14.5 month old won't nap and won't sleep - exhausted and ill

[Lizzybeans]

My 14.5 month old still won't sleep through the night and won't nap either.

Some background info

She's always struggled to eat due to tongue tie issues but week sorted that, she just doesn't really enjoy food and doesn't tell you when she's hungry. She can go for days without eating solids but she loves her milk.

She has only ever napped for 27 minutes at a time. Never longer, unless we are pushing her in the buggy

She's getting recurrent gastroenteritis and this has necessitated us sleeping with her due to night time projectile vomiting and excruciating tummy pains. She's currently gluten, dairy, wheat, egg, soya, lactose free to try to pin point the issues she's having. She's also on a specialist milk.

She started nursery 7.30am to 4.45pm monday to Thursday back in September and she loves it. But she regularly goes for 12 hours without a nap as she's too busy chatting in her cot or she doesn't show the carers any signs of being tired. They try to put her down between 10/10.30 for a nap. If she refuses they try 12/12.30 and if she does have a morning nap they'll try to give her an afternoon nap around 2/2.30. She more often than not survives the whole day on a 20 minute nap or nothing

We have a good bedtime routine of Bath, bottle, bed but due to her tummy issues she always falls asleep on us as we have to hold her upright after her milk. Due to her lack of sleep in the day (and her lack of interest in food)  I have from around 5.15pm to 6.30pm to attempt to give her dinner, bath, bottle etc then bed.

More often than not by bedtime she is getting quite wobbly, rubbing her eyes, refusing to let me put on a nappy etc but she's trying to run around like a nutter. She is also starting to hit herself in the head with her hands

She is normally asleep by 7/7.15pm and can do a stint of about  4 hours then she wakes. We try to ignore her initially as she can settle herself but then she starts ramping up and has been known to scream for 4+ hours. So we assume she's hungry due to her lack of food in the day and give her a bottle. Quite often this settles her pretty quickly and she's back in her cot.

We've just been through another bout of gastroenteritis and I've slept with her for 4 days and now she's waking every few hours, wanting milk but now she's not settling and only wants to sleep with us.

I'm ill with gastroenteritis myself now, we're all so sleep deprived that we can't get well. The only way we can settle her during the day is to take her out  walking in the buggy (she'll sleep for an hour) or to drive her in the car

We've tried stopping the night time feeds but it doesn't work, we've tried not rocking her, we've had two sleep coaches, we're at our wits end. Even the nursery are baffled and want to help

Can anyone help? People who say, make sure they have a long nap, I don't know how and neither does she!!

[jessmum46]

Hi and first of all (((hugs))), you all sound shattered and at your wits end with it all.  There's a lot going on isn't there?  I'll try my best, I don't claim to be any sort of expert but I'll share my thoughts and maybe something will help

The issues (to summarise) sound like they are
1 - medical issues causing pain
2 - nutrition issues - possibly too much milk (how much does she have in 24h?) at the expense of solids
3 - lack of independent sleep skills - understandable given how tough a time you've been having
4 - over tiredness

I will be completely honest with you here and say that I think until you get issue (1) sorted then there is not going to be a straightforward fix.  Even babies/children who are totally independent sleepers will struggle to settle when in pain and when symptoms come and go then it can be very difficult to pick apart the medical issues from the others.  How far have you got on your journey for a diagnosis?

With her food, what do you offer and when (milk and solids) and how much?  Some kids aren't big eaters, and it is hard if allergies are part of the issue, but giving too much milk can certainly make the problem worse.  Ideally the major bulk of her nutrition should be coming from solid foods now and it may be that you have to tighten up a bit on the amount of milk you allow her to have in any given day.  Around 300-350mls of milk is plenty to give her the necessary calcium in her diet - too much more can interfere with iron absorption (obviously these recommendations are for cows milk, they may be slightly different for your specialist formula).  Are there any foods she will reliably eat or really enjoys?  Perhaps we can use these as a starting point for some new ideas??

I'd be hesitant to recommend sleep training if she is in pain, but when you feel she is comfortable my suggestions would be to change up her bedtime routine, bringing her milk earlier on (pre-bath) to avoid her falling asleep on you.  Then working very slowly on a gradual withdrawal plan to get her more comfortable sleeping alone. There is some basic info here which we can help you build on - Toddlers: Walk In/Walk Out vs. The Gradual Withdrawal Method (HOW TO CHOOSE) (ignore the WIWO information, I don't think that would be the best choice in your situation).

At nursery would they be willing to rock her in a pushchair so she gets a proper nap, or at least better than 20 mins?

What are your thoughts?

[Buntybear]

Hi there and big hugs, at that age my son had wheat/dairy/egg allergies and fructose malabsorption and he didn't sleep through he night until he was 18 months old so I feel your pain.

I think that Katherine has given you a really good response already 

I know it is hard to do but I also have a feeling that the milk is preventing her from enjoying the solids so much. Obviously I am not living in your shoes though so I cannot say for sure. Would she eat things like roasted veg sticks? Porridge? Avacado? Plain meats? Fats and proteins are filling and can help her get through he night a bit better. Do you think it is a texture thing that puts her off food? Have you let her get really mucky and have fun with food?

Even with all the above going on we still managed to get Olly on a fairly good solids diet through sheer perseverance! I am not sure where you are in the world but here in the UK there are lots of free from products available. Have you had any advice from a dietician? They can also give you advice on what to eat and you may be able to get some on prescription?

I think that you are not in a great place now with so much sickness and I too would be doing what I can just for everyone to get some sleep. Until you are all well you cannot think about sleep training. When you do then we can hep you with some gradual withdrawal techniques.

HTH xx