Controlled crying

[Jellybean2017]

We have been having issues with DS sleep, won't nap unless in sling and with lots of movement, won't sleep unless laying across me, won't lay on back, won't take dummy, won't sleep in bouncy chair despite trying persistently. GP thought possibly reflux related due to constant crying in addition to to above. Tried gaviscon and ranitidine but no improvement. Referred to paediatrician.

Paediatrician said all the issues are down to sleep associations and we need to start controlled crying. DS is only four months old, this doesn't sound right as I think it's usually recommended to wait until six months at the very least. Does anyone have any advice? We have also been prescribed omeprazole even though paediatrician doesn't think it's reflux...? Surely controlled crying is a bad idea if it is reflux?

My children were sleep trained at 19 weeks and 16 weeks with no ill effects. Oldest had colic and cried unless upright and held. Eventually sleep deprivation and the intervention of my health visitor lead to sleep training. It took three nights and was bliss.

Good luck.

Doesn't sound like reflux to me if baby also won't settle in a bouncy chair tbh .
At 4 months I'd consider shush pat and pupd.
I'd do all the settling in the cot but wouldn't leave baby to cry at this age .
Baby could be hungry in the night still at this age and imo it sends mixed messages of " sometimes I cry ..mummy responds by feeding and sometimes she doesn't "
Etc

Please please don’t do controlled crying to a 4 months old

Is baby breast or bottle?

A paediatrician has given you this advice so I would assume it’s right and trust in him/her. Lack of sleep is damaging for babies.
There is no harm doing PUPD at 4 months to break associations.

I'd ask for a second opinion and explain that you don't want to do controlled crying. You don't have to just because this particular paediatrician says so.

@fortheloveofjames he is breast fed.

Does he have any discomfort when feeding? Or anything you thinks not quite right? Such as constant pulling off or arching back? How is he through the night feeding wise? How are his nappies? Any mucus?

I’d try Elizabeth Pantley book The no cry sleep solution.
It’s very very slow going but does help you move in the right direction with sleep associations and is good for bf babies.

There's no way I'd do controlled crying with any baby, but certainly not a four month old. If overtired you could invest in a mechanical swing for daytime and restart sleep, iyswim.

Feeding is generally OK after a rocky start due to tongue tie. I still feed him every few hours in the night. He brings up a lot of his feeds and has dropped two centiles.

If your GP and pediatrician referral both don't think it's reflux, I'd stop medicating unnecessarily.

With baby struggling to that extent to sleep well, the mistake obvious answer is a significant lack of calories.

You will never sleep well when hungry and not getting adequate calories. No matter what you do.

If my baby had dropped two centiles and also had this trouble sleeping, I round give formula top ups or just swap to formula feeding and breastfeeding only for fun, not for the calories.

I would definately consider formula before considering leaving a 4 month ols baby to cry. In a heartbeat, no brainer Goffs me.

No brainer for me (that was supposed you say)

I agree with fate. Our ds was a non sleeper, dropping weight and getting really skinny. I persevered with bf because... well to be honest because sheer bloody mindedness and we’d found it so hard at the beginning. Looking back I wish I’d given him a bottle a night and if I ever have another I will do alongside bf.

We were also told by paediatricians to controlled cry. So we did! And oh fuck it made things a million times worse. Do t get me wrong, I think it’s a technique that can work BUT I think only for older babies and ONLY if certain reasons are why they are not sleeping.

If it’s a habit waking in an older baby then I’m sure it works, but if it’s hunger/fear/separation anxiety (as it was I think with ours) then leavingvthem repeatedly is just fuelling the fire. PUPD made him crazy with stress. He ended up battering his face into the bars of the cot until he bled and was so afraid of he cot it took us weeks to get him back in.

At that point I stopped listening to what other people told me I SHOULD be doing and starting listening to what the baby was telling me. Which was that he wanted to be stuck to me 24/7 (sigh...) and hated being left, and was constantly hungry. We stopped trying to force him to sleep and just put him in our bed.
Remarkably, that DID work. And eventually he was secure enough to go into a big bed in his own room at 18m where he slept wthroigh within a week and has done so ever since.

Anyway, a long ramble. But four months is way too young to start cc. Listen to what they are telling you - consider supplemental bottles (we actually did solids early too on medical advice because by that point he wouldn’t take a bottle at all.)

There’s a LOT going on with sleep at four months. Try to keep things as stress free for them as possible and at six months you may see more more mature sleep pattern emerge.

Have you considered cows milk protein allergy? My DS has CMPA, and sounds very similar. He would never be put down, lived in the sling. He hated the car, pram, Moses basket. He would feed constantly and wake constantly at night, squirming and uncomfortable. He hardly slept during the day. He was generally just miserable and unsettled if his eyes were open, in the beginning he had all the signs of colic. we also tried all the reflux meds because they suspected silent reflux. I tried everything and nothing made a difference. Untill a doctor suggested if I’d changed my diet at all. DS also had a rash on and off that I thought was just dry skin/infant acne. She suggested I cut dairy, so I did and after 4-5weeks he was so much better. Since he was happier during the day and more comfortable I was slowly able to put him in bouncer, use the pram etc. He also started letting me put him down for naps and his night sleep improved. Looking back he was so miserable because his wee tummy was sore

4 months is too young for CC. Agree with fate re: moving to formula top ups. We did this and DD slept so much better.

I would hazard a guess that's he's hungry OP. definitely give formula, he's dropped two centiles this should tell you he's not getting enough calories

@fortheloveofjames I have asked for investigation into cmpa as there are family members with this and history of lactose intolerance. I stopped eating dairy/soya a few weeks ago. So I'm reluctant to give formula until we know if he has an intolerance but Dr wouldn't prescribe dairy free formula.

Not sure if can buy over counter?

He has dropped from 50th to just in the 9th (ie just on line between 25th and 9th, sorry didn't make that entirely clear) so still gaining. I'm offering feeds regularly through the day but when he is tired he doesn't want a feed and just pulls on and off and cries. I'm looking out for sleepy signs and keeping an eye on awake times and he can only really manage an hour and 15 awake.

Oh reflux is horrible OP. What our GP told us is that the baby effectively has heartburn pain, so being left sleeping flat is going to be really painful for them because that position allows the stomach acids to come back up and cause the burn pain. So you will need to quite actively manage what position the baby is in a lot of the time. So after feeding ,they said to think of it like you have a very full jug of liquid inside the baby that you are trying not to splash out or spill over.

So Eg a bouncy chair may cause problems because of ‘splash’.
So you could try baby being held by you at 45 degrees angle or basically an upright position after feeds and while sleeping after a feed, which for us works easiesf with cosleeping, though that wouldn't have been my first choice for me getting sleep myself

You can also ask your doctor about propping up their cot mattress so it’s on a slope with the baby’s head at the top. but I found that at the angle needed, they can slide down the hill.

It’s only for a bit hopefully until their bodies mature more and can keep their stomach acids down where they belong. But it’s hard going for that time so and sympathy OP.

It takes a full 6 weeks for dairy to clear from both your systems? How long have you been dairy/soya free? Are you being totally strict with it? All you can do to test is wait the 6 weeks then try the yoghurt test for a reaction and see what happens. Even if referred to a dietician, from my experience the paediatritions/docs have no clue and I had to do the majority myself... Lactose intolerance too? I hope it’s not that, that’s very rare and would be a nightmare for you . I’d be reluctant to try formula untill you’ve ruled out allergies. The only OTC formula that has no cows milk in it is soya based so no good if you’re attempting soya free aswell. Only other formula recommended by our dietician was Aptimal Pepti, but if baby is on the more sensative side of the allergy would probably still react as there is still cows milk Products in it. If he’s still gaining and there is plenty of nappies then baby will be getting enough. My DS fed little and often untill we got on top of the allergy because it was comfort due to the pain so he was also snacking. He also now sits inbetween the 25th and 9th centile bit when born was just below the 50th.

Am I missing something - you say he brings up most of his feeds, sleeps badly, and has dropped a lot of weight, but no-one thinks reflux is the problem? Sounds like reflux to me? Sounds a bit like my baby. He would often pull off the boob crying even when hungry because he seemed to know it was going to make his tummy hurt. I would try the omeprazole and a formula top up if you can and see what happens. I don’t think it’s down to bad sleep associations from what you’ve said, you have tried everything but he’s unhappy. Controlled crying won’t get to the bottom of the matter and he’s a bit young, personal opinion is 6 months at least for CC.

@Jellybean2017 in my local big Asda I noticed they were selling goat milk formula. It looks like you can get alternative formulas with them being prescribed.

If you’re worried about CMPA I’d avoid all milks from animals- even though CMPA is cows milk protein allergy, most will not be able tolerate milk from any animal. You’d need something like nutramigen or neocate from the doctors

Too little to do controlled crying!

Four months is typical for any baby with any routine you had to be out the window anyway they have a sleep regression at that age.

I needed omeprezole and it took a couple weeks for it to really help me and when it did it changed my life. (As an adult) but long term can have problems and so can coming off it straight away without weaning yourself off so listen to the doctors advice on that one.

Do not listen to your doctor about the controlled crying though that really is nonsense