Author Topic: Please Help! 9 month old nurses to sleep, several night wakings, has had reflux  (Read 1110 times)

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Offline Aapppffff

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Hi All

I'm really desperate for help! My LO is 9 months next week and had silent reflux since birth - which we only discovered at 6 months old, so have only been able to do anything about it since then.  Was told before she was just "a baby who doesn't sleep" which I refused to believe!

I digress...Due to the reflux, the only way I could get DD to go to sleep (as lying down caused discomfort) was to nurse her to sleep, and after 6 months of virtually no naps and poor night sleep I was willing to do anything to get her to sleep. I knew I was setting myself up for a hard ride later on but I had no idea how hard. On reflection, I still wouldn't do anything differently as getting any sleep was so important....

Anyways, DD would only nap for 30 minutes (scientific reason is that stomach contracts 30 and 90 minutes after food to move food along, this causes reflux in babies with weak sphincter muscle) then wake in discomfort. Since she was 6.5 months, I started to put her down on her tummy and suddenly we got 1.5 hours sleep - result! So since then, she has been having typical naps of 1-2 hours.

Our routine is 'loose' to say the least, completely determined by what time DD wakes in the morning. I’ve completed the full set of questions below but include 3 days from this week as examples of routine. Generally speaking, between 1:30-2:30 hours after waking DD goes for morning nap, then 3 hours after nap to afternoon nap and then 3-5 hours in the evening to bed time.

• How old is your child? 9 months

• What’s his/her daily routine?
TUESDAY (starting late Monday night)

23:45-03:30   Sleep
03:30-03:45   Nurse
03:45-08:20   Sleep
08:30-08:50   Wake & nurse
08:50-10:00   Activity
10:00-10:50   Breakfast followed by Activity
10:50-11:00   Nurse
11:00-13:00   Activity
13:00-13:30   Lunch
13:30-15:30    Activity
15:30-16:00   Sleep (in carseat)
16:00-16:20   Nurse
17:00-17:10   Nurse (DD showing  signs of tiredness & wanting to sleep)
17:10-18:00   Activity
18:00-18:30   Dinner & Wind-down Activity (typically sitting with Dad on sofa)
19:00-19:30   Bath
19:30-19:45   Nurse
19:45-20:40   Sleep
20:40-21:00   Nurse
21:00-02:30   Sleep

Wednesday
02:30-02:45   Nurse
02:45-05:00   Sleep
05:00-05:30   Wake & BF
05:30-06:30   Activity
06:30-06:45   Nurse
06:45-08:20   Sleep
08:20-08:50   Activity
08:50-09:15   Breakfast
09:15-10:00   Activity
10:00-10:20   Nurse (DD showing signs of tiredness & wanting to sleep)
10:20-11:00   Activity (I gave up trying to get her to sleep)
11:00-11:10   Nurse (DD showing signs of tiredness & wanting to sleep)
11:10-12:30   Activity
12:30-13:00   Lunch
13:15-13:30   Nurse
13:30-14:40   Sleep
14:40-17:00   Activity
17:00-17:20   Nurse
17:20-17:50   Sleep
18:00-18:30   Dinner
18:30-19:30   Activity with Dad
19:30-20:30   Bath
20:30-21:00   Nurse
21:00-21:30   Sleep
21:30-21:45   Nurse
21:45-23:15   Sleep
23:15-23:35   Nurse
23:25-01:00   Sleep

Thursday
01:00-01:15   Nurse
01:15-03:45   Sleep
03:45-04:00   Nurse
04:00-07:30   Sleep
07:30-07:45   Wake & nurse
07:45-09:00   Activity
09:00-09:30   Breakfast
09:30-09:50   Nurse (DD showing signs of tiredness & wanting to sleep)
09:50-10:20   Activity (I gave up again, DD struggling to settle, not comfortable, wind? Teething?)
10:20-10:30   Nurse
10:30-12:00   Sleep
13:45-14:00   Nurse (DD showing signs of tiredness & wanting to sleep)
14:00-15:40   Activity (had friends round)
15:40-16:00   Nurse (DD showing signs of tiredness & wanting to sleep)
16:00-18:00   Activity (I gave up again, DD struggling to settle, not comfortable, wind? Teething?)
18:00-18:30   Dinner
18:30-19:00   Nurse (DD showing signs of tiredness & wanting to sleep)
19:00-21:15   Activity – not true activity but sitting with DD in bedroom, trying to get her to calm. She was struggling with trapped wind. Involved some abdominal massage etc
21:15-21:45   Nurse
21:45-01:30   Sleep

• What’s nap routine? Nurse to sleep

• How long are naps? Generally have had several weeks where we had morning and afternoon naps of 1:00-2:00 each

• What's bedtime routine? Time? After dinner, gentle chat with dad as wind down and also important to stay upright due to reflux, bath, nurse to sleep, if isn’t settled after bath, will have storytime as well to help relax or some gentle baby massage to help move trapped wind.

• Do you bottle or breastfed? Exclusively BF (have given DD 2 bottles of formula ever, trying to see if it would help her sleep whilst in car but not successful!) Also, may use more in future as DD will not bf anywhere but the bedroom (not even in the lounge)

• How much? or how long? 10-15 min each feed

• If breastfed.. one side or both?? (at each feed). Both sides offered, sometimes only one taken

• How many wakes per night? Best nights have been one wake between 2300 and 0600, normal night 3-5 waking a per night

• What’s your LO like when waking at night? How long is he/she up? Stays settled and sleepy, immediately wants boob and then falls back asleep quickly.  If I move her off boob too soon she wakes and wants it again. Feeds for 15-20 minutes at night.

• When you go to him/her is she fussing or crying? Or is it a mantra cry? Generally don’t let her get to crying stage as is in the same room as me and DH and therefore don’t want to wake everyone. But if I leave her she will start to cry a lot, wake up properly and be up for up to 2 hours.

• What have you tried to settle? Pat, shh, reassuring talking to her. Sometimes this has worked (like tonight for the 2nd time ever after 30 min sleep)

• What do you do for A time and how long is it? A can be hours, but I try to vary the toys she is playing with. DD will spend time in her walker beside me in the kitchen before each meal, time on her playmat with different toys, time with me singing and dancing and standing, or drives and walks around the local village, errands etc.  Get out of the house at least once every day.

• Are there developmental issues such as teething or milestones? Yes but we’ve never been in a settled routine for sleep not to be an issue

• Have you introduced cereal? Why, how much, and how many times a day? (for LO’s under 6 months) No. DD does not have any grains or complex carbs as she cannot digest them (please do not recommend anything else on food as this is not the problem, in fact things have been better since removing grains from our diets, I have done much research in this area)

• Do they have a prop? If so what is it? Boob. Have been trying to introduce a familiar bottom pat whilst nursing. Also uses dummy, has been a life saver due to reflux - helps keep saliva moving down her throat rather than up...

• Do they have a lovie? No, but have been trying to introduce a teddy at nursing to sleep time which sometimes results in playtime rather than sleep…Also use Euan the Sheep playing some music as sometimes helps to settle DD.

So sorry that I’ve given such a long post, but could really do with some help.  I totally do not want to do CC or CIO at all.  We tried today to do PU/PD with my husband but DD was crazy crying after 40 minutes. She wasn’t uncomfortable etc, she just wanted me (and boob) and worked herself into a tizzy. I couldn’t cope myself with crying any longer.

Hopefully there’s some hope….we have on 2 occasions had 7+ hours sleep (or she has, I woke checking on her!)

Thank you in advance.

A x
« Last Edit: October 21, 2013, 00:46:01 am by Aapppffff »
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Offline TB9

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Hugs hun, dealing with reflux can be tough :(

So my big question is do you feel like her reflux is under control?  Is she currently on any reflux meds, and if so what medication and dose and how much does she weigh?

Offline Emami

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Hi hun, sorry you're having such a rough time.  My first thought reading this is that she is extremely OT.  I know you don't have a consistent routine but from the 3 days you posted it looks like she is getting some really long A times and only one nap a day.  Im not seeing any days where you have am and pm naps of 1-2hrs each like you said? The best nap she had was 1hr30 on Thursday when she had a 3hr A time in the morning, so I would go with that as a starting point and try to get a good am nap.  Hopefully if she's well rested in the morning it'll be less of a struggle to get her back down in the afternoon.

I don't have any experience of reflux so all I'm going to say about that is do you think she is comfortable now and the meds are working?

Wrt relying on the boob, have you seen this?
Gentle Removal Plan
It might be a good place to start with how to break the feeding to sleep association.  Breaking the prop and getting her more daytime sleep should help with the NW and you will all be better rested!  It's going to be hard but if you're ready to do it then there will be plenty of people here to hold your hand. 
Emma






Offline Kempy66

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Hi As another parent of a refluxer (my lg is 9.5 months) I would say, if she is on meds, your doing all you can, its horrible and frustrating but their is nothing more you can do.  You are right when you say how important sleep is, and when we were in the early stages of reflux or colic as some dr's called it...we did anything (even bouncing on a gym ball for up to an hour, dragging her around the floor on a change mat ....it seemed to work at the time!)!!!

but what changed for us was when we attacked the self settling issue. However, you go about it (there are many ways) ....yes at first it will be hard and you will want to feed her to sleep as you think...she will be overtired, she needs to sleep etc. but it its hard short term for long term gains.....FOR HER!!! the sooner she can self settle she will get better quality and more sleep.

my lg started sleeping much better after we did some self settling, but the big thing was when I STOPPED feeding her cold turkey at night at 7.5 months. 3 nights later she was sleeping through. she wasn't even distressed or seemed hungry. she was using me as a dummy, definately.its not everyones choice, but I was advised to by HV.....and to be fair it worked!!

good luck!

Offline Aapppffff

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Thanks for the replies. On reading my first query you're right that there was no "usual" days which is why I was so overcome with emotion and exhaustion at the weekend!

However, Monday morning I made sure lo slept in the morning and that made afternoon sleep better, same on Tuesday and we've regained some of the ot ground I think as lo is much more settled in herself again. Yesterday's schedule is detailed at the end of this post.

I have the reflux under control. Not using any meds other than gaviscon when needed as I've been keeping a detailed food diary and know what to give her or not and same re my food.

This weekend we are going to start formal sleep training and removal of boob. I'm just getting some rest myself ahead of it.

However, I do have some questions that I've not been able to find answers to on any forum pages or either BW books...

1. What is best time to start sleep training? Night time or morning? Only that I know if I start in morning DD is very likely to go all day without napping at all not even 5 min. Just the book says keep doing PU/PD for full nap time and if baby only sleeps for 10 min then ok, still wake her up and stick to the routine. However, what do I do in the case of no sleep? Do I stop trying and stick to the routine, so it's lunch time then continue the day in total over tiredness? Or do I keep trying to get lo to sleep?

Then when we do PU/PD at all lo will wriggle, arch her back, fight, hit out etc. If I put her down she will get even more upset (yes that's possible!) and do her really upset cry which I've never managed to calm her from other than feeding or maybe taking her out of the bedroom to have some play time... as she gets herself into a blind rage and panic and it's no longer about being tired.  How should I deal with this because I find it extremely upsetting.

So that I know what I'm getting into, am I basically going to let her get so tired that she eventually gives in (perhaps after 24 hours ???!!!) then repeat until the hours awake drop? On PU/PD I'm not sure I'll ever get her to quiet enough to do a PD

If I want to go out either for walk or in the car, should I do it during A or S time? Especially when lo hasn't slept she is likely to fall asleep in the car. Then if she falls asleep in the car do I just wait until she wakes or wake her when I get to destination (usually only 10-15 minutes from home)???

Also, her bed has been in our room since she was born as it's been easier for me with night feeding and reflux etc. And her cot set up like a bed nest so that I've had the benefits of co sleeping with lo in her own bed. Should I put her bed in her room at the same time and starting the sleep training and not have to face another problem later on? She is familiar with her own room as we dress her in there and have some playtimes in there too.

And the book says a 4 hour EASY. However, what I cannot figure out is when should baby get milk versus food?? I'm still primarily bF and want to continue as long as possible.

Sorry for all the questions but I really want to do this once and do it right!

Thanks a million. Looking forward to getting some suggestions as to what my plan needs to look like (and how full my freezer needs to be for my own sustenance!)

Ax

0600 wake & BF
06:00-07:30 A
07:30-07:45 E
07:35-08:20 S
08:20-10:30 A with try for breakfast at 09:00 but baby didn't eat much (not surprising)
10:30-10:45 E
10:45-11:00 S
11:00-12:00 A
12:00-12:30 E lunch
12:30-15:00 A (were out)
15:00-15:30 E bottle - were in car ok way home. Baby doesn't sleep in car often
15:30-15:40 E (just to get to sleep)
15:40-17:15 S
17:15-17:30 A
17:30-18:00 E Dinner
18:00-18:45 A
18:45-19:30 A - Bath & change
19:30-20:00 E feeding to sleep
20:00-20:45 S
20:45-21:00 E (after trying reassure and pat to sleep)
21:00-23:00 S
23:00-23:10 E
23:10-01:50 S
01:50-03:00 feeding for 15 min in total during this time, lots of reassurance and patting to get baby back to sleep. Finally settled when I lay beside her
03:00-08/00 S

« Last Edit: October 24, 2013, 16:26:01 pm by Aapppffff »
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Offline weaver

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The general rule of thumb is to sort the daytime sleep and the night will follow.  You will need to plan to stay in for nap times for a week or so. I'd avoid any car trips or buggy rides towards the end of A time, as LO might sneak in some shut-eye and ruin the nap plan.  Great idea to rest up and stock up on food before you start, very organised!

I know PU/PD works really well for some people but I personally never used it as my LOs both have a strong spirited streak, and LO1 is touchy to boot!  I went more with Gradual Withdrawal methods, aiming to get LO into the cot earlier in each wind-down and to do more and more settling in the cot, until you get to the point where you can put them in the cot and they will happily lie down with your hand on their back, and then gradually reducing the amount of time you have the hand on the back to a minute.  Having said that, you can get lots of information and support on the PU/PD board.  Here it is:
Pick Up/Put Down

Some info about feeding routines.  Usually varies from family to family!
Feeding routine for 10-12months

HTH.
*Anne*, loving mama to a honeybee (2010) and a sweetpea (2012).  BF for 4 proud years.


Offline Emami

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Sorry, I never did PUPD either so would second posting on that board.  As far as getting her into her own room - I think if you have a clear wind down it probably won't matter where she sleeps.  DD had nights in her own room and naps in our room for ages before we did everything in her room, but has also slept in a lot of other houses/rooms/beds, and as long as she has white noise and her loveys she goes down fine.

Also agree with weaver about avoiding the car or buggy when she is tired - it is fine to deliberately put her in there if you're planning to APOP a nap here or there, but if you're aiming for sleep training and naps in the crib then that's where you want to be!  Good luck, I hope it goes well!
Emma