4.5 months - 5-6 short wakings?

[beanerw]

Hi All,

I'm stumped as to what to do here.  My 4.5 month old is waking every 45 mins - 1.5 hrs, all night long.  She's been like this since 11 weeks (before 11 weeks, she slept nearly all night).  She only eats once, at 2 am, which leads me to believe she is waking up the other times during her sleep transitions and is unable to get herself back to sleep.  If I go in to her, she will drop off almost immediately with a soother and a shush/pat, I do not need to pick her up.  She IS able to put herself to sleep at the start of the night and the start of her naps - she is NOT able to put herself back to sleep when she wakes mid-sleep.  She does not have enough control of her soother to put it in herself; I have tried swaddling her with one arm out, but sucking her fingers doesn't seem to help.

I am wondering: do I just have to ride this out and keep going in to shush/pat/soother?  Should I let her try to cry a bit (historically when she fusses, it just gets worse, it NEVER gets better, so we gave up on that a long time ago..) Or, are the wakings because she is overtired? Or under-tired?  Is there something I can do to help her get through those sleep transitions?  Would giving her formula before bed (she is EBF) help her sleep a little "heavier"?  I'm out of ideas.

She has always been a TERRIBLE napper and a very busy baby; in the last week or two I have been trying hard to get her onto a more rigid nap routine, and for the last week she has been pretty consistent as follows:
6:30 am - wake and eat
8:00 am - nap (2 hrs)
10:00 am - eat
12ish - nap (1 hr, IF that, this nap is tough for her)
1:15 pm - eat
2:30 - nap (1.5 hrs)
4:15 pm - eat
5/6ish - she MAY catnap, but not always
7:00 - eat, bath
7:30 - 8:30 bed (sometime in here, it varies by night)
10:30 dreamfeed

She almost always wakes and requires a soother/shush/pat after 8:30 pm, then again at 12:30 am, 1:45 am, 4:00 am, 5:00 am.... you name it (it varies every night).  She has a solid feed around 2 am each night.

Any insight, advice or tips/tricks would be most welcome!!!

[Erin M]

Looking at your EASY, I think that you need to get her on 2 solid naps and a cat nap every day by extending some A times out.  At 4 months, you want to try for 2 hours of A time.  That middle nap being only an hour and the refusal of the fourth nap tells me that.  You've also got kind of a long day working -- you probably want to try for something closer to a 12 hour day and a 12 hour night.

So,
6:30 - wake
8:30-10:30 - first nap
10:30 - wake
12:30-2:30 - second nap
2:30 - wake
4:30-5:15 - cat nap
6:30 - BT
Of course, that's an oversimplification -- you're going to have to push A times slowly, about 15 minutes every few days in order to avoid OT wakings.

I'm also wondering if you have a little bit of paci dependency going on if she wakes and drops right back to sleep when you give her the paci back.

Would giving her formula before bed (she is EBF) help her sleep a little "heavier"? 

That's generally not the case, despite popular opinion that it does. 

[beanerw]

Hi Erin,

Thanks for the advice!  Since my original post things have gone from bad to worse.  Last night she was up 9 times (every hour) and ate twice.  The night before it was the same.

A few questions:
1) How do I get her to nap longer at noon?  I've tried everything - pu/pd, shush/pat, leaving her in there, you name it - she just wakes up and is UP, like wide-eyed and chirpy.  This has always been the case when she wakes from her nap, whether it's 30 mins or 2 hrs.... sometimes she'll nap 2 hours, but probably only 1/4 of the time (other than the 8 am nap - she always naps 2 hrs, I suspect from being up so much at night).
2) WRT feeding, I'm trying to get her to eat as much as possible during her daytime feeds so she doesn't want to eat a night but nothing I try gets her to eat more; she refuses milk after a while and no amount of cajoling will get her to eat any more.  But, she's up at least once or twice a night to eat - which I know might still be normal at 4.5 months but not sure?
3) with the paci, she spits it out as soon as she dozes off, and sleeps without it till she wakes.... any advice on what else to give her?  I've tried swaddling wiht one arm out, in hopes she sucks her fingers, but hand-chewing seems to stimulate her more than relax her?
4) last thing: at bedtime, we do bath and book, and then SOMETIMES she'll go down in her crib; more often than not, she's not interested yet - despite the fact I know she's tired.  Over hte last week shes' started to fuss pretty heavily when I try to put her down.  Do you think an earlier bedtime will solve this? Often she WILL fall asleep if i put her down wide awake, should I just keep at that and only go in to shush/pat if she cries?

Thanks.  My sleep deprivation is gradually driving me insane....

Claire

[Erin M]

1) How do I get her to nap longer at noon?  I've tried everything - pu/pd, shush/pat, leaving her in there, you name it - she just wakes up and is UP, like wide-eyed and chirpy.  This has always been the case when she wakes from her nap, whether it's 30 mins or 2 hrs.... sometimes she'll nap 2 hours, but probably only 1/4 of the time (other than the 8 am nap - she always naps 2 hrs, I suspect from being up so much at night).

Usually more A time before the nap.  That wide-eyed and chirpy usually means that she's not tired enough to take a longer nap, so you have to keep her up longer before you put her down for one. 

2) WRT feeding, I'm trying to get her to eat as much as possible during her daytime feeds so she doesn't want to eat a night but nothing I try gets her to eat more; she refuses milk after a while and no amount of cajoling will get her to eat any more.  But, she's up at least once or twice a night to eat - which I know might still be normal at 4.5 months but not sure?

It would be totally normal at 4.5 months to have a dreamfeed and a night feed (sometimes even 2!) -- generally we'd look for her to be going as long (or longer) during the night as she can during the day.  So, if she's eating every 4 hours during the day, she could also be eating every 4 hours at night.  The goal is that she's basically just waking to eat and then going right back to sleep. 

3) with the paci, she spits it out as soon as she dozes off, and sleeps without it till she wakes.... any advice on what else to give her?  I've tried swaddling wiht one arm out, in hopes she sucks her fingers, but hand-chewing seems to stimulate her more than relax her?

Well, you've got 2 choices here -- to either keep re-plugging until she figures out how to do it herself (probably another month or so) or to just take it away and try to help her find other ways to self-soothe.  If she's spitting it out, before she goes into deep sleep, it's probably not the worse thing in the world, from what I've heard (none of mine would have anything to do with the thing, so I'm not the best one to give advice on that...)

4) last thing: at bedtime, we do bath and book, and then SOMETIMES she'll go down in her crib; more often than not, she's not interested yet - despite the fact I know she's tired.  Over hte last week shes' started to fuss pretty heavily when I try to put her down.  Do you think an earlier bedtime will solve this? Often she WILL fall asleep if i put her down wide awake, should I just keep at that and only go in to shush/pat if she cries?

I think if you manage to make the routine tweaks above, she'll be more ready for sleep when the time comes and hopefully be able to drift off.  If she's tired enough, she will be able to drift off on her own (perhaps with some shush/pat at first if she's not used to it).  If she's not ready to sleep, she's going to protest BT.