Should I switch to 4 hr.? So much pressure...

[PuppyLuf]

My 17 week old LO sleeps the most of any baby in his daycare group.  The daycare provider and my mom are pressuring me a little to change him to a 4 hr. EASY (we are on 3 hr.).  He has recently begun waking in early morning (around 4), but goes back to sleep.  I think he may need less daytime sleep but due to his large feed amounts (8 oz. x 6), I'm not sure he can drop a bottle, and he drains them all.  He has reflux, and too much more than 8 oz. at a feed would make him reflux. He will not take a bottle sooner than 3 hrs. apart and is not eating large amounts just to soothe reflux (it is under good control).

He began STN at 12 weeks for 12 hours, but this meant he dropped two bottles and couldn't make them up during the day as that was a lot of extra and he cried because he was still hungry.  Had to add an early dreamfeed in again at 21:30 just to keep up his intake (he is 17 lbs., not overweight).

Schedule as follows
E 6:30
S 7:45-9:00
A 9:00 Takes prevacid
E 9:30
S 10:15/10:30-12:30
E 12:30
S 1:45/2:00-3:30
E 3:30
CN 5:00-5:40
A 6:00 (Prevacid, bath)
E 6:30
S 7:00 Bed
E 9:30 Early dreamfeed

So lots of daytime sleep.  I could certainly shorten naps 15 minutes here or there.

Is it possible to lengthen A time and still get enough uninterrupted sleep?  Do most babies this age really require so much less sleep than my son does?  I figured if he was sleeping nicely during naps and mostly well at night, my schedule was ok, but I am getting quite a lot of surprised looks about the 4 daily naps and the fact that he mostly still stays awake for only an hour 15 minutes at a time. 

If he slept better in the early morning, would he stay awake naturally longer during the day, or is it something we will have to work on?

And lastly, I am home from work in summer, as I am a teacher.  Would it be too long to wait until summer so I can do his transition instead of the daycare?  He will be 6.5 months by then.

Thanks.

[MasynSpencerElliotte]

 I would for sure transition now as opposed to waiting...if you do that you will have one UT baby and be playing catch up as by 6 months or so most babies are down to 2 naps and doing twice as much A time as your lo is doing or more. If you are just getting the early wakngs now t seems like he is probably high sleeps needs though and tbh I have no experience there...DD3 is super low sleep needs.

[PuppyLuf]

Thanks for the reply.  What would you suggest I do re: not being able to drop bottles?  Should I continue every 3 hour bottles and just do less sleep time until he is weaned?  Should I start weaning now or adding solids?  He really can't drop a feed or take in more at a time and I'd rather not go back to two nightly feeds.

He does get cereal in his morning bottle (for the same reason... he can't get the amount of calories he needs in just milk without throwing up).  I know it's not ideal, but I can't find another way around it.  I could possibly add cereal to other bottles and then drop one bottle, but I'm not sure that's best nutrition-wise, yet.  Thoughts?

Thank you.

[MasynSpencerElliotte]

Will have to think on that, just running out the door to an appt - but I know cereal in bottles is not recommended as it is a chokng hazard because it may form lumps. There are thickeners available that are meant to do that, not sure what is available there but I have seen one here called Simply Thick.

[weaver]

I'm afraid I don't know anything about bottle-feeding or reflux, which seem to be the factors you are concerned about.  I would say that you should not do something because of 'pressure'.  You know your baby best, inform yourself and then make your decision.

Babies generally transition to 4 hr EASY around 4 mos.  Sounds like your boy is high sleep needs (lucky you) so he may transition later.  But 6 mos will be likely be too late, as Heidi says above, you risk creating problems for yourself by keeping him on a 3 hr routine til then, probably in the form of nap refusal, early and night wakings.  The key thing is to listen to your baby.  What is he telling you he needs?

This might help:
Time to Transition - 3hr, 3.5hr or 4hr EASY

[Skadiver13]

I agree on the transition but that isn't to say you can't feed differently. I.e. you don't need to do an EASY. It could be EAES if that makes sense. Do what you need to do. My LO was reflux and even though it was under control he still wouldn't eat more than 5-6oz at a time with out trouble so we stuck with EAES or something like that.

[PuppyLuf]

Re: the rice cereal, I wouldn't be using it to thicken... just to add calories since milk isn't enough, let alone dropping another bottle.

Trying to figure out how I'd do EAES on a four hour schedule.  I think I'd have to keep LO awake for three or more hours, which is going to take a while to get there when he is barely pulling an hour and a half.  I've been working on his A-time and we can sometimes get to an hour forty minutes, which takes me walking him around in his carrier around the house and him looking dazed and a little like a zombie, but at least not crying.

I was looking at the signs of being ready to wean, and he has quite a few of them.  Holds head up well, eats quite a bit more than 40 oz. of milk a day, more than doubled birth weight, and there were others, but I closed the page!  I don't necessarily want to wean so early, but I'm at a loss as to how to keep him full on just milk when he takes 48 oz. of milk a day already, and we'd somewhere eventually need to drop a bottle.

Maybe we'll try to transition to 3.5 hour first.  I just have to figure out how to handle the bedtime top-off since he refuses bottles before at least 3 hours has passed since last bottle.  I feel a little stuck...

[MasynSpencerElliotte]

I see what you mean regarding the cereal but it is still a choking risk and rice cereal wouldn't really add much in the way of calories...would a thickener help him keep down a bigger feed? Or would split feeds work? I did EAES with DD3 for a while due to her A times.

The other factors for solids readiness are loss of the tongue thrust reflex and the ability to pick up food and bring it to their mouth as well as being able to sit independently - all 3 of those are rarely met before 6 months and introducing solids could impact his formula intake and lead to nw's to get more calories.

[Skadiver13]

I agree with Heidi. I will say my cousin introduced solids at 4 months because her lo was hungry ALL the time. He was massive. Off the charts in weight and she just couldnt feed him as much as he needed. What does your doctor say? I don't think adding cereal to the bottle will help with calories and in fact may reduce the amount he drinks because he'll feel more full.  I think you need to sepereate the issues. Moving him to a 4hr EASY I think is important. You can always feed him more often until he ups his A and gets on a good schedule and then move back to 4 bottles. That is what I did. So I fed him when he woke, before his nap, after his nap etc. I did what I needed to get the calories in him but I still stretched his A time regardless of when he fed.

[Emami]

Mine was quite HSN with some lower A times too but we were on a 4hr easy at 4 months.  She used to cluster feed in the evenings and that was enough to get her calories in through the day and she would STTN (no DF).  So her routine looked like this:

E 7am
A 1.5 hrs
S 8:30-10:30
E 11am
A 2hrs
S 12:30-2:30
E 3pm
A 1.5 hrs
S 4-4:45
E 5:30
E 6:30
S 6:45

Don't know if that would work for you but just thought I'd share.  I can't remember how we fell into this routine because there's no way she would've eaten that much so close together earlier in the day, but for whatever reason  she went for it in the evening.  Then after a couple of months we introduced solids and she dropped the 5:30 bottle and it went from there

[PuppyLuf]

His A time today was around 1:40 each time but he is currently having a very hard time falling asleep for bedtime.  He seemed very overtired by end of day, very crabby and crying hard.  Will this get better over time as he adapts, or am I asking too much of him?

Thanks, Emami, for the schedule.  It is very helpful and seems doable.

[Skadiver13]

HI hun, once he gets used to longer A times yes he will be better. But shorter naps can lead to OT at bt and they can get grizzly for sure.

[PuppyLuf]

All right... here's my proposed new schedule for LO. I'm trying it today to see how it works, but I'm kind of dreading the end of the day.   He's going to be Grizzly McGrizzelson for a while... 

E 6:30am
A 1.5 hrs
S 8:00-10:00
Prevacid 10:00       
E 10:30am                                                                                   
A 2hrs
S 12:00-2:00
E 2:30pm                                                                                     
A 1.75 hrs
S 3:45-4:45
A 2 hrs                                                                                 
Prevacid 5:45
Bath 6:00
E 6:30
Bed 6:45/7:00

Total DTS is 5hr.  This is actually half an hour more than he is currently getting, so we will see about lengthening the A-times.  Currently, morning nap is running longer than usual, and I hear a lot of rustling through the monitor as it is normally eating time.  Maybe I can get an extra oz. in him each time...

On a side note... he seems to be waking up at 4:30am from dirty nappy.  Anything I can do about that, schedul-wise (other than change it...ha)?  I'm guessing it's from his dream feed, but it wakes him up early and by default, I'm up then, too.  Thanks.

[Skadiver13]

Does he go back to sleep after the diaper change? Is there a reason you give the reflux meds at 10? Just curious. Are you going to stretch each A time or just one at a time?  Some Lo's do better with the longer A in the AM and shorter A's in the PM. That's the way mine was. After a good nigth sleep he has alwasy done much longer A's in the AM. Right now he does 7hrs in the AM and 4.5 in the PM.

[PuppyLuf]

He does go back to sleep after diaper change.  I give reflux meds at 10 because he needs them a half hour before food, and waking him half an hour earlier in the morning is not possible due to the tight schedule I'm on for work.  I'm trying to work my afternoon schedule around the time at which I pick him up from the babysitter's.  He is picked up at 4:45 usually, so I don't want to pick him up right in the middle of a nap, or be driving him when he's extremely crabby and ready for a nap because then he falls asleep early in his carseat and sleeps far more than necessary.  I'm not sure if this will work, but I can't think of too many other ways around it.