Help teaching a 7 week old refluxy, windy and not very sleepy baby to sleep

[Christingle]

Hi there

This is my first post though I've been regularly reading and taking advice from other posts and think the support everyone provides each other is amazing!

My DS is 7 weeks today. We want to help him learn to sooth himself to sleep at naps, BT and during night.  I think we've got ourselves into a prop situation which we can't really manage for the long term 

We plan to start this weekend as we want to change the habit before it gets harder as BW says after 3 months. We were planning to start at his first morning nap with shush pat but I'm worried about how it will go... My worries and questions are:

1. Will his reflux or wind affect the technique or be affected negatively by it? Is there any reason shush pat should not be used on refluxy babies?

2. I've read the importance of being consistent with the technique so know we have to keep it up once started. But do we do all naps, BT and night wakings at once? Or do we start with one of these first? I think his naps are the biggest issue but then he needs to learn to self sooth for all sleep.

3. Having read the page about shush pat on this site and in the book, it seems like DS should remain sleepy when put down into his basket and it sounds then straightforward to then shush pat until he's fully asleep and sometime beyond.

However, of the couple of times we tried the technique in the day for naps, his eyes pop open within seconds/mins of being put in the basket and he's wide awake and starts crying.

So according to the technique, we'd then need to shush pat and when he cries keep picking up and putting down for 45mins then feed then start again...Is that right?

4. I also tried s/p once earluer this week after the 8pm cluster feed so he was drowsy on milk but again his eyes also popped open though he didn't start crying. But he was then wide awake.

Once he's wide awake he just stays awake and then i assume gets more a day more OT so if i'd continued then I would imagine he would just stay awake for the full 45 mins until the next feed as he did when I tried it before at nap time, and until we had a very OT and cranky DS. If that happens, is it possible for s/p to work? Is there something we should change so that DS is at better stage of sleep by the time we reach nap/bed time so that his eyes don't pip open each time?

5. I read that s/p could take as much as a couple of weeks to work...At his age, is there a maximum number of days we should do this before stopping to give him some rest and some proper feeds if it's not working? Or do we just keep going and will that pose any health risks to LO as he'll get less sleep and feeds will likely shorten due to sleepiness?

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Our EASY history to date as background is:

WEEKS 1-5:
We started.the EASY order of things early to prevent daytime association between E and S. We didn't have a 3 hr cycle to start because we followed his hunger cues/fed on demand in those first weeks, and because he woke from naps at 45mins and we weren't aware then of the 45min sleep cycles so we didn't attempt to lengthen.  We then progressed to a fluctuating 2-3hr EASY with 1-1h15 awake times and longer naps of up to 2hrs  (Inc a 5-20min intervals - usually at 45min - where we help sooth back to sleep). I'd even grab the odd short nap when he napped!

To get him to sleep, we would go to bedroom and start by swaddling with gentle singing/ talking to explain it's bed/nap time, then onto shush/pat, starting with DS on our chest with face into neck as per BW approach, before putting him down and continuing s/p. We swapped shush for white noise after a few weeks. And he doesn't always need patting.

However, we found he fell asleep quickly on us and still does (even though the room is not so dark) - it can take just a few mins upto maybe 30mins and we have had only a couple of long witching hours of 1-2hrs which may also have been due to being OT.

So before we had chance to put him down, he'd go down asleep and then almost immediately wake up with wide eyes (OT?) and soon start crying. We couldnt reduce his A time to 45mins as his feeds were long, and still are long. Sometimes an hour.

So we decided to wait a week or 2 later to try again because we felt he was too young to do s/p and rather we'd prefer him to get a good start on feeding and sleep in his first 1-5 weeks, and get the EASY order established, and then move onto self soothing which is why I'm here now!!

However, this means the falling asleep on our chest soon became a prop - for some NW and for all daytime naps and BT.

Night: DS was able to make it through the 45min transition point at nightime until he'd wake to feed which he did every 2hr or so. After his feed I could put him down more or less straightaway as he was usually asleep and he'd stay asleep. If we changed his nappy,  we'd have to help him back to sleep again on our chest.

 (Does the 45min sleep cycle also happens at night time as I read somewhere that it's more like 3-4 hrs at night time,  is that right?).

WEEK 5.5 onwards:
As above but the falling asleep on chest has become even more of a prop. I think this coincided with when DS started becoming refluxy and windy from 5.5weeks. Whereas before we'd been able to put him down after 15-20mins asleep on us (and he'd finish the rest of the 45min in his basket and we'd then help him again through the 45min wakeup on us again and he'd then finish the sleep in his basket), now for most (tho not all) of his naps he will not finish his nap in the basket.

Perhaps the pain of reflux or wind wakes him more readily in his basket or he's just grown used to cosily sleeping on us...not sure...   

So now I'm in a situation where DS and I spend most of the day in the dimmed bedroom with DS sleeping on me, then to the lounge to breastfeed, then nappy change and back to the bedroom. My DH luckily works from home so that gives me 45-60min nap at lunchtime most weekdays whilst he sits with DS on sleeping on him. And at weekends DH takes more of the day shifts. I've just got a carrier so have gotten out once a week for a walk but am worried that the carrier will become a prop if used more often.

Night: For the past few weeks, unless a growth spurt, we've also stopped feeding at every NW as some seemed more like short comfort feeds for reflux or wind, so for those DS gets a cuddle on our chest instead until he falls back to sleep. We try not to go in too quickly but if he ends up crying or seems like he will then  so again we pick up to comfort until he's asleep as he can't a self sooth once he starts crying.


Sorry if the info's a bit jumbled and long - it's hard to organise thoughts with a tired brain  ....Look forward to your help! Many thanks

[lauradj]

Hi hon, and welcome!  From one reflux mom to another, I can tell you that nothing will likely improve significantly until the reflux is under control.  Sleep can be one of the most difficult times for reflux babies because lying down can be so uncomfortable for them.  Ensuring their pain is being managed through propping the mattress, laying them on their left side (props used to keep them there) and meds if the doctor recommends it, are all steps you can take to help your baby be in comfort.  After that, the reflux mantra is: Do whatever you need to, to help them sleep.  Tired, crying babies only aggravates the reflux further so if baby sleeps best in a carrier during the day, embrace it.  If your LO can have one or two naps in their crib, great!  I would recommend Shh-Rub, instead of pat because it's a smoother action for baby.  Honestly though, don't worry about serious sleep training until the reflux is under control.  Follow the order of EASY if you're able, but my LO had to do EAEASY for ages because he could only take 2-3oz at a time.
One very important point I hope to impress upon you is, please do not deprive your baby of any feeds at such a young age.  Babies so young often wake 3-4x a night and if feeding makes the reflux feel better, who cares?!  Your baby has no other means with which to manage their pain, help them however you can.  I know it's tiring and exhausting but right now, this is what your baby needs.  You will get your sleep back, but it takes time. 
 

[Christingle]

Thanks for the advice...It takes the pressure off getting EASY and sleep habits "perfect". DS's reflux isn't at the worse end of the reflux scale as he is a good weight so far (HV weigh in on Tuesday so we can see if he's still gaining well), but enough to cause him distress and affect his sleep.

It would be great to help him get good restful naps as he does mostly have longer feeds of 20mins+, but I think that I'm putting him to sleep at the wrong time as even before the reflux started he's fought sleep most times with the odd time going down easily making me think that the other times I'm keeping him up too long. Does it also make him more likely to wake at 45mins if he goes down OT? It would be good to get your advice on how to reduce his A time so he can get a more restful nap.

Whilst occasionally his feeds are short and we do a 2nd top up (EAEASY), quite often his feeds are long (45-60mins). I read that feeding can also sooth reflux so maybe that's what he's doing? He'll start strong and then go in and out of proper drinking or the remainder.  He starts to show sleepy signs even when on the breast (eye rubbing, ear pulling) and by the time we've reached nap time he's OT as he's been awake for 1h15-30. Should I take him off the breast early to reduce the feed time to give him chance of a more restful nap?

We also tried shush pat yesterday and it worked really for his first nap of the day (his feed was short so we got him to nap time before OT), but not at the 45min transition point which then got us into a cycle of OT for rest of day so the carrier came out to help LO catchup on sleep. So today I've shush patted first and then when he woke at his 45min mark, I'm holding him for the remainder of the nap  (he's in my arms as i write).  I know consistency is key - can we combine the two techniques if we do it consistently (shush pat to put down first, then hold for second half of nap)? or is it too confusing for him?

Also sorry also for the length of my first post - need to get used to being concise. ..first time in a chat forum and hard to know what info to include and what not...

[lauradj]

If you could write down your EASY like this:
E:
A:
S:

That would be tremendously helpful.  It's easier to read that way and see a pattern.  You could try taking him off the breast after 45 mins, if you feel he's not doing any genuine feeding at that point.  Do keep in mind that even at 7 weeks babies aren't doing anything too wild and crazy for A times.  A few action songs from you, maybe a book and a diaper change and that's probably about it.
I would definitely choose a technique and stick with it. Every. Single. Time.  Shh-Pat/Shh-Rub, is often a favourite because it's minimally intrusive.  For me, I would pick DS1 up and do Shh-Rub because he was a back sleeper and rubbing arms or legs is just not as soothing.  It worked for me but it may not work for you.  Ideally, you want to keep doing Shh-Pat until he falls back to sleep or for 45 minutes, which ever comes first.  After 45mins, get him up and going with the next A cycle. 
Have you inclined his mattress?  That can make a huge difference.

[Christingle]

Our EAS is below. We don't always follow exactly but gives an idea:

WU &E: 7.00
A: 7.45 Nappy change, wind down for nap (swaddle, talk to I  soft voice to say it's naptime)
S: 8.15 We hold him to sleep on our chest trying to keep out stimulation and with white noise then into his basket - he often fights sleep, with crying, looking around, and squirming and pushing feet down (we had patting and or singing at this point to refocus him on sleep). He then "settles" into mantra cry, then drops off. He does this 1-4 times so it can take 5-20mins until he falls asleep. This first half of nap is until the 45min end of cycle wake up. Sometimes we end up holding him the full 45 as we dont want to risk waking him as we want him to get a good sleep. At 45mins, he then wakes up with eyes wide open looking around, or crying (if hungry we'd do a feed here and then adjust the rest of day times, but usually he's tired). Then we hold him until he falls asleep again for the second half of the nap and he either wakes at 45 again, or sleeps past that until we wake him for the feed -!sometimes he's sleeping so soundly we don't want to wake him so give him another 15mins . He doesn't manage to sleep in his basket for the second half of the nap - if we try to put him down after 20mins of holding, he wakes within a couple of mins .
E: 10.00
A: 10.45
S: 12.15 As per 7.45 above
E: 1.00
A: 1.45
S: 2.15 As per 7.45 above
E: 4.00
A: 4.45
S: 5.15 As per 7.45 above but just first half of nap.
E: 6.00
A: 6.45 Bath and bedtime routine
S: 7.30 Just short nap, then he wakes up at usual 45min point. Sometimes he doesn't manage to get to sleep at all and gets hungry so we run into the feed
E: 8.30. Feeds to sleep 
S: 8.50 depending on feed length

Then feed on demand after that through the night and he feeds to sleep:

E: 9.30 - sometimes LO wants another feed about 9.30. Then straight back down.
S: 9.45
E: 10.30/11.30 DF 10 for 10 mins. Then straight back down.
Then 3-4 more feeds on demand before WU. e.g.:
1, 3 and 5, or
12.30, 2.30 and 6.30 (so I make 6.30 the WU), or
12.30, 1, 2.30 and 5.30, or
2, 4 and 6.

In this last one, when he wakes at 6 for a feed until say 6.30, it confuses the WU time - I'm not sure how to keep on the EASY track when this happens as try to keep his WU window between 6.30 and 7.30. What do you think?
And is it right to feed to sleep at nightime?

 

[Christingle]

For reflux: we started inclining his mattress from 5.5weeks when he started showing signs of reflux. Also hold him upright after each feed though this  can make Awake time even longer. HV comes tomorrow for first time since reflux started so we will find out if affecting has weight - really hope not 
For wind: regular burping. Started him on infacol last Friday and his poos are already less explosive and less farts. He has an upper lip tie which means he may take more air whilst eating but it hadnt affected his weight at the last weigh in.

On 2nd day trying ssh pat tomorrow so will report back on that soon...

[Christingle]

Hi there,
Sorry just spotted typo ion our EAS  - 12.15 should read 11.15..

An update on our shhh patting which we started last week - it went well and more and more he's able to sleep for a full 45mins nap in his cot! The biggest thing we learned was the point of sleepiness at which to put him down though we still don't get it right and sometimes put him down too awake and he soon cries, but maybe in time he will be able to go down more awake? Is that what we're aiming towards?And sometimes we miss the point and probably put him down too sleepy.  But we're still working on it and things are definitely on an upwards trajectory. The number of pick ups is reducing and he's staying asleep for longer. We stay with him for the first 20 mins.   

At first, most times he would wake 5-20mins after being laid in his basket despite us shh patting (our version being white noise, quiet singing and hand rubbing chest and side and or stroking his head). Now it varies - sometimes he still wakes 5-20 mins in, but is increasingly making it to 30-45 mins.

So it seems the main thing now to work on is that he's still waking up 30-45 mins into his nap, and we have to pick him up and restart shh pat to help him get sleepy again - tried WTS at various times in, but haven't got that to work yet. Could it be related to awake times or is the 30-45 min wake up normal even if awake time is perfect?

Also, sometimes he goes back down quite easily and other times not so we then go into activity. This results in less sleep during day compared with when we held him for the full 1h5-2hr nap. Am trying to work out any pattern - if there are times of day he likes long v short naps.

The interesting thing is that despite gaving less sleep in the day due to above, this has been without any OT repercussions later - no witching hour. And he's now starting sleeping longer at night - do you think that's due to the reduction in daytime sleep? Or is it something to do with him reaching 8 weeks?

One last question- At night time as it's ESESES,  with no activity bar a nappy change,  does that mean it's on to feed to sleep? If he's not fully fallen asleep on the breadth, then he falls asleep whilst burping...

[lauradj]

Hi there, sorry to have missed your posts!  Regarding night feeds, absolutely you feed to sleep.  I did actively burp DS2, who has reflux, but very gently.  Once his pain was managed and he was a bit older, I would just carefully put him on my shoulder for a few minutes and he would usually burp on his own while still asleep. 
I'm glad you've had success with Shh-Pat, what a relief for you.  Tracy recommended doing Shh-Pat for 45 minutes, or until the next A time arrives, which ever happens first.  Personally I usually stopped after 20 mins but it's up to you.  Just as a side note, typically 30 mins wake ups usually indicate OT, whereas 45 mins indicate UT.  You may find that helpful.  Do also keep in mind that almost all babies go through a phase around 3/5 months where they take 45 minute naps and no more.  It drives us all nuts but it passes, relatively quickly. 
I'm glad he's sleeping better at night but it's not likely linked to less day time sleep.  Sleep begets sleep, so the better he sleeps during the day, the better he'll sleep at night.  I hth!