To not sleep train when I'm certain there is something physically bothering my DD?

[blueyellowcar]

She's 18 months old and was a terrible sleeper (up every 45 mins or so with the odd 2 hour stretch) until about 6 months.

Now on a good night she sleeps ok - goes to sleep on her own in cot with me in room and then wakes every 2-3 hours for a quick feed and straight back to sleep. That works for us and it had improved to every 4-5 hours on a really good night. I think this is pretty normal.

But we have regular periods where she will go to sleep ok and then after the first wake, feed as usual and go to sleep but within five minutes start tossing and turning and sometimes even throwing herself about (with her eyes closed and making sleepy noises). She'll do this for 20 minutes or so until she is eventually so frustrated she starts crying (if I haven't intervened first).

It's like something is really bothering her physically (when she is ill she is just like this) - sometimes I can put it down to teething but I'm not certain it's always that. I've checked her for worms or any itchiness, tried different sleeping bags/temperatures and she has an air purifier. We bedshare occasionally but it's more for my benefit as easier than getting up a lot, but it doesn't really help her that much as she does the same thing. Sometimes she coughs a bit, so reflux has crossed my mind, but she has never been refluxy even as a baby (I know silent reflux exists). She eats and drinks well in the day and I think her diet is as healthy as possible for a part time veg dodger. She isn't constipated and does a normal looking poo once or twice a day.

I've asked health visitor and paed and they have talked about sleep training. I'm open minded to a gentle form when I'm confident she is well and already sleeping ok, but I'm convinced it's the wrong thing to do when she seems uncomfortable and struggling.

She was born with two congenital birth defects which she'll need surgery for in the next few years. They are rare but she is seen by specialists who have told us they don't cause any pain. Sometimes though I do wonder if this is bothering her which breaks my heart and also makes me feel sleep training isn't appropriate.

On the other hand, I'd like her to sleep better for her development needs - last night she was tossing and turning and waking hourly to two hourly again. This will usually go on for a few days before she's back to normal. I've also checked her amount of day and night sleep and I think it's right and she's not over or under tired.

It's so hard to know what the best thing is! I could also night wean (breastfed) but I think all it will achieve is removing a sleep tool that helps us because I'm sure she isn't waking for a feed as such.

Help!

If there was a physical reason then she wouldn’t have good days, they’d all be bad. Honestly I think you may just need to stop the night feeds - 18 months is too old for them. You could still breastfeed during the day

Possibly night terrors, she'll grow out of them.

My daughter used to make physical movements to keep herself awake, as she was a nightmare going to sleep so it might be something similar. If she is trying not to go to sleep she is physically trying to keep herself awake.

Vgbeat I did think that at first, but it really seems like she wants to be asleep, she lies there with her eyes closed and curls up wanting to sleep. It's different from when she was younger and wanted to play in the night sometimes when she'd shout words and mess about!

I had thought that too about the good nights but then couldn't something like reflux or skeletal pain (her problems are structural) be transient?

I'd planned to night wean long ago but will make tricky nights even harder I think hence my reluctance to now.

My DD (6mo) does this but in her case I think it's when she's trying to get back to sleep but is struggling, usually cos she is overtired. She trashes about, thumps her legs off the mattress, flings her head from side to side, makes annoyed sounds. It seems more like frustration to me but it generally just requires some soothing.

I am open to this advice you are all giving me btw, I just want the best for her.

She points to her cot when she is tired at the start of the night and doesn't seem to object to sleep per se which is the confusing thing.

(Actually that's not always true, she does sometimes and can be a little monkey but the difference is quite obvious!)

Ignore the likes of @Teddybear45 who will just tell you night wean, despite that not being what you asked for advice on, and the fact that type of advice is incorrect or unhelpful.

What I would say is if she is eating and playing well, no issues are showing in the day but she's waking at night and appearing 'fitful' or restless, then what do you think could be causing such a problem at night but not affect her in the day at all?

I have a terrible sleeper too!

Around 18 months was really bad for us, I think she started having bad dreams around this time. Started getting better again about a month later. She's now 2 and generally only wakes once at night now. I waited until her sleep was a bit better at 2 before night weaning. But that's because I couldn't cope with the idea of even less sleep.

It sounds like it could be night terrors to me.

It doesn't have to be all or nothing. Why not reduce her night feeds? Feed her at bedtime then once if she wakes after, say, 2am, but no more. We had great success stretching out time between feeds though DC were a little younger, which I'm sure helped. If they woke earlier than X hours then we kept them happy without feeding and didn't stress about trying to put them back to sleep. A couple of nights of high input from DH and both children stopped waking earlier than the time we'd set. If you don't think she's really hungry anyway then why not support her in extending into her next sleep cycle without relying on the feed? You don't have to leave her to cry.

I agree no need to night wean. Google ‘confused arousal’ and see if that fits as it sounds similar. Also there may not be a reason such as pain, it could be developmental leap, learning a new skill etc. Also (esp if you’re still bf) they’re probably still fighting off viruses they never show full symptoms of. As grown ups we wake/sleep poorly for hundreds of reasons but we can independently do things to help ourselves. At 18 months your DC still needs you to meet all these needs. I’m not sure there is a solution beyond ‘this too shall pass’ but it doesn’t sound abnormal and I’d say you are doing all the right things already.

I agree it sounds like it could be bad dreams/night terrors/something bothering her.
I don't think night weaning will make a difference, when I night weaned DS he didn't sleep any better and needed cuddles for reassurance instead of a bf.

What's her room like? I've noticed DS sleeps badly and has bad dreams when his room is stuffy/warm and much better with a window open.

You could try giving her calpol when she acts uncomfortable and see what happens. If it has no effect then you can rule out pain.

I think discomfort/mild pain is a strong possibility. Dd didn’t sleep reliably through till all of her teeth had come through at about 2.5. From personal experience my wisdom teeth came through in my late twenties and was certainly uncomfortable but not constantly and my joint pain isn’t constant either. I remember ‘growing’ pains too.

The fact she can settle herself and you are seeing signs she wants to go to sleep makes me think you’re right and she is possibly in some discomfort. The only way to really rule it out is to offer pain relief at this age since they can’t really communicate it to you.

I found ibuprofen/nurofen the best for tooth pain and bone pain. If she can have that I’d use it. I felt like we might have leaned towards overuse when dd was younger but looking back I think we struck the balance and responded to what she needed.

Oh and do what you need to with night weaning. Your needs should tip the balance with whether to night wean or not and if you feel this is the best way for you to get some rest then so be it.

I couldn’t face the thought of potentially dealing with two weeks of utterly shit sleep and battles because I just didn’t have the energy reserves to face it. Dd is incredibly stubborn and I have no doubt she was not in the category of a child who’d give up after a couple of nights - well she certainly wasn’t at younger ages when I’d tried anyway and I had no desire to repeat it!

Sounds similar to what my child was doing but at 10/11 months. This is what I did and it really helped.
I slowly started dropping night feeds. I was feeding her baby back to sleep as it was the quickest way. I knew baby wasn't hungry (to be feeding every hour during the night)
I dropped one feed every few days, I offered water or cuddles instead.
Once I was down to one or maximum two feeds per night approximately at 3 and 5am (and then awake 6.30ish feed) I then started to sleep train.
Firstly implemented a consistent hour long routine, toys being out away all noise is low and soft talking. Bath. Pyjamas. Breastfeed. The same two books read cuddled up. Place in cot after being rocked and baby is drowsy, I stayed on floor next to cot patting through bars and talking softly and encouraging until baby was asleep.
Few days later progress to less talking and removing my touch as baby is just about asleep
Few days later just shushing and no touch
Few days later sat further away and no talking or shushing (all of this is after one last big cuddle and a night night time for sleep and kiss)
Few days later place in cot and stand in open doorway
Few days later stand outside door ready to peep in and shush if necessary

It's probably the longest winded sleep training ever but it was very gentle and apart from a few very short lived protests it was no crying.

The issue your baby has (and mine had) is that she awakes and expects you to be there and needs a feed to resettle, she just learn to settle herself and I think her periods of fitful sleeping will start to drop. I also think it could be your baby really fighting her sleep rather than any discomfort. On the nights I know she is teething my baby really does cry a very different cry not just a fidget in bed that escalates to a cry and even then a dose of calpol will help immensely and then she will sleep her normal sleep.

Just to state I still feed in the night but not every 2 hours or even every hour like I had to - feeding every hour for me became a habit that my baby could only fall asleep by feeding and I knew I had to gently gently help her sleep in other ways. She is so so much more rested now after our very gentle sleepntraining as she isn't waking in a panic wondering why she's not at the breast every hour

I agree it could be discomfort/pain for some reason. DS had trouble sleeping during his first year. I tried all sorts (I actually thought it was trapped wind for quite some time) but we never did figure it out definitely. He improved a lot by 2 years of age. When DD came along she had cows milk protein allergy which was bad enough to be diagnosed. Once milk was eliminated from my diet (BFing) she was perfectly comfortable and a wonderful sleeper. But with hindsight, I could see some of her symptoms were similar but more intense than her brother's. I always look back on DS's first year and I wonder if he actually had it too.

I have 3 kids, youngest is 21 months and still up every 2-3 hours at night. The other two were the same until age 2.
I’ve never sleep trained any of them! I don’t believe in leaving babies to cry. By age 2 to 2.5 they usually crack sleeping through the night on their own.
Hang in there.
However, I did night wean all 3 at 16-18 months and just offered water

You sound resigned to it but your good days aren’t really the norm. You’ve done remarkarkably well to cope with the sleep deprivation for this length of time. I think you need to rule out pain and then try sleep training and night weaning but it depends how much the sleep is affecting you and what you can cope with.

I personally can’t cope with sleep deprivation and fortunately have had two good sleepers from an early age. I wonder if there is a bit of nature/nurture - those who can’t cant cope crack on with routines and training earlier but also maybe have babies that need more sleep too.

Have a look at sleep apnoea and see if her symptoms fit

My DS has sleep apnoea and was only discovered at age 5 due to my insistence that they run a sleep study.

No one believed me, but I was right. Tonsils out and now he sleeps like the dead.

Worth ruling out if the symptoms fit. It's just a probe attached to the big toe at home overnight.

Thank you for these replies.

I'll think a bit more about night weaning but as a PP put it I just don't feel like I can cope with the extra disrupted sleep in the beginning! On the other hand if it helps long term of course it would be worth it, I'm just not sure if it would. I will try drawing feeds out as a PP mentioned. We've done a lot of other Sarah Ockwell-Smith stuff like associating smells, a blanket etc so I feel that the groundwork is there if we wanted to.

On paper I feel like gentle sleep training would be good for her, but then I think about her x rays and to be honest I can't see how lying in one position wouldn't be painful for her, but her consultants assure me it isn't. I have tried Calpol sparingly and I'm not certain if it helps or not but I will consider it. I just feel like reducing the level of comfort if she's in discomfort at night would be inappropriate - but maybe it's just because of sleep associations. I just can't tell.

I have heard of children with similar problems to her having central sleep apnoea (also restless leg syndrome) which has less symptoms than obstructive, although her brain scan was clear so I don't think it's that. I've also heard of reflux being a problem.

She is developing really well, running about, lots of words etc and does seem happy in the day.

It could be discomfort and worth trying the calpol as others have suggested.

My lo is 9 months and like a pp, she will fight sleep when she is over tired ( she is a nightmare for day time naps but usually ok at night ). I can see she wants to sleep - rubbing her eyes etc... But when I put her down she kicks her legs, rolls from side to side, clenches her fists - all with her eyes closed until she starts screaming ( usually after about 15-20mins or so ) and I gently resettle her. It can look like she is distressed but she is fine and once she is relaxed she goes straight to sleep.

I hope your lo settles soon.