3 month old waking multiple times at night :(

[ceebs]

DS (3 months) had been a wonderful sleeper...waking once a night to feed since the beginning. Then for a few weeks, he actually started sleeping through the night. I was concerned because his intake is on the low side during the day, but the doctor told me not to wake him to eat at night.

A few weeks ago, he started waking again to eat - twice a night after the dream feed. I'd feed him, and he'd go right back to sleep. Since last week however, it's a whole different story. He wakes up multiple times, twice to eat, and many many times for no reason. He's extremely fussy and whiny. As soon as I put him down, he starts crying. I pat and shush him, but he won't settle.

He wakes around 6:30-7am. We do the eat, activity, sleep cycle based on how he's feeding that day. Usually he only lasts 2.5 hours because he only takes 3oz. (I've tried stretching his feeds, tried changing teat size, put him on reflux meds -- though i hardly think he has reflux, other than a couple of episodes here and there. Nothing has increased in intake.) He's a wonderful napper. I swaddle him, and he goes to sleep all by himself. Come night (around 6:30-7pm), it's a whole different story since this last week. He wants to be rocked to sleep, and then he keeps waking up unsettled. It continues throughout the night, and then come morning, he's an angel baby again (for the most part.)

Please help me figure out what I can do to get him to sleep soundly for at least a few hours. I'm not looking to wean him off night feeds (just so we can get at least 24 ounces in him), but I need to figure out what's causing all this fussiness. I've taken him to the doctor multiple times for his small intake, eczema, and now frequent night wakings, and she hasn't given me a single piece of advice. I'm so disappointed. I'm a horrible sleeper myself, so once I'm awake, it takes me forever to fall asleep or sometimes I can't sleep at all. And these frequent night wakings have me EXHAUSTED! I have a very demanding 3-year old to take care of as well. I'm at my wit's end. Please help!

[becj86]

I wonder with the eczema, small milk intake and possible reflux whether he's MPI and a trial of a different formula (for milk protein intolerant babies) may help. Often bubs with these issues have a good period (day for some, first part of the night for others)...

What is his A time at the moment? How long are his naps? Is your routine stable enough that you can write out a 'typical' day for us?

Anything different between his sleeping environment between day/night? Would he benefit from a night light, for example?

[ceebs]

We suspected MPI and put him on Alimentum (hypoallergenic formula) about a month ago. Although our doctor doesn't think it's allergy, but she said to keep him on Alimentum if his tummy agrees with it. On the previous formula, he had started fighting the bottle at each feed and would be extremely fussy afterwards.

We don't have a stable routine. It's all over the place, depending on how long he lasts between his feeds. So instead of following an exact schedule, I try to give him about an hour and a half from the time he wakes up to the time I put him down for a nap. His naps last anywhere between an hour to an hour and a half. Some are 45 minutes once in a while.

Basically he wakes up around 7am. He eats (15 min) and plays (for around an hour or more). Sleeps for an hour to hour and a half. The cycle repeats until about 6:30 - 7pm when he goes to bed. I give him a dream feed around 10pm. He wakes up around 1am to take a feed. And then again around 4am.

His daytime naps and bedtime are in the same room in the crib. I swaddle him still because he goes nuts scratching himself at night. His bedtime routine includes a bath, and a massage. We tried leaving a little night light on at bedtime last night, and after some whining, he eventually fell asleep. Usually we have to rock him to sleep at bedtime. I haven't tried leaving a light on for the whole night.

[ceebs]

In the next few days, I will try to note our timings and post here. Maybe there's a problem in the daytime routine. The only thing that pops in mind is that his last bottle isn't right at bedtime. So he'll have a bottle around 6 or 6:30, and then we do the bedtime routine and sleep around half hour to an hour later. I can't say for sure if he goes a full hour and a half after his last nap to bedtime. Sometimes it's more and sometimes less. Maybe he's ove/under-tired?

Do you think you could help with a sample EASY routine following a 2.5 hour schedule? I could try to do 3 hours, but because he's on 3 - 3.5 oz, if he gets hungry at the 2 or 2.5 hour mark, I feed him, just so i can get more into him. He's dropped from above 50th percentile (at birth) to between 3rd and 15th percentile on his 3-month checkup a couple of days ago.

One question: I usually wake him after hour and a half of nap if he doesn't wake up himself, so he doesn't miss a feed. If he has a bad night where he doesn't get proper sleep cuz of fussiness and crying, how do you handle naps for the next day?

[becj86]

I wonder if you're now seeing some reflux symptoms - it often peaks around 4months, having not been entirely noticeable earlier on - Reflux 101 - General reflux information

I usually wake him after hour and a half of nap if he doesn't wake up himself, so he doesn't miss a feed.

I would probably let him sleep up to 2hr, if he will do it. DS dropped from 25% to off the bottom of the chart at one stage, so I know a little of what its like to have a LO who's not gaining along the line. It tough. There can be lots of reasons for it (like birthweight being inflated due to you having IV fluids during labour) but if he is feeding so little and not gaining much, they could be symptoms of reflux (since you have him on HAF already - I think it has to be more than an allergy, yk?). He won't likely miss a feed leaving him sleep to 2hr - he'll end up with a natural cluster feed at the end of the day though probably.

If his naps are 1.5hr and his A time is 1.5hr, that's 3hr EASY... Where is he in the 3 months? He may be doing shorter naps of 45min-1hr because he's not been awake long enough if he's closer to 4 months than 3 months.

[ceebs]

From time to time, we do see some symptoms, but it's nothing like what my DD went through. DS is on 5mg of losec because the doctor thought it could be reflux. It hasn't really helped much. His feeding is ok (as in, he's not fighting the bottle or crying while eating), but hasn't increased. Some days he takes 4oz at each feed.

DS was between 50th and 75th percentile until about a month and a half old. After that he started dropping down on the chart and his growth slowed down. He's on haf and reflux meds already, yet there isn't much of a difference. His eczema is getting worse and worse, even after applying all sorts of creams. I just can't figure out what is causing it. 

He just turned 3 months a week ago.

So I've noticed that his fussiness gets worse after a night feed. I try to keep him upright for some time in case of reflux, but he just seems very uncomfortable and wakes up every few minutes. He refuses to sleep in his crib and starts crying as soon as you put him down. He's ok sleeping on the bed, though, he still wakes up unsettled every few minutes. Any tips on what I can do, or what I shouldn't do?

[becj86]

What about the possibility of it being something else? Alternative diagnoses and Reflux mimics.

I presume you have his mattress on an incline?