4 month old was STTN now wakes 3 times

[ENMS]

DS will be 4 months on Saturday. He has had two growth spurts in a row which left us with a NF and a NW/EW.  He used to STTN for about 3 weeks until 2 weeks ago (the first GS). Then he was waking up around 5-ish and we would feed him. With the 2nd GS, he added a feed around midnight.  The GS are over and now we still have these two NW's! For the first one we are trying to gradually reduce the number of oz in the bottle, giving him enough that he is satisfied but not too much (because he would also not take a full bottle in the AM).  

Last night his NF was at 2:15 which is a great improvement!    He still woke at 5:45 though and was not hungry, so we were able to get him  back to sleep by 6:00 and he then slept until 7:00.  The thing is it's not exactly at the same time every day. It's anywhere between 5 and 6AM so I can't really use W2S.  I don't rush in, I try to wait and see if he will just chat and get back to sleep but the talking usually escalates until he it shouting for us.

I used to always try to feed him though so maybe that was a mistake. Even during the GS, he would drink less at that time than during the NF (7 oz NF and 4-5 oz at that time) so he might not have been that hungry and maybe we're the ones that created this habit  

Any advice?

[Bex09]

Hi there, is your DS on a 3 or 4 hr EASY? Do you want to post your routine for us to take a look at?

Is he always taking between 4 and 5oz for the NF? If so that is still a decent feed for his age, with my DD we knew she wasn't that interested if she only took 1 or 2oz.

[ENMS]

Is he always taking between 4 and 5oz for the NF

Yes, the first NF is always 7 oz and the second one 4-5 oz (except for last night he didn't drink at the 2nd NF but he still woke around the same time).  The problem though is that he was STTN without any NF for about 2-3 weeks! Dh insists he needs to start solids but I find him a little young to start right away.

Our EASY is not the same every day because we have a short nap issue, which I APOP because he needs to get in at least one good nap.

Here is Monday:

W 5:30 (not able to resettle after NF)
E 5:30 5 oz
S 7:20-7:50
E 9:00 6.5 oz
S 9:50 -11:20 (APOP)
S 12:45-4:15 (APOP - exceptional, was the end of a GS, he didn't want to feed and had a looooong nap in the swing)
E 4:20 8 oz
E 6:30 6 oz
S 7-0:30
E 0:30 7.5 oz
S 0:45 - 5:30

and Tuesday (no long naps DD was home and I was not able to APOP):

W 5:30 (could not resettle - this only happened on Mon and Tue of this week, never before and not this AM)
E 5:30 5 oz
S 6:50-7:45
E 9:00 7 oz
S 9:45-10:15
S 12:15-12:45
E 12:45 4.5 oz
S 2:50-3:20
E 3:45 6.5 oz
S 4:30-5:15
E 6:40 5 oz
S 7:00-111:45
E 11:45 6 oz
S 12:00-5:00
E 5:00 5 oz
S 5:15-7:00

Thanks!

[ENMS]

So last night we had: 1NF at 12 (6 oz he drained the bottle), 1 NF at 4 (5 oz), 1 NW at 5:30, we resettled and he slept until 7.

I'm really confused about why he needs to feed so much at night when he didn't need to for about 3 weeks? Is it a good plan to try to reduce the oz during the night?  

I was thinking of maybe starting by reducing the 2nd NF oz as much as I can but keep the first one as is and maybe try to reduce it once we have eliminated the 2nd NF. What do you think? He feeds well during the day except that the first bottle is usually smaller especially when he had NF's.

[Bex09]

The 4 mo GS can be a huge one that goes on for a couple of weeks so it could well be that hanging around. TBH though just because a LO has STTN without a feed for a while doesn't mean that it is going to continue unfortunately. My DD did for a whole month once she turned 12 weeks and we were so pleased. Then at 4 mo with increased mobility, rolling etc she started waking hungry around 4am again, this went on until she weaned herself at 6 mo.

I notice that your DS doesn't have a DF, so TBH at this age 2 NF would be totally normal. Does he settle easily after his NFs? If so then I would feed, resettle and wouldn't worry about it too much.

[ENMS]

TBH though just because a LO has STTN without a feed for a while doesn't mean that it is going to continue unfortunately.

Really? I had never really heard of that... I know it can stop sometimes due to illness / teething / milestones, but now it is worse than it was before he started STTN.  At 1 month he was doing 6-7 hour stretches and now he can't go more than 5h? Somehow I'm thinking it must be related to his day / OT / AP?

He settles easily after the first NF, not so much after the second one usually. I really think that second one is not right, I'll try to reduce the oz and see what happens...

[Bex09]

Really? I had never really heard of that...

Well as I said it happened with my DD and I put it down to her new found mobility and burning more calories etc. On NW there have been quite a few posts where this seems to happen too. Like I said if LO settles well after a feed it usually is hunger as long as the feeding isn't to sleep and a prop yk? So you know your DS best and if that second feed doesn't seem needed then reducing the amount would be a good way to go.

[ENMS]

I find that a very interesting theory! I wouldn't have thought of it at that point, i.e. before crawling or walking... it does make sense though, I'm just surprised at the 'schedule' of his NW... I would totally get a NW between 2AM and 5AM for a feed, the midnight does surprise me. But I'll wait it out, you're totally right about the fact that he settles well after (witout feeding to sleep), so I guess time will tell what is up then! We'll also be working on putting him on a good solid EASY that might help.

[Bex09]

I am right that your DS doesn't have a DF aren't I? So I guess that is what the midnight feed is about, it has been a good stretch since his feed before BT hasn't it? Plus he takes a good feed at this NW doesn't he? He should really be able to go at least 4 hrs again though before another NW/NF.

[ENMS]

I am right that your DS doesn't have a DF aren't I? So I guess that is what the midnight feed is about

Yes, you're totally right he never had a DF.  I guess the reason why I'm so confused is that he dropped that feed at like 1 month so it's really been three months since he didn't feed at that time of night.

It's been like this approx since we switched to a 4-hr EASY (after the GS).  Could that be causing differences in his milk intake? Although it's not like I have a choice really, if I feed him at 3hr intervals he will snack and take only 3-4 oz at a time.

I also feel that the 2nd NF is what is screwing up the day and making him take in less calories during the day... he's not hungry when he wakes, then after 1h-1.5h of A time we feed him, he only takes a small quantity, and then the feedings for the rest of the day are off (due to timing with naps, etc) unless I APOP his first nap to make it a real long one, and then when he feeds after that long nap, he takes a full feed and the rest of the day is ok in terms of feedings.

Someone mentionned to me that to reduce the oz in the bottle I should mix the formula with water so that he gets the same quantity but less nutrition? Is that how I should do it? I had thought instead to reduce by 1 oz every 2-3 days until there's none left and then resettle him instead of feeding him.  Does that make sense?

[Bex09]

Yes I would probably agree with your way of reducing by giving an oz less every few nights, pretty much how Tracy suggests that you wean the DF. I can see the point behind adding more water but I always worried about doing that, just me though.

I can totally see your frustrations in why your DS is needing that feed again when he dropped it at such a young age. Now that he is on a 4 hr EASY is he actually taking more oz during the day than when he was on 3 hr feeds? I agree that he needs to be on a 4 hr EASY, for his age and also as you said to avoid snacking. Usually this transition sorts NW out though not causes them!

So, if that is the case it could well be your EASY that is partly the issue here. I guess we need to work out if those short naps are UT or OT, what do you think? Are there any props involved and does your DS fall asleep independently? I notice that you said you APOP some naps, how do you do this?

[ENMS]

Now that he is on a 4 hr EASY is he actually taking more oz during the day than when he was on 3 hr feeds?

Yes, in total he is, 30-35 oz, vs 25 oz before but most of the extra is really at night (he gets about 10-12 oz total at night), during the day it's usually (on a good day) 3 x 6-7 oz and 1 x 3-4 oz (AM feed).  On a 3-hr schedule it used to be 5 x 5-6 oz.

I guess we need to work out if those short naps are UT or OT, what do you think?

Right now I'd say they're OT... but I think the issue is developmental. He was a great napper until reflux came along, then when it got controlled he was ok for a short while, and then they all became short. I tried lots of differnt A times and nothing works so I'm really thinking it's developmental.

Are there any props involved and does your DS fall asleep independently?

He's not falling asleep independently, although we want to work on that, I started shh-pat this week and I think it made things worse I think it is a prop for him, his naps are shorter than ever and it is harder than ever to get him to sleep!  Before that we used to hold him while walking and then drop him in his crib when he was very very drowsy. He would wake, move a little, and then go to sleep. I am planning to start tomorrow night with PUPD because we really need to fix this now, he used to fall aslleep independently before the reflux but then it messed everything up!

I notice that you said you APOP some naps, how do you do this?

It used to be the swing, the stroller, or (very rarely) my arms.  It has to be a full nap because there is no way at all to get him back to sleep after a short nap.  Lately though (this week) nothing works except the stroller. So as I said above, we'll be working on some serious sleep training as of this week.  I am a little stressed though because he gets OT easily and I'm scared the sleep training will just make him so much more OT (I won't APOP naps during the training period!), but at this point, we don't have a choice, we have to sort it out because he is tired and not napping well at all. Hopefully by doing this it will help sort out the nights as well.

[Bex09]

Ahhh reflux... the all time sleep buster! We were exactly the same with my DD hun and she had to be APOPd for every nap until 4 mo! It was a nightmare. So I agree that it is probably time to sleep train, I would just take it really slow with a refluxer. You should really avoid PU/PD with a LO with reflux though as it causes the acid to rise up even more and makes things worse. Shush/pat would be a better option but I know you said that this hasn't worked too well. Some refluxers don't like the patting, my DD didn't. So we would shush and rub her back or stroke her head. Use whatever works for your DS, it might be that he depends on it at first but you can easily wean by just a lighter touch, less time etc later on.

If the naps seem OT and I would agree because a lot of them are 30 mins. Have you tried reducing the A times to see if that works at all?

[ENMS]

Well an Easter miracle happened this morning! He took a 2h20 minute nap in his crib! After a shorter A time of 1h30 in total. So I'm hoping we can replicate this tomorrow.

I will try to do pretty much as you say, I have a post on the CRC board about it, I'll do most of the comforting in the crib and only pick him up if nothing else works to calm him down.  I'm starting tomorrow night, hopefully it goes well...

[Bex09]

Oh sorry hun I didn't realise you had a CRC post about sleep training, will leav that on here though so that you get all your info in one place on that aspect. Sounds a good plan though, good luck.

Great news about the longer nap, I would try that A time again tomorrow yes. Let's hope that gets your Easy sorted and helps your nights too.