Copying and pasting your post to answer:
She is in pain from it. She is currently on Pepcid but it only helps somewhat and we are seeing a specialist Monday. In general, it seems to bother her less at night - she sleeps better then, eats better then, etc. I don' t know why - maybe she's just more relaxed then.
*** Well, with significan reflux, this changes things quite a bit. Tracy always says you need to fix any medical issues before going ahead with sleep training. So, my advice is if she's comfy and not in reflux pain, forge ahead, if she's having reflux trouble at any point, regroup, fix the problem, then resume the sleep training.
*** Emilio takes Prevacid solutab. I highly recommend it. I've read that many reflux babies sleep well at night out of sheer exhaustion from the reflux affecting their sleep during the day, but she's napping well, so that seems like it's not an issue, thankfully. I think you may just be lucky with a good sleeper!! YEA! She may very well be more relaxed at night, just go with it!
I ended up letting her sleep almost 2 hours this morning because the reflux was definitely bothering her (she threw up clear bile and squealed - waking her twice during nap, so it wasn't very restful) but in general I will try to keep that nap under 1 1/2 hours. Is your reasoning for this that otherwise she is thinking it is an extension of nighttime sleep if too long?
*** My reasoning is that if you transfer the longer sleep to the afternoon she'll be more rested toward the evening, rather than stockpiling all her long sleeps in the morning and becoming more and more tired with shorter naps as the day wears on. Babies at this age are easily overstimulated. Please make adjustments as you need to in order to accomodate her reflux just as you did today. Remember, whispering is about being flexible.
But it seems that when I wake her up she is upset and still tired and only wants to either eat or sleep - not play. Should I just keep trying to do some activity with her and only feed her if she definitely seems hungry after 3 hours?
*** Maybe try cutting that nap back in intervals, say chopping it by fifteen minutes every few days so she gradually becomes accustomed to it. Yes, I'd save the feed for when she's truly hungry. It's very easy to mistake hunger for boredom, overstimulation, or simple grumpyness. Try a swing if she's cranky. That was very lulling for both of my boys.
A few other questions:
1. How should I judge appropriate time to wind down and put her in for nap? She tends to yawn early but will still smile and play. Do I wait for other tired signs? Fussing? Try to extend her as much as possible? How do you know how far to push it?
*** Wind down can be about five or ten minutes of quiet play on your bed, swaddle, a few moments of snuggling then a few moments of patting in the crib. It's just a way of transitioning from activity time to sleep time rather than just hucking them in their bed.
2. How long should the second nap be? Say she wakes in the morning at 8 and goes back down at 9:45 and I let her sleep until 11 and feed her between 11:30-12. She'll likely want to go back to sleep around 12:30 as she'll have been up for 1 1/2 hours. Do I let her sleep up until the next bottle if she wants to - which might be as late as 4 on a 4 hour schedule? Or again wake her before it's time to feed (maybe after 2.5 hours)?
*** I think I'd let her sleep as long as she wants, but never longer than 2.5/3.0 hours or you'll rob nighttime sleep. You can always cluster feed from that point on. Just aim to get the longer nap later in the day to help with the crankies and work the feeds around it.
3. How long would the catnap ideally be? Usually I'm lucky if I can get her to go 45 minutes. But if she does go longer, again when should I wake her?
*** Oh, depends. Emilio always needed a good two hours between last nap and bedtime. I still gauge it that way -- time between naps and before bed. Our catnaps lasted about thirty mintues with me waking him (and upsetting him doing so!!) or else his nighttime sleep would suffer.
4. If she has a bottle between 3:30-4pm, and manages to take a cat nap for 45 minutes starting somewhere between 5 and 5:30, should I cluster feed her with just 2 ounces (her normal bottle is 6 ounces) when she wakes up to help make it till dinner time and relax her for some quiet activity until them? If I do, and if she wakes from this catnap around 6, won't that mess up her dinner bottle which is usually at 7? Or would I then push that back closer to 7:30?
*** I think you just have to experiment. No sense in breaking up a bottle into two ounce increments if she takes the same total of ounces in the evening. Clusterfeeding ideally adds more milk. I wouldn't sweat it too much. If it seems like it won't work out, go with the flow. She's already sleeping beautifully at night. Maybe best not to make too many changes at once.
5. How come she often wakes from jolts around 45 minutes in her crib but not in her car seat/stroller - even if totally motionless? Is this related to the reflux? In the crib does the reflux bother her more (flat, side sleeper) so when she jolts she notices it? Or is this not related? Maybe because she is more snug in car seat and there is less room to jolt?
*** Because a carseat/stroller is enclosed and wraps around her snuggly. Is she on her back? Tried a sleep positioner? She'll grow out of these jolts somewhere around four months.
I'd ideally like her bedtime to be 8pm and wake time anywhere between 7-8am. I should also point out that we're trying not to use a pacifier (unless absolutely necessary) but she can and does find her hands and she is not swaddled - she actually sleeps worse when she is - she gets too upset from it and can't find her hands and freaks out.
*** I'd let her dictate the bedtime when she's ready. Don't be afraid to adjust it later/bit earlier depending on how her day's gone... flexible, flexible, flexible. Ditch the pacifier if she prefers her hands. Hands will pay off in the long run.
Thumb suckers make nightwakings muuuuuch easier as baby can soothe on their own much sooner than with a paci.
Right now she is sleeping in car seat/stroller - hopefully she can get some rest in - she had a rough bottle and was in a lot of pain before it. But in general, I do prefer that one nap a day NOT be in her crib if possible (even when pain isn't an issue) as I have to be out and about a lot and would like her to be able to nap in stroller or elsewhere if necessary.
*** Then you have your answer on that one.
