sleepy cues at 9 weeks

[mmom]

We have none.  While most moms are finding their LO's easier to understand, i am getting more confused.  For the last 3 weeks, I have been putting my LO down awake and he has just gone to sleep.  Of course sometimes I had to ssshh, but not for too long and not every sleep.  I solely relied on the clock during those times. 

But a few days ago, my LO started freaking out when i tried to put him down and it is now taking him a very long time to get to sleep.  Yesterday I tried to just go by cues and he still hadn't yawned or fussed by the 1 hour 20 minute mark, so I just tried to put him down.  For one nap, he did fuss, so I tried to go by that.  I am not sure what the A time is, since I was at a friend's house.  But even this morning, he was awake for 1 hour and 45 minutes, which I know is too long.  However, this was the easiest nap to get him down for.  That being said, I don't know if he will stay asleep.

What should I do here?  Go by the clock?  Where do I start?  My 1st LO is a low sleep needs guy, so I don't know if I am dealing with that again or what.

Details that you should know is that my LO has reflux, sleeps in his car seat, and while he was on a 7-7 EASY (1 middle of the night feed), the past 2 nights he has slept from 7/7:45 - 5:45, so we are still figuring the day out.  He is on Rantidine, which I don't think is helping too much.  I just started Simply Thick yesterday, which I already *think* is helping.  So while I can't say his reflux is totally controlled, it seems better.

[Colin Macs Mom]

Colin was exactly the same. He never showed any sleep cues at all until he was over 1YO. We just did everything by the clock and when he protested we knew it was time to make a change. He was a refluxer on Ranitidine as well. How long as yours been on it? It takes at least two weeks to kick in and really show results.

[mmom]

Thanks Jessica.  He has been on the Rantidine since July 9th.  But last week (or the week before?), his doc raised the dose slightly.  If he wasn't waking from naps screaming, I would be thinking it is working considering these longer stretches we are getting at night.  Then again, those nap issues could be partially due to an A time thing also.  I really have no idea.

Today is a mess though.  He only slept for 1 hour this morning, ate again, then didn't fall back asleep in the car, so I had to bounce him to sleep at my SIL's house.  Then he only slept for another 45 minutes or so.  He is sleeping now though.  I have no idea what to do for the rest of the day.

[Colin Macs Mom]

When reflux is involved, you can't worry too much about a solid routine until it's totally under control or out of the picture altogether. I know that's hard to do, but it will save you a lot of stress. Every day will be very different and sleep will be challenging, as you already know. All you can do is the best you can, and do whatever it takes to keep everyone sane and get some sleep.

Ranitidine is weight-based in dosage, so it will require very regular dosage adjustments. That's the trouble with it - one day everything is fine but then suddenly LO is screaming again. My advice is if you have even the slightest suspicion that it's not working, get back to the doctor.

I know that you said he's sleeping in the car seat, and it's totally a personal choice but I would urge you to consider stopping that before too long. It can be dangerous in that LO can sort of slip down and the chin goes to the chest, and the airway can easily be collapsed. There is a safety hazard factor as well a prop factor. Have you tried elevating the mattress in his bed?

[mmom]

I had never heard that about the car seat. Boy, that just freaked me out.  DS #1 slept in the car seat from 2-5 months because we couldn't get his reflux under control.  We easily transitioned him to the crib, which is why I wasn't worried about the prop aspect. 

The crib is elevated.  He was just choking on his spit up so much that I was scared.  Now with the thickener, that seems to be improving a lot.  So we can try and get him back in the crib alone.  Actually, I can work on that tomorrow, since I am not going anywhere. 

As for the medicine, how often did you find you had to get the dose changed?  That is what no one can tell me.  The ped doesn't think it is an issue and the pharmacist just said maybe I should try a different medicine. 

Also, about giving another medication a try, I was trying to wait until his appointment on Monday.  I planned on going there saying ok, we tried the Rantidine, we have been thickening bottles, and this is what I am seeing.  The ped didn't want me to go to Prevacid right away, but that is what I am going to ask for on Monday.   The problem is, now I am second guessing myself.  Is he waking due to routine issues or is it really a reflux thing?

Speaking of routine, what is the longest you let your LO sleep?  He didn't sleep all morning and has been sleeping since 12 (it is 2:20.)   He essentially had a bottle, a diaper change, and I put him down since he had been awake so long.

[Colin Macs Mom]

Sorry, didn't mean to freak you out! Just wanted to make sure you knew  

As for the medicine, how often did you find you had to get the dose changed?  That is what no one can tell me.  The ped doesn't think it is an issue and the pharmacist just said maybe I should try a different medicine.

Colin was and is a big boy, so it was a constant issue for us. Well, probably not constant, but it sure felt like it! Definitely every time you notice that a growth spurt is happening, you will need to have the dosage adjusted. That's sort of  that your ped doesn't think it's an issue -it IS. Easy for them to say when they're not the ones dealing with the screaming and no sleep. I wouldn't give up on the Ranitidine just yet though since it's only been about 3 weeks. BUT with that being said, some LOs do need something stronger, like Prevacid. I always felt that Colin would have done much better with it, but our doc refused to prescribe it. Apparently Ranitidine is the only med that's actually approved for use by LOs. Some docs are more strict and by the book than others!

Speaking of routine, what is the longest you let your LO sleep?  He didn't sleep all morning and has been sleeping since 12 (it is 2:20.)   He essentially had a bottle, a diaper change, and I put him down since he had been awake so long.

Well Tracy said to never let LO sleep longer than 2 hours at a stretch, but in since your LO is still so young and you've had a hard time I wouldn't worry too much about that.   Colin was always a good napper for the most part but nights were unspeakable. We held him to sleep for naps until he was about 6 mo and 20 lbs - it was just too much. But by then the reflux was under pretty good control and he napped well in his crib.

[mmom]

We had an independent nap this morning in the CRIB!!  It only lasted 1 hour though.   The next nap I was out at the park with the older one, so he slept in the stroller.  But the nap after, I got him to sleep in the crib, and he woke crying. The part I am struggling now is when he wakes, is it the reflux or just a baby thing?  I couldn't settle him.  He is finally sleeping again in the swing, but I thought I was going to have to wrap him up on me because I couldn't get him to settle.

[Colin Macs Mom]

Are you kidding?  One hour is FANTASTIC! That's a great start!!!!!!  

The part I am struggling now is when he wakes, is it the reflux or just a baby thing?

That's hard to say..... are you able to decipher his cries yet? What does your gut tell you?

[mmom]

Well, I know the mantra cry and I know when he is 'complaining'.  Like he is tired and is trying to settle.  I have seen the pained cry and I can also tell that by the way he arches his back.   But as for whether all of our sleep issues are reflux related, I am not sure.  I will say that today was the easiest day in terms of getting him to sleep (with the exception of bedtime).  However, he isn't staying asleep.

My gut still says reflux, yet I am not totally sure.  When I went to his last check up, the doc could see that he was refluxing by examining him. I am curious about what he will see on Monday.

Bedtime was a total scream fest.  He was freaking out the second I laid him in his crib.  I couldn't even calm him by holding him.  He is now sleeping in his car seat.  I am totally afraid of what you told me.  But I don't know what to do.  The crib is elevated, but I am wondering if it is high enough, especially for bedtime.  That is the only time (that and the middle of the night if he wakes) that he goes down so soon after a bottle.

[Colin Macs Mom]

You have nothing to lose by elevating the crib a little more. Babies R Us sells a wedge that's a good height.

I'm glad to hear that you have another appointment on Monday - at least then you will know if any progress has been made. If not, it may be worth asking about a different med.

[mmom]

Well, I went into his room and he was still awake in his car seat, so I moved him to the crib.  He was awake and I left him - just checked on him 10 minutes later and he is sleeping. So maybe the screaming was because he wasn't ready??     I need my own personal baby whisperer...lol

We have ply wood under the crib, so it is elevated 5 inches.  Do you think it should be more?  The only reason I don't have anything directly under the mattress is because the Angle Monitor won't work that way.  So with DS#1 we elevated the whole crib.  It looked like a joke when you walked in his room, because the one side of the crib was so high.

[mmom]

After a crappy night of not being able to settle him, he won't sleep today.  It took 15 minutes of total screaming to get him to sleep.  Then he woke every 10 minutes crying.  Finally at the 2.5 hour mark, DH fed him again, since it seemed like that is what he wanted.  I am feeling very frustrated.

[Colin Macs Mom]

Oh Kara I'm sorry

Why don't you post your daily routine and we can see if you need adjusting?

[mmom]

Well, the only reason he got sleep this morning was because we went for a long family walk.  DH joked that we should just put our stroller on the front porch and let him sleep there.   But surprisingly, he went down in 2 seconds for his next nap.  However, it was a shorter A of 1 hour.  This time it was obvious that he wanted to sleep: he got very fussy.  This is also the 1st time he didn't fight me when I put him in his sack and when I laid him down, he cried for seconds before falling asleep.  i have no idea how long that will last.  But it was the easiest nap in several days.

Our routine varies, especially when there are no naps.  It was a text book 7-7 routine, with a night feed between 3 and 4.  But then he started sleeping longer at night and waking more during the day.  However, the past 2 nights haven't been good either.

Well, I was just about to post yesterday and I can't remember.   I will have to start writing it down so people can help me figure out if I am doing something wrong.  That is the part I am stuck on: am I just not getting it right for sleep cues and A times and that is the problem?  Or is reflux still playing a part.  For us, when refluxing is flaring, he doesn't like to settle during night feeds and that was last night. So even if i am missing cues and A times, I think we still have somewhat of a reflux issue.

[Colin Macs Mom]

I think those are hard questions to answer until you see what happens with the ped on Monday, TBH.