every hour - think i am going to cry!!

[Melsie]

Please help! 

My LO is 20 weeks old and has always fought sleep. I have always had to rock her and hold her to sleep for her nap times - ridiculous i know but she suffered from reflux and i was unsure of her levels of comfort therefore figured better she got the sleep that she needs rather than both of us getting stressed with sleep training which seemed impossible if she was in pain. Anyway, her reflux symptoms have pretty much cleared up and she seems more comfortable. I can now get her down in a cot but not for longer than 30/45mins. She also sleeps in push chair and car sometimes. As i write this i feel we have come a long way!!  However, I am so exhausted that it doesn't feel like it!  This is mainly down to frequent night wakings. I have never been able to dream feed her as she won't open her mouth and even if i can get breast in she doesn't suckle. She wakes at 10 and i settle her with paci, she wakes at 11 and i feed her. This is after bedtime at 7.30. After her 11 feed she wakes e very hour. I try to hold off feeding her until 3 but sometimes give in at 2. That used to be her last feed until 7 but she seems hungrier lately and i have to admit last night i gave her the breast a lot more frequently. Why??? I am attempting 3.5 EASY but its a bit higgledy due to small naps due to sleep training 

[Erin M]

Oh goodness, it sounds like you've been having a rough time, you must be so tired!
With such frequent wakings, I have to think some sort of discomfort -- or some sort of prop at play.  Is she going down into her bed awake at night or are your rocking her to sleep?  Does she sleep better when she's in the stroller, etc? 
Can you show me what your day looks like right now (as best you can, I understand it's a little all over) -- like this:
E
A
S

...let's see what we can sort out to help you. 

[Melsie]

Thanks so much. This was yesterday:

E - 7 BREAST
S - 9.30

E - 11.00 (FIRST INTRO TO SOLIDS)
E - 12.00 BREAST
S - 1.30


E - 2.45
S - 5.30 CAT NAP

7.30 BEDTIME ASLEEP BY 8

At bedtime, sometimes she falls asleep on breast but usually i can rock her drowsy and put her down almost awake but i am pretty sure she is prop dependant - paci, rocking/breast  and seems to be struggling to get through sleep cycles. I even have to rock her  back to sleep in the middle of a nap if i am holding her otherwise she just wakes up. I do sh pat whilst rocking and sometimes i can put her down and continue to do this and it works but not often. She is spirited and when she gets upset her cries just get louder and louder so i have always rushed to resettle her before this happens and she is inconsolable so she has never learnt to resettle. The thing is i know that when she is in the car and i can't do much for her but talk she doesn't calm down - she screamed for a 40 min car journey the other day  so i don't see how she will be able to in a cot if the motion of a car doesn't help her. She does fall asleep in the strolller now but again for one sleep cycle or if i stop rocking/pushing it can be less. We have had doc appointments and paed. They say she is fine but needs to be sleep trained and to start her on solids as she could be hungry.

[Erin M]

OK, you've definitely got a few things going on here -- props and routine issues for sure, and maybe some discomfort.  I've asked one of the reflux ladies to come take a look so hopefully she'll offer some insight into that sometime soon. 

So, let's think about routine here.  She's just about 5 months, right?  (I'm so awful with the week thing...)  Can she make it 4 hours between nursings, or do you need to stick more to 3.5.  Your A times are pretty inconsistent throughout the day and I'm thinking she's probably quite overtired at this point, so she's really going to need you to help her get onto a pretty consistent routine so she can get some more sleep in her.  You can have a look at some sample EASY routines for her age right here: chronological EASY samples, 4-6 months -- but I would try to get her close to a 4 hour EASY for now and see where that gets you.  So, from your wake time of 7, you would do
7 - wake up and nurse
9 - sleep
11 - wake and nurse
1 - sleep
3 - wake and nurse
5-5:45ish - cat nap
7 - nurse and BT

You might need more A time, but 2 hours is somewhat average at her age, so it's a good starting point.  If she wakes earlier, it's ok to feed her earlier if she seems like she's hungry and then go from there. 

Also, with the solids, I'd try to do them about an hour after your first nurse in the morning.  That's usually when mine took them the best. 

As for the props -- how does she do with the paci?  Can she replug at all or is she up looking for you to put it back in the night?  Can you stick with one prop and then work on dropping that one?  Have you used pat/shush at all ( Pat/shush for babies under 3 months old ) to try to get her to sleep instead of some of the props.  Given that she has reflux, I wouldn't do PU/PD.

What do you think?

[Melsie]

Thanks so so much, I will try the 4 hour EASY. I find stretching her feeds out because her sleeps can often be very short and then she seems to need feeding sooner but I will try my very best.

In regards to discomfort, I am pretty sure her reflux symptoms have reduced dramatically and she doesn't seem to squirm with discomfort like she used to. Although obviously I can't be sure but my instincts tell me if anything it is props (and although I wasn't aware of it but am now - routine) but I don't know where to start with reducing props. I have been sh patting whilst rocking for a long time and sometimes I can continue with her in her cot but not always. Mostly, she sleeps on her side and when I put her down she flings her arms back and pings her eyes open and she is wide awake! She can't re-plug the paci yet and to be honest I wish I had never bothered to introduce it because I have to re-plug so often. She is starting to find her fingers rbut I don't think I can take away the paci because it will take even longer to get her to sleep. She is spiritied and I find it difficult to catch her sleep window so I don't think that helps. I think the main problem is that she can't resettle her self after 45 mins. ALL my friends, health visitors, doctors, paediatricians have told me I have to leave her to cry and that's the only way she will ever learn. It will break my heart to have to do that but nothing seems to be working??

From here I will try to space out feeds to four hours, I will try more sh pat and take away breast to sleep because that is not often

[my3girlsjde]

Hugs hun

I know this is hard but please follow your gut and don't leave her to cry.

Was your lo ever medicated for her reflux? She's at an age where she could be going through a growth spurt and if there is reflux present it could be triggering a flare up.

45 min nap to me have always meant ot, ut or discomfort. Many drs feel if your lo is growing well that nothing is wrong. If your lo is in discomfort you'll see some behaviours indicating it ie back arching, knee pulling, grunting and hiccups frequently after feeds. My youngest never spit up yet was suffering from silent reflux.

If your lo won't sleep in the car that could indicate discomfort for sure. Just want to make sure that's not the issue.

[Melsie]

She was on gaviscon for a while. She used to show the symptoms you discussed but not anymore. Although she has been spitting up a little more than usual?? She is showing symptoms of teething?? Lots of dribbling, biting on things - she seems to feel better after teething gel/granules.

[my3girlsjde]

My guess would be a reflux flare then. I would definitely get her in to the Dr and see if meds might help her. She does seem pretty unsettled.