Back to 45min naps - HELP!

[LCBO0912]

Hi,

My son Ben, who will be 6mos next week, suffered from serious reflux from the time he was 1mos.  He experienced a lot of pain (even with medication) and copious amounts of vomiting, to the point that it was affecting weight gain.  Thanks to great medical care, along with some thickened feeds and effective medication, he is doing much better and most of the symptoms of his reflux have dissipated.  He doesn't experience the pain any more, and his vomiting has basically stopped (for the most part).  He has been gaining weight steadily over the last month, and is a much happier baby all around. 

Because of his reflux, getting Ben on a "schedule" was somewhat difficult. Feeding was basically a nightmare throughout the day; his feeds would take forever, and to avoid launching him in to a major vomiting episode, I was feeding him smaller amounts more often.  As such, 2hr naps weren't even really realistic for Benjamin.  Forty-five min. naps were actually ideal, and his actual "bedtime" was 10 (he would, of course, nap in between feeds at night before bedtime!).  He would sleep soundly from 10-6:30am.

Now that things are under control regarding the reflux, we've been able to establish a six-feed, 4hr feeding routine.  Now I'm struggling to get Ben to nap for longer than 45mins.  We were doing OK at one point - we were able to get him to nap for 1.5/2hrs at least for his morning nap, but then my husband and I had to go away for the weekend and we left him with my mom.  Since, he adamantly refuses to have a nap that lasts longer than 45mins.  I've tried PU/PD, as suggested in the BW, but it's not working.  I'm desperate for some answers as I believe it's affecting his night sleep now.  Once a sound night sleeper, he's taken to waking up several times in the night.  I'm not sure what to do.  Here is our daily schedule:

E: 6:30am - (breastmilk) and wake-up for the day
    8:00am: cereal
A: 8:20
    9:15am - wind-down (reading quietly in his room)
S: 9:30
y: 9:30 - 10:15 "Me time"
E: 10:30am (breastmilk)
A: 10:45
    11:20 - wind-down (reading quietly in his room)
S: between 11:30am and 12pm
Y: until 12:30 at latest, "me time"
A: 12:30-1:30pm - more playtime because he wakes up early from his naps!
E: 1:30pm thickened feed (Breastmilk + cereal)
A: 2pm
     3pm - wind-down (reading quietly in his room)
S: 3:15pm - I usually have a hard time getting him to sleep for this nap!
Y: 45mins
A: 4pm - more playtime because he wakes up early from his naps!
E: 5pm (breastmilk)
    5:15pm - solid foods
A: 5:45 - a lot of independent play while I make dinner
S: 6:15 - 20min catnap
E: 7:30 - thickened feed (Breastmilk + cereal)
A: 7:50pm bathtime
     8:10 read stories
S: 8:20/8:30 in bed and sleeping sleeping for the night

I give him his dream feed at 10:30pm.

Please help!

[deckchariot]

It sounds like you've had a really rough go of it with your ds!  I'm glad the reflux seems to be under control for the most part.  45 min naps are fairly common at his age, but looking at your routine, there are a couple of things you might want to try.

1. tweak his A time.  45 min naps generally indicate a lo is undertired - though not always.  At 6 mos, most lo's can handle a bit more than 2 hrs.  It looks like his first A time is 3 hrs, but his next one is 2...I'd aim for 2 hr 15 min consistently.  Actually, the first A time of the day is the one that tends to be the shortest. 

2. move his bedtime earlier.  I'm guessing you have it late to try to get the feeds in during the day.  However, lo's tend to work best on a 12 hr day.  So maybe try something like this:

E - 6:30
A-
S - 8:45 (start wind down at 8:30)

E - 10:30
A -
S - 12:45

E - 2:30
A -
S - 4:45 (cat nap)

E - 5:30
A - start bedtime routine around 6:30
E - 7 and to bed

keep the df at 10:30, and that will still give you the same number of feeds during the day, but gets him on a 13 hr day, which is closer to 12.  If he seems more tired as the day goes on, you can do his cat nap earlier and then feed at 5 and 6:30.

3.  Move his solids "dinner" to a solids "lunch".  Solids can often mess up sleeping, so its best to start with the earlier meals to prevent any issues with nighttime sleep.  Especially with reflux, I think it might be best to do lunch of solids rather than dinner - until solids are well established and he does 3 solids meals a day.  At that point, you could probably do a solids dinner at the 5:30 feed and go to 5 feeds a day.  I'm not a reflux expert though by any means.


When you say pu/pd doesn't work, what do you mean?  If the routine tweak doesn't help, you could try w2s instead of pu/pd.  I'm guessing that switching up his routine may help with the 45 min issue.  Does that make sense?

HTH
michelle

[LCBO0912]

Hi,
Thanks!  These are good suggestions.  I'll try keeping him closer to 12hrs total, as well as try keeping him up for 2.25hrs.  It's just that I pay attention for his signs and usually before 2hrs he starts rubbing his eyes, pulling his ears and so on.  If he's doing that at say 1.75hrs, should I still wait?  Wouldn't that push him to the overtired side and be just as bad?
As for moving his solids, I give him a thickened feed (breastmilk + cereal), which helps keep things down for him.  I'm seeing his paediatrician next week so I'll discuss moving things around.  We initially established that feed at that time prior to the intro to solids, so I'll see what we can do to move things around.
All I meant by the PU/PD doesn't work is that when he wakes up after 30 or 45mins, I sometimes try PU/PD, and it never ever works.  I've stayed there in his room for over an hour several times this past week and it doesn't do one iota of difference.  He will absolutely not go back to sleep.  I'm leery about W2S because I've been using that to deal with some recent night wakings, and it also doesn't do any good for Ben.  How would I employ this technique in a nap setting?  When would I go in to rouse him?
Thanks!
Leah

[deckchariot]

Sorry I've been off line for a bit, my dd is sick...

tired cues - I found with my dd that they began to be harder to read as she got older - often her tired cues were really "I'm bored" cues, and I found I could extend her if I simply switched up what we were doing.  However, it is possible that your ds isn't ready for longer A time.  You could try just extending 10 min with some really low key A time and see what happens.  Or you could just extend your wind down time so he goes down a bit later.  If he gets OT (and naps get shorter), then he's not ready, and shorten it again.

When we did w2s, it took me about 10 days to get the timing and the "waking" right.  You would go in about 5-10 min before he usually wakes during his naps.  What I did is for the first couple days, I went in 10 min early and just watched to see what happened when she woke.  I then had to use pat/shh and/or pu/pd to try to extend.  Then, I'd go in 10 min early, and when I saw the signs that she was about to wake up, I'd put my hands on her and "hold" her as she got to the transition in the sleep cycle.  If she kept squirming, then I'd start pat/shh while holding her.  Eventually, I got it right and was able to extend her past the 45 min wake up, but it wasn't a quick fix.

How's it going?  Hang in there!!