Won't sleep more than two hours at night! And hard to get to sleep!

[Lels]

Hi everyone.

I am new here and I see there is a lot of positive advice and support. My little one is ten weeks and was born premature at 35 weeks at 3.5 pounds. She is now 7 lbs 11 ounces.

I have a very hard time getting her to sleep at night. Sometimes it takes 45 mins to get her down. She will wake up 10 minutes after, 45 minutes after if we are lucky. The longest stretch of sleep she will do at night is 2 hours. I worry that she doesn't sleep enough and I am just so tired. Any suggestions?  Thank you in advance for your help! 

[sbchic1999]

That was my son exactly! I didnt address his sleep issues until he was 9 months so you are doing yourself a huge favor by starting now!

Is your daughter on any type of schedule? Post whatever her day looks like (eating, sleeping, etc) so you can determine where the issue might be.

[Lels]

Yes I figure it's a good to start now. Plus I feel so awful that she doesn't sleep.

7:00 am - wake for feed
7:45 am - activity for ten to fifteen minutes of burping and diaper change
8:00 am - wind down for nap.  Dark room, white noise, swaddle. Nap usually lasts 45 mins and the rest of the time is spent trying to get her back down after she wakes without success.
10:00 - breast feed
10:45 - fifteen min activity
11:00- wind down for nap. Again usually only 45 minutes
1:00 pm - breast feed
1:45 pm- fifteen minute activity
2:00 pm- wind down for nap.
4:00 pm - breast feed
4:45 pm- fifteen min activity
5:00 pm - wind down for nap
7:00 pm - breast feed
7:45 pm - bath
8:00 pm - nap.  Will rarely go down fornap at this time
9:00 pm- cluster feed
9:45 pm-  nap.  Will rarely go down for nap at this time
11:00 pm- dream feed.  Most of the time is awake for this feed.
11:45 pm- sleep. Lo is very fussy after dream feed. It takes sometimes up to 45 mins to get her down. She will also wake constantly
2:00 am- breast feed. 
2:45 am- sleep. Easier to get down for nap but constant waking.
5:00 am - breast feed
5:45 am - sleep. This sleep usually is straight through til 7 or 7:30 am.

Any advice is so appreciated. Thank you! 

[sbchic1999]

Does she fall asleep while nursing? What is the nap/bed routine? Has she ever slept with you?

[~Carly~]

So her adjusted age would be 5 weeks... which means that her awake time will probably only be an hour to 1h 15m, but it looks like she is getting 2+ hours because of the short naps.  Have you tried shortening her A time?  Are feeds taking 45 minutes? 

[Lels]

Thanks for the replies.

She doesn't fall asleep while nursing but does get quite drowsy at times. Her bedtime routine is darken room, turn on white noise, swaddle and sit with her while telling her softly that it's sleepy time. She has slept in the bed with me about three times in the earlier weeks.  Not recently.

I try to keep her activity time short with just burping and diaper change. She starts yawning during the diaper change!  So i quickly get into the wind down/ bedtime routine as fast as i can.  The times after the 45 min nap is spent doing shush pat in her bassinet or trying to calm her from crying. Her feeds take from 40 to 50 minutes.

I feel like I am missing something or not doing something right as she is constantly waking.

[sbchic1999]

I think she is OT since she never gets a short nap. I was able to extend my daughter's naps by doing wake to sleep. About a half hr into the nap go in and ver gently touch baby so that she stirs a bit.but.does not.wake up. This is supposed to reset the sleep cycle. It is worth a try!

[Lels]

I will def try it.  Do you ever accidentley wake her up and can't get her back down though?

[sbchic1999]

That did happen with my son. So its possible. Just start gently. Like touch the cheek ever so lightly until you can tell that it was felt. You just need them to stir a little.

[Lels]

I seem to have been able to extend naps with the shush pat. Its now just the times from 11 pm to 4 am that she is very unsettled, crying and doesn't sleep. It's so tough!  I don't know what I can do to get her sleeping during this time. And I am just exhausted from not sleeping at all.

[katie80]

Hi Lels, (((hugs))) on being so tired! Does she seem in discomfort at all? Are there reflux, gas issues do you think? Having such a hard time getting her to sleep and then staying asleep makes it seem like something else is at play.  It's great that you have been able to extend some naps, what is her daytime routine looking like now?

[Lels]

Hi, thanks for the reply!  The routine is the same as I posted above except I am pushing the awake time an extra 10 minutes.  We went to see a pediatrician and she doesn't have reflux. It could be gas...how would I know?  It's really tough to pinpoint why she isn't sleeping from 11 pm to 4 am. Any advice is appreciated. Thank you.

[katie80]

Do you burp her well at feed times?  It could be that she's just not getting all the gas out and therefore not sleeping well.  I know some people have success with gas drops.  It might be worth it to try those.

Otherwise, I think she's OT and that's why she's having trouble staying asleep at that time at night.  Typically, it's best to aim for a 12 hr day/12 hr night.  So, if she wakes at 7am, bedtime is about 7pm, give or take 30 min if needed.  It looks like in the EASY above that she still is taking several CNs throughout the evening.  That's likely adding wake time in that isn't needed, so she's getting OT and possibly OS. 

Taking her adjusted age and weight into account, a 3 hr EASY might look something like this:
E 7 am
A
S 8:10-10:00 am
E 10 am
A
S 11:10-1:00 pm
E 1:00 pm
A
S 2:10-3:40 pm
E 3:45 pm
A
S 4:55-6:00 pm
E 6:15 pm
A
S 7:15 pm (Bedtime, so every wake after this is shh/pat back to sleep until she's due a feed, so about 3 hrs)
DF 10:30 pm

She's really young, so holding her until she's quite drowsy or even all the way asleep and patting her gently is just fine.  As she gets caught up on some sleep and time goes on, you can gradually reduce the time you hold her and pat her and start putting her down more and more awake.

The other thing to note is that the DF doesn't work for all babies, it can actually disrupt their sleep if you catch them in the wrong part of their sleep cycle and cause more wakings.  I don't think this is what's happening for you as she's already awake at that time, so it's technically not a DF that you're doing.  Again, I think it's more OT, but just so you know, the DF may not work.  HTH!

[Lels]

Should I eliminate the cluster feed than as to not wake her if not needed?  That would get rid of that awake time.  I am not sure if the dream feeds working...she usually spits up quite a bit after it and it wakes her. But I have been only doing it for less than a week. The Bw book said that it could take a while to kick in. So I am not sure what to do there..

Thank you for all of your help!

[katie80]

Yes, I would eliminate the cluster feed for now to get more sleep into her. Is the DF the only one she spits up a lot after? Is there something you eat everyday, usually in the afternoon or evening that could be bothering her, causing her to spit up more? It's up to you whether you want to keep going with the DF or not.  Typically, I'd recommend to keep it for 2 weeks before reassessing, but if it's just causing more issues, it might not be worth it.

[Lels]

She spits up for pretty much all feeds...but the dream feed worse because she is semi asleep sometimes and I don't burp her. 

Yesterday was a really bad night.  She was crying and fussy from 11 pm to 6 am.  I would calm her and put her down and use the shh pat and it didn't work.  It was a long night and I felt so bad that she wasn't sleeping.  So finally at 6 am I held her and just let her sleep until 9 am.  I know I am setting myself up for AP but I didn't know what else to do!  She needed to sleep! 

Night times have been pretty bad for her this last week.  Daytime is fine.  She usually goes down for naps and is easy to settle.  I don't know how I can make it better!

[katie80]

Oh dear, (((hugs))).  It just seems like something is up that's causing her to not sleep well, she sounds uncomfortable.  Don't worry about APing her right now, she needs the sleep and so do you.  She's so young that she's not likely to pick up bad habits with AP when needed.  You've got lots of time to get her going down independently and being well rested is one of the most important parts of that.

What was the pediatrician's reasoning for no reflux?  Are you engorged when you feed her?  Are you burping her often during and after feeds, even at night?  Do you hold her upright after a feed?  Gas can really cause upset tummies in LOs.

[Lels]

It's just so strange because she goes down so easy during the day and it's so difficult at night!   The pediatrician said that her weight gain was great and she didn't appear to be in pain when she spits up.

I try to burp in the middle and after a feed. Sometimes she is tough to burp. And I don't want to go on too long because than she will get overtired.

I am not engorged when I feed her. We just went off using a nipple shiel, she has been feeding faster. Usually 30 to 40 minutes now. Would that make a difference?

[katie80]

We just went off using a nipple shiel, she has been feeding faster. Usually 30 to 40 minutes now. Would that make a difference?

It could... a nipple shield makes for an easier latch, slower flow, so now with a faster flow she may be taking in more air and milk on top of it, so it gets stuck. 

I try to burp in the middle and after a feed. Sometimes she is tough to burp. And I don't want to go on too long because than she will get overtired.

I get this, feeds with my DS generally took about 30-40 min for a long time, because I was burping him often.  But, I do think it's better to get the gas out, so it doesn't cause disrupted sleep, than worry about her getting OT.  She's easily patted back to sleep, so a touch past her A time to get any gas out shouldn't be a problem. I tended to try to burp each time he pulled off in the beginning, because I have a fast flow and a good supply of milk.  I'd then put him back on the same breast until it felt empty.  As for being tough to burp, there are lots of different ways to try to do it.  You can put her on her stomach across your legs and gently pat or rub her back, push her up higher on your shoulder so her arms dangle over and again pat or rub, or hold her chin in your hand and gently rock her back and forth and side to side. Again, I found it easier to get a burp out if I did it more frequently, than if I waited til the midpoint or end of the feed.

[Lels]

Okay..I will try to burp her several times during the feed.  Hopefully that works and makes her feel better.

I use shh/pat to try to settle her.  It works great during the day.  But at night..she seems to cry right through it.  I pick up her calm her and put her back down..and she is up again right after and we start it all over again.  Maybe I am not using the shh/pat right?

[becj86]

Is she gassy at night? That can cause some bad gas pain.

I wonder if you have tried dropping the dream feed to see if it is that which is causing some gassiness/sleep disturbance at night? Inclining the mattress can help with gas - means it comes up as a burp rather than making it down to get trapped in the gut.

[my3girlsjde]

I wonder if you have tried dropping the dream feed to see if it is that which is causing some gassiness/sleep disturbance at night?

I'm wondering this as well.

I'm also going to second the opinion of inclining the mattress and trying to keep her up after feeds. If your paed says no, you can still do some reflux tricks that do help all lo's who are in discomfort ie, keeping upright after feeds, constant winding, AP when necessary.

But don't hesitate to go back to the Paed if you suspect discomfort/reflux still. Many Dr's are of the mind that if a lo grows and thrives then things are fine. I'm not sure what the case is here, but if your lo is showing any signs of reflux, don't hesitate to go back or ask for another opinion. Take a peek here to see if anything rings a bell just in case it could be reflux http://babywhispererforums.com/index.php?topic=654.0 and here if something else might be up http://babywhispererforums.com/index.php?topic=107244.0

Regardless of the cause, it does sound like your lo has some discomfort of some kind.

[Lels]

I have already elevated her matress a few weeks back..it seemed to help a bit. Thanks for all the info.   I will definitely read those posts.

[katie80]

I pick up her calm her and put her back down..and she is up again right after and we start it all over again.  Maybe I am not using the shh/pat right?

Typically, at her age there isn't any PU involved, it's just shhing and patting in the crib. However, if she's suffering from gas, picking her up and gently patting her back can help. I would actually get her calm and pat her to all the way to sleep at this point, just so you can both get some sleep. As time goes on and you figure out what's causing her to be up so much and can remedy it, then you can start patting less and less and get her to go back to sleep independently. Is she swaddled? That seems to help the whole process, as well.

[Lels]

Hi Katie. Yes she is swaddled.  Sometimes I pat her right to sleep, only to put her down and she wakes in five or ten minutes.  Than I usually use shh/pat to calm her down.  It should usually calm them from crying?  Does it ever take longer than 10 mins of it before baby calms down?

[katie80]

Yes, it can take longer than 10 min, but if it's taking that long consistently or lasting up to 20-30 min, I'd say there's something else going on, either OS, OT, possibly UT, or discomfort.

[Lels]

If she is OS or OT, how do I prevent that?

[katie80]

It's basically a matter of knowing what she can handle for A time, looking for patterns, and keeping the last 10-15 min of activity before wind-down pretty low-key.

[katie80]

Since Lels has a current thread going on the EASY board, this one will be locked to keep all advice in one place.  Please visit this thread in order to continue giving advice and support: http://babywhispererforums.com/index.php?topic=233781.0