4 month old in sleep regression; advice or insights please!

[monopod]

Hi all, I'm resurrecting my dormant babywhisperer account! Was quite active on the site a few years ago and then things got crazy when I went back to work, and I stopped posting.

I gave birth to my second child, a daughter, in October last year and am back hoping for some wisdom! I really hope  that someone will be able to provide some insight or advice.

Basically we're going through the 3-4 month sleep regression at the moment and it seems like things just keep getting worse.

I'll start by saying that I've done things differently this time around: having my first in school (so school runs etc.), doing a course while on maternity leave that means I need time to do reading and essays, and generally wanting to be less obsessed and anxious about routines and APing etc., because I felt that I hadn't really enjoyed the early days with my firstborn and had also inadvertently negatively affected my milk supply and his weight gain through not feeding as often as I might otherwise have.

My daughter was very different from my son from the word go -- she fed like a champ right from the recovery room, has been very chilled out, and was a fabulous sleeper... All the way until 12 weeks (she is now nearly 19 weeks). At first I thought it was developmental and temporary (she had suddenly become very vocal and much more mobile). Since then, however, we've had more and more night wakings and I am desperately trying to figure things out!

I know there is probably little point in comparing her behaviour from several weeks ago, but basically she used to go down for the night no trouble at about 9+pm, and then wake 5+ to 6 hours later, followed by about 3 hours later, and I'd then get her up at 7+/8 to start the day. She actually slept through from about 10 to 7 when younger too.

There have been a number of changes since then and I'm not sure what is significant and how exactly they are connected so will list everything here. Sorry it's a bit jumbled; probably my zombie brain!

- She has become quite distractible during daytime nursings and even not that interested in nursing in the morning and after her morning nap so I thought she might be making up for it with milk at night (cue vicious cycle). So while we're loosely following a 4h EASY, often it turns into EAES to help get her dozy and get more daytime calories into her. I also cluster feed her in the evenings. I then got worried that I had become a prop as we often ended up feeding to sleep, but I have now tackled that and she has been going to sleep pretty much independently for the past few days (yay!) She also managed the 30-min transition all by herself in a nap at home yesterday (more on naps in a bit).

- We have brought bedtime earlier to 7+/8+pm. For a while she continued to have her long stretch of 5+h in the first part of the night, followed by 3+h and then 2+h (I don't understand this by the way...). But now she's waking every 2+ to 3h, with an even shorter interval in the early hours (4-6am)!

- She has also over the past fortnight been waking 1-2 h after falling asleep, and nothing will get her back down for any decent period of time other than the breast. I understand this usually means OT and so have been trying to tackle that too (she's not a great napper, more on that later). We have been trying PUPD (shh-pat close to useless) but I'm not convinced it hasn't been making things progressively worse since we started a few days ago ( I remember seeing at least improvement when we first used PUPD with my son). She is going back down a lot quicker but just keeps on waking and waking, until I feed her. She'll then go back to sleep, but still wake every 3h or so thereafter.

- On naps. We are often out as my husband now works from home and it's difficult for him if we're around. Because of my son being at school the baby also has to fit around school runs and other necessary trips -- basically I no longer feel like I have the luxury of working on naps at home. What usually happens is that she falls asleep in the car to/from the morning school run (currently after an A time of about 2h), I transfer her to the stroller where she usually has a good long nap of 2h give or take 15-30mins. Naps for the rest of the day are often more touch and go though. Sometimes in the stroller, sometimes in the car, sometimes in the sling, sometimes at home. Sometimes I get good long naps, sometimes she's a chronic catnapper. Sometimes she wakes from catnaps happy as anything and other times she's super cranky. So we're still working on that. She had a couple of days recently with great naps though and I saw hardly any difference with her nights.

- Have considered other props... She used to accept a dummy but has refused one for weeks now. She is still swaddled (is a swaddle a prop??) as she wakes herself up otherwise by rubbing her face and pulling her hair.

Not sure what else to say! Please let me know if anything doesn't make sense or if I need to provide more information...

Help?

[katie80]

Hi there, and welcome back!

4mo can definitely be a trying time.  There is typically a big GS around this time, so I'd think if she is waking and waking and only goes back for some time after a feed, that she's likely hungry.  I do wonder if she is snacking a bit during the day and not really taking good feeds.  I know at this age it can be hard to get good feeds because of the distractibility, but if you're feeding every couple hours on an EAES, she might just be snacking as well.  It's so hard with another child around, but can you try to feed her in a less stimulating environment and see if that helps?  The other thing to try would be to feed, wait 45min-1hr, do a top up feed, and then not feed again until her proper feeding time.  This would take away from the E right before sleep, so that she's still hopefully taking full feeds when needed.

The swaddle isn't a prop and if she's not rolling over, I'd leave it for now.  Lots of babies are swaddled til 6mo+.  It's hard to know if the NWs are connected to routine as it doesn't seem super consistent (totally normal for a second child until you can get to two solid naps and then one).  I'd say the one thing you could do is really work at settling her other than the breast if she wakes before 3-3.5 hr in the night.  Once you get the daytime feeds back on track and she's not likely in a GS anymore, if she's settling on her own at BT and other times in the night, those feeds should lengthen back out.

What do you think?

[monopod]

Thanks so much for your reply and for the ideas Katie.

Last night was ghastly! We had relatively good naps yesterday, a super-long one of 2.5h after 2h 15min A time, then 1h 20 min (extended from 35min with BF) after 2h 20 min A time (I'd started wind-down way before but she kept deciding she wasn't ready to sleep and wanted to play and then probably got OT in the process), then a 25min catnap in the evening (5.35 to just after 6). I got her down for the night by 8 (started at 7.30) which was probably too late but I was trying to have dinner with my son rather than disappearing as I have been for several nights now. We then got wakings at 9, 10.45 (tried shhing and PUPD but eventually fed), 1.55 (again tried to settle without BF but then fed), 5 (fed), 6.20 (!) (exhausted so just fed). Gah.

Those wakings were definitely not just hunger though some likely were, and we probably have OT as well as other issues mixed up in there??

I'm thinking a few things:

Routine-wise consistency is definitely not as straightforward as when we only had one child, but her subsequent A times after the morning one are probably too long. As I mentioned the morning nap is typically in the stroller (transferred from car seat) because she falls asleep on the morning school run and anything else is likely to wake her up. I've been trying to be at home for her second nap and have been trying to get her down as soon as I see sleepy signs, but I keep getting short naps and I wonder whether it's OT or a prop issue.

Do you know what A times are typical for subsequent A periods for a 4 month old? If she's had a good nap in the morning after 2-2.5 h A time, I ought to be able to aim for at least 2h, right? Part of the trouble is that she seems to take so long to settle that we end up OT but if I start too early she's UT!

Props. I think we may still have a prop problem; not sure what your thoughts are? Although I am managing to get her down in her cot before she is out (and she has definitely shown that she can do it from fully awake) I am still finding that I need to BF before a nap.

At night does it matter whether I put her down awake or asleep, if I am endeavouring to get her down awake for naps and at bedtime?

With regard to your specific suggestions, I'd say I'm definitely going to give lengthening out feeds  a try. Perhaps she is associating sleep with BF too much, as I said above. I had thought that she was taking good feeds overall (esp before naps as she's tired then and not a busybody like at other times), but I can see that I may inadvertently have been setting her up to snack. I'll try feeding at 4h intervals only today and see what happens; it surely can't be worse than last night!

On settling without a feed if it's been less than 3-3.5h since the last one, we've been trying that with PUPD but ahe just screams inconsolably, settles, then 10 minutes later she's up again (and repeat till she gets fed, whereupon she *usually* settles). Do you have any ideas? I'm wondering whether PUPD is the right option here, or whether I should just feed her and use a different method like gentle removal, single side feeding (I usually offer second side unless she's out).

I was also wondering about gas but find it hard to burp her at night. Either she doesn't at all, or holding her over my shoulder wakes her up and then she gets upset and wants the boob again, but if I don't burp her sometimes she spits up in bed.

Don't you wish babies had read the sleep instruction manual and were agreeable to following the instructions :p

[monopod]

Oh just thought of one more thing. I'd assumed that it wasn't a growth spurt as this had been going on too long but looking at my log I can see that it got even worse just under a week ago, so perhaps we might see a bit of improvement next week!

[monopod]

Just been reading about wonder week 19 (again; got the book with my son and mostly forgot about it till now)! Have you heard of it? There are definitely some 'oh yes!' moments there... Wonder if it genuinely is too good to be true that 'Once the baby goes through the developmental spurt, the sleep regression will be over.' ... If it is a long drawn-out developmental whatever I hope she reaches her end-goal reaaaaaaalllly soon!

[katie80]

LOL, there could definitely be some WW issues going on.  I'll hope she finishes soon too!   Yikes on the night, those are so exhausting.

Do you know what A times are typical for subsequent A periods for a 4 month old? If she's had a good nap in the morning after 2-2.5 h A time, I ought to be able to aim for at least 2h, right?

Yeah, I would think she'd be able to do about 2hr, at least.  Average A for 4mo is 1:45-2hr, so she seems on the high side.  But, if she can do 2-2.5hr in the morning and then do a good nap of 2hr or so, I'd think she could handle it again.

Props. I think we may still have a prop problem; not sure what your thoughts are? Although I am managing to get her down in her cot before she is out (and she has definitely shown that she can do it from fully awake) I am still finding that I need to BF before a nap.

It's hard to say, it can be different for all babies.  Since she can do the long naps, it seems as if she's capable of transitioning, so doesn't really have a prop issue, but the day and night can be different stories.  Does she transition for naps in the crib or are those always short ones?

At night does it matter whether I put her down awake or asleep, if I am endeavouring to get her down awake for naps and at bedtime?

Do you mean in the MOTN after you've fed her?

I'll try feeding at 4h intervals only today and see what happens; it surely can't be worse than last night!

Will be interested to hear how it goes.  I don't think you can tell anything off of one day though, it needs to be a pattern of at least a few days to a week.  And, remember that some BFd babies don't strictly go a full 4hr between feeds until they're started on solids, so you may still need to offer that top up feed 45min-1hr after the initial feed, but at least that won't be right before nap time.

On settling without a feed if it's been less than 3-3.5h since the last one, we've been trying that with PUPD but ahe just screams inconsolably, settles, then 10 minutes later she's up again (and repeat till she gets fed, whereupon she *usually* settles). Do you have any ideas? I'm wondering whether PUPD is the right option here, or whether I should just feed her and use a different method like gentle removal, single side feeding (I usually offer second side unless she's out).

This is tough.  Usually, if they wake again right away it does signal hunger or discomfort, but she likely doesn't need to be fed more often than 3-3.5hr.   Could it be that PUPD is a bit too stimulating for her?  Have you tried something more like shh/pat or just settling her in the crib?  Or, maybe stay with her after she settles with a hand on her for 15-20min to help her get into a deeper sleep.

I was also wondering about gas but find it hard to burp her at night. Either she doesn't at all, or holding her over my shoulder wakes her up and then she gets upset and wants the boob again, but if I don't burp her sometimes she spits up in bed.

By this age, I was able to just gently sit my two up on my lap, resting their side against my chest and rub their backs (either in circles or from bottom to top).  It was enough to get them to burp, but not enough to wake them.  It could definitely be discomfort that's causing her to wake so much.  No signs of reflux or anything, right?

[monopod]

Thanks so much for responding to my posts Katie! Wow, today was fun. I had all these good intentions but she had other ideas! After a great 2h 20 min morning nap I got her down for a second nap after exactly 2h A time, without nursing her, but she did consent to take her dummy for a few seconds to suck off some energy.

And then she woke 20mins later and I couldn't get her back down I tried BFing her but then she decided she was happy and would rather play! I gave up and gave her some really low-key A time then tried again as soon as she looked vaguely tired, but everything after that was a total disaster... She had two, get this, FIVE MINUTE naps which I again needed to nurse her for, until I BFed and held her to sleep for a full 1h 20mins at the end of the day in a desperate attempt to get her some sleep!! Tonight I had to nurse her to sleep again after several days of her being able to fall asleep in her cot without the boob.

Best laid plans and all that...

Sorry i woukd quote but I'm on my phone and can't seem to do it...

I don't know what was going on with that 20min nap in the early afternoon but it totally scuppered the rest of the day. Normally if she's OT she has a 30-35 min nap... Can't have been UT can it, after 2h A time?? She seemed tired enough!

I do think she has a problem transitioning in her cot. I don't think she's ever had a long nap there, although she sleepa easily enough in her snowsuit in her stroller and has also done long naps in the sling and in her Moses basket (ages ago; she's too long for it now). Maybe that's the prop issue... I would say movement, but she will sleep through in her stroller without me having to push it, so... i did wonder whether she was particularly snug in her snowsuit... Maybe she's cold?? Can't be though, she's positively sweaty sometimes!

Yes, I meant in the middle of the night after I've fed her

About PUPD, I do think it may be too stimulating for her actually. Trouble is, we didn't seem to be having any luck with shh-pat; she wouldn't stop crying at all. I already stay with her for the first 20min or so as she sometimes needs my help (I stroke her head and forehead)...

No signs of reflux, thankfully. I tried what you suggested tonight re. the burping but got nothing out of her despite the huge amount she ate just before bed!

Keeping my fingers crossed for tonight...

[monopod]

We're already getting off to a good start! She couldn't settle, I ended up nursing her again, she woke up after 40mins and I tried to soothe her in her cot to no avail; she was seriously fighting her swaddle so I took her out and put her in a sleepsack instead, she let off a lot of gas... Now it's not even 10pm and I am feeding her again!!

Maybe it is gas and the swaddle too... *frantically looks for culprits* Just ordered a convertible woombie that I hope will help her transition there...

[katie80]

(((Hugs))) hon, it seems like something else might be going on with all that trouble.  A 20min nap and then such little sleep the rest of the day seems like discomfort to me.  Is there anything you've eaten differently that could be causing her some gas/tummy issues?  No teeth working their way through (as if you need something else, right)?  I do wonder if she could go a bit longer than 2hr after such a long morning nap, but typically 20min is discomfort rather than UT.  You may want to start waking her after 2hr of a nap though, as Tracy did seem to think that a longer one can either throw the day off or take from night sleep (not after a terrible day, mind you, but maybe to start off the day, iyswim).

She might sleep better in the stroller because it's a smaller space and she's cozy in the snowsuit. If that's the case, I'd probably keep the swaddle.  I love Woombies, too!

Totally fine for her to fall asleep in the MOTN after a feed, esp as you're working on independent sleep during the day and BT.  Once she's got that down, the NFs should start taking care of themselves on their own and if they don't, it should be a bit easier to tackle them.  Again though, I wouldn't start feeding every 1-2hr, as that is definitely a prop issue (last night doesn't count... a night that bad is an exception).

As for shh/pat, you may just have to tweak it.  Some babies genuinely don't care for it.  You can stroke her forehead, pat/rub her thigh or tummy, lay one arm across her from hip to other shoulder and tap the shoulder, etc, etc.  If you think PUPD is too stimulating, try to find a way to just settle her in the crib.

FX for a better day found night for you!

[monopod]

Hello! Sorry for the delay responding 

No teeth, but possibly gas... not sure about whether it might have been linked to food I ate as I've had bowel trouble ever since the (caesarean) birth!

Yesterday we had decent naps, but unfortunately we seem to have gone back to nursing to sleep (though I don't feel as worried about this as I did last week as I *know* she can fall asleep independently). I kept the morning nap to 2h and finally managed to get her down for her next nap 2h 20 mins later; she woke after 35 mins though but I managed to extend it through BFing and she slept for 1h 25mins in the end. Catnap was in the car on the after-school club run, 35 mins. I got her to bed at a good time, but then it all kind of turned into a bit of a farce 

Basically she kind of dozed off during her bedtime feed, but awoke after I put her to bed. And then she decided that she did. not. want. to. sleep. From 1940 to 2100 (!) she alternated between being totally adorable and making these funny happy little noises in her cot, to getting yowly and complainy - only to go back to being all cute when I went to tell her in no uncertain terms that it was bedtime! I tried everything, leaving her to it (eventually cried but when I went to settle her she smiled sweetly and cooed at me  ), covering her eyes (she continued talking and then licked my hand!  )... Finally she was so tired at 9pm and really started fussing, and my husband made the mistake of taking her out of her cot, and then she had a bit of a meltdown and I ended up nursing her a few times before she finally went down properly at close to 11pm

She then woke at 2.20am and 4.50am and I fed her both times, before she woke for the day after 7.

Actually a better night than she's had for close to two weeks, but bizarre!

By the way, I think you're right, I think PUPD is too stimulating for her and she settles better in the cot (for me, anyway, my husband says it's the opposite for him; she screams louder when he leaves her in there), so we've abandoned that for the moment and I'm going to persevere with settling her with our version of shh-pat (involving mostly head-stroking).

Today we were out all day and she took her usual long morning nap in her stroller but I didn't manage to wake her in time as I was trying to get something to eat, so she ended up sleeping beyond 2h. Then she catnapped in the afternoon, 35mins after 2h 20min A time (probably OT?) and 1h after a further 1h of A time. She woke at 1640 and I tried to get her down for a catnap around 6 but she wasn't having any of it (smiling happily at me again) so I ended up abandoning the attempt. So we've got an OT baby on our hands again and she's just woken 45mins after being put to bed...

Might be a long night...

[katie80]

(((Hugs))), it sounds exhausting, but she sure does sound like she's full of personality.   Hope you got a decent night in the end.  Let me know how you get on...

[monopod]

Hi Katie Afraid we didn't have a good night for either of the past two nights, no! And baby had her jabs today so I'm not holding out much hope for tonight either...

I have, however, been thinking a lot. I've been trying to tackle things on so many fronts that perhaps I'm not persevering long enough with any single one. One thing that stands out to me, however, is that even when we've had good naps, we are still getting the night wakings a couple of hours after bedtime. I have also observed that if she gets through the first nap transition at 30 mins or so, she invariably doesn't make it past 45, and even if I've managed to get her to sleep independently at first, I often end up bfing to extend the nap.

Which makes me think that the nursing may well be more of a prop than I originally thought...

The other interesting thing is that last night, I fed her at 0110 and then she woke again crying at 0330. I didn't want to feed her again, but couldn't settle her back to sleep in her cot. She was quiet and alert but would cry every time I put her back down. I was exhausted so brought her to my bed, wrapped my arm around her and let her fuss. Lo and behold within 10 mins she put herself back to sleep without nursing...

She's just done exactly the same for this evening's catnap... She was crying and I lay down next to her and spoke to her calmly and held her close, breathing on her. She cried for a while but then just stopped abruptly, started talking to herself and then went to sleep sweetly and quietly, no nursing required.

Is this why parents co-sleep?? I don't want to replace one prop with something else I need to wean her off!

[monopod]

(Btw she did another 20 min nap after a 2h second A of the day and then refused to go back down so i do think she needs that second A time to be longer!)

[katie80]

Boo to the bad nights and the jabs... neither of those are fun.   You never know though, some LOs sleep better after their jabs, so don't count it out yet. 

Is this why parents co-sleep?? I don't want to replace one prop with something else I need to wean her off!

I don't know... it seems like most co-sleeping happens because it's easier to nurse/feed in the night, but it could also be due to closeness and comfort.  I think it's actually a good clue for you though, in how to settle her and you don't necessarily need to replace one prop with another.  I'd start using that when you try shh/pat with her and settling her in the crib.  I've known a few moms who've got down really close to their LOs while shh/patting and either put their face next to baby's or been close enough so that baby can feel their warm breath on their head.  This may help her settle initially and then associate shh/pat with going to sleep, so that you can gradually withdraw your closeness.  What do you think?

And yes, she could well need more than 2hr A before the second nap.  She seems to handle more than that just fine first thing in the morning, so she might just be a high A time baby.

[monopod]

So we had a good catnap this evening and we didn't feed to sleep tonight either Just put her to bed in her cot and didn't need shh-pat, just did as you suggested and practically lay across her with my face right next to hers so she could feel me breathing on her. I got kissed and licked a lot! Think I have a very 'sucky' baby... This is going to knacker my back though... But I feel positive about it Will stick with it over the next week as best I can and see how we go!

Also going to work on identifying that best second A time of the day

Thanks for all your help Katie, I really appreciate it!