Three months on from sleep school…

Frankie - harness free!

Frankie – harness free!

Why hello there! I can’t believe it’s been two months since I last posted here. Well, I can believe it, because I have been back in the land of work and things have been pretty hectic. But it’s definitely time for another update. Things are going really well on the Frankie-front (and the boob front – for those who read about my bad left boob). It’s now been a bit over three months since we “graduated” from Masada and Frankie is a completely different baby. Here are the highlights:

1. Frankie loves sleeping. I would even go so far to say that her cot is quite possibly her favourite place in the house. I can’t remember the last time she cried or even grizzled when I put her down to sleep and she will happily mutter away to herself (about god knows what) until she drifts off to sleep. And the same thing happens when she wakes up. If we weren’t paranoid parents who have a video monitor set up in Frankie’s room, we would actually have no idea when she wakes up because she LOVES BEING IN BED. She will easily spend half an hour just playing with her hands and having a little one-way chat to herself before we realise she is awake and it’s time to get her up. How crazy is that?

2. Frankie’s hips are almost normal. As you might remember, a week after coming home from Masada, Frankie was diagnosed with hip dysplasia so she was immediately put into a Pavlik harness. Not much fun, and definitely no Pat Pat for us. Well, I should say not much fun for me and Shannon, as Frankie didn’t seem to mind at all. But as of about three weeks ago, Frankie is out of the harness! This means we are free to use the Pat Pat technique again, although we ironically now have no use for it (see Point 1).

3. I haven’t had mastitis or blocked ducts in over three weeks. This is an all time new record for me. This is mentally exciting news (for me, anyway).

Highlights aside, I thought I’d also share Frankie’s current routine (as she is now 6.5 months old). I will preface this by saying that Frankie’s awake time is a bit shorter than what Masada recommend, but to be honest, we now take the Masada “rules” with a grain of salt and go with what seems to work best for Frankie.

7am – We wake up Frankie. Although by this time, Frankie is often awake and having little morning chats with herself. Breast feed, a bit of play, breakfast, a bit more play, then back to bed when she shows tired signs which inevitably happens around the 1.5 hour mark.

8.30am – Nap 1.

10.30am/11am – Frankie wakes from nap 1. Yes, it is quite the mega nap. Like I said, this girl loves her sleep. I started to wean about two weeks ago, so this feed is now a formula feed, followed by lunch. Incidentally, it took a week of frustration, tears (from both me and Frankie), and several different formulas before we could even get Frankie to have a drop of the stuff (she such a boob snob). How we got there in the end was dipping the tip of the bottle into some Rafferty’s fruit puree and “tricking” Frankie into sucking on the bottle. And after a couple of days of this, Frankie now loves formula almost as much as she loves sleep. After lunch, we have more play time and then it’s back to bed when the tired signs creep in – normally after 2 hours or a bit less.

12.30pm (ish) – Nap 2.

2.30pm (ish) – Nap 2 is normally another mega nap for Frankie – often lasting two hours. We do another breast feed at this time although I am now trying to drop this feed too, because I truly hate expressing milk at work. This week, some moron walked in on me expressing. Probably more awkward for him rather than me, but not great for me either. Apparently my putting a big “DO NOT ENTER” sign on the meeting room door didn’t compute in his head as meaning “Don’t enter this room you stupid idiot”.

4/4.30pm – Nap 3. This is usually just a cat nap, so we always end up waking Frankie after 1-1.5 hours.

5/5.30pm – Dinner, then a bit of play, then bath time. Then a final breast feed and off to bed. Frankie often gets grumpy after about an hour at this point in the day, although we do try to stretch her for 90 minutes.

6.30/7pm – Bedtime. 10pm – I am still doing a dream feed, although Frankie is drinking less and less from it, and Masada recommend dropping it at the seven month mark. Personally, I’d love to crawl into bed at 9pm so staying up until 10pm can be exhausting, which I realise makes me sound like an 80 year old woman.

So that’s it for now. I’ll try to post a bit more regularly – and keep your comments and questions coming as I love hearing what you are all up to!

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What does life look like 6 weeks post Masada Sleep School?

Today marks our six week anniversary since “graduating” from the Masada Mother Baby Unit sleep school. Overall, it’s been awesome – although there have definitely been a few challenges. Let’s start with the awesome:

The stuff that has got better

Frankie is well and truly into a routine (which I often manage to stuff up when I try to have a life, but that’s a story for another post). I wrote about her routine here and it has helped infinitely in organising my life around Frankie’s. For example, 9-10am is what I call “the hour of productivity”. Frankie is always asleep at this time which means I can do things like have a phone conference for work, write a proposal for a client, or even have a shower (crazy stuff like that). Then, depending on when she wakes from her first nap, I am given a bit of structure for the rest of the day too through knowing roughly when she will feed/play/sleep.

Me during my "hour of productivity"

Me during my “hour of productivity”

Despite having a bad left boob, I am still, somehow, exclusively breastfeeding. Prior to Masada, this meant being chained to Frankie who was a champion little snacker – feeding every 2-2.5 hours. She now only needs feeding every 3.5-4 hours, which means I can actually leave Frankie for a couple of hours and not worry about her dying of hunger. Amazing.

I have read that there are all sorts of definitions of what “sleeping through the night means” – ranging from sleeping from 7-7, through to sleeping for five hours in a row (which makes no sense to me as a definition as five hours does not maketh a night). Frankie has become an awesome little sleeper at night. She now always goes down without too much of a fuss between 6.30-7pm. We wake her up for a dream feed at 11/11.30pm, and then she is now almost always sleeping through ’til around 6.30 or 7am. This is a VERY different Frankie to the pre-Masada one. Granted, she is six weeks older, but what I love most is the predictability. My husband and I can now do mental stuff like have people over for dinner at 7pm and have uninterrupted conversation.

Nap time

Nap time

I am no longer a completely sleep deprived wreck. I am just a slightly sleep deprived one. Because Frankie sleeps in such big chunks at night, that means I can too. I can also nap during the day when Frankie naps (and boy do I love napping). Having said that, I am often plagued by insomnia (again, a story for another day) so while in theory I am getting massive chunks in bed with my eyes shut, it doesn’t always equate to sleep. But still, when I can kick the insomnia, I look forward to feeling more normal again…

The stuff that has NOT got better

Recurrent Mastitis. Although I did see the amazing lactation consultant Sue Shaw a couple of days ago and I think I may have solved that problem. Fingers crossed. I am one week free of blocked boobs – a record for me for the past month.

We can’t do the side pat anymore! Now – this is a BIG BUMMER. A week after Masada, Frankie was diagnosed with hip dysplasia. Great that it was picked up early, but not great for using the Masada Pat Pat. Because Frankie is wearing a Pavlik Harness 23.5 hours a day, we are not allowed to turn her on her side! I called up Masada for some advice, and they said to just pat her on her chest and at the front of the nappy. However, this makes her MORE unsettled. She screams like we have never heard her scream before. I called up Masada again to get more advice, but no one has returned my call…very frustrating. So what this means in practice is if Frankie is unsettled, we don’t really have many tricks up our sleeve. Luckily she has been really great at self settling since Masada, but we still have grizzle hour at about 5pm every night, and we normally just give in and get her up early.

Frankie in her Pavlik harness. No more side patting for us :(

Frankie in her Pavlik harness. No more side patting for us 😦

For those who have been playing along at home, I’d love to hear how you are tracking. And if you are a fellow Masada graduate, I’d love to hear how things are going for you!

My bad boob – and my top ten tips for dealing with blocked up breasts

For the last four weeks, I have been plagued with blocked ducts and mastitis. My left one is the faulty boob. It’s always been the poorer cousin to Righty. Slower milk flow, frustrates the hell out of Frankie. And it is a sucker for getting blocked up.

It all started with sleep school. While sleep school was brilliant for helping my daughter learn to be a better sleeper, it was bad for my boobs. My boobs went from feeding Frankie every 2-2.5 hours, to only feeding once every four hours. My left boob wasn’t happy about this at all and decided to go and get all blocked up and ouchy. I went to my GP, thinking that the nipple thrush I had had early on in my breastfeeding days had come back, but no, this time it was the dreaded mastitis.

Frankie still prefers my faulty left boob to pumpkin.

Frankie still prefers my faulty left boob to pumpkin.

Then, the day after this diagnosis, we saw Frankie’s paediatrician. I’ve mentioned in previous posts that Frankie has always been on the lighter side of the scale, and during her week at Masada, she had only put on 80g. Our MCHN was worried so I asked our paed to weigh Frankie. Turns out she had only put on 50g in the week just gone. Our paed decided that it must be my milk supply that was the problem so he prescribed me a course of Motilium – a drug designed to increase milk supply. I started taking it and three days later, Hello Mastitis! Then, a week after this weigh in, we take Frankie back to our MCHN and guess what? Frankie had put on 450g in one week – which was clearly ridiculous being an exclusively breast fed baby. So we concluded that our paed clearly thought calibrating his scales was overrated, and that Frankie’s weight gain was actually going well. And now my boobs had no idea what was going on because apparently there was no problem with milk supply. I came off the Motilium, but my boobs took a couple of weeks to get the message to stop producing so much milk. And in those couple of weeks, Mastitis decided to rear its lumpy, painful head a couple more times.

The wonderful husband who does the middle of the night microwave heat pack runs.

The wonderful husband who does the middle of the night microwave heat pack runs.

But the good news is, I feel like I have become quite the expert in how to deal with blocked up boobs. So for any breastfeeding mums who have been unlucky enough to have problems such as mine, here are my top ten tips:

1. Apply heat before every single feed – even at 3am when the last thing you feel like doing is going to the microwave to heat up a heat pack. This helps loosen up the blocked duct and get things flowing. My husband has been brilliant at doing the middle of the night microwave run.
2. Apply cool packs after every feed. This helps reduce inflammation.
3. Take the maximum dose of Nurofen – this will also help reduce inflammation and help reduce pain too.
4. Take 4 x 1200 milligrams of Lecithin every day. You can read more about it here but a lot of people swear by it to help oil up the milk ducts.
5. If you have a massive oversupply of milk, Sage tea works wonders to get things back to normal. Just don’t take too much otherwise you could dry up your supply completely. You can read more about dosage here.
6. Get yourself some ultrasound treatment. This will help break up the blockage. Make sure you feed your bub within 30 minutes of receiving the treatment to get the full benefits from it. The physios here really know their stuff.
7. Try to position bub’s chin in the direction of the lump. This often requires some tricky and very uncomfortable positioning work – but trust me, it’s worth it.
8. Rest. Easier said than done. I found that this was the hardest thing to do. Whenever I came down with mastitis, I would try to take at least one nap during the day, but when I was “cured”, I would go back to trying to do a million things every hour and bam – I’d be back in mastitis hell.
9. Sleep on your back. Avoid tummy sleeping like the plague. Man, I miss sleeping on my tummy!
10. If all else fails, see a lactation consultant. Sue Shaw is amazing – I saw her early on in my breastfeeding days and she is not only super compassionate, but she really knows her stuff.

Have you had blocked boobs? I’d love to hear about what worked for you.

How to answer the question: What have you been up to all day?

If you are a stay at home mum and have a working husband, then when your husband walks through the door at 6pm (or later), the first question you probably hear is “How was your day?” And because us mums are in a perpetual state of exhaustion, we can’t even remember what we did five minutes ago, let alone eight hours ago. Which is why I really liked the approach I learnt to tracking your bub that Masada uses…

When Frankie was born, I was obsessed with tracking every bowel movement, wee, breast feed, mood and so on. I was addicted to Sprout – my favourite baby tracking app (after trialling about six hundred and fifty-nine of them) – and would be on it recording information, like every hour. Obviously, everything I tracked was pretty much useless and I never looked back on it, but as a first time mum, of course I was going to track every little fart, burp, and pooh!

By the time I took Frankie to Masada, I had grown out of my tracking obsession, only to be fuelled by a new one – and a much more useful one – that the nurses at Masada taught me. You may remember me describing the Masada set-up in an earlier post, where your baby sleeps in its own little room (which looks like a mini jail cell) across the corridor from mum’s room. Outside bub’s room is a clipboard where nurses (and later, me) would track the following:

– what time Frankie woke
– what time Frankie fed
– what time Frankie was put to bed
– whether Frankie cried or grizzled upon being put into bed
– what time Frankie grizzled during her “sleep time”, and for how long
– what time Frankie cried during her “sleep time”, and for how long
– whether Frankie needed to be resettled during sleep time

And being a total data nerd, I LOVED the tracking. All this info on Frankie! Patterns to look for, conclusions to draw! Nerd nirvana!

Our little stool of Nerd Nirvana outside Frankie's room.

Our little stool of Nerd Nirvana outside Frankie’s room.

And now, one month after leaving Masada, we still use this method of tracking. It’s bloody awesome. It reminds me how long we need to keep Frankie up for, it lets me know how settled or unsettled Frankie has been during a day or during the whole week. It lets me see progress we have made since “graduating” from Masada.

Let me explain how it works:

1. When I get Frankie out of bed after her nighttime sleep or a nap, I write the time, and “up”. Or just “U” if I am feeling particularly lazy.
2. When I feed Frankie, I write BF (breast feed) and the time.
3. When I put Frankie down to sleep, I write the time and “down” or “D”. If she grizzles or cries when I leave the room, I write “grizzle/cry on exit” – or GOE/COE for short.
4. When I hear a grizzle or cry during sleep time, I time how long it goes for and write this down – for example, 2.30pm, grizzle for 4 minutes. Self-settled (if, indeed, she does self-settle).
5. If I need to go into resettle – that is, if she cries for 2 minutes or grizzles for 10 minutes, I write the time I did this and “Pat Pat”.

What this then leads to is a really comprehensive and useful record of how Frankie is tracking.

Sleepy Frankie at bath time.

Sleepy Frankie at bath time.

It also means that if my husband has been at work all day and asks “What have you been up to all day”, I can pull out the tracking sheet and show him everything that’s been going on in the world of Frankie and I.
I’d love to hear if you are tracking your bub, and for those who do try this method – what do you think of it?

The Masada Routine

I remember a couple of months before Frankie was born, I was invited to speak at a “women in business” conference put on by CommBank. Over lunch, I got talking to this amazingly successful mum who had barely taken any maternity leave, and simply worked from home in the early weeks with her bub strapped to her chest. She somehow managed to keep her sanity and get enough sleep to run her business and look after bub. Crazy! I asked her what her secret was (because clearly she had one). She said to me: you must read “Save Our Sleep”. So upon my return home from the conference, I bought Save Our Sleep and read it from cover to cover in about a day. I remember raving to my husband, “Don’t worry, we won’t be one of those sleep deprived couples – we will simply put Frankie on this amazing routine and she will be no trouble at all!” Little did I know that EVERY SINGLE medical professional that we met in the first week of Frankie’s birth said do NOT put her on a routine. She is too young.

So out went my dream of sleeping through the night.

As a consequence, when Frankie entered the world, we resisted any kind of routine. We fed on demand, Frankie slept when she felt like it (at very random times during the day and night), and Frankie decided that she would never sleep for more than 3 hours at a time overnight – and even that was rare.

One of the things I loved most about my Masada experience was getting a routine. Super helpful when I was planning on starting to work from home in the fortnight following. There have been a lot of comments and questions on this blog about routines, so I thought I’d take you through what Masada recommends, and what a 24 hour period in Frankie’s life now looks like.

Here are some of the fundamentals:

1. Feed, play, sleep (FPS) underpins Masada’s theory about routines. I wrote about the FPS routine here and here if you’d like to know more.

2. For Frankie, being three months, her recommended wake time (which includes a feed, then a play) is 1.25-1.5 hours. When she hits four months, this can increase to two hours. She is also supposed to have three naps – the first two should ideally be at least two hours, but not more than three hours.

3. Being in the 3-6 month category, Frankie should feed between 5-6 times per day. For Frankie, because she has not yet doubled her birth weight, six feeds is recommended, with the sixth one being the “overnight” feed (between 3-5am).

So with those general rules in mind, here is A Day in the Life of Frankie Rose Dolan.

7am: Frankie wakes up. And if she doesn’t – we are able to wake her. Frankie does like a bit of a sleep in like her father, so there have been occasions where I have had to waltz into her room at 8am to get her day started.

As soon as she wakes, I’ll do a nappy change and start feeding. Masada recommends starting the feed within 15 minutes of waking, so we adhere to that. I mentioned that Frankie is a bit of a runt and we are desperately trying to fatten her up so I will normally spend about 40 minutes breast feeding her. (FYI – Masada says that the milk bar should only remain open for up to 45 minutes after wake time begins to teach bub that milk does not flow on tap). After feeding, we play.

8.15/8.30am: Frankie goes back to sleep. Interestingly, the nurses at Masada said that if she starts showing tired signs before her minimum wake time of 1.25 hours, then it is okay to put her down 5-10 minutes earlier – but only for this first wake time of the day. Apparently, she will be most tired during this wake time because of the big long chunk of sleep she has just had. That old “sleep begets sleep” nugget…

8.30am-10.30/11am. Frankie sleeps. This nap is meant to be the most important one of the day. If Frankie wakes before the two hour mark, we simply resettle her (using the Pat Pat, as explained here), until she goes back to sleep, or has spent a full two hours in bed.

11am: Feed, play.

Playtime!

Playtime!

12.30pm: Second nap of the day.

2.30pm: Feed, play.

Playtime with Dad: The "who can open their mouth wider" competition.

Playtime with Dad: The “who can open their mouth wider” competition.

4pm: Third nap of the day – and the shortest one. We try to get her to do a couple of sleep cycles – so about 90 minutes.

5.30/5.45pm: Wind down. If you have been following this blog, you may remember that this is the only “wake” time where the Feed and Play order is reversed. So upon waking, Frankie has a bath, then some low key playtime, and then we finish up with a feed so she goes to bed on a full stomach.

7pm: Bed.

Frankie being smothered in a goodnight kiss.

Frankie being smothered in a goodnight kiss.

10.30pm-midnight: We do the dream feed within this window – somewhat dependent on when my husband goes to sleep as he is the one that gets her out of bed for this. We keep the room light to a minimum, and only change her nappy if it is busting out with pooh.

3-5am: Overnight feed. We do this on demand – in that whenever Frankie starts grizzling in this time frame, we do another low key feed (same rules at the dream feed about lights and nappy changing).

And then, rinse and repeat!

I’d love to hear what kind of routines your bubs are on, and if you decide to make any changes after reading this post 🙂

Two steps forward, one step back

It’s been one week since leaving the safe bubble of Masada, so I thought it was a good time to reflect on how things have been going at home with Frankie. In a nutshell, it has been 90% awesome, and 10% un-awesome. The 90% awesomeness comes from the fact that Frankie is now down for 3 naps every day (and two of those naps are 2+ hours) and has self-settled into every single one herself (no patting required). Same goes for her night time sleeps. This is a big change from pre-Masada, whereby Frankie liked to keep us guessing as to whether she would self settle or whether we would have to bring out the big guns (in our case, the electric swing). Awesome. And on average, post-Masada, we have only had to use the Pat Pat to help her resettle between sleep cycles about two or three times in any 24 hour period – so not much at all.

Yesterday was an un-awesome day. I think Frankie sensed something was in the air. Her loving, doting father has been away since Wednesday as he received some bad news about his own dad, and flew to Adelaide to be with him during the week. He gets home tonight (hooray!), but I think yesterday the exhaustion of looking after Frankie without the help of my wonderful husband finally got to me, along with the toll the week has taken on everyone emotionally. And so Frankie was very unsettled. I had to do the Pat Pat a total of 10 times – a record for the last two weeks – and it felt like she was throwing up half of every feed (not cool Frankie – you need all the milk you can get).

Today, so far, has been back to awesome. It’s coming up to 2pm and only one Pat Pat required. But my point for writing this post is that sleep school, and the weeks proceeding it, are hard work. Masada “warn” people about this, but I think that the “one step backwards” can still be really disconcerting and confusing, especially when it’s 2am and your baby is crying and you are pat pat patting and the crying continues. And you feel like curling up in a ball and crying yourself.

Frankie, back in fine form today.

Frankie, back in fine form today.

All of my Masada “group” have been keeping in touch via Facebook. We all write to each other many, many times every day and keep each other updated on what’s happening. And on the whole, it seems we are all having similar experiences – definite improvements, some really great fist-pumping days, and some really tough times too.

So if you are thinking of going to sleep school, or even if you have been reading this blog and “playing along at home”, please don’t expect the ride to be smooth sailing. The seas are choppy, but I just know it will be worth it in the end.

So what does the Masada Pat Pat technique actually look like?

Since writing about the Pat Pat technique, I had promised to create a video. So yesterday evening, I invited my dad over to film it “live” during Frankie’s witching hour (which typically starts at 5pm). Dads arrives at 5, punctual as always, and we sit and wait for Frankie to grizzle. And we wait. And we wait some more. And then we wait a bit more. And the clock ticks onto 5.45pm (time for Frankie’s bedtime routine to start) and I end up having to wake her! Thank you Masada 🙂

Frankie - after being rudely woken up by her mother.

Frankie – after being rudely woken up by her mother.

So instead of being able to film a live version of the technique in action, we created a demonstration video with Frankie wide awake. I hope that this helps you understand super clearly how this magical resettling technique actually works.

Before you watch the video, here is a little recap on the technique:

What is it? The Masada “Pat Pat” (as I refer to it as) is a technique you can use to resettle your baby if they wake before they are supposed to (e.g. after a cat nap to help them link sleep cycles, at 5am, when they can’t even get to sleep to start with, etc).

When should you use it? For bubs under 6 months, wait 10 minutes for grizzling, and 2 minutes for crying before you go into the room to Pat Pat. For overnight use, wait 20 minutes for grizzling, and 2 minutes for crying. For bubs over 6 months, you can gradually increase the “cry wait time” by 2 minutes after every time you go in to up to 10 minutes total. Grizzling wait time remains the same.

Who should watch this video? Well, obviously mums and dads should watch it. But also, it could be useful to show to people who look after your baby and need to learn how to resettle it (grandparents, nannies, babysitters, the family dog, and so on).

What if I am too busy to watch your little video? Fair enough: here is a summary of the technique:

Enter the room (and don’t turn any lights on), and do a gentle shhhhh. Don’t say their name (you are not here to play and interact). Then start the Masada Pat Pat. To do this:

1. Place the baby on its side, facing away from you.
2. Say “shhhh” in a calming way (ideally until she/he stops crying).
3. Cup your hands like you are holding an egg and with one hand on the baby’s shoulder and the other on the hip, do a fast pat. Place slightly less pressure on the shoulder pat because it doesn’t have a nappy as a cushion. Count to 100.
4. Change to a slower paced pat. Count to 100. The idea is to bore them back to sleep (and hopefully you don’t get bored to back to sleep while you are doing it).
5. If they are still crying or grizzling, do another round of the slower pats.
6. Keep your hand still on your bub’s shoulder, and then do a single pat on the hip for 50 counts. Start slowing right down for the final few pats.
7. Move the baby back onto it’s back.
8. Walk out. Even if you can hearing grizzling or crying.

Finally, never go backwards in the steps. I asked “why not”? A nurse replied “because you don’t want to be in there all night”. Fair enough. 

And without further ado, here is the video:

Feel free to share it with those who are looking after your little guy/girl using the buttons below. Or you could be all old-fashioned about it and cut and paste the URL into an email and share it that way…