Author Topic: Spirited Baby with Reflux  (Read 2297 times)

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Offline annapark

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Spirited Baby with Reflux
« on: December 30, 2005, 05:15:25 am »
Hi my baby, Thomas, is a spritied little mite with a touch of grumpiness, bless him!

He is 12 weeks old today and was diagnosed with reflux at week 7.  He tends to have melt downs at large social gatherings therefore I ensure he's not handled overly I am concerned that he is going to become too dependant upon me to soothe him and just be his entertainment at all times; once he has his meltdowns I am the only person who is able to calm him down, once calm he fusses immediately should I try to hand him to anyone else, even his father at times.

Also I'm having trouble making him sleep during the day for longer that 45 mins lots, he's bottle fed and he's getting around 600mls per day, should I increase his consumption?

Looking forward to some guidance.

Anna
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Nikki~Nathan&Danielle

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« Reply #1 on: December 30, 2005, 06:43:12 am »
Hi Anna!

Could you please post your typical daily routine and I'll have a look and see if there are any areas you could tweak.  45min naps can be a result of not long enough activity time or it could be from having reflux and maybe he used to stir and feel uncomfortable at that point in his sleep and therefore got in the habit of waking up.

I'm sorry, I don't know how much formula is recommended at this age, so you may be better posting that question in the bottle feeding forum. 

As far as you holding him to comfort him, you really need to go with what he is comfortable with at the moment.  You can't force him to settle with someone else and may in fact make the problem worse.  I know it must be tiring for you to deal with it on your own.  Keep your DH in the loop with trying to help him settle, and he will eventually get used to him in times of needing help settling too (it's probably because you are the main caregiver and because he has reflux, you have probably been the main soother up until this point).  I would hand him over when he's happy and just take it slowly.  During activity time all sit together on the floor, have baths, read stories etc and just generally enjoy your little man for what he is and he'll soon start to get more comfy with your dh.  What happens if you're not in the house and he's with your dh when he starts to fuss?

Offline annapark

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« Reply #2 on: December 31, 2005, 09:06:35 am »
Hi Nikki,

Thanks for your quick reply.  OK a typical day at the moment looks something like this, it's long so my apologies:

0100am   wake up – feed 120ml (*not normal see below)
0430am   wake up – feed 120ml
0550am   wake up - feed 60ml (due to being so close to previous feed)
0700am   return to sleep
0845am   wake up – feed 120ml
0920am   asleep
0955am   awake – tried to assist in to next 45 sleep pattern by patting on the back and sh-shing but would not cross over
1100am   wind down – small feed 60ml
1120am   asleep
1240am   wake up – feed 120ml
      Activity time in family room by laying on rug and looking at bright patterns – I am 2metres distance in full view in the kitchen all the while talking to Thomas.

0140pm   move Thomas in to pram and outside where we are eating our lunch – toys hanging in pram for stimulation and we talk to him

0143pm   yawn
0155pm   yawn
0200pm   fussing return to sleep (tried to push for 3:00pm but fussing becoming too much)
0410pm   awake – feed 120ml

Activing time in the family roomand also I water the plants outside front and back daily and he comes with me in the stroller.
0500pm    30 minute walk in stoller
0600pm   begin bath ritual
0630pm   feed – 120ml
0700pm   asleep

*FYI – Thomas has slept through the night about 6-7 times, when he does wake it’s only once and usually it’s around the 4am mark.  Last night was different and I think it’s due to him now needing more calories to make it through the night. 

Is the expectation of him sleeping from 7pm to 7am too much sleep for him?

He currently weighs approx 6600 grams and is 64cm in length

Is a yawn always an indication of tired like when I wake up after a nice long sleep I sometimes yawn but I'm not tired, is this the same for babies?  I ask because he often yawns 30 mins or so after a sleep.

Some other questions I have:

Swaddling
He has only in the past 2 weeks begun ‘intentionally’ sucking on his hand, however I’ve not kept them free as he still tends to jerk a lot in his sleep, in fact when I move from the chair after his feed and burp to swaddle him he goes nuts and that's every time these days, he knows what's coming, puttin him in his crib is becoming more difficult as although he's tired he doesn't want to go down.

I believe it’s a trait of a spirited baby and he also scratches his face quite a bit.  Should I begin freeing one hand only?

Feeding
During his day feeds I feed him in the family room, it’s fairly bright and colourful and there are loads of interesting things for him to look at, also if I’m working in the kitchen he can see me moving about and I can talk to him and also keep an eye on him body language wise.

When feeding his small feeds to get him to sleep I always feed him in his room – also at night after his bath I always save his feed until last as he has major meltdown after bath time when I change him in readiness for bed time, the feed always calms him down.

Noise
We live on a very busy and noisy boulevard and of the night I play a music CD - it has relaxing heartbeat and soft soothing maternal rhythms which is supposed to encourage calm, relaxation and peace.  I’ve been using this of the night on a continual loop until most of the noisy traffic has abated, I cease the music playing at about 10pm when we also go to sleep.  I’ve been researching a white noise machine which isn’t that easy to find in Australia have you heard of them and are they any good.

I don’t play his CD during the day as I don’t want him to become reliant on it; historically he’s slept many 3 and 4 hour stints even during the noisiest part of the day.

My husband finds that when he’s alone with Thomas and he fusses he changes position in his arms a few times and if that doesn’t work he will either walk him around outside to look at the trees etc or he’ll put him in his stroller and he has to walk him around as Thomas will fuss if left stationary while in the stroller.

Activity
I’ve in the past had bright things hanging for Thomas to look at but I think that he now needs more interactive activity.  He hasn’t had a lot of tummy time purely due to the fact that being a reflux bub he’s been quite intolerant of it but I’ll perservere.

Deb sorry for such a long message don’t rush with the response another few days won’t hurt, plus I just round the sleep Q&A sheet on the website that Tracy was interviewed for I’m going to read it and see if any of these Q’s have been answered.

Happy new year.

Anna

ps last night new years night he awoke at 3.30am I fed him and he didn't seem all that interested but still wouldn't let up on the bottle - it took me 1 hour to get him back to sleep he was in a rage from the 1st time I put him down, at which time he had that far away look in his eye.  He then awoke at 7.05am I fed him and he showed tired signs again and I put him to bed at 8.00am, he was awake again at 9.00am.
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Nikki~Nathan&Danielle

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« Reply #3 on: January 02, 2006, 06:45:50 am »
Hi!  Sorry for taking so long to get back to you.

OK, first up, I wouldn't expect him to be able to sleep 12hrs straight at this point without a feed.  12hrs sleep yes, but there will be feeds within that time (some babies do sleep through, but it's not the norm). 

Are you on a 3hr EASY generally?  This will encourage him to take a nice big feed and therefore you will not need to have the small feed before the nap yet his belly will hopefully be full enough to sustain a longer feed.  I would also pick a "wake up time" to start your day.  Wake him up, give a feed.  Help him stay up for around 1 hr, take him into his room at that point, start a long quiet winddown in his room with curtains closed and let it last for maybe 20mins - this is really important for spirited babies who are quite stimulated and need some winding down for sleep.  Don't feed him, but incorporate some other sort of activity that is soothing: read some stories, rocking, singing.  Don't let him fall asleep before getting him into bed though.  Even though down further I have suggested to get rid of the swaddle, perhaps he will be more receptive to it if you've calmed him down first this way.  Then I would help sooth him right to sleep to start with using pat/shsh with him lying in his bed, but picking up if he gets really wound up.  Once you start to have success with this, then you can start weaning out the pat/shsh. 

Feeding before his nap is likely creating an association with needing that feed and therefore he's having trouble flicking into the next sleep cycle.  I really suggest cutting this feed out and it will hopefully have the flow on effect of fixing some of your night wakings which I suspect are linked in with not knowing how to resettle himself without your help.

He sounds like he's filling up on calories during the night hours - but possibly due to needing the feed to resettle rather than hunger, you could then risk him switching his hunger to that time of day (like if you or I decided to wake at 3am and eat a full meal, soon our body would adjust to this need).  I would probably work on the day naps first and hope that the way you put him down to nap and bedtime will help with those night wakings.

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Is a yawn always an indication of tired like when I wake up after a nice long sleep I sometimes yawn but I'm not tired, is this the same for babies? I ask because he often yawns 30 mins or so after a sleep.

I found with my ds that he would often yawn not long after waking up, I found if I ignored it he would keep going, so I think they can kind of yawn but not necessarily need to go to bed.

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He has only in the past 2 weeks begun ‘intentionally’ sucking on his hand, however I’ve not kept them free as he still tends to jerk a lot in his sleep, in fact when I move from the chair after his feed and burp to swaddle him he goes nuts and that's every time these days, he knows what's coming, puttin him in his crib is becoming more difficult as although he's tired he doesn't want to go down.

Maybe it is time to let his arms out, I found both my kids wanted their arms free quite early on.  My ds used to scratch his face a bit too when overtired.  But see note above.

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When feeding his small feeds to get him to sleep I always feed him in his room – also at night after his bath I always save his feed until last as he has major meltdown after bath time when I change him in readiness for bed time, the feed always calms him down.

I would start to replace that small feed before naps with some other form of calming/soothing.  Start with a gentle rocking, but lay him down in the cot before he starts to really doze off, continue to pat/shsh if he needs it.  Since he seems to be spirited, I would think that pu/pd may be a little too overstimulating for him, so work on a calm environment to start with.  I've always found feeding directly before bedtime fine, as long as you're not feeding him to sleep, maybe do a quick quiet story afterwards to create a little break that becomes a part of the routine.

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I’ve been researching a white noise machine which isn’t that easy to find in Australia have you heard of them and are they any good

A lot of people swear by them, I too have never seen one actually advertised as a white noise machine here either.  I have heard that a fan set on low can be great.  A radio set off the station can also be used.

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My husband finds that when he’s alone with Thomas and he fusses he changes position in his arms a few times and if that doesn’t work he will either walk him around outside to look at the trees etc or he’ll put him in his stroller and he has to walk him around as Thomas will fuss if left stationary while in the stroller.

Are you referring to Thomas sleeping in your DH's arms or just when being held?  My ds didn't like me sitting still and holding him while awake or lying in the buggy still either - hmmm, personality perhaps?

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He hasn’t had a lot of tummy time purely due to the fact that being a reflux bub he’s been quite intolerant of it but I’ll perservere.

Yes, definitely persevere, now that he is likely awake for longer, you can easily wait after his feed for 20mins or so and then work on some tummy time.

Sorry if it's all a bit random and disjointed, but post back if you need clarification.

HTH

Offline ~Angie~

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« Reply #4 on: January 02, 2006, 14:33:00 pm »
Hi Annapark,

Just wanted to say that we couldn't find a white noise machine for our daughter. We use a box fan in her room. If it is too cold at night for a fan, we put the fan in the closet with the door partially closed. That way she still hears the noise, but doesn't get the air from it.  :)
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Offline annapark

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« Reply #5 on: January 09, 2006, 05:26:05 am »
Hi Nikki,

 :D
Things are coming good – I’ve bought the final BW book and have surmised that the four nights that Thomas was waking at 1-2am was due to a growth spurt, I increased his food during the day and he now sleeps from 7pm through to 5-6am consistenly then he goes down again until 8.30am’ish; oh the joy the bliss.

I’ve also persevered with this day sleeps and true to the book for Spirit children he only takes perhaps two 45 min sleeps in the morning but I usually get a 2 hour and perhaps another 45 min in the afternoon.

I have a couple of other questions:

I never commenced the dream feed purely due to being terrified that he’d wake up!  If I started giving him a dream feed now would it extend his current wake up from 5-6am to perhaps 7am or is his current sleep pattern what a dream feed would extend his sleep to in any case?  Hope that makes sense either way at the moment I’m NOT complaining.

About visiting people I’m an advocate of a child has changed our lives and I don’t expect that he’s going to come hither and dither with me whenever I wish – can you indicate how long before a bub usually settles when going on outings?  I’m talking of day visits if we had an evening event on I’d have family sit him at home like I told my mum I don’t like sleeping in strange houses so I don’t imagine Thomas will either.

Look forward to your response.

Cheers,

Anna
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Nikki~Nathan&Danielle

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« Reply #6 on: January 09, 2006, 07:21:24 am »
Hi Anna, well I'm pleased that you've managed to eliminate some of the issues.

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I’ve also persevered with this day sleeps and true to the book for Spirit children he only takes perhaps two 45 min sleeps in the morning but I usually get a 2 hour and perhaps another 45 min in the afternoon.

This sounds fine, my dd also did 2 short naps in the morning and a 2hrish arvo nap.  Now she does one short morning nap and long afternoon.

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I never commenced the dream feed purely due to being terrified that he’d wake up! If I started giving him a dream feed now would it extend his current wake up from 5-6am to perhaps 7am or is his current sleep pattern what a dream feed would extend his sleep to in any case?

Well it's interesting.  I found the DF worked a treat with my ds and he started sleeping 7pm bedtime, DF at 9.30pm and slept until 6.30-7am at 3mths.  So yes the DF did extend that morning wake up out.  BUT, with my dd I could never get the DF to work, all that happened was she'd take the DF and then still wake at the regular wake up and then again in morning.  So with her I ditched the DF and just waited it out and it's taken until 9mths for her to drop that night feed.  In your case, definitely give it a go.  I found it didn't wake either of my two up, they stirred and sometimes woke, but the DF sent them back off to sleep.

But I think you're right in that, you would either need to wait out that waking stretching until later in the morning or give the DF, it is a bit much to ask that he will sleep through 12hrs without a feed at this age (some do, and my dd did actually do that for a week until she hit a growth spurt), but I wouldn't take that as being standard and can set up unrealistic expectations.  In the book, Tracy suggests the DF is there until around 7-8mths which indicates that she would only expect 8-9hrs straight sleep until that age without food.  BTW, 11hrs straight would be considered right through the night and you may want to start your day at that point in a few weeks if you notice the routine going a bit bung with day naps.

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can you indicate how long before a bub usually settles when going on outings?

I'm not too sure what angle you're coming from here?  Do you mean if he's crying and while out?  Or do you mean settle into a pattern with being comfortable being taken out?  It really comes down to personality, my ds always needed to be home for naps whereas my dd is more portable.  It just made my life easier working around naps - yes it's a drag, but for me it meant having a happy settled baby instead of one that wouldn't nap, would fuss etc.  Also, if we'd had a big day out with my ds he would need the next day at home to readjust to the routine and get his bearings again.

HTH :)

Offline annapark

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« Reply #7 on: January 10, 2006, 03:13:30 am »
Hi Nikki,

About the settling while out’n’bout issue what I mean is that he’s not very portable ie. if we are invited out to a friends place for lunch etc. he fusses or cries while out, I have to hold him most of the time; I just think it’s him and some times will be better than others (not that we’ve gone out all that much); my husband and I have discussed this and in future we’ve decided to get a sitter as at the moment he doesn’t take well to having his routine messed with. 

We bought a porta-cot which I intend to use at my Mum and my sisters place to try to get him used to sleeping in it when he’s not at home.  Don’t get me wrong I know very well that our lives have changed and I don’t expect him to just come along willy nilly but I would like to have a day at my sisters occasionally and know that he’ll be able to settle.

I’m going to try the DF tonight and continue until he ‘hopefully’ stretches out to 6-7 as this is the time that I want his day to start and I’m hoping that he won’t be tired at that time and looking to go back to bed as he has been during is 5-6am wake-ups.

Will report back later - Anna

ps you wouldn't read about it - he woke up at 1:20am this morning blah!
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Nikki~Nathan&Danielle

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« Reply #8 on: January 10, 2006, 06:28:20 am »
Quote from: annapark
About the settling while out’n’bout issue what I mean is that he’s not very portable ie. if we are invited out to a friends place for lunch etc. he fusses or cries while out, I have to hold him most of the time; I just think it’s him and some times will be better than others (not that we’ve gone out all that much); my husband and I have discussed this and in future we’ve decided to get a sitter as at the moment he doesn’t take well to having his routine messed with. 

I think that's your best plan because if he's not the sort to like his routine messed, I don't think you can push it at this age, when he's a bit older you'll see what you can and can't get away with.  I just don't "do" lunch out, I invite people over if it comes to that.

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We bought a porta-cot which I intend to use at my Mum and my sisters place to try to get him used to sleeping in it when he’s not at home. Don’t get me wrong I know very well that our lives have changed and I don’t expect him to just come along willy nilly but I would like to have a day at my sisters occasionally and know that he’ll be able to settle.

That sounds totally do-able. :D   When my ds was 11mths I went back to work part-time and my parents looked after Nathan, we had the porta cot set up, they stuck to the routine, winddown, etc and he did great!   So if you do your usual thing and try not to rush him, you'll probably find he adapts well (just expect in the beginning that you may have to work at it a little, so go with lower expectations and relax and hopefully it all works out well).

Offline annapark

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« Reply #9 on: January 18, 2006, 06:16:22 am »
Hello again!

OK all is pretty good at the moment; I’ve successfully introduced a dream feed which I give to Thomas at around 1030pm nightly and I eliminated that nasty habitual wake up of 4am so we’re now at bed by 7:00 – 7:30pm nightly and wake up usually around 6:00-6:30am don’t seem to be able to get him closer to a 7am wake-up.

This morning for example Thomas awoke at 6:00am and he was yelling out for food so I had to feed him, he gobbled up all 180ml of it.  In Tracy’s final book she shows a routine commencing baby’s day from 7:00am and so on – she comments that if baby wakes say at say 5:00am for a feed to feed baby and return to bed until 7:00am and I presume feed again at 7:00am (not sure on that point) – would this same suggestion apply for a 6:00am wake up?  I haven’t assumed so. 

What I intend to do today for example is work his routine as he started ie.;

6am feed
9am feed
12pm feed
3pm feed
6pm feed
10 – 11pm DF (somewhere in that time frame)

or do you think it would be better for me to try to extend his feeds on days such as these to a 7am wake up time table?

He’s 15 wo tomorrow (Thursday, 19 Jan) and I’ve decided that I’m going to start him on his 4 hour routine next Monday, Mondays are always good days to start new routines I’ve found,  he will be just shy of 16 weeks but I don’t imagine that will be a problem, do you?  He was a 2.5 week prem baby and in Tracy’s book she has commented on waiting until the baby would have turned 4 months but Thomas was a big boy at birth he weighted 8.6lb and he’s always been a good eater etc. so I think I may be able to start him a little early – do you agree?

I’m not looking forward to converting to the 4 hour routine – Thomas tends to tire sooner than he is due for bed and being a spirited child I don’t like him to get overtired and/or overstimulated as he has been partial to melt-downs – any suggestions would be greatly appreciated to get him used to a longer activity period.  Additionally as I am to increase his food intake at each of these feeds how much of an increase is recommended?  He currently takes 150ml per feed with a 120ml DF therefore his current daily intake is 870ml.

I was thinking of 180ml per feed x 4 = 720ml with a 180ml DF that would increase his daily intake to 900ml so it’s just a little more that what he’s currently getting or is that not enough?

I’m looking forward to your response.

Cheers Anna  :D
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Nikki~Nathan&Danielle

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« Reply #10 on: January 18, 2006, 06:47:38 am »
Hi Anna, well it sounds like you're doing great!  :D

My dd goes to bed at 7 and wakes around 6-6.30 - she's awake for the day and not looking like she's still tired.  To me this is the difference, some babies only want 11hrs overnight sleep.  When she does wake at 5am she's more likely to be tired still, so at that age I would feed and put back to bed - he will likely sleep later if you did end up doing a 5am feed and you'd need to wake him by 7am.  But since you have a 6am, I'd tend to start the day myself like you have been doing.

As far as switching to the 4hr routine, to me, activity time length is the key to getting the feeds stretched out.  If he's wanting food sooner, then he's not ready to switch.  So give it a go, and follow the plan in the book and see how you get on, I started the transition from 3.5mths and it took about a month for my dd to completely be happy with it.  Being spirited you may find it more difficult to switch - not sure how spirited's cope with too long acitivity before they're ready??

With your proposed feed times based on the 6am waking, I used to just add 15mins to each of them if my dd was happy to go longer, so there was still a bedtime feed right before bed.  So 6am, 9.15am, 12.30pm, 3.30pm, 7pm or something like that, it doesn't really matter in my mind, but then I'm not a strict EASY follower.

HTH and good luck. :)