Author Topic: Sleep problems and other complications for a 15 month old - desparate  (Read 1109 times)

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Offline tanuja

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Hi all,

This is my first post on this website and would really appreciate any help and advice you can give me. I am warning you now that this will be a long post.

My son is 15 months old and is a spirited but happy and outgoing child.  Unfortunately we (particularly I) have done a lot of accidental parenting and he has never slept through the night and he has never really learnt to fall asleep by himself. He tends to almost always fall asleep either on the breast or bottle.  He wakes up at least once but usually at least twice a night and lately does not go back to sleep easily (staying up for about an hour for 1 of the night wakings).

I have to also tell you that my son vomits very easily and tends to vomit at least once or twice a week. I have tried crying it out once when he was around 10 months for 10 mins and he cried and cried so much that he vomited and I never tried it again.  He is also not a great eater (but is getting a bit better) he used to make a big fuss to eat and now he tends to eat a bit better but in order to get him to eat his solids we tend to have to starve him during the day and give him very little milk, so in order to make sure that he gets enough milk I tend to have to dream feed him still at 15 months. 

Below is his usual daily routine and milk intake:

7.00 - 8.00am - Wakes up
8.00 - 8.30am - breakfast (usually baby cereal with about 100mls of milk)
12.30/1.30pm - lunch
1.30/2.00 pm - has 180mls (but usually only drinks a max of 150mls) down for a nap (usually lasts  1.45hrs - 2.5hrs)
6.30/7.00pm - dinner
7.00/7.30pm - bath, massage, pj's, 210mls milk (will usually only drink about 120 - 150mls)
8.00/8.30pm - sleep
11.30pm - dream feed (120mls - usually drinks about 100mls)
between 4.00 am - 6.00am - wakes and has a 120 ml feed (usually drinks about 100mls) and then usually goes back to sleep

I have tried a combination of the gradual withdrawal and pu/pd technique for the last week and have had very little success.  THe first night i did it for 2 hours from 3- 5am and then he finally went down at 5.00am and slept till 7.00am. I mainly did pd and only picked him up when he really really cried as I was scared that he would vomit.  The second night I tried pu/pd and gw from 5.20am till 7.00am and he didn't go to sleep so I then took him out of the cot at 7am. The next 2 nights he was a bit better and got up once sometime around 4-5am and had a very wet nappy that leaked through (so I thought this was the reason he woke up and was celebrating my success with the pu/pd & gw) and I gave him his milk and he either fell asleep while feeding or went down very easily. But since that time for the last 3 nights we have gone back to doing pu/pd and gw for at least 1.5 - 2 hours.  Tonight has been really bad since he didn't fall asleep when I gave him his milk on the rocking chair I tried to put him down while he was still awake he resisted and wriggled as usual and then started crying and after a while he started coughing and threw up and after trying a few more times to put him down I relented and held him & rocked him in the rocking chair till he slept.  He then woke up 2 hours later and then it took me another 30 mins to put him back down to sleep and he would not let me put him down in his cot until he was totally asleep.  But I think he might be coming down with a cold today as he has been sneezing a lot so this might explain today's behaviour.  So I think i might have to stop with the pu/pd technique for a few days if he is sick.

My questions -

1. What should I do about the night wakings (keeping in mind that he vomits easily especially if he cries a lot and/or coughs)?
2. Should I stop the dream feeds and feeding him between 4-5.30am in the mornings (but he does drink the milk and if I give him more milk in the morning then he won't eat his food)?
3. What should I do as our night time or wind down routine - currently for nap times it is to rock him in the rocking chair and hold him and give him a bottle and he usually falls asleep quite easily. At night I give him a bath, then a massage, put on PJ's, turn off lights and rock him in the rocking chair and give him his bottle and he will usually fall asleep quite easily.
4. how do i stop feeding him to sleep and how should I time his bottle feeds and what quantity should i give him so that they don't interfere with his solid food intake (- see his usual routine above) but still allows him to get the minimum recommended amount of milk ?
5. What should I do when he is sick etc so that we don't go too far off the track - since i have already done 1 week of g/w and pu/pd I don't want to have to start all over again despite only having limited success.


Thank you so much for reading my post and for any advice that you might be able to give me.

Offline deckchariot

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Re: Sleep problems and other complications for a 15 month old - desparate
« Reply #1 on: March 12, 2009, 01:47:32 am »
{{{{{hugs}}}}} for being so brave to start with BW now!  You won't regret it, and we will be here to support you along the way.

The first thing I notice is that he is getting plenty of milk - he's at the upper end of what's recommended for bubs over 1 year - check out this link:  http://babywhispererforums.com/index.php?topic=67569.0 so I would definitely look at eliminating those dfs - without them, he's still getting about 370 mls of milk (including what's in his cereal), and that's fine.  I suspect those have contributed to the prop issue of needing the bottle to sleep.  I know lots of moms who eliminate the night feeds by watering down the bottle - eventually, your bub won't wake for just water (or you can just leave a sippy cup of water in the bed).  Also at his age, those night milk feeds can cause problems with tooth decay, so there's another reason to let them go.

If he is sick, I'd put your sleep training on hold for the most part.  My dd is a great independent sleeper, but even she needs some extra help when she's ill.  You could use that time to work on the night feeds and then that's one less thing to address once he's feeling better.

I'm also wondering if his nap is too late.  It looks like he's getting 6.5 hrs of A time before that nap, and that's pretty long for a 15 mo.  My dd is almost 2 and she barely makes 5.5 hrs of A time.  Also, if he's going down around 1:30/2 and sleeps 2.5 hrs, that's a pretty late nap to then turn around and go to bed at 8/8:30.  Many mums find that routine with 5.5 hr of A time and a 1.5 - 2 hr nap, and another 5.5 hrs of A time works well for their bubs.  If your guy has often needed more sleep than average (and my dd is like that), you can shorten those A times, but I'm wondering if balancing out your day a bit more might help with the sleep training.  If he's OT for the nap, but UT for bedtime, that's not going to make sleep training any easier (and may be part of the reason the bottle has become a prop, because he's not in his optimal sleep window).  So I'd move his nap earlier in the day.

Gradual withdrawal is definitely the way to go since he's used to you as a prop.  Have you checked out this link:  http://babywhispererforums.com/index.php?topic=80750.0  Since it's both the bottle and the rocking that is a prop, I'd start with the bottle first - separating it from the sleeping, but go ahead and still rock him to sleep (just without the bottle).  He's had 15 mos of going to sleep with rocking and a bottle, it's going to take some time to teach him a new way, and by doing too many things at once, you can actually make it harder on you (and him).  So I'd change up your winddown routine so the bottle comes earlier - even if all you do after you feed the bottle is change his diaper, rock to sleep.  Do something.  This can be a great time to start some new wind down habits - reading a story.  So he gets his bottle, and you do whatever you can to keep him awake during it, then after the bottle - change his diaper (or here is where you could put on his jammies), then back in the chair, read a story, rock to sleep.  Eventually, I think you'd want to offer the bottle before you even start the winddown (my dd gets milk with lunch and with dinner - so both before her wind downs) - so just keep moving it earlier in the routine, but still go ahead and rock him to sleep. 

Once you've removed the bottle from the wind down routine, then work on the rocking.  Rock him til he's drowsy but not asleep, then put him in the crib.  If you can lower the side of the crib so you can sit in there with him, do that.  Comfort him however you can while he's in the crib.  I wouldn't do pu/pd at his age - he's too big.  So if he stands up, lay him back down, cuddle him (while he's in the crib), rub his back, hold his hand, experiment to find something that will calm him in the crib.  Then you will gradually do that less, til he can go to sleep in the crib with you right there, but only using your voice.  Then you will gradually move yourself further away from his crib and out the door.  This will not be a quick process.  But try to think of it from his perspective - for 15 mos he's gone to sleep another way.  He doesn't know how to do things differently, so you have to teach him, but it's going to take time.

hth
michelle
Michelle




Offline tanuja

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Re: Sleep problems and other complications for a 15 month old - desparate
« Reply #2 on: March 12, 2009, 06:59:51 am »
HI Michelle,

Thank you so much for your advice, it means so much to me as I was really at the end of my tether and I work part time so  I have been going to work with less sleep than usual. Last night was pretty bad he woke up a total of 4 times but he was sick sneezing and having a very runny nose and he wouldn't let me put him back in his cot/crib so finally at 4am I gave him his milk and took him into bed with him (the first time in months) where he slept restlessly till 7.30am but at least he slept.  As you suggested I will put sleep training on hold for a bit while he is sick and work on his night feeds instead till he gets better. I will also try to give his milk a bit earlier.  I have been worried about giving his milk too early after his food but it sounds like it would be ok. 

My Dr and others have said that I should be trying to give him a minimum of 600mls of milk and hence why I have persisted with the night/dream feeds but I will try to cut this down and also try to up his daily milk though he rarely finishes what we give him now anyway.  I will also read him a book and rock with him on the rocking chair as the last step in our wind down process and see how that goes.

Finally I will move his nap time to either 12.30  or 1pm about 5.5hrs after he wakes up and see how that goes.  Then once he is all better I will do the gradual withdrawal and focus on getting him to sleep independently.

I will keep you updated with our progress. Once again thanks so much for such a comprehensive response. I really appreciate it.

Tanuja

Offline deckchariot

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Re: Sleep problems and other complications for a 15 month old - desparate
« Reply #3 on: March 12, 2009, 16:26:12 pm »
It sounds like you've got a great plan - both for now while he's sick and then when he's better.  If you've got someone else at home who can help too, that will be great for night/naps when you just need a break.  I'm sorry he's feeling poorly, that's miserable for everyone!  Please do let me know how you get on!
Michelle




Offline tanuja

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Re: Sleep problems and other complications for a 15 month old - desparate
« Reply #4 on: March 21, 2009, 19:58:26 pm »
Hi Michelle,

Thank you so much for your understanding, encouragement and very helpful advice.  Here is our update.

My son did get very sick and is now on the mend thankfully. While he was ill we worked on his feedign to sleep.  So now he has a bath and then milk then a few stories and is rocked to sleep.

I have also moved his naps so that they are after about 5.5hrs of A. this seems to help a little with the night sleeps.  But now sometimes he naps for 3-3.5 hours.  Should I wake him up after 2 hours or let him sleep for 3 - 3.5 hours which means his bedtime is much later or I put him to bed after 5 or 4.5hrs of A.

I have also watered down his night feeds a little and stopped dream feedin ghim but wait till he wakes up. I have tried not giving him the bottle but he will cry till he gets it.  He is still drinking the whole bottle though even though it is slightly watered down. I will keep watering it down more and more though over a few days.

I am almost ready to try the gradual withdrawal since he is almost all better. i have tried it a few times but with no success so far. I have rocked him till he is very very drowsy and almost asleep and put him in his cot/crib and patted him. he always wakes up straight away and cries and wants to be picked up or he wakes up completely and then plays in his cot for 10 - 15 mins till I pick him up and rock him to sleep again. What should I do about the gradual withdrawal?

Oh and by the way I have always slept in the same room as my son. He sleeps in his cot/crib and I sleep on the bed which is on the opposite side of the room.

Thanks as always for your advice, I am extremely greatful.

Tanuja

Offline lilflav

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Re: Sleep problems and other complications for a 15 month old - desparate
« Reply #5 on: March 21, 2009, 21:33:42 pm »
Hello, I just wanted to throw a suggestion out there for the gw- what I did to wean from the rocking was I rocked & patted, then phased out the rocking & just patted. I also patted while I was putting dd into the crib.  That way it isn't such a break in motion & he will get used to falling asleep in the crib.  Also some los don't like the patting, so rubbing or just placing your hand works better (especially for spirited ones so I hear).  Just go by your instincts & his cues.

Offline deckchariot

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Re: Sleep problems and other complications for a 15 month old - desparate
« Reply #6 on: March 22, 2009, 01:48:21 am »
Tanuja - it looks like you have made some progress!  I'm glad he's feeling better.  Yes, I'd keep watering down that bottle and see what happens.  Well done on waiting til he wakes also, and on moving the nap times.  If he's sleeping 3+ hrs during the day, you could either wake him earlier or put him down after less A time and see if he'd sleep.  My dd has a longer A time before her nap than after, and that works really well for her.  3 -3.5 hrs is a long nap, but some bubs need it.  My dd took a nap that long at that age as well.  She'd have 5 hrs of A time before the nap and 3.5 before bed time.  So if you want to try putting him down earlier for a few days and see if that goes ok, I'd do that first.  If you find that messes up your night even more, then I'd start limiting the nap and moving bedtime earlier.  It's really up to you and what you think will work better for your guy.

Lilflav has fantastic advice on the gw with phasing out the rocking and introducing the patting/rubbing instead.  And she's been there done that, so I'd trust her on that one :)

hang in there!  You can do this!!
Michelle