5mo: crying after/during sleep

[Apple001]

Hi all,

I'm not sure if I need to start a new topic or continue with the previous one: 4mo: 3.5-hour or 4-hour EASY?!

After the pediatrician told us to remove the night feedings and we succeeded to remove one of them. She had one feeding around 2-3am.  Then something happened and she started waking up around 10-11pm. During the first nights she would talk to herself and fall asleep on her own. But lately after "talking to herself" she starts crying/screaming. The only way I am able to calm her down is by feeding her (but sometimes she doesn't even want to feed). Of course I would feed her on demand later during the night. Then this screaming/crying started happening with every night feeding and today it started to happen during the naps too: 30-40 minutes into the nap she would wake up, smile, "talk" and then all of sudden she starts crying.
At first we thought the problem is sleeping on her tummy: during the night she would roll to her tummy, and when she wakes up she lifts her head up and can't go to sleep [she can't roll to her back]. We started rolling her to her back during her sleep, but she would wake up crying. So now she is sleeping with two rolls of swaddles by her side - but they do not help much.

Now when this "crying" transitioned to her naps, I'm not sure what to do. During the night I will feed her and she sleeps, but during the day she will not fall asleep afterwards and her EASY becomes 2-2.5 hour easy.
I tried shush/pat and it doesn't work since she is too hysterical at that point.
I tried PU/PD, but it will take me some time to calm her down even in my arms (around 20 minutes) and then as soon as put her horizontally (even in my arms) she will start crying.

I'm not sure what to do. Should I continue with PU/PD during the day and feed her on demand during the night?

Our day EASY is the same:
E 7:00 +/- 30 mins depending how close the last night feed was
A
S 9-10:00

E 10:30
A
S 12:30-2pm

E 2pm
A
S 4:15-5pm

E 5:15pm
A
Bath 7:30pm
E 7:45 pm
Bedtime 8pm

Night wakings/feedings before: 2-3am
Night wakings/feedings now: 11pm (+/- 30 mins), 3am, 6am.  (I usually try to limit the last night feed by 1-2 minutes. Sometimes it is not enough for her and she feeds for 3-5 minutes).

[Apple001]

Just a small update:
DD woke up 4 times today at night: 11pm. 2:30am, 4:40am, 5:40am! All 4 times I couldn't calm her any other way than feeding her. She didn't even feed that much when she was a newborn.

I hope it is just a growth spurt and it's going to be over without our "new" habits.

[*Ali*]

It could be discomfort?  How is her reflux/spitting up now?

I think her routine probably also needs a tweak. The first A times of the day could probably do with a push by 15 mins or so to get a longer first nap.  And her last A time is likely way too long,  especially after just a short CN. She is probably really OT at BT from that 3hr A time.

[Apple001]

Ali, thank for your reply.

I also thought about discomfort from reflux, but she doesn't spit up much: maybe once after a day feed. Her bed is dry and no spots, so no spitting up at night.
I also checked her gums for signs of teething, but everything looks normal.
Are there any other discomforts possible?

Sometimes her first A time gets increased, but her nap time is still the same. Before sometimes  I could extend it using shush pat, but not anymore.

Regarding the bedtime, when do you think it is reasonable to start the routine? If I do it earlier, will her wake up time change? She used to nap for 20-30 minutes between 6-7pm, but not anymore.


Currently it is midnight here and she already had two NF at 10:20 and 11:40pm.

[*Ali*]

I'd work on pushing the naps she has later rather than making BT earlier. She is likely moving towards dropping to 2 naps rather than needing 4 so I'd forget the 6pm one. Making the existing naps later should just help to spread the A time a tad more evenly over the day and avoid that very long A time before bed.

Reflux pain from the acid doesn't have to equal spitting up. She could be experiencing heartburn type burning from the acid coming up her throat without actually bringing anything up. Check our reflux board for more info. Reflux 101 - General reflux information

[Apple001]

*Ali*, the problem with naps that if I don't pick her up instantly after her nap and try to extend it, she will start crying. I read somewhere here about "not letting her wake up" technique by holding her arms in the right moment. Maybe I should try that.

I also noticed that:
- she stopped taking a pacifier: she will take it to fall asleep but during the night she will refuse it. But she refuses everything right now.
- her day feeding times increased up to 5-6 minutes (they used to be 3-4 minutes). <--- Is it possible that my milk has changed? Or is it just a growth spurt? Or is it just a consequence of re-appeared reflux? I think her feeding times became 3-4 minutes when her spit-ups went away.

Thank you for the link. It sounds like she has a reflux (symptoms: colic, frequent night wakings, pain when lying down, refusing to feed, arching back, ...). But I thought she doesn't have it anymore since the spit-ups ended - everything was normal for a couple of months. Maybe we should call the doctor again.

[*Ali*]

Yes you could try to catch her while she is still sleepy and see if it helps extend naps.

Feeds change all the time. It could be that her belly is bigger and she can take bigger feeds now she has grown. Or as you say could be a GS.

[Apple001]

Hi Ali, I was able to extend her first nap, but she didn't have her third nap (even the car ride didn't help), which caused a 4-hour A time. Below is our EASY for today:

WU/E: 7:30am
A
S 9:50-11:30am

E 11:30am
A
S 1:40-2:15, 2:30-3:30

E 3:30
A
no sleep

E 7pm
A
BD 7:45

[*Ali*]

Have you tried an earlier BT if she doesn't CN?

I'd keep pushing the first two A times towards 2.5hrs.

[Apple001]

Hi Ali,

Thank you for your reply again!
I didn't try to do an earlier BT that day because at first I thought she will be napping and I was working on that, then I needed to run an errand, so I took her with me (she usually sleeps in the car, but that didn't help.)

Regarding longer A-times: she doesn't do more than 2 hours especially in the morning. She usually starts shows the signs at 1:45min mark and then I start "calm-down" routine. I can try to extend it, but it means I need to carry her around during that time.

The second day went perfectly: 2 naps of 1.5 hours and a catnap. After that I noticed that she stopped crying and screaming at night when she wakes up. She finally was taking a pacifier!!! So it seems that discomfort went away (or was it a routine issue?)

The third day: one good nap of 1.5 hours and 2 catnaps of 40 minutes. We spent almost the whole day outside on the beach (because it's too hot to stay indoors - we don't have AC) and she is not a good napper outside of the house.

During all these 3 days DD was able to keep up with a 4-hour feeding routine (with exception of the last feeding after a catnap) with a solid 5-6minutes per feeding. But at night she still asks every 3 hours (11pm, 2am and 5am). It seems like she switched day and night feedings. Before she could go 5 hours after a BT-feed (till 1-2am). I guess it would take time to re-adjust to "normal".

[*Ali*]

If her wakings are always 3hrly it sounds like she may be waking at the end of the sleep cycle rather than transitioning to the next one. That is normally because of either discomfort or prop issues. True hunger wakings are more likely to be at irregular intervals I find.

So it could be that she needs to milk to soothe the burning from relux or it could be that she just hasn't learnt to fall asleep without your help. She likely does need some night feeds but I don't think it is all down to hunger.

[Apple001]

Hi Ali,

I was thinking about your comment regarding her wakings, she seems to be hungry and she won't settle unless I BF her (before I could give her a Pacifier and she would sleep).
She can fall back on her own, but most of the time she needs a Pacifier. But recently she started pulling it out and playing with it, so it doesn't help as much as it used too.  Below our last 5 nights:

Night 1: BF for BT at 7:45, then NF 11pm, 2:15am, 5:25am, WU/E 6:45am
Night 2: BF for BT at 7:45, then NF 10:25pm, 2am, WU/E 6:35am                   <- I was so happy with this night.
Night 3: BF for BT at 7:45, then NF 11pm, 2:35am, 5:25am, WU/E 7:25am
Night 4: BF for BT at 7:40, then NF 11:10pm, 2:15am, then I tried to give her a pacifier at 4:35 instead of BF, she woke up and didn't sleep at least till 5:40am. I BF her at 5:25 (I was hoping she would go to sleep, but it didn't help.) WU/E at 7:20am.
Night 5: BF at 6:20pm, BT at 7:50pm (no BF), then NF 10:40pm, 2:25am, 5:10am, WU/E 6:45am.

Do her NF seem to be regular?

Another issue: her crib is right next to mine (like a co-sleeper) for an easy BF. I thought about moving her crib as soon as she is down to only one NF. But lately I'm thinking that I probably react to her every move. Another problem is that I couldn't move her crib far (it will stay in our room, but in a different corner), so I would still be able to hear her and BFing would be a little problematic (because I would need to pick her up, BF her on my bed and then put her back to her crib).

Will moving her crib help with NW?

[*Ali*]

They do seem very regular yes.

Moving her away will only help if you make a decision not to feed her at every waking and stick with it I would think. I'm not sure how it would help on its own if you are still in the same room as she will still hear you I'm guessing.

What actually happens when she wakes? Is she crying straight away or does she lie there chatting for example? Are you getting her up to feed her when she cries or to get her back to sleep?

[Apple001]

Just to add a couple of more nights:
Night 6: BF at 6pm, BT at 7:50pm (no BF), NF 9:25pm, 12:10am, 3:35am, WU/E 6:30am
Night 7: BF for BT at 7:40pm, NF 12:00am, 2:40am, 5:10am, WU/E 7am

She doesn't usually wake up to the full alert state. (Before she did wake up several times to the full alert state, but she would chat and fall asleep on her own). She usually starts moving around and fussing while she is still asleep. (Should I wait till she is fully awake?)
I first use shush-pat, then I try to give her a paci (before just these two steps would be enough), but now she refuses the paci (most of the time) and she would start crying. Then the only option is to feed her. I tried PU/PD at this stage but it won't help.

My DH and I are thinking about me leaving after 2am feed (I will go to sleep into the living room). We did that when she had 2 night feedings (1-2am and 5am), and we managed to drop the 5am feeding. But then her "crying" sessions started as well as the constant feeding at night.
 

[*Ali*]

What are your views on the reflux? If you are in doubt as to whether she is uncomfortable from that then I wouldn't do any sleeo training/active weaning if NFs , especially not PUPD.

At NWs I'd definitely wait until she is doing an I-need-you cry rather than fussing in her sleep before you get her up. Would it help to lay your hands on her chest at all do you think?