5 months old NWs

[LPsMommy]

Background info:  I also have a similar situation with my almost 5-month old son (never a great sleeper at night, naps are also usually 45 minutes with limited success extending them, he is starting to work on rolling over, and we are having very hot weather).  He has a similar waking pattern at night often waking every 1-2 hours.  I am also stuck on a 3 to 3.5 hour EASY. 

Feeding:  How do I get more food in him during the day? I'm afraid feeding him more frequently during the day is possibly causing him to just snack, which is seems to continue all night.  He is exclusively breastfed, so I can't be sure exactly how much he is getting except by length of feed.  We haven't started food yet as I am waiting until he can sit up on his own before we start.  We are considering offering him formula after breastfeeding to make sure he is getting enough to eat.

Should I use the gradual withdrawal method for feeding during the night wakings?  Also, how would wake to sleep work with such frequent wakings at night?  It seems I'd have to wake him as soon as he got to sleep.

Thanks for any help you can give us.  I know oxfordmum and I really need to get a little more sleep.

[goldmom]

It's possible he's waking often at night due to a routine issue and not hunger. What does your typical EASY look like?

[LPsMommy]

These days our EASY has gotten way off track because the wakings started with a growth spurt. 

Feeding:  About a week ago, he started wanting to feed every 1-2 hours day and night.  I tried to prevent it from turning into a bad habit, so I started giving him some extra feeds during the day to up his intake during the day and hopefully decrease his intake during the night.  Usually I offered the extra feeds at two-hour intervals (using a 4-hr EASY schedule I added the extra feeds at approximately 2 hr intervals) and only offered one breast instead of the usual two for a full feed.  I think this has also become a problem now because I suspect he is snacking.

Naps: Depending on how long he naps, I have to adjust his awake time, but I usually aim for 2 hour A time if he sleeps for 1.5 hours.  Usually he only naps 45 minutes, so then I reduce A time by 15 minutes or so when I see he's getting tired.  I think he needs longer A time, but I don't know how to get out of the 45 minute nap cycle and extend his A time without making him OT.  I had some limited success with extending his naps before we hit the growth spurt, but now I cannot extend them at all.

Our EASY looks generally like this:
6:30 Wake
7am Eat
8:30 Nap (usually only 45 mins)
10:30 eat
11:15 am Nap
1:45 pm eat
2pm Nap
4:45 eat
bed by 6 or 7 pm depending on if he had a 30 minute cap nap 

Shush-pat:  These last few days he really started resisting the shush-pat (and it seems to be making him mad).  Previously it worked, but now I don't know what to do.  I also use PU/PD when he is really upset, but this also makes his angry these days.  My husband has resorted to rocking him tonight, which makes me feel defeated because I worked hard to break him of any sleep props using the shush-pat.

Everything seems to have deteriorated these last few days. 

Today:  He went down for his first nap by himself (mantra cry for 15 minutes) and slept for 45 minutes.  A time was 2:15.  His second nap consisted of him crying for 30 minutes.  I then needed to take him to my MIL's, so he fell asleep in his stroller for two hours.  His A time had been 3 hours at that point.   

NW: His night wakings begin usually 1-2 hours after bedtime and increase in frequency as the night goes on.  The typical intervals are now 2 hours or less.   

It seems I need help with everything at this point.   Thank you for reading all of this and giving me some feedback.  I really appreciate your help.   

[LPsMommy]

Action plan:  We made the following changes to help solve the night issues (and hopefully ultimately naps as well).

1. 4-hour EASY (since naps are not going well this mostly applies to eating, but I think it's necessary to reset his clock)

2. Not tanking up in the late afternoon, but giving a dreamfeed between 10-11

3.  I will sleep in another room for the next few nights.  We currently all sleep in the same room, and I wake as soon as LO stirs.  My husband sleeps more soundly, so hopefully this will give LO a little more time to settle himself before I'm rushing to pick him up.

4. Modify the shush-pat.  Instead of shushing, we are using whistling and light placement of a hand on chest together with some PU/PD when necessary.

5.  Increasing awake time during the day.  When we're able to get a better grip on naps, we will increase his awake to (I suspect to somewhere around 2.5h).

Let me know if you have any other suggestions.  I think we need to fix the night before the naps will be solved because we're really battling with LO being OT since he's not sleeping very well at night.  He resisted naps all day today and only slept 1.75h in total.     

[katie80]

Hi hon, it sounds to me like you've got a good action plan. Here are my thoughts...

1. 4-hour EASY (since naps are not going well this mostly applies to eating, but I think it's necessary to reset his clock)

Some EBF babies are not able to make a full 4hr EASY until they begin solids. But, you don't want to be feeding every 2hr either, because that does tend to cause snacking. What has worked well for some moms on here in this case is to do the main feed, then do a top up feed 1hr later (where you will eventually put solids into the routine) and then finish A time, nap, and do another main feed about 4hr later. I'd try this first before pushing straight to a 4hr EASY, because you don't want to worry about him waking up from naps hungry.

2. Not tanking up in the late afternoon, but giving a dreamfeed between 10-11

You'll have to see how he does with this. Some LOs this age do well with a DF, some don't. Some still like a natural cluster feed (feeding after the CN and then again before bed) and do well with it. I don't know that either one is necessarily right, so do what works best for him.

3.  I will sleep in another room for the next few nights.  We currently all sleep in the same room, and I wake as soon as LO stirs.  My husband sleeps more soundly, so hopefully this will give LO a little more time to settle himself before I'm rushing to pick him up.   

Really good. He needs a chance to settle himself in the MOTN!

4. Modify the shush-pat.  Instead of shushing, we are using whistling and light placement of a hand on chest together with some PU/PD when necessary.     

Modifying is a great plan. Some LOs are just bothered by either the shh, the pat, or both. I would be a bit careful about whistling though. I'm not sure what kind of whistling you mean, but I think it could stimulate him more than help him calm. You might just want to say your sleepy phrase in a soothing voice and keep your hand on him. But again, do what works for him!

5.  Increasing awake time during the day.  When we're able to get a better grip on naps, we will increase his awake to (I suspect to somewhere around 2.5h).

Yes, I agree his A time needs to increase.  I think you're getting some UT naps and possibly getting stuck in an UT/OT cycle. I wouldn't wait until things start coming together though, I'd start right now. If you leave his A time too low, you'll never get out of the cycle. So, push it gently and gradually (maybe 5-10/15 min every few days) until he starts taking some better naps for you. Day sleep affects night sleep and vice versa!

Hope that helps! Let us know how it goes.

[LPsMommy]

Katie, thanks very much for your input.  The biggest problem we are having at the moment is getting him to go back to sleep after he wakes at night.  We are really struggling. 

He usually wakes after 2 hours, and we spend another 1.5 hours trying to put him back down (shushing him in his crib, quietly changing his diaper if needed).  This usually gets into his dreamfeed time, so I end up nursing him even though he is awake.  He goes back to sleep after nursing.  He usually wakes again after two hours or less.  Now that my husband is sleeping with him (from 11-3am), he takes LO to bed with him when LO wakes (which I don't agree with, but I really need to get a couple hours of sleep for a few days).  LO still wakes a couple times with my husband, who comforts him a little bit, and LO quickly falls back asleep for an hour or so each time.

By 4 am, he brings LO to me to feed and I take over for the rest of the night.  I usually feed for 20 minutes and LO goes back to sleep (in his crib) for an hour.  He wakes at 5:30 am, and today I had no success putting him back down until 7 (or even just until 6 am).  I shush him in his crib.

This cycle then affects the day time sleep because he is so tired.  Should I keep the longer activity time (2.25 or 2.5 h) or shorten it according to his cues?  He wakes up tired, so he is basically tired all of the time (rubbing his eyes from the moment he wakes up and making his tired cry), but he's fighting the naps (and sleep in general) in a big way.  I don't know how to get out of this cycle because he is sleeping so poorly at night.   

We even tried supplementing with formula after one of my BF, but he didn't drink much (which was a relief to know he was satisfied after BF, i.e., I'm not losing my milk or something).  We also tried giving him formula for his dreamfeed, but he didn't want to take it then either.  We are trying to rule out hunger as the issue, which it really seems not to be.

Thanks for all of your help and support. 

[katie80]

(((Hugs))), those are some long NWs!  Do you think he's in any discomfort at all?  Does he have any reflux symptoms? Reflux 101 - General reflux information

I think if you want the nights to get better, you need to be consistent in how you settle him.  I would not take him out for a diaper change (unless he has pooped) at this age, because it's going to wake him up more rather than help.  Keep the lights off, use white noise, and stay with him settling him until he's asleep.  I wouldn't stop to DF, either.  If he's hungry he'll wake again in an hr or so, and you can feed him then.  But, trying to settle him for 1.5-2hr and then feeding will only confuse him and tell him that eventually he will be fed back to sleep.  On the other hand, if you're going to feed and you want to catch him up on some sleep, then I'd feed him right away when he wakes and see if that makes a difference in the rest of the night. 

Same thing goes with your DH bringing him into bed.  If you want him to learn to resettle, he needs to resettle in his crib.  If you want to AP him for a few nights to get him as much sleep as possible, then AP the whole night, so it's helping enough to make a difference, yk?

Should I keep the longer activity time (2.25 or 2.5 h) or shorten it according to his cues?  He wakes up tired, so he is basically tired all of the time (rubbing his eyes from the moment he wakes up and making his tired cry), but he's fighting the naps (and sleep in general) in a big way.  I don't know how to get out of this cycle because he is sleeping so poorly at night.   

It's a really tough cycle to be in.  I would still push the A time out to 2.25 to begin with.  Are you able to resettle naps at all?  Is there a way to AP naps for a couple days and see if that helps the nights and you can start working on resettling once he's more rested?