Author Topic: Up Constantly through the night PLEASE HELP  (Read 942 times)

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Offline fazza47

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Up Constantly through the night PLEASE HELP
« on: January 31, 2009, 13:31:45 pm »
My son is 20 weeks old and still isnt sleeping through the night and is far from it.  I have read the BW book especially the sleep section over and over again.  I realise that TH has to be as general as possible in order to cover all angles but we are at our whits end and need help fast.  If only there was somebody like TH who could come round to our house and help us in person.

Charlie has reflux and has had from birth however it has never seemed to bother him during the night until probably the last two weeks.  Previously he would wake only twice have his bottle and quite happily go down again.

We have another three year old and a tiny house so when baby wakes my other son wakes adding to the nightmare.  My wife is in and out during the day so we have never actually but him to bed in his cot during the day and are to scared to now incase he switches day for night. 

He has always been a nightmare to put down.  We try our level best to have a nightime routine and it generally goes something like bath, change, pjs, bottle up into bedroom, swaddle, dummy and then wife has to rock him in her arms until he is calm and then puts him in the cot.  He will scream blue murder so he gets him out rocks him again until eventually he nods off.

He will then generally sleep for approx three hours at which point he will wake refuse a bottle and then continues to wake all night crying.  We spend our nights jumping up and putting his dummy back in hoping that he will nod off again.

He generally has four bottles during the day and takes no less than 4oz each feed.  We have been advised to get him onto solids early because of his reflus so also has a breakfast of fruit and a lunch of carrots and a pudding of fruit. 

What we are looking for is somebody to say do this do that as best they can.  SHush Pat has never worked and I suppose we are doing a varient on the PUPD although there is no way in the world we could swaddle him and put him right in his cot and walk out.

Please help and ask me anything in order that somebody can offer us some help as he is now five months old and we havnt been able to enjoy him once yet as it has been one thing after another, reflux, milk intolerance, Oral aversion.

In addition just read the please read before posting bit:

Daily routine consists of:

06:00 - wake
06:30 - Fruit and Bottle
07:00 - Activity sit in chair, nappy off on mat for a kick back in chair
07:30 - 08:00 - coat on dummy in and in buggy for a sleep (have to rock)

Nap anywhere between 30 mins and one hour wakes up screaming

11:30 - repeat above but without fruit
15:30 - repeat above but give him some dinner

Really had to get to have a sleep after this feed

06:00 - bath
06:30 - nappy change and pjs on
07:00 - bottle
07:15 - 07:30 - swaddle in bedroom
07:30 - put to bed

The above routine is not a strict routine as he is a very unsettled baby so tend to do whatever we can to sort him out times vary but not massivly.

Naps are all in buggy with coat on dummy in blanket and rocked last anywhere between 30 mins and 1 hour

He wakes probably every 20 to 30 minutes per night with longer intervals now and again

When he wakes it is usually a proper cry but can be a fuss or a mantra but to be honest havnt really examined the cry

A time consists of chair and mat with toys

His props are I would say his dummy he will not go off to sleep without it.



Help

Thanking everybody in advance

Mark
« Last Edit: January 31, 2009, 13:42:57 pm by fazza47 »

Offline Sarah - Enfys' Mum

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Re: Up Constantly through the night PLEASE HELP
« Reply #1 on: January 31, 2009, 21:33:28 pm »
Well, it seems to me he has never learned to put himself to sleep.  He's rocked to sleep, so when he wakes in the night, he can't get back to sleep on his own.  Have you tried PU/PD?  Also, if he's taking short naps all day long, he's probably very tired by bedtime and therefore not able to have a good night's sleep.  My dd has been in her cot for naps since she was born and apart from the first few weeks, hasn't mixed up her days and nights.  Have you got BWSAYP?  There's a section in there about putting a 4-month baby on a routine who never had one before. 
But first, I would make sure his reflux is under control.  You say it's been bothering him the last couple of weeks.  He may have grown and need his med doses changed. 

Good luck!





Offline A pair of Charlies

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Re: Up Constantly through the night PLEASE HELP
« Reply #2 on: February 01, 2009, 14:23:45 pm »
Hi

I'll be back in a bit with some links for you to sample EASYs for this age range, typical day and night sleep (to give you an idea of what's typical) and will try to find the link mentioned above for you.

It sounds like there's a whole heap of issues here which will make this hard to treat one bit of it alone (props, EASY, independent sleep, reflux)...but I'm no expert. A visit to the props and reflux board would give you help on those particular areas..

Back later. In the meantime, hugs. What a nightmare.  :-*

Charlotte

Offline Archies mummy

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Re: Up Constantly through the night PLEASE HELP
« Reply #3 on: February 02, 2009, 14:00:35 pm »
Hi I'm no expert but I have some ideas ;) Firstly you need to teach him how to fall asleep without your help (sounds easy doesn't it!!) Your lad needs rocking cos that's all hes used to. I would try holding him still in your arms until he falls to sleep to start with. Eventually you'll be able to transfer him into his cot sleepy but awake and settle him while in his cot. If you hold him still while dropping off to sleep for about 3 days he'll learn he can go to sleep like this too. Be consistant, after this time the odd nap in car or pram won't hurt but most of his naps should be somewhere still. It's so temptingto rock when baby is crying try and stroke his cheek or head to distract him. I would get rid of the dummy once you have this sorted (one thing at once!) as it sounds like he is becoming dependant. Good luck let us know how you get on.
Sarah



Offline A pair of Charlies

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Re: Up Constantly through the night PLEASE HELP
« Reply #4 on: February 02, 2009, 15:51:19 pm »
Hi Mark and Wife

Right then. I've had a trawl around BW and have found some links to further info for you which might help:

 * http://babywhispererforums.com/index.php?topic=85499.0
 * http://babywhispererforums.com/index.php?topic=85134.0 (will help you guage whether could be really OT compared to 'typical')
 * http://babywhispererforums.com/index.php?topic=10385.0
 * http://babywhispererforums.com/index.php?topic=69369.0
 * http://babywhispererforums.com/index.php?topic=64277.0 - a consistent wind-down pays off
 * http://babywhispererforums.com/index.php?topic=89906.0
 * http://babywhispererforums.com/index.php?topic=64745.0

A bit of reading though.  ::)

It's hard to pick where to start, I think. Independent sleep is holding you back as pps mentioned, he doesn't know how to get to sleep without you guys doing what you're currently doing. And this has to be taught. Good news is that at this age, it's a lot easier than tackling it in another 4 months time...the older they get the more stuck in their ways and start hitting developmental milestones like sitting and standing which make sleep training even harder (but still can be changed!).

Trouble is, you can't sleep train an OT baby. And with reflux in the mix too, it could hamper everything you try to do. So worth checking on the reflux board for ideas and info there. As for independent sleep, there is another board for that here under sleep... but it's a NW issue too isn't it!

Another small thought is the wind-down (I've put a link above). The bedtime wind-down may be different (ours is) and I find a bath helps get the wriggles out of the babe before the night starts.

When it comes to teaching independent sleep there are a few options:
 * PUPD is generally the choice at this age (there's a board for this too so they can give you much more detailed guidance on how to do this step by step...might be worth a post). Digressing...so PUPD is an option. But as far as I understand it, it's not very effective if you dabble with it as they learn that crying longer and louder will mean you'll cave...but not 100% on that. Best try Anna on the PUPD board for that!  ;)
 * I think LO's too young for WIWO (walk in walk out)
 * Shh patt can be a bit stimulating and frustrating to them once they get a little older, however it's much more gentle on the LO on the crying front so might be worth a shot. I'll drop you another post with some guidance on shh patt but it really really long and detailed. But gives you a start point and you can pick the bits you need, if you choose shh patt... you mentioned it hasn't worked for you in the past. Might be worth another try, but only shhing or patting, IYKWIM. I've put a link to a modified shh patt further down this mail. It's a bit of a combination.
 * Gradual Withdrawl: If you feel you need to be close, and looking for a less upsetting way of sleep training, this might be for you. But it can take a while. Basically, you do a little less of everything that helps him sleep so that he learns to do more of it himself. Shh patt can help here (try maybe one or the other rather than both?) to keep them calm in your arms when you stop your AP (the rocking etc). Your aim is to get him used to going to sleep without things that only you and the wife can do. So as pps mentioned, asleep in your arms still - not rocking - then laid down in cot...and so on. I did GW over several months.  With GW, you can set your own time goals. I'll PM you something on that.

I started with a baby who would only sleep on me. Quite spirited (both he and I) so PUPD just wasn't a good thing for us; it just wound him up beyond belief. I got him into his cot with shh patt and almost sleep training with a modified shh patt...only to go on hols and it all go horribly wrong  ::). Then we did GW. He's now an independent sleeper.The modified shh patt was advice given to me on this post: http://babywhispererforums.com/index.php?topic=128706.msg1402892#msg1402892

I've rambled on, sorry. Hope some of this helps. Any queries, questions just let me know. Also, keep us posted on how you do!! And good luck to the pair of you - let's see if between us all we can get you to enjoying that lovely babe of yours (I know how you feel on the not getting a chance to enjoy...).  :)

Charlotte
« Last Edit: February 02, 2009, 16:23:15 pm by A pair of Charlies »

Offline A pair of Charlies

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Re: Up Constantly through the night PLEASE HELP
« Reply #5 on: February 02, 2009, 16:15:39 pm »
The ridiculously long post, below had some ideas. Even if you're not going to give shh patt a go, worth taking a look as gives you an idea on how to start GW (doing sp without the sp, IYKWIM.

 * Our wind-down: I swear by a short but rock solid consistent wind-down routine: Ours is a walk upstairs to his room; change nappy; put on sleeping bag; close curtains (and blind, both with blackout lining) saying bye bye sky, clouds, sun; put on music (plays throughout nap on a repeat; a quick slow smooch of a dance for 30 seconds or so to get his head in the right space and then into bed; key phrase 'time to sleep'. 5 mins usually. Hasn't changed in many months. At night, this stretches a little: toys put away, upstairs for a play (chasing around like madmen to wear DS out), bath (last few mins are quiet), dry and dress ( I put clothes and sleeping bag on radiator while in bath so it's all warm), good-nights at the window (sky, stars, moon), story, prayers, BF, goodnight cuddle, bed.

 * A time cool-down: The other thing I do (particularly if tweaking A or if he's a bit funny) is have a cool down of 5 - 10 mins just before wind-down. So nothing electronic and noisy, no rushing about with a trolley etc.

 * Constant sound or music: I play music constantly (same CD on loop, a diff one for night sleep) and it helped us a little. White noise also has got some mums great results.

 * Making the bedroom a friendly safe place they know & like: make sure the bedroom hasn't become a battle ground so perhaps let him have a play around in there (nothing exciting, more exploring) after a nap, casually - unless you do this already. If there's been sleep troubles, they can get wound up going into their room. Could also just stand at the window with him for a bit, reinforcing that it's a nice relaxing, safe place to be. Not a scary place they need to be rescued from.

 * Pain meds / teething: when something's disturbing my DS's sleep, I give him meds. The teeth can disturb them and be really uncomfortable (I imagine) without them crying out in pain. They can be moving long before they show and can disturb sleep. I think they seem to suffer more with them when they lie down to sleep. I also put on bonjela teething gel before naps if I think DS may be teething just so the discomfort holds of while he goes to sleep. There's some homeopathic tablets that some of the Mum's here recommend as they have great results with these.

 * You: pretend, act, do anything to be sing-song calm when putting him down. Lots of affection and reassurance during A when there's nap bother. No clashing or fighting - with my DS, we used to clash over what we wanted (I wanted him to sleep; he didn't want to be 'made' to) and horns would lock. Find a way of making sleep what he wants (getting the A times bang on helps with this), being supportive and caring while he drives you bonkers. I found this next to impossible but it works.... If my LO senses anger, frustration, desparation, tears etc, it's impossible for me to leave. He clings through the bars because he's scared and doesn't want to be left alone. You are their world...it must be terrifying for them. So I learnt from experience that faking the calm, serene Mama works best (even when I'm in tears outside the door a few minutes later).

 * OT: I have a rule that we still stick to now. If OT and the usual thing (SP or GW) isn't working, then we AP to get DS to sleep by whatever means neccessary. I had 3 options I knew: pram (didn't always work for me), car (90% success here) and my snuggled against my chest (was 100% now 5%!  ). I'd pop him in the car first of all, check he was warm enough and drive. He woke if car stopped (rushhour was a 'mare), same with a pram. I would drive for hours if necessary around and around and around. Dual carriageways, ringroads, motorway...anything to get him asleep and see off the OT demons. The next nap we'd get back to that bed and try again.

 * If bed isn't LO's favourite place, try the afternoon nap somewhere else that they like so they get a break of scene before nighttime. I did the pram for the afternoon nap. Slept better with fresh air, helped me get out and feel a little more human.


I started shh patt at 8 or 9 weeks when I discovered BW, thank GOD. Until then DS was a babe in arms and only slept on me, or by trickery. Don't go beating yourself up when you need to AP to get through tough times. Don't beat yourself up at all. 

So shh pat. It got my LO off my chest and into his crib pn the first go so I am a massive fan. I think for some babies the combination of shh and patt can be too much (the closer they got to 3 months I found).  This is what I did to get him off me and in that crib, and stay there:

 * make that crib nice and cosy: I stuffed a couple of hand towels rolled up down the sides so it was soft and snug against his body. When he was really tiny I also took off the top I was wearing (so it smelled like what comforted him) and popped it in there too (side or underneath. A muslin that's spent a few hours under my top, tucked in my bra also worked well - folded and tucked along where a pillow would be. Great for spitups.... Oh, and a wheattie or heatpack or hot water bottle to warm up the bed just a little helped me too. Or put the blanket on a warm radiator first. Anything that would make you feel cosier if you were them, IYKWIM?

 * find a rhythm that works for you both: the first time I tried shh patt it didn't work. I was shhhing like a banshee; loudly, too fast, too stressed to be relaxing and sounded panicky. Enter DH who (less stressed and tired) found a rhythm for us. My shhh sounds, to me, like water coming in over pebbles in the tide and back out again...so it's stronger in the middle and long. Then I got my pat rhythm too, I tried the tick tock tick tock (I'd used a heart beat rhythm previously and that worked well too). Very gentle pat on middle of upper back. I kept in my head what it was meant to simulate: womb noises, the wooshing of fluids and the tick tock of your heart. Your LO's used to that sound; comfort. You're recreating it. Not loud, not stressed, not panicked...just gentle and try to tune out if you know what I mean? Sounds unbelievably anal but over a count / beat of 8 (tick tock = 2), my shh lasted 6. Silence for 2 counts and then ssshing started again. The pat was constant. To keep calm, I tried to think back to the times I would pat my tummy gently (or rub) when DS was on the inside and had hick-ups. We had more success when I was in that mindset.

 * right then. shh patt  him while holding him over your shoulder or, if you can, in a cradle position (less noticeable when LO's laid down). Keep it going: if screaming, be a little louder so LO can hear (but not so it's loud and scary) and quieter when they quiet down. As soon as you feel that lovely little body going a little more limp and floppy get ready for your move...and keep patting... and shhing...do not stop....now move them into the sleeping position still in your arms...still patting, shhing, still your warmth. Now start moving into the crib / bed, still spspspspsp. lay down gently and keep your face close to theirs (oddly warm breath near his cheek would often resettle my LO when being moved), once you've laid down, keep spspspsps. Hard so you might need to lay on side to reach back or start patting on chest (I found back hard after a while so I started patting chest before I laid down and continued in crib), keep it going but start easing off the volume and the pressure of the pat, slowing both gently. I did this until he was in a deep sleep. And sometimes he'd wake, and the SP would begin again (while still in crib whenever I could). Sometimes I'd fall asleep SP'g. Gradually (but as quick as you feel you can) start doing less and less of the sp to get them to sleep: so aim to get them in their bed, comfortable and ready for sleep. Initially, wait with them until you know they're in the deep sleep. When I was desparate for DS to get a really good sleep, I'd stay with him so that if he stirred after 30 or 45 mins, I could get him back to sleep very quickly and with little effort (often just the gentle pressure of a hand on his chest could be enough). Investing time early on pays off; leave the room too early when they're just in a light sleep and you could be doing it all over again...

 *going down sleepy but awake: great to do this if you can. I couldn't initially. DH would put him in asleep, after a few mins of sleep in arms with SP (still SPg). I would put DS in as soon as I felt his head flop a little then get him to deep sleep in crib. Over the space of a week, I put him in the crib earlier and did less SP to get him to sleep. So...initially when his head flopped a little (just fallen asleep). Next time, just as head flops. Then just as body goes limp and relaxed but before the head flop... do you see what I mean. While in the bed, gradually do less SP to get them asleep. The shh pat is the means of you sneaking them into that bed without their noticing, IYKWIM

 * keep an eye on the road ahead: where you are heading - to be able to take your baby and, after a wind-down, lay them in their bed awake and leave them to put themself to sleep. It may seem madness, but it's where you want to get to. So everything you do should be a move towards independent sleep (there are times you can't. AP with rocking etc can be necessary when you both need rest). Over time (a couple of naps, a few days, a week - depends on babe) SP slows and eases off so it's your hand on chest with a little gentle pressure. And then nothing at all

 * cries whenever you lay him down: If you were in the cosiest place you can imagine, you'd be vocal when moved. You are warm, soft, smell like home and comfort and LO's world. Snuggled up with you is where they want to be more than anything so any move from this isn't really met with great joy. The aim is to get them so relaxed and focused on the sp that they don't really notice the move (helps if you're moving them somewhere warm!) and feel that you are still near (breath, warmth, pressure of patt initially). They don't know the bed is safe. But you do. Sounds obvious but in the frustrating sleep deprived hours I had to remind myself of that all the time to keep my sanity: babies are not rational.

My LO cried everytime put down for the first few days I think. And sometimes does now. If LO's distressed and upset, pick up and keep the sp going til they're relaxed again. And start the move again...frustrating, much? I tried to comfort in crib wherever possible, but sometimes it's not. Judge quickly the type of cry - a resettlable grizzle or an all out 'I need you' cry. I'd pick up if the latter and resettle with SP in arms; I'd try to resettle a grizzley cry in the crib but not always possible.

 * Crying. This is a personal choice. Lots of mums have success by leaving a mantra cry to settle itself and then go in if it hasn't stopped after x minutes. I never leave my LO to cry really, especially when sleep training, because leaving it hasn't worked for us. With mantra I reassure with voice as much as possible (usually outside the door, over a monitor) and then leave it a 30 seconds or a few minutes to settle himself. With the other cries, I go straight in and reassure (kiss on head, stroke cheek, soft voice for key phrase ' time to sleep') and then start backing off, slowly. I found with DS, letting him cry a few minutes actually worked against us - he seemed to feel abandoned and was awful to resettle. He settles himself a lot now (I think he knows he can do it, and that if he needs us he just has to belt out a cry). CIO is a whole bag full of hurt and will take a lot of hardwork to repair the trust, and destroys your heart while you leave them crying.

It's a horrifically really long post and I'm sorry. Just trying to give you everything I can think of to help you. Be patient, be calm, find your rhythm.

HTH

Charlotte