has been asleep an hour and fifteen minutes and seems happy when she wakes, get her up. On the other hand if she has slept only an hour, you had better do P.U./P.D. again, because most babies regress quickly once they are accustomed to shorter naps. Remember to let her have that five o'clock nap if she's tired.
Day Five. By Day Five you should have smooth sailing. Maybe you'll have to do P.U./P.D. a bit, but it will take far less time now. With a six-month-old, it may take seven days altogether -- two for observing, five for this turnaround process. With a nine-month-old, it could take up to two weeks (that's the worse case I've seen) because the baby is so deeply entrenched in his own routine that when you try to change him to yours, he'll be much more intractable than a younger baby.
The stumbling block is that parents are afraid it's going to last forever. After devoting four days to changing five-month-old Sam's routine, Veronica,