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.

[jessmum46]

How have naps been?  But yes putting him to bed too early and expecting too long of a night from him could cause issues.  Has he ever done longer than an 11h night in terms of total sleep, not counting NWs?

You know we don't support CC, GPs just aren't often aware there are other more gentle and respectful ways to sleep train so just because a medic has suggested it I think it's important your DH doesn't see that as the only or 'best' way.  Trust your instinct on that x

[Gecko2014]

We are in agreement on the CC. LO is fairly sensitive so it will be the absolute last resort for us. And I have told DH that we aren't launching into just because someone he trusted recommended it - I want to him to read about it and then decide for himself if it really the way he wants to go. I suspect it won't be.

I have had 12h and 12.5 nights from LO but these have been rare. They followed really poor nap days and one of them was when we were on holiday and room-sharing (I'm not sure if that made any difference or not). 

I got 8hrs before the NW last night followed by a noisy self settle at 230 then a feed and self settle at 330. Considering the fortnight we have been having, that was awesome.

[jessmum46]

Glad you got a better night

You could show DH the CC/CIO links here if it would help, there are some good summaries of the evidence and also some personal stories.  I think we would all say here that it shouldn't even be the last resort, it should be 'no resort' yk?  If a more respectful sleep training method isn't working with absolute consistency, then there is probably something else going on ie wrong routine or illness/discomfort.  And CC will never fix either of those things.

[Gecko2014]

I'm not sure I totally agree. I get where you are coming from but I think there is a fine line here between discouraging CC (in favour of the gentler options) and being judgmental about it. I'm not suggesting that you are doing the latter but it could easily come across that way if we start talking like this. I know plenty of families, who hold gentle parenting practises dear, but who have leant towards CC-type methods when sleep issues were impacting on the marriage, parent-child bond, ability to work and mental health needs of the family. I don't think it's fair to say that it isn't or shouldn't have been an option. I agree that decisions should be informed, by a number reputable sources, but at the end of the day, with the child's best interest at the core of the decision, only the family involved can decide what is on the table and what isn't. I wasn't going to comment but it seemed disingenuous for me to keep chatting and ignore it.

All this having been said, it's currently off the table for us. We seem to be returning to our status quo. Sleep has improved but we are back to being fairly erratic one day to the next. We are fairly set on the 1-nap routine and the 6:30 BT. What seems to vary is when I get the WU (an NW or an EW) and whether we get a resettle as to how the day unfolds. Nothing that that needs to change with any urgency but I would like to nudge it towards a more sustainable routine.

[jessmum46]

I apologise if my comments appeared judgemental, that was not my intention.  Of course every family must make the decision that is right for them.  However the core BW ethos (and this is a BW forum) does not support CC and that's what I was referring to when I said "we would all say HERE".  Tracy when she was with us asked us specifically not to debate this issue so I would ask we leave it here with the clear understanding that CC or similar methods are not compatible with the BW philosophy.  An individual family's decision is of course their own.

I'm glad things are generally improved for you x

[weaver]

Just to agree that Katherine is simply telling you the policy here at BW.  We do not support CC *at all*, *ever*.  Your GP might not be up to speed on the latest research.. have a look here...
Research on why 'cry it out' and 'controlled crying' is NOT recommended!

The main reason we don't support it that the heart of BW is listening to your baby and responding appropriately - not deciding to listen in 5 or 10 minutes time, which is what CC is.

We'll happily support and advise on BW methods though

[Gecko2014]

This is both where we agree and where I think the issue gets murky. I'm not going to debate whether its good or harmful or effective or whatever but I am going to share how I viewed some CC in the context of Tracy's recommendations. Used kindly, where you do listen and do respond to your baby, I don't think they are poles apart.

When I first read Tracy's books (with my first, grumpy baby), I had a hard time working out what was responding, what was rescuing and what was straight out interfering. He could fuss for a long time before going to sleep but it rarely escalated from fussing and if I went in during this time, he became much more unhappy than if I left him to it. Put simply, if he was allowed to fuss, he went to sleep much faster with much less crying, particularly distressed crying, than if I tried to shh-pat etc. *Sometimes* when he was fussing, I used a timer or clock to stop myself from going into him, to remind myself that he was okay settling himself in his own way and what felt like forever was actually only 3 minutes. I was listening but I was also checking myself with the clock and once I got to know that he would escalate a particular time before settling to sleep, I watched for this too. I think blindly leaving your LO and only going in when the time clicks to 5 minutes or whatever is quite different to waiting, watching and listening. I'm not convinced that this isn't compatible with the respect for our babies that Tracy imparts. This is exactly why I like this method, because it respects our babies, their personalities and their moods, as well as appreciating the reality that babies live in families where everyone else has needs as well (and thus, for example, baby cannot held to sleep all night every night).

[jessmum46]

In that case you have described it sounds like a mantra cry - What’s a mantra cry? and we and Tracy would entirely agree with you that a baby who is not distressed but rather fussing/mantra crying can of course be left to it Watching, waiting and listening is what Tracy would have advised too - S.L.O.W. down (and Appreciate your Baby's Language). The key being where cries escalate to more than a fuss/mantra and become a distressed or 'I need you' cry, that is responded to immediately regardless of the clock.  That is entirely different from what is meant by CC where the clock, not baby would determine your response and cries would be ignored up until the designated time limit, whatever the type of cry.  What you described in your post above is entirely compatible with BW

[Gecko2014]

I'm glad about that. If it was in fact a mantra, it could go on for a while. My understanding of mantra, from the book, was that it was more brief and usually at the end of the settling period right before sleep. Either way, this is how my DS1 liked to go to sleep and going in because I wanted to help him only mad him cross. This is where I lent on Tracey's work to respect him and listen to his needs, not mine. Now at almost 4, he likes to have me lay with him before sleep so, its all swings and round-a-bouts.

The significant experience for me in the context of CC however, was when my sister in law visited and, observing me allowing him to fuss as I described, told me that what I was doing was, in fact CC. I was horrified and assured her that it was not. Then I thought about it some more and wondered if we are splitting hairs a bit. Some parents are happy to let their LOs cry or fuss a bit while going to sleep, some are not happy with any crying. And I'm guess that most parents who are, even if they use a CC method, will go in if their child is distressed. Even if the strict technique says 10mins, most of us would only sit out the time if it was a fuss or tired cry, rather than a call for help. The CIO method I understand is a bit different in this regard and I also understand that you can do CC while staying in the room (in a chair or with your back to cots etc) and providing verbal reassurance. With some many variations around, I am wary to say that all CC or all versions are problematic. If we were to listen to our GP and use the CC times as a guide, it would always be vetoed by distressed cry. That, for me, is a no-brainer.

[jessmum46]

I think we are on the same page with always attending to a distressed cry

[Gecko2014]

Getting back to our current issue my LO is sick again after about 7 days well. We are back to going with the flow until he is well but I did get to make some observations in the meantime. Our days go one of 3 ways:
1. We wakes up between 4 and 5am, feeds and goes back to sleep until 6-7am, we then do one nap around 11:30/12 and bed at 6:30
2. He wakes after 5 and despite having a feed and going back to bed doesn't usually resettle. If I'm out in the car or pram he will pass out around 900/930 for anything between 15 and 60 minutes and then go down for his nap in bed around 3 hours later. BT is based on when he woke up from the nap and how much nap time he got through out the day but is always between 6 and 7pm
3. He wakes early as per (2) but doesn't CN early in the day, can't make it until 11:30 for a 1 nap day and has an early nap around 1030 or thereabouts. I can't get a second nap in the afternoon and we can end up with a really long afternoon stretch if the nap wasn't a long one.This can also happen if he wakes closer to 6am than 7am as per (1).

I have tried anchoring the nap time to 11:30, regardless of wake time but this doesn't seem to help with getting consistency or with getting a good nap each day. Even with a similar wake time and similar nap time, he will oscillate between a good 2hr nap and 1h15 or less. There doesn't seem to be any relationship with how the night goes either. Some days a bad night will increases the change of a 2h nap but generally the normal fluctuations are just as likely.

There isn't a pattern between 1, 2 and 3. It's not although a late to bed night leads to an early wake or bad nap days. They seem to rotate at random.

So my questions is this: Is it worth continuing to try and tweak the routine until we get a nice rhythm that works for him and wards off OT most of the time, or is it time to accept that my LO likes to go with the flow and bit more? I understand that if we go with the flow we will have more accidental naps in the car and pram and less consistently in bed and we could have OT bedtimes more often. Doing that to him doesn't seem fair but nor does making him conform to a routine just because I would like one.

What are your thoughts?

[jessmum46]

It sounds a lot like where we've been to be honest, still an inevitable side effect of the 2-1.  Things are settling here but we still get the odd rubbish nap or random catnap, but much better than where we were a month or two ago.  I'd be tempted to keep your 11.30/12 nap whatever really, if he really really can't make it then let him have even 5 mins around 10.30 to get him through.  A nap that early in the day you just can't let him sleep on if afternoon nap is a no-go, you'd be better to deliberately cap it very short and try for a second 'proper' nap a bit later at a time that will get you to a reasonable BT. 

That said, if go with the flow suits both of you right now that's fine too, there isn't a right or wrong here

[Gecko2014]

So... maybe we just need to ride it out until the 2->1 transition shakes down?

Going with the flow doesn't really suit me but I'm getting a bit exasperated trying to make a routine work when I feel so much resistance to it. I was just considering letting him snooze whenever for a while, so I'm not trying so hard. If that outcome is going to be rubbish naps either way, the effort doesn't really seem worth it.

I'm particularly frazzled today. We are over the worst of the current illness but have had 2h NWs for the last 2 nights. Last night he was up from around 3 until 5, just wanting to play. He was going bananas when we left the room after giving the sleep cues and stopping instantly when we went back, flapping, giggling etc. He then slept until 8am but I still put him down at 12. He had a 30 minute nap and I'm fairly sure that will be it for the day now. He will almost certainly be OT by bedtime.

[jessmum46]

Go for an early BT, if you keep the day to a short length say 11.5h or so it should be ok x

[Gecko2014]

I did a 6pm BT and he slept for 11.5hrs without a sound. Amazing for him (not so great for us because DS1 was up sick).

[jessmum46]

Isn't that always the way?  Glad you got a good night though x

[Gecko2014]

Indeed!

Would you say, as a generally rule, LOs day is 12 hours? e.g. if they rise at 630 you work on a 630 BT, give or take a bit for significant deviations to the daytime naps. Or, is there a fair bit of variability between babies?

[jessmum46]

I think there's quite a bit of variability.  DD I worked predominantly on a 12h day, DS is more like 13h or he just ends up waking earlier as 11h is a fairly standard night for him.  I do a shorter day if his nap is significantly shorter than usual, but in general stick to the longer day as it seems to work better for him.