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.

[Skadiver13]

Ahh gotcha on the meds. You'll figure it out. promise.

[TB9]

I just wanted to post because my dd2 was the exact same size as your LO at that age!

Because of her size she started sleeping through the night very early, but then around the 4month growth spurt she stopped sleeping through because she just couldnt get enough during the day for her size.  Even though she was ready, and I introduced solids at 4.5mo she still couldnt get enough during the day, and i literally *just* got her down to 4 bottles a day recently.  She never really got to a true 4hr EASY, even now her afternoon bottle and bedtime bottle are only 3.5hrs apart, andthat  is with solid dinner in between!

What I ended up doing was following whatever A times she needed to get a good nap, but add a top up bottle 30min before naptime so that she could make it through a decent nap and not wake hungry.  Is that an option for him, or do you think it woukd cause problems because of his reflux?

Do you think he is ready to go to a 4hr EASY?  Has he gone through the 4month growth spurt yet?  Just thinking you may want to consider holding off on trying to increase time between feeds until he is through that spurt 

[Skadiver13]

What I ended up doing was following whatever A times she needed to get a good nap, but add a top up bottle 30min before naptime so that she could make it through a decent nap and not wake hungry.  Is that an option for him, or do you think it woukd cause problems because of his reflux?

^ This is what I was suggesting just stated much better

[PuppyLuf]

What I ended up doing was following whatever A times she needed to get a good nap, but add a top up bottle 30min before naptime so that she could make it through a decent nap and not wake hungry.  Is that an option for him, or do you think it woukd cause problems because of his reflux?

^ This is what I was suggesting just stated much better

He just doesn't take a bottle earlier than three hours apart.  I managed to keep him up two hours this last round and it was very hard.  Hopefully will get easier as he goes (and I'll have the daycare lady take care of the schedule change the rest of the week so he can be crabby with her!! :0) By the time the weekend rolls around again, he'll be fine for me, right?!  He got 9 oz. in him, but refluxed a bit more than he had been, mostly because, I think, I had to have him doing activity after eating to keep him awake or he'd fall asleep.  All the movement caused the problem.

I'm not sure if he's gone through his growth spurt for 4 months yet.  I can only imagine how much he'll weigh if he still has to go through it. 

Is the main reason for switching to a 4 hour if he cannot eat every four hours so that he can get long naps in?  What is the shortest time a "long nap" could be and still be useful?

[Skadiver13]

Honestly 9oz is a lot for this age to take at one sitting I think? I know even know my lo can't do more than like 7oz and he's 2.  Like Tinkerbell was saying she fed 3.5hrs apart even th ough the EASY was 4. So that would still fit.  I think you need to seperate the issues here. One is you need to start thinking about transitioning to a 4hr easy but it can be done over time. He's only 4months right now so you have some time. Start by stretching out your frist A time and then work from there.  A rule of thumb I go by and this is not set in stone is anything less than 45min is usually an OT nap meaning the A time was ether too long or they were over stimulated.  45-1.5hrs is not a full nap so usually indicateds they were UT. Anything over 1.5hrs at this age is a good nap. You certainly don't have to wake them at 1.5hrs but that's 2 good sleep cycles.

Your second issue is the feeding. Work around the naps and if you need to feed in a quiet dark room right before the nap or right after then do that. Don't worry about where your E will fit into the EASY. You can also cluster feed at night before BT to help with the calories.

[TB9]

I always considered anything over 1hr to be a good nap.  DD2 wouldnt always take a second feed during her A, I sometimes just had to wait for her to be able to stay up longer.  I wouldnt push him too much to stay up longer if he isnt able to do it.  And I wouldnt push to go longer between feeds if he isnt ready.  BW is about following cues and structuring a routine around that, because not all babies are the same

[PuppyLuf]

Well, today was a disaster...   He's totally OT, screaming and crying, hungry, spitting up, and on this schedule would actually be getting almost 45 more minutes of sleep per day than he was before.  Ugh.

I cannot figure out how to keep 6 bottles in there less than three hours apart.  He spits up anything more than 8 every three, he can't do any activity because he's spitting, so it's basically 2 hours of sitting still, which is torture for him and me.

I ended up putting him down for an extra half hour nap because he and I were both miserable and he's been screaming for the past hour and a half.  I think I'M OT.

I'm completely frustrated and have been trying different schedules in my head for so long I can't think straight.  I just cannot think of some way for this to work, bottle-wise and with the half hour extra of awake time twice a day before a meal to give his Prevacid.  Honestly, I'm ready to cry with him.

[Skadiver13]

Hi hun what was your easy today?  try not to think of it as a schedule it's just a routine that you try and folow vut his cues should be what you go bym Dont try amd forxw more milk into him thatbhe can do at one sittingm Just add more smaller bottles if thats what you need to do.

[PuppyLuf]

Skadiver, This was our EASY:

6:30am      Wake and eat (9 oz.)
(Stay awake 1hr45)
8:15-10:00    Nap
10:00       Wake and give Prevacid
(Stay awake 2 hrs.)
10:30am       Eat (9 oz.)
12:00-2:00      Nap
(Stay awake 1hr.45)
2:30pm       Eat (9 oz.)
3:45-4:45      Nap in theory (except he was so OT he couldn't sleep and screamed until 7pm)
(Stay awake 2 hrs.)
5:45         Give Prevacid
6:00         Bath
6:30         Eat (9 oz.)
6:45         Bed

I guess I'm having trouble seeing the advantage of switching to a 4 hour EASY over just lengthening A-times on 3 hour EASY.  He'd still get two long naps and two catnaps, he'd get as many bottles as he needed, and he'd be getting less daytime sleep (and therefore more nighttime sleep, as is his pattern).  my purpose for trying 4 hour was to have fewer feeds, but it seems like I'll have to do more?

I just wanted to post because my dd2 was the exact same size as your LO at that age!

Do you think he is ready to go to a 4hr EASY?  Has he gone through the 4month growth spurt yet?  Just thinking you may want to consider holding off on trying to increase time between feeds until he is through that spurt 

I think maybe he's just not ready.  He's still the same size he was last month, so no growth spurt I can see.  He had just finished relfuxing after every meal finally and I was able to lower his morning Prevacid, but today he and I were covered in curdled milk again and he was draining his bottled dry and screamed when they were empty.  I wanted to cry with him...   

[Skadiver13]

Hi hun the purpose of lengthening A times is to start stretching his awake time so it doesn't impact his night sleep as it will start to eventually.  But as some have said if it's not broke don't fix it.  I think it will eventually start impacting your night sleep but if it's not currently and you are happy with how things are going than don't change it. If he's refluxing with the current dosage maybe it needs to be modified as well as not over feeding him.  I fed my reflux lo smaller bottles throughout the day while stretching his A time.  hence my suggestion to seperate the two issues.  Reflux babys have their own issues and so with mine he liked higher A times so I often had to stretch his awake periods and offer smaller 5-6oz bottle 4-5 times a day.

[PuppyLuf]

Thank you!  I will keep observing him and see what he does in the next few weeks.  He has times when he stays awake 1:45, and other times he barely makes it an hour.  EMW seem to be related to dirty diaper more than anything else, right now, unfortunately.  Wish I could make that go away.  It's been going on for 3 weeks now, and I can hear through the bedroom wall as he (loudly) poops.  Sigh.  Thank for all the help.