5.5 month old wakes every 45min to 1 1/3 hr all night

[deny45]

I am the Nana and spend 2 days and 1 night/wk with mom and baby.  My daughter is a wreck from no sleep and so am I on my night over.  Baby slept up to 5hr /night until about 4 month then started this NW.  She has GERD but this seems well controlled with Zantac now.  Swaddling helped her settle but now she is breaking out so we tried without last night which was even worse then the usual NW.  Now she can roll back to belly (without the swaddle) and cries when she ends up on her belly. 

She can be patted and shhh back to sleep most of the time in 5min or less but that still disrupts our sleep and after 2 months this is wearing us out.  She seriousy wakes 2 times and needs a feed (breast with mom, bottle with me).  She also won't nap >45 min and then the pat/shh doesn't work at all.  Her A times are about 2-2.5 hr usually.  Some nights she is obviously OT and hard to settle, but often she easily settles herself to sleep.

She co-sleeps with mom but is in a pack n' play in the guest room when i am there.  Doesn't seem to matter as far a NW.  Tried the crib with mom in the next room last night but without the swaddle she was waking every 15 min until mom swaddled and put her back in bed ( after 3 hr of trial).  Past 3 nights she appears to have gas pain waking her.  She did just start about 1 Tblsp of rice cereal with breast milk about 5 days ago, could that cause gas?  But the bigger issue is the waking us up every 45-1hr all night long.  Longest stretch is 2-3 hr from 3-6 and 6-8AM usually.   

[Erin M]

Hi, welcome!
Does your granddaughter have any sort of daytime routine that she follows?  Can you post it? 
How is she settled for sleep at nights/naps? 

[deny45]

schedule varies but goes something like this
wakes up:  6:00AM
E:  6:00  Breast (or bottle if it's me) 4oz approx
S:  6:30-8:00  This seems the soundest sleep
A:  8:00-10:30, just started a little rice cereal at this time in the past 3-4 days.  Play on the floor, sit in swing and watch mom, activity center whatever seems to please her
E:  10:30 2-4 oz
S:  11:30 - 12
A:  12-2:30  Usually a stroller walk, or in the front pack (she has always hated the facing in packs)
E:  2:30    2-4oz
S:  3:00-3:30 or 4:00 this one is the most variable can be 30 min, or 2hr or not at all
A:  4:00-5:30 or 6:00 watch mom and dad eat dinner and plays in her high chair.  Sits in her swing watches mom cook.  This can be a fussy time
Bed time routine:  bath, nurse, go to sleep 7:00-8:00.  Swaddled, and now blanket strapped across to stop her rolling.  More about this later

She wakes every 1 1/2 hr at night with some restless times between wakings that are easily quieted with patting or just a hand on her chest.
Nurse or bottle 10PM, sometimes also 12AM and then 3AM and 5:30 or 6 AM  about 4oz

Shussh, pat, PU/PD, walking around and singing, whatever seems to work at any particular time to put her to sleep.  She often goes best if just left alone in her bed with maybe a shussh or a song.  Lately she seems to wake 30 min after 1st bedtime and can take 10-30 min to settle for her 1st 1 1/2 hr stretch.

She has history of reflux but is well controlled now on Zantac.  Initial poor wt gain, poor sleep and obviously in pain from the reflux.  She now breaks out of the swaddle at 1 1/2hr and then wakes herself all the way with her hands on her face and ears (she was born with her left hand on her ear!).   She can roll back to belly but not belly to back yet (we keep practicing) so I started strapping her last night to stop the rolling and that helped, but still awake every 1 1/2 hr.  I watched her last night (can't sleep anyway) to see if I could tell what wakes her but I can't.  She has been a little gassy the past 3-4 days.  Mom has stopped all dairy when the reflux was diagnosed at 3 months which helped the gas and reflux.  This baby used to occasionally sleep for 5hr until recently.  Mom (my daughter) is getting really depressed and exhausted.  Daddy is not great at soothing baby and mom can't sleep when baby is crying so that is a bad situation too.  Probably TMI, but Thanks for your help!

[Erin M]

OK, a few thoughts:
-- she might need some more A time, especially in the first block -- there are some sample schedules here: chronological EASY samples, 4-6 months  - ideally at this age you want her to be taking 2 good naps plus a cat nap -- her 6 AM waking probably isn't when she's truly starting her day -- my guess is she's using that nap from 6:30-8 as an extension of her night sleep, which would give her a 12 hour night from 8-8 (more or less). 

-- PU/PD is a bad match with reflux babies -- it's like shaking a soda, just stirs up the acid in their tummies -- I'd stick with pat/shush, something in her crib -- I had to do all sorts of different variations with mine until I found something that they liked best.

-- I'd probably drop the rice cereal for now -- I notice you say she's started it in the past 3-4 days and she's been gassier the past 3-4 days -- could be a connection.  I'd opt for something a little more tummy friendly, like pears or avocados, or just leave off it for a few days and see if it makes any difference. 

Any possibility of teeth?  Seems like some sort of discomfort with wakings that frequent.  I've asked one of our reflux mods to have a look as well to see if she thinks there is some connection there. 

I have to say, you're a fabulous Nana to your daughter to take over some nights so she can get some sleep! 

[ZacsMumme]

Welcome! How lucky is your daughter and granddaughter to have you!

Regarding the rice cereal, it caused gas pain and constipation for my baby when we started. Personally I think the stuff is hard on the gut. I you want to start solids try something like pumpkin/squash, pear or sweet potato. These are more gentle.

Zantac is very weight sensitive. What is your granddaughters weight and dose? Is it being increased with her weight gain? A lot of LOs around this age outgrow the max Zantac dose and a PPI (alternative medication) is given to control the reflux discomfort.

I assume the cot etc is elevated? - does she have a pacifier?

How are her poops? - any mucus?

Here is a fab site on reflux http://www.cryingoverspiltmilk.co.nz

From what I have read Hun it sounds like the reflux discomfort is back. Such frequent waking for us with both my boys was always pain. If not reflux then teething or a GS, sick, constipated or gas. (And unfortunately most of these make reflux worse )

So many hugs. Reflux is just horrid. Your daughter is so lucky to have you. I hope she is ok. I know first hand (twice) how depressing and hard reflux is, not to mention sleep deprivation.

[Buttonbobs]

Just a little thought, when my DD learned to break out of her swaddle her NWs increased. I do certainly agree with Sara that it is worth looking again at the discomfort issue as this was always how reflux showed up in my DD. Byt something else you could try is a more unbreakable swaddle like a woombie or other similar products. We found the woombie indispensable and although it may very well not help all of you problems, it certainly can't hurt to try it (unless the little one is already rolling as when they learn to roll they should be unswaddled.

I'm not sure where you are but here is a link to a uk site to give you an idea of the sort of thing:

http://www.bambinogoodies.co.uk/the-woombie/

What a wonderful nana you are - my mum occasionally stayed over to help out in the early days and it was such fantastic support for me.

[deny45]

Thanks ladies.  You are wonderful.  I just got the Baby Whisperer Sleep book on my Kindle.  Quick and easy to read.  I will pass it on to my daughter when I finish and then the 3 of us (mom, dad and me) can decide what to do.  Also, we found a local sleep consultant who comes highly recommended by another mom.  And, last night MY DD (ha, there's a new use of that abbreviation on this site!) tried flipping the little hand guards down on the sleeper and left baby un-swaddled (because baby Really protested and also she can roll).  1st set she slept 2hr and woke hungry, 2nd set 2.5 hr woke hungry and 3rd set 2.5 hr and woke hungry.  This is an improvement worth celebrating.  Unfortunately she is getting too big for the hand mits so DD thinks she will try socks on her hands tonight.  We need a new acronym....DGD (darling grand daughter).

We see the pediatric gastroenterologist for a check-up today.  We really liked him.  I don't see any signs of pain from the reflux now but maybe it does bug her a night...not sure.  I think she doesn't eat enough at a time to stay satisfied and sleep well.   She doesn't really like to nurse so it has been difficult to get her to eat more often.  Hopefully the GI doc will have some suggestions for this problem.  I think the rice cereal may have been a problem which is weird because we tried it at 4 month to see if it helped the reflux and she loved it (no gas).  But we will talk with him about trying some other food for now. 

We loved the woombie but I have an even better one for you, from a company called Ana and Eve.  It's a strap you can use over other clothing and it has little pillows that flip over the arms so I think it is more comfy.  If I had seen it before DGD was born it would have been a life saver.  Check this out: http://annaandeve.com/home (sent by Yahoo! Toolbar)

I will continue to follow this wonderful forum.  Thanks once again.  (we are in California)

[Erin M]

That strap is pretty cool, never seen anything like that!  Let us know how things go!

[ZacsMumme]

Wish we had that strap this last summer! Let us know how ou all are

[Buttonbobs]

Yes that would be great in warmer weather wouldn't it! Fab find. Do keep us posted, it's be nice to know how you get on

[deny45]

GI doc said it was OK to take DGD off Zantac as she is not showing the signs of reflux for several wk, even when DD forgot to give the dose.  Sleeping without swaddle has been a challenge, but my DD reports that DGD slept a whole 3 hr in a row last night!  The sleep consultant comes tomorrow, I am so glad she will come to the house and meet them both before discussing a plan.  My DD had the flu and I was out of town at a seminar so that was a good trial for her to see what her resources were.  She had a friend/sitter over to help on Sunday and daddy went off with his pal rock climbing.  Seemed to work out well for all concerned.  I was so worried about them, it was good for me to see that DD could pull it together and care for herself and DGD without me.  I am proud and relieved.  Now I can't wait to see them all tomorrow when I get home from my seminar.  You all are so wonderful.  How did I survive without this back in the 80's when my babies were born.  I'll report on the sleep consultant in a few days. 

[ZacsMumme]

Glad things are going so well. Keep an eye on the reflux. It typically peaks around 4-6 months so it could come back. Often it an flare after a few days of no meds rather than just 1 missed dose. Hope things go well with the sleep consultant x

[deny45]

Thanks for the heads up, I will be watching.  No meds since 4/04, Dr said it would take 3 days to really be out of her system.  So far so good.  Fingers crossed. 

[Buttonbobs]

Sending good vibes for things to remain on a even keel without the meds. I hope all goes well this week for you all. Xx

[Erin M]

Good luck!