EW - 6 month, 1 week old - not sure what to do.

[TracyP21]

Hi, my DS is just over 6 months old and a terrific night sleeper but not a great day sleeper.  I have been working with the ladies on the Naps board to rectify this. 

We haven't had any NW since 9 weeks old (touch wood), but for the past few weeks he has been waking up at 5:30am ish, just chattering and will doze on/off till I get him up at about 6:50am.  He used to wake up @ 6:20am so now not sure why he is earlier.  Naps are a huge issue during the day - I can't seem to get anything over 45 minutes - the first 2 happen in his cot, the last one usually needs to happen in the pram (which can turn into a 1hr 10 nap cause he's so tired).  I have worked at extending his awake time and have him around 2hr 35-40 but still short naps. 

The big question I have is about the EW - should I intervene here and try to get him back to sleep?  He never cries out, just lies there and talks and goos and dozes on and off.  What causes EW?  He definitely can't be UT - I know he is OT as bedtime is getting earlier - from 7pm to 6:30pm.  Sometimes he is crazy silly at bedtime and stays up later, almost delirious.

The other question I have - not sure when to gauge his awake time from - the 5:30am EW or when I get him up at 6:50am.  Should I be getting him up when he actually wakes up to start the day?  I have conflicting reports about this.  The problem is it can change his Awake time by an hour! 

I have been giving him a top-up feed before naps in case he is hungry. We do have a bottom tooth coming through and I know that could be playing havoc.  Started solids last week - only a couple of teaspoons at lunch.  He is mostly BF with one bottle of formula a day.

He is mainly a touchy baby.  Just been put on meds for reflux, which have made a huge difference.

I will post EASY from yesterday (though not the best):

Awake on/off 5:30
Up: 6:45 (1.7ml randitine - reflux)
E BF
A
S: top up BF 8:15 (felt asleep here but woke up when I tried to put him in bed).  in bed @ 9:05 - didn't settle, tried till 10am.  Got up - gave Pamol - 4ml.

E 10:15 BF
A
S Bed @ 11 - asleep 11:15-12:50 (best sleep he's had in his cot during day for ages)

E BF
A
S - gave 4ml pamol half an hour b4 bed.  100ml F - top up.  Tried in bed 3:20 - wouldn't settle.  Put in pram outside at 4:25 and he slept till 5.

E 220ml formula
A
S before bed 1.7ml randitine / 4 ml pamol.  BF @ 6:20pm - got really silly - put into bed @ 7pm and went to sleep straightaway.

Woke 5:33am this morning - chattering on/off till I got up at 6:50am.

E BF / top up feed 8:15
A floor / sitting up / story
S put into bed @ 8:50 - asleep 8:55 - just heard him awake at 9:40

So his awake time this morning could be 3hr 25mins or 2hr 10 mins - so confused!

I know he is not getting enough sleep during the day - but can't seem to make headway here.  PU/PD didn't work, settled to make him more upset and when he wakes up after 45 mins he's awake.  Are the day sleeps affecting the EW?  He should also theoretically be dropping the last sleep but he really has no sleep to drop!

[becj86]

EW can be caused by a few things, a lot of which you have going on - discomfort - teeth or reflux, UT (might be time to extend those A times and drop the catnap - this is the prime time to be doing so), OT (just to confuse things ) I wouldn't intervene, I'd tweak the routine.

It not a great idea to do PUPD with a refluxer - it makes  it worse. Those 45min wakings would suggest to me either discomfort, UT or overstimulation. I have my money on discomfort if the reflux meds were introduced less than 2 weeks ago (it takes some time to see the full effect and sometimes dosage tweaks are needed) or undertiredness - A times should be up around 2hr45-3hr.

WRT his A time in the morning, if he's just chatting to himself in bed and dozing on and off, I'd take A time from when he gets up.

The topup feed could be doing more harm than good if its coming back up while he's sleeping. I presume you have his cot head raised?

[TracyP21]

Hi Becj86, thanks for your speedy reply.  We have had 45 min naps since 4 months so pretty sure its UT - I just wasn't sure what to do with the EW, whether to count them or not.  Also wondering if OS - but he seems to get excited with any activity he does, even lying on the floor looking at the ceiling!

Good point about the top-up feed - yes, we have cot head raised.  I was trying to eliminate everything when I put him to bed for naps and I thought hunger could be a factor.

I will plug on tweaking A time - the teeth are definitely factoring in big time.  Naps are very hard to come by at the moment! 

How do I drop the cat nap when day sleep is soooo little?  Should I go back to Naps board for that one?

[scruffymax]

Our LOs must be almost exactly the same age, and my DD usually wakes up around 5:45 - same thing, happy, I assume dozes on and off, and I get her up at 6:30am.  We have just in the last week moved to 2 naps but we are able to get 1.5hr naps so I know it's different when you've got a catnapper (although the reason for moving the naps was because she was always catnapping the afternoon nap).  Our routine is:
6:30am WU
9:30am morning sleep
11:00am(ish) WU
2:00pm afternoon sleep
3:30pm(ish) WU
6:30pm bedtime

We also do a DF of EBM at around 9:30pm. 

She seems to be taking good day sleeps on this routine but is quite tired and cranky by around 5pm.  I'm hoping that will settle down with a bit longer on this routine (we had a few days in a row where we were out or had visitors during her naps so she didn't have great naps).

So all up, I just wanted to say you're not alone with the EWs, and also to consider upping the A time a bit if you think your LO can handle it.  My LO doesn't have reflux though so I really can't contribute anything toward the management of that sorry!  I tend to go for APOPing when I know my LO is OT and needs a routine tweak, so she gets used to having the sleeps at the "right" time and then work on getting them in the cot.  Good luck!

[becj86]

I think dropping the catnap will come more naturally as your A times get up closer to 3hr, don't worry about that til you're getting more/better naps.

[TracyP21]

Thanks for the advice Scruffymax - your day looks ideal - would love this!  Teeth have got a lot to answer for - and he is so touchy with it. 
Becj86 - I will keep moving the first A time - convinced if I can get that right the rest of the day will run on.
Our EASY today looked like this:

E BF / top up feed 8:15
A
S put into bed @ 8:50 - asleep 8:55 - just heard him awake at 9:40 (A time 2 hr 10 mins)

E BF
A
S - tried at 12 noon - hard out crying in cot - got up 100ml F in case he was hungry, 4ml pamol, tried again at 12:30 - eventually 1pm (1.00-1:45) (A time 3hr 20 mins)

E
A - very fussy/grizzly
S - in pram - 3:10-4:30 (A time 1 hr 20mins)

E - 200ml F
A - shower etc
S - 7:15 (asleep within 5 mins) (A time 2hr 45 mins)

[becj86]

Oh, I hadn't mentioned that reflux often flares with teething, so the meds may not be quite as effective while teething, even if the dose is right.

Keep pushing that A time, the first one is pretty crucial and once you get a good first A and good first nap, the rest of the day is usually much easier.

[TracyP21]

Yesterday we did 2hr 35 mins from 6:45 WU and got a 1hr 25 min nap - he was so much happier.  Only one other sleep of 30 mins and refused afternoon nap so bedtime was 6:15pm.  Same A time resulted in a 35 min nap so not sure about this - but did have 12 hours sleep so maybe I should have pushed him a bit more.  Thanks for the tip about reflex and teething as we had about 3 spills this morning and swallowing going on again.

[becj86]

You may have to keep the second A shorter just while his body gets used to being awake for longer. Really great to get that 1hr25 nap You know he can get through a transition and sleep a good length of time in the day. I'd say stick with 2hr40 or so first up for a few days til the nap shrinks back to 1hr 20, then push it up again.