Baby 14 months - great in days, miserable all night

[BrittaBroad]

I am baffled. Our son is 14 months old. Good growth/weight, hitting milestones, babbling and generally great and cheery in the day. At night he is miserable. He has always slept terribly. Had a tongue tie (managed to bf through it, got it clipped at 11 months which helped a bit with mega-drooling and solids). He also had silent relfux, and it may be it is still just that. But it is odd to me that since he started sitting up/eating solids /when he went from vomming lots too, to 'silent' relflux behaviour so pain lying down etc. his sleep has stubbornly stayed pretty much the same. Maybe a 2-3 hr chunk at start of the night, followed by hourly (or more) waking, wanting to be latched on all night, endless shifting and shuffling and crying and arching. This has persisted through gradual shifts from 4 - 1 nap, and through patches of awful/fighting naps (3-5 months old) and not improved by getting naps sorted. He now has fairly painlessly shifted from 2 to 1 nap, and is sleeping for 1.5-2.5 hours in the middle of the day in his buggy. We have tried several reflux meds and only seen minor improvements and big side effects so off those now. Cutting out dairy and soya (nearly 2 weeks in, no sign of changes). No pattern with what he east as far as we can tell and no signs of allergy... Any ideas? I just don't get how a baby who is so fine in the day can be so not fine all night... Even if this is still reflux, shouldn't it be waning a bit by now? Are there more obscure things we should ask about? Hiatus hernia? other digestive problems? I am at a loss and very, very worn out. Hope someone has some idea of what to try or has been through something similar! It's very lonely having a baby who sleeps worse than most newborns when everyone else is getting back to some kind of normal life!

Sorry - should have mentioned, that, obviously we have his cot substatially propped up. And when he is sleeping with/on us, we use pillows to be at an angle too. So he's never just lying on a flat surface. Also seems to make no difference if he sleeps on his back or front...

What happens to get him to sleep?

Hi, I feed him to sleep normally. But we have had phases where we have tried having his father rock him to sleep, and even a couple of weeks when I was managing to take him off the boob and settle him from very sleepy with a little bit of shhhing and bum rocking. None of it made any difference to the following sleep pattern... But all of it made bedtime much longer and less nice. I am kind of ok with a bedtime feed carrying on, but am happy to try rearranging things so the feed isn't the last thing. I just don't think that's the issue though (or at least not the main one). We have thought about trying to cut all night feeds after bedtime til 5am say, incase the feeding at night is adding to windy/refluxy issues. But it's a big decision as without feeding back to sleep the nights may become completely horrific. When my other half settles him it can take a VERY long time, and even once asleep he will not be put down (he doesn't ever seem to sleep really deeply), and if I try and settle him without boob it can work now and then, but more often it takes an age of walking round and round. I just cannot do that a million times a night...

And, I should say, we have a consistent evening/bedtime which seems to work well (in that he seems relaxed but not over-tired by the time he's going to sleep, and knows what is coming, and it doesn't take absolutely ages) and his first stretch of sleep has always been his best. We have dinner about 5pm, bath about 6, and going up to bed between 6.30/7 with putting on pjs and sleeping bag in a dim room with white noise (rain sound) and reading a couple of books before fed to sleep...

If he's always been fed to sleep / rocked / walked around / shush patted, it sounds to me as though he just doesn't know how to put himself back to sleep when he enters lighter sleep phases. Would you consider some form of sleep training?

Yes, I think he probably doesn't know how to go to sleep entirely independently. He can drop off with just a bit of rocking in the buggy. However, my aim is not for him to sleep through the night or not need me at all. It is to try and work out how to make nights less distressing and exhausting. he is not waking in chunks suggesting he's up every sleep cycle. His sleep is really disturbed. I am not keen on CIO, and think any form of leaving to cry for a baby with a history of bad reflux and pain at night is a no go. It's hard to know what approach to go for when we aren't really sure what the problem is. I would happily co sleep and feed a fair bit at night if that was working for him and me, but it still involves disrupted and unhappy nights.

I feed him to sleep.... hourly (or more) waking, wanting to be latched on all night, endless shifting and shuffling and crying and arching

OK. Do you understand the physiology of sleep? Because I wonder if understanding the science will help you understand what is happening and why.

Babies, like adults, sleep in predictable cycles which involves periods of deeper sleep and periods of lighter sleep.

Its normal in babies (and indeed adults) that there will be a brief 'environment check' within the sleep cycle, when sleep lightest. This isn't really a wake-up. In an adult it might just be turning over, shuffling around and going back to sleep.

Its an evolutionary state of making sure you are still safe and secure, that nothing has changed since you were last conscious when you went to sleep. Left over from hunter/gatherer days.

But this environment check does actually work. If baby stirs slightly and her environment has changed, if she feels less secure than when she went to sleep - then it functions exactly as you would expect an environment check to do - she will wake up properly.

Baby wants to latch all night because that's how baby gets to sleep and so at every environment check between one sleep cycle and the next, latching is the only way baby knows how to get back to sleep.

Any alternate will involve a lot of hard work and lots and lots of distress, because baby has never known any alternate. You don't have to do anything different if you don't want to, but at least you will understand why baby's nights are so miserable.

I also wonder if I should have posted this in health not sleep - any idea?

Hi FATE destiny, thanks for the post. I have read about sleep cycles etc. His waking aren't regular. And he does have a longer stretch at the start of the night. When he falls asleep not feeding, but just on/near me he still shifts and cries and wakes up very frequently. For babies I know who have been fed to sleep, co-slept etc, they do carry on waking several times a night, but they do not exhibit the ongoing unsettledness and distress we are seeing (at least not from what I have heard), certainly by this age they will have longer chunks of sleep. Ditto when we were managing to settle him in his bed from drowsy but not asleep we saw little improvement. So, while I am sure there is an element of him being given a lot of help to sleep, and needing help to go back to sleep, I would be surprised if it is just that making him miserable, seeming in pain, and awake and unable to go back to sleep much of the night. We know reflux has been an ongoing issue, not sure how much it is involved now. I am reluctant to treat this as just a habit issue unless I am confident he is not in quite bad discomfort. I wondered if others experienced similar ongoing problems and found solutions or reasons. Not finding much on other threads that sounds familiar to me.

to try and work out how to make nights less distressing and exhausting

Invest in a massive super-king sized bed and sleep just in your bottoms. Baby should be able to find nipple and latch without your involvement at 14 months old. At least then, while you may be disturbed slightly you don't have to open your eyes or wake up too much.

If you dont sleep next to a wall get a bedguard and sleep with baby between bedguard and you - so that DHs sleep isn't also disturbed (no point three of you being knackered). Ask DH to give you lie-ins and early nights where possible.

Make peace with the fact that this set up will be long term and ensure you and baby get enough daytime sleep to make up for any broken nights.

CIO isn't the only option. Until you establish whether he can sleep, it's hard to ascertain whether he's genuinely distressed/in pain or just not being able to settle.

At this age I'd definitely gear up mentally and do a big drive on gentle and gradual sleep training. Pick a day and make a change. No feeding, lying him in his cot and staying right with him, hushing/patting until he falls asleep. He will cry, he'll be confused but he will eventually fall asleep. That's what you do every time he wakes so be prepared for a few tough nights. That way he is never left, he's never frightened or alone, you are there to comfort. My son's cry was pitiful and whiny, like he was grumpy at me and frustrated but he never properly cried once. From there, when he learns to settle like that, take another tiny step. Like hushing and reassuring but only holding a hand. Than again and again until you are sitting further away and eventually he will get it.

Once he's reliably falling asleep like this - if he wakes and screams blue murder every night the you can investigate what might be wrong.

Good luck with whatever you decide, sleepless nights are truly harrowing!

Or do as Fate said - just choose your path, make your peace with it and minimise the night time traumas!

I suspect we just have to carry on dealing with it, and hoping we either get some answers at his next appt with the specialist, or that he grows out of whatever it is. He had one slightly less awful patch at 10/11 months, when he just seemed to be more relaxed around going to sleep and to sleep more deeply. It was then we suddenly found we could make progress with various suggestions e.g. taking him off the boob before fully asleep, re-settling without milk in the night etc. For about 2 weeks, we saw some sign those things helped him drop off more quickly and with less from us, though he still woke often, but less distressed. Then, suddenly, that progress stopped and we were back into arching, crying and apparent discomfort. So I can see a lot of these steps to gradually support going to sleep themselves can work - but they aren't working for us.

Mine was a crossed post with the OP above (I had my own 16 month old need to go to sleep).

BrittaBroad - Your posts read like you are desperate for someone to conform this could be a medical issue rather than a habit/behavioural issue.

Have you spoke to your doctor about this? What was her suggestion?

Thanks Peppa! I agree, it is hard to unpick what is inability to sleep from lack of practice, and how much is other stuff. Like I said, we did make some headway with sleeping without boob for a brief window, then it all went tits up (boom boom). Briefly tried doing as you suggested on advice from a friend who found that worked, but not for long -he became very hysterical very quickly. Absolutely not just frustration, but really screaming and hyperventilating, if we put him in his cot and try to just pat/rock him. Ghastly. neither me or OH have it in us, and it doesn't feel like it's an ok thing to do in his case (I know it works for some babies). Same when he wakes. He never wakes and babbles/whines/grizzles or even cries a bit. He wakes and is right into full-on crying within seconds. I hope a point will come when he is more settled when we can do something like this again, expecting some resistance and annoyance, but not the same level of upset.

FATEdestiny, that is pretty much where we are at (though I wear a cardi and vest pulled down ;) ) and think what you describe is probably the least bad option for now. Like I said above, that leaves us sort of waiting and hoping he grows out of, or we get more answers, about what makes him uncomfy at night.

Thanks for taking the time to read and suggest things.

Sorry - crossed posts. I am just trying to get a sense of if others have seen this pattern of a baby/toddler being pretty great in the day and this miserable at night, and if they had, what health issues were involved.

I am quite certain there is a habit/behaviour issue involved, but I am not convinced at all it is all there is at this point. We know he had tongue tie (cut at 11 months) and reflux. But the tongue tie cutting helped eating and dribbling but not sleep, and the reflux meds have not done much for him. The other thing I have heard of that can cause this kind of pattern is food allergy/intolerance. But that feels like clutching at straws. I probably should have posted in health, not sleep... I am just a bit at a loss.

We have made such great progress with naps, bedtime with a fair bit of work, but nights just don't seem to change much, whatever we try. So I would LOVE to hear from others who had something similar and found it was related to issues I have not thought of.

It might take being dairy and soya free a bit longer to see any results if it's that (I presume you're both avoiding it if you're bfing). Mine has a similar sleep pattern if he's had too acidic food or when I've tried to reintroduce a bit of dairy. He's still on reflux meds at 16m, though just one now instead of two. He sleeps flat now, being on a slope just didn't work when he moves so much in his sleep. On a good night he sleeps peacefully and wakes once or twice so I'm sure his bad nights are down to something other than bad sleep habits (and he's always been fed/rocked to sleep). We cosleep and feed to sleep and it works for us, maximizes sleep for me. I won't do any sort of sleep training that involves crying, just doesn't sit right with me. I can have a little bit of acidic stuff now - orange juice, tomatoes etc but DS can't have anything acidic or he's just so unsettled. Like yours he's the happiest chappy during the day, just night time that it bothers him.

So I can see a lot of these steps to gradually support going to sleep themselves can work - but they aren't working for us.

If I may be absolutely brutally honest with you, at 14 months old you have left it too late for the gradual, gentle methods to be effective.

Starting from newborn, it took until my DD was 12/13 months to reach the point of being able to put her down awake (with dummy and comforter) and for her to be able to go to sleep alone, likewise for wake ups.

So over 12 months when done at a pace that was slow enough to cause no crying and no distress at all. This is with a newborn who had no habits ingrained, nothing that had to be 'weaned off'.

Realistically I would expect if you want to go from where you are now to independent sleeping at a gentle, slow, no crying pace - then it is likely to take 2 or 3 years until she's sleeping independently. By that time (aged 4 ish), she would have reached the emotional development stage to be able to sleep independently anyway. So your patient gradual withdrawal method wont have actually achieved anything.

In your position I would either accept and embrace the situation as it is and make the best of things. Or accept that to solve will need distress and tears (from everyone).

Acorncat - that's interesting, thank you. Will persist with dairy/egg/soya free for at least a few weeks and see what happens. We try and avoid acidic food for him in the evening - I didn't get the impression it would go via breastmilk in quantities that bother him by this age. But I gather you have to avoid those things mostly too, and he avoids them all together, not just in evenings? We did ask the specialist we saw if avoiding acidic foods might help, and he said there is no evidence it worsens reflux, so we haven't made a real effort with this. Do you also find things are better if you have a decent gap between dinner and bed? We try and make sure there is some fairly calm, but upright play time between dinner and bed e.g. play a bit, then bath, then reading pre bed... We still have him quite propped, but he does gradually slide down, and that does sometimes wake him (though normally he wakes up well before getting sliding to the bottom of the cot)!

FATEdestiny - you may well be right. But it sounds a bit gloomy and all or nothing to say it will take 2-3 years to see any improvement, and it's eather just suck it up or tears all round. I have heard success stories from friends with (healthy) babies around his age cutting back to much fewer wakings with gentle methods. Like I said, my aim is not sleeping through the night, or even getting him out of bed with us. At this point, I can't see why people make such a big fuss about how they can't cope with a couple of night wakings. That would be fine for me, even long term.

Glad you manged to gradually get to sleeping well at 12 months, sounds a sensible approach. Considering the health issues we had, there may have been no way for us avoiding getting to this point, as his sleep was so disrupted by feeding problems and reflux and in his early months - there was no way we were worried about teaching independent sleep when just feeding him, getting him enough sleep and minimizing pain took all our energy. I am also very glad I did not let myself be bullied into doing CIO by (well-meaning) friends when he was smaller, as I would have felt awful once his reflux was confirmed at 11 months. That rather cemented my feelings against it.

I think I will carry on largely accepting the situation, while still looking about a bit for possible things to help/try we haven't done yet.

Its not gloomy! Co-sleeping long term is lovely and she will eventually sleep better.

It's all about the way you frame it and what your expectations are. If you set yourself some realistic expectations then if you exceed those expectations you can feel positive and pleased. Set yourself the expectation that this will be "solved" in the next year and it's not and then you end up making yourself miserable for the year and then feeling (unnecessarily) like a failure after the year.

I am really not exaggerating here suggesting it might be school age until baby is sleeping independently. It really could be. So rather than feeling like you are doing something wrong (youre not, you are doing your best) or thinking you are failing at something (again, youre not), you could just accept the situation as it is and do all you can to manage the situation as it is the best you can.

Enjoy the snuggles at night and embrace your own daytime naps

I read a lot of conflicting things about what transfers through bfing, so I used to play it safe and avoid anything acidic, plus I get heartburn myself so it was a help to me too. But now I'm less careful, eg I'll have a coffee but only first thing at work when I won't be bfing for 10 hours. I looked up the foods that cause reflux and avoided them (Orange, tomatoes, onions, garlic, spicy,
Caffeine etc). DS occasionally has tomato pasta but after a disastrous night after giving him a red pepper and tomato sauce I'm still a bit wary.

I don't have much gap between dinner and bed, probably less than an hour, enough time for bath, and a play, read books, pyjamas on. On days I work he has a longer gap but I don't see much difference in his sleep. After a bad night I spend a lot of time trying to think back about what he's eaten but it's difficult, especially if he's been at nursery. We're reintroducing eggs and so far so good.

I think he'll be on his reflux meds for a while yet, his peaditrician seems in no hurry to wean him off. He missed one dose a few months ago and was just screaming after a few hours.

I'm hoping he'll just grow out of it eventually and he won't get a sibling till he does

This is probably something you've already tried but you didn't mention it. Have you tried a dummy clipped onto his GroBag? Made a hugely beneficial impact on sleep in this house. Sleep became deeper and calmer and he quickly learnt there was something soothing available to him at all times within reach.

Thanks FateDestiny - that is a positive way to look at it. Sdaly Iw ork full time so no naps for me! I do try and enjoy the co-sleeping as much as I can, but some nights it's not so much cuddles as endless grizzling and a baby in pain that I can't help.

Acorncat I will persist for a few weeks at least with the no-dairy thing. And we have a checkup with the gastro-pediatrician in the next couple of months I think... He may want us to try meds again but I am not keen. He has 3-4 molars at various stages of breaking through right now, so hoping that when they calm down we'll be more able to tell if this diet-change stuff is working.

Annarose, interesting you should suggest that. I got him a Wubbanub last week (a toy with a dummy) but he just plays with it. Never had much luck getting him to take a dummy (damn!) despite a lot of attempts, probably because of his tongue tie, and now he is older and has a working tongue he just bites on them instead of sucking! Will keep trying. Think people would think it mad to introduce a dummy at 14 months but I don't care!

Anyway, thanks for the ideas... We will carry on staggering forward.

Lots of sympathy. I can’t better the advice above, but I'm curious as to the tongue tie diagnosis so late. When was his reflux diagnosed? It sounds like you've been through a lot!

Hi Britta how are you getting on? Your situation sounds a little similar to mine (though DS a bit younger at 9 months & without the reflux issues) so it's interesting to read the advice you've been given.
Also wanted to give a voice of solidarity on the co-sleeping thing - it would be lovely if it was snuggly cuddles and gentle nursing all night - but I have a baby constantly yanking at my nips with hard teeth & sharp nails, romping round the bed grizzling to find me & constantly slapping/gnawing various bits of me to find a boob!