Pls help w 6 Month reflux waking thru night

[vmarcel]

Hi my 5 1/2 month old Oscar is waking between 4 and 9 times a night.  It's been going on for 2-3 months...  I would really appreciate some advice because I just don't know what to try... and i'm exhausted...

I went through a lot of posts and couldn't find a match with my situation... though I did pick up some tips...

Here is his profile:
- He's got reflux and being treated last 2 months with Rinitidine. His crying fits are x10 better, but he still wakes in the night.
- He is pretty dependent on the pacifier. When he wakes we pop the paci back in and he goes limp MOSt times -- but 1/4 times he stays awake crying even with the paci (we think that's when the waking makes him fully aware of reflux pain).   So with the 3/4 other times, I'm wondering: is it the prop the problem?? Should we wean him from it even tho it relieves him from reflux pain?
- He usually wakes at 2:30am and then can wake again every sleep cycle or wake/cry several times before falling into deep sleep... only to wake up 30-40mn later. He's also waking earlier in the morning 5:45 (we can sometimes get him back to sleep until 6:45)
- He knows how to fall asleep alone in his crib (no rocking etc necessary)
- He's a good napper (45 mn in the morning, 2.15 hours at lunch and 1/2 hour in the pm) - so he knows how to sleep
- He's teething -- I tried Bonjela but doesn't seem to have an impact
- I started him on solids 2 weeks ago - loves it! can't get enough (2 meals a day)
- I think we probably go in too quickly. When we hear him crying, we go in. But we've been trying to wait 5mn...

his day looks like this:
wakes between 5:45 and 6:45
Feeds at 7 (earlier if can't wait)
naps 45 min at 8:15/8:45   -- another post explained that it's good to keep the LO up later in the am. Maybe I should delay the morning nap?...
Feeds at 10:30 (bottle and then solids)
I give him a long midday nap: 11:45 to 2pm (he usually sleeps well, tho often wakes once or twice)
Eats at 2:30
Naps 30 min at about 4
Eats (bottle and rice milk) at 6:30
Sleeps at 7 (often wakes a couple times)
Dream feed at 10:30

Thanks so much for your help!
Valerie

[em_here]

hi there, am no expert on most of your probs but I have a 5.5month old refluxer.  Do you elevate the cot mattress, sometimes that is enough in itself to alleviate the discomfort of the acid rising in the throat.  Paci is probably a prop if lo continuously wakes and needs it to go back to sleep. Maybe you could try weaning it if you think it helps.  Teething could be hurting him and aggravating the reflux, someone on here told me the saliva can aggravate it.  Maybe a trip to your doc will help, has his meds been upped with his weight gain as Ranitidine is very weight sensitive, my lo has hers uppped every now and then.  HTH a little and hugs you must be shattered

[vmarcel]

Thanks Emma Louise... :-)  We've taken  the positioning precautions - and they've helped so much. Ranitidine is increasing with his weight too...
But I wonder if he should try another drug (one that prevents acid creation)?

Is it cruel to take the paci away if it comforts him when he's really in pain??
For the weaning to work we'd have to take it away permanently I suppose...
I think when you have a baby with reflux or any other medical problem you become so anxious about their pain -- maybe too much. So I want to keep him from crying at all!
xx
Valerie
 

[em_here]

I so know how you feel, i did anything to stop Abbi's pain as well, made me overanalyse her piercing crys.  I would think she was in pain, but she wasn't once on the meds, it was a habit cry. Don't get me wrong she has a paci sometimes, but when it pops out she does not wake up.  If it stopping the pain it is such a difficult decision, but are you sure he is pain, or just real upset as he wants the paci?

[vmarcel]

Hmm. good point.
I think that really most of the times it's the habit and that he wants the paci.
But about once a night or once every couple of nights, he won't settle with the paci and the only thing that'll calm him (Eventually) is to hold really close (co-sleeping) and give the pacifier... then I know it's the reflux (I recognize the cry when it develops).

It would reassure me to know that other parents with reflux babies have cut the pacifier...

How did you get your daughter to limit her pacifier needs that way?

[momofclaire]

I just wanted to jump in and say that you may also have an overtired little boy on your hands.  Although he is sleeping during the day, the 45 min nap and the 30 min nap aren't generally as restorative as you might think. I would work on getting your EASY routine to be a little more consistant.  You can take a look at sample easy routines in the EASY forum.  Also, although your little one may be loving the solids, they may be causing tummy trouble which will complicate the reflux and lead to more night waking.
Have you noticed that he wakes more since you started solids?

[vmarcel]

The solids didn't really have much impact on his sleep. Once he went thru the night without the dream feed (we were giddy in the morning  ) but otherwise I can't say it's led to more reflux episodes... But I think I better keep a diary to be sure.

on the naps, looking at the sample EASY routines board, I'm not sure what to do. It looks like most parents give a longer nap in the morning, but little or no nap in the afternoon. Maybe I should delay the morning and midday nap so there's more sleep in the later part of the day?
But eventually babies have to go on one mid day nap, don't they? so is it worth me splitting his morning and midday naps more equally at this stage?

Thanks for your suggestions!

[momofclaire]

I think maybe you might have been looking at easy routines for older babies. 

For six months here are a couple I found.
6.30am Wake and plays in cot
7.00am Breastfeed followed by oatmeal/fruit 1/2hr later
9.00am Nap for 1-1.5hr
11.30am Breastfeed followed by vege/fruit/etc 1/2 hr later
1.30pm Nap for 1.5hr
4.00-4.30pm Breastfeed followed by vege/fruit/etc 1/2 hr later
6.15pm Bath etc
6.45pm Final breastfeed
7.00pm Bed


8:00 a.m. wake up, Eat (bottle and cereal with fruit)
10:00 a.m. Nap
12:00 p.m. Eat (bottle and vegetable)
2:00 p.m. Nap (Still working on extending this one)
4:00 p.m. Eat (bottle and cereal)
Sometimes an evening cat nap at around 5:30 or 6:00 p.m.
8:00 p.m. Eat (just bottle) and then bedtime

7-7:30 - wake
8:00 - nurse
9:00 - solids
10:00 - nap for 1 1/2 hours
12:00 - nurse
1:00 solids
2:00 - nap for 1 1/2 hours
4:00 - nurse
5:30 - solids
6:30 - bath
7:15-7:45 - nurse and bed

Many babies, until 7 months or so still have an evening cat nap of 30-45 min but some do not require it.  I think you should certainly shoot for two naps of 1.5 hours each and an evening cat nap, or 2, two hour naps. 
Babies do eventually go to one midday nap. The transition can start as early as 10 months, most switch between 12-18 months, so you have some time.
Hope this helps.
Myia

[vmarcel]

Thanks a lot Myia. I'll try to balance the naps.

If any moms/dads out there have any experience with removing the paci of a reflux baby I would love to hear about it (good or bad!)

Also, what's the experience on leaving LOs to fuss/cry a little before going in the bedroom to console them? I think I go in too soon (within 1-3 minutes, depending on how deep my sleep was!). How long is good to wait? ... assuming it's not a piercing hysterical cry of course.

[momofclaire]

I would say that unless he is crying the "I need you" cry, just leave him.  Fussing, mantra crying etc...are ok. There is not a time limit per se, it is more based on knowing the babies cry. 

[mella]

dont know if this helps but we've been having similar problems with a suspected refluxer, who could wake up to 20 times a night. We've just put him on Nutramigen formula, and after a week on it, he's just done his first night without waking , although he's started to wake up at 5.45 
Mel

[vmarcel]

fantastic! how great to sleep.

The doc actually said this week that if his nights didn't improve the increased dosage he wanted to change his formula. I didn't understand what difference it would make, but now I see it could have an impact. I'll ask him about nutramigen.

[mum-of-six]

i have had 6 refluxers
only one did not use a paci
i found it helped some with the pain of reflux
I have successfully weaned them off of the dummy
firstly I only use if required and I seldom put it back in to re settle normally a shhh pat will do at night if not then I will replug.
secondly only use if not content to settle alone my LO whinges rarely so that helps us, she will sometimes need it if i miss a cue that she is getting tired.
watch for automatic plugging if LO is not in need do not give the pacifier


hope this helps

[vmarcel]

Thanks that's so helpful!! It's very good to have your long experience.
I can't believe you had 6 refluxers. my goodness.

I think i need to majorly readjust the way I replug, which is, as you guessed, much too automatic.
Right now if i cut down at night, i'm sure he'll complain a lot, but over time i guess we will both gradually learn to deal with tears in other ways... During the day this week i've already followed this rule (last resort plugging) and I realize he doesn't need it as much as i thought he did.