Author Topic: Moved cold turkey to 1 set nap time for 16.5mo, and it still isn't helping,WWYD?  (Read 4211 times)

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Offline DawnE

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DS is a horrible sleeper, and is still not STTN. After trying A times for too many months to count, someone suggested trying a set time for 1 nap. It made sense to me, so for the past 11 days, I have set nap time at noon, bedtime at 7. His naps have been between 30 min to 1hr 20min most days (I have only been able to extend twice), except for 1 day where he slept for almost 3 hours, which is the best he has ever done. The good nap day, I don't have a clue what time he woke up, sometime between 6 & 7:23. He is taking anywhere from 30min to 1hr 15min to fall asleep at bedtime, so most nights he is asleep between 7:45 and 8:15.

I was going between 1 nap and 2 for about 6 or 7 months before trying this, but he didn't seem to be moving any closer to 1 nap. At the end I was doing a 20 or 30 min A time in the morning, and he would not fall asleep for the pm nap until he had an A time of 3h30m to 4h15m, no matter how early I started. The pm nap was anywhere from 30min to around an hour. His days were becoming too long this way, which was another reason for trying the set 1 nap.

Every night has multiple NWs, with the average being about 10, a couple of which he will put himself back to sleep for, the rest I have to go in. Usually at least 2 are an hour long or more. A couple of times a week they will be 3h-4.5h. The set nap time has not seemed to make a difference in the NWs. A couple of nights have had a couple less NWs, but otherwise it seems to be about average.

He is currently teething eye teeth and molars, and because of the teething is having a reflux flare. He was weaned off of the reflux meds about 7 months ago. A few months ago he was diagnosed as MPI, and has been off of all dairy for a couple of months, with no change. I am pretty sure there is another sensitivity or intolerance, or perhaps something physical that is wrong with him, and I just have not been able to figure it out yet. Going over his food and sleep logs I have not found any correlation. Someone has suggested salicylate sensitivity, but I have not had time to look into that.

I know it is likely that part of the problem now is that he is APed to sleep, but his sleep problems have been going on for about a year, months before the AP started. The AP started because of the sleep problems, not the other way around. He does put himself back to sleep occasionally, but if he wakes up screaming or is sitting or standing, I have to go in. I do not think the AP is the entire problem, because he can put himself back to sleep, and I don't see why we would have 3h-4.5h NWs a couple of times a week when we are in there with him, if that was the only problem. Another part of the problem may also be SA, but don't know how much. The monitor went out a few weeks ago, and I don't know when, sometime between midnight and 8 am. When I went in he was whimpering, so I don't know how many hours he had been crying for me. Ever since I have been working on helping his negative association with his crib. It did seem to add a couple of NWs for a few nights, but that was about it. I have started taking him into bed with me the last couple of weeks (for the first time ever) as I am too exhausted to keep dealing with this all night long. I don't like doing it, but am not sure what else to do. When in bed with me he still wakes up, but it isn't quite as often. It still takes him a long time to fall back asleep usually.

So I'm not really sure what the problem is when he is waking. Teeth, reflux, the AP, SA, or something else.

During the day he is mostly happy, with a few grumpy and stubborn times. He shows no tired signs at all until right before bedtime, or after we are in his dark room. He just always looks tired and has circles under his eyes, which makes me sad and frustrated, as I have tried so many things to get him to sleep.

So, all of this to ask, WWYD?
Would you:
1 - keep the set nap time at noon for a bit longer, and hope the nap lengthens out, and things improve?
2 - move the nap to 11:30, hoping that with the shorter A time he will take a longer nap?
3 - move the nap to 12:30, so there is less time between his bad naps and bedtime?
4 - try moving back to 2 naps? (The problem I see with this is that his days were becoming 14 and 15 hours long, and he wasn't actually getting much more sleep than with 1 nap, it was just spread across the day)

I'm not sure what to do, as nothing I do seems to make a difference with the NWs. I don't want to change too much on him, but he is so obviously chronically OT.
« Last Edit: April 19, 2010, 03:25:02 am by DawnE »

Offline brenda2

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if you think he is ot then i would move the set nap to 11:30.  i think 1 nap is a good idea for his age.  if he does a 30 min nap at 11:30 maybe there would be time for another short nap later in the day around 3:30 if you cant extend which i would try first of course.

i would also try to be consistent with how you deal with the nws.  give tylenol or whatever meds to deal with the teething issue and then i would do walk in walk out to deal with nws at this age.  go in talk to him, lie him down and leave.  repeat.  what is the AP you mention to get him to sleep?  if it has been going on for a year then i would disagree and say that it IS a problem for his sleep regardless of how it started.
   

   


Offline londonmama

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I'm going to hang back on offering too much advice so that we can get you some new eyes in case I'm missing something.

MORE EYES PLEASE LADIES!  THIS WOMAN IS A SAINT AND NEEDS SOME SLEEP! lol

But I really think you need to trust your instinct on the medical/health issue.  I agree with you that there is something going on physically.  If it was purely an AP problem, he would be sleeping much better in your bed.  The fact that he is still waking multiple times and is still hard to settle (maybe not as hard, but still) when co-sleeping indicates to me that there is something else going on.

From what you've said I would think it is either (or a mix of the 3):
1.  Needing to go back on reflux meds
2.  He is getting milk protein regularly somehow, because it is hidden in something you haven't found yet.  For e.g., I know that a lot of meds are in a lactose base - I know lactose is different than milk protein, but maybe there is something like this where MP is hidden somewhere??
3.  He has another sensitivity that you haven't found yet (e.g. the salicylates I was talking about, or something else).

Is he under the care of a good allergist?  If you happen to be in Toronto I can recommend one!  Otherwise, maybe someone on the Health boards can help with allergists in your area?  Can you look into starting back on reflux meds to see if that will help, just to rule that out?  And then the next step would be a full exclusion diet for a few weeks with all possible allergens cut out, and then see if he improves.  You then add back in groups of food one by one to see which one causes the problems to start up again.  But you can get more help with this at the time, if you have to go down this road.

Do you keep food diaries?

In terms of coping with the sleep...If I were you, I would start him out in the cot at bedtime and resettle in the cot during the evening but after your bedtime I wouldn't hesitate bringing him into your bed if that makes things a bit better.  Once you resolve the underlying health issue, we can help you transition into his cot all night.  You are on your own dealing with an incredibly difficult situation, and you need to look at coping mechanisms at this stage.

Offline londonmama

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Found this thread on what foods can have milk protein hidden in them:
http://babywhispererforums.com/index.php?topic=135427.0

This is on the food allergy board.  Maybe worth posting on there to see if anyone else with milk protein issues recognises the sleep problems you're having too?

Offline londonmama

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One more thing....

"Infant Insomnia
Chronic insomnia in infants has been linked to allergies to cow's milk proteins. In one study, a group of children with known allergies to cow's milk proteins, as well as a group of children with chronic insomnia but undiagnosed allergies to milk, slept well when milk was removed from their diet and slept poorly when milk was reintroduced. Those children in the chronic insomnia group were tested and found to have allergies to cow's milk proteins. So if your child has chronic insomnia, think about getting him or her tested for allergies."
http://www.webmd.com/allergies/guide/remedies-to-help-sleep

There's got to be milk protein hidden in something he's eating.  It just stands to reason!  I bet there is somone on the food allergy board that can help.

Didn't I say I was going to stop providing advice??

Offline Kay Dee

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Hiya, you poor thing!! I can't really help on the medical side but on the fixed nap, I'd move it out to 12.30 so his afternoon isn't so long. I think it's more important to prevent OT at bedtime than naptime IYKWIM.

Is he AP'd to sleep for bed and nap times or just for the NWs?

xx
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Little lady: June 2010

Offline babybarr

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Hi there,

I can empathise with you.  My DS spends many hours up at night too.

The first thing that really stood out was that if your LO is only taking a short nap you are still sticking to a 7pm bedtime.  I reckon if he is bad napping then you need to get some extra sleep in somewhere so start with an early night.  Say 6pm and see what happens.  I would do an early nap and then get another nap in any way possible.  While I appreciate he probably has some sensitivities we need to try and get him on an even keel without him being to OT. Have you tried meds at naps?

Laura x
LAURA xx




Offline ~ Vik ~

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Have you thought about an intolerance to soy? Many babies who are intolerant to milk also have problems with soy as the proteins are similar - called MSPI. Would be worth looking into - but you may have to see a gastro specialist rather than an allergist. Though both painful and dangerous, the mechanism of intolerances is different from allergies. There's a good explanation on one of the threads on the food allergies board. I will try to find it for you.

Do you give pain meds? Have you thought about getting back on reflux meds to deal with the flare? You really can't effectively sleep train with a lo in pain :( And let me tell you, eye teeth were HELL here, worse than any other teeth. We had ds dosed on motrin and Tylenol and still got nws.

Going to try and find that thread and will be back.
D ~ dairy, egg, peanut/nut and mustard allergies
Proud to have breastfed for over 24 months!


Offline ~ Vik ~

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D ~ dairy, egg, peanut/nut and mustard allergies
Proud to have breastfed for over 24 months!


Offline lilisuze

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i was going to add "soy intolerance" to the list. or as PP said possible hidden MP's somewhere in his diet. My 18mo is also MPI and i know we are in for a bad night if he has some milk, or if he has had too much soy milk in one day. My theory is it gives them tummyache and they just cant settle.

I did the 10 wake-ups a night for a while last year, before i got tuned in to the MPI and we switched to soy. All the time he was on regular forumla he would wake, I would settle him down, 10x a night. Boy was i tired. The day after we switched to soy, it was like I had a different child. All that time I had been thinking he was a difficult sleeper, when it was what I was feeding him making it happen.

Not saying thats definitely the problem of course, but a small change can make a BIG difference, we just have to figure out what it is!

lili xx
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Offline londonmama

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Thanks for chiming in everyone!  Just the new "eyes" we need.  Keep it coming!

Offline brenda2

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definitely go with your gut.  if you think there is something medically going on you should get it checked out.  you can't sleep train a lo in pain.  i also agree that eye teeth are the worst!!! and molars too.

also agree that while a set nap may work a set bedtime won't if he does a short nap.  so if you do the 1 nap at 11:30 but it's short and you can't extend or get a second nap then you need to move up bedtime.  you may need to move forward bedtime anyway to aim for a closer to 12 hour day if he's just having the 1 nap.  when my lo first moved to 1 nap she was doing an 11 hour day/13 hour night.  don't be afraid of an early bedtime, it is a great tool against ot even if they wake up at the same time they'll have had more sleep and be more rested.  so if he's up at 6 am bedtime should be about 6pm.

i agree it's hard to cope with so much lack of sleep, we had nws like this with dd2 for 8 mo and i was at the end of my rope.  we were wondering if it was reflux, teething (she did have reflux) etc but finally i just cut out the night feeds an got really consistent with how i was handling her nws and everything turned around.  and i didn't really think she had any props as she would go down independently but then be up every hour all night and i didn't feed at all of them, just a few and did shh apt for the rest and still it was terrible.  so don't underestimate the power of a prop.  if he's used to being in your bed then this may be why he's having so many nws.   but for sure go with your gut if you think there is something medical going on.

   

   


Offline DawnE

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Thank you everyone for all of your thoughts and advice. I am going to trying to answer each question and thought, so this may be a bit jumbled.

londonmama, thank you for all of the links you have provided (including the ones on the other thread). You have stuck with me for a very long time through this, and been very supportive and helpful. I am always willing to listen to anything you have to say.

Vikki, Dylan's mommy! thank you as well for the link.

brenda2, when you were having NWs, how long were they? A few minutes, or hours long?

Restarting the reflux meds may be something that we have to do. I have not been able to get an appointment with the paed until the middle of May, so that will not be an option until then.

We are not seeing an allergist. There is not one close to us, as we live in a rural area. All we are seeing is a GP and paed.

I have been keeping food and sleep diaries since about 3 months old. The sleep diaries were started because at around 2 months we were having nap issues. Then at 3 months he stopped STTN, and I was a bit concerned. The food diaries started because I knew he was not having as much as he should have been having to eat/drink, but wanted to see just how much. Then I continued because I thought it would be fun to keep a log of his first foods as a keepsake for when he grew older. The sleep problems continued, and I thought perhaps there was a correlation with the food. I have just continued since then. They just give a list of the general foods he eats and amounts, not each specific ingredient.

DS had a blood test about 3 months ago for milk, soy, egg whites, and fish, and I'm not sure if there was more. That is how the MPI was confirmed. He is still getting some amounts of milk proteins. Very little I am sure, but I haven't kept track of exactly how much. I was told by his doctor to keep him on trace amounts of milk proteins, so that his body would hopefully become used to them from repeated exposure, and he would outgrow the MPI. I was told to cut out obvious sources, such as milk (and formula), yogurt, and cheese. Since he was diagnosed MPI, he has been on a soy formula. We did have a good 2 week period of sleep at the end of Jan/beginning of Feb, where he would wake up 2-4 times a night and put himself back to sleep almost every time. I think I was only in his room twice in one week, which is really good for him. At the time he was only drinking 4-8oz of milk formula a day, so I was sure taking out so much of the milk proteins would help, but it hasn't seemed to make a difference.

I have been giving Tylenol and some camilia for the teeth, but have been avoiding Motrin and Advil. The Motrin and Advil seemed to help sometimes, and other times they just seemed to make his stomach hurt and make things worse, so I was giving them very infrequently when londonmama recommended I stop completely, and I haven't given any since.

The amount of formula he has before bedtime does not seem to affect his night at all. Some nights he only has 1 oz, other nights 9, and it doesn't seem to matter which he has had whether we have a good night or bad.

I have been sticking to the 7 pm bedtime because I have been so inconsistent for so long with his times. Because we were going back and forth between 2 naps and 1 for so long, his day was all over the place, and his bedtime was varying by hours. So I guess I have just tried to be consistent with this. I have tried for a 6:30 bedtime a couple of times, but he still has not fallen asleep until 7 or 7:30. I am very afraid to put him down earlier, as he tends to do a 10 or 11 hour long night, even with all of the NWs. A 7pm bedtime results in a 5 or 6am wake-up, so I am afraid to go earlier and end up with a 4 am wake-up, especially because there are nights I don't get to bed until 2 or 3.

He was put down to sleep independently until about 4 months old. If he had problems falling asleep, I would rub his back or pat his bum. The sleep got worse and worse, and by around 7 months we APed to sleep all the time. He was rocked for quite awhile, and now is to the point that we just hold him until he gets drowsy, then put him in his crib. When he has a NW, I listen to see what kind of cry it is. A light cry he will likely put himself back to sleep. Screaming, I go in and lay him back down if he is standing or sitting. I will try that a few times, and leave my hand on his shoulder if he seems to need it. If he keeps sitting up or screaming, I will pick him up and hold him until he gets drowsy again. He has had only 2 night feeds in the last (about) 8 months. 1 during the night a couple of months ago, but he was up for a couple of hours after that, so that was ruled out as a reason for some of the NWs. Another was for an EW, to see if he would go back to sleep (which he didn't) so I haven't tried since.

I think I am saying it poorly, but I do think the AP is part of the problem. There are some times when he cries that I am pretty sure he just wants me. I just don't think it is the entire problem. And I personally feel that it is unfair to try and sleep train if he is in pain. I definitely never thought I would still be helping my almost 17 month old to fall asleep. I'm just not sure what else to do. I feel that there is something else wrong, but it is hard to get help from anyone once they hear about the AP. But I feel like I can't wean the AP until I figure out why he is in pain and waking up screaming so often. So I feel like I am stuck in a loop, and I'm not sure how to get out.  :-\

I have started up another thread on the food allergy board to see if I can get some more ideas http://babywhispererforums.com/index.php?topic=169939.msg1903606#msg1903606

Thanks for all of the replies!



Offline DawnE

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I forgot to say that all of the different reasons for the different nap times are logical, but I think we may end up having to try and go back to 2 naps for a bit. I hate to change things on him again, but these teeth are really bothering him. We had a couple of not too bad nights, but the last few have gotten worse and worse. He has been taking 50min to 1h20min naps, so even with a 6:30 bedtime he is still seriously OT. I'm thinking of trying a set 11:00 am nap, 3:00 pm nap, and 8:00 bedtime. Any thoughts?
« Last Edit: April 23, 2010, 22:26:42 pm by DawnE »

Offline brenda2

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brenda2, when you were having NWs, how long were they? A few minutes, or hours long?

when dd2 was 8 mo and we had many nws they were only a few minutes - either i would feed her and she'd go back down or i'd shh pat and she'd go back but then wake up an hour later after another sleep cycle because she couldn't transition, we had the same sort of nws with dd1 at 5 mo due to paci dependency.


I think I am saying it poorly, but I do think the AP is part of the problem. There are some times when he cries that I am pretty sure he just wants me. I just don't think it is the entire problem. And I personally feel that it is unfair to try and sleep train if he is in pain.

i can relate to feeling this way.   iwasn't sure what to do with dd2 either because i knew she did have reflux though it didn't seem to bother her during the day. but finally i thought i should rule out the AP first because i didn't want to put her on medication that she didn't need - i thought that was worse than sleep training with her possibly having pain.  i mean when you do the sleep training you're not leaving them to cry, you are there with them comforting in the crib.

i will also say that with dd1 who was an independent sleeper she had croup at 18 mo and she was really sick.  she slept on me for a week because she couldn't breath.  all naps and all nights were on me.  needless to say getting back on track was really hard.  when she woke at night i would hold her even though i never did this before she was sick, i just felt so bad for her as she could hardly breath.  so that turned into nws after she was better - she would still wake for the cuddles.

it may be that you need to stop the cuddles etc and comfort in the crib and see if this makes any improvement.  sounds like you have stopped rocking him to sleep which is good.  if it doesn't then you'll know something is up.  for us it really only took a couple of days of being really consistent to see a difference. with both girls (i have had to sleep train a lot due to various things, travel, illness, paci etc...getting back on track can be hard)

as for the soy formula - we're in canada and when we were having the difficulties with the reflux and nws my doc said well maybe it's a MPI so to rule it out (i was still bf) he said i should avoid all milk or use this formula that is for MPI - it's not soy.  it's hyperallergenic formula and says right on it for babies with MPI.  but it's expensive and i think it's a new product.  it didn't make any difference for us.