4.5 Month Old Chronically Overtired -- Please Help!

[WillowTree]

Please, please, please help... Things are such a wreck!   

Our 4.5 month old DD is incredibly, chronically overtired.  She has been this way for so long now.  And the problem was recently severely worsened while working with a pediatric sleep center that mucked with her sleep terribly.  We are no longer working with them and are desperate to heal our LO.  She has been a very poor sleeper all along (hourly wakings, wanting to go down for the night at 3 or 4 in the afternoon, only cat-napping), but recently made some incredible strides.  She's been sleeping a good 11-12 hours each night without waking, but her naps are a horrible mess.  Rarely more than 30-45 minutes.  We tried some things to extend naps, but it's been recommended that we first get her out of OT before we can develop a routine, work with A times, extend naps, etc.  DD has also become much better at self-soothing -- she sucks her thumb to help herself fall asleep.  All sleep is now in her crib.       

We only recently discovered BW.  I am so ashamed to say that we were accidental parents to the extreme (tried to follow Dr. Sears attachment parenting and it really did not work for us or DD).   

We tried to implement a 4-hour routine as detailed by Tracy in TBWSAYP pp 39-46, but put a stop to it with advice from a wonderful lady on this forum.  She advises keeping A times very short and quiet, and just napping DD as much as possible through the day.  We are doing are best to do this, but DD just will not settle back down.  She's always awake for 1.5-2 hours no matter what we do.  And she spends much of this time trying her little heart out to go to sleep.  We even try to settle her before she gives sleepy cues, as her cues seem to come a little late these days.  We also started putting her to bed very early as of last night -- 6pm.  (She does wake earlier when we put her down earlier... I know that's not supposed to be the case...)   

Our wind-down consists of carrying her into the nursery, making everything dim, changing her diaper and singing softly to her.  We then hold her in our arms by her crib for a few minutes before laying her down.

I'm sure I'm leaving out relevant details, but I'm so desperate to hear any additional suggestions that might be out there... So sorry to ramble.  Any thoughts are greatly appreciated.  Thank you so much! 

[lilac83]

Hi~ Could you post what a typical day looks like for your DD? That's great that she's sleeping well at night, that's definitely half the battle. Hopefully we can get her sleeping better during the day soon too!

[Joelle]

Hey Willowtree,  wow- days must be full on for you!! I can totally relate! I have a 4 month old bubba as well and I too have to work hard to have her day sleeps be as good as her night sleep, which, like you, is a good 12 hours. Some days I have found it best just to totally go with her flow and get her up and put her in her bouncer and let her play because its really obvious she wont go back to sleep even though I know she probably needs it!

I have had DD on a routine from the moment she was born and it has worked really well for her (she was sleeping through the night from 6.5 weeks) and has continued to be a good sleeper (most of the time!!). However, her day sleeps started getting out of hand about 3 weeks ago, but recently I had a bit of breakthrough which may assist you- The moment I notice her tired signs (even if it seems too early) like staring, fists clenched, rubbing her eyes, I immediately wrap her and put her to bed. I found that I had been letting her go too long in her 'A' time and then she was going past her 'wind down' and back into very awake again... Once that had happened, I'd missed the window for sleep and then I'd only get 45 mins nap from her and rest of the time it was on for young and old. Since starting this, she has given 3 x 2-3 hours sleeps throughout the day.

Although we are definitely fans of routine and it totally works for us, it has also helped to be led by her as well in terms of hunger and tired signs, so its a team effort between her and us. If she's screaming hungry an hour earlier than the routine dictates, I will absolutely feed her, if she's tired straight after a feed, I am inclined to put her to bed. This isn't generally the norm, but does work for me to listen to her cues on these occasions.

My routine (if it helps) is as follows:

6.30am 'E': I get up and she's already awake and playing in her cot. I feed her.**(This morning at 7.30am she fell asleep in my arms straight after her feed and rather then really wake her up I thought 'what the heck, I'll see if she goes back to sleep'. I'm really glad I did because she slept for 3 hours!!)
7.00am 'A': Activity time for however long - this is where I watch for tired signs. generally, however, she will be awake for 1.5 - 2 hours all up.
8.00/8.30am 'S': Sleep time- I wrap her and put her back to bed.

10.30am 'E': Feed
11.00am 'A': Activity
12.30pm 'S': Sleep

2.30pm 'E': Eat
3.00pm 'A': Activity
3.30pm 'S': This sleep always comes early

5.00pm 'A': This is where our routine changes and she's up and awake and firing on all canons but not hungry. So we play, go for a walk, have our bathtime etc. Then, when she's hungry generally around 6.00pm/6.30pm I feed her.
6.30pm 'E': Eat
7.00pm 'S': To bed for the night

10.30pm: A dream feed, but she is starting to drop this feed.

I don't know if this helps, but I can totally relate to the no sleep during the day! Last week DD pretty much went the whole day with 2 x 45mins naps!! It was crazy!

You are doing an amazing job! Your bubba is sleeping through the night, which is so awesome! Let us know how your day naps work out!!

[WillowTree]

Thank you, Robin and Joelle!!!! 

I WISH I could post a typical day for you... Ugh.  What we've been advised to do for the past several days is to throw everything aside and work on getting DD out of OT by following her cues and letting her nap as much as she wants, whenever she wants.  In so doing, the days have been all over the place... And no matter how quickly we pounce on her cues and wind her down, even if we wind her down in advance of sleepy cues (because she often gives them a bit too late -- if at all), she still never sleeps long.  The most is probably 50 minutes.  And it's more like 30ish minutes most of the time.  (I should mention: To wind her down, we dim lights, turn on white noise, change her diaper while singing softly to her, read her a story, cuddle her for a moment before putting her in the crib... She counts on sucking her thumb, so we don't swaddle.  She stopped liking the swaddle at around 3 months, actually...)  She often seems tired within an hour or less, but will inevitably be up for closer to 2 hours trying to get to sleep.  Yesterday she took 4 naps.  Tried for a fifth before bedtime, but even though she was so tired and frantically wanting to sleep, she just couldn't get there.  Ended up being awake for over 3 hours!  So we just got her ready for bed.   

We try to keep her A times very, very short and quiet, but she STILL has huge problems falling asleep... which means she's awake for longer than she should be (often fussing/crying for 30+ minutes, sometimes way more, as she's trying to fall asleep).  So the OT cycle just repeats and repeats.  Even AP doesn't get the job done.  And sometimes our presence -- patting, shhing, pu/pd -- just seems to make it harder for her to fall asleep.  Like we're a distraction.  Especially me.  When I pick her up, she instantly wants to nurse for comfort and gets even more worked up.  (Definitely not legitimate hunger -- many times she'll have just eaten -- but she's been nursed for comfort in the past...)  And when we were trying for a routine, when it was time for the nap to end and time to eat, we were afraid she was learning that if she screams for 1.5 hours, she'll get to nurse -- not learning to extend a nap.   

We are very new to BW.  What we had been doing was trying to get DD on a 4-hour routine following Tracy's plan on pp 39-46 of TBWSAYP.  She states that if you have a 4-month old who has never been on a routine before, you should definitely start with 4 hours.  And that to get them on the routine, you have to hold them to the clock times during the retraining period (as opposed to following their cues).  So we tried this:

7:00 Morning Waking, Eat, Diaper, Dress
7:30 Activity
9:00 Nap

11:00 Eat
11:30 Activity
1:00 Nap

3:00 Eat
3:30 Activity
5:00 Nap

6:00 Quiet Activity, including Bath, PJs
7:00 Eat, Read Stories
7:30 Bedtime

She fell asleep quickly at nap times (often in advance of nap times), but never stayed asleep (and then had to have longer A times as a result).  And she was sleeping great at night.  We've had a little NW & EW since we started trying to get her out of OT.

We're also concerned that doing PU/PD, etc. to extend naps or even just following Tracy's plan to get her on an age-appropriate routine would just take her right back to OT... assuming we were able to get her out of it in the first place.  On the other hand, we know that a lack of routine can create/exacerbate sleep problems, which is why we were eager to follow Tracy's plan.

I know, it's such a mess, isn't it?  DH is staying home from work today so we can figure this out.  We felt like DD was doing better when we were trying Tracy's plan... Maybe we should get back to it?  DD's sleep has been an utterly life-consuming issue for months now.  I'm just an absolute wreck... and feeling like the worst mommy on the planet.  Any additional guidance you can offer is greatly appreciated.  Thank you so much!

[*Liz*]

I'm not the right person to advise on napping as I have struggled for weeks with my ds - and still do. Things are easier now - but we still get plagued by the short naps all the time. It got easier at about 5 mths as I think some of this short napping is developmental really.

But - you are not the worst mummy on the planet - you just have a baby who hasn't figured out daytime sleep yet  You care very much and that is why you are putting all this effort in.

[WillowTree]

Thank you so much for your words of encouragement...

What happens to your daily routine when your LO takes short naps?  How does he get through the day until bedtime?  Do you find he's OT?

[lilac83]

Like Dyeeli said, a lot of this short napping is developmental. It seems to hit most LO's around 3/4 months and lasts until about 6/7 months. It's absolutely not anything you're doing/not doing. What I would suggest is try to follow her cues for 2 days. Don't worry about the clock. Put her down when you think she looks tired, feed her when you think she's hungry. Keep a log of all her days, if you would like you can post each day on this thread and if anything jumps out at anyone they can give you their thoughts/advice. Try to be fairly specific with how long wind down was, how long it took her to fall asleep, how long she fed and anything else you feel would be of importance.

Your wind down looks great! I'm wondering if it's happening a bit too early though and she's still UT when laid in her crib, but then shifts to OT when she doesn't settle. Let's see what the next 2 days look like though and then we can get a solid plan in place!

[*Liz*]

Well sometimes we manage to catch up, and other times the routine goes out the window! But tomorrow is another day.

I suppose I do all sorts of things to try and avoid a screaming baby at 6pm. My ds is quite good natured and can handle a certain degree of tiredness without too much of a disaster - but it does affect his nighttime sleep a lot.

If his first nap is short I follow cues for the next nap, and feed when I go over 3 hrs (I mix BF and bottles and usually use a 4 hr EASY). If the second nap is another catnap I either follow cues or get out the buggy for the next nap and hope he will stay asleep for an hour or so when I get home. If I've had three short naps then he goes to bed early at 6pm instead of 7pm 

When I get a very OT baby I prefer to do a bit of APOP with the buggy or car drives to catch him up for 2 days and then try again - but my lo is independent to sleep when he is well (this took a little time but we got there). I have tried to get him out of OT with very frequent naps but have found that there is only so low he will go now. So for example if he was extremely tired and fell asleep in the car seat for 20 mins but wakes when we get home I'll have to give him a bit of A time until I get fresh sleepy cues else he just won't go down - I have to let the sleepy cues from the premature wake up go away first. But I only AP once a day when its all a real mess - I don't want to confuse him.

You will find a way of soothing to sleep - it just takes a bit of experimenting. My ds cannot see me either else its game over. These days I just leave him too it and only return if he needs me. But when he was the same age as your ds I used to make sure the nursery was very dark, and sit at the top end of the crib where it was harder for him to see me. I used to shhh and put my hand on his head. He seems to have gone off this now though.

It sounds to me as though your lo is getting there really - she is learning a method of self soothing at the moment which is unfortunately just taking her too long and she often can't get over that final hurdle. It will come  .

How did you used to get her to sleep? Was it a BF? If so its just taking a little time to adjust. My ds sucks his muslin cloth now.

But just to say again - the naps with lengthen. I got my first 2 hr crib nap when my ds was 15 weeks old, then none again for another month, and then slowly they started to arrive. It was purely developmental - he had to learn how to get through the sleep cycles and as he was independent to sleep there was nothing I could do to speed up the process.

[peachespoe]

My LO is almost 5 months. She would only nap 30-45 minutes at a time until about two weeks ago, when one of those naps magically extended on to 2 hours one day. I do think its developmental. Since then she has at least one longer nap a day (usually mid day). Other than that, I just let her wake when she wakes. Usually she is happy upon waking, so I figure she got the rest she needed. Now, her night sleep is another story. She sleeps around 7pm to 6:30 am these days, waking to nurse twice and then a few other wakings here and there in which I or DH have to help her back to sleep. We are really struggling with the nights.

SO, if your LO is sleeping so well at night I think that is great!! Why do you think she is OT? I have a friend who's 5 month old sleeps 12 hours at night and only catnaps 30-45 minutes throughhout the day. She figures if he is sleeping so well at night and seems happy duing the day, why mess with the naps.

With our LO, we have had success putting her down for naps following the 90 minute rule. About 90 minutes after her last wakening she starts to show signs of sleep. About 70-80 minutes after waking, we start to calm things down, maybe walk her around a little, talk softer, give her a massage, etc. Then between 90 minutes and 2 hours we watch for the signs of sleepiness. We swaddle her, give her a paci, and rock her a little. She used to fall alseep easily that way. Lately she has quickly escalated into OT meltdown-mode-of-no-return when it is very hard to soothe her. Just yesterday, I decided I had had enough with these meltdowns. I knew she was tired, so I put her down in her bassinet (swaddled) and did a combo of shhh/pat and PU/PD, leaving the room at two minute intervals. I really thought that she would cry for an hour, but it only took ten minutes of this. I did it again in the afternoon and it took just one two minute interval. I did it again this morning and again, she was out within two minutes and has slept so far for an hour (she is still sleeping). Usually this early morning nap is just 30 minutes. I am going to keep at it all week and hope this helps with the nights. At six months we will do this at night too (and try to get rid of the paci), but I am not ready yet.

I recently ordered a book called "The 90-Minute Baby Sleep Program: Follow Your Child's Natural Sleep Rhythms for Better Nights and Naps" by Polly Moore. I haven't read it yet, but it has good reviews on Amazon. Since I obsereved this 90 minute cycle with my LO on my own and its very consistent, I figured I should read the book to see what she has to say to help us at night.

[Joelle]

Hey WillowTree! Just dropped by to see how you're doing?? Hope LO is sleeping better and you're feeling a little more sane!!! ((((((((hugs!)))))))

[WillowTree]

I'm so sorry I've been absent for so long.  I don't even know where to start!  Thank you all so incredibly much for your wonderful advice and support.  This is truly an amazing community of moms!

We've been following Tracy's plan on pp 36-49 of TBWSAYP.  (This is where she details how to get a baby LO's age onto a routine if they've never had one before.)  We've committed ourselves to sticking with it consistently two full weeks to see what kind of change it makes for our LO.  Tomorrow is the one week mark.  Things are going all right -- I admit I can hardly bring myself to talk about it, as I don't want to jinx any progress we're making!  She's been taking longer naps, but we're not out of the woods yet.  The routine may need work at the end of the two weeks...

I'll check back soon!  In the meantime, thank you from the bottom of my heart for reaching out.



 

[WillowTree]

Oh dear.  Where do I begin, ladies?  Our efforts to strictly follow Tracy's plan for getting DD on a routine seem to have helped greatly, but we are definitely still having some troubles.  I'm starting to wonder if that's just how it will be?  Some days will be good, others will be a wreck, and so it will be until LO is all grown up -- or at least no longer napping.

A little background on DD:  She sleeps through the night.  She does fall asleep on her own.  (She sucks her thumb.)  We have consistent routines for naps and bedtimes.  (In fact, we are quite militant about it.  I may never get out of the house again in the name of LO's sleep!)  We have also darkened her nursery considerably, which seems to be helping her stay asleep.

The routine we try to stick to looks like this:

E - 7:00 (both breasts)
A - 7:30
S - 9:00 (can be as long as 2 hours; often 1-1.5 hours)

E - 11:00 (both breasts)
A - 11:30
S - 1:00 (can be as long as 2 hours or as short as 40 minutes! often 1 hour or more)

E - 3:00 (both breasts)
A - 3:30
S - 5:00 (often 45 minutes)

E - 5:45 (one breast)
A - 6:00 (includes cuddles, bath, jammies, BF - both breasts, story)
S - 7:00

Bedtime used to be 7:30, but we've ended up doing it at 7:00 lately because she's so tired when her naps are mucky.  For the past several days, her cat nap has been happening at more like 4:30.  And that afternoon nap can be long or short - hit or miss!  So it's quite hard to tell you how long her naps are.  We just wake up each day, cross our fingers, and hope for the best.

Here are some of the issues we're having:

(1) DD wants her morning nap after only maybe an hour (or a little more) of A time.  Pushing her to 9:00 as Tracy says to do it tough.  She will often wake early in the morning, babble a bit, and then go back to sleep.  I understand that this is normal.  The trouble with this is that her babbling often occurs too close to her wake up time of 7:00 a.m. (often around 6:00-ish)  Now, I feel pretty sure this isn't her waking up for the day, as she will sometimes fall back asleep before I come to get her up at 7:00.  And when she doesn't fall back asleep, she gets tired very soon after eating. 

(2) Sometimes it isn't babbling that wakes her in the morning or from a nap -- it's a poopy diaper.  And then she can't get back to sleep.  Poopy diapers have been sabotaging naps, too. There seems to be no way to avoid that? We try not to rush into her room if we hear her wake up (gives her a chance to fall back to sleep before we distract her), but it seems that sometimes she's been sitting in poopy and that's keeping her up. (She won't do more than fuss a bit until a good 30-40 minutes go by, so we discover the poopy too late. Not that she'd be likely to go back to sleep anyhow.)

(3) DD doesn't seem to be able to handle the A times that other 5 month olds can handle.  For instance, I had to wake her up at 7:00 this morning to keep on routine.  (Or should I not?)  She was not happy about this despite having slept straight through (with the exception of maybe 10 minutes of babbling in the early morning, to the best of my knowledge) from 7:00 last night.  She was ready to go back to bed after only maybe an hour. 

(4) LO always gives tired cues well before her nap times.  It's my understanding that she really should be able to handle 2 hours A time -- and should be encouraged to?  (It may sound crazy, but I wonder if DD would ever increase A times without our pressing the issue...)  She had a wonderful nearly 2-hour nap this morning, but was STILL fighting to go back to sleep well before 1:00.  I don't want to put her down too quickly and encourage a cycle of short A times, short naps...

I hope I've made some sense.  I'll be happy to clarify any points I can -- and I greatly appreciate any guidance.  I can hear LO stirring... That seems to have been a good 1.5 hour afternoon nap, but I bet you she struggles to get to the cat nap!  Is it too much -- to go from 2:35 in the afternoon to 5:00 for a cat nap -- at her age?  Especially if she's had good night sleep and two good naps?  It doesn't seem like it should be...

And now I'm rambling again.  My whole life revolves around LO's sleep... I feel like I've lost all ability to think clearly about it anymore.   

(Update: Only an hour after waking from a very good afternoon nap -- and having had a very good morning nap -- DD is a fussy yawning little thing.  I just really cannot win.)

[lilac83]

Hi!

How long will she sleep if you lay her down when she gives you her cues? If she takes short UT naps, then you'll be better off keeping her up the 2 hours of A time and having her take longer naps. A 2.5hr A time (from 2:30 to 5:00 catnap) shouldn't be too long for a 5 month old. However, if her A times throughout the day are 2 hours, then I would suggest to continue putting her down at 4:30 and letting her sleep until 5:30 which should get her to a 7/7:15 bedtime.

Some LO's do need more sleep than others. If you think your DD falls in this category, it's absolutely ok to keep shorter A times. The first A time of the day is usually the shortest and the final A time before bed is short because it's following a short catnap. So if you think 2hr is too much for her, shorten to 1hr 45min and see how she does. The problem you may run into is that she starts taking UT naps because, although she feels tired, she's not tired enough to take a good nap.

About the poopy diaper, my DD's naps have fallen prey to those many times. Usually in the AM. Nothing you can do unfortunately, but I'm sure lots of other mom's have sympathy with you about this as well.

[WillowTree]

Hi, Robin!  Thank you so much for your reply.  I really appreciate it.

Unfortunately, if we follow DD's sleepy cues (which we used to do all the time), she will take very short naps, probably 4-5 a day, lasting for usually 30-40 minutes.  And then she wants to go to bed for the night in the late afternoon/very early evening (and will wake all night long).  We went through this for a long time and it was such a mess.  Our pediatrician kept telling us not to worry about it, that DD would grow into a healthy rhythm all on her own... So we held out and held out.  And then we discovered BW and felt like fools -- and terrible parents.     

Sometimes even with 2 hours A time, she still takes short naps... There seems to be no good balance between UT and OT for DD.  It's one or the other.  I guess she's just quite sensitive when it comes to sleep.  And that makes it very hard to find the magic moment when she's just the right amount of tired. 

It is so hard because we want so badly to be able to put her down to sleep when she shows us she's tired -- sometimes I feel absolutely criminal keeping her awake (and worry a lot about OT) -- but I really can't see any other way.  If we let DD take the reigns too much, chaos follows... and then she's even more miserable. 

I also really worry that DD won't simply start staying awake longer on her own as she gets older.  That we'll constantly have to push here and there to extend those A times.  I mean, goodness... We're racing up on 5.5 months and she's showing sleepy cues after only 1 hour of A time?  That's no good.  At her age, there is so much to see and do in her little baby world.  And how can we show her those things if she's always feeling sleepy -- or being allowed to sleep at the first sleepy cue?

I feel so defeated by this whole thing.  It wakes me up at night with anxiety.  I feel like every other mom is doing it all better somehow.  That DD is getting short-changed with me because I'm mucking it all up.  I love her so much.  What I wouldn't give to see her well-rested and happy, happy, happy.

[WillowTree]

So this morning she woke at about 6:35 -- as near as I can tell -- and I went to her at 7:00.  I was trying to get her close to her nap time of 9:00, but didn't want to push it too far since she woke early.  After our nap routine, I put her in her crib at about 8:40 and she was asleep pretty quickly -- 8:45, 8:50 at the latest.  I first heard her stir at 10:07, so it seems like she napped for about 1 hour + 10-20 minutes.  Is that an OT or an UT nap?  She's happy to see me when I make an appearance.  She'll grin and play with my hands.  But she'll still show me she's tired by rubbing her eyes, rolling over to suck her thumb, etc.  It's like she wants to go back to sleep, but can't.