Starting EASY with 3.5 month old

[cgf]

Hi, how are you all?
Our little girl is 3.5 months old. Ive posted before wanting to start her on EASY, but she's had a lot of constipation/gassiness issues and we're just getting that sorted, she hasnt really taken to much of a schedule before then. ALso, Ive had a very rough postpartum period with a lot of anxiety and insomnia, so i had to take a lot of help in caring for her and didn't feel like i could properly implement EASY when I had so many other people involved in her schedule. Were both TG in a better place and Id love to implement a proper routine. I remember reading that by 4 months it gets harder to break bad habits, and Id love to designate the upcoming week to helping her get on a proper schedule. I know the first question will be what her current schedule is, and I'm embarassed to say that she doesnt really have one.

We have a basic routine, we try to follow Eat, play, sleep. Sometimes my nanny will feed her right before bed, which drives me bonkers. Ive tried explaining the routine to her but we havent quite mastered it. In general, baby wakes up fairly late and goes to bed pretty late. She has sometimes slept a full night (10 or 12 hours uninterrupted) but sometimes wakes up every 4 hours. IN general her most fussy period is until 11 at night, and then she is not up for the day (as in, she feeds but goes right back to sleep) till about 10 in the morning or so, all of thisis very rough estimates. Its not uncommono for her to nap great naps, 2-3 hours in length, but also not uncommon for her to wake up after 45 mins or so. Her tummy i sjust beginnig to settle, im nt sure how big of a role that takes in all this, it definitely distrupts her having a proper bedtime as she isnt asleep for the night until so late.

Id love for her daytime routine to be more predcitable, and for her to have  a bedtime thats more similar to my older kids, 7 or 8 pm.

A few other questions- if her nap is too short, do i work on getting her back down, or do i just start eat, play sleep again?
Also, she is used to sleeping in a rocker, but sometimes in her crib. Somtimes she needs to be shushed to bed, but she often falls asleep on her own. whats my best bet for getting her down independently if she has trouble going down on her own? She often doesnt but just in case.

Also, is there a sleep log i can print out so  that i can properly explain to the nanny her schedule and have her write it down too?

Thank you so much for the help and support i always get o this site- . sorry for the rambles. i get the feeling that aside from her stomach discomfort, she's a very content and happy baby. unless she's having a tummy episode, she is so calm, I feel that if we would implement  a good routine shed take to it super well.

[creations]

Hi there

OK here are a few links which might help, first off EASY logs, although these are designed for you to fill in and keep a record of what happened when, they do not set out to your Nanny what you want to happen - but perhaps they can help. You could fill one in with the routine plan and perhaps Nanny can fill out daily logs of what actually happens so you can review the day.
https://babywhispererforums.com/index.php?topic=265967.0

If you want to really go full on with getting onto a consistent routine you could lift one of the EASY routines from here:
https://babywhispererforums.com/index.php?topic=63161.0
Which has 3hr, 3.5hr and 4hr EASY times set out - these are intended as a guide on how to move from 3hr to 4hr EASY but as you are approaching the age of moving to the 4hr EASY you could pick the most appropriate and just run with it.

Your current routine is obviously running several  hours different to where you want it. The only way to start moving that is for you to move it (or nanny to move it, what I mean is baby is not going to just do this for you).  If morning WU is around 10am you could literally just wake up at 7am and start the day, keep her awake (I do mean keep her awake) and expect there to be some grumbles about it, keep her up for her A time and then let her nap at nap time.  This is the fastest way to get on the routine but you might not be comfortable with the speed of change. If you want to go slower then you could move WU time 30 mins or 60 mins earlier each day for a number of days. If you do this I suggest your write out a plan for the entire shift (that's one to two weeks worth of daily routine times to write out before starting) so that you know what time to get her up, feed, and nap her each day throughout your plan - and then stick with it.  Remember on your plan that BT will move the same amount each day (so 30 or 60 mins earlier depending how fast your plan to go) and you will see the last day of the plan you have something like 8pm BT and a7am WU the following morning.

Getting onto a routine is not exactly the same as sleep training.  You can do both at once or you can stick with your usual methods for putting her down with help when needed and tackle sleep training more seriously after the routine has been changed.  Your choice.
Any health issues do need to be taken into account when sleep training, LO should be fully fit. Whilst it is possible to gently sleep train with some health issues it is not recommended to tackle it in a serious way really unless LO is fit (eg I sleep trained my DS who had reflux but it was very gentle and took a lot of my time and effort to sooth and comfort him throughout).

Moving LOs to the EASY routine always involves a few days of observation, you can use the printable logs for your own record keeping and look back over 2 or 3 days to see what kind of A time and nap length she tends to have, also to see how often she is feeding. This can help you work out a suitable routine to move to - we can help advise on this too.  When you post your EASY here please do it in the usual format used on the forums - it really  helps us to support you more quickly and easily. So:
WU 10
E 10
A 1hr 30
S 11.30 - 1.30 (2hrs)
E 1.30pm
A 1hr 30
...and so on through the day to
BT 11pm
and include DF, NF or NWs
Include short notes about LOs mood, if she needed help to settle, if you resettled a nap or helped to extend it etc, if she was not hungry for her milk etc.

Hmmm..I think I covered your questions, do let me know if you need more help.

[cgf]

Thank you so much.

Ive been keeping a log the past couple 2 days and I'm going a little nutty... seems to be no rhyme or reason to her schedule!!!

Let me share what I have thus far.. your support means so much to me
(A full feed for her is about 6 oz)

4/26
E 730pm  (only 3 oz bec she ate recently)
S 8pm (fussed until 930)
E 9:30 (not a formula bottle, just the syrup the dr recommended for constiopation)
E 2:30am 4 oz
S 3:15 am
E 5:45 am
S 6:20am

WU 9:20 am
E 9:20, full bottle
A
S 10:45
E 11:45, only took 2 oz
A
S 1:00 pm, with quite some help
Awake 1:30 (my nanny wasnt sure what to do with her so she took her out, bathed and walked around with her...)
E 2:00 4 oz
S 2:30
E: 5:30,  wasnt very interested, only took 3 oz
A
S 7:00pm didnt want much bottle, took maybe 2oz
E  8:30, 6 oz (full bottle)
BT 11:15 (didnt settle until then)
now this night, i mentioned to the night nurse that maybe shes awaakening more out of habit then hunger. SO at the next few wakings she gave baby paci instead of bottle and she settled back down fairly easily.
Awake:1, pacifier
Awake: 2:15am pacifier
E 6:00am 6 oz
S 6:30
E 10:40bottle, not much interest, vomitted some
S: 12
Awake 12:45, wouldnt go  back down, worked on putting her back to sleep for abt an hour... shes relaxing in bed now not sure if shes falling back asleep or not.


This is wehre were holding now. Is this enough of a log to see her routine? I will keep updating..  The schedule seems so all over the place, I'm totally not sure where to begin. I do know that Id love her nights to start earlier, and her wakeup to be earlier in the morning, one thing that seems constant in her schedule is the fact that she goes down pretty late and wakes up late...

One question I have is, what to do when she wakes up too early, do we restart the cycle and give food, or do we attempt to get her back down. Secondly, if I want to teach her to self soothe, what method do i use? Shush pat or PU/PD at this point? (shes 3.5 months). Would lvoe some handholding here, where to begin and what exactly to do... would it help if i kept record for another couple days? Thank you so much!!

[creations]

Hi
Could you clarify in your EASY times when she wakes from each sleep please?  If the wake up time is when you do E I can work it out but if she wakes before this and there is some A before E then I would need to know how long she slept for. For example there is a sleep which looks like 2.30pm to 5.30pm, did LO sleep for the full 3 hours or less than this?
When you post your EAS times please show how long each sleep is eg:
S 2.30 - 3.30 (1hr)
and how long each A is from waking to sleeping.  This would be really helpful.

It's also not clear if there was another milk feed at BT around 11pm when she had previously eaten at 8.30pm and went to sleep at 11.15pm.

This is wehre were holding now. Is this enough of a log to see her routine?

Yes this is fine for now (other than needing to know if those sleeps went all the way up to E or if they were shorter), thank you.

would it help if i kept record for another couple days?

It would help if you could continue to record your EAS times throughout the process of moving her routine and learning to self sooth. You don't need to post every day in fact it would be too much if you did, but it will be helpful for you to see how things are going and also to have those records to hand when we need to have another look.

what to do when she wakes up too early, do we restart the cycle and give food, or do we attempt to get her back down

Keep the E to a regular time so every 3hrs or if LO is sleeping it can go longer than 3hrs although I wouldn't go longer than 4hrs during the day.
It is your choice to resettle or get her up and start the A time - there are options on how to get this routine in place and the choices are yours here.  Naps are usually expected to be 1.5hrs to 2hrs so if she has slept this long you can certainly get her up. If she short naps you can decide for now if you want to resettle or get her up.  As your routine changes I might make suggestions on particular naps.

Secondly, if I want to teach her to self soothe, what method do i use? Shush pat or PU/PD at this point?

We always use shush/pat as the first method- you will pick up if LO is crying and put down when LO is calm (or drowsy or even asleep if necessary) but the method of reassurance and soothing is shush/pat. You can start in arms and continue in the cot for as long as needed. Don't worry at this point about giving too much help as shush/pat can be weaned gently.
I actually wouldn't focus too much on self soothing just yet but rather shifting the routine to a more suitable time to fit with the family. This is for two reasons:
1. it is easier to break down what needs to happen and do one thing at a time (routine first, sleep training second)
2. sleep training is only going to be possible when LO is on a suitable routine for age, putting LO down too early or too late is not conducive to sleep training and learning to self sooth.

, I'm totally not sure where to begin. I do know that Id love her nights to start earlier, and her wakeup to be earlier in the morning

OK   So you can begin right away.  If you re-read over my previous post there are two options for shifting routine:
1. all in one go, lift a routine out of the link I gave and start in the morning by waking her. Follow clock time rather than cues whilst the routine is implemented. This way is faster.
or
2. wake her up 30 or 60 mins earlier each day (and begin the routine) for a number of days. This way is slower.
It really depends what you are comfortable with.
Your LO is 3.5 months and looking at your current times is likely ready for a routine of E at 3 - 3.5hrs and A time of 1hr 30 min.
You would record the WU time and jot down when E and S are next due then watch the clock and keep her awake to the time, starting wind down with the aim of having her nod off at the 1hr 30 mark.

Through the night it is absolutely  normal to need 1 or 2 feeds and it looks like your LO is doing a good stretch of longer sleep between E over night so there is no problem there. If it is less than 3hrs since last E in the night then I would suggest you resettle, more than 3hrs feed.

OK.  Its over to you and your nanny
All you can do is review the advice, decide how you want to move forward, and then start.

Let us know how you get on.

[cgf]

Thank you SO much for your response and support.

To clarify, yes, when I wrote E she woke up and ate right away. I will write the schedule more clearly from here on. There was no additional feed unless I wrote it, as in from 8:15-11 she was just fussing but not fed. (I thought it would aggravate her tumy even more)

So, our main issue seems to be eating too little (not a full 6 oz, how do i even know if thats what shes meant to eat? ) and sleeping capping at about 45 mins or an hour. From what I understand from your reply, the main thing is to keep the eating on a 3 hrish routine, so if she awakes too early, is it best to wait till shes ready for a full feed (3.5hr) which will give us A time before eating, my concern with doing that is that her A time is only abotu 1.15 hr, and i ttakes her 30 min minimum to eat, so Im worried she will eat too close to sleeping and wont be ready to eat again after waking up,(especially if her naps have been too short.) which messes up the next cycle as well.. do I make sense?

Thank you so much for your help. So far with your advice, we moved her whol eday earlier which is a huge help and a huge relief. Let me just share our most recent few cycles so I can show you what were still strugglig with...

Sat night 4/27
E 9:15pm 4 oz
S9:50
woke up twice in middle of the night, just gave paci and she went back down fairly easily
E5:20am 4oz
S6am (this was when her cycle was slowing moving earlier, so bc her night started so late i treated the 5 am wakeup as night)
E 8:45 am 4oz
A 8:45-10:10
S 10:10-1 (was out with the family, dozing on and off in carseat generally slept well)
E 1 pm 6oz
A 1:00-2;15, screaming, very constipated, gave suppository, struggled to put her to sleep
S 2:30 with a lot of holding, rocking, then shush pat in crib, (only slept 2:30-3:30 striaght)
3:30, woke up, shsuh patted her back down till 3:45, slept on and off until 5
E 5:00, 6 oz
A 5-7, having a lot of trouble going down, finally fell asleep 730ish.
S 7:30
E 8:30, nanny gave contsipation syrup, not formula
A 8:30-9:15, went back down (treated it as a night wake)
A 12:15 pacifier back down (in retrospect I shouldve reminded the nanny that she dint have a good feed since 5 pm she probbaly needed a formula bottle before bed)
E 2:15 am 6oz, back to bed at 3:00
E 7:20 am, only took 3 oz (seems disinterested in bottle)
A 7:20-8:30 seemed tired and ready for bed
S 8:30, easily with shush pat (slept 8:30-9:30 only)
E 9:30  4oz
A 9:30-10:45
S put her down at 10:45, didnt go down till 11:30, very gassy and unhappy, slept 11:30-12:30
E 12:30

This is where were holding. Whats our best bet for
1. naps that are consistnetly too short-
2. disinterest in eating full bottle. (is it safe to assue that a full feed for her might not be 6oz?? im never sure how to tell.)
and do you always feed beofre bed, and not follow EASY for the cycle right beofre bedtime but EAES? in her kind of schedule, how do i know which is the feed right before bed, if were still in the process of slolwy moving bedtime?

ty so much for your help, your support means so much to this anxious mama !

[creations]

Hi there
Looks like you are moving the day well with that 8.45am WU but I would have made the 7.30 sleep her BT rather than letting her nap again and then doing another A time - it's okay what you did, I know it is really confusing when moving the day so much, try to aim for 12 hr day (or close to 7 - 8 pm BT) at the moment so that her BT doesn't end up too late in the evening.  Anything after BT you treat as a NW and either feed if E is due or sooth back to sleep rather than giving A time.

Can you tell us a bit more about the constipation please? I see you have used a suppository and a constipation syrup.  Are these prescribed by the doc?  Is your LO not pooing every day or how often? Are the poos hard like bullets and hard to push out?
If the constipation syrup is a medication I would have thought the time it is given LO would have needed a milk feed, you say forumla wasn't given, now I'm wondering if it is a special type of formula which contains this constipation meds so LO actually is getting a feed at that time - if not then please check the E times especially with your nanny as it looks like a couple of times only meds are given and not milk where I would have given milk as it has been 3hr+ since previous E.
for example here:

E 5:00, 6 oz
A 5-7, having a lot of trouble going down, finally fell asleep 730ish.
S 7:30
E 8:30, nanny gave contsipation syrup, not formula
A 8:30-9:15, went back down (treated it as a night wake)
A 12:15 pacifier back down (in retrospect I shouldve reminded the nanny that she dint have a good feed since 5 pm she probbaly needed a formula bottle before bed)
E 2:15 am 6oz, back to bed at 3:00

LO is fed at 5pm and not given milk again until 2.15am.  I would have fed at 7pm and got her to bed for the night at 7.30pm.  If not (as you weren't planning on BT at 7.30pm) I certainly would have fed at that 8.30pm E, it has been 3.5hrs since last milk feed.  There was another opportunity to feed at 12.15am which is 7hr 15 since last milk feed which is a long time.  Waiting until 2.15am means LO has gone 9 hrs without milk.  Really 3 months (or 4 months) this is a long time to go without eating.  Even LOs who are considered to be sleeping through the night only do a stint of 5hrs sleep without food, some might do longer, maybe 7hrs but they are asleep and when they wake they are fed.

So - milk feeds.  Feed every 3.5hrs unless LO is asleep. If it looks like LO is going to go to sleep and sleep past 3.5hrs then feed early rather than letting it get very long between E times.
Always feed just before BT, this is part of your wind down and it doesn't matter if it has only been 1hr or 3 hrs since last milk feed, feed again at BT in enough time to fit it into the wind down before sleep is due (ie start 30 mins before BT).
At night, watch the clock, if it has been 3hrs+ since previous milk feed then go ahead and give a night feed. No A time in the night, just feed, nappy change if needed and straight back into bed.
If you can get the day feeds on track plus the BT feed at BT then you might see fewer feeds in the night and a better feed at WU in the morning - lets see what happens.

OK - keep going

[cgf]

Thank you SO much for your prompt and super helpful answer!

Hi there
Looks like you are moving the day well with that 8.45am WU but I would have made the 7.30 sleep her BT rather than letting her nap again and then doing another A time - it's okay what you did, I know it is really confusing when moving the day so much, try to aim for 12 hr day (or close to 7 - 8 pm BT) at the moment so that her BT doesn't end up too late in the evening.  Anything after BT you treat as a NW and either feed if E is due or sooth back to sleep rather than giving A time.- So, i wanted to put her right down after feeding, but she wasnt going to sleep-- essentially fussing from 5-8:30.

So, as far as the constipation/gassiness, yes the syrup and the suppository were both prescribed by the dr. I actulaly went back to the dr today, who said that bec its been such a persistent issue and not just a couple of days here and there with constipation, I should switch her formula to one that might be easier on the stomach. we made the switch today and hoping for some improvement.
Tonight she ate before going to bed at 7, hopefully that will help some, but shes been refusing her bottle at two differnet E cycles today, which throws the whole thing off balance and makes it hard to remember when she ate and when she needs to eat.

So, new plan. Make sure she gets a good feed (or at least try!!) before BT. If its been 3+hrs since feed, feed agin at night. How about the day feeds? how do i encourage her to eat more, and more consistently at each A time? Today, even when its ben a while since a feed, she still was pushing her face away from bottles

Heres what happend today: (continuint from earlier post)

E 12:30 (only 3 oz)
A 12:30-2, tried feeding repeatedly but didnt take the bottle
S 2-3:30 , with some wakeups (i was pushing her outside in stroller)
E 3:30 (refused bottle), kept trying till 4:30
A 3:30-5 ish awake
S 5-6
E 6:00 refused bottle
A kept trying bottle, 6:30 finally took about 3 oz
S 7:30, took another 3 oz before bed

I'm jsut at a loss of what to do about her lack of appetite at E times.. and her short naps. she only took that 1.5 hr nap (2-330) bec i was pushing her around, which she finds soothing. I think shed be so much happier on a steady schedule of efficient eating and sleeping!! What else can i do??

Thank you SO much. i cant tell you how grateful I am for the support!!!

[creations]

Hi sorry for the delay in replying

I will ask for some additional feeding advice for you - for now all I can really say is that some LOs eat less than others and some find the evening and night time feeds more comfortable if they are in any discomfort during the day, this might be the case for your LO (or might not).  It may also be that if you try on and off with the bottle for a long time she could be having little bits over this long period and then isn't sufficiently hungry for the next feed. So if you feed on and off from 12.30 to 2pm and then feed again at 3.30 it's only been 1.5hrs since she *possibly* had something to eat.
I would watch out for keeping a bottle too long, my understanding is that anything not taken within 1hr of the beginning of the feed should be thrown out due to bacteria levels.
It does seem somewhat worrying that she is refusing so many feeds though and going from 12.30/2pm until 6.30 without a feed between.
Has the GP said anything about the type of formula you are now using - is there a chance it doesn't taste nice?  Have you tried offering it warmer/colder to see if it makes any difference?

For now I would use the stroller if this helps her to sleep more peacefully - I realise it is not the end goal, that would be independent sleep, but your LO seems to have some health issues and we generally don't advise beginning sleep training unless LO is fully fit.  I'd say wait a while and get the routine in place then sleep training will be the next step.  In any case you can't sleep train with a routine which is not working so lets focus on WU time, naps times and BT, plus E times in the day and NFs.
I recommend you write down all her times so that you do not need to remember when she ate but have it written down - sleep deprivation makes us all forgetful. 

[Martini~]

Ok so let's try to help:)!

I am not an expert in constipation issues but probably can help with bottle feeding. At her age she probably should drink around 20-30oz per 24h, with 18oz being really a minimum for some LOs and 30-40oz maximum for some LOs. There is no need for her to eat 6oz at each feed (it's 6oz of water and powder so around 200ml yes?), also 3-4oz would mean a good feed for LO. Feeds during day can be apart 4h at that age with a bottle but can also be still 2-3h apart. It all depends on last feed, time of the day, amount of milk taken at night etc. I would presume that if she had no feed for 2.5-3h (refused bottle is not a feed), if she is moaning she can be hungry.

Secondly, She is refusing some feeds after 3h and you said that feed takes 30min which is long for a bottle fed baby at that age IMHO. If you are not breastfeeding at all and there is no risk of mixing bottles with breast I would firstly try a bigger teat or different bottle. Secondly I would check what kind of formula you are using. Some special formula can taste awfully (like Nutramigen) and LO only takes it when they are awfully hungry. You can also check if the temperature of milk is not to cold or hot for her, some LO have preferences. Try to feed in a quiet darker place without distraction. I would try for a lot least 10min and with her in different position like on hands it in bouncy chair.

I would be tempted to think if her constipation problems are coming from the fact that she is dehydrated as drinking so low number of formula. How many wet nappies she has during 24h? How is her weight gain?

Keeping all that in mind I wouldn't worry about eating/sleeping schedule to be so precise if you have problems with bottle feeding. And it seems that you have as LO is totally refusing bottles even after 3-4h sometimes twice in a row. I would be precise with sleeping schedule and A times but just try to incorporate E in between even if it means feeding every 2/3h. If LO is refusing bottle at all don't wait until next feed but just offer milk once again 1h later. I wouldnt worry about feeding too close to sleep time for now, just make sure she is not fed to sleep and that should be enough. Quick short routine after bottle and she can go right to sleep.

Re night feeds - my LO is going 8-9h without a feed from 7/8 weeks old and it works for both of my sons. But in only happens because they have plenty of milk during day. That said we are 4mo with DS2 now, he is breast fed but we can switch to a bottle and he still can be hungry after 3h or 2.5-1.5h in the evenings where feeds are smaller. Two days ago he ate 6oz formula bottle at 2:30pm and was starving at 4:50pm, and then once again hungry at 6:30pm which was his bedtime feed.

At night pacifier is probably fine if she wakes just for a brief replug and sleep well until morning but I would only do it if she is gaining weight well and had a lot of milk during day. After a day with 15oz drunk for example I would be tempted to use every occasion to feed additional couple of oz. However as said before it depends on her weight gain.