NW Help

[Kateraid10]

Hi Ladies!! My name is Kate and I found your site through a friend.  I am hoping you could give me some answers as to what I'm doing wrong.  This is my first baby and going into this I had no idea babies didn't sleep when they were tired.  Naive eh?  Here is my info:

My LO is 20 weeks old and slept through the night from 6 weeks to 3 months when we transitioned him from bassinet to crib (both of which are in our room).  LO has reflux, is EBF (no bottles) and a chronic cat napper.  Since the transition, he has taken to waking every 2-3 hours in the night.  I started being stricter with his naps and he started sleeping 6 hour stretches, and then up again every 2-3 until morning. This lasted for about a week and then went back to normal. Every month or so his reflux meds need to be adjusted due to his weight and it throws off his sleep.  Recently, he's waking every two hours and still only napping for 30 - 50 minutes.  He also eats about every two hours during the day which is a stretch from every one hour which went on until about 3 months, which stretched to 1.5 hours and now 2. We hold him upright for 20 minutes after each feed. He used to be swaddled and is currently sleeping in Merlin's Magic Sleep Suit. A typical schedule for us is:

8:00 wake
Nurse (both sides)
Play
9:30 Nap
10:00 wake
Nurse (both sides)
Play
11:30 Nap
12:00 wake
Nurse (both sides)
Solids (rice cereal or oatmeal)
Play
1:30 nap
2:00 wake
Nurse (both sides)
Play
3:30 nap
4:00 wake
Nurse
Play
5:30 Nap (this nap is usually hard and takes us longer to get him down for.  Depending on what time he goes down, he wakes half an hour later and is up until bedtime)
8:00 bedtime
(routine is PJs, Reflux Meds, Story, Nurse, Bed)

Props - DS is nursed to sleep at night and bounced or rocked to sleep for naps although I can put him in his crib when he is drowsy for naps and he will doze off
I know I probably have quite a few bad habits but I need HELP!! we are so tired and I can't even nap during the day when he does because it takes me 30 minutes to fall asleep! I have tried jiggling him 20 minutes into his nap to extend it.  Out of 13 tries, it worked once.  I don't know what else to do.

Props - we do rock LO to sleep

[Kateraid10]

I forgot to mention, when he wakes at night he isn't crying just babbling.  If left he cries.  I pick him up and SOMETIMES can rock him back to drowsy and asleep but most times he gives me cues to nurse.  I'm not sure if he is using the extra feeds to soothe his reflux or if it's a habit or what but he does a full feed and right back to sleep.

[Erin M]

This is my first baby and going into this I had no idea babies didn't sleep when they were tired. 

That comes as such a shock, doesn't it?  I was very surprised with my dd1 to find that out as well. 

Anyway, I have a few thoughts --
First off, you need to increase your A time, especially before that first nap.   You should probably be over 2 hours right now -- and extending your A time should give you some longer naps.  At his age, we would expect 2 decent length naps and a cat nap (which you'd probably be getting ready to drop in a few weeks). 

I would also start phasing out the rocking to sleep -- he should be going to sleep independently for naps/nights now. 

I'm going to ask one of our reflux mods to have a look at this too to give a reflux opinion on some of what you're seeing as well. 

[ZacsMumme]

Hey Hun.
(((Hugs)) I too had a chronic CN. My first refluxer did 20 min bursts for months
Anyway. Totally agree with Erin. Up those As! If you can't resettle with APOP of these tricks
How do I address habitual wakings? (wake-to-sleep and other methods) then cut back the next A time 20-30 mins.

So the reflux...is it silent? - does LO have dairy intollerance or just reflux?
Cot elevated?
Paci?
I assume meds are ranitidine/Zantac? - is he on the max dose? 2 or 3 times a day?
Do you feel reflux is controlled? - bare in mind teething causes flare ups too

[Kateraid10]

Ughh thank you ladies for your replies! I am at my whits end.  Cried myself to sleep last night as he was up every half hour.

Ok so I will up his A times... extend by 15 minutes or just keep him up?

His reflux is silent (no dairy intolerance, just reflux)
His cot is elevated with books and a wedge
no paci and no bottles - he only takes the boob
He is on the max dosage of ranitidine for his size 1.13 mls twice daily (just started this dosage two days ago)
His reflux has been controlled until recently and yes he is teething! I didn't know that could affect it. It seems worse at night.  He's napping in his crib right now happily but at night he lays down and 45 minutes later is woken up to swallowing his reflux.  I end up putting him to sleep in a rock-n-play because of it's steeper incline. Last night he only nursed every four hours but I think that is because my husband was up with him.  I think he smells milk with me and just wants to soothe.

As far as weaning him from the rocking, I have it now so I only have to lighly bounce him for a few minutes... lay him down drowsy and put my hand on his tummy until he falls asleep.  This works for naps... at night it's a whole other story.

[Kateraid10]

I will also mention that last night, after hours of putting him to sleep, he slept for two four hour stretches... so would it be a self soothing issue with the rocking if he can do that?  He has gone six hour stretches as well.  Most confusing baby ever!! haha

[Erin M]

Extend As by 15 minutes every 3-4 days until you get some longer naps -- if you start getting 30 minute naps that he wakes up crying from, you've probably gone too far, too fast. 

Good work on the rocking!

[ZacsMumme]

Hugs, has the ranitidine helped? You should see improvement by now
This is a terrible age for reflux, both my boys reflux peaked at this age. If he is doing well then go for weaning the rocking, on a bad day it's ok to do what you need OT in order to both get rest and him some sleep.

If you can resettle at 45 mins that's great, sometimes a syringe of cooled boiled water helps my LO (though he then gets the paci too ) as it washes down the acid. Gripe water can help was well. But, if you can't resettle, more naps and shorten the next A helps prevent OT

[Kateraid10]

Thanks ladies. The ranitidine has helped a bit but even in his inclined crib he wakes from swallowing what's coming up so for now he's sleeping in his rock n play as the incline is a lot steeper. I've heard it takes a few days for the ranitidine dose increase to take effect and have noticed that as well in the past so I'm waiting to try him again In his crib where I know he's more comfortable and can stretch out better.

Yesterday was rough as he refused to nap. We had to drive an hour away for a family event and hoped he would nap in the car after an hour of unsuccessful attempts at home but he refused. Tried taking him for a walk and bouncing etc and maybe got a couple twenty minute stretches. Last night he slept for a few four hour stretches probably because he was so tired. Today, I was able to extend his morning nap to an hour only and then it was game over. He's napping now so fingers crossed this one extends and we're on our way to a better nights sleep.

ZacsMumme Thank you for the cold water tip! I'm going to try that. It's so hard to see them so uncomfortable. When did your little ones outgrow their reflux or show signs of improvement? The doctor said it should be letting up by now but it seems to be peaking.

[ZacsMumme]

I don't know why drs say it improves after 3 months. Colic often eases but I don't know anyone with an LO on meds for reflux who has had them improve significantly till after 6/7 months.
T is 5.5 mths and still hit and miss. We have good and bad days. H is on a high dose of a PPI to control the acid. He's also on solids, these have helped with the milk coming up - and keeping things in the tummy.
Z was on meds till ~20 months I think, he improved a ton around 7/8 months.

If he will take a paci this will help the reflux and possibly with his sleep. Is a blessing and a curse though the dummy

I would let him sleep wherever swill settle for now for naps (as long as it is safe) even if you have to hold him for some.

Has the ped/dr discussed solids with you at all? Or something like infant gaviscon if the milk coming up is causing problems even without acid.

[Kateraid10]

Hmm nice to hear in just a months time I could see some improvement. I have the doctors blessing to start solids and I give him some daily but some days he really likes it and some days he wants nothing to do with it so we are still working on that. I find he naps great in the stroller and will sleep for the better part of two hours if I go for a long walk so I am planning those for nap times on nicer days as the incline helps also!

[ZacsMumme]

Great, do lots of walking
Not sure when you offer solids but I find am is usually a better time if they're not keen. Also, try to avoid cerial and stick with bland veges or pear

[Kateraid10]

Is cereal no good for reflux?? He's not too keen on it.

[ZacsMumme]

It is hard on the tummy, and often constipates x