5 month old...never napped well

[sparklewings1984]

Hi all,

I've previously posted in the general sleep forum, started when LO was 11 weeks old. Never had a consistent EASY but previously had managed to get him to take his first nap in his cot with only a few mins of fussing beforehand. I can count on one hand the number of times he has ever napped for more than 45 mins except in his pram whilst on a walk.

Ok the current situation:
 - LO just turned 5 months old but was 3.5 weeks prem
 - EBF
 - Has had reflux since birth which I thought he had grown out of at 12 weeks old for it to return with a vengeance as silent reflux. He has been on omeprazole for 2 weeks now and it seems to be getting it under control.
 - He has allergies to cows milk and soya, I have been excluding all traces from my diet for 5 weeks now and the past 2 days I have finally seen a huge improvement in his mood and his nappies!
 - Definitely teething for which I am using some lactose free granules

So....now that his reflux is under control I'm ready to start the sleep training again. I have NO IDEA  how to get him to sleep for naps. I can't even APOP him to sleep,  nothing seems to work without endless screaming, with the exception of nursing him to sleep. I have resorted to this at least once per day over the past few weeks because the screaming was getting horrendous. He still then only naps for 10-30 mins in my arms.

I'm certain he is chronically OT but don't know how to overcome it. He sleeps generally well most nights, BT routine starts at 6.30pm when OH gets home from work and LO is in bed by 7.30pm. He is in cot in his own room. Since the 4 month sleep regression ended and his meds now working he seems to be waking at 10pm for a feed, then either wakes once or twice for a feed in the night and WU at 6.30am. He usually totals about 10-10.5 hours night sleep.

Daytimes...he used to do 40 min naps and I was trying to figure out his perfect A time when I stopped the ST because of the reflux pain. He always had long A times. Last week I had one day where I did WD at 1hr 50 mins and he fell asleep independently at 2hr 20 mins but only slept 20 mins! This seems to be our new nemesis, the 20 min intruder.

I've been trying him with slightly longer A time this past 3 days, starting WD at 2hr 10 but he then just screams and won't calm down. After 30 mins of the screaming I give up and get him up ready for his next E...which inevitably results in him falling asleep on the boob.

Where do I start?

[sparklewings1984]

I'll add a bit more detail now. BT routine is: give him his meds, have a little sing and kick about then bath, boob feed sat on my bed (usually falls asleep but then wakes slightly when I put him into his sleeping bag ), into sleeping bag singing Twinkle twinkle, cuddle upright to get last burps out for 10 mins, into cot in his room usually asleep.

Nap time routine is nappy change, into cot lying on his sleeping bag and sing couple of nursery rhymes, then whilst singing Twinkle twinkle I zip him up into his sleeping bag and close the blackout blind and put on his light show soother with lullabies playing. As he is a touchy baby I don't sh pat as such,  i put my hand on his tummy and say a phrase instead. Usually he is smiling at me during nursery rhymes and then as soon as i start zipping up his sleeping bag he turns grumpy and starts fussing or crying. Sometimes he is distracted by his light show soother and these are the times he usually falls asleep independently.

I'm now getting to the point I'm convinced he is hungry and not feeding well enough to sustain him through his nap. I think from having the reflux he got into a habit of snacking, i usually feed him 2.5 hourly. 

[sparklewings1984]

He currently is only getting about 1.5-2 hours total daytime sleep in 30 minute chunks and I know it isn't enough. I used to attempt all first naps in his cot and then take him out in the pram to APOP a long nap during the day. Now that he is older he won't even stay asleep in the pram.

I can't even write out a typical EASY as I don't have one for any days that work! All I can say is that when he wakes in the morning he is usually happy and will chat to himself in his cot for 5-10 mins before crying out. Every other time I have managed to get him to nap he ALWAYS  wakes up fussing and crying. Even if I cuddle him to sleep and hold him through the whole nap he wakes crying.

Please please please give me some ideas...should I just set aside 2 full weeks of doing every nap in the cot? Given the fact he isn't getting sleep even with APOP I may as well just deal with the OT baby during the process.

As I said before my main concern is always that he is hungry because he is ebf but I'm getting some prescription formula tomorrow and trying to get him weaned fully onto that by introducing 1 bottle per day and increasing it each week.

[katie80]

Hi there, I'm sorry you haven't got a reply yet!

If you're quite sure he's not in discomfort anymore, which it sounds like things are going in the right direction with the reflux meds and elimination diet, I do think setting aside a couple weeks to exclusively work on getting him to sleep in the crib is a good idea. Although, it sounds like you're still getting some 20min maps, which are generally considered discomfort/pain.

As far as a plan, I'd stick with an A time of 2-2.5hr, as that's average for 5mo old. I'd keep a good log of your EASY/settling for a week and then start to look for patterns.  Try to settle him for 40min at the start of each nap.  If he doesn't fall asleep, get him up and do a 10-15min break and then try again for the rest of the nap time.  If he does fall asleep but wakes early, try to resettle for 20-30min.  If he doesn't go back to sleep, get him up and start a new cycle with a slightly shorter A time (maybe 20-30min shorter).

If he's touchy, I would actually get rid of the light show thing, as that's probably distracting/over stimulating for him. Most touchy babies like to sleep in the dark with white noise and not a lot of intervention.

As for feeding, do you have any proven reasons why you think he might not be getting enough or that he's really hungry? If he's gaining weight well and things are good on the reflux/intolerance front, I wouldn't think you have cause for worry.  It is common at this age to do top-up feeds with EBF babies, as often they don't make it to 4hr between feeds until solids are started. So, you could do a big, main feed upon wake-up and then a top-up about 30min before nap time (just make sure he doesn't fall asleep nursing ). 

I hope that helps... I'm not sure I answered everything for you (I'm tired myself today ), so be sure to ask other questions if you have them.

[sparklewings1984]

Thanks for the reply, most appreciated! Do you think the following EASY would be something to aim for? He is only likely to ever do 2 sleep cycles which would be 1hr 20 for him so I've based on that :

WU
E 7am
A
E 8.30am top up
S 9.15am

A 10.35am
E 11am
A
E 12.30pm top up
S 12.50pm
                     
A 2.10pm
E 3pm
A
S 4.30pm catnap

E 5pm
A
BT routine 6.30pm
E 7pm and bed by 7.30pm

This will get him 3 hours daytime sleep which would be amazing! I think I'll try and start from this weekend as I don't really have any commitments next week except for one group on Tuesday morning that I can fit in with his awake time.

I am getting him weighed tomorrow for the first time since he started his meds so hopefully he will be back on track. He was starting to drop down the centiles.

[katie80]

I think that EASY looks like a really good starting point. Good luck and let us know how it goes!

[sparklewings1984]

Just another thing as you mentioned about the 20 min naps could be pain... The other week when he fell asleep independently at 2hr 20 and then only slept 20 mins ,he didn't wake up crying, he was just lying quietly in his crib  (I stuck my head in the room to see if he was still asleep). He was very smiley and alert.

I think most of the time now when he sleeps for 15/20 mins it is because he is OT from fighting the nap so much. I guess it is because of all the AP I've been doing with him that he now hates the cot again.

Questions before I start on my ST:
 - what if he totally refuses to take a nap? Eg first nap at 9.15am if I try for 40 mins and he won't settle, then get him up at 9.55am for 10 mins, then try again for the rest of the nap time...If he doesn't fall asleep by 10.35am and I get him up again, what do I do??? He is definitely going to fall asleep nursing in this case. Obviously work my hardest to keep him awake and then try for the nap again straight after?
 - If he does fall asleep nursing, do I just place him in the cot at that point? Or should I gently wake him straight away and then place into the cot? I guess if he falls asleep I would straight away remove my nipple from his mouth but this doesn't normally wake him he just wriggles around and then goes back to sleep. However I've tried then laying him into his cot at this point and as soon as his bum touches the mattress he starts crying and won't settle.
 - do you think it is worth doing the top up feed in the nursery? I could do the rest of his A time downstairs and playing with toys and then top up feed in the nursery, then have quiet A time such as reading a story etc before wind down. I take your point about the light show, it has seemed to distract him enough to fall asleep a few times though, it is a very repetitive thing.
 - what do you think about the fact that he is always happy when I first lay him in his cot singing nursery rhymes but as soon as I start to zip up his sleeping bag he starts to cry. He must realise that means it is nap time and is protesting?

[katie80]

Just another thing as you mentioned about the 20 min naps could be pain... The other week when he fell asleep independently at 2hr 20 and then only slept 20 mins ,he didn't wake up crying, he was just lying quietly in his crib  (I stuck my head in the room to see if he was still asleep). He was very smiley and alert.

Is his room dark/set for sleep? Could he be overstimulated?

- what if he totally refuses to take a nap? Eg first nap at 9.15am if I try for 40 mins and he won't settle, then get him up at 9.55am for 10 mins, then try again for the rest of the nap time...If he doesn't fall asleep by 10.35am and I get him up again, what do I do??? He is definitely going to fall asleep nursing in this case. Obviously work my hardest to keep him awake and then try for the nap again straight after?

Yes, work your hardest to keep him awake and try for a nap after you've done a diaper change and maybe a walk around the house.

If he does fall asleep nursing, do I just place him in the cot at that point? Or should I gently wake him straight away and then place into the cot? I guess if he falls asleep I would straight away remove my nipple from his mouth but this doesn't normally wake him he just wriggles around and then goes back to sleep. However I've tried then laying him into his cot at this point and as soon as his bum touches the mattress he starts crying and won't settle.

This is a hard call. You may find that he's so exhausted, that you can't wake him and the only option is to lay him down to sleep (he may still not wake). If he does wake when you lay him down, I'd take him out of the room and do a little walk around/diaper change and then try for a nap after a proper wind down. I think it's kind of unfair to go right into try to settle him to sleep if he wakes after falling asleep nursing, it must be quite confusing for them.

- do you think it is worth doing the top up feed in the nursery? I could do the rest of his A time downstairs and playing with toys and then top up feed in the nursery, then have quiet A time such as reading a story etc before wind down. I take your point about the light show, it has seemed to distract him enough to fall asleep a few times though, it is a very repetitive thing.

Sure, that sounds good. Just as long as he doesn't dose off during the top up.

- what do you think about the fact that he is always happy when I first lay him in his cot singing nursery rhymes but as soon as I start to zip up his sleeping bag he starts to cry. He must realise that means it is nap time and is protesting?

He does likely realize what's happening. He could be protesting because he's UT and not ready to sleep or he could be protesting because he's OT/OS and it's part of his personality (Tracy said that some touchy babies need to get their extra energy/stimulation out before sleep and thus protested/cried to sort of drown out the rest of the world).

[sparklewings1984]

Hi Katie,
His room is quite dark bit not pitch black, it has a blackout blinds but light creeps around the edge. I've taped black refuse bags around to cut out some of this extra light but it still isn't really dark. There is nothing in the room to stimulate, no pictures or cuddly toys in sight etc.

I really think he may be UT for the first nap and is protesting for that reason. I've done his first nap of yesterday and today in the cot to give me a base ahead of starting fully tomorrow. Yesterday I put him into the cot at 2hr 10, did wind down. He started really screaming but I just kept trying to settle in the cot. After 40 mins he was still crying so took him out of the room for 10 mins and just wandered round carrying him. Then when I tried again he fell asleep after 10 mins crying. He was so OT by this point  (after 3hr 10 A time) that he was jolting throughout his fitful 30 min nap.

Today I put him in the cot after 2hr 15 and he cried hard for 15 mins, then was kind of crying on and off moaning  and quietly staring and drifting off for 15 mins. He only did a 20 min nap. It was really sunny today so maybe he woke because the room was even lighter than usual?

I will keep 1 more day with the 2hr 15 A time and then maybe try 2hr 30 tomorrow for 3 days. He has previously needed longer A times to even get a 40 min nap from him so expecting he may have long A times for his age now. What do you think?

I'll keep a full EASY log from tomorrow, then only problem is that I forgot we have swimming lessons at the weekend, usually Sunday but this weekend will be Saturday. That will throw things out a bit

[katie80]

His room is quite dark bit not pitch black, it has a blackout blinds but light creeps around the edge. I've taped black refuse bags around to cut out some of this extra light but it still isn't really dark. There is nothing in the room to stimulate, no pictures or cuddly toys in sight etc.

I think that sounds normal.

Also think your plan sounds good... if he's always had higher A times, he may well need 2.5-2.75hr in order to sleep well. It sound like you've already had a bit of success with settling, in that the time has decreased.

[sparklewings1984]

Thanks Katie. I'll post an update each day as may need some moral support to get through the crying. When we were doing well before I was getting him to settle with less than 5 mins of crying in the end but couldn't get past the 40 min naps. Oh how I wish for 40 min naps now!

I've just started weaning today too, just a tiny bit of veg purée at lunchtime so I'll give that instead of his top up feed then.

[katie80]

Sounds good. Happy to support you, hon. It's not easy work, but very worth it.

[sparklewings1984]

As I said we have swimming today so starting properly tomorrow but just wanted your thoughts on the following. I did his first nap in the cot again this morning and put him in it after 2hr 15 A time. He didn't cry when I tucked him in and closed the blinds today. Instead he was smiling and cooing at me the whole time. As he wasn't crying I left him to see if he would self settle as he has done a few times. 10 mins of babbling away and then started crying so I went in and calmed him in the cot. He started smiling and cooing at me again. Left him again.

After 2hr 25 A time he started crying properly and took me 10 mins to calm him in the cot. Then 5 mins of on and off grumbling and then asleep for 15 mins...then wouldn't resettle so I got him up after 10 mins of trying as it was near the end of the nap time by then anyway.

Do you agree with me that he seems UT? Hence the protest crying for the last 2 days and the smiling and cooing today instead of sleeping? I've tried putting him into the cot at 2hr 15 for 3 days now so was planning on trying 2hr 30 for 3 days now.

Also I haven't fed him to sleep during the daytime at all for the past 2 days and I think he is coming to terms with that! Does it matter that I still feed to sleep at BT and NF? I think from what I have read on here the answer is that it is not a problem yet and ok to wait until older to start weaning from the BT and NF nursing to sleep?

[sparklewings1984]

Also, wondering if you think I should try swaddling for naps as I know it can help touchy babies and reflux babies. We used to swaddle every night until 11 weeks when he literally wriggled amd wouldn't settle at BT until I unswaddled him and then slept brilliantly that night.

I'm nervous to reintroduce it for naps now as he rolls tummy to back and probably won't be too long until he is rolling the other way. I've been tucking him under blankets for naps now  (instead of sleeping bag ) buy he always gets his arms out and jolts awake or scratches himself etc etc.

I'm so frustrated. I literally can't get him to nap at all, he is so so so grouchy in the afternoons. We had to leave his swimming lesson after 10 minutes today because he wouldn't stop screaming from OT. He is such a gorgeous boy first thing in the morning and after the rare real naps that we get.

[sparklewings1984]

Ok so here is how today went:

WU 6.10am
E 6.40am
S 7am (took him off the boob before he fell asleep in arms)
A 7.45am
E 9am
A (2.40)
S 10.25am (25mins)
Put in cot at 2hr 25 for wind down. Less than 10 mins of fussing  (not hard crying) before sleep. He was wriggling and kicking off a lot, not sure if reflux or trying to roll as seemed to be trying to get onto his side
A 10.50am
E 11.15am
A (2.00) 
E 12.15pm solids
S 12.50pm (25  mins )
Into cot at 1hr 50. 5 mins of crying then calmed and wriggled a bit.
A 1.15pm
E 1.45pm
A (2.05)
S 3.20pm (35 mins)
Put into cot at 1hr 55 mins. Again 5 mins of fussing.
A 3.55pm
E 4.15pm
A inc BT routine
E 6.15pm       
S 6.45pm

He seems to be getting much better already! Now just need to figure out these crazy short naps.

Will do the same tomorrow and see what happens.