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My 22 Month wakes up every 2-3 hours

PostPosted: Wed 13 Mar, 2013 9:18 pm
by stasjia
Since my son was born - he had silent reflux and I was up 45 mins after every feed patting his back. He never learnt to sleep through the night. He is now 22 months old and out of habit, wakes up every 2-3 hours for a bottle. I know he is doing it out of habit now because he waves the bottle at me for more, if its too cold or if he 'needs more' (I have tried giving him minimal amounts and also water - which doesn't work).

I am now at that stage where it has gone on too long and unsure how to stop this and get him to sleep through. We tried control crying - he gets upset quite easily and when he does, he will throw up (we do not like this approach).

He won't change his baby bottle to a sippy cup. although he drinks a sippy cup during the day with no problems.

Re: My 22 Month wakes up every 2-3 hours

PostPosted: Sat 16 Mar, 2013 12:13 pm
by NgalaOnline
Hi Stasjia

Thank you for your post. It does sound like you have had a challenging 22 months without much sleep, which must be exhausting.

Night time bottles can become a strong sleep association (or a learned way of getting drowsy and falling to sleep) for many toddlers. Removing this sleep association is often quite challenging for the toddler and the parents for a period of around several days to a week. The majority of parents do find, however, that once the night time bottles are stopped that their child's sleep and settling does dramatically improve, and many toddlers will begin sleeping through the full night. Many parents also find that their child's daytime appetite for food will also improve. When children have a sleep association that they can not provide for themselves (such as sucking on a bottle to fall back to sleep) it means that they do not know how to rouse briefly between sleep cycles and then resettle themselves into the next cycle of sleep, without calling for their parent to come and provide thing that they associate with falling to sleep. Once this sleep association is removed and the child has learned to do some other soothing things for himself (such as rolling over, sucking his fingers, stroking his hair or his sheets, or cuddling a teddy) the child will be able to briefly rouse in the night and then settle himself back into more sleep without the need to fully rouse and call for you.

There are a number of reasons for which it is a very good idea to stop the night time bottles. Night time bottle feeding in toddlers has been shown to be strongly related to an increased incidence of dental decay, as saliva production (which is the mouth's way of cleansing itself) drops off dramatically during sleep. Bottles cause the milk to be distributed around the teeth in a way that promotes decay and milk contains a lot of natural sugars which bacteria feed off. If a child falls asleep with a bottle in his mouth the milk often remains pooled in parts of the mouth, bathing the teeth in the milk. Bottle feeding whilst lying flat is also linked to an increase in ear infections, as the milk can drain into the child's Eustachian tube. In addition to this, children who consume more than 600ml of cow's milk in 24 hours are found to be at increased risk of iron deficiency anaemia. This results from a number of reasons, one being that calcium is known to inhibit the uptake of iron by the body, and also the fact that children who do consume excess amounts of cow's milk often have a reduced appetite for solid foods. Cow's milk has also been found to cause microscopic amounts of bleeding within the GI tract and this contributes to the iron deficiency anaemia experienced by children who consume more than 600mls of cow's milk per day. Many parents whose children consume a lot of fluid via bottle during the night find that their child will also be more likely to wake due to a very wet nappy.

It is very likely that the first 3-4 nights of trying to settle and resettle your child during the night without a bottle will be quite challenging and involve not a lot of sleep. Many parents find they have the best success if they can prepare themselves mentally and physically for these initial nights of a new way of settling. Ways of preparing yourself may include waiting until a weekend, resting during the day, reducing other responsibilities during the day at that time, and having some support present to help you with the night time settling. Parents also find it helpful if, when their child rises in the night, if they can get up and dress themselves warmly and then be prepared to remain out of bed until the child has gone back to sleep. Many parents find this to be less frustrating than continually having to get themselves out of bed. This approach will mean you need to be able to have some rest during the day. At 22 months your child is likely to understand more than he is able to verbalise, so it is beneficial to give a brief and simple explanation to your child about what will be happening in the night as you settle him to bed. Some parents will do some sort of ritual with the child about removing the bottles from the house, such as posting them in a letterbox, planting them under a "bottle tree", donating them to a "bottle fairy" or exchanging them in some way for a new toy. On the night you begin this new way of settling, it will also be very beneficial to put your son to bed awake, not have him going to sleep with a bottle at the beginning of the night. After 12 months of age it is best for your child to use a cup or sippy cup during the day, for reasons of dental health and also limiting the amounts of fluids being consumed, and for this reason you might find it best to remove the bottles from the house altogether.

It is very likely that your child will protest for a few nights and feel angry or confused regarding the removal of the bottles. This is normal and understandable. Your child is happy with the current sleep association and has no understanding about why this needs to change. It can be helpful to remind yourself that you are making this change not to be mean, but because you know it will have many positive benefits for your child and your whole family. A lot of the crying that your child may show will be related to the fact that he is feeling tired but does not know how to handle the sensations of tiredness and go back to sleep without the provision of his usual sleep association. Most parents find that the first 3-4 nights are the most challenging, and that the child then begins to settle much easier without any or as much protesting. Usually, if you are able to be consistent, significant change is noticed within a week. It is important to provide a child with comfort and reassurance if he is becoming distressed.

You might find that your child continues to cry and protest at the change during the transition even when you are with him providing reassurance, but persisting through this whilst supporting him can help to bring the change more quickly. If you find that your child is too upset about you leaving the room when he is trying to settle himself, you might find it is less stressful for him (even if he does still cry or protest) if you remain with him. You may like to sit on a chair or on the floor near his cot. He may be soothed by you providing some hands on support such as patting or stroking. If this calms him, you can provide this soothing for several nights, then aim to draw back and stop this hands on soothing over several nights. Other toddlers may be aggravated or stimulated rather than soothed by hands-on settling, and for these children it is helpful if you can just remain as a calm source of reassurance and support near his cot during his time of protesting, until he falls asleep. It is best not to converse with him, give eye contact, or engage in games of lying him down constantly if he keeps standing up. Just remaining nearby, "sssshhhing" and occasionally giving a brief verbal cue such as "sleep time" or "lie down" can help to make the transition less stressful for your child. If your child does stand up repetitively it is best to mainly ignore this and wait for the child to lie himself back down even if this takes a while. You can lie him down after ten or fifteen minutes but if he leaps straight back up again it is best to go back to ignoring it again for a time. It is best to approach these periods of night time resettling with the expectation that the first few times may take as long as an hour or two for your child to go back to sleep, and that this could even occur more than once in the same night. If you are able to persist through though this it is very likely that the protesting periods will reduce and stop within a few days, and that improved night time sleep will follow.

Children do have a very sensitive gag reflex and crying can trigger a child to gag or vomit. This is particularly more likely if the child has recently had a large volume of fluid. If you expect that your child may vomit, some parents choose to layer the cot with a sheet, then a waterproof mattress protector, a sheet and another mattress protector so that if the child does vomit you can quickly change the bed without a lot of fuss or without having to take the child out of the cot. Having a damp washcloth and a sippy cup with some water in it nearby can be helpful. If your child does vomit, quickly and calmly cleaning him up, providing some calming and reassurance and then continuing is the best approach to take.

I hope this information is helpful. Please call the helpline if you would like more information or support.