NY resolution: finally crack sleep/routine for my 7mth old..... Please help!

[MrsTigs]

Happy New Year BW family! Hope you all had a lovely time over the holidays    I started this thread (4 month regression - how to get back on track?!) when my daughter was 5 months old and we'd been struggling with her naps and night sleep for 6-8 weeks. Fast forward another two months and we are still struggling 

So, my one and only NY resolution this year is to figure out what's going on, get her on a more consistent routine and (hopefully) sort out her night sleep so hubby and I aren't such zombies!  I'm sick of looking at my previous thread, so thought I'd start a fresh one for the new year!    Here goes:


Naps
We have been aiming for 3hr A time during the day, but it's a bit hit and miss! Sometimes she will nap for 1-2hrs, other times it's 20mins and she won't resettle  In the morning, particularly, she gets fussy around 2-2.5hrs, but I've been pushing her to 2.75 or 3hrs and then mostly doing 3hrs in the daytime unless her nap was really, really bad. She's a mix of textbook/spirited I think, so often gets OS and stays up longer than she should when there's lots of activity from older brother or we're out and about!

If she cries during a nap, I can generally resettle with a dummy, but she typically wakes up happy regardless of the length! If she's had a decent sleep, then she will happily play in her cot for a good 10-15mins before calling for me to get her up.


Nights
At night, she goes down around 6.30/7pm, but often wakes an hour later, usually just for a resettle with dummy, but sometimes for more milk. She's cut three teeth over the last two weeks and was waking hourly throughout the night..... but is now still waking for more milk around 11pm/midnight and then again around 3/4am. And she is usually quite restless after that, sometimes waking at 5am, 5.30am, 6am and then up for the day around 7am.

We moved her from her moses basket in our room to the cot in her own room on New Year's Day and so far that hasn't made anything worse! We have a double bed in her room, so to date one of us has still been sleeping in with her, as she wakes so often in the night...... but we have been letting her thrash about and settle herself as much as possible.


Feeding
She started solids at 6 months and loves her food so far  We're doing a mix of puree and finger food and she typically eats whatever we offer with great excitement! She is a refluxy baby and I think she does suffer from wind/digestive pain quite a bit, but that seems to have settled down now, as she's got used to solids . She also sometimes gets red, blotchy skin on her face, which makes me wonder about food allergies, but I can't pinpoint a likely cause.... She's been formula fed since about 3 weeks old, with no problems aside from the reflux. We've never medicated for that as, apart from extra laundry, it's never caused her or us any major distress! I do think that sometimes I mistake windy fussiness and itchy skin/eyes as signs of tiredness, which doesn't help me 'read her' accurately 

We're also struggling a bit with the timings of her meals and milk feeds. She doesn't seem hungry for milk when she wakes at 7am, but is currently having two night feeds of about 2-3oz so I guess that will have an impact. We tend to go straight to breakfast around 7.30 and do milk afterwards, but she's a real snacker on her bottle and ends up drinking it close to nap time, creating a feed-to-sleep situation. And this of course then continues throughout the day  We also dropped down to three 8oz bottles soon after we started weaning, as she just wasn't interested in her 11am feed, but I'm now wondering if we did that too soon and she isn't getting enough milk? I went back to four smaller bottles yesterday, but still seemed to be offering them when she wasn't very interested 

She was having 25-30oz in total over four bottles and has now dropped to around 20oz in the day, but with an additional 4-6oz in the night too. She's has three lots of solids each day and is much more interested in food than milk. She eats half a weetabix with milk for breakfast, a 125g jar (or equivalent) of puree plus finger food (cheese, fruit, breadsticks) for lunch and another 125g jar or equivalent for dinner. She often has around 6tsps of plain yoghurt with fruit puree after lunch and dinner too and would probably eat more of everything if I let her/had it available! She has been eating breakfast around 7.30, lunch around 12.30 and dinner around 4.30/5pm, which fits in well with us and her brother, but I'm not sure how to space her milk feeds around that  Also, when she starts nursery (admittedly not for another 5 months!), their mealtimes are 11.30 lunch and 3.30 tea  So I'm not sure whether to use that as my starting point now, even though it doesn't really fit with our typical day....


Props
She has had a dummy since very early as she is a sucky baby and it seemed to help her reflux. It was also a fab tool for easy settling with older brother demanding attention too! But we're wondering whether it's now become a prop? Back in October, when she was waking every 1-2 hours at night (with no sign of teeth!), we considered just taking it away, but then she got sick with bronchiolitis and was in hospital for a week and it was so helpful in comforting her! So we've stuck with it for now...... I think she is on the cusp of being able to reliably find and replace it herself, especially as she is now in her cot with more space. We bought her a set of glow in the dark dummies as part of her Christmas stocking! 

As mentioned above, she also has a tendency to feed to sleep, as her routine is a bit all over the place and she takes so long with her bottles. So I think we need some help sorting out a better pattern for her 


Sample EASY
Here's our pattern from yesterday, which was quite a good day:

W/up: 7.10
E: solids 7.45 (Weetabix with milk and a couple of toast fingers)
E: milk 8.30 (8oz, but over an hour or so)
A: 2hrs 45mins
S: 9.55 - 11.10 (1hr 15 sleep)
E: milk 11.30 (offered, but not interested)
E: solids 11.45 (cheese sandwich, banana)
E: milk 12.45 (took about 3.5oz before our walk, then 2.5oz just before nap)
A: 2hrs 55mins
S: 2.05 - 3.05 (1hr sleep)
E: milk 3.30pm (4.5oz over the course of an hour)
E: solids 5pm (125g veggie puree, yoghurt with fruit puree)
E: milk 6.20 (offered at 5.45 to try and space out from bedtime, but not hungry. Took 4oz and fell asleep on bottle)
A: 3hrs 30mins
S: 6.35 - 11pm (cried out at 10pm, but went back off by herself)
E: 11.10 (3oz)
S: 11.15 - 3am (resettled with dummy)
S: 3am - 5am (cried out at 4am, but went back off)
E: 5.10 (3oz)
S: 5.45 - 6.30 (coughed herself awake)
S: 6.30 - 7.10

And here's today so far:

W/up: 7.10
E: solids 7.45 (Weetabix with 2oz milk)
E: milk 8.30 (6oz, but over an hour or so)
A: 2hrs 40mins
S: 9.50 - 11.20 (1hr 30 sleep)
E: milk 11.45 (offered, but not interested)
E: solids 12.45 (minced beef and swede puree, yoghurt with apple puree)
E: milk 13.15 (6oz over 45mins or so)
A: 2hrs 45mins
S: 2.10 - 2.39 (23mins  )

Her second A time today was short because she was getting really fussy and almost falling asleep on the bottle downstairs. Typically though, she seemed really awake once I'd got her upstairs and in her sleep sack.... She looked around for a bit, but then did fall asleep on the bottle (again)   I replaced dummy and tried another 2oz milk, but she's just smiles when I go in and then starts crying when I leave.


Questions

• Do her current A times look ok? I was wondering about increasing again to 3hrs 15, but we've actually had good naps and a better night on 2hrs 45/3hrs these last two days 
• Should the last A time before bed be the longer one? She did 3hrs 30 yesterday and that seemed to work ok
• What should I do if the second nap is a bust like today? A catnap at 4.30/5pm is pretty late..... but how early can I realistically do bedtime and still fit in dinner and milk etc?!
  
• Should I aim for milk feeds before solids? I know "food is for fun until they're one" so does that mean I need to focus on keeping milk quantities up, even though she's really eager for food?
• Roughly how much milk vs solids should she be having at this age?
• How best can I break the feed-to-sleep pattern when she takes so long over her bottles?
• Should we still think about taking her dummy away? Or is it more a timing/feed-to-sleep problem?

I am now in tears myself as I just can't take much more    I am going to talk to my Health Visitor/ Community Nursery Nurse as they offered one-to-one support once Christmas was out the way..... and I'm considering talking to my GP about possible PND too as I just feel so down    I'm not sure if the sleep deprivation is causing me to get depressed, or whether the depression is underlying and just exacerbated by the lack of sleep. Either way, I just want to shut myself in a dark room for a few months and emerge when she's, say, 18 months and (presumably) on one nap and fewer bottles!

Sorry for the essay, but any help with fresh eyes would be most appreciated! Thanks xx

[creations]

Oh Mrs Tigs. I'm so sorry you are feeling so down  
I haven't read your full post yet but saw you were on-line just now and wanted to send you a (((hug)))

I'll read through your post now xx

[MrsTigs]

Thanks Creations! Virtual hug much needed and appreciated!

We actually had a better night last night though    Early bedtime was a complete bust, despite such a micro second nap. She slept from 5.40-6pm and then wanted up to see older brother and play! Back up to bed at 7pm, but we had two or three wake ups and lots of screaming and arching out of my arms until 8.40 when she finally settled 

But then she slept right until 6.30 with just one wake up between 2am and 3am for nappy change and 3oz milk  . So that's a huge improvement - can't remember the last time that happened over the last 4 months!

Today has gone a bit squiffy already though as I put her down at 9.30 (3hrs A) and she woke after 26mins  Still had dummy and bunny, so I left her to it and she put herself to sleep again after 20mins of playing and chatting to herself. Coming up for another 25mins now and still asleep I think....

So I guess it was too early, despite being 3hrs A? I suppose she got more night sleep last night! So perhaps I should have stuck with 10am for her first nap? And how do I treat a "split" nap like this one? It doesn't feel like she'd be as well rested as a continuous nap of 1hr plus??

Ouch, my brain hurts! Never mind her, I've got a serious case of OT build up! 

xx

[creations]

OK, I've had a read.
I do agree with you that routine needs a tweak to get things on track again and to even up these naps, feeds etc.

My first thoughts are:
EAT
- right away wean the second night feed. She doesn't need it, she was previously taking her milk in the day (with one NF) so get back to that. Continue the first NF of the night as usual.  Reduce second NF of the night by 1oz each night for 3 nights - take in a paci and water in a bottle. If she kicks up a huge fuss over the smaller milk offer paci or water and sooth her back to sleep with shush/pat or your usual method.
- continue to offer milk on WU or 30 min after WU (mine couldn't eat when he first woke,m he needed time before food), after a few days or a week I would imagine she begins to accept the milk as that second NF will have gone.
- move breakfast solids later.  Allow for her morning milk feed plus 1hr.  So breakfast will be more like 8-8.30am.  Do not offer the 8.30 milk as an extended feed. if you want to offer milk with the solids meal or directly after the solids then do so as an additional drink (although water needs to be offered with food too) but I would offer for a max of 10 mins and she either takes it or doesn't.  You are not starving her, she has plenty of E times throughout the day where you give the opportunity for her to eat.
There is a chance that for a few days her overall milk intake drops a bit whilst she adapts to the times, to stop the snacking though you need to offer at consistent times and for a reasonable length of time (lets say a window of 30 mins), not extending the bottle for long periods or offering again an hour or so later.

After these points are in place the rest of the day should begin to go a little more consistently with milk feeds roughly 4hrs+ apart (4 in the day and 1 at night) and solids approx 1hr after milk.  Roughly:
milk 7, 11, 3, 7 (fitting around naps and BT)
solids 8, 12, 4-5

ACTIVITY
- Extend A times to 3hrs and not put down before then. There is a chance that taking milk so close to nap time is making her look sleepy when she is not really ready for a sleep.  There is also a chance that eye rubbing, yawning and other signs are misdirecting you.  LOs this age can yawn due to boredom and rather than needing a nap they need a change of scene or activity. Change rooms or hand her a toy, sing a song. Fill the 3hrs up.  At 7 months many do longer than 3hrs A time and this might also be on the cards.  Not feeding so close to nap time will probably help too.  Use the paci and shush/pat to put down for nap.

SLEEP
Extending A times as above might be all you need. However, going on my personal experience, I would see the GP about possible reflux meds or referal to paediatrician.
My own DS didn't start reflux meds until about 5.5 months old (so not much younger than your DD) it made the world of difference. Many people say they grow out of reflux at 6 months, well not in my experience. Mine needed meds until he was 2yo and following this roughly once or twice per year we see a reflux flare up and need to medicate again, he is about to turn 6yo.  We now medicate for a few weeks across growth spurts if sleep goes terribly off and other reflux symptoms are seen. Then we drop it again.  Mine was always called a "happy spitter" by HVs and GPs until I demanded to see a paedi who diagnosed silent reflux within minutes and prescribed meds immediately.  Believe me there was nothing "happy" about disturbed nights.
Whilst you say the reflux doesn't cause any problem other than increased laundry, when I read how things have been for you, I feel reflux could well be playing a part in disturbed naps and nights and the tendency to snack on bottles.
You might also consider use of cot blocks and a baby safe cot wedge for in her cot. These help to elevate the head end.

Okay those are my first thoughts.  Now on to your questions:

Also, when she starts nursery (admittedly not for another 5 months!), their mealtimes are 11.30 lunch and 3.30 tea  So I'm not sure whether to use that as my starting point now, even though it doesn't really fit with our typical day....

No, I wouldn't use their routine to base your current routine. LOs routines change a lot between 7 and 12 months.  At nursery the 11.30 lunch likely fits with most LOs naps (some do a short am nap waking in time for that early lunch, some drop to one long nap at 12 months so need to eat early before the nap) and the "tea" at 3.30pm will be like a snack.  By 12 months your LO will have switch the 3pm milk to a 3pm snack so this will fit pretty well. Many LOs will then have a further "dinner" solids at around 5pm either at day care or at home (or later in the evening if they are picked up later).

Do her current A times look ok? I was wondering about increasing again to 3hrs 15, but we've actually had good naps and a better night on 2hrs 45/3hrs these last two days 

At least 3hrs for now. Whilst you sort out her NF and day feed times. No less than 3hrs.

Should the last A time before bed be the longer one? She did 3hrs 30 yesterday and that seemed to work ok

If it works for your LO that's fine. Some do like a very long A time before bed. Some do not. Mine liked a very short A time before bed it was always his shortest, that just how he was.

What should I do if the second nap is a bust like today? A catnap at 4.30/5pm is pretty late..... but how early can I realistically do bedtime and still fit in dinner and milk etc?!

You can do BT at 5.30pm and just ready yourself for a disturbed night.  That's what I'd do. It's almost impossible to fit in all the solids and milk feeds with such an early bed time but if you already tell yourself that you expect her to be up for another feed at say 8pm then you won't be bothered by it.
Hopefully though this will not happen too often as you are going to extend those A times, not feed before sleep, and ignore any drowsy signs until the full 3hr or 3hr+ is up.

Should I aim for milk feeds before solids? I know "food is for fun until they're one" so does that mean I need to focus on keeping milk quantities up, even though she's really eager for food?

Yes milk before solids. There are of course LOs who do switch around but mostly we advise milk first. If you want to go the other way I would suggest seeking the support of a paediatrician and talk about the reflux, the milk and solid eating, the blotchy skin reaction too.
Her milk intake is okay.  Dairy solids also counts towards her daily intake and I see she is having cheese and yogurt so these count too. I wouldn't worry too much about it. Yes milk is her primary source of food until 12months old so we do focus on maintaining milk feeds at this age, solids are in addition, but it doesn't look like she has dropped her milk so dramatically that you need to "do" anything about it other than focus on them being at regular consistent times rather than spread across hours.  Some refluxy LOs do prefer solids (mine did) so you might be happy for a certain amount of her dairy to be in solid form. Personally I wanted my LO to take as much as possible of formula because it is a complete food with all the nutrients and vitamins needed where as cheese or yoghurt is not - having said that some health professions don't seem to distinguish that way between formula and dairy solids.  This might be something you raise with a paediatrician.  It is also possible to make dairy solids out of formula, so that the vitamins etc are still taken but LO feels they are eating solids rather than milk, it might also be more comfortable for a refluxer.  Things such as milk pudding (literally just adding corn flour to the formula and cook over heat to thicken to a thick custard consistency which sets firmly when cooled), white sauces.

4 milk is the day and 3 meals for now.  Later (around 10 or 11 months) the 11ish and 3ish milks switch to a solid snack with water/milk as a drink and 2 milks (WU and BT) continue.
At 12 months it is advised bottles are dropped but LO still needs 1 or 2 good milk drinks or a decent intake of dairy per day. Some people keep a bottle for longer to ensure the dairy intake.

Roughly how much milk vs solids should she be having at this age?

Primary food is milk. Secondary food is solids.
Some refluxers really just like solids - mine did. He ate solids like I had been starving him for 6 months.  Milk is important though as mentioned above. It is a complete meal whilst the solids are not. At this point your LO can't get all she needs from solids.
Some at this age would suggest you cut right back on solids to get the milk intake re-established (proper milk at proper times, no snacking no extending) although personally I don't think this is needed at this point.  I feel you can get the E routine on track by being strong and consistent.

How best can I break the feed-to-sleep pattern when she takes so long over her bottles?

I think I detailed this in my first thoughts.  You just do it.  Stop giving her the bottle when it is not milk time.  She will not starve. You offer food (milk or solids) 8 times per day (4 day milk, 1 night milk, 3 day solids) - when can she starve??  She has *plenty* of opportunity to eat.  Be confident that she does not need milk prior to sleep and does not need to feed to sleep. Soother her to sleep and offer milk at milk times.  You can!

Should we still think about taking her dummy away? Or is it more a timing/feed-to-sleep problem?

Hard for me to comment on dummys, mine never took one. However, for now I'd leave it so you can focus on getting on track with your routine.  I think the advice is to wean from 6 months (for teeth growth) but I also read that many keep the dummy much longer especially when LO can self-plug.

I'm considering talking to my GP about possible PND too as I just feel so down

I would speak with your GP.  There is no harm in speaking honey.  Having a LO with such disturbed sleep etc can really impact but speaking through with your GP perhaps you and your GP together will be able to work out if this is only connected to sleep deprivation or if there is more.  I would advise mentioning this when you go to see GP about possible meds for LO and tell GP how you feel, say you are willing to make a separate appointment for yourself if need be - or make a joint appointment for yourself and LO when you call them.

I just want to shut myself in a dark room for a few months and emerge when she's, say, 18 months and (presumably) on one nap and fewer bottles!

No! not 18 months that's bang in the 18 month sleep regression!!
Hang in there honey. Please do see your GP.  Even if LO doesn't need meds, even if you do not need meds or other help with PND, there is really no harm in speaking with your GP, that is what they are there for.
Many more hugs.
You will get through this xxx

[creations]

Today has gone a bit squiffy already though as I put her down at 9.30 (3hrs A) and she woke after 26mins  Still had dummy and bunny, so I left her to it and she put herself to sleep again after 20mins of playing and chatting to herself. Coming up for another 25mins now and still asleep I think....

So I guess it was too early, despite being 3hrs A? I suppose she got more night sleep last night! So perhaps I should have stuck with 10am for her first nap? And how do I treat a "split" nap like this one? It doesn't feel like she'd be as well rested as a continuous nap of 1hr plus??

For now I would just count it all in as one nap.  You gave her the chance to sleep from 9.30 - 11 and she can choose to sleep or wake up and chat to herself for a bit and then go back to sleep. Try not to worry too much about it.  I know we do, I know we all want our babies to sleep properly, but sometimes they just don't!
Overall, yes, perhaps she did need the longer A time 3hr 15.  Maybe from today do 3hr15 first A time and 3hr second A time. But I would count it from whenever she ends this nap even if it does end up being two broken naps of 25 mins each.

Glad to hear you had a better night x

[MrsTigs]

Hi Creations, thank you so much for your detailed reply! I really appreciate it   

I've had a skim read, but am flying solo with kids tonight as hubby is away    So I'm heading to bed shortly! Will read properly when he's back tomorrow and we can digest together   

Thanks again!
Tigs xx

[creations]

You're welcome. I hope you find something there helpful x

[creations]

I've been meaning to come back to add about that red blotchy skin. I totally forgot in my earlier reply.

I'm not saying don't see a doc about it, of course do if you are concerned, but we had it here too, for my DS it was a contact reaction only, it was not food allergy he was not sick or poorly in any way other than the red blotchy skin. Here is was usually tomatoes, exactly where they touched or if he picked up with his fingers/fist then he would spread it on his face, it would go up his wrist and arm because he would lean his arm on the high chair tray.  Other foods such as red peppers (capsicum) which he still says now make his fingers tingle.  He can still eat these foods.
The worst reaction was to garam masala spice on potato wedges, looked like hives, I washed him immediately and it went down in a short while. I just avoided that spice, it was again contact skin reaction only.  He loved eating them though!

[MrsTigs]

Hi Creations    I've had a read and started implementing your advice, so here's a quick update/ some further questions:


EAT
So we started on regular 4 hourly feeds on Friday. The quantities overall were quite small to start with, particularly at 11 & 3 (2-3oz) but she does seem to be regulating a bit now (5oz each time yesterday, plus usual 7oz at bedtime). We've been offering milk on first wake up (if around a feed time), but she does seem to need time to have a look round and see what's going on before she eats! So we have been offering again after 20mins or so and then she does a bit better...... But she is very, very easily distracted (especially if Mr 3 is around!) and seems to need lots of little breaks. I'm wondering whether she needs to go up a teat size? We tried the larger ones a while back and they just flooded her, but perhaps we could try again? Even with breaks, we are still ending the feed within 45mins (from first attempt on waking).

We're also offering solids around the times suggested, which fits in well with us as a family - 7.45, 12.30 and 4.30/5ish. The amount of solids she's having has decreased a bit, partly due to more regular milk I think, but she also had a couple of really off days this week when she wasn't even interested in her usual Weetabix or favourite dinner. So perhaps those teeth are still moving around?    But overall she is still very interested in food - she get's so excited! Your comment about your son starting solids like you'd been starving him for 6 months is spot on for us too 

She's had some very disturbed nights (see later), but also some better ones with only one night feed of 3-4oz. This has been around 2am though, not 11pm as before....... This is mainly because she's been having her bedtime bottle somewhere between 6pm-7pm (depending on naps), going to sleep, but then waking after 1-1.5hrs. We've been resettling with dummy, sometimes two or three times, and then she's properly off to sleep somewhere between 8.30-9.30ish. So she hasn't been waking for a feed at 11pm and we haven't wanted to disturb her! But I'm not sure if this is the right strategy? Or whether her bedtime wake ups indicate that she'd like more milk at bedtime? She takes a full 7oz feed at bedtime and her quantities overall during the day have been creeping back up.... She also typically eats a good dinner at 5ish. Maybe she is having too much milk and food later in the day and that is causing her tummy pain? She typically has her largest intake of solids around 5pm and her largest milk feed at bedtime 


ACTIVITY
We have been trying to stick to 3hrs A time, but did 2hrs 45 on Saturday morning as she had woken practically every hour in the night and was exhausted – she then had a 2hr sleep in the morning and another 1hr in the afternoon, also on 2hrs 45. But after a much better night on Saturday (8.30-6am with 2am feed), she only did 30mins on a 3hr wake time Sunday morning and we ended up on 3x30 minute naps that day. Despite the good naps on 2hrs 45, I feel like she is (or should be?!) ready for longer A times, if we could just break the UT/OT loop and have some consistency, rather than one good day+night, followed by a bad day+night. So perhaps we need to look at 3hrs following a bad night or nap, but 3hr 15mins after better sleep? She also seems quite sensitive to OS, plus is trying desperately to crawl, so I do need to look at her activity and stimulation levels prior to naps..... She does get plenty of floor time to practice moving though, and Mon-Weds tend to be quiet with just her and I at home 

We have obviously stopped feeding to sleep, except for bedtime when I just can’t get the last bottle into her before she’s too tired! (Rubbish second naps don’t help there!) We are just using the dummy to settle her for naps as she doesn’t really want to be cuddled now that she's not having a bottle. We change nappy, pop into sleep sack, attempt a cuddle in the rocking chair (she immediately starts crying and squirming) and then put her down and give dummy. She mostly goes off instantly with dummy, but I still wonder whether they are producing a “pseudo nap” in the same way that the bottle did…… I.e. the action of sucking sends her off is she’s anywhere near nap territory, regardless of actually being a bit UT? Like a badly timed car ride! Just a thought……


SLEEP
Over the last week or so, we have seen some better nights, with just one night feed and stretches of 4-5hrs either side – a huge improvement!    However, they are still interspersed with very poor nights where she wakes (or at least cries out) every 1-2hrs. Bedtimes are also very unsettled with multiple wakes ups from bedtime at 7ish to around 10ish. We’re not sure whether to offer more milk or just try to resettle with dummy…... Sometimes she clearly just wants the latter and can’t quite find it herself (or is already too distressed to look for it!); other times she refuses dummy, but will eventually settle a bit in my arms, after a lot of screaming and arching away, and can then be put back down with dummy. I keep thinking this is a sign of OT (or UT?!) but perhaps she is experiencing reflux pain?

On that subject, I visited my GP and he has prescribed Gaviscon just for her night bottle. I’m not all that convinced by his advice though, as he firstly dismissed the bedtime screaming and night wakings etc as “usual childhood stuff then” but proceeded to ‘Google’ reflux and suggest Gaviscon when I pushed the matter. Anyway, we have been giving 2 sachets in her bedtime milk since Friday and have enough for a two week trial. He mentioned we could look at switching to a cow’s milk free formula or trying different reflux meds after that, but I wouldn’t say we’ve had a firm diagnosis or treatment plan! I plan to give the Gaviscon a go, discuss with my HV too and then revisit GP for further discussion if things don’t improve. My friend also suggested a chiropractor or cranial osteopath - she visited the latter with her daughter and found it helped – so I plan to chat with my own chiro at my next appointment.

Whilst you say the reflux doesn't cause any problem other than increased laundry, when I read how things have been for you, I feel reflux could well be playing a part in disturbed naps and nights and the tendency to snack on bottles.

I think you’re right! As LO slept so well for the first 3.5-4 months, we didn’t really think too much of her spitting up/ occasional bedtime puking and crying…… And then when sleep went wonky, we looked more to other causes such as dummy prop, teeth, colds, schedule issues. But I think reflux pain is definitely something that we have to now rule out, if we can!


Re early bedtime

You can do BT at 5.30pm and just ready yourself for a disturbed night.  That's what I'd do. It's almost impossible to fit in all the solids and milk feeds with such an early bed time but if you already tell yourself that you expect her to be up for another feed at say 8pm then you won't be bothered by it.

We have tried a 5.30 bedtime a couple of times after short naps, but she has just taken a 20-30min "nap" and then been wide awake again    So I'm not really sure where to go from there..... I guess just try doing bedtime again 30mins-1hr later? The first time it happened I took her downstairs at 6pm and tried bedtime again at 7pm - she was asleep by 7.20, but woke up again twice at 30min intervals for dummy before finally settling from 8pm - 6.30, with a feed at 2.30.

I'm beginning to wonder if she's desperate to get back to the 8pm-6am pattern that she did from 5/6wks to 16wks?    We tried bringing her bedtime forward due to (presumed) OT screaming at bedtime, but perhaps she just prefers slightly less night sleep and more day sleep? We were keen to get more of our evenings back, and felt like she should extend her night sleep as she got older, but maybe that was a mistake? #soconfused 

Re early morning wake ups
So this is a new element to add into the mix    Whereas previously, if she woke early (5am onwards) we could resettle a couple of times and push her to 6.30/7am, she has lately taken to waking up for the day at 6am. And today it was 5am!!    Any thoughts on why her wake ups are creeping earlier? And how best to deal with them?!

No! not 18 months that's bang in the 18 month sleep regression!!

Ha! Maybe not then.... How about 18 years?! 

Thanks so much, again, for all your help    I do feel like we are making some progress, little by little!  She just woken (from a 1hr nap!) so I'll return to this later and post our EASY for the last few days.

[MrsTigs]

I've been meaning to come back to add about that red blotchy skin. I totally forgot in my earlier reply.

I'm not saying don't see a doc about it, of course do if you are concerned, but we had it here too, for my DS it was a contact reaction only, it was not food allergy he was not sick or poorly in any way other than the red blotchy skin. Here is was usually tomatoes, exactly where they touched or if he picked up with his fingers/fist then he would spread it on his face, it would go up his wrist and arm because he would lean his arm on the high chair tray.  Other foods such as red peppers (capsicum) which he still says now make his fingers tingle.  He can still eat these foods.
The worst reaction was to garam masala spice on potato wedges, looked like hives, I washed him immediately and it went down in a short while. I just avoided that spice, it was again contact skin reaction only.  He loved eating them though!

Thanks for this addition    I think you could be right as LOs skin does seem to have settled down a bit over the last couple of weeks. She still has red patches on her hands and I also noticed some patches on her upper chest when I dressed her this morning, so I think it's most likely due to dribble/ a contact reaction, like you say. I've been putting Aveeno cream on it, which was the best for my son's eczema and it certainly seems to have calmed a little, along with the very red, dry patches on her forehead and cheeks.

As a family, we are all very prone to eczema and dry, sensitive skin, so I guess this is something to expect with her also. Maybe I was adding 2+2 (itchy skin + screamy sleep) and making 5    Will definitely keep an eye on it though!

[creations]

Hi
It sounds like there are some improvements in the routine which is great

I'll try to go through to see where I can add any thoughts...

I'm wondering whether she needs to go up a teat size?

Could you post a short question on the bottle feeding board with this?  Sorry I am not much help, I don't know when they usually increase the teat size, when I tried with DS he could never take anything other than the first size or I think I had a multi/flexible size or something (is there such a thing?) which was okay but basically I couldn't change his teat until he dropped the bottle at 12 months.

She takes a full 7oz feed at bedtime and her quantities overall during the day have been creeping back up.... She also typically eats a good dinner at 5ish. Maybe she is having too much milk and food later in the day and that is causing her tummy pain? She typically has her largest intake of solids around 5pm and her largest milk feed at bedtime

It's quite unusual for LOs to take a big dinner but if she likes it I see no harm. Do make sure the BT milk is big enough for her to take her fill and leave an oz in the bottle so you know she's had enough. BT was always the biggest feed for us, my DS would take pretty much double what he did the rest of the day.

So perhaps we need to look at 3hrs following a bad night or nap, but 3hr 15mins after better sleep?

These are both still on the shortish side for 7 months so don't be afraid to increase if needed.

Bedtimes are also very unsettled with multiple wakes ups from bedtime at 7ish to around 10ish.

Sounds like either OT (esp if second nap is not good) or teething pain or reflux.  I doubt it is hunger during these early evening wake ups.

He mentioned we could look at switching to a cow’s milk free formula or trying different reflux meds after that, but I wouldn’t say we’ve had a firm diagnosis or treatment plan! I plan to give the Gaviscon a go, discuss with my HV too and then revisit GP for further discussion if things don’t improve.

I would just ask for a referral to a paediatrician.  In the UK it seems they like to try gavi first but all it does is thicken the milk to form a sort of barrier to try to stop the milk coming up, it doesn't treat the acid. Gav can help initially but in our case and many I've read after an initial improvement things seem to just get worse again.  A paediatrician is more likely to listen to your description of symptoms and check LO over listening for refluxing etc and offer a trial on some meds.  If it makes no difference to sleep or anything then you can stop, they will likely want to see you in 1 month anyway to review how it's going so you can decide together if it is helping.
It does sound to me like this needs to be followed up. You can chase routines all around the house but wont' get things sorted if reflux is disturbing sleep.

I'm beginning to wonder if she's desperate to get back to the 8pm-6am pattern

10hrs is quite short but not unheard of.  Mine only did 10.5-11hr nights all the way until he dropped all naps, then we got 12hr nights after he settled down.  If you think this 8pm-6am night is the best for her I would work out your routine based on that so you know where you stand.

The skin reaction - mention it also with the paediatrician when you get your appointment.  IME speaking with GPs and HVs was not all that helpful for reflux, seeing the paediatrician was a totally different experience.  The GPs and HVs all seemed to go along the lines of "happy spitter" and "everything is okay" or "you are a first time mum".  GPs and HVs are all different of course, just saying my experience and I needed to state I wanted a referral and from there on we got the reflux under control pretty quickly, I wish it had been much much earlier.

Off to do my own DS's BT now

[MrsTigs]

So, here's the our EASY for the last few days, since we started trying to regulate her feeds:


Friday 6th Jan
W/up: 6.20 (2hrs total naps the previous day, one night feed, brief wake ups @ 3am, 4.45am and 6am)
E milk: 6.40 (4oz, some added to breakfast)
E solids: 7.45
A: 3hrs 40min (due to docs appt to check for ear infection and discuss reflux meds)
S: 10.03 - 10.45 (42 mins in stationary car seat with dummy)
E milk: 11am (3oz)
E solids: 11.47 (couple of toast fingers, not that bothered)
A: 3hrs 9mins (difficult to settle)
S: 1.55-2.28 (34mins in stationary car seat, replaced dummy at 20mins, wouldn't resettle at 34mins)
E milk: 2.40 (4oz)
E solids: 4.45 (veggie and fruit puree)
E milk: 5.30 (attempt at EBT, Gaviscon added, fell asleep on bottle)
A: 3hrs 40mins
S: 6.07-6.24 (17mins!! then wide awake for 25mins)
S: 6.47-9.30 (with brief dummy resettle at 8.20pm)
E milk: 9.35 (4oz, fell asleep on bottle again)
S: 9.47-1.20 (cried out loudly @ 10pm, dummy resettle @ 12.30am)
E milk: 1.20am (2oz)
S: 1.30-6.10 (dummy resettle @ 3.30am, cried out but didn't wake @ 4am)


Saturday 7th Jan
W/UP: 6.10am
E milk: 6.35 (4oz, but added lots to breakfast)
E solids: 8am (gave teething gel after breakfast as v. grumpy!)
A: 2hrs 45mins (getting v.fussy)
S: 8.55-10.55 (2hrs solid)
E milk: 11am (3oz, not interested, tried a couple of times until 11.45)
E solids: 12.30 (veg puree, yoghurt with fruit puree)
A: 2hrs 50mins (grumpy, gave teething gel)
S: 1.45-2.50 (1hr 5mins)
E milk: 3pm (only 2oz)
E solids: 4.30 (veg puree, baby rice with 2oz milk and fruit puree)
E milk: 6pm (in three goes until asleep! With gaviscon, plus gave teething gel)
A: 3hrs 30mins
S: 6.20-6.50 (30mins, then very awake for 40mins!)
S: 7.35-1.45 (dummy resettle @ 8.30)
E milk: 2am (3oz)
S: 2.05-6.10 (4 hours straight!)


Sunday 8th Jan
W/UP: 6.10am
E milk: 6.30 (5oz, hungrier, some added to breakfast)
E solids: 7.45am (Weetabix)
A: 2hrs 55mins
S: 9.05-9.40 (35mins, woke happy and wouldn't resettle)
E milk: 11.10am (5oz, out at cafe, but ate well)
E solids: 11.15 (Few bites of my tea cake!)
A: 2hrs 50mins
S: 12.30-1.03 (in car, woke after 33mins and didn't go back off)
E milk: 2.40 (5oz, ate well)
A: 2hrs 45mins
S: 3.45-4.20
E solids: 5pm (veg puree, cooked veg finger food, oatcake, yoghurt with fruit puree)
E milk: 6.45 (7oz, fell asleep on bottle)
A: 3hrs 5mins
S: 7.25-8.55 (1hr 30mins, woke screaming, arching in my arms, suddenly settled and took dummy  )
S: 9.05-2.30am (5.5hrs, but with dummy resettle @ 10pm and 2am)
S: 3.10-5am (wouldn't resettle, up for the day  )


Monday 9th Jan
W/up: 5am 
E milk: 6am (almost 4oz)
E solids: 7am (Weetabix with 1oz milk)
A: 3hrs
S: 8am-8.30 (30mins, found her up hands and knees!)
E milk: 10.20 (4oz in 30mins)
A: 2hrs 55mins
S: 11.25-12.45 (1hr 20mins)
E solids: 12.45 (sandwich, yoghurt with fruit puree)
E milk: 2.30 (5oz in 30mins)
A: 3hrs 5mins
S: 3.50-4.25 (35mins)
E solids: 4.45 (veg puree, corn snacks, yoghurt with fruit puree)
E milk: 6.20 (but most upstairs from 7pm, with gaviscon)
A: 2hrs 45mins
S: 7.10-now (nearing 2hrs, but with dummy resettle after 30mins)


Sorry for the minutiae.....    I've been scribbling in a notepad, so took the opportunity to review and write out more legibly!

Does anything jump out?  We are definitely, definitely making progress, although still struggling a bit with LO being unsettled in the early part of the night, and now it seems with waking early in the morning and not wanting to go back off.  But at least we've had some longer stretches at night; the 4 hours on Saturday night without a wake up or needing us to find dummy is amazing, given current form (on hubby's watch of course!  )

[Clairehv]

Hi Mrs Tigs
Just read your posts and wanted to send a hug. I could have written most of your post and Creations has been helping me as well.
Sleep deprivation is a killer and with an older child to look after there is so little respite. I have also been feeling very flat and I do think it is the tiredness.
If at all possible get DH to take both out in the day and just have a well deserved nap.

No real solutions I am afraid but just sending love x

[MrsTigs]

Hi Mrs Tigs
Just read your posts and wanted to send a hug. I could have written most of your post and Creations has been helping me as well.
Sleep deprivation is a killer and with an older child to look after there is so little respite. I have also been feeling very flat and I do think it is the tiredness.
If at all possible get DH to take both out in the day and just have a well deserved nap.

No real solutions I am afraid but just sending love x

Thanks Claire!  And to think I used to moan about my son's daytime catnap/ in arms napping habits.....    At least he pretty much slept 7.30-6.30 from 12wks, with the usual brief disturbances for teeth, illness, developmental milestones etc!

My daughter is "easier" in the sense that she naps in her cot and can take decent 1-1.5hr+ naps if the timing is right and the planet's are aligned.....    But her night wakings and erratic patterns are really driving us bonkers!    Hubby actually took himself off to the doctor's today to discuss feeling so down and what support might be out there (for him, but also for me - I've been meaning to make my own appointment, but keep forgetting, such is my lack of brain power!)

Sleep deprivation really is the pits isn't it? It's making me resent my daughter for not sleeping, and my son for demanding my attention and adding to my stress    Bless him, he's dealing with a tense, emotional mummy, who's mentally absent most of the time due to exhaustion and over-thinking....... no wonder he's feeling a bit insecure and anxious, which only increases his need to test that we still love him by acting up   

I'm sorry you're having a tough time too    I guess all we can do is keep trying to solve the puzzle and telling ourselves that this phase won't last forever! I'm rubbish at keeping things in perspective, but am trying really hard not to spiral into complete doom..... Hubby and I are taking turns on the night shifts and trying to give each other regular breaks - I've got afternoon tea with the girls coming up this weekend and I cannot wait! 

Hugs to you too xx

[creations]

Does anything jump out?  We are definitely, definitely making progress, although still struggling a bit with LO being unsettled in the early part of the night, and now it seems with waking early in the morning and not wanting to go back off.

Nothing is jumping out.  The overall routine looks more organised, predictable and appropriate so I agree you've made great progress.
You're doing really well to manage those days with the short naps by adding in another CN too.
I only really can think reflux at this point.  The change in my DS was significant once he got his meds.

Seeing as how you describe the family, it is impacting everyone. Honestly I would go directly back to the GP immediately and say you will certainly continue the gavi trial (maybe suggest it is used in all milk feeds?) but you want the referral put through so that you join the waiting list. You are not going to be seen straight away (unlikely anyway) and tbh you all don't need to be waiting two week on gavi to find it isn't enough to then be referred to then wait another month for an appointment - you need to get the ball rolling - if sleep suddenly improves and reflux symptoms disappear or the gavi solves everything you can let the hospital know that you no longer require the appointment with the paedi and they will just move to the next on the list.  I know you are tired and have too much to do, but this one thing I would make priority and get it done tomorrow.

And when you call for the GP appointment, I suggest you ask for a double appointment - LO and yourself - you might as well while speak to the doc about how you are felling while you are there. It's one phone call and one journey for you, it's one appointment to fit naps around instead of you putting yourself last and not seeing the doc because you are worried about naps or feeds or your older child needing you.  It's my suggestion.

In practical terms, can you put a DVD on for your older one and cuddle him on the sofa whilst he watches and you shut your eyes?  I've done this with my DS when I've been either totally sleep deprived or poorly, I snuggle him right up to me (he sits) whilst I am laying down and he feels like he gets a good amount of Mummy time even though I am resting/sleeping.  I know it's still reliant on LO2 napping so it's not likely to happen every day but even once can feel like a relief when you are so tired.

I also hope the doc was helpful for your DH.  My DH suffered paternal post natal depression so I have some understanding of just how much men can be effected.  hugs to you all.
Many hugs x