4 month problems

[Raroo]

I am having some issues with my 4 month old DS. A few different topics but probably falls under EASY, if not please feel free to redirect me.
DS has silent reflux which he is being treated with 5ml Zantac twice a day for. Our easy goes like this. It's currently a 3.5 hr EASY slowly transitioning to 4.
Wake up 8am
E one sided bf exclusively
A 8.15-10 lo won't actually independently play in this time. Hates the chair, hates the mat. Just likes to be carried around or sit on my lap. Will only go down for a few minutes here and there
S 10- 11 30 needs to be resettled every 40 mins or so using sh/pat. When dd is around hard to do so soften will wake up after an hr or so, be it, easy ruined= Bad day
E 11 30
A 11 45- 1 15
S 1 15- 3
E 3
A 3-5
S cat nap for half an hour at 5 if I'm lucky
E 6
A bath at 7
E 7 30
S 7 45
E df at 11

Then we have nw's at 3 and then 5 and then hard to settle sometimes till 6. I will feed from 6.

Here our problems. The night wakings are not stopping even though I am not feeding during that time. It's hard to resettle lo every time he wakes up,day and night. Sh/pat can go on for half an hour sometimes and I have been doing it since birth. I don't think lo is hungry at nw's because sometimes he will just go straight back to sleep and when he was younger he slept through to 5 on his own. The dummy has unfortunately become a prop. Lo uses it all day otherwise screams and sleeps with it and needs it to fall asleep. He sleeps on his stomach only due to reflux (dr's advice) and ends up pushing he dummy out on mattress when he turns his head to other side. Day time naps are usually very all over the place. Above I posted a very ideal day schedule but really it's usually a messed up day.
Please suggest changes or advice which can help improve things here. Lo is a very miserable baby, I don't know if it's teething ( he cut two already a couple weeks ago) or maybe the reflux is not working anymore although dr just raised the dose. This has been like this for a little over a month.
Thank you so much for reading

[jessmum46]

Hugs, it does sound (from what you've written) like LO might still be uncomfortable . Teething can lead to reflux flares and it's possible your LO may need either a dose adjustment or a change of meds.  Can you get in for a review with your doctor?  Do you have a thread over on the reflux board?

At night if you just fed at the 3am waking would LO settle until morning, or would the 5/6am wakings still happen?  I only ask because although LO slept through when younger, STTN is not a one-way process and what many people don't realise is that it is normal for a LO who has previously STTN to start waking more at around four months in conjunction with a big growth spurt.  DD did exactly this - slept through from early on, then from about 4 months started waking for a NF again until she was firmly established on solids around 7 months.  Growth spurts can also coincide with reflux flares

Could you post a day or two of what actually happens rather than the ideal?  It may help us to make some suggestions.  Ultimately though until LO is definitely comfortable any tweaking will be quite difficult and so that does need to be addressed first.

Have you ever seen this? Sleep and the reflux baby.

[Raroo]

Last night was bad. Lo had dream feed at 11 then woke up at 3 and settled after few minutes. Then again at 4 30 and just would not go back to sleep. He wasn't crying, just wanted to wake up. Eventually I fed him at 5 15. Then fed him at 9 15 which was the start of our day. He was very cranky and went back to sleep at 11 on his own until 11 30, then woke up playing and had to be sh/patted back to sleep from 11 50 to 12 45. Then ate and was up Till 2 50 and had about a 15 minute nap because we were out in the stroller then woke up and only resettled at 4 till 4 15 when I gave the next feed. Then stayed up till 6 and then slept half an hour. Had half a feed at 7, had bath, finished feed and was asleep by 8. He then slept till 11.30 and I gave a feed. It's now nearly 1 and he's sleeping. I'm expecting a 3am wake up . I guess I can try feed then and see how rest of the night goes. Just don't want him to expect a feed every nw. I had bf sleep association with my dd and really don't want a repeat!
Maybe I will see if dr will change meds because I really can't up his dose anymore, it's much higher than recommended dosage for his age.
Thanks so much for the care and advice! Do you think I should try w2s for the 3am waking?

[jessmum46]

I think a chat with your doctor would be worthwhile

Does he always wake at 3am?  You could try w2s if so, around 2am.  I've never used it personally but know it does work well for some.

I do understand the anxiety about feeds at night, especially if you've had issues before.  At four months though I'd have thought it reasonable to feed as long as it's 4h or more since the last feed (ie at least as long as LO can manage in the daytime).  What can help avoid a prop is to decide before you go to LO whether it's a 'feed' or 'not feed' waking.  If it's been more than 4h then just feed right away and resettle.  If less than 4h, then resettle all the way to sleep without a feed, even if it takes you past the 4h point.  That avoids LO learning that protesting for long enough = feed.  Does that make sense?

[Raroo]

Ok going to talk to dr. Maybe can switch meds. Thanks!
I fed at 4 45 this morning and lo then woke up at 7 and then wouldn't resettle for a bit again. Maybe that would be an indicator he is not hungry but rather in pain, right?

[jessmum46]

Could well be - I generally found longer NWs were related to discomfort, though that's more of an EW so could be OT-related

[Raroo]

Dr said to keep on taking the Zantac as is. He says there is no way to know the nw's are related to pain. He said if it continues for a while he will refer me on to a specialist. In the meantime things are terrible. Every night lo is up anytime between 2 45 and 4 and is so so hard to settle. I do sh/pat and he moans and squirms for a while and then stops so I stop and then he carries on. So we start again. It can take about 2 hours. I.am.exhausted. He naps for between 30-40 minutes then needs resettling and then again naps for short. I tried pu/pd because I think he is way too dependant on the patting but he screamed and screamed anytime I put him down. He is also so dependant on the dummy, I was hoping he would replace it with his thumb but he never did. He still wants to be held most of his A time. Any ideas?

[jessmum46]

More hugs . I would avoid PUPD if you can as it can often aggravate reflux.  Stick with cuddling or shh pat instead if that seems to help.  I'd also keep the dummy for now.  I know it can be hard work replugging but it can often really help with the reflux.  Did you want to post a recent EASY?  I wonder if sleep hasn't been good recently whether you might need to shorten up some of those A times a touch?

[dache]

Hugs. Reflux is hard to deal with.
I agree with Katherine about PUPD. Its not a good idea for a reflux baby.
Sounds like we are going trough same the things although my lo is 6m.
She has never slept trough the night. I df at 10.30 and then I feed her whenever she wakes up (between 1-3). She was waking at 5.30 to feed  (i used to feed her but using the diluted formula thing she stoped needing it) now she wakes most of the time at 6 and 7. Today lucky me it was 7.
Some babies cant go trough the night without a feed so I`d check for that. Offer a feed and its just a snack its not hunger. My lo takes 6oz at that feed so I know she is hungry.
Also I wouldnt worry about the paci. Its the same here. When she wakes up early from a nap I replug and most of the time she goes back to sleep. I am aware I use it as a prop but I`d go crazy with out it, so I dont care.
What I learned going trough this process, and what I`ve been told by the ladies here is that when it comes to reflux you just do what ever works for the lo. Letter on, when lo is better you fix things.

[Raroo]

Thanks for replies!! Things are only worse!!! Our schedule is feeding every 4 hours which baby manages great in the day. I try a nap after 2 hours in the morning. It's always only half an hr so I try resettle. Another nap in afternoon. Again I try for 2 hour nap. Then cat nap for twenty/30 min at 6ish and bed at 8. Lo sleeps till df at 10 30 if I'm lucky. Then up throughout the night. Last night was 1.30 and I managed to resettle. Then 3 30 and wouldn't resettle. I tried sh/pat for an hour and then dh just put him in bouncer and stayed up till he went back down at 5 15 and then he woke at 6 15. I fed him. Then he slept till 8. The long wu is the killer. He isn't screaming, he is jut not settled. Keeps lifting up his head and moaning, fighting sleep. I have absolutely no idea what it's from but I'm beyond exhausted. Each day is just getting worse and worse. He is such a miserable lo in the day, needing to be held all the time. I don't know where to start.

[jessmum46]

Would you mind writing out a recent day (what actually happened ie what times LO woke, when you tried for naps and what time he actually slept) in EAS format? Just make it easier to tell what's going on

Is he 5 months now?

[Raroo]

Wu 8 30
E 8 30 (finished feed I had started at 6 30)
A 8 45-10 25
S 10-30- 11 45 resettled till 12
E 12 15
A 12-30- 2 10
S 2-15- 3 took about 15 min to resettle till 4 30
E 4-30
A 4-30-7 including bath. Wouldn't cat nap
E 7-7 20
S 7 20-7 40
Then lo would not go back to sleep till 12!!!! He was not screaming just very restless and wouldn't settle anywhere not even on my chest.
Nw's were 12 45 (resettled after few min) 2 something (resettled easily after screaming for 5 min) 3 45- 4 45
( he screamed and screamed and screamed arching back and kicking arms and legs really fast)
7 30- feed
Wu 9
That was yesterday and last night

[Raroo]

Lo will be 5 months in a week

[megsx87]

Im really sorry I have no advice other than my LO is doing exactly the same! I am new to BW however he would go down after a feed at 8.30 wake at 1ish take forever to settle to the point we have co slept he wakes up at about 2.30 for a kick about feeds at 3 goes back in cot and is awake for the day at around 5-5.30 fed at 7am cat napped for 20mins straight after and then we got up. Tried an earlier bedtime routine tonight as he was getting tired around 7 so seeing how this works. Going to give ssh pat a go and a cuddle as he too has reflux so pu/pd i dont think will work well. Hope things are slowly getting better for you xx

[jessmum46]

Hi and sorry for the delay in getting back to you.  How are things?  Happy 5 month 'birthday' LO

Looking at the day you posted you are possibly starting out a bit UT (1h15 is a pretty typical UT length nap) but then ending up OT from a short nap and refused catnap.  It looks like you're hitting the beginnings of the 3-2 and may need to start pushing your A times a touch, as well as bringing BT earlier on days the CN is refused.  Have you seen this?  All about the 3-2 transition- 5/6 months