what to do?

I didn't sleep last night. I haven't slept in a year and a half. But I really didn't sleep last night. I think I actually snoozed for about 3 hours, but not three consecutive hours. What am I to do? I cannot do "cry it out", not when I think that my child is in pain and that is why they are waking up. What am I to do at this point?

I yelled at the kids last night. I feel so so badly about that. I have literally cried about it all day long. I yelled at them to lie down and go to sleep. The worst thing is that it worked, for a while. They did lie down. They were frightened by my voice. OH the guilt in that!

Something has to change. I cannot do this much longer.

I emailed Ann Keppler. I didn't really know where else to turn. I also emailed Dr. Mosca's nurse in case Madeleine is feeling pain and that is why she is waking up.

Here is my email to Ann:
Hi Ann,I hope it is okay that I am emailing you. I don't know if you remember me, I attended First Weeks (and next months) with my twins, Max and Madeleine. We talked extensively about how to help with sleep issues. Well, the twins are now 18 months old (almost) and still terrible sleepers. I thought we would just manage until they were developmentally ready to 'sleep through the proverbial night' but now it is getting really problematic. They wake up from 2-4 times a night each. I'm still nursing them and do so in the middle of the night when needed. I have tried to night wean (send in the daddy, tell them milk is no more etc.) much to no avail- they scream, pull, bite, fight- it is awful! I'm not totally ready to wean them but I am starting to feel resentful toward them, which makes me feel terrible. Last night I yelled at them and I feel so horrible about that. It has come clear that it is probably time for an intervention. They attend the infant/toddler program at the Experimental Education Unit at the UW and their teacher there has encouraged me to contact you.

There is a catch with all of this. Madeleine underwent major surgery about 6 months ago. She was born with an orthopedic birth defect and had her foot amputated and two osteotomies. Sometimes she wakes up in the middle of the night crying and holding her leg and I cannot be sure that she is not in pain (they tell me kids do not experience phantom limb pain but I'm not too sure). We live in a small two bedroom in an apartment building so I am conscious of our neighbors. They share a room now but usually end up sleeping with my husband and I at some point in the night.

I know you do sleep consults but I'm not sure if we could afford you. I wanted to check in and see if you had some quick advice or if you feel like the problem is big enough that we should scrape the money together and have you intervene.

Thank you for anything you have!

And her response:

Hello Niki,

Of course I remember you and your twins - happily. You are a wonderful mother.

It sounds as though you have experienced a lot of difficult decisions and adjustments to Madeline's surgeries. And, I would trust your intuition about whether or not Madeline is experience pain in her leg by her behavior. Does the rubbing of her leg help her? That would be a way to override the pain sensations by sending other sensory sensations to her brain in the same way rubbing the lower abdomen in labor reduces the pain sensations of the contractions.

Probably the best place to start is to look at their food/milk consumption during the day and try as hard as you can to pack the calories in during the day with foods like avocado, and other calorie dense foods. If you know that are getting a lot of milk (which at this stage of lactation has more fat than whole milk) and lots of dense calories, then you could begin to try anything to soothe them at night except nursing.

I would suggest you have a look at Ferber's newest book for some ideas (I don't support all he suggests) and I really like Elizbeth Pantley's book The No Cry Sleep Solution for Toddlers and Preschoolers. I think it is much better than her book for infants.

Right now I am taking a sabbatical from parent consultations to work on the revision of Pregnancy Childbirth and the Newborn. Barb Orcutt, a colleague and wonderful nurse is covering from me. She directs the Breastfeeding Center at the Birth Center, is practical, thoughtful and smart. She joined me for several sleep consultations last month. You could contact her at bgorcutt@comcast.net if the other options didn't provide you with enough new ideas. I hope this helps. Great acknowledgment to your sensitive and thoughtful approach to parenting. ~ Ann

Yes, good ideas to try. In the mean time I will be a bad friend, an emotionally fragile mother and a complete basket case wife. My apologies to everyone this affects.