4 mo nap battles makes EASY impossible

[Leewh]

My DD is almost 19 weeks old (just over 4 months).  She’s never been a good sleeper.  We have so many sleep problems that I don’t know where to begin to help her get more rest. 

1)   We use a pacifier bc we were told it helps reduce discomfort from acid reflux, but the pacifier has become a serious problem.  She has trouble with it falling out while falling asleep, which wakes her and causes her to cry for it.  I also suspect this affects her naps as she wakes and doesn’t have the pacifier to put herself back to sleep.  We have talked about getting rid of the paci but want to wait until after a vacation this month. (As for the acid reflux, she’s on medication twice a day but she still has problems with it).
2)   We are weaning the swaddle so she is currently one-arm out.  We hoped that she would be able to find her thumb/fingers while sleeping but that hasn’t happened yet (even though she sucks on her hand all day…)
3)   We rock her before sleep.  We do try to put her down drowsy but awake.  That works sometimes.  Then we do PU/PD and continue putting her down more and more drowsy.  However, I rock her to extend naps so that may confuse her?

She’s fairly consistent with 30-45 minute naps.  I always try to extend her naps when she wakes crying, but not when she wakes up cooing to herself.  I have tried leaving her in her crib cooing, but she has never put herself back to sleep.  She continues to talk to herself until she’s bored, then begins to cry.  When I do try to extend her naps, I pick her up and rock her with the paci until she is fully asleep again before I lay her down.  Nothing else works.  I’ve tried the diff rousing techniques, pressure at jolts, holding her, pat/shh, PUPD, etc.  I can usually extend one nap during the day by rocking her to sleep.  I have limited myself to 20 minutes of trying to extend a nap.  If she’s not down within 20 minutes, I give up and wake her for activity.  This past week, I’ve changed her schedule to have longer awake time but am still getting 30-45 min naps.  It’s so difficult to keep her up past 1hr 30mins as she becomes so fussy.  I generally find her going to sleep around 1hr 15mins. 

At night, she is very fussy before bedtime.  Once we get her to sleep, we may have to go in an hour or two later to replug her once or twice.  Usually, she then sleeps through the night (typically from 7:30pm – 6am) with one wake sometime during 2-4am for a feeding.  She eats and usually will go right back to sleep. 

Her short naps makes it very difficult to have a “schedule” so I try to just maintain a 3.5 hr EASY routine.  However, my EASY gets all over the place bc of weird naptimes.  A typical EASY schedule could look like this:

   6am      wake up
E   6:00-6:20   nurse (she’s EBF)
A   6:20-7:15   morning routine (i.e. wash face, change clothes, medicine, diaper)
S   7:15-8:00   nap. Wakes cooing from 1st nap, leave in crib 15mins, until she cries.
A   8:00-9:00   tummy time, make faces at baby
E   9:00-9:15   nurse
A   9:15-9:30   hold upright (acid reflux).  Usually gets fussy.
S   9:30-10:05   nap, wakes fussy
        10:05-10:25   rock w/ paci to extend nap.
S   10:25-11:30   nap.  Still wakes fussy usually
A   11:30-12:30    gym, go outside
E   12:30-12:45   nurse
A   12:45-1:00   hold upright
S   1:00-1:45   nap, wakes fussy. 
   1:45-2:00   try to extend nap.
A   2:00-3:00   swing or bouncer, play with toys.  Usually fussy
S   3:00-3:45   wakes fussy, won’t extend nap despite efforts
E   3:45-4:00   nurse
A   4:00-5:00   singing, toys.  Usually fussy
S   5:15-5:45   shorter nap
A   5:45-7:00   play with dad, bath
E   7:00-7:15   nurse
A   7:15-7:30   bedtime routine
S   7:30-6:00am   will wake 1-2 times btwn 8-10pm for replug.  Wakes btwn 2-4am for feed.

I don’t know whether what I’m doing is working or right.  I have gotten so upset over her sleep prior but am trying to let go of the stress of it to just enjoy my days with her before returning to work.  However, I do feel she is chronically sleep-deprived during the day and would probably be less fussy if we could help her sleep better.  Any ideas?  Suggestions?

[*Becky*]

bumping up x

[Ima shel Alon]

She has trouble with it falling out while falling asleep, which wakes her and causes her to cry for it.

I had the same problem. I used to go 10-15min after DS fell asleep as I knew his sleep is deep enough then and would very gently take it out. I read other mommies here doing it and then tried it myself and it worked for us. Like you, the paci became a prop for us and we just weaned 'cause we couldn't stand anymore the plugging in. We used pat/shh for sleep training at around 5m and ot worked very well for us. Took a couple of days to implement but it worked . Consistency is a key with any method you'd use to sleep train, for some babies it takes longer to learn a more independent sleep. I think it's only up to you if you are willing to put the work in. I don't say this as a judgement in any way. We had props till DS was 10m, but we were always happy with what we chose as props, yk?
The other thing that would effect her naps and sleep is the length of her A. what you are describing now, that she is happy and chatty when she wakes up, hardly ever settles back to sleep from a short nap - that would indicate UT. If you look here: chronological EASY samples, 4-6 months you'd see that many babies her age are doing more like 2h A time and she is not there yet. I know that it looks like she can't manage more than that, it's often like that, but we can help her stretch her A times gradually and hopefully that will make her nap longer as well. When you increase A time you do it by 10-15min every 3-4 days till you get better naps or till you are at an age appropriate A time (which for you would be around 2h). Every time you increase the A you stick to it for 3-4 days because that way you prevent her from getting OT and that's also how long it takes a LO to get used to a new A. You can read about it more here: What are A times and how do they fit into the EASY routine?
It sounds like what's happening now is that her naps are UT, but by the end of the day because she didn't have restorative sleep she gets OT from the day.

We rock her before sleep.  We do try to put her down drowsy but awake.  That works sometimes.  Then we do PU/PD and continue putting her down more and more drowsy.  However, I rock her to extend naps so that may confuse her?

Tracey meant PU/PD to be a last resort, only after pat/shh has been tried and didn't work. But PU/PD is not suitable for babies with Reflux . The picking up and putting down aggravates the acid, so I really think you shouldn't use it anymore.
Do you have Tracey's book? She gives a lot of info there about pat/shh.
Here: Sleep interviews with Tracy on the third post, from 24.2.2006 after the PU/PD part, Tracey talked about pat/shh.

And last thing... No tweaking in the world will help if she is in discomfort from the Reflux. Even if she will be on good A times, the pain will prevent her from sleeping properly, so the pain has a priority now,yk? Have you thought of changing her meds? Is it a while that she is on them? Is her mattress elevated?
HTH, hun, I know it's a lot to take in and that it's really hard to deal with sleep. I have been there myself and it's far from being bearable. (((hugs))).

[Leewh]

Thank you for your help!  I think I'll work on stretching out her A times for now.  I've already discussed changing her meds with her Dr so we're working on that.  Hopefully a switch in A time will be helpful.  I'm not quite willing to take away her pacifier yet as I want her to be able to use it for an upcoming flight we have.  Though if the A time change doesnt work, we may be taking it away shortly after our return!

[Ima shel Alon]

Good luck! Let me know how you're doing .