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Thursday, September 15, 2016

Problem Solving: 22nd Month Hurdles


Any time we go through rough patches, regressions, setbacks, etc., I love to write a post and "think through/talk out loud" to figure things out. I hope this also gives you, as the reader, some good insight and reassurance that things aren't always pretty and perfect over here!

So, where to begin. Let's start by just listing all of the "issues" that have been going on for the last month. Which, by the way, almost all of them seem to be getting worse! Things kind of get better, and then when it comes back it's even more prevalent.



- Delaying bedtime (asking to go potty, and for water)
- Taking a long time to fall asleep at night once she does lay down
- Refuses Independent Play (Room Time)
- Wants out of her crib immediately upon waking (instead of staying quietly in crib as she used to do)
- Asks to be held ALL THE TIME
- Hits/slaps me or herself, flails arms/bites her finger, when she doesn't get her way (seems to be only with mama)
- All out real tears when she doesn't get her way
- Short nap
- Waking in the middle of the night and calling for us
- Throwing fork/food/plate at the table (on occasion)

That's a ton of things that I just listed, and it includes all of the big areas (sleep, independent play, eating, following direction). Every area of her life is being impacted right now. And, I feel like I'm probably missing something that I need to add to the list! Most of the list comes back to simply wanting MAMA at all times. All of the hard work that we put in for sleep training, independent play, etc. feels like it's gone out the window this month! Obviously, it hasn't. She is in some sort of a regression, and she certainly hasn't lost her ability to do room time, or listen to Mama. The sleep training that we did, taught her how to put herself to sleep, and she hasn't forgotten that after 1.5 years of being able to do it. It sure feels like it, though!

It is important to take a look at what's going on to see if we can identify a cause for some of these disturbances.

- Just recently (past two days) she's had a slight fever, runny nose, diarrhea
This would account for the sudden extra clinginess this week.

- Last week her words exploded and she started trying tons of sentences
- In the past month she was really focusing on talking and expressing herself more
She is obviously in a huge developmental milestone. Words are just starting to pour out of her. EVERY time she's been through a big milestone, her sleep has been impacted slightly. (learning to sit, stand, walk, and now talk)

- She's asking to go potty after just having gone
- Seems to be irritated/itchy around the entirety of her private parts
May have a UTI. We brought her in a few weeks ago and the pediatrician didn't think she had one. Yesterday, since the symptoms are still prevalent, I just insisted that we go ahead and test so I can rule this out. They also checked for ear infections, etc. All is good pending a clear UTI test.

- She's cutting all 4 eye teeth at the same time
- Her 1st year molars are finally all through this month (even though they cut months ago)
- No sign of 2 year molars yet
Eye teeth and molars are the two times I've heard from MANY parents that it caused severe disruptions. We've decided to assume that the teeth are a factor and give ibuprofen to help. Caroline also points to her mouth and tells us that it hurts at times, so we do a few days with medicine, and then take her off to see if anything resolves. She is better on the medicine, but still super clingy and it is not helping with her sleep- more just with her behavior.

So I am not exaggerating when I say that the last 3 days have been incredibly hard. She's got a virus at the moment, so it's making all of the above issues even more dramatic. All day long, she's upset. She screams if I set her down just so I can use the restroom. She continues screaming and crying when I do get to pick her up because she's so angry with me for setting her down in the first place. She is refusing naps and bedtime sleep until she's so tired that she just crashes. Once she does finally fall asleep, she wakes shortly after and is immediately screaming. I can't win with her at the moment. Everything I do upsets her. It is just an awful feeling. Add to this, that on Sunday night (when the virus symptoms started), she started saying "Mama, mad", and I feel just horrible about everything.

It is amazing to me that she recognizes when I'm upset, and can put words to explain it, first of all. That seems incredible for this age. I didn't even know she knew what "mad" meant. The fact that she recognizes the emotion and can call it by a name is pretty amazing.

On the flip side, I felt so small when she said it. Yes, I was mad that she hit me, and frustrated that she told me she had to go potty and then didn't go (just to get out of bed). I am firm and consistent with her, because I want her to recognize that it is not ok to do these things. I actually want her to know that I am upset with her. But wow, once she identified it correctly, it burned! Instead of feeling the success, I felt like I'd failed and that I was maybe getting frustrated with her too much.

And when I think about that- "Am I getting frustrated too much?", really the answer is no. She's testing every boundary right now. She's not listening all of the sudden, she's hitting, she's ignoring me, she's screaming, she's making excuses to get out of bed. All of those need consistent, firm reactions. She's asking for her boundaries to be reinforced. She needs to see that those things are not ok to do. She needs to be taught what to do instead, and she needs to know that it frustrates me at times. That means saying no a lot throughout the day, and her getting upset at me all day. I'd rather that, than allow her the freedom to take advantage and not have set boundaries. All of that considered, it still stung when she pointed out I was "mad"!

So, back to our troubleshooting. Here are the possible causes that I can come up with (I think it's a combination of all of these affecting her):

- Teething- eye teeth and molars together could be the reason for MANY of the above reactions

- Lack of sleep- she's in a bad cycle at this point (working on 1 month of this behavior), of having less sleep because of the above issues. Her behavior seems to be getting worse, which is most likely a direct correlation to the continued lack of sleep (which only gets less as the behavior gets worse and she gets more and more overtired)- viscous cycle!

- Possible UTI - I took her to the doctor today for the second time this month and insisted on testing for a UTI. They found trace amounts of blood and bacteria in the sample- not enough to confirm an issue. So, they are doing a culture to see if she has anything wrong. Waiting on results!

- She has a virus (this only accounts for the sudden 3 day craziness, and not the entire month)

- Potty training- She has been potty trained for 3 months now. After listening to all of her symptoms, our doctor concluded that it is possible that potty training is having an impact. Once potty trained, they hold their bowels longer. This can cause constipation. Constipation can cause them to feel the urge to urinate more frequently, and can cause a multitude of behavioral issues (according to our pediatrician). Once her virus is gone, she wants me to keep an eye on this and possibly treat with miralax. This would be a 2 month treatment, but should help with a variety of her behavioral and physical symptoms. She has only been slightly constipated at times, so I'm not convinced that this is the issue, but I'm game to try anything that will make her feel better!

- Age- If you look up 2 year sleep regression, it's a big one! Many parents even end up dropping the last nap at this age because it appears as though their toddler is resisting the nap because they no longer need it. While 2 year olds still need their nap, they do go through a regression where they fight the nap and even fight bedtime sleep. Their sleep needs are changing. The average 2 year old only needs 12-14 hours of sleep (this is total in a 24 hr period)! If your 2 year old is on the lower end of that average, they may really be fighting a full 12 hrs at night in addition to a nap!

- Developmental Milestones are HUGE reasons for sleep regressions to begin in the first place. She sits in her crib and practices talking (when she's calm), so I know that this is having an impact on her. She wants to practice and be awake to do so!

What we are doing


- Once I find out for sure that there is no UTI (we also have a clear on ear infections, etc.), and once her virus is gone, I may need to be even more firm in reaction to some of Caroline's behavior- specifically those behaviors that are directly impacting her sleep. I am not keen on doing CIO at this age (see why here), but we may end up getting to that point. I typically go in when she calls me, explain to her that it is still nap time, and that I will be back when her nap is over. I then leave the room. I do let her call for me for several minutes before going in, but I don't like to completely ignore her at this age.

- Setting clear boundaries and sticking with them. This is so hard, but so necessary. I feel like I'm ready to give in just to avoid having to hear her cry and scream. I know this is not beneficial for either of us, however, so I am going to choose to stay on the path that we've already done so well with. This is easier said than done when your entire day is full of screaming.

- Identifying her emotions. I want her to know that I understand what she's saying and feeling. I am continuing to try and help her find ways to channel her emotion as well. I tell her things like "it is ok to be mad", but then I also give her techniques to use to calm herself down, and ask her to try and talk to me once she's calmed down. She's stopped using these 2 techniques, but I am sticking with them in the hopes that she regains interest in them since they were SO incredibly effective! As of today, I'm changing my tone a bit. It is no longer a suggestion, I am telling her to use the technique. If she doesn't listen, and if she is not calming down, I tell her I will return when she's calm and leave the room. She calms down immediately! When I reenter the room, she starts screaming again. I leave again. She calms down. We repeat until she remains calm while I'm in the room.

- Room time. This one is so hard for me. I put her in her room as I always used to do. She used to last 35 minutes and loved her independent play time. Now she lasts maybe 2 minutes. She calls for me and cries. I return, tell her it is still room time, and leave again. We use the my tot clock which changes color when room time is over, so I refer her to that as well.  I can only handle doing this a few times before I just stop and try again the next day. I think I need to push through this a bit more to help her get back to it. She is a much happier child when she gets her independent play time.

- Putting down my phone. She's simply happier when I don't have it in my hands. I need to do better with this anyways!

- Encouraging her. I always think it is best to respond with positivity when at all possible. Focusing on what I want her to do, instead of what I don't want her to do is key. It's hard, but it is key to her focusing on those positive behaviors as well. She'll still hear "no" all throughout the day....it's inevitable, but I want to offset all of the "negative" moments with lots and lots of positive ones throughout the day. She is, after all, doing so many amazing things right now!

- We practice talking all day (when she wants to). I can't force her to talk. This is a hard milestone to have her practice right before naps or bed, as I always recommend for babies that are learning to walk, sit, stand, etc. Practicing right before bed helps minimize the urge to stay awake or wake early to practice. What we have done recently is started giving her a book to read in her crib. She talks and "reads" the whole book a few times out loud prior to laying down and going to sleep. This has actually really helped her a lot!

- Transitioning to a big girl bed. Yes you read that right. We had already planned to do this. Once we gave her a book in bed, and saw how great she did with simply setting it aside and laying down for her nap, we decided she was ready for her big girl bed. I've always read to do it before the age of 2, or wait until after 3. This makes sense to me based on her current development. We also jokingly added another reason: Since we seem to be in a regression already, why have another one later? LOL! We also found an amazing deal on a used twin bed from a mom in the area. She needs it gone, so we are picking it up this weekend. We don't have room for an extra bed, so Carolne's crib is getting taken down the same day. Ironically, getting her excited about her big girl bed this week, seems to have made things worse. She seems to want it now instead of in a few days. She wakes asking for her bed and is very upset that she doesn't have it yet. I am now pretty much terrified of what the transition is going to do to her sleep, but we are also all very excited about it! I actually think she's going to do great with the transition. I doubt we'll have any new issues arise, and I'm secretly hoping it's a random magic key to getting her back on track! I'll be posting about our plan later this week, and will be updating you with our progress as we make the transition next week.


Side note: With everything I just wrote about, I have to say, Caroline is doing really well with a lot of things as well! While she has an all out tantrum because I can't pick her up one moment, and while she gets mad enough to hit me if I say no to something she wants, she is also still listening pretty well! When I use my technique of having her "look at Mama, please", and then make a request, she does exactly what I ask (only after allowable wait time of course...which can feel like an eternity). Toddlers just process everything at a slower speed it seems like, as well. Allowing the wait time is huge to seeing if she's actually going to listen. She is also incredibly patient (sat at the doctors office with me for 1.5 hours and was a perfect angel). She politely asks to go potty, waits before crossing the street, asks to hold my hand, says please when she wants to be picked up, and so many more wonderful things! It is easy to get caught up in everything that we seem to be "struggling with" at the moment. Then your doctor comments that "she is incredibly advanced for her age", and all of your worries and troubles melt away. She is so amazing, and she has learned so much. My expectations are high, and she's rising to every single one of them. She's in a little setback right now when it comes to clinginess and sleep, but she'll get back to her "normal" soon. She's going through so much right now, and it is important to not let that get lost, either. Happy parenting! Happy "terrible twos"!


UPDATE:
The day after I wrote all of this I did a few things that helped tremendously!

1. I decided that, while I was being firm and saying no, I think I was being too nice about it. I was so worried that something was wrong (ear infection, uti, etc) that I wasn't just saying no and giving a consequence on the first time. At bedtime I decided enough was enough. I put Caroline down, told her it was bedtime and that she needed to close her eyes and go to sleep. I told her her clock would turn yellow when it was time to get up and mama would be back to get her in the morning. I always inform her of all of those things. This time after I left, she said "oh no, oh no". Usually she just starts crying and saying potty. So, this time I went in because I thought something was bothering her. I asked what was wrong and she said "hmmmm". Then started jumping up and down saying "potty". I was very stern this time and said "No, Caroline. I'm not doing this tonight. Lay down right now and go to sleep." I told her I loved her and left the room. She immediately quieted down, and was soon asleep! She slept all night and when she woke early in the morning, she waited patiently for the clock to turn yellow!

2. I got a new reward that would motivate her! The sticker chart WAS working awesome. Then it stopped being motivating. So, I decided to stay with stickers because she really does love them. I found some Daniel Tiger stickers on amazon, however. These did the trick! She LOVES the Daniel Tiger characters! When she started screaming for me during her nap, I went in. Told her all of the above things that I say for bedtime, but also showed her the stickers. She was so excited about them. I told her she would get one if she was quiet and tried to sleep until her clock was yellow. Success! She got one after her nap, and two this morning after she woke from the night!

3. I'm leaving the room when she cries. I remind her of the tools she has to help calm herself down (breathing deep, putting her hands together and squeezing), then I say "I'll come back when you are calm". Amazingly enough, as soon as I leave the room she stops crying. This tells me that it's all for show. When I come back in I compliment her on doing a great job calming down. She immediately starts crying and screaming again. So I am leaving and repeating this until she remains calm when I am in the room. It worked very well!

4. Room time is no longer getting cut short. She was calling for me and I'd return and explain that room time wasn't over. Eventually we'd just stop and try again the next day. This time, however, we powered through and did the full 35 minutes. It was brutal. She cried at first and pounded on the door. I came in and gave her ideas of some fun things to do. I told her I'd be back when her clock was yellow. Eventually she quieted down, but she just sat with her blanky by the door. It broke my heart. She was a much happier child the rest of the day, however. I've always noticed she does much better with room time. I know she'll get back to having fun once she stops focusing on mama not being there.

5. FOOOOOOOD
This girl is just putting the food away this week in particular. I am getting her thirds and even fourth helpings! She wasn't asking for more at lunch, but I decided to ask her if she wanted more and have a lot of food ready. Good thing I did! She ate 1.5 peanut butter and jelly sandwiches, half of an avocado, 3 crackers, 6 cherry tomatoes, 1/2 kiwi and some grapes for lunch. She woke up after the 45 minute mark right on cue for her nap, but then she went back to sleep for the first time in....FOREVER! I hadn't originally thought of a growth spurt for the napping issue, but I think I might be onto something with this!

She knew I meant business yesterday, and she listened to me so much better. I thought I was being firm enough, I thought that I was being clear. The reality, however, is that I wasn't. We both benefited from these tactics. While it made for a hard day and I felt bad about things, I know it is leading us in the right direction.

Useful Resources:
5 Things About 2 Year Old Sleep
Resistance to Independent Play
Transitioning Your Focus To Positive Behavior
2 Tips That Stop Tantrums Effectively
Look At Mama, Please
How to Encourage Your Young Child's Communication Development
Sleep Regressions


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