Frequent night wakings - nearly 6 month old

[Surana]

hi I got some great advice in the easy part of the forum and have just about gotten on track during the day with a routine I think is becoming more like easy than it was. Trying to get between 3.5-4 hours between milk; increased awake time to generally 2.5 hours although sometimes less first thing in the morning and a bit more before bed time; at least 1 nap of 1.5 hours a day, more frequently two of that length then a 30-45 minute nap; and did try to bring back bedtime to 7pm although we had issues with that and so doing roughly 7:30-8.

Our big issue is night time. Like I say he's going down about 7:30-8 most nights, occasionally a bit later or earlier depending on his naps (which becoming are more consistent but not totally consistent, they still move around a bit). He wakes regularly and often wakes for the day early but doesn't always wake up cheerful but still seems tired.

Last couple of days have followed pretty much the same pattern give or take a few mins:

6:50am - wake
7 - breastfeed (usually brief), up, change, activity time while I make a bottle
7:30 - milk (often just 2oz)
8:15 - solids (baby rice with another couple of oz of milk to get him to take more!)
9 - asleep
9:45 - reinsert dummy, back to sleep
10:30 - wake
11 - bottle (again, 2-3 oz)
11:45 - solids (fruit)
1 - asleep (in harness today as we were out; cot yesterday)
1:30 - awake
3:00 - milk (varies how much he takes here - 2-5oz, and a bit of breast milk)
4:00- asleep
4:45 - reinsert dummy, back to sleep
5:20 - awake
5:45 - solids (rusk) followed by a bit of breast milk to help it go down!!
6:40 - bath; night clothes and sleep bag
7 - stories, singing, bottle (again varies - from 4-7oz)
7:30 - lay to sleep. Sometimes he goes down quickly; other times he protests and eventually falls to sleep at or after 8. Yesterday it was after 8.

Nights, he tends to wake up after initially going to sleep about half an hour later. After that he then wakes up about every two hours. Sometimes he settles quickly with his dummy and a soothing hand: other times he wants fed. I have tried in the last week to reduce feeding to 11pm (7oz) and 3pm (breastfeed); I'm also trying to feed him when he's not crying so he doesn't think crying will get him a feed. He often wakes up 10:30; 1:30; 3:30; and 5:30 or 6. Sometimes he won't go back to sleep when it's the 6am wake; sometimes he will.

I think the dummy is becoming a prop, but I'm wondering if he is also genuinely thirsty given he doesn't drink much during the day? I've tried to persuade him to take more but he's generally resistant. I seem to have a 'spirited' baby (although we call him a vandal and a bully lol ) and he's easily distracted.

I have tried a bit of pick up put down - this initially seemed to stop the waking after half an hour at the start of the night but it did start happening again. It doesn't seem to have much effect when it's coming up to 11 or 3 in particular. Would it not work if actually he knows he's due a feed soon? Is this the issue with it? I'm slightly reluctant to make him go all night without a feed as like I say I'm not sure he's getting enough in the day, but thoughts and advice would be really appreciated

Sorry for long post

[Surana]

I should also say - one long nap and two or three short ones are fairly common for us too, and these days tend to be the ones he goes to sleep before 7:30. Two long naps and one short tend to make a later bedtime

[Martini~]

Have you thought Honey that he may sleep too much during day? Average A time for 6mo is around 3h and they start to survive day on 2 naps at that age (of course 2 longer naps like 1.5h). Is he a high sleep needs baby? Waking after BT and EMW can be both UT and OT but with amount of sleep he gets and rather short A, I would bet on UT.

[Surana]

Thank you for responding  I did wonder that and have tried to extend the first A in particular but he really struggles, even when increasing that one gradually, he ends up getting upset. I'm not sure if it's a loop, undertired after lots of day sleep and overtired because it affects his nights? He's never been a good sleeper to be honest, we've never had more than a five hour stretch out of him

[Martini~]

Ok Honey, firstly very sorry for writing she instead of he in my previous post. I have already corrected my mistake. Once again sorry.

Going through your post once again, I think you definitely should try to work on your feeds. You seem to offer him milk 10 times a day (counting BF + FF).

7 - BF
7:30 - FF (2oz)
8:15 - milk in solids (how many oz?)
11 - FF 2-3 oz
11:45 - solids (fruit)
3:00 - FF 2-5oz + BF
5:45 - milk in solids
7 - FF 4-7oz
11pm (7oz)
3pm BF

I understand that you try to put more in him, but sometimes it has an opposite result and they tend to be not interested as they already took a huge amount. Moreover, I think you underestimate your breast Honey:). At 6mo many kiddos will BF for 5-7min and will take all they need meaning couple of oz! And I see that many times you offer BF and follow with FF - why you do it? Yes, your son may take some FF after BF  but it's usually because it flies from the bottle. At 6mo the minimum they should get is 20oz and from what you wrote I am quite sure he take more but in very small amounts:).

Would you consider some feed consolidation?
I would consider:
- stopping to give him FF after morning BF (I am quite sure he takes what he needs already with FF)
- I would consider resigning from breakfast for time being or offer a very small fruits breakfast immediately after morning milk (small means 1-2oz of fruits)
- then go to 11am bottle straight away in hope that he will take a nice big bottle
Thanks to that I hope he will take most of his milk intake in two morning feeds.
- at 12 I would offer him solids, but would try for some veggies. He is 6mo so you will be just introducing proteins but lunch is a great moment to give it to him
- 2:30/3:00 bottle or BF (decide what you want to give him) I would make this feed at 3:00 or move it earlier if he still is not taking constantly a 6-8oz bottle at BT which should be your goal at this age; we struggled with BT with feed being at 3pm, but when I moved it to 2:30 he took slightly less but was happily taking a full BT milk
- 4/5pm dinner - I would offer here some rice cereal with milk and veggie or fruit for now; for him at  that age a portion of 2oz milk + 2oz fruits will be a lot so look out so not to overfeed him here as he may refuse BT bottle
- 6:30 or 7pm BT bottle (hope for 6-8oz)
DF - as much as he wants
NF - BF as much as he wants

That's only an option but in general I would resign from 1 solid meal and offer him for now only 2 meals. I am a fan of lunch and dinner when on two meals, but many will offer breakfast & lunch and no dinner. Routine would look more like shown below.
7am BF
8am breakfast
12noon milk
1pm lunch
4pm milk
6:30/7pm milk
Just pick what you think is suitable for you.

Regarding sleep, with such a long nap at 5pm it's normal he is not interested in going to bed before 8pm.

Regarding NW... Have you considered dummy being a prop? It seems that he wakes many times just for dummy. 6mo is age when they cannot replug it by themselves,  but still around 7/8mo they will. I would consider teaching him from now on how to replug it by himself. So everytime you replug, don't put it in his mouth, but take his hand, look  for a dummy and make him put the dummy in his mouth. You can already put couple of dummies in his cot. When he will learn how to replug, it will be easier for him to find one.

Hope that helps! If you have any other questions, please feel free to ask!

[Surana]

Thank you so much for the suggestions I've tried implementing longer A times yesterday, he actually managed 3 hour with little problem except for after WU and he took two 1 and a half hour naps. Unfortunately because of how timings were I needed to give him a short nap later in the day (15 mins at about 5:30 I think) as otherwise he'd have been doing over a four hour stretch, but given he won't sleep 12 hours at night (he's just doing ten typically at present if he does an early wake up; 11 if he doesn't) and seems to really struggle to go much beyond a 2 hour A after his initial wake up I'm not sure I can avoid it? First nap of the day was about 9:15-1040, second 1:45-3:10, and I try to get his bedtime sleep starting about 7:30 (it was 8:15 because of the nap yesterday).

The bf/ff issue is because I had always wanted to ebf but had to supplement at the beginning as my milk wasn't coming through (I had c section) and my boy was such a big hungry boy my supply never quite caught up. Didn't help my nipple became very cracked and sore too,meant there were times I had to give my nipples a rest. So I've just gotten into the habit of giving as much as I can, but my breasts don't seem to store enough for a full feed, he sucks for a while then gets cross as the flow becomes very slow. But I can see how that can impact on other things including sleeping, so will try your suggestions to see if they make a difference and pump after I've given a formula.

I do think the dummy is a prop, although unusually last night he went to sleep without it and slept for w couple of hours before wanting it. I've ordered glow in the dark ones to help him find them at night and will try to teach him to replug them himself.

Thank you again, really appreciate your advice and suggestions x

[Martini~]

Thank you so much for the suggestions I've tried implementing longer A times yesterday, he actually managed 3 hour with little problem except for after WU and he took two 1 and a half hour naps. Unfortunately because of how timings were I needed to give him a short nap later in the day (15 mins at about 5:30 I think) as otherwise he'd have been doing over a four hour stretch, but given he won't sleep 12 hours at night (he's just doing ten typically at present if he does an early wake up; 11 if he doesn't) and seems to really struggle to go much beyond a 2 hour A after his initial wake up I'm not sure I can avoid it? First nap of the day was about 9:15-1040, second 1:45-3:10, and I try to get his bedtime sleep starting about 7:30 (it was 8:15 because of the nap yesterday).

If you think he needs a catnap, it's really fine. I know many people say catnap may interfere with night sleep, but it's mainly happenening when kiddos do a full 45min and after 2 longs nap and normal WU. If your LO did shorter naps or woke up earlier for the day I would definitely go for a short catnap of 15-20min. You can also try EBT - some kiddos catch up on sleep very well.

The bf/ff issue is because I had always wanted to ebf but had to supplement at the beginning as my milk wasn't coming through (I had c section) and my boy was such a big hungry boy my supply never quite caught up. Didn't help my nipple became very cracked and sore too,meant there were times I had to give my nipples a rest. So I've just gotten into the habit of giving as much as I can, but my breasts don't seem to store enough for a full feed, he sucks for a while then gets cross as the flow becomes very slow. But I can see how that can impact on other things including sleeping, so will try your suggestions to see if they make a difference and pump after I've given a formula.

I would encourage you to open a new thread on BF board or if you want I can ask some ladies to come and pop in to advise you how to tackle BF issues. I thought you were mix feeding of choice but if it's because you have supply issue, you may address the problem differently. I am not quite sure if you can ditch the bottle at that age completely and go back to BF, but it's possible you probably need to feed him from breast as much as possible to increase supply no matters timings and ditch the formula completely. Please let me know what what you like to do:).

[Surana]

Hi, I'm not so concerned now about upping bf as he's older. I don't mind formula feeding as well as bf.

I've cut down on the number of feeds but I'm still getting multiple regular night wakings (every two hours) and he's gone back to waking after about 45 min after bt. He's also always waking before 6 which he wasn't doing before and is too early for me. I don't think he can be getting enough sleep when currently he typically goes to sleep at 8pm and wakes several times in the night? I guess with the clocks changing soon thatll change his waking to just before 7 instantly lol, but the night wakings I'm finding hard currently pushing A times to between 2hr45-3hr, although first A time is always a battle as I'm trying to make it later but am being met with resistance. He's now not doing more than about 30min sleep after the first A time of the day anyway. Any thoughts?

Current routine but varies in times and nap length:
6am wake but I just leave him in cot with minimum interaction
6;45 - up; bf
7 - A
8- small quantity fruit (eg few peeled grapes)
9 - S
9:30 - A
10:45 - ff
11:30 - E; veg and/or carb
12:30 - S
2 - A
3 - FF or bf; depends how hungry he seems
4:30 - S
5 - E (baby rice or rusk)
5:15 - A
6:40 - bath
7- E (ff), bedtime routine
8 - S
8:30 - wakes
10:30 - wakes
11 - df
1 - wakes
3 - wakes; bf
5 - wakes
545-6 - early wu

[Martini~]

Firstly it's would be good to rule out hunger. How much is he having on FF feeds, has it increased?

Secondly with 6am wakeup and 8pm BT he has a long day and might be OT at BT especially after long A when last nap was short (30min). So what I would do:
1. don't push the morning the nap, normally I would probably advise to push but if you can rely that his second nap is longer, that means that both morning A and S are fine.
2. Make BT an hour earlier. So if you have a nap 4:30-5:00 make BT around 7pm. It's short but it's fine after such a short nap. Frequent waking after BT may be a result of OT so it's worth checking if that will help.
If that will work for you I would keep that routine with 3 naps going for a time being. And gradually move the whole routine so you have a short morning nap and longer afternoon one, when catnap is eliminated. Usually we say 5/6mo it's time to go to 2 naps but if both of them are long. If you have two catnaps and one longer nap, I would say it's perfectly fine to keep that routine for next month or even more.

Other option is pushing the morning A until you get longer A. He is doing 3h after short nap and giving you a nice nap what suggests this first nap is UT. My son was exactly the same, it was difficult for me to push the morning A and I hated that. So I was happy with a short nap in the morning and catnap in the evening.

[Surana]

Sorry for late reply, been unwell. Thanks again for the suggestions.

He's generally, I would say, taking maybe 20oz FF including dream feed and then 3 or 4 feed from me, not including night time. He is an unusually big boy though so I assume needs more than typical (98 percentile approx for everything). His first nap can generally be relied on but I do need to pop his dummy back in when he stirs. If he doesn't do a longer morning Nap sometimes that does make afternoon nap longer. So maybe short morning nap and longer afternoon nap and then a catnap like you suggest would work. He can get the dummy in his mouth himself with a bit of effort, and pick it up, but for some reason doesnt want to do it between sleep cycles. I think he is simply waking up between sleep cycles and needs a dummy to go back to sleep, do you agree? I've tried with the earlier bed time - I managed to get him to sleep at 7:15 one night and he didn't do his usual of waking up again shortly after, but still did the regular night wakings and early rising. Usually when I try to put him down early he just takes longer to get to sleep and it ends up being nearer 8 anyway.

[Martini~]

If he takes 3/4 feeds from you, he might be getting plenty of milk including formula. Even counting 4-5oz for a breast feed you would have 20oz of formula + 4*4oz= 36oz which is close to upper limit. Of course he can take much less and just suck and he also a being bigger might need more milk, but still I wouldn't think his night waking are because of genuine hunger. Especially if you already offer some solids.

Long morning nap can reinforce early waking with some kids so I would either let him sleep 45min and that's all and count on second nap to be longer or I would try to push the morning nap later. Him needing a dummy after 45min may mean he is UT so he wakes, but dummy makes him sleep a bit longer. My son was more eager to do UT naps with dummy. How long is the morning A now? When he sleeps longer on afternoon nap does he also need a dummy back?

Regarding NW, I would say it's already probably a prop Honey that he neds you to go back to sleep rather than hunger. Can you please let me know how his usual NW right now looks like? How many NW you have at night (don't count those before DF) as I assume they are OT wakings.

I would also go for a earlier BT if that enables you to get rid of this NWs in the early part of the night. Doing that for 3 days at least so he can go out of being OT. What do you think?

[Surana]

Ok, will try a short morning nap, longer early afternoon nap if possible and catnap late afternoon and aim for a 7 o'clock-ish bedtime. I don't think he's especially hungry either but perhaps thinks he needs it - he can get hysterical when he wakes up at around dream feed time and it takes me a few minutes to make the milk. Last night he was screaming but then only took 4oz, and this morning when he woke up his first feed of the day was short, so he can't be too hungry! It's quite normal for him to take 12-14oz between the feed before bed and dream feed.

Night wakings - typically I will dream feed at 10:30/11, he'll wake at maybe 1, then 3, then 4:45 then 6. Roughly, it does move about a bit. He generally won't go back to sleep at 6. I did have the issue last night of a 4am waking and he didn't go back to sleep for a hour and needed a lot of comfort from me. He has had two teeth pop through not long ago but I think the discomfort is definitely less now, and we give calpol. And to be honest he's never been a good sleeper so I really don't think it's ever simply been a case of teething.

I'm wondering whether it's worth trying to get rid of the dummy altogether and try to eliminate the middle of the night feeding, if it would make it easier to tackle the night wakings?

Thanks again

[Surana]

So I pushed bedtimes back to about 7, did a short morning nap (at about 9:15-9:30) which has been half an hour, long nap starting at about 12-12:30 and lasting hour and a half, and a short late afternoon nap of about half an hour, and we still have regular night wakings and despite the clock change this morning he has gone back to waking before 6 at a loss about what to do but its getting s bit more urgent trying to sort it as it won't be long until I'll be easing back into work