SLEEP > Naps

4 Months & Going In Circles

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robinsegg:
Hi BW!

I am in need of some extra eyes.  I have a 4 month Textbook DS who is EBF.  He developed a feed/hold to sleep association that became more clear around 3 months.  Because I knew the 4 month regression/Leap 4 was coming I started to change up his routine.  He stopped wanting to sleep in the light downstairs and so at 13 weeks we started to put him down for naps in our darkened room with white noise and swaddle.  I would bounce and shush him to sleep and transfer him in after he fell asleep.  If this was not working after 15-20 minutes or so I would feed to sleep.  I was trying to reduce the amount of time spent holding (around 5-7min) before putting him down or if fed to sleep I would do the Gentle Removal Plan.  His awake time around 15 weeks was 1hr 20-30min.  We went away at the start of week 15 and he was up hourly all night and was needing held for all naps. 

At 16 weeks he started to roll (now in sleepsack).  He was waking up as soon as he was put down asleep and so we were holding him for all naps.  I have 2 other small children and so that wasn't going to be sustainable.  I was trying to make a plan for sleep training (used PU/PD for DD successfully at 5.5 months) but thought I should hold off due to the regression/leap.  I had read the book Bedtiming and so had waited with my DD to sleep train at that time.  We had an appt with the ped at 16 weeks and she strongly encouraged me to sleep train.  The most he could sleep by himself was 30 minutes after being put down asleep.

I started shush pat/PUPD at 17weeks.  I have been doing it consistently for 11 days now and a feel like I am chasing my tail.   His nights are much better, up 1-2 times.  Around day 3 or so I thought he was getting it.  He would be starting to SS as I was lying him down with PUPD.   We have a 12 day/night routine.  Naps are very hard to extend, if he does go back to sleep it is for 10 min tops.  He was a good sleeper when he was around 2 months, up 1-2x a night and so to make up for that fed very frequently all day.  At this point he does 3hr feeds which feels like a big space to me.  I find I cannot APOP a nap with him unless he is in a stroller or car seat.  If I hold him horizontally he expects to be able to suck.  He is on a 4 nap schedule, he is generally held by DH for the CN and sleeps great this way!

He does not like shushing but I have the white noise on, he does not seem to care about patting.  If I lay him on his side he arches his back and looks behind him and cries.  I usually end up putting him down because he flops around, pushes his legs against me, pulls hair, roots around etc.  Day 5 was terrible. He rolled front to back, naps 30 minutes.  I was trying to increase his first A and was getting varied results.  I was aiming for about 1 hr 40 minutes.  20 minutes naps started on Day 6 and are still going on day 11.  I try to extend naps.  He starts usually with eyes closed & crying and then it turns in to frustration that I am trying to still get him to sleep.  He self soothes by sucking on his thumb, thumping his legs on the mattress, and mantra crying.  He usually cries as I lay him down.  Once on the change table he is happier, **he wakes from ALL naps crying**.  He has put himself back to sleep a few times when waking in the evening after bedtime but never for naps.  I do give him a chance for naps if he is doing a mantra cry.  When he was doing 30 minute naps he would just start to stretch and slowly rouse.  I tried holding pressure on his limbs with no success.  I have tried W2S a bit with no success.


His WD is diaper, sleepsack, book and song.  He is disinterested in the book and starts crying usually during the song.  Average day sleep is about 3 hours.  Yesterday and today I have been reducing his A time in an effort to catch him up on sleep.  He is just getting these little fragments of sleep never a restorative nap.  I do not know how to move forward and am at a loss because I cannot APOP naps with him as mentioned before.  He does not sleep in a carrier or swing.  I was trying to push through with A times but it seems as if it backfired.  Because all naps are short I do not even know what his A time is.  I feel like we won't get progress until this Leap is over but I am not sure of how to get through it. Here is the last 3 days. He is now 18 weeks.

Saturday

E -0415
WU 7am
E 725
A -2 hrs, did not seem tired in his room so took him out for quiet time
S 902-925, tried to resettle 20 min
E 1035
S 1107-1127, would not extend
S 1225-225, held by DH so he could get some sleep
E 240
S 418-454, held
E 510
E 640 Top up
Bed 655, wake up at 730, 745, 755, 810 & 9(put self back to sleep)

Sunday
E 0045
E 0350
WU 713
E 720
A 1hr 38 min, very tired
S 851-914, tried to resettle x 1/2 hour
E 955
A
S 1047-1113, up to room at 1030, tried x 15min to extend
A 1/2 hour, up to room, crying
S 1222-1245, sleep was light, lots of jolting, would not extend
E 115
A Up to his room around 145
S 213-240, 255-305
E 4pm
S 425-535
A
E 610
A
S Up to room at 630, likely too early, bed at 7.  Woke 4x but resettled by himself. 
   Cried out at 1130 (usual feed time) but did not wake.

Monday

*Sad day, crying when put down at A time.  Happy if held.

E 0400
WU 718
E 725
A 1hr 29 min
S 857-917 (school run, slept when we got home, falling asleep when we got home) Bounced back to sleep 922-934
A Up to room at 1040
S 1057-1121 back to sleep with resettling 1129-1150
E 1230
A Up to room at 1250 (1hr)
S 113-140
E 245
S 310-350 (in stroller, school run)
E 430, snack
S CN 455-535, held by DH (usually his best nap of the day)
A Grumpy, sad, not interested in feeding
E 6
A Up to room 630
E 650 top up
Bed 715, up 745, 805 (assisted back to sleep)

Any advice is greatly appreciated!

Robyn

deb:
My first thought looking at the amount of daytime (lack of) sleep was reflux, but at 4 months that's less likely as a new issue. It does, though, seem like perhaps he's uncomfortable or even in pain and you holding him is enough to distract him so he can settle.

I had zero luck w/ either PU/PD or pat/shh with either of my kiddoes, so I feel your pain - all we ended up with was overstimulated baby and sobbing momma. Works a treat for lots of kids, but as you can see, you're not alone in having it not quite work out for you.

I'm wondering if there might be a latent ear infection happening, or even early teething starting. Have you tried pain meds maybe 20-30 minutes before sleep-time? If you do and it helps, you're on to something, even if you haven't localized it, in which case a look in the ears may clear up the mystery. Since he's EBF, it might also be something in your own diet causing a tummyache; many babies react to dairy especially (In addition to dairy sensitivity, I found I had to avoid all brassicas while nursing, so no cabbage, broccoli, none of those!).

Also, the 3-hour E schedule may be part of the problem. Will he tolerate going longer between feedings? Less frequent but larger feeds become more the norm around this age, more of a 4-hour EASY around 4 months (give or take, your mileage may vary of course). And it won't be long now before he's looking seriously at solids, which will definitely affect the number of calories he's taking in during the day. Might want to try a Dream Feed, maybe 10-10:30PM, see if that helps him sleep thru a night waking. (These helped us at first, then mine started taking more daytime calories and ignoring the DF.)

One more thought: has he shown any new skills lately? Both my kids' sleep got wonky around developmental leaps: rolling over, sitting up, pulling up, first word, tying words together, that sort of thing.

robinsegg:
Thanks for the reply.  He has started rolling in the last couple of weeks, both ways.  I have wondered about silent reflux and am just not sure.  I meant to ask the ped at his 4 mo appt and forgot.  By all accounts he is a happy thriving baby.  At times he does seem to sputter out of nowhere.  I will pay more attention to how often this happens.

I will also try and space the feeds out and try not feeding right before sleep.  Sometimes I do offer a feed if his next meal falls in a nap period. I can also try keeping him upright after feeds.  He does sucks his hands quite a bit but not sure if this is related.  It may be now that we are putting him down for naps the problem (if he has reflux) is just becoming more apparent.  He would happily sleep all day if my DH held him. 

Today was pretty bad.  He slept for about 2.5 hours all day.  His first nap was 30min and then it fell apart.  I can’t get his A time right to save my life.  I can’t tell when I’m doing his WD if he starts crying because he is OT or UT.  He had 4-5 wake ups after he went to bed.  The first 30 minutes after he fell asleep. This is the 5th day of these wakeups.   He was pretty fussy today and seemed to want to feed more.  Not sure if it is due to OT or the leap.  He’s crying before sleep, when he wakes, and during the resettle attempt.  But once on the change table after I give up he calms down. 

4 months is such a period of change that I keep hoping something will change once things settle down but there is no way of knowing if and when that will happen. It is very overwhelming and consuming as you all know. 

deb:
I know you said you have other kids so this may not be doable, but if there's a way for the first A time to keep him in his room in the relative dark & quiet and really tune in to his sleepy signs, not even let him get really overstimulated...maybe on a weekend when you have some help, or first thing if he's waking that early and not resettling sometime.

And yes, keeping him upright a little bit might help.

If he's due for a nap, given how short he's napping anyway, I'd just put him down w/o a feed if he lets you, see what happens. With any luck his next feed will be a bigger one if he sleeps thru the E mark, and you can start working toward bigger and more filling feeds.

What kind of actual activity is he doing during his A times? Lots of tummy time? (except for the first one, perhaps) Exercise can wear them out really well! Mine would snooze like crazy if I took them swimming - any chance of visiting a local pool? (Note: many indoor pools tend to be chilly for babies; I let mine swim in full-body pajamas before we broke down and got a baby wetsuit. Your mileage may vary.)

One other thing I was able to do w/DD#1 because she was an Only at the time was let her sleep on HER tummy on MY tummy; she gave it up around 4 months, but while she did it, we both slept a good couple hours straight thru and it was BLISS. (Make sure you pee first; ask me how I know LOL) Might be a thing to try if/when you have another adult in the house to keep the other kids occupied.

robinsegg:
His A time blends in with Y time because Y time never happens.  So he will spend a bit of time in a bouncy chair while I do a task.  I try to keep it short and then we move to the floor to play.  Good thought about the tummy time, could always do more. 

Today was a very busy day, had to go out of the house 4 times.  He woke at the 15 min mark for 1 nap and he ended up sleeping while I held him for about 1.5 hrs.  He woke when I put him down to get ready but ended up sleeping/feeding for another 20 minutes or so.  He seems to be more fussy, clingy and hungry for the last few days.  Because of his short naps I just can’t figure out an A time to shoot for.  Should I just go by his signs? He will eye rub, get red brows, look tired or start fussing. 

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