Change to 4hour Easy-night wakings and early morning wakings!

[Christy P]

My son is 4 months old. He has reflux and started waking 5-8 times a night at 3 months. Prior to that he was sleeping 4 1/2-6 1/2 hours and then getting up every 3 after that. I have been following a 3 hr easy, pretty much like clockwork. 7am feed, 8:30 nap, 10 feed, 11:30 nap, 1 feed, 2:30 nap, 4 feed, 5:30 cat nap, 6:30-7 feed (to keep upright a little before bed) 7:30 sleep. He's always been a terrible napper but i've been working on extending his naps w/ pu/pd and wake 2 sleep for about a month. We're doing pretty well now. I can usually get him back down for the full 1 1/2 hour.

Recently we have been going through alot of changes. He is on a new medicine for the reflux, hoping to reduce the night wakings. I was feeding him twice a night. 12:30 and 4:30ish. The dr wanted me to try to cut out one of the feedings, if he could tolerate it. The hope was the he was waking after eating b/c he was uncomfortable from the reflux. I am now feeding him once a night at 2 ish. He seems to be doing pretty well with that. He is definitely hungry by then. Even before I made this change w/ feeding he had started waking up earlier. He used to wake up between 6:30-7 (usually 6:45 ish). Now he is hard to get back down after 5:30-6. This morning I tried to feed him at 5:30 to see if he would go back down-no luck.

I started moving him to a 4 hour EASY on Monday hoping it would help but his early wakings are throwing a wrench into things. He is really beat by 7-7:10 if he wakes at 6. Normally he could go 1 1/2 hours no problem. I got him to go the 1 3/4 hours 3 times this week. He has then been sleeping 1 1/2 -2 hours. I let him go the 2 since that is our ultimate goal. I'm going to try to work on stretching his next cycle to 1 3/4 hours next.

Anyway, that was alot of information but my question is how do I deal with the early waking? Accept it and adjust his schedule accordingly? It's been going on for a while now. I've tried stretching him for weeks. If so, should I move his bedtime earlier? He is really tired by bedtime.

Also, if anyone has any advice on dealing w/ the night wakings I sure would appreciate it. I'm so tired. He is getting up roughly around 10, 11, 12:30, 1:30-2, 4, 5, 5:45-5:55 and then on and off until I accept he's awake We just pat him, sometimes he takes the pacifer and keep a hand on him until he settles. Most times it takes 5 minutes and he's back out. We don't pick him up and he rarely cried unless he is in pain. Ideas???

[teezee]

bump!

[Christy P]

any ideas on how i can get more replies to this?

[teezee]

sorry for the long wait for a response - my deepest apologies - it must feel like its been forever given the circumstances. 

the waking at three months could have been due to a growth spurt. at 4 months are these wakings the same? tracy suggests trying to settle lo in the crib and if lo wakes within an hr - feed as lo is hungry. if lo sleeps longer than an hr than you know that is wasn't hunger and will need to do sleep training.

now that lo is 4 months i would suggest moving to a four hr routine - with a lo with reflux - i know it can be hard as i would have to feed my lo smaller meals more often which kinda threw easy out the window for some time - but i still followed a routine it just happened to look like eaesy - but would never feed to sleep - would have 5 or ten min of A time before the sleep.

you might want to try having that second nap a bit earlier in the afternoon - i am not sure how long lo is sleeping for but 10am - 2:30 is an awful long time for a lo that age to be up for.

what kind of medication is your lo on? is it helping? how have the wakings changed (amount of them and nature of them since the meds).

as far as extending to a 4 hr routine and A time- i think he could handle a bit more..lo's get used to a good routine and learn to become tired at that time kwim? just extend it slowly 15 min or so at a time every few days and keep the extra time very very low key. if you extend the A time, the naps may also fall into place as lo will be more tired to be able to stay asleep then. if you are putting lo down so early for his am nap that could really contribute to the early wakings and makes sense at to why he is so tired - b/c he is making up for the lost sleep from the early waking.

def if lo is really tired by bedtime move the bedtime earlier for the time being - if lo is overtired you will have a whole new set of wakings to deal with on top of everything. it is better for lo to get to bed early rather than need extra sleep in the am or take an extra long catnap before bed..at least if bedtime is early he will be 'making up' for lost sleep at the appropriate time. i think that in fact some of those wakings are due to overtiredness (the early evening wakings) and the others for the reasons i have already mentioned.

i don't know if you have looked at the colic, reflux, and crying board but they have some wonderful tips on how to try and make lo more comfortable...i am sure you have tried some/most of them but might be worth a peak

i also want to mention that you are doing a fabulous job just need a little tweaking in yhe routine i think - it is soo hard with a lo who is in pain - i must say you are a better woman than i - at this age i fed lo all night long AND let her sleep in bed with me...i was just a 'little' guilt ridden over it all...

[Christy P]

thank you for the reply! Sometimes he wakes w/in an hour but usually we put him down at 7:30ish and he wakes between 10:30-11:30. I have been working on getting him on a 4 hr routine. He was doing great at 1st-no problem going 4 hours to eat and is doing 2hour awake for the 1st stretch and then between 1 1/2-2 hours on the 2nd stretch-depending on the day. I haven't been able to stretch his thrid awake time yet. When I first started this he was taking 1 1/2-2 hr nap in the am and a 2-2/12 hr nap (which I have to extend each time b/c he wakes at 30 min for most naps) in the pm. Now he's back to shorter naps which messes up the rest of the day. So, he's back to 3 naps and a catnap most days. Also, he's getting fussy to eat at 3-31/2 hrs.

He doesn't go 10-2:30 awake-here is his rough schedule now. 6:30-6:45 wake,7am feed, 8:30-8:45 nap, 10:30-11 feed, 11;30-12:30 nap (depending on wake time), this nap gets complicated b/c it can run into the next feed-so we have to play this one by ear.- not awake more than 2 hours- sometimes push feed up. Ideally eats at 2:30-3. Nap pretty much right after. Sometimes takes a long nap here sometimes short. If it is a long nap he doesn't take a cat nap & eat around 6:15-6:30. 7:15- 7:30 sleep.

We used to have a very textbook routine 7,10, 1, 4, 7 and the naps 1 1/2 hrs after wake. It's gotten a little crazy since trying to move to the new routine and I'm not sure how to adapt to his early wakings from his naps. I feel like we don't have any routine any more. Should I just continue to move his nap times when he wakes early?

He is currently on prevacid and soy formula. He's been on prevacid for about 2 weeks. I thought we were seeing a difference by the end of last week. He had his best night ever and only got up once. Then 3-4 times the 2 nights after. THEN the next night he got up 9 times. I'm stumped. We have been having a hard time getting the full dosage of prevacid into him so we tried giving him zantac at night. The first night was the night he got up only once but then it's gone downhill since then so maybe that is a bad idea.

Originally he was put on zantac when he was 2 mon. At that point he was waking 2-3 times a night to eat. It wasn't until he turned 3 months these horrible wakings started. We upped his zantac but it didn't make a difference. The dr is convinced this is physical but i really wonder if it started due to a growth spurt and maybe growing out of his dosage of zantac and now he's used to us soothing him when he wakes.

Thanks for the support. If it was just me, he probably would be sleeping with me but my husband keeps me strong and on track.

[teezee]

when it comes to changing to a 4 hr routine esp in this situation - don't be a clock watcher. go on what you lo needs - if it needs to be between 3.5-4hr routine than go with it - trying to aim for 4 hrs but doesn't nec have to be that long. maybe the 2 hr A time in the morning is too long? maybe try cutting it down by 15 min to see if it will help. the shortest A time of the day 'should' be in the morning with A times subsequently getting longer throughout the day. when lo's aren't feeling well often they aren't able to stay awake for as long for A time b/c the sleep helps them heal and get over the discomfort - so if you can stretch it out then go for it - if it isn't possible yet than don't.

if a nap runs into a feed don't worry about it. it's not like the early days when you sometimes have to remind lo that it's feeding time..lo will wake when he is hungry. i wouldn't let any naps go past the 2 hr mark though.

to be honest i had a horrible time getting my lo on a 4 hr routine - don't know if it was b/c of the reflux - or if it was just her and her spiritedness..but it felt like it took forever and i remember posting "HOW DO I DO THIS?". after a month or so things were more on track but it varied between a 3.5-4 hr routine throughout the day usually. i would aim for 4 but did what i had to do for lo.

i believe reflux peaks at about 3 to 4 months - so hang in there!! yes, zantac is VERY weight sensitive-i was having to get dd's dosage upped constantly for those first few months as they grow soo much then. maybe have you tried taking lo to another dr? i know i had to go to a handful before they would even diagnose her. and then another handful before i got a dr that prescribed her a decent dosage to keep her from being uncomfortable. she is getting the zantac twice a day still and i am thinking that if you are giving two doses of zantac / day consistantly (as it really does take some time for it to fully help lo..although i saw results the first day, and then it seemed to get worse for a couple weeks but then leveled off kind of). i don't have any exp with the other med myself - but if you would like additional advice or support the reflux board has awesome mods and other ppl who have all been through this as well.

good for hubby!! my dh was working midnights - and it was a nightmare to have to go through it alone - glad you have the support 

wish i could be more help - it is such a sticky situation at the point you are at right now...but i would maybe try the zanatac again, get the dosage adjusted and keep him on it a bit longer...good luck hun {{{{{{{{{{{{HUGS}}}}}}}}}}}

[Christy P]

New development. I put him to bed early last night and the night b4. Still waking within 1-3 hours. Last night went down at 7. Woke at 9:45 then 11. At 11, he was awake. Kicking his legs, trying to make eye contact and talking. My husband tried rocking him, patting, etc, all to no avail. Finally he fell bts after 45 min. Ideas?

[teezee]

could lo still be in pain due to reflux and/or gas??

[Christy P]

It's certainly possible but the puzzling thing is that he isn't crying. He is smiling, kicking his legs and wanting to play!

[teezee]

than chances are it is something else

would you mind posting lo's routine so we could take a look? it is probably just a matter of tweaking a bit ...like stretching out A time a bit here and there.

[Christy P]

Ah-that is an interesting question and perhaps part of the problem. Prior to trying to move him to a 4 hr plan we had a clockwork schedule 7, 10, 1, 4, 7 with naps an hour and a half after waking. When I first started working on increasing his A time we were doing:
7 feed, 8:45, nap but that's where it all starts to go wrong. Some days he'll nap for 1 1/2 -2 hrs but most days it's 45 min. I always try to extend the naps but many days I am unsuccessful. Which then means he is tired way b4 12:45-1, when he technically should be going down for a nap. I end up pushing up his feeding to 10:15-10:30 so I can get him back down for a nap between 11-11:30. The rest of the day gets wacky from there.

The naps are really my problem. He always wakes up in the morning cheerful and rested but it goes downhill after the first nap and I feel like we almost have no routine anymore.

Ideas?

[HeatherC]

Here is a link to a post with a sample 3.5 hr routine in it.  Perhaps with his need to feed more frequently due to reflux, but also to increase his A time slightly, this might help.
I was wondering if he sleeps in your room at night?  I tend to think that you shouldn't go to your lo if they are just making noises in the night, but rather only if they are truly crying.  My dd used to grunt and groan in the night, and by me trying to calm her down and get her back to sleep (which she was really kind of asleep still), it only woke her more and made the situation worse.  Soon, I moved her to her own room.  I realize you said he is already wide awake sometimes, but I would stay out of his line of sight.  Sure you might want to check on him, but I would give him a chance to resettle on his own.

Also, like teezee said, try to watch his cues for naps.  If he takes a short nap, and never goes back to sleep, he's going to need a nap sooner after the next feed than usuall.  You have to take into account the total amount of A time that starts when he wakes from each nap.  So, if he wakes from a nap and has 45 mins to go until a feed, and he can only handle 1.5 hrs total A time, you'll need to put him down probably soon after his feed.  Allow enough time at the end of A time for a winddown.  So, if he wakes and feeds at 7 am, start the winddown about 8:10, and have him in his crib around 8:20.  This will give him a few more minutes to unwind on his own and hopefully drift off to sleep.  That's just a thought.

[Christy P]

Thank you both! He does sleep in his room and initially I went in pretty quickly when he made noise, so he wouldn't wake my husband. However, since the night wakings have gotten worse I have stopped that habit! I wait for a few minutes to see if he will settle himself. Usually he doesn't but every now and then he will. Ok, that is good to know about putting down early for naps. That is what I have been doing but it shoots the "routine" to heck and I haven't been able to figure out how to get around that. Also when he wakes up early. I wasn't sure how to adjust the schedule.

When I first started moving him toward a 4 hr routine he took to it very well and was definitely consuming more at his feedings. Went from 4-5 ounces to 8! However, we've had some regression on that over the last week and a half. I think it is due to the reflux but I need to give him his bottle in 2 stages, over a 30-40 min period and then he will still usually take 6-8 ounces. He recently had an upper GI test and I had to feed him every 2-3 hours and he seemed to do better with it. Perhaps I am pushing this too soon?

I eliminated 1 of his night feedings about 3 weeks ago and he took to it no problem. I think I was feeding him out of habit. Whne he wakes up he really doesn't seem hungry just having a hard time settling himself back down or playful.