SLEEP => General Sleep Issues => Topic started by: Amytheo on January 26, 2016, 09:59:47 am

Title: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 26, 2016, 09:59:47 am
My baby is nearly 5 months and has suffered from reflux. He hasn't ever slept longer than 2.5 hrs at night and his naps are only 40 mins. He has slept with me for the past 3 months since his reflux was bad.
He seems on the mend with his reflux now, medication works and he seems pain free. So I'm trying to get him in his cot (in his own room) and sleeping better.
So this is what's happened after 2 nights:
So 1st night I got him drowsy and put him down. He screamed so I kept picking him up, getting him drowsy and putting him back down. After 1.40 mins he fell asleep. he woke through the night as normal, I fed and put him back drowsy which seemed to work ok. First night looked like this:
Night 1: 1hr 40 mins 7-8:40
9:30 - 10:10 short feed
00:00- 00:50 long feed
1:40-2:20 - short feed
4:20-4:50 - long feed
6:50-8:30 - long feed in bed, cuddles, play and up for the day

Last night I did pick up/put down where I put him back down as soon as he stopped crying each time (night before I got him really drowsy each time I picked him up). It took 40 mins and 35 pickups but he was asleep by 7:30. He slept until 10 and I fed him and he went back to sleep. Great. Then he woke 40 mins later! I did pupd 25 times and he went back to sleep (didn't feed him) and he woke half an hour later! So I fed him and he went back to sleep. Woke 40 mins later!!! I fed him again and tried pupd but 40 mins later and 25 pickups he was screaming his head off.
 I gave up and put him in bed with me where he slept for 3.5hrs. It was 3:30 when I gave up. Am I doing it wrong or is this to be expected that he would be this bad to start with? Should I be putting him straight back down as soon as he stops crying or should I get him drowsy first? Can I just do it at the beginning of the night and forget the rest or is that pointless? I'm so confused!!

I'm so annoyed I gave up on the 2nd night but I was confused as to why he was waking way more than usual. I expected it to be bad to begin with but not for him to wake up every 30-40 mins through the night.
I wonder if I'm expecting too much from him. Should I just concentrate on getting him to fall asleep in his cot to begin with and put him back there through the night but forget the night time pick ups, just to get him used to being in his own cot. or is that counterproductive and it's all or nothing?

Does anyone have any stories where it was this bad to start with? The reason why I'm confused is everyone seems to say the start of the night is bad but they sleep for longer through the night straight off. Never seen anyone say they get so much worse through the night.
Title: Re: Bad sleeping all round and reflux. Help!
Post by: trimbler on January 27, 2016, 15:15:02 pm
Hi there (((hugs))) you must be exhausted! Please could you post your routine during the day, including feeds and naps, so we can look for any clues there? It may be that he's overtired or something else that could improve with a routine tweak...

Just something to consider with reflux LOs - PUPD can exacerbate reflux symptoms, so I think it's possible that he may be ok now generally but PUPD could be kind of shaking things up again and actually making him more uncomfortable - do you think that could be happening, from how he's reacting to it? Hard to tell from a distance, but not always straightforward to know close up either, I realise :-* Have you ever tried some form of shh pat, where you try to comfort him in the cot without picking up? You may find he gets on with that better, although some reflux LOs find the patting can be uncomfortable, so maybe just a hand on him or some other soothing physical contact which isn't having him in bed right next to you? Shush-pat - How to

As for whether it can be this bad to start with - I'd personally keep expectations low the first couple of nights, but I'd hope to start to see some improvement after that. Are you sleep training for naps too? If not, how is he currently getting to sleep for naps?
Title: Re: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 27, 2016, 23:23:53 pm
I'm in the process of changing his routine (what there is of one!) as he was on a 3 hour one but he no longer seems that interested in feeding so have moved onto 4 hours. So his new schedule that worked today is:
Wake 7am
S:9:15-10 (in bouncy chair, try to get back to sleep after 45mins but never works)
E: 11:00
A: 11:15-12:30
S 12:30 - 14:00 (have to resettle half way through - in cot)
A 14:00- 15:00
E: 15:00
A: 15:00-16:00
Cn 16:00-16:30
A 16:30-17:30
Cluster feed 17:30- 17:45
Bath, stories, feed and bed 18:00 (normally asleep by 7:30-7:45)
He then wakes randomly through the night.

I get him to sleep during the day either by rocking in bouncy chair, car, pushchair or holding him whilst standing.
I think the pupd was really hard on him and I'm not doing it again until I'm sure his reflux is ok. I didn't do anything last night and he woke really uncomfortable, in pain and he's been sick a lot today too. I don't feel right doing sleep training whilst he's like that, I'm not going to be harsh with him when I know he's in pain which means I can't be consistent so what's the point?
I would love to do shh/pat but the problem is he screams if laid down when he's awake. Because he went undiagnosed for weeks (long story!) he never wanted to be laid down as it was obviously really painful for him and so I think now he associates it with pain. No one can lie him down unless he's feeding (and then he cries when you do it until you put nipple or bottle in his mouth),on his playmat or changing mat. If you lay him down in your arms or on a bed, crib etc he screams and tries to pull himself up.
Having said that I did try doing it tonight and he lay there for a bit (on his side) and let me stroke his head and sing to him for about 5-10 mins and then just started crying again! So I think he is getting better but it's a slow process.

It's just so frustrating as I know I have developed bad sleep habits (and continue to do so) but I don't know what else to do when he's in pain so much. Every night I think I'm not doing it right and it's going to be hard to break these habits but whenever I then try and do any sleep training I feel so guilty as I'm thinking is he in pain and this crying is making it worse?
Title: Re: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 28, 2016, 08:32:37 am
I missed out a feed at 15:00!
Title: Re: Bad sleeping all round and reflux. Help!
Post by: trimbler on January 29, 2016, 14:09:19 pm
I've put it in for you ;) You can always go back into your posts to edit, just click 'modify' and hit 'save' when finished ;)

(((Hugs))) it is really hard with reflux LOs :-\ I'm pretty sure in hindsight that my DS had reflux but I didn't have the confidence to keep pushing when my concerns were dismissed the first time. So much better with DD who was medicated from around 3mo. What's your DS on? Have you seen a doc recently re his reflux? Do get him checked out, it may be that a change of meds would help or a change in dose. You're absolutely right, you can't really sleep train when he's in pain, but it may be that there are particular times of the day when he's a bit better and can handle some shh-hand/stroke/whatever helps him.  I know what you mean about associating lying down with pain, I've definitely seen that in my LOs as babies. Have a read of this for more ideas: Sleep and the reflux baby.

As for the routine - I can't help wondering whether the first nap may be a little UT? Have you tried pushing that first A time a little, to try and get a longer first nap? I suspect the second nap is OT after the short first nap, but great that you were able to resettle. It may be that he needs around 2.5h A time before both naps - or a little less before the second if the first nap was short - does that make sense? It looks like he takes a long time to get to sleep at BT? What's that like? Is he screaming? Chatting/playing? Wanting to feed? Lastly, just wanted to mention that you don't have to keep the feeding intervals exact. If he's really not interested until 4h then it's fine to wait until then before offering, but you may find you get on better with 3.5h sometimes - just want to give you the freedom to be flexible with that :-* Especially since reflux LOs tend to get on better with slightly smaller, more frequent feeds compared with other LOs of a similar age.
Title: Re: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 29, 2016, 18:35:09 pm

Thanks for the reply. He is on ranitidine for his reflux. His dose is the highest it can be for his weight and he gets weighed every two weeks. I have a paediatricians appointment in a few weeks but he'll be weaning by then so may be a little late.
He is such a trooper with the reflux, a really happy baby but you can tell he struggles. Everyone that holds him comments that he tenses a lot randomly and he is always chewing his mouth.

The routine is very early days (only 3 so far) so it's trial and error at the moment. The first nap he falls asleep within a couple of minutes which is why I thought it was the right time but maybe not?
The second seems to be the same too, today he was asleep within 5 mins and slept for an hour at 12:30. He has a tummy bug at the moment and I've been told to feed him little and often to ensure he stays hydrated so I fed him back to sleep at this point and he slept for another 45 mins.

His bedtime is the worst to get him to sleep. I feed him to sleep (something I want to change but struggling with the technique due to reflux) and he always feeds for about 5mins and conks out straight away, practically comatose! He then wakes ten mins later and then carries on feeding on and off for about 40 mins and then lies on me for a bit longer before finally falling asleep.
I've tried doing later and early bedtimes and he always ends up falling asleep at around 19:30-19:45.
So last night I gave him a feed at 6pm downstairs and he did the comatose thing then. When he woke he was grizzly so we did bath and bed straight away. I started the feed to sleep at 19:10 and he was asleep by 19:40.
So I think he is OT but needs a CN and then BT at 19:15 rather than 18:30.

So today oue day looked like this, but bare in mind he has a tummy bug so the eating is out:
E: 7.30
A: 7:30 - 9:30
S: 9:40 - 10:15 (10 mins to get to sleep and couldn't resettle, tried for 40 mins before giving up)
E : 11:00
A: 11:00-12:15
S: 12:30-13:30 (10 mins wind down with books and 5 mins to get to sleep)
Feed to sleep: 13:30-14:45 (fed for half an hour before sleeping)
A: 14:45-17:00
S: 17:00 - 17:30
E: 18:00 (yesterday he did the comatose thing at this time but today didn't, presumably as I managed to get him to nap at 17:00)

I'm planning on doing bed time at 19:15 and seeing if he goes down more easily tonight. He fell asleep really easily at 17:00 too which is why I think 2hrs15mins seems to be his best window but do you think I should push it to 2.5hrs to see if he sleeps longer?

I forgot to mention that he also slept until 22:00 last night, longest he's gone in the evening for a while which is great. But he then did his usual every 2-2.5hrs through the night! When he does wake he always wakes crying a lot and falls back to sleep very quickly if I feed him, unless he's straining and struggling with pain but even then he sleeps really quickly once he's calmed down from that.
Title: Re: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 29, 2016, 20:28:39 pm
Arghhhhh! That bt was a nightmare! DP did bath time at 18:30 and was done by 19:00. DS winged as soon as I sat down for stories so just did one and then started feeding to sleep. At 19:15 his eyes suddenly pinged open and looking around. Managed to get him drowsy again but then it turned into how it normally does at bt and it took another 50mins for him to fall asleep. Wondering if we did it too early and I should have pushed it all back by 15mins so we were doing the same time as yesterday.
Title: Re: Bad sleeping all round and reflux. Help!
Post by: trimbler on January 30, 2016, 15:18:18 pm
Aw poor thing - I really would ask about different meds then, there are stronger ones than Ranitidine and if it's not keeping the reflux symptoms under control properly then he'd probably benefit from trying something else. Don't let anyone tell you he doesn't need meds after 6mo or weaning, etc, many LOs do as reflux can continue much longer than that.

Ok sorry need to get my LO from nap now, will be back later :-*
Title: Re: Bad sleeping all round and reflux. Help!
Post by: trimbler on January 30, 2016, 20:14:04 pm
Ok I'm back now!

Looking at your routine I still think a push in the morning A times might help - it's quite usual for LOs to be able to fall asleep easily at an A time they're used to, but which is still not quite long enough to enable them to have a nice long nap. Some LOs need pushing very very gently, taking lots of care not to let them get wound up - my DS only ever managed a push of 5mins at a time! But others seem to take it in their stride, you may well have a good feel for what yours can handle, so go with that, but do try a little push. It may well be that 2h 15mins is still right for him later in the day, especially after a short nap or two - that would be quite normal to reduce A times as tiredness accrues during the day.

Now as for BT, I think you're right that he's tired enough to sleep then but hasn't quite accrued enough A time during the day to be ready for night sleep, if that makes sense? So on those grounds I'd also be suggesting a push in A times, which could help with that if it works... And then maybe as you say, pushing BT a little later too, but that will depend a little on how much A time he's had during the day. It's a bit hard to judge but looking at what you've posted so far, it seems he needs at least 9h A time during the day, perhaps a bit more? Time spent resettling or feeding to sleep you may want to count as worth half of the A time when he's properly up, so you could consider that when working it out. You may not find that useful, I just mention it as I find it useful personally to have an idea of how much A time my LOs need over 24h (or conversely how much S time they need!), as this is likely to stay fairly consistent over a long period of time, whereas A times and naps etc will change rapidly, as I'm sure you've already experienced!

Poor thing though with the tummy bug and all that :( IME those multiple wakings at night with lots of crying often have meant discomfort of some sort - I suspect the reflux, it could of course be teething and/or the stomach bug too, actually reflux tends to flare up with teething as well :-\

Does that make sense? Sorry I feel I'm rambling ::)
Title: Re: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 30, 2016, 21:36:01 pm
I'll try pushing the morning nap so a time is 2.25 and see what happens. His routine today was this:
E: 7:10 (fell asleep again so gently woke him up at 7:30)
A 7:30-9:20 (got really wingy)
S 9:25-10:00 (woke up crying which is unusual for this nap. Tried resettling and feeding but wouldn't go back to sleep)
E 11:00
N 12:00-12:45 (got wingy again and thought he'd be OT after short morning nap. He woke up smiley and bright eyes, wasn't going back to sleep!)
N 14:15-15:00 (went for walk after short nap to see if he'd go again and got another 45mins)
E 15:20
N 16:45 - 17:15 (again was  wingy)
E 18:15
Bath and bed 18:45 (started feed to sleep at 19:15, was asleep in 20 mins but I didn't believe it could be that quick so I waited before putting him in cot then he woke up when I did so had to resettle! So didn't leave him asleep til 20:15!)

I've only put eat and nap times in as everything else is activity time!
I do think I should be pushing the A time maybe. He got wingy at about 17:45 today but I managed to distract him and by 18:15 he was laughing and playing again so I think I may be misreading his bored winges as tiredness in the morning (think it helped Db was out as he always automatically says he's tired or hungry if he starts whinging!)

I'm going to make a gp appointment on Monday as my sister pointed out today that it's unusual that he wakes regardless of sleeping with me or in his cot. Plus although the average is 2.5hrs, its more random then routine (eg last night is 1h50,2h30,2h40,1h10,50mins) so don't think it's sleeping cycles or habitual times.

Thanks for your help with this, I don't feel so "lost" anymore
Title: Re: Bad sleeping all round and reflux. Help!
Post by: Amytheo on January 31, 2016, 07:33:27 am
Something that I haven't mentioned is that until very recently he wasn't getting up in the morning until about 8:30. He would wake at 7ish as if it was a night feed and fall straight back to sleep and then wake very happy and smiley at 8:30.
I've been waking him at the 7ish feed but do you think I should just go with his natural wake up time and have a late bt 12 hours later? The reason I started waking him was that I realised it was probably not realistic to expect him to go to bed at 18:30-19:00 when he wakes at 8:30!
Title: Re: Bad sleeping all round and reflux. Help!
Post by: trimbler on January 31, 2016, 19:08:30 pm
That's interesting - if you're happy with a later WU and later BT there's no reason why you can't do that - we went with 8am WU for a little while since it was the only way I could work out how to fit naps around preschool runs. Some LOs can be nudged into starting their day earlier or later, whilst others seem to have stronger biorhythms of their own, so if you feel that you're really working against him by waking him at 7am, by all means let him sleep and start the day later - as you said, that will mean a later BT... But come to think of it, perhaps that's what he's been telling you all along that he prefers?

Glad you've decided to book the appointment - really hope it's useful, have a read of this if you get time beforehand: Reflux 101 - General reflux information

I think you're probably right about his whinging, as LOs get older they kind of get more complicated in their needs and wants, it's no longer just about hunger, tiredness or discomfort, but boredom or a need to change scenes comes in. See how you go with stretching those A times then and having a later day, and keep us posted :-*