Pediatrics/6-month-old Sleep Issues
Hi, Dr. Olson:
My wife and I have a 6-month-old son (5-months corrected) who constantly and predictably fights sleep. He has been extremely fussy from the outset and, as it relates to sleep, this has steadily gotten worse. We have tried many, many things (which I will detail below), and find ourselves very much at the end of our collective rope.
We prefer natural remedies when possible, so we have consulted with chiropractors, a craniosacral therapist, and have tried different probiotics for his gut. None of this has helped. More recently, we finally broke down and, on our pediatrician's advice, filled a script for anti-reflux medicine. This also appears to be ineffective. The only other recommendation from our pediatrician that we haven't implemented is to add rice cereal to his bottles. This recommendation came as a possible way to get him to sleep at night, as well as to help increase his weight.
Our son has been breast-fed only to this point in his life, and he is pretty small. At last check, he was 12 lbs., 10 oz., and that was at his 6-month check-up (though, as stated previously, he is 5-months old corrected). Even comparing him to a 5-month-old, he wasn't on the chart for weight. I am willing to begin giving him rice, but my wife has read different books suggesting that rice should be added later. She's also read that babies don't actually wake up in the night out of hunger and that adding rice won't help. I have spoken with some people, however, who relayed very different experiences (i.e., that it did help), so I don't know what to think.
I have read some of your advice to parents experiencing similar struggles, and I will admit that we have started some bad practices. Often, we do put our son down 100% asleep. I know this is not recommended and that he should fall asleep on his own in his crib, but it has been nearly impossible to accomplish that. With two parents working, sometimes we just have to get by day-to-day. We have also brought him into bed with us on a number of occasions. Again, we knew it was a bad idea, but it made for a more tolerable night when we simply had to sleep.
I can't highlight enough how difficult this has been. We have another son (now 4) who was born at 25-weeks and spent 4 months in the NICU, and I think elements of what we're experiencing now are more stressful than that was. He is just so sensitive to any small change when trying to get him to sleep. Even when I am trying to put him down 100% asleep, he often wakes up on the way down. I can get him to sleep in my arms, but he typically wakes up on the way down to the crib.
In the interests of providing more data, it is not only with sleep that he struggles. Just through the day, he is a difficult baby. One thing that seems to help is taking him outside. He can be completely inconsolable in my arms, with me bouncing him, walking him, and doing anything I can think of, and then as soon as we step outside, he becomes quiet. I don't know if there is any significance to that, but I'm trying to provide you with all the data I can.
At this point, we don't even have a good guess as to whether his issues are related to discomofort or if it is behavioral. There are some parents who say they can interpret every different cry from their baby, but we are clueless. I don't want to put undue pressure on you by saying you are our last hope, but I will say that I eagerly await your reply!
Frustrated and tired,
Kids vary greatly in their abilities to adapt to their surrounding. Some kids are laid back and can accept anything and others are not. You clearly have a kid you is inherently a bit on the latter side.
Seldom are sleep problems due to medical issues. If a baby is obviously having acid reflux, or this is being considered, a trial of ranitidine twice a day might be warranted. You tried this and it didn't work.
Behaviorally, we stress the concept of last waking memory, LWM, the notion that how one falls asleep has a great bearing an their night time response to waking. Kids wake up all the time at night, video studies tell us, and the "good" sleepers look around, find they are in the crib they fell asleep in, without a parent present, and go back to sleep. Feed your baby, do a consistent bed ritual, and when drowsy, but not asleep, leave the room. Clearly he will cry. It would be very reasonable, as long as his LWM is of the crib and not with one of you, to let him cry. He will not be emotionally scarred due to this. He will love you guys as his parents in the morning. For some parents, this is easier if you wait for 10-15 minutes of crying, go back into the room, and without holding, say "good night" and leave. For other parents and their babies, this is like throwing gas on a fire. It might make things worse.
Feeding has nothing to do with this. A breast fed baby can, at at least 5 months of age, sleep through the night.
Again, probably the same old advise you are getting, but I hope this helps.
Good luck, dr. Olson.