Author Topic: 4 month old sleep disaster  (Read 2025 times)

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Offline TracyHodgins

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4 month old sleep disaster
« on: April 27, 2018, 09:24:04 am »
Hi, my 4-month-old's sleeping has been a disaster lately, how can I help her sleep better?

During the day she will only sleep for ~35 minutes, and will go to sleep again after approximately 1h 45 minutes.
I tried stretching her awake time to 2h or 2h 15 minutes in hope of getting a longer nap, but it seems that she's only harder to put to sleep (and still wakes after 35 minutes).
During the day she sleeps in her crib with a pacifier and white noise machine turned on.
Her nap/bedtime routine is putting on a sleep sack, a bit of rocking and singing and then being put to bed awake. She fights her naps big time but usually PU/PD will get her to sleep within 10-15 minutes.
I tried eliminating pacifier (I think that may be a reason for the short naps, as she tends to spit it out and then immediately want it back and wake herself up), but then she refuses to sleep at all (she can lie in her crib and cry for hours, despite any attempts to calm her down).
I also try to resettle her into another nap when she wakes up after 35 minutes and that doesn't seem possible.
She will only nap for longer stretches of time if she falls asleep cuddled with me on my bed, and even that doesn't work all that often.
Naps in a pram or car seat don't work that well either - if I take her for a walk, she will still wake up after 35 minutes and refuse to go back to sleep. However, if she's out on a walk with her grandparents, she can sleep for 2-3 hours (why?). She only wakes up every once in a while, looks at them and goes back to sleep within a minute or two...

Nights are also tough, I put her down for the night at about 6:30-7 PM after about 2h of awake time, but she will wake up after 35-40 minutes again (probably due to being OT during the day - nap problem). I don't mind as it's a chance to catch up on nursing (she often seems to be too fussy/tired to take a full feed during the day), but it probably disrupts her sleep a bit.
She sleeps with a pacifier, but it doesn't seem to be that much of a problem at night (she usually doesn't wake up if it falls out).
She will sleep in her crib till about 1 AM, then wake up to eat again.
Usually after 1 AM feed I don't put her into her crib again but let her sleep with me instead, because I'm tired and don't want to deal with settling her for a millionth time that day... Also, she's sleeping in the same room with me and my husband, so her crying wakes him up. I don't want to move her to another room until at least 6 months old, as from what I know this is safer.

She will then wake again around 4-4:30 AM - if I'm lucky, she will nurse and fall asleep again, if not, she will be fully awake and ready to party.
Sometimes she lets us sleep in till around 7 AM - I tried recreating those days but no luck, there seems to be no pattern.

My baby is terribly tired and upset and so am I, I have no time for myself.
I also feel bad for my baby, as her awake time will often consist of looking at me eating breakfast or taking a shower, as there's almost no other time when I can do this. 

Sample schedule (from a "good" day):
7:00 - wake up
7:00-7:20 eat
7:20-9:00 awake
9:00-10:30 sleep (this was cuddled next to me)
10:30-10:45 eat
12:45-13:20 sleep
13:20-13:30 eat
15:00-15:30 sleep
16:00-16:05 eat
16:45-17:05 sleep (in a pram)
17:20-17:30 eat
19:30 - bedtime
20:00 - wakes up again, eat
00:30 - wake up for feed
4:00 - wake up for feed
7:00 - up for the day

However, on most days she can't even get one nap longer than 1h.
Our "bad" days start at around 4:30 AM and are continuous cycles of 35 minute naps and 1:45-2:00h of awake time.
This is exhausting for everyone, how can I make her sleep patterns better?

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Re: 4 month old sleep disaster
« Reply #1 on: April 27, 2018, 11:38:32 am »
Hello and welcome to BW forums :)

Sorry to hear your LO is having a hard time staying asleep, I can well imagine you are totally exhausted. For what it's worth my LO went through the 4 months regression and slept only 45 min blocks despite being an independent sleeper and I clearly remember how limiting and tiring that sort of day is.

The first thing that springs to mind though is the possibility of your LO having reflux or silent reflux. It seems she may be in pain which is making it hard for her to stay asleep, also fussing at her feeds during the day but not at night is quite common with refluxers.  Have you considered reflux or read the symptoms?

The second thing I wonder is what are her grandparents doing differently?  Have you asked for information about how they put her to sleep, if she is swaddled? Is it a different pram or the same pram? Do they bottle feed to sleep then put her down? Do they add or remove any wedges or tilt the pram up, rock it or walk? Do they have the hood up?  I would probably try to observe exactly what they are doing (out of sight of LO to recreate as closely as possible the situation she is usually in when with her GPs). If there is literally nothing different then you can put it down to her knowing that you are not around so no point waking up to see you. If there is anything different though I'd probably pay good attention to what it is.

If it was me, what I'd probably do in the short term would be to put in more of those cuddles on the bed with you for nap time.  It isn't the usual BW way but if she will get a good sleep it's worth at least one per day that way. There are also steps you can take to gradually wean her from being snuggled up close and laying more apart from you on the bed (perhaps with one hand on her) which can work towards learning to sleep better without you.


Offline TracyHodgins

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Re: 4 month old sleep disaster
« Reply #2 on: April 27, 2018, 12:49:32 pm »
Thank you for your input!
The first thing that springs to mind though is the possibility of your LO having reflux or silent reflux. It seems she may be in pain which is making it hard for her to stay asleep, also fussing at her feeds during the day but not at night is quite common with refluxers.  Have you considered reflux or read the symptoms?
This my first baby so I'm completely in the dark about the normal and not-so-normal behaviour in infants. I can match my baby's symptoms to virtually every disease I read about on the internet, however her pediatricians say she's healthy.
Two months ago I consulted two separate doctors regarding the possibility that my LO has reflux, but they both said that it didn't look like as if she had it, and that she was thriving so I had nothing to worry about.
Quote (selected)
The second thing I wonder is what are her grandparents doing differently?  Have you asked for information about how they put her to sleep, if she is swaddled? Is it a different pram or the same pram? Do they bottle feed to sleep then put her down? Do they add or remove any wedges or tilt the pram up, rock it or walk? Do they have the hood up?  I would probably try to observe exactly what they are doing (out of sight of LO to recreate as closely as possible the situation she is usually in when with her GPs). If there is literally nothing different then you can put it down to her knowing that you are not around so no point waking up to see you. If there is anything different though I'd probably pay good attention to what it is.

Same pram, same conditions, the only difference is that I'm not there. My LO likes to look at the person who's pushing the pram - she dozes off quickly when that's her dad or a grandparent. I should be happy that she seems to like me enough to postpone her nap, but most of the time it's just me pushing the pram so she gets very little sleep.

Today even cuddles didn't work much - I was able to resettle her after 35 minutes but she woke herself again after 10 more minutes. I'm afraid that I'm making her sleep habits even worse than they are now.

Oh, furthermore my husband's parents and work friends think that 7 pm is much too early to put LO to bed (not that we asked for their opinions... 😀). They recommend 11pm, because then the baby will sleep for at least 6-7hrs until the morning. I told my husband that 7 hours of nighttime sleep is too little for a 4 month old baby and he agreed, but he's still upset that all my efforts to make our daughter sleep normally seem to have no effect. That's frustrating...
« Last Edit: April 27, 2018, 12:52:24 pm by TracyHodgins »

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Re: 4 month old sleep disaster
« Reply #3 on: April 27, 2018, 14:04:23 pm »
Honestly I think if you felt there could be a reflux problem this could be the issue.
My DS was suffering silent reflux for several months before he was diagnosed and in that time various health visitors and GPs said he was fine, a "happy spitter" they said ("he's NOT happy he's just polite to strangers" was what I said). We saw so many docs. Every time I was told he was fine because he was consistently gaining weight and thriving. he was not fine. They didn't see the screaming. Eventually I put my foot down and demanded a referral to the paediatrician at the hospital and also bought some over the counter reflux meds on agreement of the pharmacist (infant gaviscon which really only helps short term).
When we finally saw the paedi (DS was 5.5 months by then) she diagnosed silent reflux within 2 mins of entering her office and gave me a prescription for proper reflux medication. And within a couple of weeks or less he had calmed down.
Coincidentally the "4 month regression" ended at 5.5 months too and he started taking proper long naps just as he had when he was younger before the reflux got so bad.

I am also a first time mum, I only have one child. I've been through a lot of "Oh he's your first is he?" every time I take him to the doctor, to be honest I am fed up of it. There have been several medical issues I have resolved by pushing hard for attention rather than being given the "he's your first" response.  We may well not be highly experienced as first time mums but we can and do have an instinct and we spend a lot of time with our babies to see how they are effected.
Personally I would push for a referral.
The better sleep your LO gets with others could also be more of a "they can't solve my pain so I will  not bother to tell them how bad it is" whilst with you she her approach is "this hurts, I need attention". I know this might sound a bit out-there but it is amazing what our babies tell us that they don't tell other people, it's just that everything they say is crying because they haven't learnt to talk yet.
I'm guessing of course, I'm not a medical professional and I am only hearing what you have described.  There can be long lasting problems associated with untreated reflux.

Here is a link to our CRC (colic reflux and crying) board, there are a couple of reflux stickies at the top you might have a look at to see if reflux or silent reflux could be the issue.
https://babywhispererforums.com/index.php?board=13.0
Silent reflux is when LO rarely spits up a full milk feed but other symptoms and signs are there, they may bring up milk but not all refluxers do.

Meanwhile you can try propping her more upright for sleeping with a cot safe wedge and/or cot blocks and see if that helps.  Or hold her more upright and see if she can get some better sleep that way.

I would say that taking only 35 min naps is not normal especially taking into account that you are offering a reasonable length A time and age appropriate routine and using various props and ways of sleeping to try to encourage longer.

They recommend 11pm, because then the baby will sleep for at least 6-7hrs until the morning.
with regards to this.  I'm not sure where you are, some countries/cultures have a much later BT and we would not go against a person's culture. There is however a sleep window which comes much earlier than 11pm so we generally do not recommend shifting a routine this late.  Instead the usual routine is for baby to go to bed earlier (7 or maybe 8pm) and then to have a dream feed at around 10-10.30pm this is 3 hrs after the BT feed and means that the long stretch of sleep can come after this and when you are sleeping.  "sleeping through the night" is classed as 5 hrs, yes it's short, anything beyond that is a bonus. So in effect this is like giving your baby part of the night sleep, then feeding when your friends have said (11pm ish) and then putting to bed for that long stretch. You can get the stretch of sleep for yourself without keeping your baby up so late.
Not all babies will sleep 12hr nights, mine only did 10.5 to 11hrs, but when looking at routine we aim for 12hr nights until we know otherwise and adapt accordingly.
People try to help, but often their help is not where you need it.  Many of us have learned to smile and say "thank you".  For some I would reply "you had the opportunity to decide XYZ for your child, now I'll decide for my child" not quite as polite but there you go.

By the way - you are not making her sleep habits worse.  You are trying to help her sleep which is absolutely the right thing to do. If she was sleeping 2hrs in arms I would be more likely to offer suggestions on how to move her from arms to cot but she isn't. She is showing signs of pain.

I hope this helps.  We are here to support you.  and on all points only you can decide.


Offline TracyHodgins

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Re: 4 month old sleep disaster
« Reply #4 on: April 27, 2018, 18:38:53 pm »
First of all, thank you for an extensive reply. This really helps.
Here is a link to our CRC (colic reflux and crying) board, there are a couple of reflux stickies at the top you might have a look at to see if reflux or silent reflux could be the issue.
https://babywhispererforums.com/index.php?board=13.0
Silent reflux is when LO rarely spits up a full milk feed but other symptoms and signs are there, they may bring up milk but not all refluxers do.
Now I'm pretty sure that reflux can be the issue. One of the paedis even commented on my LO's red throat, but she said it probably was a cold (it wasn't, she was healthy).

Quote (selected)
When we finally saw the paedi (DS was 5.5 months by then) she diagnosed silent reflux within 2 mins of entering her office and gave me a prescription for proper reflux medication.
How did she diagnose the reflux, based on symptoms only or is there any examination that she performed?
I am currently based in Poland, I just googled "silent reflux" in Polish but the results are scarce. I don't think that my paedis will take me seriously, even though they seem to be really knowledgeable. They just consider reflux in babies completely normal.
I will check if there are any paedis nearby who specialise in GI disorders in infants, maybe that's where I should reach out for a diagnosis.
Quote (selected)
If she was sleeping 2hrs in arms I would be more likely to offer suggestions on how to move her from arms to cot but she isn't. She is showing signs of pain.
All of today's nap attempts were disasters, she slept 2x 35 minutes in her cot and then I was able to get her to nap for 1h 5min being constantly rocked. For the fourth nap, I took her for a car ride as she always seems to nap a bit better in her car seat, yet she still woke up after 35 minutes. I guess we're going to have a tough night.

Thanks again, I guess I need to find a good paedi ASAP.

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Re: 4 month old sleep disaster
« Reply #5 on: April 28, 2018, 09:29:47 am »
How did she diagnose the reflux, based on symptoms only or is there any examination that she performed?
I listed symptoms, not all of them, and the paedi said almost right away "Well I can hear it" before she was even holding him.  She did take him from me and do a brief exam but not tests, and she'd diagnosed the reflux before the exam just based on my description and what she could hear when not even holding him. Her "exam" from what I remember was hold him, listen to chest, look in ears etc, just a once over, very brief.
She prescribed reflux medication and asked me to bring him back in 1 month, she said if there was no improvement we'd need to try something else (the formula for milk and soy protein intolerance) but that she would prefer not to try that right away because it tastes horrible and lots of babies reject it so if we could avoid that then good.  As well as the medication she also prescribed a milk thickener to put in his regular formula, again there are thicker formulas for reflux but this thickener meant he could stay on his usual milk.
I didn't feel rushed in the appointment but it was very brief. It was amazing how we had struggled for so long and then it was over in a flash.
When we returned a month later our problems were solved, he was pain free, sleeping well, no more screaming blue murder, no need for special formula or anything else.  As I had started solids too she offered to refer us on to a paedi dietician if DS struggled with solids but I declined at that point, he loved solids and was doing well so this was left as an option if needed in the future. It was never needed.

Many months later (I am trying to remember his age but don't recall just now, perhaps 12 months+ ?) I had another problem thread on BW and the ladies here suspected his reflux was no longer under control. I kept saying it must be controlled because he's on meds. They kept saying, it sounds uncontrolled, what is the dose, get it checked. I went to the GP to have the dose checked and was told DS was fine, thriving, happy, the meds were fine. Ladies here said again the dose wasn't controlling the reflux. Went back to docs again and was told my DS was on the maximum dose they could prescribe and it was sufficient.  By this time I knew it was the reflux, the ladies here had opened my eyes to it and I realised all the symptoms made sense.  I phoned the paedi's secretary (here we cannot just see the paedi without a referral from the GP) and explained the situation. I asked her to speak with the paedi, gave my DS's weight, age, meds dose and symptoms.  The same day she rang back with a new dose to begin immediately. It was almost *4 times* what he was currently on.  He had been struggling on a quarter dose.  On the new dose he was good again and I felt a fool for not having it changed earlier, for not recognising the symptoms quick enough, for not ringing the paedi sooner - but we can only do what we can do and it is not always easy.
My DS was on meds daily until 2yo...I tried twice to wean him off.  Then he was meds free for about a year and then suddenly needed them again (another struggle to get a prescription but once I did he was better again). He is 7yo now and we still get phases time to time when he needs some meds for a few months and then seems okay without again for a long period. It is usually my DP who notices the pattern of symptoms and when the symptoms become more than DS can handle so need meds.

Like I've said before. I'm not a medical professional. I only know the experience I had. Obviously people want to avoid unnecessary meds, but on the flip side if your baby does have pain and reflux this is a problem that needs resolving.  If it isn't reflux then (to me) it is something else bothering her.  I think your instinct is that something is wrong but you have perhaps been overriding that instinct because your have already seen doctors.

There is a list of reflux symptoms on that link I gave you. Your LO doesn't need to have ALL of those symptoms. Mine didn't have all. But enough.
As it is effecting both your sleep to such a great extent I think this is reason enough to seek further medical help. You both need sleep.
it may not necessarily mean you need a different paedi, possibly going back to the same one who noted the red throat would notice that you keep returning and that the red throat isn't improving?? Maybe  :-\

I would probably try having her sleep more upright, get a deep cot wedge and cot blocks. Use a sling or let her sleep upright in arms for naps.
« Last Edit: April 28, 2018, 09:38:33 am by creations »