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Attachment Parenting
webMistress0609
member
Sleep Specialist Sez...
webMistress0609
member
The visit was good & bad. Probably the most important thing is that Ari's reflux is not as under control as we thought. Dr. said his nose & throat were very red & irritated, & there was "cobblestoning" in his throat - basically red bumps that indicate irritation. Ari hasn't been spitting up at all & we figured everything was under control w/ the diet changes & increase in Prevacid. Guess not. I'm pretty bummed about that actually, we were hoping to start weaning him off the Prevacid soon.
Anyway, Dr. said we need to drop night feeds ASAP. One reason was the whole "babies don't need night feeds after 4 months" line, but the other is that can be making the reflux at night worse, which I can agree with. I noticed the nights that Ari doesn't nurse at his usual 11:30 time he does much better, it's just been hard to get him to completely drop that feed. He's usually only nursing @ 11:30 & again between 5:30-6ish now, except for when these 2 teeth have been coming through. I don't have a problem with dropping that 11:30 feed especially, & if weaning @ night will help his reflux then I'm okay with it. I planned on doing this @ a year anyway.
Dr. also scheduled a study for the night of Jun 8th - enough time for the extra reflux meds to kick in & the night weaning to take place. That way we can see if that helps the restlessness or not, or if there is another cause. Dr. sez reflux can cause apnea symptoms, so we may resolve the issue if the reflux is totally under control.
The bad part was the whole associations & bad habits lecture. He asked about bedtime & bedtime routine. I told him bath, lotion, nurse, read a story while nursing. Sometimes he falls asleep while nursing but its only 10% of the time, usually he pulls off & just lays there for another few mins while I read & then drifts off. The whole nursing/reading takes 5-10 minutes. I don't think this is a big deal. It doesn't take an hour, it's not a fight, it's not an elaborate thing of rocking & singing & nursing & ... It's 10 minutes. Would reading to a 5 year old for 10 mins be a big deal? And Ari is able to stir & put himself back to sleep multiple times throughout the night, he's just restless & thrashing & snoring/sputtering between 12-5. That's all. And that's not normal. And that's not something normal sleep training is going to solve.
Anyway, when we 1st stated the routine, he said wow, he falls asleep in 10 mins by himself?
Me: No, I read to him & leave the room after he falls asleep.
Dr.:Oh, so you have to hold him. 
Me: No, he's usually next to me after nursing. Sometimes I still hold him. It's 10 mins. Who cares?
Dr.:And where does he sleep?
Me: He sleeps in our bed.
Dr.: (With more ) Well we'll work on that too, I'm sure you want him in a crib soon.
Me: Nope. Tried moving him out & he slept worse. Tried numerous other times, gave it a full 2 months to work, same effect, & we prefer him close to us anyway.
Dr.: Well, after we get the reflux solved we'll have to work on these behavioral issues that are affecting his sleep since you're having to spend time putting him back to sleep several times a night.
Me: No, I don't, I mentioned pretty clearly I let him work these partial wakings out on his own. I've tried having DH tend to him or I'll try to soothe & it makes it worse. Remember I said that 5 minutes ago?
Dr.: Well when you're having to rock or hold them back to sleep & they can't fall asleep on their own...
Me: (cutting him off) I don't have to rock or hold him back to sleep. I move even farther away from him in the bed when he starts thrashing. I actually have tried putting a boob in his mouth to shut him up & same effect, makes it worse. So we pretty much ignore him, but it does keep us up & it's not very normal for an infant to snore & sputter & thrash all night right?
Dr.: We'll work on his associations. It will involve some crying & it will get worse before it gets better. But we'll get him to be a good sleeper & sleep in a crib by himself. He won't be crying out for you any longer.
Me: ( now with the 
because I'd said 10 times at this point hes not waking up crying and/or needing anything from anyone) Whatever. Lets see what happens when we get the reflux under control. We had it under control at one point & he slept really well, in bed with us even, for about a month & a half. And I've successfully managed to cut his night feedings down from all night bar to 2 with no crying, so we'll do that too.
When we left DH said "dude basically stopped listening to you after 5 mins" Now, if I was having to do elaborate routines to get Ari to go to sleep multiple times a night, then yes, it needs to be addressed, & maybe if nothing else works there may need to be some Ferber-esque training. I'm just not seeing it at this point though. Ari isn't snoring & thrashing b/c he wants to be rocked. Hell I haven't rocked him to sleep in months. I've been trying to instill good sleep habits as much as possible & trying to balance my want to parent him to sleep with making sure he's not overly dependent on anything. If Ari has shown the ability to sleep or fall asleep more independently I've given him a push in that direction.
Whatever, I've screwed him up & made him a horrible sleeper. Bah.
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Re: Sleep Specialist Sez...
I have several thoughts about your post:
- I would ecstatic if I could go through a routine and DS drifted off to sleep on his own while I read. That is impressive and I think really good for a baby who isn't even a year old yet.
- It seems like the underlying premise of the doctor's advice about breaking associations is that your baby is somehow doing this on purpose. Calling it "behavioral issues" would be a problem for me, I think.
- It makes total sense to me that reflux would keep him up at night and that feeding in the night makes things worse. I had horrible heartburn when I was pregnant and my 3am snacks didn't help the heartburn. Since Ari is already lying down, I can definitely see that he would have reflux issues with eating at night. While I'm a huge advocate of feeding babies when they wake up at night, I can see the doctors point on this one.
I'm glad you were able to get in and hopefully you can get the reflux under control.
(edited age)
"Dr.: We'll work on his associations. It will involve some crying & it will get worse before it gets better. But we'll get him to be a good sleeper & sleep in a crib by himself. He won't be crying out for you any longer. "
Grrrrr... I can't stand it when doctors decide to solve a problem you actually don't need or want solved.
But, it does sound like he might be some great help with getting the reflux under control again. And, hopefully then Ari's sleeping will become closer to what is developmentally average for his age.
You are doing a great job as a mom! And, btw your bedroom routine sounds great, and it sounds like Ari has a peaceful journey to sleep every night.
Gah! I'm impressed that you didn't punch him for not listening to you! On one hand I'm sure he sees quite a few infants who do have sleep association issues, but that doesn't mean that the problem with every infant is about associations!
I'm completely crossing my fingers for you that clearing up the relux is the answer. Seriously, my fingers and toes are crossed. And I'm going to ask why your regular pedi didn't look in his nose & throat and realize that reflux was still an issue? Our doctor looks down the throat at every appointment.
None, and I repeat NONE, of this is your fault. Kids sleep the way they sleep and given how you describe his sleep there is something internal going on. Whether it is the reflux or apnea or something else, this is not about good vs. poor parenting, this is about Ari's body when he's sleeping. The way you describe him sounds just like Todd when he's teething - restless, snoring, moving, thrashing. But for Todd it lasts 2-3 nights, not months.
And really, Ari goes to sleep easier than both my kids. It is a rare night that it only takes 5 minutes from books to bed, and that is with each one of us taking one kid. Solo parenting both at bedtime takes at least 20-30 minutes, minimum.
Hugs and I hope the reflux meds do their job really quickly!
Sorry it was a somewhat unsatisfying visit :-( It does sound like the doc missed the boat on what it was you wanted help with. I'm with Eco that I would be annoyed by the "behavioral issue" label - my guess is that most parents seek out a sleep specialist for "behavioral" reasons so he's giving his standard spiel. Hopefully, he'll actually listen to your needs next time.
I agree that if the reflux is an issue, that could be causing his disrupted sleep. Hopefully, cutting out that last night feeding will help.
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@MrsAmers: I'm kinda ticked that the pedi didn't notice that too. We just had a well check up recently & had another mini check when we brought up these sleep issues 2 wks ago. If they would've said "hey noticed this" we would've said "oh that's why he's not sleeping."
I agree with the other pp that the "associations" thing is the standard answer. Annoying that he threw that label out there when it's not really the case here but whatever. Looks like we're on to something w/ the reflux not being under control though. Night nursing & reflux is solvable, & Ari won't have to go through adenoid surgery or anything like that either.
ETA: What would be really awesome is if the reflux meds & dropping the nursing works, & Ari repeats his 8 hour stretch of sleep w/o restlessness like he did the 1st night in the king bed. Then I can go in for the follow up appt & say "hey, he's STTN now, & still in our bed, & I still read to him. Amazing huh?"
LOL! I love it!
Ditto! :-)
ditto to this! Sorry it wasn't a totally great visit, but hopefully will help some long term and get the irritation under control. What are you doing with that? increasing the prevacid?
Yeah dude is def not AP friendly. He asked if Ari used a paci, which he does maybe 50% of the time but spits it out right before or after falling asleep. He told us his daughter used one till she was 3 mos old, & when he had to replace it 5 times in 1 night he just let her CIO. Took 3 nights but he broke that habit by gawd.
Anyway, we're on 15mg of Prevacid already, so he said add 1.6 ml of Zantac before bed. Zantac has never helped Ari, so we'll see what happens with that. Dr. was thinking dropping the night feeds could help the reflux too, which makes sense to me, & I don't think it will be extremely difficult to get Ari to drop that 11:30 nursing session. I'm not super worried about the feed @ 6ish even though the Dr. seemed to think so.
LOL I guess the rumors were wrong! Sorry!
At least he had some concrete ideas about increasing the reflux meds and trying to cut back on night time feeds.
What is the big deal about the 6 am feeding?
Is it weird that since I don't go without drinking anything for 10-12 hours, I don't expect my kid to? I usually wake up at night to pee and I drink at least 8+ oz at that point. So maybe it is familial! DH is the same way.
seriously sounds like it is mostly medical. your sleep associations sound nonexistent (meaning that is a good thing). hoping things work out for you!
me too!
The big deal is that he's nursing!!! When he should be sleeping!!!! It doesn't matter that he nurses for a minute then goes back to sleep for an hour or so & it doesn't bother me in the slightest!! He's stuck on nursing & cosleeping, OMG!!!
Kidding. As much as I hate his reflux is not under control, at least we have something to work with & it's an existing problem, not a new one like enlarged adenoids or something.
This is the part where I scratch my head:
Dr.: (With more
) Well we'll work on that too, I'm sure you want him in a
crib soon.
Me: Nope. Tried moving him out & he slept worse. Tried numerous other times, gave it a full 2 months to work, same effect, & we prefer him close to us anyway.
So you DONT want him in a crib or you're assuming he can't be in a crib because it makes things worse. Those are 2 different issues and I don't blame the specialist for his subsequent assumptions.
Do you want the kid out of your bed? I think the doctor is assuming such because you didn't say "No we want him with us." You jumped to "it doesn't work.''
Sounds like you're onto something. I'm a big fan of night weaning. I will not endure the hell I did with Jo again with the next baby. no. f'ing. way.
Sorry, I was trying to shorten an already long post. I actually said we tried moving him out even though we didn't care to b/c it's usually the 1st thing recommended if your kid is a crappy sleeper & bedsharing. He slept way worse. I have no interest in trying to move him right now, bedsharing works.
I tried numerous times & gave it plenty of time to work (every night for 2 months in fact), because I kept thinking & everyone & every book kept suggesting he may just need his own space & it would help cut down on night feeds. Well, Ari fully wakes up & freaks out every 30-45 minutes if he's in a crib or PNP . If he's in our bed he can self soothe back to sleep whether we're there or not. Even with all the thrashing, I can at least let him work it out on his own & he'll eventually go back to sleep. If he's not in the bed he starts screaming. And calling "mum-ma!".
I explained all this in detail to the sleep dr. I'm not sure he believes my kid actually sleeps better in our bed or can self soothe better in our bed, but whatever. Ari has his own brand of sleep trickery.