Frequent Night Wakings - 3.5 Old

[AshBlack]

Hi all,

This is my first post, however, I have been helped out by reading this forum over the past 3 months!  My 3.5 month old son has been on EASY since he was 6 weeks old, and has done really well with it.  I went back to work 3 weeks ago and the nanny is so impressed with his "schedule".  He dropped his 2 a.m. feed about a month ago (he is almost 18 lbs - only ever had breast milk and was born under 7 lbs - he is a good eater!) and was sleeping through the night.  Over the past week he has not been sleeping at night well - and I think there are a few things going on all at once and I need some help!!! A normal day looks like:

6AM Wake, breastfeed, light activity
7:30 Nap
9AM Wake, feed (5oz pumped breast milk when I am at work) play
10:45 Nap
12PM Wake, feed (5oz pumped breast milk when I am at work) play
1:30 Nap
3:00 Wake, feed (5oz pumped breast milk when I am at work) play
5:15 Nap (Only sometimes - we are usually just getting home and he doesn't always go down)
6PM Wake, breastfeed, watch mom and dad eat dinner
6:45 Bath, dress, book, wind down
7:15 Bed (in a co-sleeper in our room)
10:40 Dreamfeed (move him to his crib, where he takes all naps when home)

We have swaddled him since he was little, and started a pacifier only while sleeping when he was 8 weeks or so.  I think the major problem is that he wakes up and is looking for his pacifier, and since he is still swaddled can't self soothe with his hands (he sucks on them all day long!)

Lately, he has been waking about an hour after he initially goes down.  We put the paci in, and he is back asleep.  When it drops out, he doesn't wake up.  He usually stirs right before his dream feed (sometimes as early as 10 p.m.) so he has been awake when we start the dream feed but falls asleep while eating.  He is then usually able to sleep for an hour or two, and then is up looking for the paci (routing, mouth open, head turning for it), from there until 6AM he is up doing the same every 30 minutes to an hour.  We are so tired!!!

I don't know if I should try to get him to sleep without the swaddle first, or try to get him off the paci (but how???) I have tried the gentle removal and he just freaks out.

Any thoughts?

[PaulsMom]

Hi and welcome!

Hugs on the broken sleep.  it is so much harder when you are tired.  It looks to me that you have a paci addict on your hands.  I'm also not sure if he's looking for you since he started out in your bed. 

I think if depends on what you want to do.  If you want to keep the paci, then you can start to wean the swaddle but keep in mind that usually bubs can't re plug themselves until they are around 7 mo (some can do it sooner).

If you want him to suck his hands rather than the paci then you of course will need to wean both. 

To wean a swaddle, I would start with just leaving one arm out of the swaddle for naps and see how he does.  By this age, he may not wake himself up.  Once he's fine with one arm out, then remove the other arm. 

If you want to wean the paci, I would do it cold turkey.  It will be hard on him for a few nights but doing this early may be easier than doing it when he's older.  I had to wean my DS (at 7 mo) from the paci and I introduced a lovie at the same time as weaning so he had a comfort item to adopt.  I also used shh pat to help calm him and made sure his hands were on the lovie. 

hTH

[AshBlack]

Thanks Paulsmom!  If we go cold turkey for the paci, what is the best approach when he wakes up?  Shush/Pat in his crib?  What if he gets really worked up into lots of tears?    I hate when he cries!  I know it will be better for him in the long run, but need to make sure I am prepared. 

Also, when he is in our room for the first half of his sleep he is in a side sleeper, not in our bed - and I am actually not there until about 9 p.m.  I do this so he is easier to pick up (and less likely to wake) for the dreamfeed.  Do you think the fact that he is waking up for the dreamfeed could set him into this frequent wakeful sleep?

Thanks again!

[PaulsMom]

For going cold turkey with the paci, I would recommend shh pat unless he's getting really upset in which case I would pick up, calm him and then do shh pat.  For my son, the first night was rough but it got easier over the week.  If you want to introduce a lovie, you can sleep with it first so it has your scent on it which can help to calm him down. 

Wrt side sleeper, have you thought of doing the df with a bottle?  That way, you might be able to feed him without picking up (and you should be able to do this in his crib).  If he's waking fully for the df, then this could be distrupting his sleep and causing him to wake more.  Would you want to try not doing a dream feed?  Try tanking him up before bed and then see how it goes?  (This might be less painful than weaning a paci!)

[Erin M]

You can also catch him a little earlier with the dreamfeed before he wakes (get yourself some more sleep in the process too!)

[AshBlack]

Thanks again! Last night was so much better.  There have been so many variables at play that it is hard to know what helped.  I think he may have been a bit too hot, so we left off one layer last night.  I also put him to sleep in his crib instead of in the side sleeper and then moving him after the dream feed.  He slept from 7 until 2:45(!!!) We had decided to keep using the paci until the weekend, and it feel out right when he fell asleep and it didn't bother him.  When I went in at 2:45 he seemed hungry, an even though I haven't fed him overnight in a month, I just felt that was what he needed. And boy, did he! He had a full feed (both breasts) and went straight back down - no paci.  He woke at 4:30 only because one arm escaped his swaddle, but once I reswaddled he was back sown until 6! I only got out of bed twice, which is leaps better than 10 or 12!!

Could it be that it wasn't the pacifier he was looking for over the past week but food?? It breaks my heart to think he was hungry that whole time - but he wasn't crying.  Should I now reintroduce a mid night feed? I was thinking if he wakes up over 3 hours after the dream feed that I would feed him, but I don't want to mess up his day time feeds.

Thanks!

[PaulsMom]

I'm glad last night went better.  It's not unusual for babies of this age to take a night feed.  Also there is a gs around 4 months so he may be having his spurt sooner? 

With regards to feeding at night, I agree with having rules as to when you will feed vs just resettling at this age.  He should be able to last just as long at night as during the day so I tend to wait that long before feeding.  If it is a gs, it should only last for a few days.

[AshBlack]

Thanks again for insight.  We have a slightly different pattern happening now, and I am wondering if we should drop the dream feed.  He is still going down at 7 p.m., but over the past few nights he has been fully waking up between 10 and 10:30 (before I have a chance to try to feed him while asleep).  I feed him and he goes down pretty quickly, and then he is awake again between 2:30 and 2:45. 

So that means he a full feed at 6 pm, top up at 7 pm, full feed at 10:30ish and full feed at 2:45....and now I notice he isn't feeding as well at his 6 am feed.  I am afraid I am shifting his caloric intake to the night. 

If I drop the dream feed but keep feeding him upon his second waking, is it possible he will start eating more during his day feeds?  I don't want him to be hungry overnight, but I don't think he needs to be feeding every 3 hours.

What do you think?

[PaulsMom]

Hmm...  if he's taking a full feed both at 10:30 and at 2:45, then I would be inclined to keep them however for the DF, you might want to consider doing it a bit earlier so that he's sleeping. 

WRT to the 6 am feed, I'm thinking that he needs to transition to a 4 hr EASY so that he's taking better feeds during the day.  here is some more info:
Time to Transition - 3hr, 3.5hr or 4hr EASY
3-4hr EASY Transition – In 5 Minute Increments

Do the transition gradually and see how he does. 

[AshBlack]

Thanks Paulsmom - the switch to 4 hour EASY has been something I have thought about.  My question about this transition is if he is currently eating 6 oz of pumped breast milk at day care for his 9, 12, and 3 feedings, do I have them offer him more than 6 ozs?  How will he take in all his calories if he is essentially dropping a feed during the day?

[PaulsMom]

You will have to give more per bottle.  Likely if he's going longer between feeds, he will want more.  I don't have lots of experience with bottle feeding as I am bf my dd but I'll ask for some assistance about how to go about this. 

[*Kara*]

Hello... just popping on to say that yes, if you do move him to a 3.5 or 4 hr routine, he will need more in each feed.  I don't think he would be able to do 4 hrs between feeds though... very few BF babies are able to get to a 4 hr routine before you start solids around 6 months.  Also, he is a big boy so will need a good amount each day to support his growth rate. 

Does he drain the bottles of breast milk?  If so, you should be offering more in each one.  If he drains 6 ozs now, offer 7 ozs.  It may be what he needs to get to a 3.5 hr routine.  Currently, he is taking a 5-6 oz feed every 3 hrs.. so he will certainly need an ounce (or two) more each feed to be able to go 3.5 hrs between feeds.

With regards to the night feeds/dream feed - I would be tempted to make sure he has a full feed right before he goes down for the night, put him into his own crib for the night (I suspect that you coming to bed may be interrupting his sleep pattern and causing him to wake for that DF).... skip the DF (you may have to resettle for a few nights as the DF likely has a habitual waking aspect in your case)... and feed when he wakes at night without hesitating so long as it has been at least 3.5-4 hrs...

You did have one super good night and I think that might be a big clue to getting better sleep

[AshBlack]

So I am back  Our little guy is now 4 months and having major sleeping issues, and we are at a loss.  Here is what last night looked like (day time is the same except he is now taking 6 ozs per feed - every 3 hours - at daycare):

5:30PM: .5 tablespoon of rice cereal with breastmilk
6:00 Bath, wind down, story
6:30: Breast feed
He got super cranky here (only day 3 of cereal at his dr's recommendation - could that be bothering him?) and was hard to get to sleep.
7:15 Asleep - swaddled
9:00 awake, unswaddled playful
9:15 Asleep
10:40 Dream Feed - both breasts, right back asleep
12:00 Cried out - by the time I got to his crib he was fine and asleep - may have cried out while sleeping?
2:45 - awake, fussy, fighting swaddle, lifting legs and slamming them....but didn't seem hungry - he wasn't crying, just fussy and moving alot
3:10 Asleep (after a lot of shush/pat and pu once)
3:15 awake again, so I decided to feed him (accidental parenting??) he ate from one breast and fell back asleep
5:30 awake out of swaddle, looking to play - managed to get him to sleep on my chest (AP again!!)
6:15 Up for the day and fed on only one breast, refused the second (which makes me think he didn't need the NF after all)

The swaddle is an issue, but we have tried nights without it - and he just goes crazy moving his arms and legs.  I can lightly hold him down as he is falling asleep the first time and he can stay asleep for a while - but after the first NW he will be flailing again.

HELP I am so tired and don't know what to do!

[PaulsMom]

hugs on the nws.  4 months can be a trying time when it comes to sleep. 

The number of nws makes me think that there is discomfort involved.   

As for his day time routine, see if they can feed him every 3.5 hrs as Kara has mentioned.  If he's draining 6 oz, then offer 7 oz.  Putting him on a routine meant for a younger baby can cause nws as they start to snack rather than taking proper full feeds.

wrt the rice cereal - He's still young to be given rice cereal.  It does cause tummy upset in lots of babies so see how he does without it.  Contrary to popular belief, giving rice cereal will not help him STTN and at this stage of his life, breast milk or formula has all the nutrients that he needs.  Both milk and formula have more calories in it than the rice cereal and often the additional iron that is added to the baby rice will cause tummy issues, constipation, etc.  I would be more inclined to up his milk intake in lieu of starting solid foods.  Also keep in mind that there is a 4 month GS.

The other thing that can cause discomfort is teething.  some start early and I've found with some babies, the teeth moving in the gums hurts more than the cutting of teeth so you don't really know that that is the problem.  You can try giving some type of pain relief (numbing agent, teething powder, Tylenol, etc). 

WRT swaddling - he sounds a lot like my DS was at that age.  He also discovered how to thump the crib mattress with his legs.  If he's touchy or spirited in nature, then I'd continue to swaddle him as long as he's not rolling around.  My DS is touchy and was swaddled until he was rolling and then we continued to swaddle his leg up for many months after that!  It did help him sleep and know that it was bt.

There is something called a 4 month sleep regression that coincides with other developmental milestones or Wonder week 19.  What's getting to be more important now is to not use soothing techniques that you don't plan on using moving forward (ie. accidental parenting).  If you are alright with holding him or rocking him, then that's fine if you want to continue doing that but otherwise I would recommend that you use a technique like shh-pat.