3 week old not settling for naps/40 min naps and waking every 40 min at night

[jennfullwood]

I would be so thankful for another set of eyes on my baby's sleeping pattern. Hubby and I are absolutely exhausted and I am so stressed and terrified, to be honest. We had major sleep issues with my now 3.5 year old son, despite following baby whisperer routine and I know what a long road ahead I could possibly have if I can't get this correctly early.

Baby girl is 3 weeks old. I'm trying desperately to get her on this routine and have since she was born. First week was great. I was trying to nurse her despite painful latch issues and working with lactation. She was having frequent diarrhea which I was told over and over was "normal" for babies her age. It didn't seem to cause too many sleep issues other than about 12 diarrhea diapers at night. Two weeks in, my breasts were so torn up they thought I had nerve damage - I went to pumping and antibiotics to try to heal. Even pumping became too painful and I lost my milk supply quickly. So we introduced formula and her diarrhea got even worse. She was up for 4 nights straight with painful crying and diarrhea poops. Finally the pediatrician decided to listen and had us switch her formula to soy. Diarrhea has now stopped, but her sleep is left in shambles and I can't find a way to catch her up on sleep. I am thinking all of the sleep issues now are plain OT.

She will barely go down for naps, despite hardly any wake time. I feed her, change her and put her straight back down. Sometimes she will go down for a nap that lasts only 20-40 minutes, but most of the time now, I can't get her down at all. She shows no tired signs...no yawning, no fussiness, no crying...she is a calm happy baby even when overtired apparently. I have tried leaving her up longer and just letting her go to sleep on her own. Yesterday she laid in her bouncer and napper for 3 hours without falling asleep before I finally fed her again and she feel asleep on the bottle and then slept 1 hour before waking. We have tried everything to get her to sleep - even went and bought this expensive swing which she won't sleep in either. If I do manage to get her to sleep in the swing, she still wakes every few minutes.

Nigh times are even worse. I put her down last night at 7pm and she woke at 7:40 and then again 40 min or so after I got her to sleep the second time, which takes forever to get her back down. She continues to wake all night like this between feedings. She will usually have a huge awake period lasting hours at night - last night it was from about 10:00-2:00am. She's been doing this for a straight week now and I can't seem to correct it. The only place she will remotely sleep is the moby wrap which she has been living in pretty much all day when I can't put her down for naps - but this is broken sleep because she doesn't sleep soundly in the wrap. It's just my last resort.

I have a 3.5 year old at home. It is a huge challenge dealing with both of them and trying to time her naps perfectly. I am utterly exhausted. Please...any advice on how to get her caught up? Does this seem like OT? It seems like it has to be...but then there's always the part of my brain which wonders if she just may not need as much sleep as others due to her not ever fussing, crying? Should I leave her up longer? Her wake time usually ends up being over an hour by the time I struggle getting her to sleep...more like 1.5 hours by the time I get her in the moby wrap. Any advice please? Thank you.

[Kellyjs]

Huge hugs, it sounds like you've really had a rough time of it.

I think she may be OT. Newborns can't really handle anything over an hour A time. But I do wonder if there's more issues at play for you here. In any case she should be sleeping longer at night. Waking every sleep cycle to me, sounds like discomfort. Have the doctors checked her over fully? Any reflux? How's she doing on the soy milk now?

I'm going to get more experienced eyes on this fr you too xx

[Buntybear]

Hi - have you asked your doctor about reflux?

Reflux 101 - General reflux information

I am including this link too in case it is useful but this this applies more to mums who need to exclude foods from their diet

Does my LO have food intolerances?

There is a possibility that your LO could have MPI or even MSPI which would mean you would need to change your milk. I didn't bottle feed so I am afraid don't have much knowledge of the mils available but something like Aptamil Pepti?

[lauradj]

Hi there!  Yup, I agree with the above mentioned solutions.  My DS2 had reflux and also couldn't tolerate my breast milk, despite me cutting out dairy so we put him on soy protein formula.  I used Similac and it worked well for my little guy. 
It does sound like your LO is in discomfort.  How is her weight gain?  Have you tried elevating her mattress?  I was also told to lay my DS on his left side as that helps minimize reflux.  You don't know if that's the issue of course but these were all recommendations made to me by my midwives prior to us getting in to see the doctor.  If you choose to lay her on her side, make sure you put a towel roll under the sheet to keep her in place.   

[jennfullwood]

Thank you all for the replies. We have tried every kind of sleeping surface. Right now, we have her mostly in a rock n play, which is elevated and would help with reflux if that is an issue. She doesn't spit up at all though, and my son who did have reflux, would spit up tons. I'm not sure if babies have to spit up to have reflux? She doesn't really seem to be in pain though, except for the occasional gas/burp that gets stuck, but that seems normal to me for little babies. I did speak with a pediatrician who was on call again yesterday and they asked me to bring her in to see if they needed to start reflux meds, so I am going to make an appointment for tomorrow. This was a different pediatrician than we normally see and she asked if baby was hungry. I will admit that I have been controlling her formula ounces a bit because our main pediatrician said I was feeding her the maximum amount that I should be at her 2 week appointment, which was 3 oz every 3 hours (sometimes more often through the night). She made me feel as if I was feeding her too much. She had gained 1 pound up from her birth weight at her 2 week appt, so weight increase was good. So she said not to feed her any more than 3 oz. So when this other pediatrician mentioned that it really got me to thinking and I offered her more formula last night letting her decide when to quit eating. She took 4.5 ounces right before bed and then about 4 ounces each feed through the night. She woke up much less often and made it 3 hours between each feed. She did wake 1 hour after I initially put her down for bed, which maybe is just still this OT from lack of sleep as well. She was very restless and waking a bit from 4:30am-6:50am when she woke for good. I have a really hard time getting her to sleep to 7am, even when feeding around 4:30am. Probably because light sleep cycles in the morning hours and it's hard for her to stay asleep?

She woke at 6:50am this morning and I fed and kept her up a bit. Took her back upstairs at 7:40 to start wind down, but she wouldn't settle. She never yawns usually until after I start wind down, so it's very hard to seen any tired signs. I finally got her settled in the swing and asleep by 8:30am, obviously way too late but she just kept falling asleep and then squirming back awake. I guess I need to keep her awake time even shorter.

So do you ladies thing the feeding could have been contributing to all of these wakings and LONG wakings? I will keep offering more formula as well as keeping her A times even shorter. I keep trying to head closer to the 1 hour mark for A time, but it seems to be too much. I hardly ever am able to get her to settle for a nap and she ends up in the moby wrap, which she sleeps horribly in.

Oh, and she seems much better on the soy formula. We went from about 15-20 diarrhea diapers a day to now around 3-4 firmer poops a day which are all mostly during the day and not night. She doesn't have the discomfort crying that she did before when she pooped, so I feel like the soy was the right move to fix that issue. Took awhile to get the pediatrician to listen and support, but finally was able to get some action on it.

Thanks ladies...any other advice regarding her A times I would greatly appreciate. I'm just not sure how long to keep her A time. Sometimes she would immediately go right back down from feeding after only being awake 20-30 minutes because she still falls asleep on the bottle some. In those situations, should I just put her back to bed or should a rouse her and keep her up for a few more minutes? Every time I've kept her up when she's been falling asleep on the bottle, I've not been able to get her to settle.

[jennfullwood]

And now it's 9am and she just woke up crying in the swing, 30 min after finally falling asleep. OT I am sure this is? I am at loss on how to get her caught back up when she keeps waking and won't sleep through a solid nap.

[jennfullwood]

Sorry for the continual posts, but maybe this will shed some more light....

That last nap he woke up after 30 minutes...at least I thought it was 30 minutes, but it could have been 40.

He woke up and refused to sleep in the moby wrap (I usually use this last resort to extend his naps). Many of his naps I'm for sure he wakes up at the 40 min mark. Since he refused to go back to sleep in the moby wrap, I just messed around with him crying for 30 minutes (I thought it was tired crying) but I fed him at 10:00 and put him directly back down to sleep. He really had no problem going down I'm sure because of the feed, but could also be because of a longer A time? He is still asleep and it's he's going on 1.5 hour nap. I haven't had this happen in days. So when he woke up from his first 30-40 min nap, he had A time of 1 hour 15 minutes before he was back asleep. He hasn't woken at his normal 30-40 mark (sometimes it's hard to tell when newborn actually falls asleep if they are suckling at the binky).

So now I'm wondering if his resisting and not settling at naptime could actually be UT? It's almost ridiculous to think about with everything else happening, but I have to wonder. Could his waking at 40 minutes after being put to bed be UT as well? Many times I put him to bed with a very short A time thinking he is so overtired that it may help. Am I just working against her trying to force sleep when she's not quite tired enough? Again, she doesn't get fussy or yawn before the 1 hour A mark...

My brain is so tired from thinking this all through. I did these calculations for 3 years with my son, and it's about to drive me crazy. A times are very difficult to figure out and what seems obvious is not always right I have learned. :/ Any thoughts with this extra bit of info?

[Kellyjs]

Yes, quite definitely it could be UT for the first couple of naps then leading to OT by the end of the day. It's what we call an UT/OT loop and it sucks! I was wary of pushing A times as I do think OT is at play by the end of the day, but the fact he's waking every sleep cycle at night leads me think of discomfort and if that is the case whatever we do to his routine may not work as he wakes at the end of a sleep cycle because he's uncomfortable yk?

Waking 40mins after BT could be the discomfort I mentioned or actually more likely to be OT. I hate OT before BT it makes for a rubbish night sleep and EW too sometimes. All we can do at this age is follow a rough easy plan, watch out for their cues and see what happens. It is such early days for any predictability to happen, you may not remember from last time 

Ok, so this long nap was in his bed then? Could you write out the days easy for me to see? It's so much easier to read that way thanks xx

[jennfullwood]

Thanks to all. I see that in my sleep deprived state I keep referencing my baby as a "he" when in reality it is a "she"! I'm not used to having a girl yet and do that often. 

Buntybear -  thanks for those links. I see that reflux does not have to have a spitting up symptom. That is still bugging me wondering if this could be an issue. I have an appt for her tomorrow at ped's office to check for reflux or any other issues.

Kellyjs - So the waking every 40 minutes did not happen last night like it has been happening the rest of the week, so that was encouraging, although we still had lots of wakings. Last night she woke about an hour after being put down for bed and I think once more and then slept until her usual feeding time around 10:30. I haven't worked out doing the dream feed yet because she's too sleepy usually, but this feed right now is around our bedtime anyway. She pretty much woke up every 3 hours last night with the random waking in between but wasn't awake for long stretches like usual. Once 4:30am came, she woke often and was very restless until 6:50am when she was crying and awake for good. OT I assume in these early morning hours. The only difference last night was I allowed her to take more formula per the advice of a different pediatrician I spoke to on call (my normal ped advised me to limit her formula intake, so I had been only allowing 3 oz a feed). She took about 4oz at each feed last night. I guess the other difference is that I think she did get more daytime sleep yesterday and also had a sleep very close to bedtime which probably helped counter some of the extreme OT, but obviously, was still OT.

I'll try to post EASY from today, but it's all over the place right now. I will say that today has been quite a bit better though. I'm actually still leaning towards OT now for those beginning naps as well even though many of them are 40 min naps (or could be 30 - 35? Hard to tell sometimes), especially because she was so restless and waking in the early morning hours. That first A time I probably need to keep very short because of her crummy nights right now.

Here goes today's EASY c #olz@< wqSAzso far:

Wake - 6:50am (restless and waking often since 4:30am)
E - 7:00am
A- 7:30-7:40 (took her to wind down at 7:40 but would not settle. Finally got her to settle down in the swing after several tries at 8:30am)
S - 8:30-9:00am (woke after 30/40 minutes and could not resettle. Tried to put her in moby wrap. Slept a little bit then got fussy because of hunger I think and wouldn't sleep anymore.  At 9:45am I started to feed her but she fell asleep after only 1.5 ounces and I put her in her bed. She woke just a few minutes later and I finished her entire feeding at 10am)
E - 10:00am
A - none (put her straight down as she was asleep on the bottle)
S - 10:15am-12:05 - this long nap WAS in her rock n play bed - almost 2 hours!!! I guess A time here was shorter bc I had her asleep in Moby wrap partially and lead to a good nap)
E - 12:15
A-12:15-1:05 (too long A - would not settle. Finally settled at 1:40pm)
S-1:40pm-2:15 (woke after 35 min and tried to resettle (almost!) but she kept waking back up hungry I think as it was close to feed time)
E - 3:00pm
A - NONE (very sleepy, fell asleep on bottle so I put her right down to sleep in her bed)
S- 3:30-currently still sleeping almost at 2 hour mark  (this nap was long bc of very short A time I assume)


So it seems it's probably all OT I guess. Writing it out legibly really helps to see the patterns. Gotta keep those A times short, does that seem correct?

So what do I do when she wakes early (before 7am)? Do I just start the day at that time and do the cycles as best I can from there? Bedtime is all wonky and at a different time each night. I never know how to make this work into bedtime. And it makes the feeds wonky too.

And what do I do if she takes a short nap?? If it's still an hour until feeding time, what do I do with her? She would become OT if I left her up till feeding, but wouldn't nap because she would be hungry? I just get lost on what to do in these cases.

Yes, I know there is no predictability at this stage! I have to remember that, so thank you. But my son worked EASY almost flawlessly for the first 3 months until we started having some issues, so I was selfishly hoping she would do the same. 

Thank you for all the extra eyes on our routine.

[lauradj]

Ha!  If there is one thing I have learned, it's that no two babies are the same.  Our first was a total angel baby and our second, while textbook, had pretty bad reflux so it really caused havoc the first 8 months of his life.  Today I was daring and had our carpets and couches professionally cleaned.
I am actually shocked that your paediatrician told you to limit your baby's formula amount.  I would definitely discourage you from limiting your baby's food intake.  She will know when she's full.  Just use the slowest/small hole size nipple you can find and otherwise, I'd let her go for it.  Regarding A times, newborns really cannot handle anything more substantial than an hour, eyes open to eyes shut, so I'd recommend pulling those A times back a bit.
If my LO woke before it was time to eat I just did EAEAS but VERY minimal.  I'd get DS2 up, do some thoughtful wall gazing whilst singing a song, then offer food, than more thoughtful staring with brother providing stimulating entertainment and then back to bed. 

[jennfullwood]

Thank you Lauradj. Can you clarify what you mean when baby wakes early from nap - you said you did EAEAS. Why two sets of EA? If they woke early from nap, you fed and had A time and then fed and a very small A time right before bed just so you weren't feeding to sleep? Is that correct?

So I took baby girl to pediatrician today and they decided to take her off soy formula and put on hypoallergenic formula. I had noticed the past few days on the soy her poop continued to get thicker and she started having stomach pain when pooping again. She woke up twice last night that I knew were because of stomach pain followed by poop, so now she's constipated on the soy. She has also started crying lots more in general and I didn't know if it was because she was in pain or if it was because of tiredness. Dr. said her gut is so inflamed and she's so uncomfortable, she just can't get calm enough to sleep. She said that's why I've been having such a hard time catching up on the OT.

So I am praying this new formula will help turn things around, as expensive as it is. I'll update after a few days if I can tell a difference.

[lauradj]

Oh the poor little love, it sounds like your doctor is on it so that's a huge relief!  I hope the hypoallergenic formula helps.
Yes, if my LO's woke early from their nap I offered milk because that's the order they're expecting but it was typically refused.  I would do A time, feed when they were expecting to be fed and some very minimally stimulating activity before putting them to bed.  Does that make sense.  I should mention between the reflux and genetics, neither of my LO's were/are very big so I offered them milk whenever it made sense to.     

[Buntybear]

Hi - i hope the new formula works for you - if it does then it would say to me that she has MSPI so you will need to watch for this when you wean too xx

[jennfullwood]

Hi ladies, just wanted to update where we are.

So we started on Alimentum formula two days ago and her constipation immediately cleared up and now we have normal painless poops again. Thank goodness. She also seems to generally be more calm and happy. So I'm relieved that part is sorted out for now.

Her night sleep has been much better. Last night she ate and went to bed at 8:00pm, woke at 11:30pm, 3:00am, 5:00am (pooped but had to feed to get back to sleep but would only take 2 oz.) and then woke for good at 7:00am. She went right back to sleep after each feeding, so a big improvement from where we were before.

I'm still at loss for her daytime naps though. I'm concerned she might not begin to stretch her feedings at night if I can't get her daytime sleep sorted out. I feel like I'm aiming at a moving target and missing every time. 

I have yet to be able to get her down for her initial morning nap. I have tried way short A times (feeding, changing and putting straight back to bed, which is about 35 minutes), the normal A time as in the book for newborns 50-60 minutes and starting wind down at about 45 minutes, and I've tried longer A times which never work of course. I just can't figure this baby out. She shows absolutely no tired signs before I take her to her room. She will offer a yawn, but only after I start the wind down and I'm not sure that counts. Could sneezing be a tired sign in newborns? She does sneeze.

This morning we got her up at 7 and I fed her milk and she seemed so tired. She was acting like she wanted to fall asleep as I was burping her. She didn't really seem alert, so I thought that I might should just put her back down to sleep. I tried this, but then she just wouldn't go to sleep. By then she was more alert and just laid in her bed for 30 minutes without crying. She rarely cries. She just stared at the wall. I finally went up and got her and brought her downstairs for a few minutes and then took her back up to try again. By this time she was really tired I could tell, but just laid in her bed sucking crazily on her paci and couldn't get to sleep. I left her there for about 15 minutes and she never cried unless paci fell out, just sucked. Finally got her up to put her in moby wrap just to get her some kind of rest - she immediately falls asleep in the wrap.

So I'm guessing I tried putting her down too early (even though she acted like she was falling asleep burping) and then I missed her window and she got overtired. She will be 4 weeks old on Tuesday. I'm going to stop trying to put her down early and just stick with the one hour of A time for age and make sure to start wind down at 45 minutes. Does this sound like the right thing to do?

Also, if I can't get her down and she ends up in the moby wrap for an hour of unsettled sleep, I usually will leave her in moby until next feeding, feed her and then put her straight down. Sometimes I can then get a longer nap doing this. I am assuming if she has a crappy nap or really short nap, that A time needs to be cut short, is this correct?

It's so hard to tell with her with no tired signs. Maybe as she gets older she will show more tired signs or at least fussiness when she starts getting tired. I am thankful she is not a screamer though - she very rarely cries. Usually only when she's hungry.

Any advice on any of this? Thanks again for reading and offering your help. I so much appreciate it.

[jennfullwood]

Well ladies, I am about at the end of my rope.

LO started reacting to the Alimentum formula and now peds have started her on EleCare which is just like Neocate. She still has diarrhea after 2 days on it, although much less often. So frequency has improved, just not the diarrhea. I am at loss of what to do...we just have so many issues going on. Her nights are still kind of okay. She woke every 3 hours last night with one random waking at 2:45 that we couldn't get her back down for and ended up feeding her 30 minutes early to get her back to sleep. She did wake 40 min after being put down which was OT from the day of crappy naps and woke early at 6:45 am.

I still have not been successful getting her down for naps without waking. This is killing me because I know she needs lots more rest. Yesterday was one 30 min nap and 2 naps at 40 min - the rest of her sleep was on me in the moby wrap after her early wakings. Other times I simply cannot get her down for a nap. I feel that I'm missing her window and she's OT, but I'm not leaving her up for more than 45 minutes before starting wind down.  It takes me 30 minutes just to feed her. Again, no tired signs. She does start sneezing around the time I begin to start wind down...perhaps sneezing it already OT. She doesn't yawn until after I start wind down. Maybe I should literally feed and put her straight back down several cycles in a row.

I may go ahead and start posting in the nap thread.