Sudden NWs: To feed or not to feed? (and other questions)

[katerinask]

Our LO is 4m 3wks old and has been an excellent sleeper until now. She has slept through the night (approx 8:30-8:00 with a DF at 11) since 2 1/2 months, up until last week that is. Over the last few days she has had 1 or 2 NW per night, for which we have kind of improvised each time, depending on what we thought was wrong. Some nights it seemed to be her tummy (she has slowly started fruit purees), others hunger (so I BF'd her) and other times she just needed help getting back to sleep.

A few weeks ago we saw some very major changes with her sleep, like much more pronounced sleep cycles, some disaster naps, resistance to naps and BT, but things seemed to get better on those fronts. So we thought, hey, we must have escaped the 4m regression relatively unharmed! But now the NWs are making us think that those problems were just the beginning of the regression period.

Here are my questions:

- Could THIS be the actual 4m regression? If we assume the earlier nap issues were also part of the same thing, is it normal for the regression to last this long (i.e. 2-3 weeks)?
- How do you treat the night wakings without creating any problems for the future?
- I find it really difficult to know if she is hungry or not... Generally speaking she has NEVER refused the breast and usually has quite a lot as well, so I'm not sure whether that is an indication of her hunger, or if it's just her usual big appetite?
- She seems to find it difficult to fall back to sleep on her own at BT and NWs. We don't hold her, just reassure and shhhush her while she's in her cot. I'm wondering whether we should keep doing that, or whether it's reinforcing the idea that she can only get to sleep when we are with her? How could you train her to fall asleep on her own, without deserting her and creating trust issues? Or is it just normal for us to have to be with her until she falls asleep at this age?

Any help for this confused first time mum would be much appreciated

[trimbler]

Hi there, you could certainly still be in the region of the 4mo SR. Tbh I couldn't say how long it lasts, I think so much changes during this time that it seems to take many/most of us a good few weeks just to catch up with all the changes, and in the meantime we probably have our LOs on a non-ideal routine, which just exacerbates the problems Do you think she's had her 4mo growth spurt? It's quite usual for LOs to need feeding a bit more around this age (and I'm talking milk, rather than solids), but that would probably be short-lived. I'd also caution against introducing solids early (ie before 6mo) - contrary to popular opinion, it can actually cause more sleep problems rather than solve them, as it may cause some discomfort to their immature digestive systems. So if you're concerned that solids might be causing problems, it's fine to remove them altogether for now, and see if that helps. There's no rush

It sounds like you're doing just right at night I'd expect most LOs that age to need the reassurance that you're there. You can start trying to gradually reduce the amount and duration of the help that you're giving her, perhaps reassure her until she's drowsy but not yet actually asleep, for example.

Please could you post your daytime EASY routine too, as there may be clues as to what might be affecting her nights?

[katerinask]

Hey there, thanks for the help!

To answer some of your questions:
- I really don't know if she's had her growth spurt yet... She's such a hungry little girl all the time, it's difficult to tell  She has definitely grown alot, both physically and developmentally. But like you said, any higher demand in food due to a growth spurt would be short lived.
- We have introduced fruits only, and only for 1 meal (and I always offer milk afterwards). I realise it is quite soon, but I honestly think that we are what Tracey describes in the book as an exception to the "no solids before 6m" rule. Our LO was born 1 week late, at 9.4lbs. She has all the signs that point towards introducing some foods: She can sit well, hold her head/neck/core very well, she has doubled her birth weight and shows REALLY great interest in people eating. She practically grabs our forks out of our hands and throws herselft towards it with an open mouth! She also started to reduce the amount of time she could go without food, from 4hours to 3, or sometimes even less. When we started she showed some mild signs of constipation (went for 2 days without a poo) but once we cut down on apple and banana, and gave her pears and avocado instead, she seems much better. I have considered cutting back on the fruit, but I'm really not sure that it is the food that's throwing us off. I will discuss it with our paediatrician though next week.

OK, here is yesterday's EASY. She was in such a good mood all day, it went really well, but we still had night time problems.

WU & E: 7:45 > This was earlier than her usual 8-8:30 wake up. She had milk from 1 breast, since it was so full from a whole night of no feeding.
A: 8:00-10:00 > Topped her off towards the end, offering her the second breast (the one I expressed milk out of - our doc has said that it's always good to let her drain the breast after pumping)
S: 10:00-12:00

E: 12:00 > Almost all of a small avocado and a small pear, plus some breastmilk.
A: 12:30-14:00 > Also went for a walk outside with her in the babycarrier. She was in a great mood, smiling to everyone and everything along the way!
S: 14:00-16:00 > This was unexpected! I rarely get a 2 hour nap from her here. I figured she was catching up on sleep from a bad night and an earlier wake up.

E: 16:00 > Breastmilk
A: 16:15-18:10 > Took her to work for the first time to see daddy and colleagues (my DH and I run our own business). Again, in a great mood all the time.
S: 18:10-18:35 > Fell asleep in the car on the way back. Only got about 20-25 minutes sleep, which wasn't ideal, but she seemed OK waking up, prob because she had such good naps earlier. Usually, when we are at home, this nap is a real struggle.

E: 19:00 > Breastmilk
A: 19:15-20:45
S: approx 21:00 > Started wind down at 20:45, offered some breastmilk, she nursed for a bit and then went to bed.

DF: 11:45

NW: Woke up and 3:30 and kept us up until 4:30. During this time she would be crying, but not all-out balling, which told me she was not hungry. It was more of a struggle/whimper. We didn't lift her up, only sat with her. During this hour she fell asleep a couple of times and then woke a few minutes later. Later in the night I heard her being awake at 5:30 and 6:30, but I gave her a few minutes before going in, and she fell back asleep on her own.

What do you think? Any clues? 

P.S.1: We have always had this later bed-time / later wake up time routine going. I think it may be a culture thing, but here in Greece life seems to just go on further into the evening. She is always in bed by 21:00 at the latest though, sometimes at 20:30. This has never been a problem for her routine.

P.S.2: We have always done the DF quite later than Tracey's suggested 10-11 timeslot and we never faced any issues with that.

P.S.3: Sorry for the long post

[trimbler]

Hiya, sorry I don't have long so may have to stop half way and come back later...

Tbh as she's still so tiny, I'd assume that if she wants to feed and takes a good feed, then she needs to. I understand why you're keen for her to start solids and wouldn't be surprised if your paediatrician agrees when you discuss it, but still worth the discussion, IMO. Of course, milk is still the most important, so do concentrate on getting her to take a good feed if you can. At this age LOs can get very distracted whilst feeding and may end up not taking a full feed - on the other hand, they may be quicker to feed because they're more efficient. But if she's getting hungry sooner then I'd suspect she may not be taking in quite 'enough' milk each time, I say that cautiously though, have a think and trust your own mummy instincts, you know her best

Ok will have to return later, BT to do now

[trimbler]

Ok back now and had a better look through all of your post It sounds like you have a good idea of whether she's hungry, and that perhaps she's not waking to feed so much now? Also sounds like you're doing the right thing at night, by going to her when she needs your comfort, but waiting to give her the chance to settle herself where appropriate

Just two thoughts for now:

Have you tried feeding her milk after she wakes from her morning nap? We usually recommend offering the milk first, and then solids a little later, just so that the solids don't replace the milk in her diet, just supplement it. The idea would be to maintain her milk intake, not reduce it just yet, but add a little solids in alongside.

I suspect she may have got a bit OT after her CN, since she had a full A time (actually on the long side) after just a 20-25min nap. Most LOs would need a shorter A time after their CN. I'm not worried about the later WU and BT if this is working for you - we actually did similar at this age for our youngest as it fitted better around dropping our eldest off at preschool. Perhaps try bringing BT forward a bit though, if the CN was short? OT can often result in EW, which is counterintuitive I know, but sometimes a slightly earlier BT can help LOs to sleep longer at night and catch up.

No worries about the DF either, Tracy's recommendation was for a 7-7 day, so your DF is fine for your 8-8ish day

[katerinask]

Hi and thanks for the responses - sorry it's taken me this long to post back!

So, the past couple of nights have been really good again. She slept straight through, as she used to previously. I'm too scared to say it's over though - don't want to jinx it!

The one thing we did change, was the solids. She is having some trouble with constipation so we stopped completely. I don't know if that's what was causing it, or if it was unrelated. The constipation unfortunately hasn't gone yet, so not sure if it was that or not.

Anyway, finger crossed!

[trimbler]

Brilliant news Yk, you really don't have to rush the solids, we actually had a couple of false starts when we tried to start DD off, due to constipation and then the flu. So she didn't really have anything until closer to 7mo and loves her food now I'd expect her bowels to sort themselves out again soon, I'd just give them a complete break until you see the paediatrician (in a few days anyway, right?) and discuss it all then