Milk sleep association

[munchkinsmumma]

Hi there,

I'm a ftm to a lb. He is just over 12 weeks. We had a very rough delivery (ventouse, shoulder dystocia, back to back, episiotomy and third degree tear). He has always been very unsettled when it comes to sleep, particularly naps.

I can count on one hand the number of times he has fallen asleep on his own. He was initially breastfed but now formula fed. He does not like a dummy which is very frustrating because he's a sucky baby. I have tried many different brands and shapes of teats, to no avail.

Everyone keeps telling me that at this age they can't form bad habits but I assure you that my son already has. He will scream and cry hard when he is tired until I give him milk. I have tried white noise, shush pat, light show, swing, sling, Ewan the sheep, rocking, swaying, leaving him in his crib etc but he will not settle. I watch his sleepy cues and try to wind him down after 1 hour 15-20mins so try to avoid him getting over tired.

My concern is that we are now over feeding him (particularly at bedtime) because it's the only way that will settle him to sleep. He'll take a full 6 ounces and then s'times another 4 ounce bottle. Surely this is a SIDs risk?!! Nearly every evening, we will settle him to sleep (with milk) and he'll wake exactly 30 mins later and it's back to square one.

Does anyone have any advice? I've spent most of today in tears because he finished his bottles and wouldn't take anymore but wouldn't settle. It's so frustrating.

Congratulations on your ds. Firstly please don't worry about sleep associations, he is only tiny and they feed so much at this age. I was wondering if it may be silent reflux that's bothering him. My little boy really struggled with this and it only settled once he was prescribed ranitidine. As their throat is so sore with stomach acid they take on more and more milk to try and soothe it. It's so hard dealing with an unsettled baby. I would speak to your hv or GP.

Feeding to sleep isn't a SIDS risk

I would perserveer with the dummy, it sounds like exactly what he needs. What do you mean by not liking the dummy?

It's not unusual to need to hold dummy on baby's mouth. Not usual that the tongue-thrust reflex spits it out. Tapping the outside of the dummy encourages baby to suck, but it can take some perserverence before they "get" that they need to suck this thing in their mouth. Until they get It, the tongue-thrust will spit it out because that's the reflex reaction.

All that said - 12 weeks is a time of a massive increase in calorific need. It might be that the extra feeding you are having is simply because baby needs more calories over 24 hours. Have you tried feeding much more frequently through the daytime? I did full bottles every 2 hours or so throughout my daytime (ie 7am-11pm) in order to calorie-load tgroughvtge daytime so less milk was needed at night.

Hi Jemima,

Thanks for replying. He had some reflux in the early weeks and the GP prescribed him a 3 week course of omeprazole which sorted it out.

I don't believe he's in any pain, just very unsettled and overtired. I try to soothe him to sleep when he's tired but he doesn't settle and then becomes overtired and then it's mission impossible!

I've been trying to resettle him for 2 hours now since he woke up 30 mins after we put him to sleep. He didn't nap well today so I assume he's seriously overtired.

I'm completely at a loss. I don't want to feed him again because he's not hungry.

Hi Fate,

Thanks for your response! I meant could over feeding at night be a SIDs risk? He only ever takes 7+ ounces at night if he won't settle to sleep. So I'm sure we're over feeding him s'times to get him to sleep.

Interesting you should say that about 2 hourly feeding. We had been feeding him 3 hourly since he was born (advised by paediatrician because he had prolonged jaundice) but these last few weeks he has been very fussy feeding. We were making up 5 ozs every 3 hrs and often he'd take 2-3 ozs and then refuse. So I presumed he wasn't that hungry and only today, started to stretch him out to 4 hours. I thought it had worked well because he took 6oz feeds x4. He gets constipated very easily and I thought this might have been due to the constant snacking of an ounce here and there.

I should add that he was a big lad at birth... 10lb 4 ozs and last week he weighed 14lb 7 ozs. So I presume he's gaining well.

Regarding the dummy, he does exactly as you say and uses his tongue to thrust the dummy out. He gags and chokes on it and screws up his face when I try to put it in. I tried to aim the teat towards the roof of his mouth because I'd read that that is how the sucking reflex is activated but it doesn't seem to work. The only time he'll take the dummy (and not every time) is when he is crying which is when he's already overtired. And even then he'll take a few sucks and realise it's not milk and push it out. I know it's exactly what he needs. Could a tongue tie affect his ability to suck a dummy or bottle? Even with the bottle it seems that he forgets how to suck s'times. The health visitor said his frenulum looks quite tight but then said no more.

Today he has slept a total of 3 hours 30 mins between 7am and now. I've been trying to settle him now for 2 hours and 40 mins. Sorry for the essay. Thanks for reading and I appreciate your suggestions.

Yes a tounge tie can effect both the ability to take a bottle and suck on a dummy. You said he had reflux, it's unusual for it to resolve that quickly. Silent reflux is when they are still in pain but aren't sick, tounge tie can also present with reflux. You said he was breatfed to start with can I ask did you have a lot of problems with latch?

Feeding at night isn't a SID's risk in fact babies who sleep longer and wake less for milk are shown to be at higher risk of SID's.

Hi MigGril,

Yes we had a lot of problems with latch and he was constantly bobbing on and off. The midwives checked it and said it was fine but I knew s'thing wasn't right. He was feeding for a few minutes here and there and this was all day long. I thought he was fussy at the breast because he wasn't getting enough but in hindsight, it was probably the latch. I was completely exhausted and the midwives pressured me to top him up with formula.

Even now with the bottle teat, his tongue flicks all over the place trying to latch s'times. God I miss breastfeeding. I was heartbroken when I stopped. It still makes me feel down when I think about it. If only I'd had the right support, I'm sure we'd be still be breastfeeding now.

Sounds like you had a really hard birth. Have you heard of the KISS-syndrome? The acronym stands for kinetic imbalances due to suboccipital strain, which means that the delicate joints in the baby's neck suffered during birth. This can cause chronic pain and is more frequent in big babies and ventouse deliveries. It can be treated with physiotherapy and osteopathy. Might be worth talking to your GP about it, maybe he can refer you?
As for the bf, I can imagine how you must feel remember it is just a tiny part of being a mum - it's a huge deal now, but over the years, it will become less and less significant as you share more and more experiences with your LO.

Hi scrumptious! Thanks for your response. I hadn't heard of KISS syndrome but this makes sense for babies who've had difficult births. I don't think he's in any real pain because his screaming bouts coincide with nap time, rubbing of eyes, yawning, fussing etc. And he settles as soon as I put the bottle teat in his mouth. If I try to use a dummy, he becomes furious and screams harder! Lol

He's drooling a lot and constantly sucks on his fists, but it doesn't soothe him and he stops after a few seconds. I doubt it's teething pain if he only does it when he's tired?

Sucking his fists is just baby trying to satisfy the need to suck. Sucking is a natural way for baby to self-sooth. It's the whole reason why dummies exist. Fists dont firm a vacuum seal like a teat/nipple/dummy does, which is why some babies can find sucking their hands unsatisfying.

But the only thing that satisfies his need to suck is the bottle. I don't mind except on the occasions when he refuses the bottle because he's full or whatever and then there's no way to get him to sleep except letting his squeal until he rides himself out.

One other question FATE, if you don't mind... Every night we try to put him down to bed for 7:30/8. The bedtime routine begins one hour before (it always takes at least an hour to settle him). Like clockwork, he wakes up after 30 mins. Any thoughts on this?

12 weeks old, you don't need a bedtime.

Baby should always sleep in the same room you are, for SIDS recommendations. This includes the evenings. It also fits in with baby's natural tendancy towards shorter naps through the daytime.

The 7.30/8pm sleep is a nap. It's not a nights sleep. By all means have a routine (as in bath, massage, change into nightwear) at any awake time around 7pm-8pm. Then put baby back down for another nap as you have done all day. At any wake up that happens at a time you'd go to bed (day 10pm-11pm), take baby with you upstairs and do feed then put baby down upstairs.

Once naps naturally extend you'll find baby not waking from this evening nap. When you have to start waking baby to take upstairs because you want to go to bed, that's the signal to start baby having a proper bedtime.

That happens around 5-7 months old. You're fighting a pointless battle trying to insist it before hand. You'll just waste your evenings in a silent, dark room settling a baby from one nap to the next for no benefit.

You really don't need to worry about it at this age, it's normal.

My 9mo still has the sodding bottle to sleep association. Now I'm trying to do something about it. No way at 12 weeks.

I disagree btw about babies younger than 5 months not having bedtimes. My ds started falling asleep at around 8 for the night at 10 weeks. This then dropped to 6.30 at 14 weeks and stayed the same ever since.

He did that on his own though, I didn't force it.

If feeding him gets him to sleep, then feed him. Honestly. At this age assume that it's hunger first.

Absolutely BertrandRussell. Always assume hungry first and feed.

Indeed I think it's largely impossible to over feed a 3 month old with milk. If baby has too much milk it will just come back up again.

So just feed feed feed.

No advice on how much he drinks. Can you give him breast again to see how he is and if he will suck. You might relactate too.

Oh, god, please don't add extra stress by suggesting she tries to relactate.

OP- honestly, if he cries, try milk. You don't know whether he's hungry or not- feeding babies is not an exact science. If he has some milk and goes to sleep, then he was hungry.

I didn't even know it was possible to relactate at this stage!

I think he's just wanting to cluster feed at night. He's taking 9-12 ozs in the space of 2-3 hours these last few nights, which I suppose is great because he's doesn't always feed well during the day.

Thank you for all your advice and suggestions. It's good to get some reassurance and new perspectives. I need to stop treating my lb like he's some sort of alien creature that I have to study and just go with the flow more

It is possible- but not very likely. Please don't add to your worries!

Just feed him. Bf babies often have lots of little snackettes that you don't really notice- it sounds as if he wants to do the same. A bit trickier with ff, but doable. Don't worry for a second about overfeeding- just do whatever gets the most sleep for the most people. Including you.

Wow I didn't say OP must relactate. Just for comfort sucking, if OP wants to.

Op sorry I didn't come back, I think from what you have said it maybe worth asking about having his tounge checked for tounge tie. The bobbing on and off you discibe with breastfeeding sounds quite classic, also him not being able to keep hold of a dummy.

Babies can have problems with bottles to and its worth looking at as it can make moving onto solids hard to.