over alert and over tired - vicious cycle

[BlessedKylie]

Background Info: My daughter will be 8 weeks old on Friday. She was 9 lbs at birth and is now almost 13lbs. She has never been a good napper (at least not for one entire day - good morning naps, bad afternoon or vice versa). She was diagnosed with reflux a few weeks ago and put on Zantac. We have her sleeping on a 45 degree angle and her changing table is elevated. I also keep her upright for 30 minutes after each feed. However, I don't know if that has anything to do with her problem.

I tried to start EASY when she was 3 weeks, but she has never been a good consistent napper and the reflux complicates things - especially at night. After she feeds, I have to keep her up at least 30 minutes - which means she is sleeping on my chest for 30 minutes (longer if I happen to fall asleep too). If I put her in her crib after a feed, even with the 45 degree angle, she refluxes and wakes up crying.

Lately it seems that she will have decent sleep at night (although she still wakes every 2-3 hours to feed), decent morning naps, but then by mid-afternoon, she doesn't want to sleep. If I do get her to sleep, she will wake up 30-40 minutes later crying and want to play. More often than that, though, we don't even get to the sleep part. She starts screaming as soon as we start walking up the stairs to her room. If I take her back down stairs to the main living area, she is fine as long as she is entertained - by either being walked around or played with. But then I have to entertain her for 2 hours + to try to get her to her next feed.

When she wakes up from her naps early (or doesn't go down at all), and is crying, she stops when I pick her up and walk her around or play with her. But if I'm not supposed to let her cry it out, how do I break her of this?

When I put her down, I've tried to shh-pat, I've tried walking her around and any other prop that usually works, but she just will not go to sleep. By 6 or 7 (this starts with her 1 o'clock nap), she's so overtired she just screams. I finally put her on the breast and let her fall asleep on my chest or her swing just so that she can get some sleep. But I don't want her sleeping on my chest forever, but I can't seem to break the cycle without feeling like I'm depriving her of the only way I know to get her to sleep.

This was her day yesterday:

E 5:30
S 6:15 - 6:45 (putting her to sleep) 6:45 - 9:15 sleep

E 9:30
A 9:45 - 10:20
S 10:20 - 10:50 (putting her to sleep)  10:50 - 12:45 sleep

E 12:50
A 1:15 - 1:45
S 1:45 - 2:30 fitful sleep
A 2:30 - 3:40 (walking her around)

E 3:40
S 4:00 - 4:40 (putting her to sleep) 4:40 - 5:20 sleep
A 5:20 - 6:15 (mostly her screaming b/c she was so tired)

E 6:15
S 6:45 - 7:10 (putting her to sleep)  7:10 - 7:30 sleep
A 7:30 - 8:15 (walking her around)

E 8:15
S 8:45 - 9:45 (on my chest) 9:45 - 11:15 in crib

E 11:15
S 11:45 - 2:00

As you can see, there is a lot of A - because of her bad napping, I play with or walk her around to try to hold her off until her next feed. BTW, our A is very low key - mostly me talking to, singing and making faces at her. Other times, I leave her in her chair and she plays by herself (this is only in the morning though, if she had a good night's sleep).

[cipo]

Hello,

I am no expert but have had a similar problem with my ds since he was 5wo up until 8wo (then I found Tracy's book  )
I thought I had to wait for him to be asleep before putting him down but I was wrong.

I found that if I read his cues (third yawn, no more interest in playing), then wind him down (hold him for a few minutes, give him his dummy, tell him that I will put him to bed now) it works well most of the times.
Initially (first two-three days) I had to stay with him and pat/shush, now it's no longer needed. I would leave the room and come back only if he starts complaining, to which I would shh/put back his dummy.If he is really upset then I would pick him up until calm and then put him back again.
I also found that he sleps better on his tummy, because his arms and legs don't bother him, i.e. he is contained. I felt comfortable doing it b/c he could move his head well and put it on one side, so his breathing was OK.

I don't know if this will help since your dd has reflux....maybe you could try the reflux board as well.

Best of luck with it. Hugs,

Serena

[BlessedKylie]

Today I tried to wind down earlier - after 45 minutes of A and when I saw her first yawn. We did our normal wind down. I put her in her crib awake. She was ok for about 3 minutes, then she started fussing. I tried to let her work it out, then she started crying. I tried to s/p. She was calm for about 2 seconds, then started fussing with intermitant crying. After about 5 minutes, she start crying, then screaming. When she started screaming, I picked her up to s/p. That didn't work and her crying got worse. So I added rocking. After about 3 minutes, she was out. I let her sleep for about 5 minutes on my chest and then put her down. She stayed down for about 40 minutes. Then she woke up fussing. Again, I tried s/p with same results. I finally picked her up and s/p with rocking and she slept. I again tried to put her down, but she woke up and by then was too stimulated to sleep.

I posted on the reflux board too, but I think night time routine is affecting daytime naps... this was my other post:

I posted another topic earlier, and did some looking back at my daughter's diary and think I may be on the brink of developing a monster. At night, she usually goes down pretty easily after her 10:00 feed (her 7:00 can be a battle), and then wakes every three hours (almost to the minute) until morning to eat. Each time, she goes to sleep pretty easily. However, after she eats, because of her reflux, she falls asleep upright on my chest for 30 minutes and then goes to her crib.

During the day, I cannot get her to sleep without rocking her to sleep and then putting her in her crib. Even then, I will only get 30-40 minute naps out of her. Today, when she woke up early, I tried to s/p her back to sleep. She fussed for about 5 minutes, then started crying, then screaming. As soon as she started screaming, I picked her up and tried to s/p. That didn't work. I finally added rocking her. She went to sleep in about 3 minutes. I let her sleep on my chest for about 5 minutes and then tried to put her in her crib. Instant crying. I tried to s/p, but she escalated. I then tried to rock and s/p again, but she was already too stimulated and wouldn't go back to sleep. I then started walking her around. She was fine. She looked around at everything for about 40 minutes at which point she started crying to be fed (was about 2 hr 45 m since last feed). I fed her and she fell asleep on the breast. I tried to pick her up to carry her to her room and she started crying. She is now sitting in her swing fussing, but not yet crying.

What do I do if s/p doesn't work? I don't want to have to rock her to sleep every time. What makes things worse is that at night, that is how she falls asleep.

[Zoey]

Hiya!

First don't feel bad for anything you have to do to help your Angel sleep with reflux.  Many of us believe there is no such thing as Accidental Parenting with a reflux baby - they are in such discomfort you have to do what you can to help them rest.

How long since she was put on Zantac?  If it was a few weeks ago, my best advice is to take her back in and get her weighed - Zantac is dosed by weight and if she is alot heavier then the dose needs an increase to be adequate.   Here is a great site I use alot:  http://www.marci-kids.com/ - they are finding that Zantac and other H2 drugs aren't really the best, most effective way to treat reflux.  You may want to try an increase of the Zantac and if it still isn't working after sometimes, ask to switch to another class of drug.  The more informed you are about the available treatments, the easy it will be for you when speaking to the doctors about what your LO needs.  That site is awesome.

Is she vomiting alot or silently refluxing?  If she has alot of vomiting they can give her a medication that can help with that - Zantac doesn't.

I would try rubbing and shhing.  Babies with reflux find it painful when they are burped, or patted on the back.  To burp you can try rubbing upwards.  And for pat/shh you can try rubbing in circles instead, or patting her butt.

Are you using a Tucker sling or something like it?  Moms have great results with them!  Stacy gave the link.  If you dont wanna try that I can tell you about my speed bump and incline.

Have they ruled out any problems with your milk?  Any imbalance or something in your diet that is irratating her?  Are you comfortable with your latch?  Have you talked with your doctor about tummy sleeping?  Is she using a paci?

When you carry a baby they feel weightless, when you put then down asleep they suddenly feel their weight again and this is startling and they wake up, most often crying.  So, when you can get her discomfort managed, try putting her down calm but awake.  Also, could you sit her in the car seat or swing for those 30 mins after she eats.  I would think weaning that later would be easier then weaning you - espcially since you BF and smell like milk.

Most important, please don't feel badly about anything you have to do now to help her sleep.  It can all be fixed later.  Don't be afraid to be a squeakt wheel with the doctor.  Tell them how this is affecting her sleep.  If she is in pain she isn't going to sleep well period.  Big Hugs to you, I know EXACTLY what you are going through.

   Love,
Zoey

[BlessedKylie]

She was put on Zantac about 3 weeks ago. She weighs almost 13 lbs, and takes 1ml 2x per day. I tried to find a site regarding dosage for her weight, but couldn't for Zantac.

She is a silent refluxer and suprisingly, a happy spitter. Her reflux mainly causes gulping fits. If I lay her down too early, she will vomit violently and cry, but if I keep her upright, then she will have gulping fits only on occasion (as long as she gets the Zantac). These fits usually just wake her up and then she cries b/c she's awake too early.

I have her on an incline now. It used to be 45 degrees, but even with a speed bump, she would squirm all the way down and get scrunched up which made things worse. Now she's at about 30 degrees, which seems to do the trick, although by the end of a nap, she has managed to get her knees over it and work her way to almost flat...

We haven't talked about my milk mainly b/c she isn't fussy when she refluxes, she just gets irritated. I tried tummy sleeping, but she doesn't like it unless it's on me.  She does use a paci.

So are you saying to put her in her swing for 30 minutes during the night instead of on me?

I really don't think it's the pain that is affecting her sleep, but the habit of falling asleep on me (although when she does wake with gulping fits, then I know it's the reflux). Most of the time, I thinks she wakes after her first cycle of sleep and is wondering how she got in her crib and wants me to fall back asleep... but since the s/p doesn't work, I'm having a hard time getting her to do that.

PS - I do not burp her with patting - I do with rubbing and she burps great. And I tried shh/rub, but also to no avail...

[Zoey]

I would ut her in the swing or carseat or some seat like that for the 30 mins.  I just think that will be easier to wean if she falls asleep in it - later.  If she sleeps on you, well I think that is harder to break because - who doesn't want to sleep on Mumma?

I am glad you don't feel it's flux issues keeping her awake.  If she is overtired/overstimulated it may be hard to try and find any form of pat/ssh that is soothing, at that moment.  Try experiment when she first wakes up in the AM and see if you can find combination that is soothing.

Good Luck.  Let me know if I can help.
Zoey

[BlessedKylie]

What seems to work is the shush/rock. So here's my plan... I just did it for her 6:00 nap (we're a bit off schedule today)...

Do the 4S wind down. (She lasted about 3 minutes before she started crying)

Put her in the crook of my neck and shush/rock until she calms. Once she calms, continue shush/rock for 1 minute. After 1 minute, slow to half rock, and continue shh-ing for 1 minute. If she is still calm, stop rock altogether and shh only for one minute. Then stand and shh for 1 minute. Put her in her crib, (but continue as if I'm holding her - both arms around her and my chest on her head) and keep shushing. Minute after minute, slowly remove my chest, then one arm, then the other, then stop shushing.

If she starts crying after I stop rocking, then I first try the half rock, but escalate to full rock if that doesn't work.
Also, if she starts crying when I put her in her crib, then I shush and "pat" her, which actually kind of rocks her.

For my first test run, it took 25 minutes to get her in the crib and asleep. She slept 5 minutes, then woke up and seemed like she was trying to go back to sleep on her own. She did that for 7 minutes and then started crying. I tried to shush/pat/hold in the crib, but she kept crying so I picked her up and started again. The second time it took her 35 minutes to go to sleep. However, it has been 30 minutes and she seems to be out.

Does this sound like something that will work? Any suggestions or tweaks?

Also, during the night, I'm going to try to decrease her upright time. Tonight and for the next 3 nights I'm going to only do 25 minutes, then for 3 nights 20 minutes and so on until I can find the least time up that will not cause her to have gulping fits. Do you think that is an OK decision? If she doesn't need the full 30 minutes, I don't think I'm doing anyone any good by giving it to her...

A couple of questions though:

Should I treat day sleep and night sleep as two different things? Keep doing what I'm doing at night (since it seems to be working)? And do this for day naps? Or will that confuse her?

Also, since this will inevitably affect her daily sleep, her A time will be drastically reduced until this works. Should I just feed her, keep her up (mini-A) for 30 minutes and then start this? She will undoubtedly be overtired until I can undo what I've done.

Do you think the increased crying will make her feeds more frequent?

Do you think I should black out her windows during the day? I think she wakes at night, but puts herself to sleep because there is nothing to stimulate her (I have her monitor turned way down so that I only hear crying - she's a loud grunter).

[Zoey]

If your goal is to just get her to sleep, and get EASY up and running - then sure in this situation it sounds good.  But if you are aiming for her to fall asleep on her own at some point, then you should remove the rocking to sleep.

For variation ideas on pat/shh - you can rub - back, butt, head; pat butt; a gentle butt jiggle; gently rock her IN the crib; or try tapping the mattress next to her.  The shh part doesn't seem to be a problem.  See you can phase all of these things out when she gets older and work easily toward independant sleep.  Rocking and having her fall asleep on you - I can't see a way to lessen that to phase it out.  When you use pat/shh this young, you can use it to put her to sleep with it, and as she gets older you use less and less so that you aren't putting her to sleep anymore, she is doing it. 

As for the 30 mins, I think use your judgement - you can try to back off.  Owen at 7months still sits upright for 15 mins in his bouncer seat (not bouncing lol) after bottles.  If not he vomits, but that's him.  You can surely try.  When he was littler, he sat in the bouncer seat for 30 mins after each bottle and watched a Baby Einstein DVD (which is 30mins!) Experiement!  I would still stop holding her for that time, that isn't doing anyone any good

I am a big fan of consistency - so I would do the same thing for all naps so not to confuse her.

Yes at 8 weeks, alot of crying will make her hungry and increase acid production .

If baby is sleeping long stretches at night and goes back to sleep after a night feeding - basically her body knows day from night - then Yes, go ahead and blacken the room in the day.

I hope this helps!  Let us know if it doesn't.  I don't mean to burst your bubble about the rocking.  Like I said, if you goal is to just have her sleep, then go for it - if you wanna try and teach sleep and set yourself up to have an indep sleeper, then I would remove the rocker.

Love,
Zoey