Author Topic: 5 month old - Shush/Pat started working very well, but only for a few days  (Read 173 times)

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Offline Nicolas Leon

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Hello all,

We have a 5 1/2 month old baby who has been on EASY routine since he was born, exclusively breastfeed. Up until now we have been rocking him to sleep, walking around the room until he was deep in sleep and then putting him into his crib. Oftentimes he would wake as soon as his body touched the crib - up he'd go, back in arms, rocking back to sleep. He has been a terrible sleeper since day one, taking short naps throughout the day, waking many times during the night. It's been quite difficult for us.

Last week we decided to start sleep training and began with shush/pat. We were really amazed at how fast and well this method worked. For both naps and bedtime, we began by following the same routine - told him that it was time to rest, lowered the blinds, put on relaxing music, rocked him for a minute to get him in sleep mode and lay him down awake. We sat next to him, a hand on his chest, giving him reassurance, and he feel asleep calmly. He began to sleep long naps (1.5-2 hours), and slept much better at night as well - with only two wakings to breastfeed and he'd fall right back asleep alone in his crib, without any help. My wife and I were taken aback, joyous in the newfound rest our baby was getting. And us as well!

But after four days he began to resist shush/pat and started to cry in his crib. So we began to pick him up, calm him, and lay him back down. But this almost seemed worse, as every time we did this, he began crying more and more upon laying him back down. A few days have past and he now cries all hell when we place him in his crib and he's back to short naps and numerous night wakings. It's as if he now completely rejects his crib. We pick him up when he cries, calm him down and set him back down as many times as may be needed. But what happens is that he ends up falling asleep in arms when we pick him up to calm him down. So it's almost the same as before.

We are lost now. We don't now if we should continue shush/pat and try to calm him without picking him up, although that entails crying in his crib, or to continue pick up/put down over and over, even though that means he ends up falling asleep in our arms (which is exactly what we are trying to avoid).

Here's his routine last week before we began sleep training:

7am - wake & feed
10am - nap
10.45am - wake & feed
2pm - nap
2.45pm - wake & feed
5pm - nap
5.45pm- wake & feed
6.30pm - bath
7.30pm - feed
8pm - bedtime
11pm - wake up to feed
2am - night waking
4am - wake up to feed

Here's his routine after sleep training:

6am - wake and feed (he wakes earlier than before, we assume because in general he's better rested now)
9.30am - nap
11.30 - wake and feed
3pm - nap
4pm - wake and feed
6.30pm - bath
7pm - feed
7.30pm - bedtime
1am - wake up to feed
4am - wake up to feed

Since sleep training led to a much longer morning nap, it has shifted his routine, eliminating the second afternoon nap. Maybe he wasnt ready for this.

Any advice is welcome as we are at our wits end.
 
« Last Edit: July 10, 2017, 12:01:58 pm by Nicolas Leon »

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Hello, welcome to BW forums :)

Great you had such quick success with shush/pat - what a shame to hear things are tricky for you again.

A couple of things which come to mind as possibilities for the "regression" in sleep training:
1. often on day 5 of ST people see a regression, LOs last ditch attempt to see if the rules are always going to be like this or if they can get it back to how it was with the props which were previously in place.  Hold firm, support him of course but keep on putting him down in the cot for sleep (I'll add below a tip which may help)
2. With a longer morning nap it is possible that he needs a longer A time to help him get a decent afternoon nap.  His first A time was 3hrs and he was sleeping a short nap, his first A time is now 4hrs and he is sleeping a longer nap of 1.5 or 2hrs. It could be that he likes the longer time.  Increasing the second A time could help with the nap resistance. The crying could be him trying to tell you that he is not yet ready for sleep. You could try an additional 15 mins A time (3hrs 15) and see if this helps over a few days.
3.  Some times LOs realise that they sleep better without you (because they are confident of your support and they know you will always return when they need you) so crying can be an indication they want you do go away and let them get on with it.  It is confusing and I am not suggesting you leave your LO to cry alone, we don't agree with that, but it might be worth an experiment to put him in his cot and say "have a nice sleep, call if you need me" and just walk out.  If he calls or cries then of course you can go directly back in.  I did this with my DS because my presence really bothered him.  There were also times when my DS needed me (illness, teething or whatever reason) and wanted a pick up and cuddle but would also scream to be put back down because he knew he was really tired and he wanted to be in his bed sleeping.

We pick him up when he cries, calm him down and set him back down as many times as may be needed. But what happens is that he ends up falling asleep in arms when we pick him up to calm him down. So it's almost the same as before.
What you could try is after a couple of pick ups instead of fully picking up you position your hands as though you are picking up but only raise him a couple of cm from the mattress, he feels his weight lifted, feels the comfort of your hands firmly around him but you are close enough to the mattress that when he nods off you can get him down gently but really quickly.  If he gets to the point of nodding off the second you pick up even a cm off the mattress then barely lift him at all, firm hands on, raise his weight only slightly and put back down but keep the firm hands on him.  Wakes again - then firm hands on him but don't lift.  This way you should, if you are quick and alert to what he's doing, be able to get him on that mattress before he nods off, even if your hands are still on him to begin with. Next step is to stay alert to what he's doing again but hands off before he nods off.

It's as if he now completely rejects his crib.
This can sometimes be cause by OT but looking at your times my hunch is that it could be a little bit of UT (under tired). If he screaming blue murder and rejecting the crib you could try taking him out of the room for 10 min then going back in. Just say "looks like you are not ready yet, okay lets go and look out the window for a while".
Your current A times are within the guidance times but these are only guidance and some LOs do better with a bit less or a bit more than the guidance.

eliminating the second afternoon nap. Maybe he wasnt ready for this.
At about 6 months that last CN drops to leave two long naps so it is not unheard of for a 5.5 month old to move to 2 naps. The only thing at the moment I'd say is that the second nap is not really long enough and I would expect him to need two proper naps of 1.5-2hrs and that with two good naps the nights should also get easier.  Taking into account though that he was getting through the day on 3 naps of only 45 mins he is still getting more sleep than pre-sleep training.

6am - wake and feed (he wakes earlier than before, we assume because in general he's better rested now)
Yes it could be. There are a couple of other possible reasons:
1. his BT is earlier which can lead to earlier WU - he was doing 11hr nights and is now doing 10.5hr which is not hugely different.  10.5hr of better sleep is better than 11hr of lots of NWs
2. His A time before BT might be too long, it's around 3hr 30 min so although BT is earlier he is getting more tired before BT and could be a bit OT. OT before night sleep can cause multiple NWs and also earlier waking (as in waking before they have had enough sleep).  You could try to reduce the A time before BT by making nap 2 a bit later but also longer.
3. Possible teething pain - teeth can move quite a bit before you see them cut the disturbed nights and earlier morning could be due to pain but because you've recently sleep trained it causes a confusion over the cause of disturbed sleep.  If there is pain LO can wake up earlier than usual because they come into the lighter sleep, feel the pain, and then can't get back to sleep.  If there is a chance of teething you could try meds at the 4am NF (night feed) to see if it helps bring WU later.

No clear cut answer I'm afraid as every baby and every routine differs, but hopefully a few ideas there of how you can go forward.  Keep in mind just how wonderful those few days were when things all seemed to click and go well - you can have more of that ahead if you keep going with the gentle and respectful sleep training methods.


Offline Nicolas Leon

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Thank you so very much for your long and thoughtful answer. It's really wonderful support for us. Sometimes one is so tired that we can't see the whole panorama. Your words help a lot. We are going to follow your advice, it all seems very sound.

There's one thing that my wife does during shush/pat, and we wanted to hear your opinion in regards.

She lays LO down in his crib and shush pats reassuringly; when he starts to cry, instead of picking him up, she leans into his crib and places her check next to his, while continuing to shush pat. This usually helps him to calm down and fall asleep.

Do you see a problem with this? Do you think there may be an issue with her "entering" his crib? Is this in any way an invasion of his sleeping space, or could it confuse LO in any way? Just wondering and would love to hear your thoughts regarding this.

Thanks again for your help.

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I'm glad I can be of some help :)

What your DW is doing during shush/pat is totally fine in my opinion.  Part of the BW book also describes certain baby type who need a very loud shush right near their ear (but not into the ear as it can cause damage).
Many parents adapt shush/pat to suit their LO or because it works (for example mine did not do well with patting, I used rubbing or a rocking motion with a firm hand on him). Generally we try to focus on things which can be gently or gradually weaned, reduced and reduced, rather than things which are "props" which are things which are very hard to reduce or change.  Adding additional support whilst LO is inside the crib is much easier to reduce than for instance bringing LO into your own bed - you can take yourself out of the crib and LO is still in a known environment, seeing the same view, feeling the same position on his own mattress, this is a huge difference from trying to get LO out of a parents bed into a totally different room, different bed etc.
In fact during a difficult transition for my DS, moving from a baby hammock by my bed into a cot-bed in an adjoining room when he was 9 months old, I put some bedding on the floor by him so I could stay all night, at some point I actually climbed in with him (talk about invading his sleep space!).  I didn't get much sleep it has to be said, I barely dozed the whole night, he didn't sleep well either, but the entire transition was complete in 3 days and he was then as confident to go to sleep on his own in there as he had been to go to sleep on his own in his hammock.  My DS wouldn't even sleep in my arms, he certainly didn't want me in his bed but he also needed me very very near him for that difficult change.

Going back to the cheek to cheek shushing - keep in mind you only do as much as LO needs, you comfort LO and then reduce, if LO is crying hard and needs calming you add in more comfort, and then you reduce again. When parents stay alert to what they are doing, how LO is responding and how much LO needs then these supports are quite easy to reduce and wean.  When parents are tired it is easy to fall into a daze and just keep on with the additional support without thinking about it, this is where you can get "stuck" at a certain point because you teach LO to rely on it.  Getting "stuck" leaning over a crib would be a very uncomfortable position so keep that in mind. But, sure, it's fine if it is a brief thing and your DW is comfortable enough.  All of us know here that even shush/pat can be very uncomfortable leaning over a crib or sitting on a stool with an arm through the crib bars...
Tracy did say EASY is not always easy!  Worth it though :)

hope this helps. Do feel free to ask more questions either here or across the other forum boards, as needed.


Offline Nicolas Leon

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Once again thank you for your thoughts and advice. It's very helpful to us.

If you don't mind, I'll continue asking, as one has so many doubts and doesn't want to mess up ;)

We're still struggling a bit, but it does seem to get easier. What we have found though is that while our LO does get into his crib and falls asleep quite well, he often wakes up after 45 minutes. Always 45 minutes, not 35 or 55, but 45. And when he does wake up, it's impossible to get him back to sleep. Well, during the morning nap it's a bit more feasible, although it takes a lot of PO/PU. But in his afternoon nap he has been waking up after 45 minutes everytime, and it is impossible to get him back to the crib. I've even tried to re sleep him in arms and lay him down asleep, but even that doesn't work as his eyes pop open immediately. And he is clearly still sleepy, since as soon as I pick him up, he sinks his face against my chest and falls asleep. Any advice on resleeping him when waking too soon ?

The second doubt we have is regards to EASY. Since he wakes up and eats, and then has some 3-3.5 hours activity time, should we feed him before his following nap? EASY used to work just fine, but now that he has much more awake time, it's tough to get him to sleep 3 hours after waking up without feeding. Specially if he is to sleep 1.5-2 hours. This would mean that if he ideally has 3 hours A time and 2 hours S time, then LO would go 5 hours without feeding. And since he is strictly breastfed, that seems way too long between feedings. How do you recommend we adapt our EASY schedule for our little one?

Once again, thank you.

« Last Edit: July 14, 2017, 02:50:05 am by Nicolas Leon »

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If you don't mind, I'll continue asking
That's fine, ask away, the BW community loves to help.  We've all had help in the past and continue to get help from the community as our LOs grow into toddlers and school kids.  I couldn't manage without the support this place gives me :)

What we have found though is that while our LO does get into his crib and falls asleep quite well, he often wakes up after 45 minutes. Always 45 minutes, not 35 or 55, but 45. And when he does wake up, it's impossible to get him back to sleep.
There are usually a few possible reasons for this:
- has not learned yet how to transition from one sleep cycle to the next, sleep training helps with this and you can also do a W2S (wake to sleep) which is another sleep training method to teach him he is to sleep longer and how to transition. Here's a link:
https://babywhispererforums.com/index.php?topic=223809.0
look at naps option 1.  You begin soothing before the transition time and continue into deep sleep.
- some sort of pain, discomfort, external influence (noise, too hot/cold) or developments (learning to roll, sit, stand).  As LO comes to the end of one sleep cycle rather than transitioning into the next they fully wake because they are in pain, or learning to roll or too hot/cold.  Knowing your baby and looking for clues as to what the issue is can help resolve this.
- LO is UT (under tired).  Sometimes LOs are tired enough to fall to sleep for the nap but not tired enough to transition into the next sleep cycle so they wake after 1 cycle of 45 mins.  For this you would increase the A time.  Sometimes it is only a small increase needed, 5 or 10 mins and this will help the transition.  Sometimes it is a much larger increase needed.  If you look back at reply #1 I mention A times and nap resistance. Your LO is on quite a good A time for age but the times are only guidance, you may need to go to 3hr 15 rather than 3hr to get a better nap.

For the shorter naps at this point I'd suggest first trying W2S and possibly another 10-15 min on the A time.  A times can vary a bit for each nap, the second A time might be longer than the A time before BT for instance.

should we feed him before his following nap?
Yes you can do.  In terms of guidance routines the 3hrs A time often comes around 6 months when LO is introduced to a little solids, the small amount of solids can help to tide LO over and go a bit longer between milk feeds.  LOs then naturally go a little longer between E especially when they are sleeping they are able to go more like 5hr between milk feeds.  Again it's just guidance and it is fine to do a BF before the nap to make sure LO is not hungry.  I would just time it so that there is a bit of A before putting down to sleep so that you avoid a F2S (feed to sleep) prop - a nappy change and a few mins is enough.
At this age it is still advised to BF on demand, LO might not be asking for milk prior to nap but you can offer a top up feed before nap time so that he is getting enough.

hope this helps


Offline Nicolas Leon

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Thanks again creations!

I`ve tried something similar to W2S, adapting it a bit. I can't get myself to waking him up :o, sleeping has always been such an issue. What I have been doing since your last suggestion though is going into the room at 30 minutes and waiting for him to wake. He's a little clock, always waking between 35 and 45 minutes after falling asleep. He always wakes up suddenly, a bit startled, but since I am there next to him I simply place my hand on his chest and shush a bit and he goes right back to sleep; usually for another 45 minutes - which gets him to 1'15'' to 1'30'' naps. Good enough for me :)

I'm not sure if this adaptation to the method will help him transition between cycles independently, but at least he's napping better. Maybe I'll try actually waking him a bit soon.

And since all your advice has been so helpful, I'm going to continue asking away  ;D

Sleep training is working quite well, we see advances being made, and naps having gotten much better. So, now another issue that has us really exhausted - night wakings.

LO has never been able to sleep through the night, not once. I figured sleep training would help this issue, but it really hasn't changed much. And I think the main issue isn't so much the amount of times that he wakes up, but that sometimes it'll take him and hour (or more!) to get back to sleep - which is incredibly frustrating.

His night waking are pretty consistent, varying just a bit here and there, but usually something like this:

7.30pm  bedtime
12 - wake and feed
2 - wake, help him sleep again
4 - wake and feed
6 - wake up

Like I said, when he wakes and is able to fall back asleep quickly (with shush pat), it really isn't so bad, but when it takes him over an hour to get back to sleep, it's truly exhausting physically and mentally. The long awake time always occurs at the 4am waking - he clearly isn't as tired anymore and it's much tougher to get him back to sleep. Sometimes I end up rocking him in arms back to sleep from exhaustion, although this isn't even a proper solution, as he'll often wake up as soon as I put him in his crib.

Should we wean him of the night feedings altogether?

He's turning 6 months old this week and we're going to start with solids. Maybe this will help a bit, he's strictly breastfed until now. Although I don't have much hope that this is the solution. I realize our LO is a habitual waker, and we need to address this issue.

Like always, any help is much appreciated.











 

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I'm not sure if this adaptation to the method will help him transition between cycles independently, but at least he's napping better. Maybe I'll try actually waking him a bit soon.
This is fine and it really should help. It is similar to one of the W2S methods. If you look at the link I gave above and scroll to naps method 1 it is pretty similar, it's about seeing them through the transition rather than disturbing them. There is another type of W2S which disturbs LO with a light touch.  You don't actually wake LO though.

His night waking are pretty consistent, varying just a bit here and there, but usually something like this:

7.30pm  bedtime
12 - wake and feed
2 - wake, help him sleep again
4 - wake and feed
6 - wake up

Two night feeds are well within normal at this age, especially for a BF baby.  Solids may not make much difference for several months depending how much is taken but also large (too large) amounts can even increase the night feeds because solids don't have as many calories as milk so LO can end up more hungry rather than less (tummy full of solids means taking less milk in the day which leads to more night feeds needed).
Have you tried BF at the 2am NW instead of holding off until 4am? I just wonder what would happen.  Your LO is getting a long stretch from BT to midnight and that is the part that is classed as "sleeping through" (which is only about 5 hrs). I realise the 2am NW is only 2 hrs since the previous E and usually we'd say wait until 3hrs but as it is so hard to get back to sleep at 4am maybe eating at 2am would help him just go through to 6am rather than wake again?
I would try it for a few nights and see what difference it makes.
I would continue to feed 1 or 2 feeds at night and go easy on the solids, tastes and learning about textures rather than trying to feed him up.