Going back to PU/PD. Advice appreciated!

[J-Dad]

Our daughter is 6mos and is on 4-hour EASY.

We have used sleep props for most of my daughter's life--mostly nursing/feeding to sleep, and she began sleeping through the night around the beginning of her 3rd month. At around 4 months, though, everything went to crap and we decided we had to get serious about EASY and use PU/PD. We had great results and things improved immensely for a week or more...

...after a couple of weeks, though, we had some regression and both her mom and I slipped into accidental parenting. Her mom would feed her to sleep after a night waking or I'd hold her until she fell asleep when she wouldn't nap. Now, at 6 months, we're relying on props almost every time. Lately, that only means me holding and swaying with her until she goes out (which, thankfully, she does quickly) then putting her in the crib. Lately we've had many, many night wakings, too. Obviously, this can't continue.

We're planning to start tomorrow [Tuesday] going back to PU/PD for all her sleeping but I'm tired just thinking about it. Here's why:

• I can probably count on two hands the times I've seen this baby fall asleep on her own, and every one of those was using PU/PD last time.
• She sleeps on her back, so no Pat/Shush.
• She rejected the swaddle months ago.

We're following the steps, winding down and having a sleep-appropriate room. We're following the schedule and her cues as well as we can. We're trying to pause and give her a chance to self-soothe (She doesn't.). She also eats well--she's 99th percentile for weight and we've just started her on some solids as well as breast milk. Right now I'm just really, really worried about how long PU/PD is going to take and whether my wife and I will have the energy for it.

Now that I've typed all this out, I realize there isn't exactly a question. I'd just appreciate any tips you have that helped make PU/PD work for your family and any encouragement you have. We're already tired and feeling more than a little apprehensive about going into this!

Thank you!

[creations]

Hi there
Stopping by with some support and perhaps a few things to think about.

Now that your Lo is 6 months she may need a change in routine, although you are following a routine it may not be the best she needs to enable her to learn to self sooth and go to sleep with less help.  At this age many are on (or in the process of dropping down to) 2 naps rather than 3.
If you need help with routine please post a recent EASY, times that happened rather than what you aim for.

At 6 months most LOs still need a night feed so it is not necessarily a bad habit that Mummy is feeding her at night to settle, she is likely hungry.  BF babies may need night feeds for a good while yet (and often formula fed up to about 8 months), there isn't any point trying to stop all night feeds as you'll just end up awake longer in the night.

She rejected the swaddle months ago.

No need to swaddle to teach independent sleep, mine didn't have a swaddle after about 10 wks old, I only used one rarely in desperation to calm him through some bad phases of teething and reflux when he was thrashing so much I could barely keep hold!  In any case swaddles are not really suitable once a baby can roll which is around now.  So no swaddle is no problem.

I can probably count on two hands the times I've seen this baby fall asleep on her own, and every one of those was using PU/PD last time.

Try not to let this put you off.  What has happened in the past is not an indication of what is going to happen now.
Know your goal and how you are going to approach it, always supporting through the tricky times, never leaving her to cry alone and you will get there.

She sleeps on her back, so no Pat/Shush.

Most people don't pat the back any more because the guidance is for babies to sleep on their back. Some people roll LO to pat the back and roll onto back when they are asleep, this sounds awkward to me but people manage it. Others pat the tummy or hip or nappy area, obviously not hard on the tummy you don't want to hurt her or bring milk up, but nappies are quite padded, you can still provide the hypnotic soothing rhythm of the patting without it being on her back or too firm.
Another option is to adapt the patting to a rub or a rock. I see you are currently rocking to sleep so this could be an option for you as she is already accustomed to this soothing method.  Rocking can be weaned just like patting can, you start out like usual with whatever level of rocking sooths her (this is the wind down not the sleep) and then you reduce and reduce over days, always returning to a strong rock when needed and a less rock (or on/off start/stop rocking) as soon as she calms to gradually wean it until eventually you are hands off.
One way to begin this process is (rock as usual for a period for wind down) to switch to rocking with her laying horizontally in your arms if you don't already (ie if you currently rock with her upright over your shoulder).  If she fusses you go back a step, increase the rock, raise her a little, then back down to horizontal etc she'll get used to it.
Next is to reduce the rock so that when she nods off in arms you are motionless
or
Next is to put her into the cot and continue to rock in the cot - I did this with mine who couldn’t be patted. A firm hand on his tummy/hip and a small movement of the hand produces a nice little rocking. You can do this for as long as needed in the cot and all the way to sleep if necessary. If she is very upset you PU and sooth in arms then PD and continue to rock in the cot with firm hand. If she is calm you reduce and reduce if she fusses you increase a bit and then reduce again.  This can help to avoid lots of PUs because she stays in the cot as much as possible.

If you are both consistent with the approach and use it for all naps and night sleep I think you ought to see improvement in a few days or a week.  it can be hard work and it can initially take longer, I think you know that, but with your support your LO is going to feel confident to fall asleep in her own bed.
Good luck for tomorrow

[jessmum46]

Edit - sorry must have just hit post as Creations did the same!

Hi and sorry you're both so tired out - these little people are amazing but hard work!

So the first thing that would help to know is are you aiming for the 'standard' 4h EASY which has 2h A time, and 2x2h naps with a catnap?  If so, that may be a big part of your difficulties now she is 6 months.  That standard routine is very appropriate for a 4 month old, but by 6 months many babies can handle 2.5-3h A time and are headed towards the 3-2 nap transition, if not there already.  Having an inappropriate routine is one of the commonest reasons for troubles with PUPD and I suspect you will see success far quicker by making sure what you are aiming for is realistic. 

Could you perhaps post a typical day for her now, when she wakes/sleeps etc and for how long?  That might help us to guide you as to what sort of routine to aim for. 

Have you seen the FAQs about PUPD?
https://babywhispererforums.com/index.php?topic=275699.0

And also this one about the 3-2 transition?
https://babywhispererforums.com/index.php?topic=246541.0

Just to pick up on one or two small points - you can definitely use shh pat for a baby who sleeps on their back   We all know that's the safest place for a baby to sleep from a SIDS point of view and it just becomes a case of adapting it to make it work.  One of mine I sat next to her with my hand kind of laid across her nappy area/tummy and patted the hip on the opposite side.  The other I just stroked his head and shh-ed.  Swaddle not needed - never used it for either of mine really and at 6 months I wouldn't be wanting to introduce it anyway from a safety point of view (rolling). 

You can definitely do this and we're happy to be here supporting

[J-Dad]

Thank you creations and jessmum46 for your thoughtful replies! You've given me a lot to consider, particularly extending DD's A time and dropping the evening catnap (which she has seemed keen to do, anyway).

I hope to give a more detailed response soon, but last night was long and I don't expect today's naps to be terribly restful for anyone. Nonetheless, please wish us luck! Hopefully I'll be back soon with a success story.

[J-Dad]

Just a quick update:

This morning was not fun. LO was as grumpy as I can remember her being in the past several weeks. This could be due to how little uninterrupted sleep she got last night, the vaccinations she received yesterday, or some combination thereof.

Whatever the case, she absolutely refused her bottle. This is something she's been doing lately, arching her back and whining when I try to give it to her, but today she downright refused. She also refused to play on the floor. Basically, she was a big grump, so I just held her.

Well, at about 2h of A time I felt her neck start to go limp on my shoulder so I whisked her up to her room and started setting the stage while stimulating her just enough to make sure she wasn't asleep. I put her in the crib, put one hand on her head and used the other to pat her. I moved the patting depending on how she moved, rolling from her back to her side. Eventually, I began singing the song I use to get her to sleep and patting her rhythmically on the diaper. Within 5 verses, she was asleep,  and she's still asleep almost half an hour later. No PU/PD necessary!

Now I'm just hoping she'll make it through the transition in a few minutes and I'll get a full 1.5h from her. (Haven't seen 2h since her first weeks of life, but I'd certainly take it!) Between the lack of sleep last night and the grumpiness this morning, I'm certainly not thrilled by the prospect of trying to use PU/PD to extend this nap!

Thank you both again for your help! I'm obviously still anxious, but I'd say (cautiously) that we're off to a pretty good start.

Edit: Well, she slept for about 45 minutes. I tried to use PU/PD for roughly 40 minutes to get her back down, singing the song I use to get her to sleep about 90 times in the process. She would scream in a way I would describe as fury mixed with some terror whenever I tried  to set her back in the crib. Soothing her after putting her down took an increasingly long time as she eventually became so worked up that she gave herself hiccoughs. After about 40 minutes I gave up and gave her a bottle, from which she took about 1-1.5oz, then began fussing again.

Two questions:

• How long do you let the baby cry in the crib with you there before picking her up?
• How long do you hold the baby? I've gotten mixed impressions on this. In one of the reports of a consult with Tracy it says to put the baby down immediately. In the book, I've read both "as soon as the baby stops crying" and "when you feel the baby relax".

Again, thank you!

[creations]

Sounds like a great start even though I know your night was a hard one!
Going to sleep in her cot on day 1 is fabulous

I would suggest you use the song for now if she finds that soothing. I used the same song at every WD (all naps and night sleep) for YEARS with my DS.  Mostly just the once through during wind down while he had a cuddle then put him down awake gave a key phrase and left the room. Sometimes he needed the song repeated many times though.  Eventually I switched to a CD plus my singing and then dropped the singing and he had the CD music to go to sleep with.

The 45 min nap is usually a sign of being UT (under tired, A time needs increasing) or can also mean LO has not learned to transition alone, this is linked to learning to sleep independently and also linked to the habit of sleeping longer (rather than the habit of getting up after 45 min). In your case I'd say the A time is not helping.
I would increase the A time, watch the clock whilst you go through the routine change and sleep training. Move to 2hr 15 for all A times stay there a couple of days then increase to 2hr 30 for a couple of days and if naps have not lengthened by that point then consider increasing to 2hr45.  3hrs is pretty normal at 6 months but we usually advise to increase in steps not a big jump.

Also, have you ever used or read about W2S (wake to sleep)?  Here's a link, I suggest naps option 1:
https://babywhispererforums.com/index.php?topic=223809.0
Where it says begin to pat you use your adapted method of patting or a firm hand or rocking in the cot.
Begin at 35 mins (based on the 45 min nap) or if you find this disturbs her then go in the room and ready yourself with you hand 1cm away from her body so that as soon as she starts to transition/wake you begin right away. This way you may catch her whilst still sleepy and more successfully sooth her back to sleep.  it's generally calmer than waiting for LO to wake and then trying PUPD.

How long do you let the baby cry in the crib with you there before picking her up?

A mantra cry you can let her be in the cot, you can either leave or stay.  Any other crying need attention of course. If she is clearly upset I'd just pick up right away and sooth in arms.

How long do you hold the baby? I've gotten mixed impressions on this. In one of the reports of a consult with Tracy it says to put the baby down immediately. In the book, I've read both "as soon as the baby stops crying" and "when you feel the baby relax".

There are age adaptations, it could be the consult you read was with an older baby or it could be that it was at a point in PUPD where LO is nodding off within seconds of being picked up but crying/screaming the moment they feel their weight back on the mattress - in a case like that you'd have to pick up and put down immediately to catch the very brief window of calm being held before nodding off.  I didn't actually use PUPD for sleep training with my DS but there was one occasion I used a similar/adapted method when I moved him into a new room and he was upset by it. He was screaming blue murder on the mattress but nodding off the second I lifted him so I did a few PUs where I only picked him 1cm off the mattress and then put down again and then did one PU where I didn't really lift him just firm hands as though lifting and barely shifted his weight before letting go again.
So, sometimes the descriptions vary but it depends on the individual circumstances and baby's age too.
In your case I would hold until calm then transfer to the cot.  But if this seems impossible and you know she desperately needs some sleep and she has become far too worked up then you could actually shush/pat (sing pat) in arms until pretty much asleep then tell her you are putting her down and continue to sing pat in the cot again.

hope this helps

[J-Dad]

Thank you again, Creations.

I'm unsure about the nap length issue. Sometimes she sleeps 1.5h with no problems, but I'd say 75% of the time it's 45min.

She was definitely giving me her sleepy signs after 3h of activity this afternoon, and in fact fell asleep after 3h09m of wake time. Then she woke up, and I spent about 22min soothing her in the crib. Didn't have to pick up put down but 2-3 times, though, and she did fall asleep in the crib, so yay for that!

[Slightly later...]

I took your suggestion about waiting by her crib for the 45-minute wake-up. (I'm not quite bold enough to actually do wake-to-sleep yet.) At exactly 40 minutes she had a little jolt that didn't seem to wake her, so I just stood there. At 45min her arms moved a little, but again, no waking, so I thought I was home free. I was in the process of sneaking out of her room as she jolted and woke herself. Fortunately I was still close by. She opened her eyes, fussed a bit, rolled back and forth a bit, but I put my hands on her and sang her her sleep song and within about 2-3 minutes she was asleep again. Thank you!

Thank you, too, for putting up with my play-by-play. 

My wife will be home soon so we'll see how the evening goes. I don't know yet whether we'll still try for a catnap or just go ahead and eliminate it. I don't think she's really had enough sleep today to go without one, but maybe it's best to just scratch it now so that she's good and tired for bedtime.

[creations]

You're welcome

Sounds like you've had some success today too

Sometimes she sleeps 1.5h with no problems, but I'd say 75% of the time it's 45min

My guess is a build up of tiredness leading to the occasional longer nap.
LOs can also show sleepy signs which are habitual and misleading. At this age it is helpful to watch the clock for the longer A time and she will get used to it. Once the new routine is settled that's when you can return to looking at signs or altering routine as needed due to extra stimulation from play or visitors or extra physical activity such as swimming which might tire her out earlier than usual. That's the flexible aspect of the routine.

I was in the process of sneaking out of her room as she jolted and woke herself.

Sneaking during the transition is risky. You may need to hang on in there quietly for longer until she is properly asleep. The FAQ explains 20 mins after the transition so that she goes into deep sleep and less likely to wake with you leaving but you can play it by ear. I was able to go in 1 min before a transition, sooth and leave 1 min after (during a tricky nap drop) but when you are trying out the method it does and is supposed to take longer.  Do it for a few days and see how much help you need to give. You may be able to stop after 3 or 4 days or may need to continue another week. It depends on her A times etc too of course.

I don't think she's really had enough sleep today to go without one, but maybe it's best to just scratch it now so that she's good and tired for bedtime.

Check the A time. Whilst you are in the middle of changing routine you might need to:
- and a CN (any length you need 10 min - 40 mins) this might make BT later than usual but when the short CN goes you will move BT back to a more reasonable time
- with no CN use EBT, bring BT much earlier. Even 1-2hrs earlier.
A very long A time just before BT can lead to OT nights with NWs and EW the next morning, better to avoid if possible.

Keep going and good luck
-

[J-Dad]

Day Three

Things are...not so good.

Tuesday night
I don't actually remember this terribly well. I know her mom probably spent 40min to an hour trying to get her down to no avail. LO eventually got so upset that she debuted new cries of terror? that we hadn't heard before. Truly harrowing. Eventually, Mom asked me to take over and I was able to get her down using PU/PD. She slept to her dream feed, and I think she went down after it peacefully, but then there were at least two, maybe three unscheduled night waking from which her mom couldn't get her down and I had to step in.

Wednesday
I began attempting to extend A time. First nap started okay. It took 15 minutes of crib time for her to get to sleep, but I only had to pick her up once. That said, when I went in to do wake to sleep she woke up immediately and I couldn't get he back down. I think I spent 40 minutes attempting it.

Second nap: Looong A time due to trashed first nap. Went down easily but slept only 20 minutes. Woke screaming and difficult to console. I managed it after 20 minutes, after which she slept a full 45-minute cycle.

Evening: There was significantly less screaming as Mom tried to put her down, but ultimately I still had to come in and get her to sleep at last. I know Tracy recommends never switching parents during the process but all I can say is that, depending on the time of day, neither of us have thus far been able to keep it up for an hour or more.
Again, I'm fuzzy on the details. I don't think she made it to her dream feed this time. I think I had to go in and put her back to sleep before that. After the dream feed there were at least two additional wakings before her next scheduled feed, again, possibly more. I don't think we did a proper PU/PD for any of those. She seems to have become harder to console, so if I finally get her to calm down on my shoulder, I just let her drift on off to sleep, reasoning that if I put her in the crib and she starts crying again I don't know how long it will take to get her to sleep. I'm not saying I did the right thing, but you try reasoning with sleepy J-Dad.   

So yeah, right now things aren't great. I don't really know that I should expect anything better only two days in, especially when we're being so inconsistent. Thank you, though, for your suggestions and for taking the time to read this.

[creations]

Regressions and fighting harder are not uncommon.  LOs can appear to be going with it and getting used to it and then suddenly have another surge of fighting, I'm trying to remember which day it is common, I think day 5 so it's a bit early for that but as we always say, they are all different.
It is also known LOs can build a habit with individual carers. They know who will feed them to sleep, who will rock them, who insists they go in the cot, and they go with it.  She might be fighting Mummy harder because you started the training and she didn't realise Mummy was in on it too and the increased level of screaming or fighting the new method can perhaps be decoded "you have got to be JOKING! I get this from Daddy, not you too Mummy!! Come on give a kid a BREAK!"
The only way through it is to keep going through it, consistency.

That second nap which was only 20 mins is classical OT, long A too tired, screaming difficult to settle but then sleeps a full cycle. It actually means you are on the right track increasing the A time.  she is going to get used to the longer A time but equally I suggest you don't go over 3hrs A before the next S. If you suspect OT go in for your W2S earlier, at 15 min and be ready with your hand 1cl away from her body for the jolt/scream and begin resettling immediately, more chance of a quicker resettle. You might also have the courage to begin the resettle before the 20 mins, maybe at 15 min or 18 min and you could avoid it or keep it minimal this way.

Thank you, though, for your suggestions and for taking the time to read this.

You're welcome. I('ve had plenty of support in the past and am happy to pay it forward.

[jessmum46]

Just popping in to offer support too.  I have nothing to add to the excellent advice you are getting from Creations but keep going, you are doing an amazing job between you

[J-Dad]

Well, things have been bad pretty much all around. This morning's nap was 24 minutes after which I couldn't get her back down. Last night she woke several times and it was difficult to get her back down. Finally, this morning she wouldn't take her bottle at all. I was feeling utterly discouraged.

Well, when I was trying for the fourth time to feed her I looked in her mouth and realized her right top incisor was breaking through., I gave her some Tylenol, waited 20 minutes, and then gave her the bottle. Then she drank about 2.5oz. She's still grumpy, but at least we have a reason.

So, should we continue with pu/pd or wait until this bout of teething is over?

[creations]

I read your first paragraph and thought "ah she's poorly" then saw your second paragraph, teething.
You can continue with the training but obviously just be sympathetic that she's not feeling great so go gently, more cuddles is never a bad thing.
You can try pain meds 20 min before a nap although obviously not every nap and every feed or you'll be giving it too often.

Ibuprofen is good for teething and through the worst times (the cutting is the worst and can be a few days) you can use both ibuprofen and paracetamol to space out the meds. I used to make sure we had one dose left for the middle of the night and sometimes gave a "dream meds" where I told my DS I was putting medicine in his mouth (syringe) and half asleep he'd open his mouth for it.

You can also try raising the head end of the cot as the incline reduces the pressure on the gums and she might find it less painful. A cot safe wedge or cot blocks are best. Some people use a rolled towel underneath the mattress.

Teething is horrible.

[J-Dad]

Ooh, good reminder about alternating Ibuprofen and Tylenol. I knew that at one point so I'm going to blame sleep deprivation for why that slipped my mind. I'm going to pick up some Ibuprofen while we're out tonight. I like the idea of a "dream med", too. DD generally gets her best sleep in the last part of the night, but a little extra help sure couldn't hurt!

Today has been rough. After the first super-short nap she wouldn't take her second nap at all. I finally just took her out to the store with me figuring if she fell asleep in the car or the stroller it would be bad training but at least good for her to get some sleep. Nope. She stayed awake the entire time. I finally put her down and got her to sleep in her crib 4 hours and 20 minutes after she had last woken up.    That said, I used the proper procedure and she actually went down fairly easily, so yay?

Thank you again for the tips and the encouragement. It really helps me get through the day!

[creations]

got her to sleep in her crib 4 hours and 20 minutes after she had last woken up.

You can't force them to sleep you can only offer the opportunity, which you did, several times. It's all you can do.

I used the proper procedure and she actually went down fairly easily, so yay?

usually we need babies to be healthy for sleep training but I sleep trained mine while he had undiagnosed reflux (!) and then some of our trickiest routine changes have been more easily changed during illness. A case of sleep being rubbish anyway and can't get any worse.
You didn't force your LO to go 4hr+ without sleep but her level of tiredness appears to have helped with the cot-nap.