LSN baby seems to resist predictable routine

[Gecko2014]

Hi Ladies,

I'm re-posting here from general sleep issues with regard to my 13month old's routine and how to tweak it for him. The best I can ascertain he is LSN - the child health nurse says that he needs to sleep more, I would like him to sleep more and the books say he should sleep more but... for the most part, he is fairly happy with 13hrs of sleep a day. The bigger issue for me is that my LO seems to want his 13hrs to occur in a different formation each day - some days we have EW, some days we have extended NW, somedays we have a long naps, some days a cat nap (and occasionally, but rarely now, 2 CNs). This is despite my efforts with his routine and being as consistent as I can, where i can. We've done an early-ish 2->1 transition which helped for a week or so before we the random-ness returned. If this is going to be his lot, so be it, but I would like to see that I have done what I can for him get more sleep and regular sleep, before throwing my hands in the air and letting him do as he please.

Our basic day since the 2->1 transition is: WU around 630, nap around 12 and BT around 630. An A time of ~5h in the morning and ~4.5 in the afternoon has worked well but there is a range here where the outcome doesn't change. This is the last 3 days:

Monday
S - 740pm-420am
E - BF at 440 then back to bed
S - 515-715
E - breakfast
S - 12-1 (seemed tired by wouldn't resettle)
E - BF at 1:30
A - afternoon activity including afternoon tea, dinner and bath
E - BF at 6 with top up bottle
S - into bed at 623, asleep by 633

Tuesday
S - 630pm-430am
E - BF and back to bed at 5am
S - 545-749am (longer than normal for a resettle in the morning)
A - breakfast, play at my mums, morning tea, lunch
S - 1pm-130pm in portacot (later than normal due to late rising)
E - BF at 1:30
A - play at mums then back at home
E - dinner
A - bath etc
E - BF before bed at 5:45pm and top up with cows milk
S - into bed at 6pm, asleep 610pm

Wednesday
S - 610-450
E - 5am and back to bed but did not resettle
A - out with daddy for the morning, feel asleep for 3 mins in the car at 9
S - Int bed at 11:20, asleep 1147-115
E - bottle with daddy on waking
A - afternoon at home
E - BF before bed at 6, asleep 6:30-11pm then awake until 2am (despite feeding, patting, cuddling etc etc)

[jessmum46]

Some thoughts....any teething?  Long NWs for us are generally related to discomfort although significant OT will do it too.  Did you try any pain meds?  Routine-wise I have a couple of thoughts.  Firstly that if you are trying set clock times, you need to stick to them regardless of WU time.  So not pushing nap or bedtime later for a late WU or LO doesn't have the chance to self-regulate.  DD would always go down at usual nap time even after a late WU, she may have slept a slightly shorter nap but it would have been enough for her to be rested after a shorter A time.  Pushing nap or bedtime later always backfired.  If you are doing set A times then do set A times, but don't keep changing the goal posts.  So make it nap always 5h after WU for example.  Either way (set clock or set A) can work, but consistency is vital.  I also think you need to consider your LOs likely total sleep needs.  If you LO really truly only needs 13h in 24, then the set routine you aim for should reflect this.  A 5h morning A time and 4.5h afternoon just is never going to work if LO only needs 13h yk?  That's expecting a total of 14.5h sleep.  I do think your LO probably does need a bit more than 13h, he's probably OT (falling asleep in the car so early, short naps) but equally shooting for a routine that has 14.5h of sleep may be unrealistic.

Also, that early morning breastfeed.......is that a habit do you think?  Are you happy with it?

[Gecko2014]

Teething - yes. I think we are about to start seeing the first molars but I'm not certain of this (and my husband is very anti-teething so its difficult issue in my house). Most of the time, during the WU, he's happy - very happy - just not tired. When he's more unsettled during the WU, I suspect discomfort - either teething or illness is impacting.

I think he needs more than 12 but probably not at much as other babies. Of note, our best night sleeps (12 uninterrupted hours) occurred when he had only 30 minutes nap time but this is not sustainable for several days, only the odd one.

We have been doing the A time until recently, when I started switching to clock-time to see if this would help him regulate. I stick to the time when there are less dramatic shifts in WU time (30-60 minutes, for example) but felt that nap time was way too early or way too late when the shifts were more dramatic. It goes against the grain for me to be clock-driven rather than baby driven but I can trial it and see what happens. I would also need to set the WU time in this case also, wouldn't I?

The early morning BF is just new this last week. Prior to that, the first feed was 600-700 and I was delaying it if he woke earlier. We just started trying it in an attempt to get him more sleep in the morning following an EW. For about 3 days it worked a treat, then I had him feeding at 5am AND wanting to stay up. I'm happy with doing the feed if it means getting him back to sleep but less happy if we are going to all be up anyway.

[Gecko2014]

I just checked my maths on the overall sleep hours and what my targets should be.

I think something like 6:30pm-6:30am with a 90 minute nap at 12 would be reasonable and work for us (13.5 overall, with A times of 5h and 5.5h). I would envisage that on days that he woke at 6 or earlier, or if we can get BT to 7 when the naps are working better, he might take 2 hours at the nap. I do however think that 12hrs overnight might be a struggle for him so maybe I should work on 11 overnight and 2 during the day.

[Gecko2014]

Also (sorry :-/) looking at the day today, I think he is chronically OT at the moment. What would you suggest to get him back 'in the black' so to speak, while I'm trying to sort out a sustainable routine?

[jessmum46]

When we are in a tired mess I make use of a bit of AP if I can to extend naps (car usually works for us) and offer some early bedtimes.  Even a one-off super EBT can help break a cycle, if you go early enough then when LO wakes at 10-11h it's usually so early in the morning that their body clock will allow them to (eventually) go back to sleep and then start the day at a more reasonable time x

[Gecko2014]

I have been doing some EBTs and getting in 2 naps when I can but we aren't really getting ahead. Turns out he's ill again thats mucking everything around, right after we started getting the routine sorted.

What/ how would you use AP for lengthening naps when there are OT issues? And what do you call a super EBT - we are currently doing 6 as our 'earliest' - I'm concerned that any earlier might be treated as a nap and then we'd have 3-5hrs awake in the evening.

[jessmum46]

If DS wakes early from his nap and is clearly still tired I fling him straight in the car and drive around for a bit, he will sometimes nod off again which helps with catching up.  You could do same with holding, rocking etc if your DS responds to that.  I always tend to go for the independent settle in bed to begin with though. 

If he's ill you probably up just need to go with the flow a little for now though....

The key to EBT/super EBT is to get LO down before they are OT.  So I have on rare occasions done 5/5.30pm, it worked better with DD than DS I would say but it is definitely worth a shot if you've got a serious OT build-up x

[Gecko2014]

Yeah.... I've tried a few of those things to get a resettle (pram, car, holding, feeding etc) without any luck. It seems that when he is awake, he's awake. Getting the best A window for him to sleep enough without waking seems to help more than trying to resettle.

We are definitely going with the flow at the moment. He is ill, I am ill, the rest of the family are getting ill and as a result LO is resisting feeds as well as waking more than normal. Arrghh!!

Is it ever the case though that some babies need/want a 'go with the flow' approach as their norm? Even before illness this guy seems to  keep switching it up all the time. Not just with developmental changes but every few days. We crack the routine, it works like a charm for maybe 3 days and then we are back to haywire again.

[Gecko2014]

And a related question: spirited babies sometimes go a bit mad when they are tired... or OT?

My little guy has only been up 4h45 just now (where 5h is his normal for the morning) and went crazy during the wind-down for nap routine. I had to scruff him by the shirt to get his nappy changed and hold him down to get his clothes done up because he was trying to flip off the table, giggle and laughing when I pulled him onto his back but then crying when I wouldn't let him flip over again; he then fell off the chair into the side of the change table (which is wooden) and started laughing then head-butted the window sill because he was throwing himself into the back of the chair and goofing around.

A lesser version of this isn't uncommon during the wind-down - he will usually crawl off between the cot and wall, as though he wants me to chase him and romps around on the chair while I'm trying to sit quietly and read him a story. Then.... once I pick him up (sometimes mid-craziness and with a bit of a fight to get into the sleeping bag) he settles into his pre-bed cuddle and chills out ready for bed. It's like a switch from energy 9/10 to energy 2/10 and ready to self-settle.

Today's extra level of crazy follows from the best night sleep he's had in 10 days so.... less tired (presumably) than he has been.

[jessmum46]

That kind of crazy would have been the edges of OT for both of mine, but like yours both have gone from 100 to zero in literally a minute or two so somehow they seem to cope with it!

[Gecko2014]

I find the 100 to zero thing quite bizarre. Good .... but odd.

He may well have been OT the other day from a run of bad nights with illness and such but I ended up with a 2.25h sleep. Which was amazing! We later had a 2hr NW which soured it a bit but... I'm still trying to figure that out.

[jessmum46]

Huh yes you would have thought that a good nap would equal a better night . Still illness lingering?

[Gecko2014]

Yeah... still lingering. We finish up antibiotics tomorrow. His routine and mood seems to be getting back to normal though.

The extended NW is not unusual for LO. Prior to this illness it happened about once a week. Sometimes on good sleep days, some times on average sleep days but never from memory on really really poor sleep days (those days I get 12 continuous hours at night). During this run of illness we had him up for a minimum of 2 hours at night (waking anywhere between 1030 and 3am) 7 of 10 nights.

[Gecko2014]

The alarming trend we seem to have developed during this period of illness is a 6pm EBT most nights (so it's not even early anymore), 2-3 hours awake during the night and then a 7am start to the day. The nap durations are variable and don't seem to be having any bearing on the night stuff - a 2hr sleep or a 1hr sleep doesn't change the NW incidence or duration.

Thinking about this and the likelihood that LO is LSN, he has 13 hours 'night time' where we are either sleeping for trying to get him to sleep. Could it be that the EBT that we have been offering because of the illness and the poor naps (and generally trying to get on top of the OT pattern) are related to the NWing? Could it be that he only wants/needs 10 or 11hrs at night and by starting at 6pm we are setting him up for the NWs? I'm trying to work out where to start in fixing this mess and I'm wondering if I should suck up a few OT settles at BT to get a 7pm BT and see if that helps. Worse case scenario, he'll NW because of the OTness but... we've got that anyway.

Thoughts?

Re: The NW, I think we have some AP going on. My husband has done most of them lately and there is a lot more picking up, cuddling and facilitating sleep than normal. Where we once would do these things, once in a blue moon, and then put him into bed without indent, he is now waking on transfer and the battle starts over again. All of this having been said, I hear him wake at least 2 other times in the night, including when he might sit or stand up, vocalise etc and on these occasions he resettles himself without any intervention. My GP has recommended CC to address the NWs and my husband is keen but, I'd like to exhaust my other options first. 

Any ideas about where to start would be much appreciated.