4 month old terrible at napping

[loopylala]

I've been following the ssh/pat technique to the letter over the last few weeks to try and get some structure and sleep into my little boy but i still don't seem to be doing it right.

He's on a 3 hourly routine but never naps for any longer than 30 minutes, and always wakes from those naps screaming.  I've tried putting him down after 50 minutes of A time, to an hour and a half of A time (including the 10 minute wind down) thinking he might be OT or UT, and everything in between.  I keep making the A time shorter as the day goes on as I know he's not getting enough sleep but there's only a certain amount you cut back on before it burns into his eating time!

He's a very content baby until I try and put him down to sleep, at which point he becomes miserable.  It can take anything from 20 minutes to 45 minutes to get him to sleep with ssh/pat.  If he hasn't slept by 45 minutes of trying I tend to take him out for a walk because I know he'll go to sleep in his pram after walking for another 20 minutes or so.  Ultimately, I don't mind listening to him screaming in my ear for that duration, but I know he'll wake after 30 minutes to the second, and it's getting harder and harder to put in so much effort for such a short sleep.  I try to get him back to sleep after he wakes but he's even more persistent at screaming than he was before the nap that eventually it turns into his next feed time anyway.  I take care not to over stimulate him before his wind down time aswell.

Any advice....? I'm going out of my mind here.  Thankfully he's pretty good at sleeping at night.  He settles himself down straight after his last feed with no bother, and normally wakes up once (sometimes twice) before getting up in the morning.

Here's a very rough guide to the routine that I do with him.......

E   7am
A   7.30am - 8am
S   normally get him off to sleep at 8.45 for 30 minutes sleep

(then repeat the same for 10am, 1pm, 4pm, and 7pm feeds).  As I said, I've tried extending the activity time for longer as he never really appears sleepy after an hour of being awake, but that doesn't work either.


Thanks
Laura

[becky1969]

I think little guy is UT which is why he's only sleeping 30 minutes and is fighting you.  Then of course he gets OT the rest of the day from lack of sleep.

At 4 months we typically see 1h45-2h A time.  So even when you try 1h30 it's too little.

Let's revise to a 1h45 routine and see if that helps! If not, we'll experiment until we find the magic spot.

routine:

Awake 7

S 8:45-10:45


S 12:30-2:30

S 4:15-5:00

Bedtime 6:45


Let's see how that works!  So, let's go over Awake times, just in case there's some confusion.  Awake time starts the moment their little eyes open and ends the second they close for sleep again.  A time includes time to feed etc.  I usually advise starting wind down about 10 minutes before their Awake period ends, so that you're sure to put them down within their sleep window.  I suspect the reason you haven't seen sleepy signs is you haven't kept him up long enough yet!  


Just so you know, at 3 months there's also a developmental change that occurs that makes them start to wake at the 30-45 minute mark.  We use a technique called HTTJ (holding thru the jolts) to help them go back to sleep.  I don't think this is what's going on with your LO, but what I think happened is your A times were correct and you hit that developmental milestone.  Thinking he was OT, you shortened As or kept them the same even tho he was actually ready to increase.  If we get him up to the correct As and he wakes at the 45 minute mark we will then start using HTTJ to help him over this developmental change.  

But first, just change your As and report back!  


Also, at this age we should be on a 4 hour EASY.  Hopefully as naps lengthen, that should help.

[loopylala]

Thanks for that, shall give it a go from tomorrow...

I have another query about the HTTJ as I was reading about the wake to sleep on these forums.  Although he's (only just!) recently started to roll over onto his back from his belly, he still sleeps in the day on his side.  This is purely due to the ssh/pat that I've done to get him to sleep.  I'm not sure when to roll him onto his back, as I have tried before and unfortunately it wakes him up (either he's a fairly light sleeper or I'm doing it at the wrong part of the cycle).  

So, if he's on his side, whereabouts do I apply pressure before the jolts?  Or should I try and get him on his back beforehand so I can hold his chest and legs?

Thanks again for your help..... I'll let you know how I get on!

[loopylala]

Well things started off great - he woke at 6.45.  Fed him and played with him until 8.15, then spent 15 minutes whispering in his ear whilst walking around our living room.  Then took him into his room, changed him, sang to him and put him in his cot.  Only needed to do ssh/pat for 5 minutes before he fell asleep at 8.40.  Was so happy that it was so easy to gt him down.

However, just before I was about to go into his room to try wake-to-sleep when I heard him screaming. That was at 9, so he'd only managed 20 minutes sleep.  Then I spent 70 minutes doing ssh/pat with him SCREAMING at me (with intermittent calm bits when i picked him up when he was getting too bad).  Then gave up - I'm feeding him now.

So I'm lost now on so many levels.  

I tend to stay with him for 5/10 minutes after he falls asleep, and if I'm supposed to go into him for wake-to-sleep 5 or so minutes before the jolts....... well then that leaves me with around 2 minutes........ not even long enough to brush my teeth.  Am I supposed to stay by his side with my hands on him for the full 2 hours with no breaks?  (I'm feeling increasingly jealous of mums who have babies with 45 minute naps.)

Also, as it stands, when should I now try and put him to bed again since he's already tired.

Finally, could it just be that I have a baby that doesn't require that much sleep?  Before, I would take him down to play after his short naps and he would be happy (although he would be yawning and get increasingly harder to get down for his naps as the day went on).  It's just that I don't know how I'll cope with him screaming in my ear for 6 or so hours of the day.....

[loopylala]

I don't know what to do so I've given up.  Today has been terrible.
He's either been eating or screaming with the exception of the 20 minute sleep this morning and a 20 minute sleep about 2 hours ago.  I stayed in there with my arms over him to guide him through the jolts but he still woke up screaming.
After each feed I've put him in his chair for 20 minutes so he has a fairly calm activity time.  But as soon as he goes near his cot he screams and screams his head off.  So after listening to it in my ear for a total of around 4 hours I can't cope with it anymore and it's only 3.30.
I don't understand what I'm doing wrong..... it's been 3 weeks of doing ssh/pat and he still doesn't seem to take to it.
Currently I've left him in his cot crying........ please please please can someone help me.  I'm sat here crying not knowing how to cope.

[becky1969]

Oh sweetheart!!! I will do everything I can to help you!!!

First, here's an explanation of why they wake at 20 min and what to do about it.

http://babywhispererforums.com/index.php?topic=64161.0

I don't think your baby needs less sleep.  He's really really exhausted.  I'm beginning to wonder about reflux, however.  You can go to the reflux boards and read more about the symptoms.  A reflux baby often has trouble sleeping flat because it causes much pain in their esophagus.  We could try elevating the head of his crib as an experiment and see if that helps.  Crying when he gets near the crib is often a sign of reflux, tho it can just mean naps are mistimed and he's saying "hey! I'm not tired yet! Leave me alone!!" 

Even if you're not seeing spit up, it doesn't mean your child doesn't have reflux.  My son had silent reflux and didn't get dx until he was 16 weeks old because it is just THAT hard to dx.  In our case naps were fine -- he had enough time between eating and sleeping that he did OK.  But nights were AWFUL -- screaming for 2 hours straight at bedtime.  He'd be fine if we were in a lighted room, but if we took him into his darkened bedroom he'd yell his head off.  Turns out he was terrified of being laid down flat 'cuz he knew it was going to hurt, poor dear.


So, let's look into reflex and try to treat him as if he has it -- which means keeping him elevated a full 30 min after eating, elevating the head of his crib, and use any other tricks they list on the reflux board.


Next, let's look again at nap timing and see if that can't be tweaked.  Timing is still off.  He woke at 6:45 and didn't fall asleep until 8:40.  That's 1:55, probably 10 minutes too long.  I know 10 minutes seems like not very much, but it is an eternity when their A time is only 1h45.  So, all that means is instead of playing until 8:15, maybe you only play until 8:05 so that you have time for your wind down.  And actually, 15 minutes of winding down + 5 minutes ssh/pat is probably too much wind down -- that works out to 20 min.  I'd like you to keep it more in the 10-15 min range for the whole deal.  More than that it can get a little too stimulating.


So sorry, sweetie.  we *will* figure this out.  Let's try to suss out whether this is a medical or a sleep timing issue.  some more investigation is needed. 

[jimbomum]

Hi

Sorry to intrude on this post but I have a very similar situation with my DS who is nearly four months. I am at my wits end and cannot stand the crying anymore. He crys everytime I try to put him down and I cannot read his sleep cues at all. I don't know what has gone wrong as things were going so well with ssh/pat last week and suddenely it is impossible to get him down. If I do he wakes again 15 mins later. It is so frustrating and I am taking it out on DH.

I keep reading conflicting advice about naps and I cannot see the wood for the trees. No idea whether he is UT or OT. I was ready to scream at him earlier and had to leave the room.. I just can't do this anymore - think I would be better just doing AP and living with the consequences.

[becky1969]

jimbomom -- lots of hugs, love.  A crying baby is enough to send anyone over the edge.  If you want to do some AP for a few days just to get some sanity back, do it.  Then if  you want to work it out some more, I'm here to help.  We've all resorted to AP for sanity sake at times, so don't feel bad and don't feel like it means you can't try BW methods again once you feel less overwhelmed. 

[alaroche]

Does something developmental happen to the babes at around 4 months because I am having this issue too.  My LO was a pretty good napper till around 4 months.  Pretty independant, didn't require a lot of wind down and would stay asleep past the 45min mark.  However, for almost a month now the journey to sleep has become rockier and rockier.  Some days I feel like the worst parent in the world and the AP doesn't even seem to work a lot of the time.  After I've spent 45min trying to rock her to sleep with her screaming in my ear I begin to wonder if I am really helping her.  If nothing else, I very much feel your frustration.

[alaroche]

Oh and I forgot to mention, one thing that I have had limited success with is white noise.  There was one day where her naps were wonderful and I think I have my blow dryer to thank for it!  Even when she woke about 20minutes into her nap (I have had absolutely NO success with HTTJ, or shh/pat once she is awake) I turned the blow dryer on just outside of her door and she fell back asleep.  I couldn't believe it!

[becky1969]

A developmental change happens around 12 weeks where their REM/non-REM sleep cycles change up and they no longer go straight into a deep sleep.  This means they have a light sleep cycle around the 45 min mark, and since they aren't used to it they wake up and are MAAAAD!    Also, there is a transition from the 3 hour EASY to the 4 hour EASY between 3 and 4 months old.  That can also cause short-napping believe it or not.


If you want to post your routine I can help!


But 4 month sleep troubles are very normal, as you can see from all the people jumping on this post! 

[hrk]

Just a thought not to dismiss the reflux comments.  Some 's come to mind (ours was a silent refluxer)...

You mention he eats a bit and being happy upright after eating.  Is lo eating a lot?  Swallowing can temporarily soothe the esophagus.  Keeping upright is also a nonmedical adjustment for reflux, so gravity may be holding the tummy contents in their place.  You could try raising the incline of the mattress to at least 30 degrees (with towels under the mattress) to see if that makes any improvement.  If lo is sleeping better in more upright things, that may give you an indication that it may help. 

Try not to feed before lying down for naps, and keep upright for some time after night feeds.  REflux 101 will also give you a good number of things to look at as far as figuring out if it could be a factor.  It also lists nonmedical adjustments to try to see if that helps.

What are your nights looking like? 

Any issues with gas?

Hugs and hopes that all settles for you very soon,
Jean

[loopylala]

I'm not too sure it is reflux... I read the pages and he doesn't necessarily follow any of the signs.  He's great, thankfully, at getting his wind up.  (The only thing that he does do that might point to it is that he sometimes throws up his milk a couple of hours after drinking it.....).  Even so, I have elevated the cot more (I'd already had it at an angle from when we first put him in it).  I also keep him upright after his feeds for 20 minutes, just in case!

I've been really persevering with the ssh/pat technique, and thankfully it's paying off.  When I get the window right, and I am getting better at picking up his cues, it normally takes me 5-10 minutes to get him to sleep.  Sometimes only a minute or two.  He often doesn't cry when I do it aswell - he tends to look at me and smile, in one last attempt to play with me, but I carry on ssh-ing, then he snuggles into his lovey and whimpers before falling asleep.  So I'm really REALLY happy about that. 

However he still doesn't sleep for very long.  I've managed a couple of 1 hour- 1 hour 20s, but that tends to be for one nap every day/every other day.  Today I even stayed with my arms over his shoulders and legs (he was still on his side) for the full 1 hour 15 minutes!  He had 8 jolts in total.... unfortunately they were evenly spaced out from the 20 minute mark, so I don't think I could have left and come back in at "moments".  And he did still wake up crying.  I was desperate to try and make him sleep longer, but 1 hour 15 was his maximum!

Night times have regressed recently too.  He used to recently be able to sleep from 7pm until 4.30 - 5.30 (where he'd then decide the day would begin) but for the last few days he's waking up from around midnight for a feed and then back to sleep for an hour or two before waking up for good!!!!  Early mornings indeed.  I tend to go in a ssh/pat him from then on in until 6ish but he sleeps for 20 minutes at a time in those early hours.  It's getting quite hard!

I'll post you my day today and see what you think!

(Last night he fell asleep at 7.15pm)

E - 2.20am (bf)
S - 3.15

Woke at 5.15 and 'napped' with my help until I gave in and got up.

E - 6.30am (7oz)
A - until 8.10 (i handed him over to my husband after feeding so I could get some kip)
S - 8.20 - 9am

E - 9.00am (bf)
A - had his third set of jabs at the doctors so couldn't do my routine as I would have liked!
S - 11 - 11.30 am (fell asleep in the car and I stayed parked outside my house so as not to disturb him!)
A

E - 12pm (7oz)
A - kept it fairly calm until bed, when he went straight down
S - 12.55 - 2.10pm
A

E - 3pm (7oz)
A
S - 4 - 4.40 (just woke now....!)
A

I will then give him a bath at 5.30, then massage, then at 6pm bf and possible bottle top up should he want it.  So he tends to fall asleep anytime between 6.45 and 7.15.

Out of curiosity, if he does wake after 20 minutes/half an hour what do you suggest I do....? I don't want to feed him any less than 3 hourly since I already want to extend it to 4 (once he gets more sleep in).  I try and put him back down but it makes him pretty irate and just involves him screaming in my ear.  I've also tried picking him up and quietly chatting to him in his darkened room for 15 minutes before putting him back in his cot..... again no luck!!!!  On this website there's lots of advice of how to avoid the 20/30/45 minute naps but I can't seem to find anything about what the routine should look like whilst these short naps are occuring (other than keeping the next A time short...... but if the naps are constantly that duration what do we do?!!!).

The rest of the time he really is such a happy bunny, and very sociable.  He just makes a fuss when I try and make him sleep when he doesn't want to.  I'm pretty sure that as soon as I crack the day naps he'll be better at sleeping at night until the morning (or vice versa).  I just don't know how to extend those naps!!!  Even with me applying pressure for his whole sleep duration didn't seem to do the trick fully.

Could he be teething?  He has his fist in his mouth at every available opportunity, and tends to fuss when breastfeeding, and often cries with the bottle (he wants the milk..... takes the bottle but after a few sucks starts crying whilst drinking.  I don't think it's wind as I make sure I wind him very frequently, and he still continues to fuss even when a burp comes up). 

Thanks so much everyone for all the help and advice.  I am feeling a lot better recently.  Just being able to get him off to sleep without too much hassle is giving me hope that things will improve.  A week ago I thought I was going out of my mind, but now, although I am still VERY tired, I am enjoying my time with him again.

Laura

[hrk]

Hi!  Just wanted to let you know I will read through when I get a chance.  I am glad that you are feeling better. 

DS was a frequent feeder and slept *somewhat* (I am using that EXTREMELY loosely)decent until 3 months, but woke a lot to feed at night.  We rotated between bad night and good night in the 3rd month.  By 4 months, things were "off the hook".  5 months he went on low dose of meds that reduced the frequent eating and improved naps a little, but did nothing for night.  9 months someone had suggested looking at the marci site for dosing info, and he was way underdosed for his size and age by those recommendations.  Two days after the high dose of meds, he slept through the night.  Our pedi was very skeptical that it was anything medically related, but rather bad habits.  We had the long wakings at night as well as frequent short ones.  I could watch him fall asleep, and see him wake a minute later crying.  He seemed to be trying to fall asleep or falling asleep from exhaustion, but unable to stay asleep. 

Curious to see where you are in the suggested daily amt of sleep when I check back. 

Sending loads of hugs your way~
Jean

[becky1969]

I'm inclined to think reflux as PP is.  My son didn't get put on meds until 4 months either.  We also had a pretty good sleeper up until around 8-12 weeks when all hell broke loose.  By 4 months old we were having horrible horrible nights.  My son actually was always an awesome napper, so he was unusual that way. 

The spitting up milk 2 hours after a feed is unusual, and makes me wonder if you've got some digestive issues happening.  I'd be inclined to put him on some reflux meds and see if that helps.  All that jolting you saw is *also* unusual -- that says reflux to me as well.  He's probably refluxing and it's making him wake at each 20 min sleep cycle.  No fun for him or you!

Try the meds and see if that helps.  It's tough at this age because there's no easy way to figure out what the problem is.  But you sound like the mom of a refluxer to me, and I've seen a lot of kids like that on this board, if that helps!