Where to start?

[Anika920]

Alright I got some documentation. I am concerned about DS not gaining weight and noticed if I am on a 3 hr EASY 12hr day that only provides 5 Es? That is definitely not enough for my LO. What am I missing? I plan on feeding him when he wakes up and about an hour afterwards since we are EBF I am very concerned that it will lower my supply and we will end up with failure to thrive. I hope you can decipher my EASY this time 

5/3

E 6:30
S 9:00 (woke up after 30m shh pat in bed about 10/15m) woke up on his own
E 10:40
S 12:15 (woke up after 30m shh pat in bed about 10/15m) I woke him
E 2:15/3:10 (here is one of the extra feeds I mentioned)
S 3:45
E 5:25
S missed CN
Bath
E 7:45
S 8:30-12:00
* No DF woke after 3.5 hours for first feed. I brought him to bed and he woke me around 2:30 I latched him and he didnt wake me until 5. (2.5h)

5/4

E 7:40
S 8:53 (started WD too early took 25m) (woke up after 30m shh pat in bed about 20m)
E 10:50
S 12:20 (woke after 20m 10m shh/pat)
E 2:00
S 3:30 (woke up after 40 and 50m shh/pat twice both for 5 mins)
E 5:15 and 6:05
S 7:05 (hard to settle started at 6:45 for CN)
E 7:35
Bath
E: 8:15
S 8:45
* woke up at 10 (1.25hr was not planning on DF but fed him since he woke)
S 10:30-11:45 (1.25h)
S 12:15-1:05 (50m)
brought him into bed to cosleep. He typically is restless when he cosleeps and I am positive he is not getting enough sleep. He seems to go through whole wake cycles starting anywhere from about 3am on depending on when he wakes in the middle of the night. When we are persistent and put him back to bed in his bed he wakes up within anywhere from 10m-1.25hrs typically.
This morning I had DH take him and try to put him in his bed before morning. He was playing and awakw in bed from 5:30 until around 6:45 and woke up at 7:15 when I went ahead and started our day.

[newkidontheblock]

I am very concerned that it will lower my supply and we will end up with failure to thrive.

It's that serious? What has the doctor said about this? Do you have access to a LC - is DS nursing properly and for long enough? DD was born with a low birth weight & this was a big worry for me for a long time. It didn't help that she would take AGES to nurse also. It is important to let him stay on the breast long enough to get to calorie rich milk which comes later. In these early days, I feel that it is good to nurse regularly, and re-nursing a half hour or an hour later means he would be getting more of hind milk.

Day 1

E 5:25
S missed CN
Bath
E 7:45
S 8:30-12:00

In this instance, if it were me, I would have PD for bed at 7. With the nap ending at 5.25, there is no need for a CN but bedtime was too late. From what I have read and experienced, babies usually do one long stretch at night - but here he is waking quite soon after bed, which was probably due to over tiredness rather than hunger, although I'm sure he was happy to eat:)

Day 2

E 5:15 and 6:05
S 7:05 (hard to settle started at 6:45 for CN)
E 7:35
Bath
E: 8:15
S 8:45
* woke up at 10 (1.25hr was not planning on DF but fed him since he woke)
S 10:30-11:45 (1.25h)
S 12:15-1:05 (50m)

Same here again, honey. You don't need a CN when nap 3 is ending this late. I understand that you are doing it because you want bedtime to be later but then he is OT anyway as the day is too long, ys? This is why he is waking so much at night. I really feel that you should try for a consistent 7pm bedtime. Then you can slowly try and move your day back by 10-15 minutes. But for now, this is hurting more than it is helping.

[Anika920]

Okay so if he is getting longer days then the catnap is cut. That makes more sense. What are your thoughts on the short naps I am having to extend every time?

I have seen LC I got to a group on Tuesday where I can do weighed feeds. He transfers milk okay. He used to be much more efficient. I used to have OS but it is smaller now. I had an LC recommend giving him larger bottles at night to help him sleep. We were off routine and because she scared me about him being hungry and from last week he either didn't gain or lost went from 12.13 to 12.10 (I stated cloth diaper and can't remember if he was wearing one last week which would definitely add weight) he has been pulling off the breast early and seems hungry still, but not completely interested in nursing. Dr says to lengthen his feeds so that he gets a good full feeding. LC sat on demand. On demand definitely seems to help him better with weight gain, as when he was only allowed to nurse every 2.5-3h is when I had a plateau in weight gain my first time doing BW. It's almost like on demand or schedule doesn't seem to work 
I will try to get him into bed by 6:30 tonight as that's when he WU. Giving him a larger bottle last night and even giving him more oz expressed breastmilk did not help. He still woke after 1.5h but BT was late because I was going through emotional stuff thinking my supply has dropped and he's not sleeping due to hunger. At group he got about 2.5oz so as you can see 5 feeds would only yield half what he needs. He spits up a lot IMO I know what they say it looks like more, but he'll still spit up after over an hour sometimes. Dr isn't concerned too much about his weight. Was planning on having him assessed for tongue tie but DH doesn't want to do it and it would be 100% out of pocket.

[newkidontheblock]

What are your thoughts on the short naps I am having to extend every time?

I'd say they are so very normal at that age. It is mostly developmental and will get better as he gets older. It is great that you are able to extend the naps. Hopefully soon he will be able to transition himself.
short naps at 3-4 months? Take it easy, it will get better!

If you are worried about weight gain, follow his cues & your gut instinct and nurse him on demand. Following BW doesn't mean you have to space out the feeds, hun. Just follow a routine of feeding, playing and then putting baby down for a nap. How would you go about 'lengthening feeds' ?You nurse for as long as he eats, right? And offer often. I wasn't ever able to keep DD on for longer than she wanted. Of course she took 40 minutes for each feed till 4 months. What I was advised by my doctor was to nurse every 2 hours. So I would nurse her for however long it took. Then she would take a 2 hour nap and then I would wake her up and nurse her again. Day and night. Until her weight normalised. In fact we kept waking her up for much longer than necessary until the doctor told us to please let her sleep.Then we stopped waking her and fed when she WU. I always offered bottles of expressed milk at night though because she took so long to nurse and so that DH could help me. I would wake up and pump at the same time. We also were told to burp her for 10 whole minutes, and we religiously did this. I think just keeping her up for that long after a feed helped to reduce spit up. Burping regularly during the feed also helps. Stress is not good for you, your baby or your supply, sweetie. Just relax and nurse him whenever and for however long.  Consider pumping and offering in a bottle for night feeds. Isn't it more stressful to keep weighing before and after feeds?

Lastly, stick to a fixed BT. What time did the last nap end? If 5 or later, then 7 might be better

[Anika920]

I apologize. I thought I had replied to your last post and found a shrunken window with my half reply. DS must have woken up when I was typing it.

I have been nursing him just about every hour he is awake. I have also noticed that it seems to help him sleep better and maybe even longer with a fuller tummy. I go to a group lead by a lactation consultant where we can do weighted feeds, so it is nice to be able to see his weight gain. DS seems to be a pretty impatient eater so he will only nurse as long as milk is very readily available. I can feel letdowns and while he use to stimulate 2 or more I only ever feel the initial one. And sometimes when it has been close to the last time he nursed he gets really mad at me that it is taking a whole minute for the milk to letdown.

I have decided to move onto a 4hr EASY as DS is now about 4.5 months (19w). I am super excited to be able to keep him up a little longer. It is hard staying on a 1.5hr A time. Unfortunately, the longer A times and S times means that we will likely be missing going to the group I mentioned above. But feeding on demand will ensure he gets enough milk during the day and keep my supply up. I am already artificially helping him with galactogogues and pumping.

[newkidontheblock]

It's normal to not feel the later letdowns. You know, DS being impatient reminded me of an issue I had with my DD. I had a lot of trouble with her bedtime feed at around 5/6 months. For some reason, I started having an issue with a slow/no letdown. She would get SO impatient waiting and I would get stressed and worried and that wouldn't help matters. I couldn't understand it since I never had that issue before. Then another BW here advised me to try spacing out my feeds and see if it made a difference. And it totally did! The thing was - DD was simply not hungry! She wanted to hang around and comfort nurse but she wasn't hungry enough to work for it, ys?

Anyway, I'm glad that things are better. Week 19 is the storm, so be prepared for some iffy days:)

[Anika920]

Thank you. We just had our 4mo appointment today and our ped said I HAVE to make him wait at least 2.5hrs between feeds. It is nerve racking for me, but he assured me that he will actually have poorer weight gain feeding so often. There is a room I can take him into and do weighted feeds. I did it after our Dr appt and he took in 4oz. Most I've ever seen him get! So sounds like spacing feedings out might just be what I need to do. And yes I have the same issue and get stressed out when DS is mad at me and not getting milk like he wants. It is very stressful for me. Also the Dr said that at his 6mo appointment if he is still not self soothing he wants me to do some tough love and CIO. As you know I am doing BW so to avoid CIO. So here's hoping that more full feeds will get him to sleep longer!

[newkidontheblock]

but he assured me that he will actually have poorer weight gain feeding so often.

Yes hun, Tracy also talks about this. Basically they get into the habit of taking in just enough to take the edge off, rather than a full feed. So they keep getting hungry pretty quickly.

Also the Dr said that at his 6mo appointment if he is still not self soothing he wants me to do some tough love and CIO. As you know I am doing BW so to avoid CIO. So here's hoping that more full feeds will get him to sleep longer!

Grrr at your doctor! So easy to give bad advice. So glad that you have chosen a gentler route. CIO breaks the bonds of trust between the LO and the caregiver and is so stressful for the baby. Don't worry hun, we're here to support you and help you through this in a way that will be comfortable for you and your LO. At the end of the day, he is learning a new skill - sleep - and this is important for his entire life. Have you seen this?
Research on why 'cry it out' and 'controlled crying' is NOT recommended!
Kara & Alexandra's Story
If you are desperate to let your lo "cry it out"...read this first

[Anika920]

I have often wondered what the heck happens after CIO. I try to be a pretty logical person and it just doesn't make sense to me that letting a baby cry all of a sudden this miracle happens and they no longer cry and just go off peacefully to sleep forever. It makes much more sense that it is what you have to do whenever they won't sleep. And the cries of a baby tear at a mom's heart so letting them cry alone goes against our maternal instincts. Thanks for sharing those with me. I have a ped in the family and I asked her when DS was about 2 months if an infant could just HATE sleep (as unfortunately he has been a poor sleeper since March!) her short response. Yep, put him in his crib and get ear plugs. Really!?! A baby who is 2 months!!!

[newkidontheblock]

Hugs
How are things now? Sorry for the delayed response. We're on holiday at the moment

[Anika920]

About 2 weeks ago my LO had what is called a choking episode in his cot. He had been fussing for about 15m before bed and then stopped and was just wide awake rolling around in bed for about 45m. Typically we don't leave him that long and we try to help him get more drowsy, but we figured we might be interfering with self soothing. Once he finally fell asleep he was awake after 35m he let out a quick cry and went back to sleep. Moments later I noticed him looking like he was in distress in the monitor. When I ran into his room and flipped on the lights he has a small spit up next to him and a ton of saliva in his mouth and was having difficulty breathing. We called 911 and went to the ER but thankfully we were able to get him crying and breathing before help arrived. It was absolutely traumatizing. This was after a day where he took in (for him) large feedings but at the expense of us nursing for 30m minimum. I had rented a scale and he was going every 4 hours between feeds with 2h wake times and 2h naps. So I was so curious to see how the night would go and it was a disaster! 
Ever since then I have been hypersensitive and much more cautious with my LO. He has been cosleeping a lot more and I fear that because of that he has fallen back into bad habits and going down for naps and BT have been hard again. Dr said that the choking episode is from reflux and he is back on meds again. I had thought that he had gotten over the pain from reflux as he had been a pretty happy little man for a while. He still spits up but he seems to be a happy spitter. I am just at such a loss now. He is already down for his first nap. He woke at 7:30a (we started cosleeping at 12:40a) and started showing sleepy cues after only being awake for about an hour so I went to put him down and he cried and battled me for about 25m. He still cries 9.8 out of 10 times when we even just take him into his room. And if it's not that quickly it happens once his PJs go on. Trying to WD I have scratches on my neck and he pinches and pulls my hair. I have been following a pretty set BW routine with him since he was a few weeks old and it just doesn't seem to STAY good. We get some very successful wins, but then we regress and it is back to fighting to get him to sleep. We haven't held him to sleep since he was much younger and have been working on putting down drowsy but awake for so long now, crib calming, PU/PD and it just seems that no matter what we do he still cries most of the time before sleep and wakes up crying.   

[newkidontheblock]

Oh my gosh. You poor things. *hugs hugs hugs* I am so glad he is okay. What a scary experience. Is his crib mattress on an incline, hun? That really helps. For the first few months we had to even fold a thick sheet to keep Eris's head elevated. I thought it was quite dangerous but the doctor insisted we do it. I removed it as soon as she started moving though.

But hun, I think he is fighting you so much because he is probably not sleep yet. He might be tired but not ready for a nap. Sleepy cues can be quite unreliable after a while

[Anika920]

Thank you. Our dr. talked about elevating the cot but he is rolling around a ton and he would probably just end up at the bottom of his crib. I try to keep him on his belly now. Dr put him back on reflux meds. But I never thought that they helped much the first time and had wondered if the side effects were actually messing with his sleep. I have been bad with documenting and we have gotten off schedule, but the night of the choking episode he didn't fall asleep until 8:30pm. So we had tried for a proper bedtime and about a 12 hour day. I haven't been documenting so much but have been trying to stay pretty close to a 4hr EASY with on demand nursing still. Some days I just can't hold him off because he is nursing poorly. Distracted, bobing on and off and showing interest for a few seconds and then losing it again. It's getting exhausting and making me want to stop BF, but at the same time I want to continue because I am stubborn and feel this is what is best for him and I have the supply and equipment my babe just won't take well. I found with the scale he basically takes in only a small amount per feed and is only probably averaging around 20oz during the day so he needs those NW feedings. I am not sure if he has a tongue tie as he seems to nurse well if he wants to nurse, if he does I think it would be minor, but is effecting him somewhat.

Since the incident his naps have shortened and his first NW shortened. I was also sick and he could have been sick as well, but since he coughs and sneezes often it's hard to tell. He has been congested, but reflux can cause that they say.
Today he has done a bit better but only awake for 1.5h (I tried to put him down too early for first nap and so when he finally went down it was at the 1.5h mark) with a 2 hour nap. We danced at his next A and he was so relaxed and acting tired so I put him down at 1.5h and he didn't fight me much at all, but cried when I put his PJs on. He has been asleep now for 45m but seems like lately if he is up for 2h he is napping for about 1.25-1.5h. He/we were doing so good I thought until that stupid choking episode. I am not sure if it is better to keep him up for the 2h or let him get longer naps? Since he wakes so much at night I am not positive that he isn't just really OT throughout the day.

Saturday night I couldn't get him to take a late afternoon nap even cosleeping so we tried to put him down earlier and the night was horrible with him waking about every hour!

[newkidontheblock]

Really sounds like you are having a rough time. Hugs Have you posted on the reflux board? Maybe there might be some helpful suggestions there too? How old is he now, hun?

[Anika920]

I did post on the reflux boards. I am having a hard time. It is very stressful on me. I know my DS loves me but he can be so hard. And I haven't had a decent nights sleep in 6mos, he is 5m 2w now. He is overall doing well, meeting milestones and cute as can be, but he is very needy and fusses easily. I have decided to work on my milk supply again so I have been pumping and giving him bottles as well as nursing and this has still not made a great impact in his sleep. I'm sure it is because I have been cosleeping and he nurses on demand at night so I have become a human pacifier. I told DH this is my last attempt at pumping up my milk and trying to get him to nurse well. I just can't do it anymore. This is the 3rd time (at least) that I have worked on pumping my supply up for him. He is IMO a lazy eater. I have an OALD and he learned to just get the easy milk and not work harder for the hind milk. He is beating me up! I will see a lactation consultant again on Thursday. We'll see! Thank you for all your support!