7 month old inconsistent night wakings

[m.ned]

My DS turns 7 months tomorrow and is still waking two times during the night to eat (breastfed with solids 3x a day). This is an improvement from when he was 6 months old and waking 3 times a night, however ideally I would like him to only wake once. When he wakes it usually starts as a mantra cry and then escalates. He gets VERY upset if we try pu/pd, but we usually try shh/pat before feeding. The two night wakings are not always consistent, but previously the first would usually occur between 12:30 and 3am and the second would usually occur between 4:30 and 6am. The first NW I can tell he is actually hungry and takes a full feeding, but the second one I am trying to get rid of because he will only suck for a few minutes until he falls back to asleep. I was slowly decreasing the amount of time I was feeding each night (over the course of a week) and was down from 8 minutes to 2 minutes when the NW times suddenly changed. For the past 3 nights he's been waking between 10:30pm and 11pm, refusing to settle with shh/pat (gets quiet but starts crying as soon as the patting stops) and will only go back to sleep if fed (which he eats well from both sides). He then sleeps through the night and wakes again for his second NW at the usual time (between 4:30 and 6am). I'm now not sure what to do because the first half of the night is when he used to sleep the hardest (6-8hrs straight) so I'm not sure why he's waking and acting hungry and I don't know what feeding I should try to eliminate first. He's been on solids since he was 5.5 months and nurses 4-5 times a day.
Here was our EASY from yesterday (he's always been a high A baby). His naps have just started getting longer than 45 minutes and he is going down independently (for the most part, or might need a few shh/pats):

W/U 7:30
E 730 (nurse both sides)
A - solids @ 9 (2oz fruit)
S 10:45-12
E 12 (nurse both sides)
A - solids @ 1:30 (1-2oz veggie)
E - 2:30 (top up feeding, nurses one side, this varies from day to day)
S 3:30-5
E - 5 (nurse both sides)
A - solids @ 6 (2oz fruit/veggie, 4 tsp rice cereal)
7pm - bedtime routine: bath, lotion, sleepsack, nurse (in the crib by 7:30, talks to himself until he falls asleep)
8pm - sleep
NW @ 11pm and 4:00am, up for the day at 6:30am

He does not have a pacifier, does not have a lovie, but I'm worried the breast might be a bit of a prop. He does not have any teeth yet, but I do notice at the 11pm feeding he seems to be biting a lot. He was constipated earlier this week, but we straightened that out and does not seem to be having tummy problems from the food. He is fairly mobile, rolls alot, walks around in his walker, and scoots/crawls on his tummy all over the place. He's very active during his A times. I'm worried that he's not getting enough A time before his bedtime routine, but he starts to get reallly fussy at 7pm on the dot no matter what time he woke from his second nap.

I have no problem feeding him once a night, but I really need to get rid of one of the feedings!

[katie80]

Hi there, sorry for the delay in reply.  To be totally honest, nothing jumps out at me in terms of why he would be waking... he's an independent sleeper, his EASY looks good, he doesn't seem to have any prop issues.  There is a chance he actually needs both feedings still and he could be on his way to dropping one on his own.  If you'd like to help him in this, I guess the only thing I could suggest is to not feed him until a certain amount of time has passed.  We typically recommend to make the NFs at least as far apart as the day feeds, so 4hr in your case.  But, he's basically already doing that, so you may want to go ahead and push it out to 6hr.  You could start by pushing the first NF to at least 4hr from the BT one and then gradually pushing to 6hr.  The only thing is, it's usually harder to resettle in the early morning without a feed, so that one might actually be the more difficult one to get rid of.

If you think he's starting to teethe though, you may want to give him some pain meds to see if that helps him go longer.  He could be waking up for a BF, because it is a natural analgesic for some babies. 

What do you think?

[m.ned]

Thank you so much for your reply! Part of the reason I am getting so frustrated is because I can't find any reason why he would be waking, so maybe you're right and he really is hungry. He went from 3 to 2 feedings on his own, so it's very possible he's on his way from 2 to 1 (fingers crossed!). Tonight I'll try to push him out to 4hr (he's been waking at 3/3.5hr on the dot) for the first feeding and then move towards 6hr and just leave the early morning feed where it is right now? Hopefully when I try to push out that first feeding to 6 hrs he'll drop the second on his own? When I was trying to wean him from that second feeding, I was able to get him back to sleep eventually, but did find he was waking earlier than usually after I got him back to sleep. He doesn't tend to eat very much at that second feeding. With the first feeding, the first night this week when he woke earlier than usual we spent over an hour trying to resettle with no luck . My husband was able to get him quiet, but he would wail as soon as the patting stopped. I usually let him mantra cry for awhile until it escalates, but I'll try to make sure he really needs me before I go in. It seems like once he knows I'm there, he refuses to go back to sleep without eating!

I feel like as soon as I have him figured out, he changes again!

For the teething meds, would I just give him a little motrin?

[m.ned]

Just an update. He woke up at the 3hr mark and I patted him for over 45 minutes. He would go quiet and I thought he was asleep but it turned out he was laying there awake and would go ballistic as soon as the patting stopped. I got him to the 4hr Mark but patted the entire time. He was sleeping 8 hrs straight before and I am so frustrated because I don't understand why the change and why he won't settle! He does not need to nurse to get to sleep for naps so I'm not sure why he thinks he needs it at night. Also I'm worried that feeding him after fussing for an hr makes him think I'm giving in, what do u think?

[katie80]

For the teething meds, would I just give him a little motrin?

Yes, Motrin or Tylenol. 

Also I'm worried that feeding him after fussing for an hr makes him think I'm giving in, what do u think?

Yes, we typically advise that if you choose to settle, you need to settle all the way to sleep and not stop to feed even if you go over your initial set time.  Otherwise, it is confusing for the LO and is not really teaching anything. Get him all the way to sleep and then feed upon the next waking, even if it's only been 10min.

He was sleeping 8 hrs straight before and I am so frustrated because I don't understand why the change and why he won't settle! He does not need to nurse to get to sleep for naps so I'm not sure why he thinks he needs it at night.

(((Hugs))), that is frustrating for sure.  We just need to figure out why he's waking and not settling any other way (easier said than done, probably).  Either he's truly hungry, in discomfort from teething/tummy issues, or has a patting/nursing prop in the MOTN (doesn't typically happen with an otherwise independent sleeper, but definitely can).  Have you introduced any new solids lately?  You mentioned he was constipated earlier last week, could there be a connection there?  What do you think is the most likely cause of him waking?

[m.ned]

Sorry it took me so long to respond! We had about 4 nights of more random NWs: one night with only 1 NW and a 6am EW, then a couple of nights with 3-5 NWs. However, we were able to settle with a little patting at the wakings we didn't want to feed at and now we have returned to our normal nights with a NW between 12:30 and 3am and another between 4:30 and 6:30am. I still had no idea why he was waking until yesterday when my sister-in-law was letting him gnaw on her finger and found he had cut a tooth! First time mom right here, no idea what a tooth cutting looks/feels like, but he has one that has broken the surface! So that would definitely explain the random unexplained NWs the past week. He really wasn't fussing that much like he was in pain or anything, but next time I will know to look for the signs so I can give him some pain relief. Poor little guy! He also started with the 30-40 minute naps again, so I'm trying to tweak his awake time again. We're hovering around 3hr45min which seems like so much but it's the only way he will take a good nap!

Anyway, I do have another question now that we've returned to our normal NWs. I still would like to eliminate one of these feedings. Since he usually goes 5-6 hours before his first nightfeeding, I was trying to eliminate the second waking. I almost had it gone the first time I slowly decreased the amount of time I was feeding him each night, but I know that you said it can be really difficult to resettle in the early morning hours. What do you think would be the best way to tackle one of these NWs and which one should I aim to get rid of first?

[katie80]

TBH, I would give those wakings a little bit longer still and see if the second one goes on its own.  It's very normal to still have both wakings at this age.  Otherwise, I would do as you were working on before... trying not to feed him before 6hr for the first waking and then either reducing the time and eventually resettling at the next feed or hoping it goes on its own.  It's not quite habitual enough that you can use wake-to-sleep to get rid of it, so resettling is really the only other option.

Gad you found the culprit for the extra NWs and that they're back to normal!  Even if you had experienced teething before, you might not have known it, because they all teethe differently.  My guess is that it's pair will be along shortly.

[m.ned]

I am back, so sorry it took me so long to respond! My DS is going to be 9 months on Friday (can't believe it), and we are still at 2 NWs. We had about two weeks of 1 NW around 4:30am and a couple STTN when he was 8 months, but then all of the sudden he went back to where we were before. You were absolutely right and he did go from the 2 NWs to 1 completely on his own, which is why I hesitate to sleep train, thinking there may still be a possibility of him dropping one of these NWs. Right now, I am feeding at both (which is SO bad) because it's the only way I can get him to settle back to sleep. I'm pretty sure we have a MOTN prop issue, but he is sleeping independently for his naps. Here is our current EASY:

E 6:30 BF (both sides)
A solids at 8:30/9 (yogurt and 3oz apricots)
S 10-11/11:15 (we were at 4hr10min A time, but have scaled back b/c he has been SO fussy in the mornings around the 3hr mark. I don't think this is the cause of the NWs because the NWs happened before I started pulling back on A times, but I'm not ruling it out)
E 11 BF (both sides)
A solids at 1/1:30
S 3/3:30-4/4:30 (he seems to handle 4hrs of A time in the afternoons very well, so sometimes I will push it past 4 hrs)
E 4:00 BF (both sides)
A solids at 6:00 (4oz veggies and 3tbsp rice cereal)
6:45 w/d bath, pajamas, nurse
S 7:15
NWs around 2:00am and 5am

He has 4 teeth (top canines and bottom middle teeth) and I'm pretty sure the top middles are on their way as well. I have given motrin, thinking the NWs are discomfort, but the motrin seems to have no effect on them. He is crawling and sitting up, but not pulling himself up yet. The NWs started about 3 weeks ago.

I'm worried about the breast being a prop during the night. I have found that he will eat very well if I let him stay on the breast for a full feeding, but if I pull him off after only a minute or two and pat him on the back while on my shoulder, he will settle right back to sleep. This makes me think he's not really hungry, just looking for comfort. I don't think I will be able to sleep train without my DH b/c as soon as I go into the room, he expects to be fed. Shh/pat no longer works, picking up seems to make things worse, so we are thinking of trying PU/PD, but are hesitating whether to start if DS is going to drop the feedings on his own. I think if we do PU/PD, we are going to wean him from both feedings so we don't confuse him by feeding at one NW but not feeding at the other.

Any advice you can offer would be wonderful! I know the breast being a prop is completely my fault and I've let it go on for too long, but with teething and illness and everything else, it's so easy to fall into!

[m.ned]

Any ideas?

[katie80]

Hi there, sorry for the delayed reply... I haven't gotten on in the last few days and wanted to be able to read back through the thread to refresh my memory. Don't feel bad about nursing in the middle of the night... it's really hard to know what's best sometimes. 

He has 4 teeth (top canines and bottom middle teeth) and I'm pretty sure the top middles are on their way as well. I have given motrin, thinking the NWs are discomfort, but the motrin seems to have no effect on them. He is crawling and sitting up, but not pulling himself up yet. The NWs started about 3 weeks ago.

My first thought reading through was teeth.  When are you giving the Motrin, before bed or at one of the NWs?  If it's at BT, it may well have worn off by 2am, and that's why he's waking later in the night/early in the morning.  It doesn't seem to be routine related, although it would be nice if you could get one of the naps to be a full one.  What if you do the morning nap at 3h45min?  It looks like 3.5hr might not be quite enough, but maybe 4h10min was a little too much?  He could also be more fussy in the morning if his teeth are bothering him.

As for doing PUPD to wean him, that's completely your choice.  You can do it for both wakings or just one if you'd like.  I had a nursing prop at this age in the MOTN, because my DS teethed heavily from 7-10mo (got 6 teeth). I was the one doing the settling, my DH is a bit of a softie, so I only felt I had the stamina to drop one feeding at a time (and I also knew that last early morning feed would be hard to settle).  So, I settled all the others and kept the early morning one until I was ready to get rid of that one too.  At this age, PUPD is usually just PD, but since he's not pulling up to standing yet, you may still PU.  However, you don't really hold them at all, so it usually works best to just try to settle in the crib.  If you feel like he desperately needs the reassurance, you can pick up and say your sleep phrase and then put down again.  Expect some major resistance the first few times, but it should get better relatively quickly.

[m.ned]

Thank you so much for your response! Sorry it's taken me so long to respond, my LO has had roseola all week. I think you are absolutely right and teething is causing the NWs. We definitely have a prop issue with the breast, and the high fever over the past couple days has only made the NWs worse and the prop issue worse! But, him getting healthy is priority number one, and I'm sure all of the extra nursing will help keep him from getting dehydrated.

When I give motrin for teething, I usually give it right before bed and you're right, he's probably waking up when the medicine wears off. DH and I were going to try giving a second dose at the first NW and start sleep training this week (now that he his caught up on sleep and work), but our plans were derailed by the illness. On top of that, DS's top two middle teeth have broken the gums, so he's extra grumpy this week! We will start as soon as he's better, although I'm sure we're going to have our work cut out for us after all of the nursing this week.

He's just starting to pull himself up, so our PU/PD plans may end up being just PD. We have never really stuck with any sleep training in the past, so i know we are really going to have our work cut out for us! We will only resort to PU/PD if DH is unable to get him to settle in the crib. We will see how this goes! Hopefully I will be able to help without DS going ballistic (I'm the softie).

I guess my only question would be, with all of the teething, how do you know if it's the wrong time for sleep training? If he's really in alot of pain, I feel bad denying him the comfort of nursing. At the same time, I know we really have a prop issue, teething pain or not. Do I just let the medicine help on the really bad nights and go forward with the sleep training once he is over the roseola? I feel like the longer I wait, the harder it's going to be, so I'm starting to get really nervous.

[m.ned]

Hey! Just wanted to let you know we are back down to 1 feeding per night. We did a couple nights of PD and somehow, that seemed to do the trick! He was not happy, but I think he's starting to understand that he does know how to get himself back to sleep during the night. In a couple of weeks we will start trying to wean him from the last feeding now that we know what works. Thank you so much for all of your help!