5.5 Month old with frequent night wakings

[SamanthaHourd]

Hi everyone,

I am new to the forum and new the Baby Whisperer Way. 

My daughter is 24 weeks old.  She has never been a good sleeper, and has never slept through.  She was at her best at night time at around 3 months, waking maybe 1-2 times per night.  She then came down with a nasty cough and since then her sleep has just gone to pot. 

She is currently on 4 hour EASY.  She has been on this for a month.  She has a great little routine during the day but despite this her night time routine remains unchanged, if not worse.

She is bottle fed but is a terrible feeder.  Before moving her onto EASY she would graze all day, never taking more than 2oz at a time and would usually take a maximum of 16oz a day.  She would then take on average 8oz through the night.

Since putting her on 4 hour easy, he feeds have improved but they are still not brilliant.  I offer her 6oz bottles but it is rare she will take a full feed, and it will usually take me the full two hour she is awake, offering it her little and often, to get her to take 6oz.  It is impossible to get her to take anymore. On a good day now, I can get her to take 20-24oz before bed.

She is also have 3 v small meals a day.  I avoid cereal as it makes her constipated.

Her current routine is as follows:

Wake up: 6 - 6:45am
E: 7am (but will graze the entire time she is awake). Breakfast at 7:30am
A: 7:30 - 8:30am
S: 8:45-10:30-10:45

E: 11am (same as above will graze the whole time she is awake). Lunch at 12:00
A: 11:30 - 12:30
S: 12:45 - 2:30 - 2:45

E: 3:00. Dinner at 4:00
A: 3:30 - 4:30
S: 5 - 5:30-5:45

Bath: 6:30
E: 7
Bed: 7:15-7:30

She does often wake during her naps, but I can usually get her back to sleep.  She is still swaddled.  She will go to sleep without a dummy but if she wakes I will give her one to try and send her back to sleep. I will first try the dummy, then shushing and finally a bottle if all else fails.  I don't use PU/PD.  She does not have a lovie. I have to admit I am not consistent with how I settle her as I am simply exhausted.  Whichever works the quickest! She will usually settle pretty quickly with one of the three methods. 

Last night she woke 5 times.  That is pretty much the norm.  At best she will wake 3 times.  I try to DF her but she wakes before her DF at 10:30pm.  Last night she woke at 9:30, 11:30, 1am, 3:30 and 4:30 and was up at 6am. 

Any help will be greatly appreciated as I am losing my mind!  I do this on my own as my husband works abroad and is only home 1-2 weeks at month at the moment. 

Thanks in advance!

P.S after reading a post on here, I thought my daughter may have reflux.  She will fuss and refuse her bottle, scream and arch her back when feeding.  I spoke to my HV yesterday who dismissed me before I'd said what her symptoms were.  I called my GP today for an appointment only to be lectured for not raising it as an issue sooner! I am seeing my GP on Monday.  I HAVE raised her feeding issues with my HV before, but never put it down to possible reflux and they have never shown any concern so I have never associated it.

Please help!  One very stressed out mum here!

[Erin M]

(((hugs))) sweetie, sleep deprivation is hard!  Have you tried using any of the tips for helping reflux babies sleep -- elevating her cot, having her upright for awhile after her feeds?  I'm going to ask one of our reflux mods to take a look and see what they think. 

You're probably heading into 3-2 territory sooner rather than later (where you drop from 3 naps to 2 naps) which means that you probably need to start increasing your A time -- your day is kind of long right now with the cat nap in it.  There's some info on that here: All about the 3-2 transition- 5/6 months -- your naps are a decent length though, so I'm not convinced that's the issue.

Are you getting wakings consistently at any point in the night or are they seemingly random?  Do you ever automatically feed?  With her not taking a ton during the day, I would expect you'd have at least one waking due to hunger, maybe more. 

What about possible causes of discomfort?  Did your wakings change at all when you introduced solids?  3 meals is a lot for a 5.5 month old.  Any possibility of teeth?

I spoke to my HV yesterday who dismissed me before I'd said what her symptoms were.  I called my GP today for an appointment only to be lectured for not raising it as an issue sooner! I am seeing my GP on Monday.

And this ^^^^^makes me mad on your behalf.  How are you supposed to know these things?  That's their job to help you if you're seeing problems, not your job to figure everything out.  Grrr....

[ZacsMumme]

Hi Hun.

Hugs. Sleep deprivation is so hard.
Here is some more info on reflux. Knowledge is power so knowing more will enable you to have some ammunition at the drs that something IS wrong - should your LO fit these symptoms.
Often reflux doesn't present itself obviously until 3 mths. The 4 mth GS is horrendous for refluxers too.
Have a look here Reflux 101 - General reflux information
And through here for information http://www.cryingoverspiltmilk.co.nz

Hard your LO been checked for tongue tie?
Does she have any MSPI symptoms?
Does my LO have food intolerances?

Elevation is helpful, as is the paci. Winding well after feeds is also important as wind/gas makes it worse, and crying also aggravates reflux.

Do whatever works for now. Especially if LO is in discomfort there is no point sleep training.

Your LO sounds a little lie my ds2 - they love solids because it keeps the milk down. Can you mix milk into her food so she is getting more in that way? Solids either helps or makes the reflux worse. Have things improved or declined since starting?

Ill be back but let us know how the drs goes ((((hugs))))

[SamanthaHourd]

Hi ladies,

Thanks for your replies. 

Her night wakings have been random.  Very rare one night is the same as the one before.  Before putting her onto EASY I did used to feed automatically when she woke up, but then I made an effort to not offer her a bottle unless it had been 4 hours before her last feed since putting her on EASY.  Again I haven't been entirely consistent as sometimes she'd wake and not settle with me putting my hand on her back or dummy and as a last resort I would just offer the bottle even if it had only been a couple of hours since her last feed.  She would never take much though at any one time.  I have not long introduced solids and her night wakings have been bad for a couple of months now. 

I am trying to think if they have gotten worse since solids but I honestly can't say.  I wake so often I forget how many many times I am up most nights! Her meals are very small though.  I still offer milk first and then only 5 or so spoons of solids for breakfast and lunch.  She has a fruit puree in the afternoon.  She would eat more if I let her, but I am mindful she is still very young and I am worried about over feeding her. I also mix a bit of her milk with her food just to get her milk intake up.  Her milk intake hasn't dropped off since taking solids though, it has remained the same.  Before starting EASY (and before solids), it was much worse. 

She has never been checked for tongue tie. Some of her symptoms also point to MSPI and I am going to raise all this with my GP tomorrow.

Since I suspected she may have reflux I have been making sure she is fed upright and have elevated her cot a little.  I didn't attribute any other causes of discomfort to her night wakings though.  I think she may be teething and last night I tried putting some teething gel on her gums before bed. I am pleased to say that the past two nights there have been an improvement.  The night before last she woke only twice.  I managed to feed her her dream feed before she woke (she doesn't take much, around 2oz).  She then woke at 12:30am, but settled when I put my hand on her back.  She then woke at 4:30am.  I tried the hand on her back which didn't work, then offered her a dummy but she spat it out and cried.  I then offered her a bottle and she took 3oz and went back to sleep until morning.  Last night I gave her her dream feed and she didn't wake until 4:30am!  Not sure if this is a one off though, it's the best stretch she has ever done.  It did take me a whole hour to get her back to sleep as she just wanted to play after she had had some milk.  Once she did settle she didn't wake until 7am.

I am also going to start to extend her A time.  I tried to extend this morning by 10 minutes but she did take a lot longer to settle and I ended up resorting to using the dummy so she could fall asleep (she usually falls asleep without it) and so far she has been sleeping peacefully for an hour. 

Thanks very much for your input, ladies.  I will let you know how I get on with the doctors tomorrow.

[ZacsMumme]

I'm really glad the last 2 nights have been better
Let us know how the drs goes. TT check only takes a min

[Erin M]

Good luck sweetie!  I'm so glad you had a few better nights. 
And, this:

It did take me a whole hour to get her back to sleep as she just wanted to play after she had had some milk. 

reminds me of a need for more A time, so I think you're right to extend it. 

[SamanthaHourd]

Just a quick update on my visit to the GP. My GP is of the view my daughter has reflux and have prescribed gaviscon. Hopefully this will help! Past couple of nights have been no better. Had a terrible night on Tuesday 

With regards to extending her A time, my daughter is managing to stay awake for 2 hr 15 min. How will this affect feeding times as the extended A time means she naps later and into her mid morning bottle. How would you go about this?

[Erin M]

As long as it doesn't look like hunger is causing her to wake early from her naps, you'll just have 2 feedings that are spaced a little further apart, and then later on in the day, 2 that are closer together.  (((hugs))) on the reflux, there are ladies on here who are much more experienced with it and will give you some great advice there, I'm sure.

[ZacsMumme]

Hugs. If it doesn't help do go back and ask for a med trial of Zantac or a PPI. Gaviscon is often a temp measure for mild reflux...given her age I think she may need more than this but she may not!
Th
Hugs....let us know how things go with gaviscon. You should see immediate progress as it is given for the said feed YK?

[SamanthaHourd]

I'm not seeing any improvement with the gaviscon. Feeding is till hard work. She doesn't enjoy it, and its at the point I think we both dread feeding time 

I am also having real trouble with extending her A time. She wakes so early (around 6) and I try to get her to go back but it's a fruitless effort. I won't take her downstairs until 7am, as that's when I want to start the day. I offer her a bottle and the whole fight starts. She'll refuse it and then if I managed to her her to take it she'll guzzle it and then stop suddenly and refuse it again. It seems the whole A time is taken up by this, and then by 8:30 she's rubbing her eyes and getting grumpy. I tired to keep her awake til 9am and she fought going down for a nap. She then woke after an hour, wide awake and wanting to play and there was no way I could get her to go back. It's 11:30 now and since 11am I've been fighting with her to get her to drink her milk it's taken 30 minutes to her only 3oz down her. She doesn't seem tired yet though.

Yesterday was the same. She went for a nap at 8:40am and slept a bit longer until 10am. She then had her second nap at 12:30 and slept until 2:30, but she refused to have a nap around 5 even though she was clearly tired. I left her and bathed her earlier at 6:15, bottle at 6:30 and she fell asleep whilst feeding and was asleep before 7pm. She then woke 30 minutes later and then at 9:30pm and I couldn't get her back to sleep until 11:30pm. She then woke at 1:30, 3:00, 5 and 6. Possibly more but I can't remember.  I don't mind feeding her obviously if she wakes hungry but I know not all these wakings are hunger.  I fear whatever I try it just doesn't seem to get better, she just shuns everything I do! Where am I going wrong?

[Erin M]

Is there any way that she will fall asleep for sure (like in a swing or with you or something?) -- I would try that at 6 AM if she wakes early. 

[ZacsMumme]

Or...it's not ideal but a lot of LOs are wired to wake early and it is less stressful to make WU 6/6.30 and BT earlier too. Just a thought as T does this and we had endless battles and trying to fight him to sleep. Once we just adjusted his routine 6.30-6 things improved for all of us YK?

Re feeding...sounds like the reflux isn't really controlled by the gaviscon. I would pay the dr another visit and ask about trialling ranitidine/Zantac.

[SamanthaHourd]

Hi ladies, just a quick update.

I persevered with extending A time. We are almost at 3 hour and DD is doing well. Extending her A time did seem to help with the early 6am start, however she is now waking at 5am but I am able to get her back to sleep either with simply holding her hand or she will talk herself to sleep. She now wakes for the day around 7am, give or take 15mins. This has made it so much easier to plan her day. She is going down for her morning nap well, very rarely fights it but for one day we go to play group which just happens to be bang on nap time but she loves it so I put up with her being a bit grizzly late morning/mid afternoon. She will usually nap 1,5 hours uninterrupted. Her afternoon still needs a bit of work. Think I need to tweek her routine somewhere but we are getting a few 45 min naps where she won't go back down. At best she naps for 1hr 15, but on average she will nap for an hour. She is not grumpy when she wakes, she is wide awake and wanting to play.

Feeding is still not great, although its a bit better. I have seen my GP again who wants to give the gaviscon a little longer as I did report a bit of an improvement, with a view to trying some meds if it remains the same. We are managing 7oz feeds, 4 times a day (have just upped her feed).

Night wakings much better! She is waking at 2am and 5am. I really want to get rid of the 5am one as she isn't hungry then (has refused milk when offered), but her 2am waking she seems hungry will drink 4oz.

So all in all much happier mummy and daughter! Any advice on extending the afternoon nap and the 5am waking?

Thanks so much for your help, ladies. You have saved my sanity!

[Erin M]

I'd say it sounds like you need a touch more A time before that second nap by her demeanor when she's waking. 
As for the 5AM waking, getting your daytime A time right could help that -- I'd also just keep doing what you're doing and it should even out -- that 5AM time is a period of very light sleep for LOs.

[ZacsMumme]

I agree with Erin.
5 am is a common EW for his age too so your not alone, gentle tweaking will hopefully help shift it later x