Author Topic: super complicated situation - chronically overtired 5.5mo old  (Read 211 times)

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Offline Alpharatz

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My daughter is almost 6months old and we've had wrecked sleep for the last almost 3 months. There've been so many health/developmental/circumstances that have caused problems that I'll just give the cliff notes version.
She's EBF and we're barely starting some solids - some banana here and there. She's nursed every 2 hours almost around the clock her whole life (will explain more later). She's in the 90% for height and weight - 19lb and 27" at almost 6 months old. She's a very efficient nurser and typically doesn't nurse longer than 10min. She uses a paci only for sleep - naps and night. I know it's a sleep association but I'm struggling and can't bear the thought of not having a "trump card".
We've historically co-slept but are trying to have her sleep in her cot in our room as we have a 2 year old and they are NOT ready to share a room yet and there's no where else to put her cot.
Here's a basic breakdown of our last 3 months.
~3 mo: daytime naps 40min-1 hour and anywhere between 4-6 of them; nighttime sleep 4-5hour stretch  with frequent nursing/wakings after.
THEN she started waking more frequently at night as we approached the 4 mo sleep regression and by the time she was 3.5 mo she was waking every hour during the night.
After a couple weeks of this, my husband and I started sleeping in the living room to give her some space from me and she returned to 4 hour stretches at night...for a few nights until we had her 4 month vaccinations. She had a bad reflux flare up from the Rotovirus vax and then spent the next week screaming/arching/thrashing every hour and half overnight, throwing up/burping up. Daytime naps are about the same - 4 naps around 40 min-1 hour each with the random 2-2.5 hour nap if she was in my arms in bed. She would sleep an hour or two overnight in an inclined rocker but slept best ON me. And by best, getting 1 1/2-2  hour stretches at night.
THEN we got RSV. The whole family.  Ended up in urgent care once with her, she lost 12 oz in a week and a half. Nursing sessions increased by necessity to every hour and sometimes less day and night. During this process, her nursing was terrible and I noticed that she had a severe upper lip tie. Got it evaluated by a lactation consultant and then a pediatric dentist who discovered a posterior tongue tie and two buccal ties on the top gums in addition to the lip tie.  Got them all revised in Feb and have been recovering well.  Her nursing has shifted from every 2 hours day and night to about 3 hours day and night. Good improvements.
But, now that we're semi back on track with life, other than getting sick again this week, she's so overtired that we're in the vicious cycle of too tired to sleep.  I'm going out of my mind with my own sleep deprivation.
A really good day used to look like this, almost textbook. Active times typically 2 hours from the end of the last nap so it varied up to 30 min depending on how well she slept. Our wind down routine is: lights low, diaper change, meds (if any), sleep sack or zippady zip or swaddle, give paci, pick up and hold upright while listening to 5 min of lullabies, put in cot/rocker/wherever saying "night night time to sleep", couple more minutes of lullabies and typically, she's asleep within 10 min. Carrier naps are the same routine of diaper change, paci, lullabies, "night night time to sleep".
Our best day:
700 wake up; nurse
720 A
900 S (~1 hour)
1000 wake up; nurse
1200 S (~2-3 hour)
230 wake up; nurse
400 S (~1 hour)
500 wake up; Nurse
600 nurse
700 S for bed
waking every couple hours through the night to nurse then go right back to sleep. I didn't mind the cosleeping... then it started getting bad.

This week, this is an example of one of our "better" days, our regular/worse days the naps are 40min - 20 min:
600 wake up; sometimes she'll nurse, sometimes not. get up for the day
645 nurse
Nap 1 (55min)
745 wind down;
750 S (in rocker; swaddled with paci)
855 wake up crying;
915 nurse
Nap 2 (55 min)
1050 wind down
1100 S (in carrier with paci)
1155 wake up; happy (on mama still)
1230 nurse
Nap 3
140 wind down
150 S (paci in bed with me while toddler naps)
250 wake up; happy (with mama)
255 nurse
400 nurse
Nap 4 (40 min)
500 wind down
510 S (in rocker, swaddled with paci)
550 wake up; crying
600 nurse
630 wind down, longer bedtime routine (swaddle, paci, lovey)
700 in rocker; fussing escalating to full crying
750 nurse
800 S in rocker
1000 crying; paci back to sleep
1150 crying; nurse 10 min (move to my bed); back to sleep
1250 crying; paci back to sleep
110 crying; paci pack to sleep
130 crying; nurse back to sleep (maybe she's hungry?)
330 crying; nurse back to sleep
545 crying; paci
600 start to wake up, nurse back to sleep
630 wake up for the day.

A good day this last couple months has had 4 hours of daytime naps and only 5 or 6 night wakings. 
This last couple nights I've been keeping her in the rocker or the cot and it's extended her nighttime stretches to 2 1/2 almost 3 hours but it's still about 7-8 wakings every night. I don't know how long it would take her to go back to sleep if I didn't give the paci or nurse. I've been trying to get her to sleep ASAP to not wake the 2 year old in the other room.
The past few days the naps have reduced to 20 minutes in the cot or rocker most of the time and only 40 in the carrier. I can only get more than an hour if she's in my arms in my bed.
I tallied her sleep totals yesterday day and night sleep and it was 12 hours. No where near where she needs to be.

Here's my problem: I cannot spend hours working on her naps like I did with her sister (I followed BW to a T with her and it was great but I spent hours and hours by her side during naps) because I CANNOT leave the 2 year old unattended that long. I can't tell if PUPD is too stimulating but she definitely doesn't respond to SHH/PAT and gets more angry if I don't pick her up.
I  have been trying to put her down for her naps earlier (reducing her A times from 2 hours to 1-1.5 hours) but she has been fighting and screaming in frustration until , if I'm lucky, she gets to typically the 2 hour mark of what she's been used to and then finally goes to sleep...if I'm not lucky then it can go on and on....but regardless, she then wakes up after only 20-40 min.... then I try putting her down again and she'll fight and scream sometimes for upto an hour if I have the stamina for it.
During her awake times she's a happy camper - super social and terrible about hiding her sleep cues so I've been having to go off the clock...which isn't working. She can go up to 4 hours without nursing during the day but she makes up for it at night so that's not been working for us either.

I've been post-poning structured sleep training because of the reflux, illness, mouth surgery, teething, travel, guests, etc. but it's getting to a point I don't think there'll ever be "good time" for it. She won't settle at night for her dad anymore (will get hysterical until she throws up after 40+min of his working with her) so it's all on me and I'm losing my mind. A sleep coach friend says lose the paci but honestly I'm not even sure how I'd do that at this point. I've tried not giving it to her and then the only way she settles is nursing after getting hysterically worked up and I just can't be her human pacifier. I don't mind her crying but it's just that she gets so worked up she throws up and is all clammy and sweaty that I just can't let her do that. Most naps she wakes up crying  (unless she's in the carrier or in my bed with me) and we've had to go back to swaddling if she's not in bed with me which seems like a huge step back.
We have done cranio sacral work with her and it helps for a couple days but then something else throws us off. Her pediatrician is not helpful and just says she's a high needs baby, she'll grow out of any of the reflux stuff and it's just a phase because she's obviously doing well and gaining fine.

Any and all input appreciated...

Beth and Alana (the amazing non-sleeping wonder child)

Offline becj86

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Re: super complicated situation - chronically overtired 5.5mo old
« Reply #1 on: March 13, 2017, 06:05:09 am »
Hi Sweetie, sounds like you're exhausted!

At almost 6 months, she probably needs 2:30 to 2:45 A time, so actually increasing the A time whilst it may seem counterintuitive because she's so tired should help rather than hinder. Once she goes to sleep (which should be easier because she's not UT and fighting), just be ready to go in and hold through the jolts/shush pat back to sleep/reinsert paci at the 20-30min mark as she will have those OT wakings because she's tired and she's not used to these longer A times. That should then help with your nights which are pretty classic for OT and too early a first nap. Frankly, I'd avoid PUPD at this point, she's so tired she'll not likely learn much anyway, yk? In your shoes, I'd probably happily AP what naps you can into her for the first few days of 2.5hr A times, get her used to sleeping THEN once you've a more suitable routine, then look at ST. For sleep cues, its much easier to watch the clock til ~10min before when you'd expect her to be ready for a nap then watch for cues. TBH, its not surprising you're seeing no cues up to 2hr A time at 6 months of age - she just needs longer A times for a start.

Hugs, lovely. Try a few days with 2.5hr A time and see how you go. Reduce to 2:15 or so if she has a short nap. Push through that crankiness that will happen at 2hr or so because she's so used to napping then and stick with 2.5hr for a few days. Once we see what that yields, we can tweak further :)