You can get more exotic prescription stims still from most places. E.g. Mydayis (adderall xr with three instead of two sets of granules), Azstarys (methylphenidate and a prodrug methylphenidate), and Adzenys (different type of slow release adderall). If they call any Bartells they will tell them what they have in stock. Have them do that before contacting the doc, then have them tell the doc what is available.
Read the article, and many of the comments here. I have a hard time squaring a lot of the hard and fast rules against my own experience. Certainly one persons life can’t detract from large scale statistics. However, I have 6 children. They have all responded to methods of behavioral training in wildly different ways.
My oldest two could not do sleep training. 10 months of trying for almost every night and they did not just adapt. My middle daughter embraced it after a single night. My adopted middle son didn’t need it at all and was naturally “good” at sleeping. My youngest daughter and son will fall asleep right away if around someone, but otherwise will stay up for hours (but never cried about it).
Again, one family experience but each child has their own needs and responses. I’ve never found a single method that works universally in any aspect of parenting.
this... with my first kid I didn't know how to handle, advice was 'to leave it cry to sleep', but it felt like torture to me, inhumane, letting it cry for so long.
A little baby just doesn't want to be alone. I discovered just sitting in the same room, reading something on my tablet was enough to fall a sleep after like 20 minutes, 90% of the time.
And yes, there are those nights nothing works. Just take him/her out, watch same television and have the baby on your belly to relax. A kid is not a robot, you can't expect it to go asleep when you say it's time for bed, there's no on/off button. I'm often amazed by parents who expect the kid to be tired at exactly 19.00 each evening.
That's not how it works, the first year is horrible. You as a new parent will be exhausted by the amount of not-sleeping you'll get, and the amount of attention the kid needs. Expect nothing less, things will get better when the kid grows older.
I think it is something of western culture to put a baby in a separate room and leave it alone, and thinking it feels comfortable and save and you can mind your own business.
> That's not how it works, the first year is horrible. (...) things will get better when the kid grows older.
Except when they won't. Our older daughter started having real sleep issues around when she was 1.5 years old. From that point on, every night was one of "those nights nothing works". Her sleeping schedule became quite consistent: roughly 21:00 - 05:00 if she didn't nap during the day, or 23:30 - 05:00 if she slept even as little as 15 minutes at any point during the day.
We went through pretty much every trick in the book. Less attention. More attention. Earlier supper. Rituals. Toning down lights an hour before bedtime. Music. Singing. White noise. We consulted a psychologist specializing in small children. But nothing helped - in fact, the more we tried, the worse it would get, with our daughter often going to sleep past midnight, only to wake up at 05:00 sharp.
Now I'm going to admit to something that's AFAIK seen as even worse than the "cry it out" method. Something I was very surprised wasn't even mentioned in the entire article. After half a year of unending torture that started to very negatively impact our marriage, in an act of desperation, we gave our daughter melatonin drops.
This solved the problem instantly. We all slept very well that night. And the next one. And the next one. Sleep again became something reliable.
Obligatory YMMV, IANADoctor, consult your pediatrician, etc. But the point is, every kid is different, and sometimes things don't get better (and it's very hurtful when others try to reassure you they will).
For our kids, they do sports. Heavy duty sports, since age 2-3.
Now they basically volunteer to sleep on their own.
Bedtime is not a drag. Its a priviledge. And Its glorious.
Every kid is different. But they are all energy machines. Starve the machine of energy, or use it all up, and the machine will go idle. .You have to find what sticks.
You would be surprised what kids can do with a soccer ball at that age.
You do need a nearby fenced playground that attracts other kids, so you can work for hours without having to be in the middle of it.
Their self-service probably begins at earnest at 3 yrs, though, to be fair.
Before that, its all home playing.
But be creative. If the above situation is not for you, then a properly weatherized, large jaccuzzi is also a great option for an old toddler, particularly if you have a retired grandma or a nanny nearby that can watch them as a hawk.
A toddler, or really any kid below 8 yrs will not run out of things to do in a jacuzzi. Particularly if outdoor temp is above 75F
There will be the occasional crying from someone getting pushed while playing soccer, or scared and swallowing water because another toddler pushes the infant down temporarily.
Activities that push kids to exert themselves do come with periods of difficulty. That's also energy-draining.
> Isn’t bodybuilding bad for kids’ growth in tallness?
Bodybuilding, as such, is generally considered dangerous for kids; whereas age-appropriate strength training is not (though even that is generally recommended for significantly older than 2, most sources I’ve seen suggest not younger than 6-8 to start.)
You might be aware of the pathway that generates melatonin.
It begins with tryptophan, which can be converted either into niacin or serotonin. Taking a niacin supplement with tryptophan will boost the opposing pathway.
Serotonin is itself the source of all melatonin.
Adjusting diet is not as controversial as a hormone supplement.
Do not attempt this while taking an SSRI, which can be deadly.
I think the op is talking about anything that helps create serotonin whilst taking a serotonin reuptake inhibitor is a bad idea and I agree....
I have seen the results of MDMA + SSRI when I was at a party many many years ago... The seizure that person had was full body ... All their muscles were tense... It was lucky we got them to hospital asap as they almost died (30 minutes to live the doctors said) and even at that point needed to be put in a medically induced coma for days... (I took this person to the hospital and heard the rest from the person's family)
I mean melatonin is super safe and fairly effective. Definitely less suffering than crying all night for all parties. It's reasonable to assume a baby would like not to be miserable- so why not!
IANAD, I don't have kids but I'm curious why melatonin properly dosed would be seen as worse than crying to sleep. From what I've learned about melatonin it seems to me you did the right thing
because people don't know what effects that would have on a growing baby. (I'm not saying scientists but just random people)
questions that would worry them would probably be things like what if the baby start depending on them and their bodies reduce/ceases to produce melatonin naturally, and that this permanently affects the baby.
I haven't looked into the findings for theses kind of questions, but even if you look into it you'll also have to be condident of the reliability of the results. maybe it's harmless for adults but not for 2 year olds. Maybe the pediatrician you went to see didn't prescribe them for a reason.
Because it's a chemical! A hormone! Because you're dosing your kid with a drug! You're taking the easy way out! You're using a shortcut to cover for your inability to endure the first few days of ${sleep training method}!
While I reserve any judgement on GP’s use of melatonin to help their child sleep, I think the tone of your comment indicates a confidence in pharmacology that is difficult to justify, or at least betrays significant immaturity about the complexity of these sorts of decisions…
> I think the tone of your comment indicates a confidence in pharmacology that is difficult to justify,
Hey, being condescending about magical thinking and pseudo-reasoning does not automatically imply a special confidence in pharmacology. That said, I do have perhaps above-average confidence in pharmacology, based on some experience and paying attention to details. Much like scientific papers, pharmaceutical products have specific effects and ranges of applicability. If you're aware of those and the trade-offs you'll be making, then pharmaceutical becomes a very effective tool - one that works reliably and consistently, unlike magical / naturalistic thinking.
> betrays significant immaturity about the complexity of these sorts of decisions…
I think it's the other way around. The example responses I provided are, to me, how immaturity looks like in the reasoning department. A lot of complexity in these sorts of decisions is created by people giving such replies, as now parents have to also trade off effective solutions against being judged by others.
I think the argument is more along the lines of a lot of people automatically assuming something like this would be bad without any direct justification.
The same people that will then feed their kids heaps of antibiotics for a viral infection.
Well, no. Melatonin does affect things other than sleep. That said, you do what you need to do as a parent. I would only (silently) judge someone if they jumped right to that and kept at it. Messing with hormones should be a last resort, even if it seems benign.
1) "Last resort" doesn't mean "don't use, ever". A lot of the commentary on baby sleep issues would have you delay trying this until you've tried everything else repeatedly - or, in other words, indefinitely. But sleep deprivation of the entire household is no joke, at some point trying the same methods that didn't work again and again is just torture, and the negative effects far outweigh trying a hormone supplement.
2) Most advice around this topic is based on magical thinking, examples of which I included. Yes, bodies are complex, bodies of developing children even more so. Yes, hormones in general are hugely impactful and messing with them is dangerous. But it's not magic, it's not tainted by evil or something. We do have some idea about what the risks are.
The underlying idea behind the examples I provided (real and widely spread, unfortunately) is a knee-jerk rejection of anything man-made, of any intervention that wasn't available to our great grandparents, or their great grandparents. It's irrational and dangerous and annoying, and usually comes bundled with thinking in absolutes (instead of trade-offs).
I think this is born out of puritan ethics attached to counter-culture “pure” living. Essentially all desired outcomes must be earned through righteous, hard work. Anything short of this effort is cheating.
For me, it’s out of respect for the body’s natural methods of dealing with problems. Obviously there are some cases where it’s useful to interfere with the body’s processes.
But in general humans are extremely complex. We tend to think that we have a better understanding of things than we actually do. The human body does things that we still don’t understand fully, and unless there’s an incredibly clear understanding or benefit of some treatment, I’m hesitant to try to change it. Mostly because of how much I know that we don’t know yet.
If we don't know how the human body works, then surely we don't know that melatonin is better or worse for the body than not taking it. Perhaps it is worse, or perhaps it is better, but either way it has at least one positive effect.
The primary concern is its (potential) effect on natural production. Most human hormone production is governed by the hypothalamus-pituitary-adrenal axis. Internal feedback loops suppress natural production for extended periods of time if exogenous hormones are introduced.
One of the most common examples of this is exogenous testosterone. If you take it long enough, the LH/FSH feedback hormones drop, the leydig cells in your testes atrophy and go dormant, and your natural production could be suppressed forever. Nearly all retired bodybuilders (and other athletes who use gear) are dependent on TRT for life, for this reason.
The open question is whether introducing exogenous melatonin to patients whose natural production is already very high (as it tends to be in children) could lead to lifelong dependency on it. That's the concern.
Thanks for sharing, and I'm happy it worked out for you and yours!
The implication in your response is, unfortunately, what both my wife and myself secretly fear. I've been diagnosed with ADHD as an adult (and after becoming a father); there's another diagnosed case in my immediate family, and at least one highly probable one. Given how highly hereditary ADHD is, we're afraid our daughters may have it too, and we're struggling not to read any unexpected behavior as evidence in favor.
> It is very hard to get a diagnosis pre 6/7 but of course we can see behaviors and project our thoughts.
We're not planning to get an early diagnosis. I feel it's really too early to tell for sure. We are observing carefully though, and carefully listening to feedback we get from daycare/kindergarten and various child development specialists. So far, we haven't heard anything that isn't somewhat common with children this age.
The "projecting our thoughts" bit is tough, however, as it happens automatically. I try to keep an approach of "assume it's normal at this age until proven otherwise" when dealing with her, and the idea that she could be having executive functioning issues actually makes me more empathetic when she keeps ignoring what we say or gets randomly distracted.
I have 2 with ADHD. One with impulsive and dyslexia and the other with inattentive.
The dyslexia plus impulsive is quite a challenge but early identification is key.
If we hadn’t made all the changes and waited till 10 onwards we would be in a totally different situation.
Keep going, try not to over analyze and courage!!!
Occasionally. Her sleeping patterns have regularized now - though off the drops, she's somewhat more prone to wake around 03:00 seemingly recharged, only to fall back to sleep around 06:00 and then be near-impossible to wake up an hour later - but at 3.5 y.o., we have some success in talking her back into sleep, so it's no longer a big issue.
The drops still come in handy in specific situations that we know will disrupt her sleeping pattern, but that too has become less of an issue. For example, it used to be that car travel in the afternoon would have her sleeping through the whole trip, and then refusing to sleep at night, and it would take a couple of days to get her back to the usual sleeping pattern. But in the last ~6 months, she stopped sleeping so much in the car, and learned to fall asleep if the right ritual is followed.
That's a coincidence, my daughter is 3.5 years old too!
The reason I'm interested is my wife is pregnant with our second. First four months our daughter slept all the time. 5 to 11 months was an nightmare. Then it settled down and she sleeps 8 to 6.30 most nights. I think we were lucky, especially after reading what you went through!
> That's not how it works, the first year is horrible. … things will get better when the kid grows older.
My first daughter would wake, have a bottle, fall asleep within a few minutes for 3-4 hours. Wake, bottle, fall asleep for 3-4 hours.
The first year was sooooooo easy. The 2nd year I wake, make bottle, hand it to her, she drinks and falls asleep.
She’s 4 now and can’t stay in a room alone during the day or night. That’s harder because now I can’t go toilet because she will scream at the top of her lungs until someone is in the room. But sleeping is me staying in the room for 5-20 minutes till she’s asleep.
I moved my child to his own room when he was past 3 years old. I had to, because a second child was coming.
Before that age, I also tried several times, but each time I gave up because he protested too much. It was just easier to let him sleep in the same room.
When he started sleeping in his own room at 3.5 years old he had to adjust psychologically. I had to convince him that monsters don't exist, or if he still believes they exist, at least that they can't get in because they don't have the key. I also got a night lamp for him so he would be less scared.
He would still get up frequently and seek me out because he was scared. The counselor advised us to put him back in bed and be consistent about it. If he gets up 20 times, put him back 20 times, no matter the protests. He accepted this after a few weeks.
I also told him that I won't stay until he falls asleep because I have to sleep too. I said I'll stay with him for max 5m, even if he's not asleep. After a few weeks and many protests he finally accepted.
Thanks for the info! Currently I’m in Taiwan staying with family and the plan is to move to New Zealand at the end of next year. Until then we have no space lol so daughter sleeps in her own bed next to ours.
But in NZ she will have her own room so that’s when she will need to adjust. I hope the 2nd one is easier. She’s only 4 weeks and wakes only twice a night to feed.
> I have a hard time squaring a lot of the hard and fast rules against my own experience.
I think it's the same thing like in other self-help sub-genres: any of such hard and fast rule will work very well for some people in some situations. That's why there are so many of such rules, why they're often mutually conflicting, and why they all have armies of evangelists behind them.
> Certainly one persons life can’t detract from large scale statistics.
Conversely, those statistics talk about what's average, typical. Some things have high enough variance that even most solid RCT only works as a guideline for policy at scale.
I have only two children, but it's clear to me both develop according to completely different trajectories. It kind of makes sense as, even if us parents didn't change in any way, and the environment stayed constant, our younger daughter is still spending a lot of time in the company of her sister. That's a huge additional high-variance input source :).
This. As a father of three kids it's sometimes fun to look at people going through this – you are the smartest person about kids if you don't own any yet and most stupid one with the second one if you realize that you can't reuse almost any knowledge you gained with your firstborn. By the time you have a third one, you've already accepted that they are all very different and you have to learn from them, grow with them and adapt.
I have two kids. I already have to parent both of them differently. It’s like being a first time parent all over again when the second one arrived. And strategies that worked at 2 years don’t carry over to 4 years.
So I’m always skeptical about articles offering generalized parenting advice.
I visited Japan for the first time a month ago, and basically followed this advice. Got lost in Tokyo. Well as lost as you can be considering Apple or Google Maps and SUICA are pretty much universal wherever I went. And cash.
Didn’t speak the language, didn’t try to make people speak English - asked for the Japanese menu and used Google translate to figure it out.
This was mentioned in one of the other threads about this - but you can purchase XBox games outside the Microsoft Store platform just fine - Best Buy, Amazon, Walmart, even resell on eBay, and Microsoft doesn't take a cut.
Microsoft receives a fee from developers that participate in their licensing program, which is generally a royalty on each sale ranging from 1% to 30% depending on the negotiating leverage of the publisher.
Developers are not required to participate in that program to sell games/software for the xBox, and some don't, but MS doesn't guarantee that any unlicensed software will work with the current version of the system or any (software) updates to the system.
Can you cite a source for this claim and provide an example of a game that was physically distributed in stores without the publisher having a signed publishing agreement with Microsoft?
> Developers are not required to participate in that program to sell games/software for the xBox, and some don't
They may not be required to take part in the standard distribution licensing program, but instead have the option of participating in ID@XBOX, where the games still have to be certified by MS to be allowed on the platform. This program also seems to be exclusive to digital distribution and smaller indie studios.
In the end MS is still always in a position to take revenue cuts for access to their platform, and mostly exercises it.
For the first transaction MS most likely gets a cut, but after that you can resell xbox games (at least the ones sold on physical media). You can't resell ios apps.
Yes, I'm equally mis-informed, but allowing companies to make games for your console requires some payment to the creator of the console to allow that.
It's how consoles are sold at a loss, but make it up through game sales.
Microsoft still get’s their ~20% for games sold in other stores. So, in terms of Microsoft’s profit on XBox those sales channels are closer to downloading over WiFi vs cellular modems.
They also prevent other digital retailers from selling on the XBox which is very relevant for in game purchases.
Not necessarily the case. The newer xboxes don’t come with removable media and the bought keys are tied to your Microsoft account.
The whole thing is slippery mass of corporate worms trying to fuck each other over for market control and the only losers are the end users. I want nothing to do with any of them any more.
That isn't true at all, Microsoft absolutely takes a cut from physical game sales, and also places arbitrary restrictions on what can be sold and requires pre approval for everything. That's literally the business model of the Xbox.
It's no different to the iPhone at all. It's just less controversial because people think of their phone like a mini computer but always expected consoles to be closed.
Microsoft also negotiates with publishers/developers, so it's not a flat rate. MS (and Sony) let the market decide what their royalty is for every sale, and that's what anti trust laws want.
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My wife had me buy her a poster this year which I have found to be particularly profound in a variety of life's situations. It says, simply "The grass is greener where you water it."
> Building the era of custom tools just for your company, only to do specific jobs is long gone.
Isn't that the biography of 99% of the open source projects in the big data and distributed processing world? I understand they are open now, but didn't they start as custom tools just for a single company?
It seems like the "error" that Fog Creek made was to not open source Wasabi, though even that seems more like a hindsight has 20/20 vision kind of thing, as open sourcing a project is no small feat, especially to a small software company.
I was expressly hired at my current gig (re-startup) in Pioneer Square to migrate from an existing .NET solution to JVM on AWS with a heavy Cassandra component (all on Linux). I started a company up here some years ago and we opted for the Windows platform due to the availability of talent. I think that has changed in recent years, and I feel like the Seattle startup scene these days has a really healthy balance of a lot of different technologies.
I'm 31. I was 25 when I got married, which was also the same year the company I co-founded hit the skids and eventually a brick wall. That first year was really rough on us (we started with 1 child and had another in the middle of that year), but we survived and watching that company burn was one of the most valuable life lessons I've ever had. We've had another two kids since then, and I've learned a few other things along the way.
Before I was married, all of those fears and anxieties ruled my life. I think that's partly what attracted me to the startup world and ultimately to starting that company. I wanted to chase my ambitions and fight that feeling of loneliness. However, the great lesson I learned from that company, and ultimately from the last few years of marriage and kids is that you won't be alone when you choose to value the people you love over achievements you earn, stuff you buy, or even just stuff you work really hard on. I poured it on with the 90 and 100 hour weeks the last 6 months of that company and in the end the company crumbled and my hard work left me with nothing but bitterness toward my creation (I eventually got past the bitterness). Today I invest that time in my wife and my kids, and they are my world to me. They're my best friends. There's no earning their love, but the time I spend with them is never wasted. I don't get through the week, having prioritized them over other things, and think to myself "man, I really wish I'd spent an extra 20 hours on that personal project" that will never do anything for my personal fulfillment beyond some temporary ego boost.
Now. That's not to say I don't still love the startup and technology world. I do. And I still have those personal projects. And that professional community. I also love working hard on stuff that pushes the envelope. But the funny thing is that ever since I put that part of myself in a bounded box I've enjoyed it more and been more productive. There isn't the sense of having to keep up, and yet I'm still able to. Consequently I'm happier at work and since I don't draw my personal worth from it, I can take setbacks and move on and still enjoy it.
I don't know that everyone should get married, but it seems to me that, based on everyone I've ever known, that you best fight loneliness by surrounding yourself with people who will stick by you regardless of job, religion, social status , health, or anything else. To me, the question to ask is - if the world fell apart right now, would the people you prioritize still be with you?
Thanks so much for sharing your perspective. You've put words to some half-formed thoughts I've been having since a recently failed relationship. Live and learn
