3.5 month old, big for age, with very erratic night wakenings

[mommyroo]

Hi, Please help.  My 16-week old has slept 5-6 hours at night for only about 3 weeks of his life (and they weren't even continuous).  For the last couple weeks he's been up every 1-3 hours with no rhyme or reason.  I got Tracy's second book from the library and found out he might be hungry:  he's a big baby (maybe 18 pounds now; was 15 pounds at the 2 month visit).  I pump at work and he eats on average about 8-10 ounces from the sitter during the day (over 2-3 feeds; he eats every 3-4 hours).
I'm a working mom so it's not so simple to do EASY by the book.  My son is watched by an elderly lady in her own home; she also watches a 20-month old.  I asked that she feed him every 3 hours but otherwise have not pushed EASY on her because I didn't want to stress her and she often has her own ideas of watching children (she's very loving and I trust her very much, so I'm OK if her ideas are different from mine sometimes).  Anyway, my son kind of fell into EASY on his own.  He eats every 3-4 hours then is awake for about 1 hour, then naps 1-2 hours after being awake; this doesn't happen every day but is a kind of norm.  He usually takes 3 naps a day.
I have tried to keep bedtime consistent (this I can control!) at 8pm.  His nighttime lasts until about 7 am, with usually 3-5 wakenings in between.  I feed him at nighttime only if he hasn't eaten for 3-4 hours, and he'll usually have a full feed.  Any wakenings in between are solved with a pacifier.
Two days ago I started a 10 pm DF of 3-4 oz formula in case he was hungry, but he has still been waking up 3-4 hours after this feed.  I had tried the DF when he was younger, but it never seemed to help then either--do some babies just not accept DFs, or does it take some time for them to get used to it?
Also, I have started giving the sitter bigger bottles (5 oz) for his feeds.
Am I not pumping enough?  Should I be eating more carbs to have richer milk?  I have been losing pregnancy fat, but only 1 pound every 3-4 weeks, so i don't think I have a calorie problem.
This wakening is really grueling since I go to work during the day.  Any advice would be greatly appreciated!!!!!

[momofclaire]

Hi, and welcome to the site. 

I have a couple questions...
When he wakes at night and it isn't time to feed, does he go right to sleep with the pacifier?
Can you tell me how may oz per day he is drinking, including night feeds? 
How many total hours of sleep does he get in a day? 
When, time wise, is his last nap? /How much time passes between the last nap and bedtime?
Does he fall asleep without a prop, ie, bouncing, bottle, rocking, at night and naps?

I don't think you need to worry about having "rich" milk, however I would be sure to pump your breasts until they are empty as the hind milk is the fatty milk.  If you would like, I can send a breast feeding mod over or you can post that question in the bf forum.

Post back and I will try to give you more advise and less questions. 
Myia

[mommyroo]

Hi, Thanks for the welcome.  To answer your questions:  He usually takes a paci before naps and at bedtime.  Much of the time he spits it out as he falls asleep; I've been trying to remove it right before he falls asleep at bedtime so that he doesn't use it as a prop (at night, at least--I don't think the sitter is as worried about the prop as I am, but for naps I don't see as much harm as at night).  He does go right to sleep with the pacificer in the middle of the night, unless he's hungry, then he'll wake back up in half an hour or so (this only happened a couple of times and is not the usual, since now I feed him if 3-4 hours have gone by since the last feed).
Total hours of sleep is around 16 hours per day.  While his first two naps are more consistent (usually in the morning and early afternoon), the last nap is all over the map.  It usually is around 45 min to 1 hour and can begin anywhere between 3:30 and 5:30 pm.  I try not to let him nap after 6 pm though.  The time and length of the first naps also varies, but usually the morning nap is 1 hour and the early afternoon nap is about 2 hours.  The long one is usually not solid and about half the time the sitter has to give him the pacifier in the middle of the nap.
I know a more rigid routine might help, but again I think this would put too much pressure on my sitter (and probably on me as well since I don't want to make her feel bad).
I do pump until my breasts feel empty.  This results in about 10-12 oz per day of expressed milk.  I am not sure how much he has total because the rest of the time he is on the breast (totals about 5 times in 24 hours) except for the new formula dream feed of about 4 oz.
Hope that helps you.  Thanks again!

Mommyroo

[momofclaire]

Mommyroo,

Part of the problem, I think, it that his daytime routine isn't consistant enough.  I know you are concerned about talking to the sitter about this.  You may want to visit the working parents forum.  There is a thread over there about getting nannies and sitters to follow easy. I think you will find some good ideas.  If you can't find it let me know, I will go on a search.

Here is a link to sample easy routines for your little one's age.
https://babywhispererforums.com/index.php?topic=10385.0
Do you cluseter feed in the evening? 

[mommyroo]

Thanks--I will look in that section and see if I can find some tips.
I do cluster feed in the evenings, about every 1.5-2 hours after I pick him up from the sitter, until bedtime.

Last night he only woke up 2-3 times between 7:30 PM and 6:00 AM!  The times were very similar to the night before, so he actually did the same thing 2 nights in a row!  Although he still woke up at 1:30am, 3.5 hours after the DF, I think the DF might be working to set a clock at least.  At 1:30am I tried to use the pacifier but he woke up again 45 minutes later, so I ended up feeding him; then I fed him again at 5am when he woke.
It's only been 2 nights in a row with similar wakenings, but it gets me hopeful at least.
Maybe after he establishes a pattern I can work on shortening the feedings at night.  Is this a good route to take?

mommyroo

[momofclaire]

I would certainly look for patterns.  If you find that he is waking at the same times each night, you may be dealing with habit instead of hunger, which can be dealt with.  I would try to up his food intake during the day as well.  You might find that if you can get him to take a bit more during the day, it will be easier to end a night feed.  Keep in mind that many babies take one night feed until 6 months.  It is possible to be night feed free at four though.  It just depends on your baby.

Keep me posted.

[mommyroo]

Hi, I think we have a pattern now, instead of the erratic wakenings.  We do the dream feed around 10-10:30, then baby will wake up twice: 1-2ish and then 4-5ish.  He's on a newborn feeding cycle again!  But at least he's predictable.  I'm trying to get rid of the 1-2am feed if I can.  I started using a pacificier but he wakes up 1 hour later, then I feed him.  i hope if I continue the pacifier at the first wakening he will slowly push himself back, hour by hour.  So far we've only done it 1 or 2 nights.
It's tough this way, though, because I end up getting up 3 times instead of 2, but hopefully it won't take more than a week.  What do you think?  Any other tips for getting rid of this feed?
His daytime schedule has actually become more erratic the last couple days, because the sitter moved him to a crib to nap (he was napping in the car seat).  He actually was pretty regular, when I compared it to the samples on the link you gave me. I think he's developing a new routine with the crib though; sometimes now he takes really  long naps in the afternoon and this has thrown off the feeding.
I couldn't find the working parents forum--do you have a link?
Thanks.

[momofclaire]

Here is the link to the working parents forum.
https://babywhispererforums.com/index.php?board=15.0
I would be careful trying to end both feeds as he may need one.  Waking one hour after he woke the first time could mean that he was really hungry the first time.  It is not unheard of for babies his age to need 2 night feeds.  I would try what you are doing for a week and see how it goes.  Be sure to up his feeds during the day just a bit to compensate for those calories. 
Keep me posted.
Myia

[mommyroo]

Hi, Thanks for the link.
Actually, I was trying to get rid of one feed (the first one at 1am).  Last night, though, he was able to go from 2am to 7am without eating (woke up once at 4am and went to sleep with patting), so I think you are right and he is hungry the first time.  I am going to follow his lead and try to get rid of the 4am feed instead.
When you said it's common for babies his age to have two night feedings, does that include the DF?  I thought TBW says they should be able to last 5-6 hours at night at this age?

[momofclaire]

The book does say that babies should be able to go 5-6 hours but each baby is different and it is more important to know your baby than follow the book, actually, that's the idea in the book, really knowing your baby.

I think it is a better bet to pat/shh and soothe the second waking.  When I took Claire from two night feeds to one, I fed the first wake and pat/shh or used the paci for the second.  It worked very well.  I also find that if you feed the first wake then the feed overnight doesn't interefere as much with that morning feed.

The two feeds do not include the dream feed.  I think, from what you tell me, your baby would do fine with the DF and one night feed. 
Hope all this helps.
Myia

[shanlbc]

I just want to mention that I have a (somewhat) elderly nanny too...who is also very sweet and loving.  I was concerned about her following EASY (since I had worked so hard to get it established while I was off work) so I just made her a chart of E, A, and S times.  I know EASY is not supposed to be a schedule and sometimes she does get too hung up on the actual times, but at least it gave her a guideline of my (and DS's) expectations.  It actually made things better for her...she never has to wonder whether he is sleepy or hungry and he goes down really easy for naps this way.

I know that you can't always tell your sitter exactly what to do...this is just what worked for me.  Good luck!

[momofclaire]

How is it going?

[mommyroo]

It's seems like DS can sleep from 2-6 am pretty consistently now, without feeding.  So that's much better than a couple weeks ago!  Still doing DF at 10-10:15PM.
Is this about as much as I can expect at this age?

Last night he also woke at 12am but I think that's because he had a very weird day at the sitter's (slept most of the day and only ate once!).
So I reminded her to feed every 3-4 hours, even if it means waking him from a nap.  I try to give the first waking feed at the same time each day, so I hope we can set some knid of routine that way.
Thanks to shanlbc for the suggestion about the chart--I had the same idea.  He had a passable routine for awhile that he developed on his own, so I wrote down the general eating and sleeping times  (she gives me a paper everyday recording what he did that day, and I have been looking for patterns).  But what is she to do when he varies?
For example, Monday morning I had DS at home (sitter had a doctor's appointment) and he got hungry and tired before his usual times. 
I don't want her to become frustrated trying to follow a schedule during the day.

[momofclaire]

It is less about sch and more about his cues. I would work on making sure he gets a little more consistancy with his days.  If the sitter lets him sleep all day then he isn't going to sleep at night.  He should be woken up if he sleeps to the 4 hour mark of not eating during the day.  You may even tell her 3.5 depending on what kind of easy he is able to do.  Does that make sense?

[shanlbc]

I have been doing the same thing with my sitter...I think a combo approach works.  She will start to notice his cues more when she has a rough idea of when to start looking for them.  Then she will start to pick up on them when they come earlier/later, etc.  I know it's hard...