Struggling with sleep for a 4 month old

[Gillian C]

Hi,

DS is almost 4 months (but weighs and looks like 6+ months).  He is a bit of a touchy sleeper (but otherwise textbook), and I have a preschooler (almost 3), so we've struggled with sleep all along.  I had been shh-patting him consistently, and it was working to help him nap for a while, but only if he sucked on my finger at the same time (he refuses to use a paci).  Then, about a month ago, we went on vacation, and since we were all sleeping in the same room, I resorted to nursing him to sleep.  When we returned, he got a cold, so I kept it up.  Then, he learned to roll over from back to front.  Now the only way he can get to sleep is if I nurse him to sleep - he has rejected the finger sucking, and won't hold still long enough to pat anymore!  He just rolls around crying, and picking him up only seems to make him madder because I'm trying not to feed him.  We really don't have a daytime schedule anymore, because his naps are usually 30 minutes, so I don't know how to adjust EASY to fit that.  We've been trying EASAS, but since he won't sleep without at least a short nurse, it's more like EASAeS, which really throws him off.  It also takes me a long time to wind him down (walking and singing, sitting and singing - usually when he starts crying, rocking, shh-patting), so he's usually OT.  The only times I've been able to get him to take a longer nap have been occasionally in the stroller as long as I don't stop walking, or if I nurse constantly (happens when I fall asleep in the chair with him...).  Then, he can take 2+ hour naps.

All this was "okay" for a while, since he was sleeping relatively well overnight.  From the beginning, he's been a decent night sleeper - 1-2 night wakings, longest sleep was consistently 7ish hours.  But all that has changed, and these past few weeks, he's had between 3-6 night wakings, and he takes between 30-90 minutes to get back to sleep.  I can't resettle him in the crib, so I end up feeding him, which I think is making it much worse.

His first nap is almost always in the car dropping DD off at preschool, and his last nap is sometimes interrupted by picking her up, but only rarely since he rarely sleeps long enough for this to be an issue.

Other info - no paci, no lovey, EBF.  Usually up around 6:30-7:00ish, bed for the night between 7:30-8:00ish.  Average A times tend to be longer than I'd like because he's so hard to get to sleep, especially if I don't nurse, probably closer to 2:15ish.  Anything else I missed?

I guess my question is where to start to fix his schedule.  I don't know whether to work on getting his feeding on a schedule (but his napping will likely wreak havoc on that), extending his naps, breaking the nursing prop, breaking the finger sucking prop, or night training.  Or just try it all at once, have a terrible few days, and hope things get better?  At this point, I'll try anything, and I can arrange for a few days in a row to work on things if needed.

He's still so young, but I want to keep going as I mean to continue, and we were doing so well with the shh-patting earlier, but now it's just failed entirely and he's sleeping worse than he ever did as a new infant!  I'd appreciate any suggestions - I'm so tired and everything I try seems to make it worse.

Thanks!

[jessmum46]

(((Hugs))) this is a rubbish age for sleep.

It sounds to me like you've been unfortunate and had a combination of travel, illness and 4 month sleep regression (i.e. waking up a bit and starting to form habits) which has led to a nursing to sleep prop.  Plus a bit of over tiredness from too-long A times, disturbed nights and short naps.

As a starter I know you feel there's not much of a routine but could you log the next 2 days for us just so we can see what happens?  It may give us some clues as to the sort of A times he could handle right now and give us an idea where to start with a plan.  Can you also tell us your drop-off and pick-up times so we can try to work round those?

don't know whether to work on getting his feeding on a schedule (but his napping will likely wreak havoc on that), extending his naps, breaking the nursing prop, breaking the finger sucking prop, or night training.

I suspect that breaking the nursing to sleep prop will actually deal with the finger sucking prop, the nights and probably help the naps too so I don't think it's necessarily such a big job as you think   At this age although you may have a rough few days you should also see progress very quickly, it's much easier with a 4 month old than a toddler! 

For sleep training at this age you can use shh pat or PUPD.  I would start with shh pat but you can combine the two, really PUPD at this age is a lot of calming in the crib with shh pat anyway and only picking up to calm if needed - check out the FAQs on the PUPD board   Combining your chosen method with the right routine will help - without seeing your current routine I would guess that A times of around 1h45 may be a good place to begin - so start a wind-down aiming to be in the crib for around the 1h30ish mark to begin with, hoping for sleep around 1h45.  You try for 45 mins for a nap, if no success take a break for you both out of the room, some low-key activity and then try again.  The first few times you may get no naps but at some point the OT starts to work in your favour as LO will not be able to fight so hard against sleep.  At bedtime and for NWs you go as long as it takes - you don't stop for a break.

With regards the feeding many breastfed babies this age won't manage 4h between feeds.  However you can aim towards the feed times on a 3.5 or 4h EASY but add in some extra top-up feeds during A time.  So the day will look a bit like EAEAS cycles instead of just EAS cycles.  The key is to separate that second top-up E from the sleep, so make sure you do it early enough in A time that LO shouldn't fall asleep.  30 mins after the main feed can be a good time for a top-up as the milk will be richer in the high calorie fats, but you can do it closer to nap time if you prefer - just don't let LO go to sleep and make sure there is some A time afterwards, even something low-key like a nappy change. 

At night at this age I'd aim for something like 3.5-4h between feeds.  If LO wakes sooner than that time, use your chosen method (shh pat/pupd) all the way until LO goes back to sleep, even if it takes you past feed time.  Then feed at the next waking - that way LO doesn't learn to associate protesting for ages with getting what they want. 

Hope that gives you a few things to think about to begin with

[Gillian C]

Thank you so much for the extensive reply!  This gives me hope.  I'll post a few logged days shortly, and hopefully start right away with the adjusting.  Last night was somewhat better, only 2 wakings (but one was still 1+ hours...), but still lots of room for improvement.  Fingers crossed!

[Gillian C]

Firstly, I just succeeded in getting DS to nap with Shh-pat/PUPD combo (no nursing or finger sucking) after only 41 minutes of trying!  (only a 30 minute nap, but hey, better than expected)

DD's drop-off - we have to leave at 8:15, usually home by 8:45
DD's pick-up - leave by 3:40, home by 4:10
Some days, I can get DH to cover 1 or both, but in order to keep it consistent, I've been doing both mostly.

Quick question about shorter naps and fitting them into the E timing.  You said that if he wakes early, I should continue to shh-pat until he falls back asleep.  For a 3.5 hour EASY, that means his nap "should" be 1:45 (with A times of 1:45).  So anything significantly less than that should be met with shh-patting until he falls back asleep.

Also, for shh-patting, I tried keeping him in the crib as much as possible, picking him up only when he was crying rather than complaining.  I put him back down as soon as he calmed down a bit.  Is that right?  He rarely calmed entirely.

Thank you again for your support and help!  I REALLY appreciate this!

A couple of past EASY logs:
Saturday:
Woke - 6:45
E - 7:00
A - 7:20 - 9:00
S - attempted to put to sleep until 9:30, nursed briefly, asleep 9:35, awake 10:05, attempted to resettle with sh-pat, no luck
A - 10:30
E - 11:00 (I wanted to separate it from the nap)
A - 11:20-1:00
S - attempted to put to sleep until 1:30, finally nursed again, longer, asleep by 1:45, awake 2:15, attempted resettling in crib, no luck
E/S - desperate for a break, I fed him to sleep and kept him on the breast until 3:15 (I fell asleep!), transferred to crib, awake 3:30
A - 3:30 - 5:00
E - 5:00
S - attempted another nap at 5:30, wouldn't take it without more nursing, and it was getting so close to bedtime that I opted out
A - 6:00 - 6:30
E - 6:30
S - routine started at 7:00, started to cry at 7:20, I rescued with nursing, asleep by 7:40
(NW - woke at 9:45, 12:00, 2:30, 4:30-5:45, then slept until 7:30)

Sunday:0
Awake 7:30
E - 8:00 (didn't eat much, probably because he ate so much overnight!)
A - 8:15 - 8:45
E - 9:45, drifting to sleep (I let him because we were at a friend's house)
S - 9:45, awake 10:00
A - 10:00 - 12:30 (with a stroller walk to see if that would help - it didn't)
E - 12:30, fell asleep
S - 12:45 - 1:15
E - 1:30
A - 1:45 - 2:45
S - 3:00 with a brief nurse, awake 3:45
A - 3:45 - 4:30
E - 4:30
S - 5:15 - husband attempted shh-pat until 6:00, abandoned because too close to bed time
E - 6:30
A - 6:45 - 7:30, including wind down, and a brief nurse to sleep
S - 7:30
(NW - 10:00-11:00, 12:00, 1:30, 3:45, 4:30 - 5:45, sleep until 7:00)

Monday:
Awake 6:30
E - 7:00 (not interested, likely due to night feedings)
A - 7:15 - 8:15
8:15 - leave in car to drop off DD
S - 8:40, moments before we arrive home, walk in stroller to keep asleep, awake at 9:10, tried to walk him back to sleep 'til 9:45, no luck
E - 9:45
A - 10:15 - 10:50
S - 11:00, successful shh-pat with finger after only a brief nurse (a small victory, but we celebrate when we can!), awake 11:45
E - 12:00
A - 12:30 - 1:30
S - 1:30 brief nurse and to sleep
Had to wake at 3:35 to collect DD - first unassisted long nap in weeks!!!
A - 3:35 - 4:30
E - 4:30
A - 4:45 - 5:00
S - 5:15, DH attempted shh-pat for 45 minutes, gave up because too close to bedtime
E - 6:15
A - 6:30 - 7:00
S - routine started at 7:00, asleep by 7:35 (with minimal nursing)
(NW - 1:15, 4:00 - 5:15, woken up at 7:30)

[jessmum46]

Well done on the nap!  Hopefully it will get easier   Your technique sounds fine, really as long as you are consistent any variation will work. 

So resettling naps.....well to be honest I would decide a limit for your own sanity that you are willing to try resettling for.  I used to know within 10 mins or so if it was going to happen, and if not I just used to get LO up and carry on with the day.  There's no point in sitting shh-patting all day in the dark - miserable for everyone!  All I would do after a short nap is just slightly shorten the next A time, not too much, and then hope for a better nap next time or at least one you can resettle.  That might mean you end up feeding in the middle of A time but that's ok.  It's also important to keep a check on those nap lengths.  If you are consistently getting 30 minute naps that can indicate over tiredness.  45-80 minute naps can be a sign LO needs a little more awake time.  So yes a textbook 3.5h EASY would be 1h45 A time, 1h45 sleep, but a 1h30 sleep is two sleep cycles and may be all some babies will sleep, and others may love their naps and want to sleep for 2h.  So the 'textbook' EASY is rare, rather it needs adapting to your own baby

So looking at your logs I notice that the first A time all 3 days was pretty long.  I know it's hard with drop-off and you can't control him falling asleep or not in the car, but that first long A is probably throwing the day off somewhat.  The best day was the last one where he had the shortest A time after the short nap, and he settled quite well.  I wonder if it might be best to start your day at a consistent time so that you aim for him to sleep intentionally on the first school run?  Say a 6.30 start to the day aiming for a sleep 8.15/30ish?  If it happens to be a long one you could do a full A time again afterwards, but if it's short most days at least you could work on that and try to work out a good A time for him after a short nap to get a longer second one?  I know several people have found that especially with older one a short am nap, long lunchtime nap and later CN type of routine may work better than a traditional EASY.  What do you think?

[Gillian C]

Thanks again for providing such wonderful and timely support!  So nice to know I'm not alone.

Day 1 went fairly well.  The night, on the other hand...
7:30 - I had to wake him up
8:00 - E
8:50 - S in car, transfer to stroller
9:20 - awake, attempted to resettle by continuing to walk, but no go
11:00 - E
11:15 - start of "nap," shh-patted 41 minutes
11:58 - S!!!
12:30 - awake, attempted resettle, gave up after 30 minutes
1:15  - E
2:00 - "nap," shh-patted 10 minutes
2:10 - S
3:35 - had to be woken to collect DD (a glorious long nap!)
4:20 - E
5:10 - "nap," shh-patted 20 minutes
5:30 - S
6:00 - awake
6:50 - E, top-up around 7:20
7:45 - in bed, shh-patting
8:05 - S
11:45 - awake, shh-patted.............
1:20 - S
4:30 - awake, shh-patted some more
6:10 - S?
6:25 - awake, attempted shh-pat for 10 minutes
6:35 - up
6:45 - fed (but only when calm and separated from sleeping by a change)

I agree that the morning nap is a problem - it's never in the crib, and it's never exactly when he needs it.  I do like your idea of making it a short nap with the mid-day one being longer - then the long nap shouldn't be interrupted by picking up DD.  Once we have this sleeping thing a bit better sorted (especially the nights!), I'll try to fix it a bit.  Possibly a later wake-up would work too, so he wouldn't fall asleep in the car.  Lots to think about!

About night times, since that was rough last night...  Is he in fact old enough to be going all night with no feeding?  He was pretty unhappy at 4:30-morning (but that's always been a hard time for him, even with being fed), but he would calm for long stretches, just lying there, sucking on his hand and staring at me (but not sleeping, and then getting upset again).  He's not swaddled anymore (we stopped about a month ago, when he started rolling over - add that to the perfect storm!), so when he rolls, he pushes up on his hands, and sometimes his knees.  I haven't been trying to change his position, just trying to find somewhere to pat (back, upper chest, shoulder, etc.).  Is that okay?

Thank you again for all of your help.  I'm already noticing he's falling asleep better today, so I'm feeling so much more optimistic, despite the poor sleep last night.

[Gillian C]

 

DS slept through the night last night!  We're still working on the naps, but they have gotten SO much better.  We'll continue to tweak as necessary, and hope that last night wasn't just a fluke.  Thank you for all your help!

Gillian

[Gillian C]

A bit of an update after more than a week of trying the shh-pat:

That good day appears to have been a fluke.  Things really haven't improved in a big way, although we're still staying the course and hoping.  The good news - DS is now falling asleep in his crib with shh-pat after 5-20 minutes, mostly of him being calm.  He's mostly on a 3-3.5 hour E schedule, which is much more predictable for me (with top-ups periodically).

The remaining challenges...
1.  The vast majority of his naps are still only 30 minutes (and when they're not, they're 45), even when I shorten his A times to try to accommodate previous short naps (or lengthen them due to outings or driving DS).  I can often (about half the time) get him to take a longer first nap by putting him in the stroller and walking for 2 hours.  I've tried for up to an hour of shh-patting to resettle him, and he occasionally drifts off for a few minutes, but wakes the instant I stop shh-patting.  Usually, I try for a bit, then get him up, have some low-key A time, and try again in a bit.  Then he naps for another 30 minutes.  Very frustrating!  Yesterday, we spent all but 45 minutes of our afternoon in his bedroom, with no success.

2.  I don't know how to keep adjusting his E times to accommodate the short S times.  His E keeps ending up right before his S, and then we're right back to where we were.  Or, he wakes up so I feed him right away, and he falls asleep in my arms again.  (This tells me he needed a longer nap, so we try again, and usually fail.)  So I'm really struggling with trying to maintain a 3.5ish hour E schedule when he sleeps for 30 minutes and shouldn't be awake for more than 1:45.

3.  Nights.  We're now back to getting 2-3 wake ups (which is an improvement from 2-6, I have to admit, but it's still really exhausting).  We're shh-patting still, but it takes a long time for him to resettle - often 45 minutes before we can leave the room.  And after his wake-up sometime between 5-5:30, he really doesn't go back to sleep, but rather dozes on and off.  This continues to make mornings unpredictable because I don't know what time to start counting his A time.  His first wake up is often around 8 hours after bed (which is lovely and back to what he was doing 2 months ago).  Is he capable of going longer?  I wonder if he'll resettle better for the rest of the night if I feed him, but I also would prefer if he went the entire night.

And he's awake (after only a 20 minute nap).  Any suggestions of what I'm doing wrong?  (I can post some of our recent logs later if you'd like.)  Thanks!

[jessmum46]

Hi, I'm sorry it's been a while. Wondering how you are?

[Gillian C]

Doing much better, thanks!  DS is now relatively consistently STTN, with a cry around 5:45, but he'll usually resettle.  Naps are still a struggle.  They're almost all 30 minutes, but he often takes 1 long nap a day (with 2-3 short ones).  Sometimes he needs me to resettle after he wakes up, which can take 20-45 minutes, but then he'll stay asleep for a while.  His unpredictable napping schedule is a challenge, because it means I can't reliably schedule things (or know whether I'll need to wake him up to pick up DD), but since his nights have improved, I'm just going to go with it, and hope he improves when he passes this developmental stage.

Thanks for your help!
Gillian

[jessmum46]

That's good news . It honestly does get better as they get bigger, both mine were a bit of a disaster sleepwise at 4 months (though in very different ways!) but we've ended up mainly in a better place!

Good luck and let us know if we can help again x

[Gillian C]

Hi!  We're having some new and pretty major sleep disruptions, and I am curious to know if they're just normal developmental things (so ride it out) or if there's something we can do.  DS had been STTN for almost 2 months now, but continuing to have pretty unpredictable (but mostly short) naps.  We were working on those with limited success.  Life was pretty good, if unpredictable.

DS is 6 months old today.

Now, for the past week, he has been waking up SCREAMING and being extremely hard to put back to sleep.  His NW times are pretty random, and he's up crying inconsolably for between 1-3.5 hours.  In desperation (and trying to keep DD asleep), I started feeding him at night, thinking maybe this was a growth spurt?  It worked once; other times, he ate and then kept on screaming.  He doesn't seem to be teething, he doesn't have a paci, we had been using shh-pat/PUPD and it's stopped working.  He does have a cold, but he's had colds on and off for over a month, so I don't think it's that?

Last night and tonight, he's woken up exactly 30 minutes (his typical nap length) after bedtime (7pm) and has taken 2 hours to put back to sleep.  Then he wakes again at various times - 10, 12:30, 2:00, 4:00, usually only once or twice.  Each time, it takes forever to get him back, and shh-pat/PUPD aren't working at all.  Walking him around helps a bit, feeding him helps a bit, rocking him helps a bit, but nothing actually settles him.

He started solids about 2 weeks ago, so we've stopped them again in the hopes that this helps.  He's been crawling for a while, but maybe he's practicing trying to sit up from all fours?

Our approximate EASY before all of this started:
Awake 6:45
E 7:00
A
S 9:00 (usually this was his only long nap, sometimes only 30 mins, sometimes as long as 3 hours, really no consistency)
E 10:30
A
S 12:30 (usually only 30 mins, but rarely this would be a longer nap)
A
E 1:45
A
S 3:00 (another 30 mins)
A
E 5:30
A
E (top up) 6:30
S 7:00

(But the naps really varied.  A times about 2 hours 15 mins, S times mostly 30 mins, E times about 30 mins after waking.)

We've tried W2S for the naps, which worked for about a week, but then he started waking at 25 minutes (which was when he was being roused).  So I moved the W2S time to 21 minutes, and then he started waking at 20 minutes.  So I've given up on that for now, partly because he's SO tired from the nights that he sometimes now takes a longer nap spontaneously.  Not sure what to do about this, but our priority is the 2-3 hours of screaming a night...

Any thoughts or suggestions?  We're getting pretty desperate - I'm averaging 4-5 hours of broken sleep a night.  So discouraging!

Thanks!
Gillian

[trimbler]

Hi Gillian, hang on in there, I know short naps are so frustrating and then when they lead to OT and you get horrible nights (whether or not related to the OT) you must be so exhausted - (((hugs)))

Just wondered how long he's been off the solids now? Our DD also seemed to react badly to starting solids, we had to take it really slowly with her with a couple of false starts, I wouldn't worry about stopping for a couple of weeks to see if it helps, then try a little slower or different foods. That screaming and difficulty settling does sound like it could be discomfort - have you noticed any bloating or changes in her stools or straining or anything like that?

The other possibility that comes to my mind would be accumulated OT from the short naps. I'd suggest trying to push out that first nap a bit, if she 's currently doing 2h15mins A time before it and now rarely taking naps longer than 30mins, I suspect she's UT, even if she still displays tired signs. Has she ever gone longer than 2h first thing? Be wary of letting her have a short (ie 2h) first A time followed by a long nap, as she may use that to catch up on night sleep and so get into a vicious cycle of poor nights and long morning naps... But I don't think that 's your issue right now! So try pushing to 2.5h first A time and hold for a few days to see what happens, you may then need to push further to get a good nap again. Some LOs are doing 3h A at this age so whilst you don't have to aim for that immediately, do bear that in mind

Finally, you may find you need to tweak your shh pat now that she's a bit older, many LOs find they no longer like the shh and/or the pat so you could try reassuring words (just a predictable, short phrase, which you can repeat ) instead of the shh, or a hand placed on her instead of the pat, for example. Or you may now need no physical contact or no voice, depending on her preferences.

Do let me know your thoughts on all of this, we'll do our best to get you back on track

[Gillian C]

Thank you so much for your reply!  DS has ALWAYS been a short napper, despite our best efforts, so I was hoping it was just developmental.  I agree, the A time is very short.  I was reluctant to lengthen it because I also thought he must be OT...  But I think now it's all backward!  I'll give it a go with increasing A time to at least 2h30mins, and trying for similar A times between other naps.

Today, naps went a bit awry this morning, so he was really tired by afternoon.  He slept for 45 minutes, then DH was able to resettle for another 1.5 hours!!!

He has been off solids for about 4 days now.  We'll probably try to reintroduce in a bit.  He was so excited about food - I think that was what went wrong - he ate about 2 ounces of sweet potato and still wanted more!  We'll go slower next time around.  I haven't noticed any bloating or straining, but he was definitely gassy, especially after that "mega-meal," and went for over a day with no poops (unusual for him).

Hmm - hadn't thought of that for shh-pat.  DH has been successfully changing his style for this, but I hadn't been.  We'll try for more age-appropriate consistency.

Hopefully, his nights will sort themselves back out with all of this - thanks again!

[trimbler]

Yay for that resettle at least you know he can do it just beware of pushing all the A times at once, especially after a short nap - you'll probably need to reduce it a bit after a short nap to avoid OT. I would often assume 30min meant OT and took a lot of convincing to push A times with DS but sure enough, 30mjns can be UT too

With the solids, did you offer milk first? Some will offer solids about an hour after a good milk feed, the idea being that they're not too hungry so don't overload themselves. Others find they need to offer the solids immediately after the milk to prevent gorging I'm sure you'll find the right approach for your LO