sleep is still not established

[mehibbitts]

Hi I am needing help with my 5 m old’s sleep.   He has reflux, but it is undercontrol with meds.  He is on a 4 hr. easy eating routine, but his naps have never been predictable.  We had him sleeping for the night @ about 3.5 months then he got an ear infection that broke his routine.  We did some acc. Parenting to get him to sleep b/c he was in pain.  Now we are having a hard time braking the habits.  He doesn’t wake at the same times each night (2-3 x’s a night) so we can’t use wake to sleep (my favorite used on 1st born).  I don’t believe he is hungry either.  When I use PU/PD, he just continues to cry even when I PU.  Shush pat is what we are using at the moment, but I feel he is addicted to Mom or Dad putting him back to sleep each time.  It doesn’t seem like he is progressing into sleeping on his own.  Also for his nap he always wakes up after 45 min. then I shush pat for 10-30 min. and we usually get another 45 min.

[katie80]

Hi and welcome to BW!

I'm glad to see you're using shh/pat. PUPD can serve to aggravate reflux, so is not recommended for reflux babies, even if it's under control. If you feel like he hasn't progressed from shh/pat, it's usually just a matter of gradually reducing your help. So, stop patting and just hold a hand on him once he goes quiet. Then, start to remove your hand a bit earlier and earlier, always going back to shh/pat if needed, but removing again before he's all the way asleep. Here's a link on this same thing: Why are Shush Pat and PU/PD not props?

What does his EASy look like during the day? It could be that a little tweak would get him sleeping through those naps without having to resettle each one. Or, you could try w2s to extend those...

Have you tried feeding in the night at some point to see if it makes a difference?

[mehibbitts]

Thanks for replying.  Last night he sttn not sure why, but I'll take it.  We changed him from a pack-n-play to a crib.  We figured he wasn't sleeping through anyway.  But to our amazement he slept.  It could also be that he drank more yesterday than normal.  Maybe a growth spurt??? His easy varys, but here is a typical day.
6:30-7 wake up BF
7:30 solids
8:45-9:00 down for nap( usually up 45 min. later.  Use shush pat 10-30 min and another 45-60 min.)
11 bottle 4-6 oz
12 solids
By 12:15 he is getting tired so down in bed@
12:30 45 min. Wake sush pat sometimes another 45 but not always. Then it gets crazy. I  put him to sleep when he gets tired for the naps. Usually 2 more 45 naps, but not always.
3 wish bottle 4-6oz
6ish bottle then solids (I give a bottle only if the last feed was 4oz or less.)
6:30 bath
7:00 BF bed

[mehibbitts]

His activity times are always 2hrs or less depending on the length of his last nap.

[katie80]

Last night he sttn not sure why, but I'll take it.

For sure!

His activity times are always 2hrs or less depending on the length of his last nap.

I would say these might need a bit of a bump.  45min is usually a UT waking, which is why you likely can't always get him back to sleep in the afternoon.  Is he closer to 5mo or 6?  Avg A for a 5mo old is 2-2.25hr with lots of 6mo olds at about 2.5hr.

Has he been on solids for very long?  What types of things is he eating?  3 meals a day is A LOT for a 5mo old, and refluxers can sometimes struggle more with solids than other babies.  That could be playing a factor in the NWs.  If you'd like to keep 3 meals, I would at least move the dinner one to 4pm to give his tummy more time to digest before BT.  This will also likely make the BT BF better, so he's more full in the night.  And, it's not unreasonable for a 5mo old to still have a NF, esp if he doesn't have a DF, so don't completely rule out hunger either. 

HTH!

[mehibbitts]

He always has a DF.  I can't keep him up more than 2 he's without him crying tired.  He will be harder to go down.  He just started with a 3rd meal.

[mehibbitts]

He has been NW before I intro solids.  He eats 3 very small meals about 1oz each feed.

[katie80]

I can't keep him up more than 2 he's without him crying tired.  He will be harder to go down.

He may not be ready, then.  You can try to extend the naps with w2s.  Typically, for a 45min nap, you'd go in around 32-33min and rustle him a bit.  I'm assuming you know how, since you've used it before, but just in case you want a refresher, here's a link: How do I address habitual wakings? (wake-to-sleep and other methods)  45min naps can be developmental at this age, until about 6-7mo, but I'd try adding even 5min of A time every few days if you still can't get them to extend, because if you can get good solid naps, I think that will help your night.  The choppy afternoon with several CN might be attributing to the NWs.

As for the solids, that sounds fine, although I still don't know if he needs the 3rd meal.  I'd just make sure it's not too close to BT if you decide to keep it.

Keep us posted...

[mehibbitts]

For an update: My 5 month old (He will turn 6 month on the 4 of March) is doing better at night.  1-2 wakes just for pasi.  We'll work on that prop after naps are routines.  HE is still waking 30-45 min. after being put down for his nap.  He is not under tired when put down. Shush pat has stopped working.  Looking for more advice.  W2S  is a hit and miss.  The last 2 days he was not able to return to sleep with sush-pat.

[katie80]

Shush pat has stopped working.  Looking for more advice.  W2S  is a hit and miss.  The last 2 days he was not able to return to sleep with sush-pat.

Honestly, these are classic signs of UT.  He was having longer naps and now they've shortened; you can't get him to extend with w2s or shh/pat.  He's tired enough to fall asleep, but not to sleep more than one sleep cycle.

His activity times are always 2hrs or less depending on the length of his last nap.

This is more appropriate for a 4-5mo old, rather than an almost 6mo old.  Here's a good link with average A times: Average A times and "Is my baby ready to increase A time?"

He may well be showing tired signs at 2hr, but those could be out of habit or boredom.  The other info you've given me says he's UT.  I know it's not fun to deal with a fussy baby, but I'd really start pushing him by at least 5-10min every few days.  It can take them up to a week to get used to a new A time.  I was the same way and never wanted my baby to get OT, but at some point you realize that what you're currently getting isn't much better, so it's worth a try to push it out.

[mehibbitts]

Very often he wakes after 30lmin. of nap.  Also he wakes after BT.  Sometimes 2-3 x's until DF which he wakes up for sometimes.  Here is our easy today (not typical)February 28th Thursday

6 breastfeed 630 a.m. + 4 oz bottle
7:30 solids
7:50 down for a nap
8:20 W 2 s
8:37 awake shush pat did not work because would not settle seems wired ( frailing arms and legs) but not crying
8:57 stop trying shush pat out of the room
10:25 6 ounce bottle
10:50 overtired had to rock to calm down until eyes we're close ( normally goes down on own)
11:25 awake rewrapped shush pat
11:38 asleep
1:45 awake--b/t the (18 min shy of a 3 hr. nap)
2:00 6 oz bottle
5:35 down for a nap hard time settling
6:07 awake
6:15 solids (late b/c late cat nap) 6 oz bottle
6:45 bath
7:15 BT  asleep by 7:30 awake @ 8:15 and again @ 9:15

[mehibbitts]

To make a correction
He woke at 6:00(which is on the early side for him) then BF @ 6:30 +4 oz bottle

1:45 awake-(18 min shy of a 3 hr. nap) 13 min. of shush pat

[katie80]

I hate to sound like a broken record, but he's UT first thing in the morning and that's why you can't extend.  He was up less than 2hr and took a 47min nap, that was unextendable (classic UT).  Then, he was up for over 2hr and ended up taking a 2.5hr nap in total.  Sure, you needed to help him get to sleep and resettle him, that was a long time to be up after a short nap and he was OT, but after you resettled he slept 2hr, so he wasn't so OT that he couldn't keep sleeping.  This tells me that he resettles and sleeps when he's tired enough to do so.

Start pushing the A times.  You may need to help him to sleep a bit and resettle him when he wakes for a few days, but his body will adjust to staying awake later. 

[Erin M]

Start pushing the A times.  You may need to help him to sleep a bit and resettle him when he wakes for a few days, but his body will adjust to staying awake later. 

Hey sweetie, just wanted to second this ^^^^^^^

It's hard to make that jump sometimes to extending A times since we all worry about out LOs getting overtired, but it makes such a difference.

[mehibbitts]

Just for an update...we are sttn DS had an ear infection ( 3rd or 4th one since he's born).  I should have know there was something.  He always start waking when he has an infection.  his naps are still a hit and miss.  Like yesterday he did 2 good naps 1.5-2hr, but today first nap only 35 min???

[Erin M]

Like yesterday he did 2 good naps 1.5-2hr, but today first nap only 35 min???

Are your A times consistent between the days or are they different?  Their sleep needs change a lot at this age, I found myself to always be pushing A time.

Glad you're getting some decent nights, ear infections were always one of those things where I'd wonder what was up and then figure it out and feel silly that I hadn't realized sooner. 

[mehibbitts]

Well I guess I spoke too soon.  We had a 5 night run, but last night he woke up at 9:00 after BT and again at 12:45-!:30.  Should I drop the CN even if his previous nap was 45min. which would put his activity time before BT about 4-5 hours long.   He is 6 months and 1 week old.  Yesterday was 4 every short naps 30-40 min. each, but today was as follows:

Wake @ 6:15 (really early)
E 6:50 6oz bottle and solids at 7:30
A  2hr. 25 min
S 8:40 awake @ 11
E 11 bottle 6oz and solids @ 12
A 2 hr. 25 min.
S 1:25 awake @ 2:10
E 3:15 bottle 6oz
A 2 hr 10 min
S 4:20 awake @ 5:01
E 6:00 solids  bath @ 6:30 and bottle 6oz
S  normally after bottle, but always on his own-- not tonight?? waiting for him to go to sleep as I type

[mehibbitts]

to answer  Erin I try always to look for his sleep signs but I watch the clock also and try for the same A times 2hr 15-25min

[Erin M]

I'd say pushing A times with a mind towards dropping the cat nap is a good plan right now.  I notice you got a really long nap in your EASY, but you were working on a broken night's sleep -- but when you tried the same A time later, you got a short nap.  I'm thinking more A time.  The tired cues can be somewhat unreliable when you're pushing A times, so better to clock watch for a week or so and see if it helps.  I'd just increase by about 10-15 minutes past what you've been doing, hold there for a few days, and see where it gets you. 

Did I link this yet?  I can't remember, but have a read if you haven't already, it's very useful: All about the 3-2 transition- 5/6 months

[mehibbitts]

Last night DS BT was 8:00 then woke @9:30 paci, sh pat, out.  STTN:-)
Today already out had a Dr.app. after an of nap how long of an A time??

[Erin M]

If it's shorter, cut the A time by 20 minutes and see where it gets you -- it's really trial and error with difference babies. 

[mehibbitts]

Looking good.  We are working on dropping CN so moved up BT.  Wakes early,but it will work itself out.  Naps are getting better 1.5-2.  A time is about 2.25-2.5.

[Erin M]

Great!

[mehibbitts]

DS is now having NW b/c he has turned on his belly.  Should I leave him on his belly and sh pat or return him to his back?

[Erin M]

You're right at the 6 month mark -- I believe at 6 months the recommendation is to put him down on his back and then let him roll to however he wants.  Can he turn back on his own?  If he can't, I'd give him lots and lots of time to practice it during the day (extra tummy time!) so he can roll over at night.  Some people will try to put them near a side of their crib so they can't roll over.  Is he over or under 6 months? 

[Erin M]

Here's tummy sleeping info: Tummy Sleeping

[mehibbitts]

I do put him on his back to sleep but he turns to his belly on his own in the middle of the night and it wakes him.he is 6 months in 2 weeks.  He can roll back to front and vice versa, but at night it seems to wake him up. I don't mind him sleeping on his belly if he's more comfortable.

[mehibbitts]

Naps are getting much better.  I have cut the CN on good nap days, but keep it if needed on not so good nap days.  He is having 1.5-2 hr naps :-)  thanks for all the help even when I was in doubt.

[katie80]

Sounds like really good progress!   Both mine started rolling to their tummies around 4-5mo, so I ended up just shh/patting them there. The recommendation here is that if they're strong enough to roll over to the tummy, they're strong enough to sleep there. 

[mehibbitts]

We are having multiple NW again. DS easy for the days we stay home:
E - 6:00-7:00 not sure why the EW
A - 2.5-2.75 hrs
S - sleeps 1.5-2 he's
E - 11:00 solids@12 ish
A - 2.5-2.75
S - 1.5-2 hrs
E- 3 solids @5:30-6
Bath@6- 6:30
Bottle then BT@7 wish
Wakes many times at night.  Last night @3, 4, 4:20, 4:50,5:30, 5:50 finally 7:15 for morning wake up. It doesn't always happen b/c he turns on his belly, but not sure why.  Always seems tired to me.

[katie80]

Those early morning, frequent wakings seem like discomfort to me. Have you just started solids? What types of things is he eating? Otherwise, I think the routine looks good.

[mehibbitts]

He has been eating for about 2 months now. He eats stage one puree.  When he wakes early and we take him out of his crib, he seems fine.  He never has a bottle before 7 even when he wakes early.

[katie80]

Hmm, normally frequent wakings at that time of morning indicate some type of discomfort or hunger.  If you don't think his tummy is hurting from the solids, could he in fact be hungry? Lots of LOs have a growth spurt raround 6mo.  I can't remember if he has a DF or not?  Have you tried feeding in the early morning to see if it helps?

The other reason for wakes like that is UT, but his routine doesn't suggest that, which is why I'd think hunger or discomfort.  What about something environmental, like temperature? Could he be getting cold at that point in the morning?

[mehibbitts]

He seemed to be waking at the same time each night, so I had decided to W2S it work for the first NW but not the 2nd.  Then last night after 1:30 he woke every 1.5 until 7:00   could use encouragement. 

[katie80]

(((Hugs))), it's so tough when they go back and forth like that.  I'm sorry you're feeling discouraged, let's see if we can figure something out.

Then last night after 1:30 he woke every 1.5 until 7:00

That seems like discomfort again to me.  Have I asked about teething at all?  Could he need an adjustment to his reflux meds?

What is your routine looking like these days?

[mehibbitts]

well I took him off his reflux meds in the morning to try and ween him off.   I really don't see signs that his belly would be hurting him, or other sym. of reflux.  But I do believe he is teething. He's constantly having his hands in his mouth drooling much more than normal ( even his luvly is wet) chewing on everything. Today it is very difficult he is crying constantly. He is normally a happy baby but he's night wakings were even more frequent last night.   I have been given the children's motrin and gum med, but very cross.  Any other suggestions?

[katie80]

well I took him off his reflux meds in the morning to try and ween him off.   I really don't see signs that his belly would be hurting him, or other sym. of reflux.  But I do believe he is teething.

Did you take him off his meds under your Dr's guidance/advice?  I don't know all that much about reflux, but I do know it can flare while teething and it seems that not many LOs are successfully weaned from meds until they're a bit older.  I do think the NWs and fussiness are likely due to discomfort.  Whether it's a combination of teething and reflux or just teething, that's what they sound like to me. 

(((Hugs))), I know it can be exhausting to be up all night and have a fussy baby during the day.  Is there any way you can AP him for a nap or two, so that you can get a break?

[ZacsMumme]

Hi there,
My almost 6 month old is being a bit of trouble like this too ATM. He is sick with the flu but I do find he does this when teething, sick, refluxing or GS. My guess is that if he is teething this has caused a reflux flare (which they do) and because meds have been weaned the acid is causing pain. What meds was he on Hun?

Have you noticed any of the symptoms come back?  Reflux 101 - General reflux information

How are poops? Constipation can also cause sleep issues. Is LO congested at all?

Hugs, I get it. I'm severely sleep deprived today too

[Erin M]

What's your routine like these days?  It can help us figure out if some tweaks might help too.

[mehibbitts]

We're Sttn again :-) I think it was teeth and reflux.  I ended up giving his meds again and teething subsided too.  He is currently on prevacid compound 2x a day 2.5 ml not sure of the dosage b/c thew out the bottle getting new one today. 

[katie80]

Yay for STTN!

[Erin M]

Yay!

[mehibbitts]

What is normal wake times for a soon to be  8 month old ?  His naps aren't as good as before. This is causes a CN that we had cut out and sometimes even a NW.

[ZacsMumme]

Gently push the A times out longer and things should come right.
What was your EAS? - my ds1 was on ~3.5 A times at this age one was longer.

[katie80]

I agree, average is around 3-3.5hr. Is he getting teeth or anything developmental to interrupt sleep?

[mehibbitts]

I'll try extending.  I figured he was in need of a little push! TY

[katie80]

Here is a link with averages... I always find it helpful! Average A times and "Is my baby ready to increase A time?"

Good luck!