4.5 months still not extending naps

[mommykay410]

Hi becj, Thanks for popping in.  DS will be 6 months on the 21st.  I just moved him to a 3 hr A in the last few days since he wasn't making it through any naps anymore without patting in the middle and with the EW, and he wasn't showing sleepy cues as early either.  He always has been on the high end of the average A times for his age it seems.  I also dropped the CN completely, his last one was about a week ago and that was only because of super short naps that I wasn't able to extend that day.  I am having to pat him to fall asleep for naps everytime now though, which I'm thinking is a tad bit OT.  Yesterday was the first day that his 2nd nap ended close enough to BT to not be OT, waking at 4:55, so I was hopeful for a smooth night, but he was still super cranky during BT routine and I had to pat him to sleep like always.  He was always able to fall asleep independently for naps and nights since very young, but these last 2+ months he has gotten progressively worse.  I have been having to pat him to sleep at BT and every night waking for weeks now as he can't seem to settle on his own at all.  I'm pretty sure his main issue at night though is his eczema because he squirms to much and can't seem to get comfortable all night.  I'm in the process of trying to find a solution for that    He was still good about falling asleep on his own for naps within a few mins of being put down until a few days ago and now I'm having to pat him for those too.  I'm starting to worry that the patting is becoming a prop that he needs to fall asleep and stay asleep. 

His EAS for the last couple days:
(Nov. 12) WU 7:40 (rare lately to wake this late but I was glad because I figured it would help extend his day to not be OT at BT
E 8:20, apples 9:30
N 10:30-12:45 (fell asleep on own, had to pat from 11:05-11:20)
E 12:50 sweet potatoes 2:15
N 3:35-4:15 (had to pat to fall asleep, would've tried to extend for longer nap but had to go to parents' for dinner)
E 4:25
E 6:50 (fell asleep while nursing, had to pat him when laid him in crib)
S 7:35 (had to pat at 8:20, again at 8:40, again at 9:20 & 9:30)
E 9:45 (had to pat again when laid down after feed)
S 10:25-10:30 pat again
S 10:35-12:25 (fed him, down at 12:55, pat at 1:05-2:20 finally settled completely to sleep)
S 2:20-4:35 (fed him and patted back to sleep)
S 5:10-6:15 (pat again)
S 6:40-7:20 WU
Nov. 13
E 8:20, apples 9:30
N 10:20-12:20 (had to pat to sleep and at 11:05)
E 12:30, carrots 2:00
N 3:20-4:55 (had to pat to sleep and from 4-4:15)
E 5:15
E 6:50
S 7:30-9:10 (fed and pat back to sleep)
S 9:45-10 (pat)
S 10:05-1:30 (he woke up sometime between there and I had to pat him but I'm not sure what time bc I fell asleep on his floor)
E 1:30, down at 2, pat 2:15-2:45
S 2:45-4:15 (fed and pat back to sleep)
S 4:55-5:45 (pat)
S 5:55-6:40 (tried to nurse him back to sleep but he was too interested in looking at the window starting to get brighter with sunrise, so I laid him back in his crib to see if he'd fall back to sleep, not sure if he did but I did on his floor lol)
Nov. 14 WU ~7:05? That's when I heard him start making noises after laying him back in crib
E 8:10, pears 9:00
N 10:05-11:50 (had to pat to sleep and at 10:40)
E 12:05, sweet potatoes 1:10
N 2:45/50- sleeping now, had to pat him to sleep

I am definitely not expecting a full 11/12 hours straight at night, although he has done that about 3 times, but I'd love to go back to the one feeding at 3/4 or even two feedings at 10/11 and 3/4.  I thought DD was my bad sleeper, but boy was I wrong ha.  The last time he only woke once or twice just to eat was the beginning of October, which was just a lucky day I think, and he's been having these multiple NWs since the end of August.  I am crossing my fingers so tightly that he stops this mid-nap waking at 6 months like he's supposed to because I don't know how much more of this I can take.

[becj86]

He's rousing at 35min quite a bit - maybe that's the length of his sleep cycle... Generally an OT waking is easier to resettle.

Getting on top of his eczema will be a big part of helping him. Have you ever tried going to sleep when you're itchy? Its really hard!
I presume doc has you using lots of emollients and not washing with soaps, etc.  I suspect part of the reliance on patting may be that its a distraction from the itch, which he is needing when he gets to the transition between cycles also. The itch can be made much worse by being a little too hot - I assume you have him in cotton clothing, nothing synthetic to trap the heat and sweat.

Those wakings early in the night look like OT or OS.

Edited to add a link to some general advice re: eczema: https://www.rch.org.au/kidsinfo/fact_sheets/Eczema/

[mommykay410]

Thank you for the link!  I feel horrible for his itching at night.  I have been giving him a bath every 2 days and using an eczema wash in the tub and sometimes an oatmeal bath.  His room is the coolest one in the house since it is above the garage so he is definitely not hot at night.  I have him in cotton jammies and a sleep sack.  I have been using Cetaphil lotion in the morning and at bedtime, as well as vaseline on the scaly patches.  And the doctor has me using hydrocortisone when it is flared up and oozing.  Nothing seems to be taking away the itch though.  I have tried at least 4 different lotions/creams for it.  I am taking him to an allergist later this week to see if they can test for any food/environmental allergies/sensitivities that may be causing it to flare up.  It doesn't seem to bother him during the day at all or during naps. 

Yes, the 35 minute transition time seems to be his usual spot recently.  It used to be 40 mins, and at times he'd cry out at 50 mins or the 1 hr mark.  Usually if he makes it past the hour mark he is good, although there were a few days the other week that he'd cry at 1hr5 or 10 and have to pat him.  He actually settled himself and slept through his afternoon nap today for the first time in ages!  He did cry at the 35 min mark but by the time I got up the stairs he had stopped.  He was also kicking his legs at an hour but settled and stayed asleep til 4:35, so 1hr50min nap. 

I do think he gets OS at BT because of the combination of DD running around and wanting to be there, plus taking so long to lotion him and coat all his dry patches.     I will see how tonight goes now that he had a good afternoon nap.  With his A being around 3 hrs now, it will not be that long til his normal BT so fingers crossed!

[becj86]

What's the sleep sack made of? I know we had to go with a cotton blanket tucked right at the bottom of the bed (feet at the bottom of the bed, cotton blanket tucked to shoulder height) so there was no heat or sweat trapping and if you do the blanket that way, they tend to wriggle up and away from it.

Yay for a good nap! FX for a better night for you. I know how irritating those wakings so soon after BT are when you just need some me time.

I wonder if a cream or ointment may help more than the lotion... Here's some info about specific emollients: http://www.eczema.org/emollients  I'm just putting some ideas out there for you to consider/speak to your doctor about.

[mommykay410]

The sleep sack he is currently using is cotton.  I do have a fleece one for winter but I haven't used that one with him.  I just order a whole bunch of fleece pajamas for him for winter too since it's so cold in his room...guess I shouldn't use those then huh. 

I have used Eucerin eczema relief creme, Aveeno baby eczema nighttime balm, pure shea butter, coconut oil with frankincense essential oil, an organic eczema cream I got online, Aquaphor for dry patches, Cetaphil eczema calming lotion, and Vaseline for dry patches.  Multiple people have suggested the Cetaphil which is why I chose to try that one next, but that one is technically a lotion.  I may try Mustela next since that one specifically says "emollient" on it.  I'm not sure how good it is to keep changing up what I use either, but I want to find the best one for relieving the itch for him. 

Tonight I gave him a bath, lotioned, nursed him at 6:50 and he dozed toward the end but was awake when I laid him down.  He started fussing then crying as soon as I laid him down around 7:10 and I patted him on and off til he fell asleep at 7:30.  I've already had to pat him at 8:05 and 8:45.  Not looking too promising for tonight 

[becj86]

Can you ask the pharmacist re: a cream or ointment with no irritants like essential oils, etc. QV or cetaphil are the brands we would recommend here but I'm not sure in the US. You can probably get a cetaphil cream rather than a lotion, if you ask for it more specifically. They may not have it out on shelves much because it's thicker and less comfortable for the general public. Your DS has dry skin that's not forming a proper barrier as ours does so he needs the thicker one to keep his moisture in.

[mommykay410]

I had him at the allergist yesterday and he recommended using the Desonide the ped prescribed on all of the dry patches, not just when it's weeping like originally instructed.  I did that last night and this morning, and I can already see a difference in some areas of his skin.  I put a thin layer of that on first, then I put Eucerin cream over top (it's a bit thicker than the Cetaphil that I have so I figured I'd try that again for a bit).  I ordered Mustela emollient cream that should be here tomorrow so we'll see if that helps any.  The dr also suggested giving him Claritin to help take the edge off the itching.  I want to double check that with his ped first though because I don't want to just drug him up.  His face flared up again today, so that is not helping with his night sleep right now.  I had to pat him to sleep and he was out by 7:10, followed by patting again at 7:55, 8:20, feeding and patting at 8:40 because he wouldn't take a full feed at BT, and patting again at 9:25 

Last night was the best night we've had in weeks since he did a stretch from 9:30 when I patted him-2:30.  But the early morning hours from 4:30-7 were very disrupted, especially from 6-7. 

Naps have been a tad better some of the time.  He slept through his morning nap for 2 hrs straight the past two days which I am super thankful for.  I had to pat him at 35 today for his afternoon nap but he settled right away and slept for an hour 10.  Yesterday's afternoon nap was a disaster as he was OT most likely from the dr appt and couldn't settle to sleep quick enough, so I had to pat him to fall asleep then woke at 30 mins.  I patted him for 10 mins with no luck so ended up rocking him back to sleep but that didn't last very long.  Hoping we are almost out of this broken nap stage so that at least one aspect of his sleep can be restful. 

[becj86]

Hopefully the cream makes a difference and heals things up for him so you can maintain his skin better. Hugs xx this must be exhausting.

[mommykay410]

Hi ladies, I'm back    I figured I would just post back on this thread rather than starting a new one, as the issues are the same.  DS will be 7 months in 10 days and is still not consistently sleeping through nap transitions or falling asleep on his own at night.     We are up to around 3hr20-25 min A time which was just extended to that in the last couple days from 3hr15min.  I have been having to pat him to fall asleep for most naps because he can't settle himself, which I think is a tad OT.  Sometimes he will sleep through the nap, waking after 1hr10/20/40mins.  Other times I'm patting at 35 mins still.  He has been waking up from his afternoon nap somewhere around 4:45/5:15 depending when he woke from his morning nap.  His bedtime has remained the same though, so I give him a bath around 6:30 and then til I lotion him and get him dressed I nurse him around 7 or just before and he has been staying awake during that most nights unless he had a crappy pm nap, so I am laying him down wide awake and smiling for bed.  He is good for a few minutes and then he starts fussing, which I let go until it escalates and then I go in to shh/pat.  There was one night last week that he fell asleep on his own for bed but that was the only day he's done that in months.  It isn't usually very long that I have to pat him, he is asleep by 7:35.  But then he wakes after around 40 minutes, and then again around 9:30 and sometimes again around 10:15, at all of which times I go in to pat him or pick him up to burp him if he is kicking his legs from gas.  Gas seems to be a big culprit in his wakings, so I try to make sure he has a good burp before I lay him down but it doesn't seem to help.  He is usually good after the 10ish pat til somewhere between 1 and 4 when I nurse him and he falls back to sleep on his own.  But then somewhere around 5/6 he starts kicking his legs and fussing with gas again and he can't settle until he wakes for the day around 7-7:30.  So from 5 on I am in there shh/patting every so often til he wakes. 

So my questions are, what can I do to get him to fall asleep on his own at bedtime since he is clearly awake and it's not a nursing/prop issue?  And I'm guessing nap not falling asleep on his own is an A time issue, either OT or UT but his sleepy cues are pretty much nonexistent anymore so it's hard to tell which it is.  And I really thought that the transition patting would have resolved itself at 6 months, but apparently not.  Since I'm not rocking him or nursing him or holding him to sleep, what kind of sleep training could I even do to get him falling asleep independently? 

I think I have the eczema controlled right now, although his face is still not completely clear, but I've been swaddling his arms for both naps and night to stop him from scratching.  That is going to have to come to an end soon too though because he is rolling both ways during the day.  He doesn't roll at all at night, so I've been letting it go for now. 

Another issue is that he hasn't been nursing very much during the day, especially his first morning feed.  I can get him to eat on one side maybe, but rarely a full feed.  Even if his night feed was back at 1:00.  He just never seems to take a full feed during the day.  He is doing great with eating solids, but I don't give those to him til at least an hour after he nurses at least somewhat.  The only times he eats a good full milk feed is at bedtime and middle of the night. 

Any insights?

[becj86]

Gas can be a big issue, even at this age. My DS and I battled it for over a year. So, my suggestions are:
1. feed lying back a bit - is he gulping in air to cope with your milk flow? Sometimes letdown is too much for them and sometimes just the steady stream can be like drinking from a fire hose. have a look at biologicalnurturing.com - it has a video of laidback feeding and it made a huge difference for us.
2. burp well - for DS, I found he needed the heel of one hand pressing gently on his belly (not so much he'd regurgitate his milk but enough to encourage the milk back out (think of the balance one achieves when squeezing air out of a hot water bottle). That can be achieved sitting on your lap or lying on your arm.
3. Don't feed an hour after a feed when he's wanting to get the gas moving. Use a dummy if you are using one, do a tummy massage (an arch from one hip to the other, his right side to his left side encourages the gas along the large intestine and out + push his knees up into his belly firmly but not too hard)

He may be getting enough from one side. It may seem he's taking more in the evening because your supply is at its lowest then and he takes the second side. In the middle of the night, LO is often more relaxed and takes a good feed then for that reason.

He is good for a few minutes and then he starts fussing, which I let go until it escalates and then I go in to shh/pat.

He may need you to shush/pat when he's fussing rather than escalating. I think he might be telling you when he's the right amount of tired and once he's escalating, he's OT, hence your wakings through the evening. I think if you can do a week of shush/pat at fussing time and then maybe only shush, then move back to the door and shush when he's upset, you can get him sleeping independently in stages. Its maybe just too big a leap in skill for him at this point.

[mommykay410]

Thanks for the tips...I will try to do the shush/pat as soon as he starts fussing and gradually wean to just shh.  I've been trying to lighten up my hand and just shh more at night when I pat him so he doesn't get stuck on needing my touch, so hopefully that will do the trick. 

I will check out that video of the laidback feeding.  I think he is gulping at first, yes.  I ordered some probiotics for him hoping that might help with his immature gut since gas drops and gripe water haven't done anything for him at all, actually I think the gripe water makes it worse.  I guess he is getting enough from one side, although it really doesn't seem like he is feeding very long during the day at all, but he is happy so I guess he's getting what he needs. 

I do burp him as you described with my hand on his belly while he sits on my lap.  I switch between that and him over my shoulder until I get at least one good burp since sometimes the change of position helps him.  I also change his diaper between sides in the middle of the night and when he lays down flat and I get him back up again he burps another time or two.  So I think that is probably the issue after he eats the other side because I don't lay him down flat and get back up again like that, so it sits in there and gets stuck while he is sleeping.  I will try the tummy massage and see if that helps too. 

Can you clarify what you mean by

3. Don't feed an hour after a feed when he's wanting to get the gas moving.

[becj86]

Just some people will feed, then feed again when LO has gas because they often give off hunger cues to try to get more milk - when they feed, the rest of the gut moves a bit too so it can help move the gas along. Unfortunately for we who have babies who gulp in air as they feed, it can perpetuate the cycle of feed - gas - feed, etc.

[mommykay410]

O ok that makes sense.  Although I have been guilty of that in the past.  I used to feed him at the 10ish waking in hopes that he would sleep longer after that, as a sort of dreamfeed even though I never really did a true dreamfeed.  But the ped last week said that he shouldn't be eating in the middle of the night anymore at this age, (which I know is not true for BF LOs) so I decided to just pat him at that waking and not feed til the early morning hour waking, and that seems to be working. 

[becj86]

Oh yeah, and gripe water makes the little bubbles into fewer bigger bubbles so that is ok for some kids and not others.