Hi there
I've just read through your posts here and on your BF thread to see if I could get an idea of what's going on for you.
I see on the BF thread you said she has reflux and is medicated. Although you had the meds checked for dose quite recently it could well be that these meds are not helping her enough and it is highly likely you need to go back to your doctor and ask about alternatives or to be referred to a higher health professional (sorry, I don't know how things work where you are, here I'd ask my doc for a referral to a paediatrician). Ranitidine is not the only medication available for reflux and there are many LOs who need other meds.
When you take into account that her day routine and ability to self settle are all good, that she eats well in the day and so on, it really does point to a discomfort problem at night. Night is a very long time to go in pain. Whilst she might happily go down for a 1.5hr- 2hr nap and cope with laying down and staying asleep for that length of time that might be the maximum length of time she can really stay laying down before the discomfort overwhelms her, it would make sense that she is up SO frequently at night.
The other aspect is that refluxers can find comfort in suckling and swallowing, milk helps to neutralise the acid and the swallowing action can help to take the acid back down. This would make sense with the number of feeds she needs at night.
Silent reflux gives all the discomfort without much (or any) spitting up. Mine had silent reflux, the difference on meds was unbelievable.
I really do advise seeking further help from a medical professional.
I also advise, if you don't already have them, to look for a cot wedge and cot blocks to elevate her sleeping, make sure they are health checked for safety.
I see she is a side sleeper - laying her on her left side is preferable as this works to keep acid down (it's to do with the shape of the tube etc) whilst on her right may allow more acid up.
As she has reflux I would not recommend PUPD. The action of too many PUPDs is like shaking a pop bottle and can cause more pain. I only once did a very short PUPD with my silent refluxer, he was totally independent sleeper but it was his transition from hammock to cot which caused a disturbance. I kept the PU level and low so his body position changed very very little and he calmed with my lift. I placed him back gently, he'd cry, I picked him again, each time I only lifted about 5 cm from the mattress to hugely reduce the amount of movement and so as not to aggravate the reflux. It was super hard work on my back leaning over the cot like that but I knew two things 1. he was not suffering a reflux flare up and was on a good level of meds for him, 2. that his inability to sleep was purely due to the hammock/cot transition and he needed some reassurance.
I'm mentioning this in case you ever find you need to do similar but I don't advise this to solve your current night wakes because it is not a matter of a recent easily identifiable temporary problem.
OK, reflux aside, a few things you might want to rule out:
- does the temperature change much at night, is she getting too cold? too hot?
- can she roll to reposition herself when she needs to (to prevent the discomfort of being still all night)?
- is there anything different about her sleeping arrangements between nap time and night sleep?
- are there any noises at night which might be disturbing her (such as traffic noise which might blend with general 'life' noise for naps but which might seem loud at night)?
- is there a chance she can here you during a nap (TV, radio, you chatting) which is missing during the night?
- are her bed clothes comfortable?
You don't need to answer all these, but do give each careful consideration and maybe investigate further. Tracy taught us to look at the bigger picture, sleep disturbance is not always about routine and props. And if it is "no" to all those things then I'd go back to the reflux issue.
hugs, you must all be exhausted with being up so often at night xx You'll get through it, you will.
Edited to add: I would skip the evening meal for now. You just don't need anything near bed time which could throw a question into the works about gas, intolerance or digestion. I would offer breakfast, 1 hr after milk, and lunch 1 hour after milk (roughly, the times are not crucial), be sure to offer water along with solids and offer a top up BF straight after solids if she is interested. she does not need to be eating a lot of solids, just tastes on those 2 meal times. hth x
