how to transition between sleep phases??? - the 45min intruder...

[Miracle Baby]

My AG is about 14weeks (4 prem) and just starting the 45min nap thing...

ok so my main question is - is it ok to use a dummy to transition between sleep phases when AG wakes and cries at the 45 min mark? 

I know I rush in too soon but I'm terrified to let her cry with her reflux unless it stirs things up. 

If I leave her to try and go back to sleep on her own she gets really worked up and it's show over - I'll have two hours of screaming on my hands coz she's now too sore to sleep and she's not hungry so she just screams...

I was using the dummy with my thinking being - it's too early to have a feed here I'll use this to hold you off - before I read about sleep phases. 

I was also reading about the need for plenty of "suck time".  BEcause AG is bottle fed EBM most of the time (due to refulx issues) she doens't get a lot of time because she guzzles her bottle so fast.  SO maybe the dummy is a good thing?

Should I try shh-pat at the 45min mark?  I'm so scared of it not working... the dummy works eventaully or if she doesn't go back to sleep she is at least happy till feed time - unless she drops it at which point she cries and i give it back to her. 

But then again - every now and then, like yesterday evening she refused the dummy when she woke after like a 25-35min nap and just woke screaming and screamed for the next two hours before she fell into an exhausted sleep (we tried the dummy, the shh-pat, the pram and in the end after DH and I had subbed off twice each it was good old walking and shhh-ing that finally got her to sleep.) We woke her after 45mins or so for a DF at 10pm and then she slept through till 3.30am-ish... ... ... 2hr break in my typing while AG just did exactly the same thing !!!!  Only after her afternoon nap this time - DH is home now and trying to get her to sleep - bless him!!!! :-) Is this normal "arsenic/witching hour" behaviour or is it reflux or is it AP or what?!

[*Jo*]

Hello!!!

Oh Reflux, ((HUGS)) what a nightmare for you. Our Lo has reflux. ok there are a few things you can do to help the situation. first of all is she on any medication for the reflux?
Here are a few things you can do

* elevate the head of her cot or mattress slightly so that shes not flat on her back, this will help the stomach keep the contents from coming back up and burning her little throat.
* Paci if needed, reflux babies need paci's to help soothe the pain
*swaddle - the less she moves around the better
* If you are going to do shh/pat i would recommend a different version as when you do pat her on the back you are likely to irritate her reflux. What we did was we patted the mattress next to his head quite firmly so the vibration was the same as patting on the back. We also used a paci whilst doing this.
* keep her elevated for 20-30mins after a feed.

Basically you cant really train a reflux baby as they are in pain. once you have the reflux under control then you can start on sleep training.

Now for your main question - I think at this age and considering hte reflux that it is fine to use hte dummy. dont rush in as soon as she cries, wait about 30 seconds or so to see if its a pain cry or just a "i want to go back to sleep" cry.

Im going ot move your thread to the reflux boards as you may get some better advice there as this seems to be the main issue

[*Jo*]

Oh Honey, ive just found your other posts in regards to your little girls reflux, you have had an awful time of it lately! its very similar to our story though and we ended up in the hosp for three days as Caleb developed a feeding aversion and was diagnosed with Cows Milk Protein Intolerance. Once we had it under control it was just a matter of gently re introducing the feeds again. Reflux is just awful, I really do feel for you, i know what its like and I used to think I was the worst mother in teh world for getting so upset all the time when it wasnt my baby's fault, he was just in pain. Things are soooo much better now for us and i know they will get better for you too.

What are you doing to help her reflux at the moment? are you able to put your routine up in EASY format??

[Miracle Baby]

thanks calebsmummy :-)  I can put a tick next to the following

*elevated mattress
*losec (omeprazole)
*swaddle
*modified shh-pat (still experimenting with that one)
*20-30mins upright after feeds (thankgoodness she will now go in bouncinete and we don't have to hold her!)
* waiting 30sec-1min before going in when she wakes at 45min mark, though straight away if she wakes screaming rather than just crying...

SO routine - today would be fairly typical of a day where we had to go somewhere (often NOT worth it!  am so house bound)

If we skip the four hours of screaming last night and go from

DF 10pm
MOTTF 2.30am (hard work for poor DH!! lots of screaming... waiting... attempting feed... etc)
up for the day...
7.30am

This pattern has only been the last three nights - daylight savings seems to have her waking at the same time each day and a nice time too i might add!!!

E - losec with apple puree (like a TINY bit) c.70mls EBM, takes about 15mins
A - (including NC etc) 30-45mins
S - 10-20mins of wind down and screming and soothing and all that, had to put her in capsule for sleep coz had to take DH to work.
Y- ha ha!! that's hallarious! Expressed and by the time I'd tidied up all that and started my journal she was awake again - gave her the dummy and she settled after dropping it a couple of times and crying again, went to sleep

Got in car to go to Drs - she started screaming (due for feed - doh!)
E - 10.55am attempted feed in waiting room (takes less than five mins to get to GPs) - NOT successful, nurse came out and asked if i would like some privacy - I assented readily and tried to feed her in one of the nurses offices - not much more luck.
A - happy looking around and talking - NOT keen on being lain down and stippied for imu shots - only to be told "oh actually we can't do them because the hip-spica is in the way - you'll have to wait till it comes off in january!!!"  Also discoverd a potential weight LOSS (scales at GP may be unreliable... outreach nurses coming from hospital tomorrow) NOT GOOD! 40gm loss over six days!!!  Even if she'd not put any weight on that would be bad but to lose it!  I do NOT want to end up back in childrens ward!  Am trying to get hold of pead.  will try again tomorrow am.
E - attempted re-feed - not interested.
A - back in capsule and home
E - had  another few mls (60mls total)
S - usual dramas going down asleep by 12'30pm FULL NAP!!! PTL!!!!
Y - ha ha! house work!

E - 2pm (I woke her) 70mls
A - 2'15pm
S - started wind down about 3pm asleep by 3.30
Y - expressed

WOKE AT 45MIN MARK - wouldn't take dummy to re-settle.  Same thing happened yesterday and I tried to soothe her to sleep and that was what caused four hours of screaming so I tried feeding this time...

E - 4.25pm (20mls - guess she wasn't hungry)
A/E - just let her sit on my knee quietly until she started making hungry noises again then attempted re-feed, got a total of 60mls into her. getting grumpy by 5pm.  NC and quiet pre-bed sitting
S - first attempt at lie down 5'15pm screamed, didn't respond to shh-pat, picked up and calmed on shoulder till sleepy - repeat SIX TIMES!  Eventually fell asleep (I thought) then started crying ten mins later.  GAve her hte dummy, think she's asleep now (6'10pm)
Y - posting!!!! And I better go cook dinner! nuts!

WHEW!

Does that answer your question? :-)

[*Jo*]

wow my head is spinning, i can only imagine how yours is doing being in the middle of it all!

well i would start by saying that i think (dont quote me on this) that for the first nap of the day she is UT, she should be doing an hour 15-20mins at her age (i have accounted for the preemie difference making it 10 weeks of age) when you say your A time is 30-45mins thats very short. A time is "eyes open to eyes shut" so im not sure if you included that in your A time.

if she is going down UT then she will wake early as her body is saying "i dont need that much sleep as i wasnt that tired anyway" and you most likely wont be able to get her back to sleep. in fact its almost a given that she wont.

THEN becuase its such a short nap i wouldve made the next A time slightly shorter. because you dont give exact times for all your EAS im not sure how long she is awake that second A time.

now that i know you are already receiving help in reflux and this is more of a routine issue im gonna get this shifted to the EASY boards

BTW our Caleb is also on omeprazole, the liquid kind, hes been on it for 5 months and we find it really works.

[*Liz*]

Hi I'm now going to move this onto the EASY forum where we can continue the routine advise.

I'm in a rush now but will pop back later and try and help a little too.

[Miracle Baby]

quickly - coz I should go to  bed!  AG is "up" (eyes open till when I try and first put  her down) for about an hour or just over.  Sometimes I start wind down a bit sooner than the hour mark coz lately she's been giving me tired cues (I think!) way earlier - even in the morning easy.

and contining on from the above routine....

she slept 20mins then woke really grumpy did not respond to all attempts to settle - resorted to feeding - 45mls short and quite A time (about 20mins -maybe too short?  but getting grizzly and giving tired signs???) spent till 8'15 trying to settle her took about 8 attempts to get her in bed without the screaming starting again.... but once she went down at 8'15pm good till we woke her for DF at 10pm (not ideal coz we had to give her losec with DF coz she go so mucked up earlier and also had to do NC but she went back down fine... so far!!! crossing figers till 2.30/3.30ish!)