Although I started to write about the 4-month stage transition yesterday, I want to return to the 8-11 month old stage we've already touched on for a reader's question. I've got a few thoughts about the issues she raises and then I'm hoping that the rest of you can chime in with additional suggestions/words of advice/encouragement. I. is a mother of an 11-month old who has had severe reflux problems from birth. She wrote:

Right now, his good nights look like this:

10:00 – Nurse. Asleep by 11:00, in his crib.

12:00 or 1:00 – Wake up. Nurse for 20 minutes, followed by
20 minutes of holding to get into deep sleep before he goes into his crib. (If
he's put down before then, he cries and we risk a complete wake-up.)

2:00 or 3:00 – Wake up. Nurse for 20 minutes. Go back to
sleep, but only on a person; at this point, he just will not go back to sleep
if he's not with a person, so one of us ends up sleeping in the recliner with
him.

7:00 – Wake up for the morning.

And on his bad nights, anything can happen – he doesn't go
to sleep until 12 or one, then he's up every hour all night long, with an hour
and a half in the middle of the night where he's totally awake and ready to
party. Or he just won't sleep at all except on a person.

He tends to make up for it by sleeping more in the daytime;
after bad nights, he'll get more sleep during the day (always and only on a
person, though; I cosleep with him at every nap, because otherwise there is no
napping) than he did at night.

It's not really a sleep pattern so much as a sleep
dysfunction at this point. We'd cheerfully cosleep with him in the bed if we
thought it was safe, but our bed is really high and has no rails, so he'd have
to sleep between us, and we're both large people and my partner is a heavy
sleeper, so we're a little worried about that. (One possibility would be to get
a new bed, or to get bed rails for this one. If that's what it will take, we'll
do that.)

Our pediatrician has advised crying it out. But intense,
long crying spells tend to lead to reflux episodes, which leads to a) more
crying and b) vomiting, and by the time he's soothed, cleaned up, and changed,
he's awake,
so crying it out seems like a bad idea for him. (Also, I really don't
think we can take it; time and again, we've been the parents who caved
after a minute of crying. We'd both rather be up all night than let him
cry, in all honesty.)

Other people keep telling us that it's the nine-month sleep
regression, but – he's eleven months old. It seems like this is more than that.

Any advice would be very, very welcome. I'd especially welcome
suggestions for a sleep training method we can use, and some idea of
when to start it, and any ideas about what we can do in the meantime."

Oh man… this sounds so hard for everyone: your poor baby and his "growing pains", what with the reflux, teething, and first cold and poor you coping with trying to soothe a baby in pain all the while terribly sleep-deprived . As I see it, there are many parts to this sleeping "question":

1. Reflux problems and the associated sleep situation that requires mom or dad to sleep with the baby upright on a recliner.

2. The child's developmental age.

3. Frequent night wakings, sometimes completely unpredictable.

4. The child being overtired when nights are bad and compensating with longer naps during the day.

5. The desire/need for you guys to co-sleep but the obstacles therein.

6. The need to change the sleeping situation with an appropriate method that works for the whole family.

PHEW!  Did I get it all? It really does seem like some change is required for the whole family to get more rest and feel better. I know there are many parents out there who have dealt with reflux
problems and have found various solutions along the way. Given that you've been dealing with reflux problems with your boy since birth, you're probably an expert yourself by now. That's not my
area of expertise, so I'm hoping others will join in with their words
of wisdom on that front.

So, let me start with #2: Even though he's 11 months, he most certainly still can be in the throes of this developmental transition that starts around 8/9 months. He should be heading out of it soon, and in the next couple of weeks, you can start trying to implement a new plan. IOW, it's good timing to make a change.

#3 and 4 are connected. The frequent night wakings may be in part a function of your child being overtired which, in turn, has an impact on his napping situation, and so on. You may have heard from way too many people that children often have a harder time going down, sleep fitfully, and LESS, when they're overtired. Although Weissbluth seems to suggest that this is a new insight, our grandmothers and nannies have known this forever. My first suggestion to you would be to try to put your baby down "for the night" at an earlier time, especially given how early he still wakes up (7 am). Some kids wake up late (at around 9pm) and so they go to sleep for the night later as well (10 pm or so). This difference in sleep windows is often culturally determined and often reflects a preference for later nights and mornings on the parents' part (as well as the child's). That's all good if the child is getting adequate amounts of sleep. But in your case, that may not be the case given your description. So, my first suggestion would be to try aiming for a significantly earlier bed time, like 7 pm or 8 pm. You probably won't be able to make this change immediately (although it may be worth a try). So, you can gradually inch his bedtime earlier and earlier over the course of a week or two. Although not all babies respond well to this, many do. And counter-intuitively, many babies sleep longer when they're put down earlier.

#5 may be the most straightforward one to tackle. If you and your husband want to co-sleep and you think this will be the best way for all of you to maximize your sleep, then go for it. If you can afford a new, bigger bed that will make everyone more comfortable this may help. Some bed rails may work, but I'd be cautious about how safe they are for wriggling, soon-to-be toddlers. Also, keep in mind that this is a change in your sleeping situation that may last for a long time. If you and your husband like the idea of long-term co-sleeping, great. But if you want to just do it for a month or two to get out of a "bad patch", then you might want to consider what your ideal sleep situation would be instead and work towards that. Your baby is entering a great, relatively stable, resilient stage very soon. This new stage is a window during which you can shift sleep patterns; a lot easier than making changes during the 18-21 month period!

Finally, #6: I'm not big on advising any sleep-training method over another without knowing a family very well. My approach is more along the lines of providing all the possibilities and letting you choose what best fits your parenting style. In our book, I reviewed the main sleep-training methods and the pros and cons of each (it would take pages and pages to do that again here and it probably infringes on some copyright issue or another). You're obviously not into CIO methods, so stay clear of any of those. For the life of me I can't understand why pediatricians advise families to carry out sleep-training methods that go against the parents' own general approach: it's insensitive for one, there's no empirical research to suggest any of the more extreme CIO methods work any better than the more systematic non-CIO method, and the advice is doomed to fail if parents don't feel comfortable following through with the method consistently.  (Gah. I'll get off my soapbox now. Sorry.) More importantly, full-out CIO sounds like it would not be a good thing for your baby, given his serious reflux problems that get exacerbated when he cries a lot. There are gentle, "no cry" techniques that have worked for many families (Pantley is the guru for this approach). These are methods that allow you to gradually change sleep conditions while still providing some level of comfort and support for your baby. There's more graduated methods like Ferber's, that does allow for kids to cry, but for short periods that you can control. Other "controlled crying" approaches suggest allowing the child some fussing and crying before falling asleep, but remaining with him while he does so. And of course there's various co-sleeping arrangements, which the Sears folks have written about extensively.

Can anyone suggest specific methods that have worked for you in a similar situation? Any words of advice for I. on transitioning to a co-sleeping arrangement? What about the problem of reflux and how it fits into solving these sleep problems?

There are so many fascinating change during this transition period that I could spend 10 posts just going into the emotional and cognitive characteristics of kids this age. But in the interest of also being pragmatic and helpful to the more sleep-deprived, let's talk about B's questions about her 9-month old daughter:

Let's start with that last HILARIOUS statement. I'm tempted to suggest that all your friends are lying, but of course that's just plain obnoxious of me. But I would wait a week or two and see if that sleep setback that hits most 9-month olds doesn't also hit your friends' kids

Your instinct is right on. Night weaning at 9 months can be a tough battle. Yes, there IS a better time. The next stable period starts around 12 months. From 12-16 months, kids are much more resilient and weaning can be a much easier process than at 9 months when separation distress is peaking.

To elaborate more on the nature of this transition let's think about what the 9-month old baby is all about: beginning around 8-months old, she is very attentive to adults in her environment, and in particular her mother (poor fathers often take a back seat during this phase). The 9-month old is very attuned to her mother's goals and to where her mother is looking. What does mom see? She's also attuned to mother’s emotional cues, as conveyed by her facial expressions. What does mom think of this situation? What does she want me to do about it? In particular, we see an infant who begins to understand joint attention, who experiences herself as a social partner with her parent, sharing the same perceptions, the same world. Learning to dance a more sophisticated dance with mom and LOVING it when she can demand, and receive, the attention she strives for. So, weaning a baby at this age is likely to feel like a real intrusion to this new-found synchrony and you're likely to hear loud and lasting cries of protest against anything that disrupts this sense of connection that baby now knows can be initiated and maintained by her own actions. 

In terms of whether you should night-wean before you move her to her own room, there's a few ways you can think about it. If you don't mind continuing to lie next to her crib for the next couple of months, and if that's getting you both the most sleep possible, then you could continue that way and then wean her in combination with transitioning her to her own room. If you really want to move her to her own room now, then you can still nurse her in her room each time she wakes up at night. Having said that, this stage might make it tough to change sleeping arrangements like the room in which she's going down for the night. On the other hand, since you say she seems to really like her own space to some degree, maybe it will go smoothly. You could try and see how she copes with it the first couple of days.

In terms of what strategy to use because she's a tension releaser, I'm stumped on that one mainly because I think during these transition stages, some kids can flip from tension releasers to increasers and vice versa. (If you don't know what we're talking about, check out Moxie's compelling distinctions between kids who increase vs release tension when they cry). It's sometimes even hard to define a child based on this dichotomy during these highly sensitive periods because they ALWAYS seem to be increasing in tension to some degree… until they stop. How long and hard does a releaser have to release before he turns into an increaser? I found it impossible to figure this stuff out when my boys were 8-11 months old and again when they reached 18 months. All I knew for sure during those periods was that I was a tension releaser.

Anyone out there night-wean at 9 months? If it went smoothly for you, any words of wisdom for B? Anyone out there night-wean at 12 months? How did it go for you?