Tips for weaning off AP and APOP

[cath~]

My LO is 8 weeks and was (is?) a terrible napper from birth.  Nights are better than days (thankfully!) but could be better too, possibly by improving daytime sleep.  I posted on here a few weeks ago and got some really helpful and reassuring advice.  However, we'd like to try weaning her off the APOP that we have been using to help her sleep and I wondered if other than just persevering with shh-pat in her basket, if there were any other tips anyone had and if I'm going about it the right way.

Here is our situation:

We were (are) very worried she wasn't (isn't) getting enough sleep.  In the first four weeks or so she seemed constantly irritable (OT probably) and for a few weeks never got more that 8-9 hours sleep per day (i.e. in 24 hours).  Because of this we wanted to help her sleep however we could since sleep is obviously so important!  During the day and evening (usually until around 9-10pm when she gets her (hopefully) final feed) most/a lot of her naps have therefore been in the pram or the sling.  We sometimes manage to get her down in her moses basket for her morning nap and occasionally at lunch or in the afternoon, but not very often.  She now usually gets around 10-12 hours sleep per day, which is still on the low side but better than 8 or 9.

Generally we are following a 3 hour EASY routine, with 7 or 8 feeds per 24 hours, from whenever we start in the morning (any time between 6 and 8am usually).  Her awake time is around 1.25 - 1.5 hours (ideally, although sometimes the calming takes longer and sometimes we reach the next feed without her managing to sleep).  She takes about 40 mins to feed at the mo, then with 5 mins for burping and 5 mins for nappy change, plus winddown and calming to sleep, it's hard to reduce her awake time.

At night and during the night (i.e. after a night feed around 2-4am) she sleeps reasonably well and often puts herself to sleep (e.g. at around 10/11pm when we put her in her basket in the right mood (alhtough it can take her 30 mins or so before she falls asleep) so we know she can do it, but other times we use shh-patting.

The trouble is during the day and the evening (she is quite fussy in the evening, possible OT from the day).  Probably/possibly due to all the AP and APOP we have been using (in an attempt to help her get some sleep!) she seems to really resent being put down for a nap in her basket during the day. 

We swaddle (which she doesn't seem to like and struggles against) and do shh-patting as described on this site (but she sleeps on her back so we pat on the side of her bum/thigh, not her back).  We tried using a pacifier which she would take for a while but now refuses it completely.  Sometimes it seems like the shh-patting works and she has nodded off and I am still shh-patting just to make sure (I read on hear you should do it for 20 mins to start with) but then she wakes up again crying and I cannot calm her.  And then it is time for her next feed.  Occasionally though it does work completely, but it's quite rare.  Also, when I have succeed using shh-patting, the nap has been quite short (sometimes only 10 or 20 mins), probably because the shh-patting takes so long to work she is OT by the time she nods off.

When it doesn't work and we reach the time for her next feed, she is then so tired that usually for the next nap I use APOP (go out for walk in pram during day if weather OK or in carrier at home in evening or if weather bad) so that she can at least get some sleep (although even this APOP doesn't work 100% of the time)!  Is this OK or should I persevere with shh-patting for the next nap too, even though she is already OT and really needs some sleep?

I know it will probably take a while of persisting with the shh-pat technique for daytime/evening naps but I was wondering if there were any other tips for weaning her off the APOP (we would especially like this during the evenings, since during the day it is inevitable that not all her naps will be in the basket at home) or is it just a matter or perseverance?

Sorry - I realise this is quite a long rambling post! Many thanks for any advice!

[EloysH]

Hi 

Firstly hugs for all the hard work that is happening around nap time (hugs). It is all so hard with a new baby at the best of times.

I am just wondering if reflux could be a factor at play here. I have had two boys with silent reflux (no spitting up) and what you are going through now very much sounds like my first boy who had mild reflux.  When ladies tell me that it is  so hard to keep their LO to sleep I wonder about the reflux factor, a bit of discomfort will really disrupt their sleep. And these babies need alot of APOP because they are just too pain uncomfortable 

Of course it may be that she is just grossly over tired. But it seems to me that you are doing all the right things! 

Could you post your approx routine so we can see how long she is awake for and how many naps in the day? 

Also here's some basic info on reflux symptoms, maybe you would like to familiarise with them and keep an eye out?
http://babywhispererforums.com/index.php?topic=654.0

Please feel free to visit the CRC board for more info 
Eloise

[~Sara~]

Hi hon

Like Eloise requested, seeing her routine would help us see if some routine tweaking might help, or if there may be another underlying issue.  I, also, thought of reflux while reading through your post.

*hugs* Hope to hear from you soon.

[cath~]

Hi,

Thanks very much for your replies and so sorry for taking ages to get back to you!

We've been making some progress with weaning off using carrier and pram for naps on purpose (she still obviously naps in them when I'm out) and getting our daughter to nap more in her basket at home.  However, she really fights + cries when we try to put her down for a nap and often/usually wakes around the 30-45 minute mark.  The last (cap)nap of the day often doesn't happen at all or I only manage to get her to have 5-10 mins amongst much crying.  Once or twice she has had 20 mins during this nap, but never without much protesting!

I had assumed that the short naps were due to her being OT (she always awoke crying) and tried reducing the awake time by making sure she had had her wind down and was back in her basket by 1hr 10mins after she last awoke.  With a shorter A time for the first nap of the day, this does (sometimes) seem to help reduce how much she protests when we put her down but doesn't extend the nap (so I wonder if she is then UT?).

Her tired signs are usually fussiness/irritability by which time it is too late so I have had most success just watching the clock to decide when to put her down, rather than waiting for her to appear tired.

She is 12.5 weeks now and has always been a very alert baby (so perhaps she may also be OS sometimes, but I do try to avoid this...).

Here is an example of what happened yesterday:
E 7.30
A 8.10 - started wind down (see below) at 8.30 and then in basket by 8.40, then shh-patting
S 9.00 - she awoke at 45 mins but managed to resettle herself for a further 45 mins of sleep (first time this had happened!)
E 10.35
A 11.15 - started wind down at 11.30 and in basket by 11.35, then shh-patting
S 12.00
A 12.35 - shh-patting
then S-A-S-A-S on off, 5 mins of each (shh-patting when awoke crying each time) until next feed
E 13.20
A 13.50
S 14.30 (in pram because I needed to go shopping for dinner - so this was a good nap)
E 16.10
A 16.40 - nappy change then tried to put her down for nap but she was screaming and couldn't calm her down for a nap at all
E 17.50
A 18.20 - bath, short massage, wind down, shh-patting
S 19.30
E 21.15
A 21.55 burping, nappy change, then straight back to bed
S 22.15
E 4.30
A 5.00 burping, nappy change, straight back to bed (she always settles herself quite well after this feed - no crying)
S 5.20 - 7.15  - this stretch of sleep is always quite on/off - she never cries but we can hear her waking from time to time with snorts and wriggles.

When it is time for a nap I take her into our room (where she sleeps), close the curtains, play a lullaby (always the same one), swaddle her (only body and legs, not arms because she is now sucking her hands to soothe herself a bit) and hold/carry her whispering 'sweet nothings', rocking her a bit until the end of the lullaby, I then put her in her basket.  If she cries then (more than just a grumble), which she usually is, then I will shh-pat (patting on thighs cos she sleeps on back - this seems to work.  I tried patting on back but she is too wriggly to hold like that) until she is calm and still.  She is normally quite happy before I start this winddown but it's as if once she realises that I'm about to put her down for a nap (i.e. when I lie her down on her swaddling blanket and turn on the lullaby) then she gets really upset because she doesn't want to nap.  So in fact my 'wind down' actually just ends up (usually) winding her up!  I wondered if anyone had any suggestions of changes I could make to the wind down and/or ways of 'teaching' her that naps are a good thing she should look forward to!  (I try, of course, with my tone of voice to make it sound like a good thing when I'm putting her down).

During her daytime naps we play white noise (the sound of a hairdryer) because this seems to help her nod off and stay asleep for longer.  She doesn't need it at night though.

During the day even with the curtains closed the room is fairly bright so the head end of her basket is covered with a dark sheet to block out visual stimulation.

So really I wondered if anyone has any suggestions of how we can get her to:
(a) protest less when we put her down for a nap (different wind down technique?),
(b) extend her naps, and
(c) get her to have her last nap of the day.

I guess I'm asking quite a lot!

Many thanks for any suggestions.

[cath~]

PS regarding the reflux, we had wondered if she might have silent reflux due mostly to the bad napping, but have since been less convinced, since that seems to be about the only symptom from the list that she has.