The Discontented Little Baby Book (2015)

If there is one book that I wish I have read before I gave birth, it is this: Pamela Douglas' Discontented Little Baby Book. 

She is the founder and medical director of the Possums Clinic in Queensland. I first encountered her work when I was so desperate about getting some sleep and kept reading about infant sleep training programs that involve leaving babies alone in their cribs in their own rooms despite the babies' crying (extinction methods). There are "gentle" methods in which parents check on their baby after a few minutes to console the baby without touching him/her. I found these "gentle" methods ineffective for my own child because once he starts bawling, he can't hear anything I say to him... in other words, these are still extinction methods but with added comforting steps for the parents. The babies aren't comforted at all. 

Anyway, I found her work in an Australian parent support website called BellyBelly. At first, I was impressed by her emphasis on maternal mental health care after giving birth. This aligned with my observations on my son's paediatrician and my OB-GYN: both doctors were very concerned about my mental health during well-child check-ups and my six-week postpartum check-up. They both reminded me that there are resources in case I need additional mental health support. I had thought that I probably looked awful during these visits that they had to remind me about what's available for me. But after reading Dr Douglas' articles, I realised that doctors really are concerned about maternal postpartum health. And now I know why. The first few weeks with my baby were some of the darkest times I've ever had (those were definitely up there with the final days of my PhD thesis-writing) and I honestly don't know how I could manage without the support of my family. 

After reading her research article on optimising parent-infant sleep, I thought that her approach aligned with how I want to parent my child. At that time, I've had enough of staying indoors because my child had to be on a feed and nap schedule and I shouldn't be overstimulating him or keeping him awake too long (I was—still am—keeping track of how long he is awake and the time intervals between feeds and diaper changes). And that's aside from the COVID-19 pandemic that's just kept getting more widespread in California (at least at the time I stayed indoors... these days, the number of new cases appear to be decreasing).

Here are five points that I liked from her book and her philosophy on taking care of babies (not in any particular order):

Treat enjoyment of my baby as an important value. 

The emphasis of other sleep consultants (via their blogs) and parenting websites for rigid routines (e.g., feed-play-sleep and Eat-Activity-Sleep-You) pressure parents (especially those afraid to fail) so much that they forget to enjoy spending time with their baby. They feel that they're not good parents because they couldn't keep up with the sleep-feed schedules. The stress they feel naturally transfers to the baby, who may become unsettled. What Pamela Douglas recommends, instead, is to take things slow and enjoy spending time with the baby. After all, this challenging stage in the child's life is very short... just a few months. She recommends mindfulness and several therapies for parents who are really very stressed out. In Australia, there seems to be some sort of residential facility that helps mothers with newborns where those with sleep challenges can get 24/7 support; this is not available in the USA though.

How long do I stay awake after the baby has gone to sleep for the night? 

Apparently, the difficulty that parents face really isn't babies' sleep because its length is biologically dictated. What really stresses parents out is the inability to quickly fall asleep after the baby has started sleeping into the night. In my case, because I'm utterly exhausted, I easily fall asleep. But other parents can't sleep as fast, perhaps fearing that their children might wake up soon or they probably have long winding down routines (like watching the telly or surfing the net for hours before they feel sleepy). So they end up really tired and stressed out... and may explore sleep training options just to stop babies from signalling to them if they need anything.

Take the baby along with you when you go outside the house. 

I was really raring to go outside for walks, so when Pamela Douglas mentioned that being outdoors can actually help settle a crying baby, I decided to do that as soon as he stopped crying hysterically when placed on his stroller or on the infant carrier (I realised soon enough that the cries were complaints: the infant seat insert in the stroller system was crowding him and the carrier was too tight on him). Once comfortable, my son had no complaints about our morning (if it's not too cold) and afternoon (if it's not too warm) walks. After taking in his fill of the view of the vegetation and the parking lot, he'd typically fall asleep. I'd continue walking around the neighbourhood to take in the fresh air, taking advantage of the uncrowded pathways. 

Baby catnaps are okay. 

Other sleep consultants' articles recommend that babies my son's age should be napping three times a day for at least one hour because this is the minimum amount of time for restorative sleep. My son really just sleeps for 35–45 minutes when placed (asleep) in the bassinet or the crib; he sleeps longer when he sleeps near me or on me (and I can't do anything else but watch the telly or catch up on my reading via my phone). According to Pamela Douglas, I shouldn't be worried about catnaps because these are biologically normal (one-cycle sleep) during the day. Note that I have never offered daytime naps to my child in darkened rooms to simulate nighttime sleep because I want him to differentiate daytime from nighttime... contrary to advice from other sleep consultants that I've read.

Babies sleep well if hunger for milk and sensation are satisfied. 

I don't have much concern about milk because my son just guzzles it down during feeding time. At the moment, he drinks a little more than 1L of milk per 24 hours already! But as he has become more awake, he's not getting lulled to sleep by milk anymore. So I'm thinking that his appetite for sensory stimulation isn't satisfied if he has trouble sleeping; walking outdoors has always led to a good nap for him (albeit short). After his first morning nap, all his naps occur after we've played with his rattles and crinkly toys, sang action songs (nursery rhymes, mostly), observed sunbeams and shadows, and named things he's looking at at home. Pamela Douglas doesn't prescribe sleepy cues because she believes that primary caregivers know their wards more; so in my case, as soon as I see my son rubbing his eyes or starting to become fussy, I know that it's time to offer a nap, depending on the context (just finished drinking milk; diaper just changed). Now, unless he's really fussy, I typically spend 10 minutes (max) rocking him to sleep.

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Yeah, I've read a lot of articles stating that rocking a baby to sleep is a bad sleep association and is a deterrent to becoming independent. I disagree because 1) a baby feels safest with his/her parent and that can make him/her sleep easier; 2) I cannot believe that sleep consultants expect babies to not have sleep associations while adults are allowed to wind down with their entertainment gadgets; and 3) babies can't even walk, eat by themselves, and change their own diapers and yet they are expected to be independent.

I liked The Discontent Little Baby Book so much that I have given ebook copies to friends who either have recently given birth or have just found out that they're pregnant. If they have decided that they are going to sleep train their newborn at some point, I think that the book is still helpful because there are anecdotes about maternal mental health problems and management, breastfeeding issues and how to solve them, and settling issues and potential solutions. This book's content is applicable for babies up to six months old. I'm not sure if Pamela Douglas has already written down anything for older babies. If she has, I'll be buying that book too.