George was born with a mild cows milk protein intolerance, he began breastfeeding but quickly developed a fussy feeding style, pulling off the breast frequently due to pain.
He was heavily dependent on the dummy as a newborn, not only for his naps and night sleep, but also his awake time after his feed to help him keep his milk down. As his mum became dairy free, George was exposed to less cows milk via her breast milk, and his reflux symptoms calmed down.
I went to see George when he was 6 months old, and still waking 4 times a night. Once for a feed, and 3 times minimum for his dummy to be replaced. While this didn’t feel like a lot when he was a newborn, now that he was eating solids once a day, and was over 8 kg, mum felt he really should be sleeping longer at night.
Mum also noticed that George was rubbing his eyes and irritable by 8am, he needed a nap at this time, but never slept for more than 45 minutes all day. It was clear to me that George was not getting very restorative sleep at night, and this meant he was not coping with his awake time during the day, and this was part of the reason he was cat napping.
The other reason was George’s dependency on the dummy to get to sleep.
I explained to mum, that it wasn’t fair on us to expect George to re-settle back into a sleep cycle, when he was
a. over tired
b. dependent on the dummy to get to sleep
We needed to help George get over his sleep debt by consolidating his night sleep, and we needed to teach George to self soothe, so he could then learn to re-settle after a sleep cycle over night and during the day.
At 6 months, George was still 1-2 months away from being able to find and replace his own dummy. He only had the co-ordination to play with his dummy when he was not over tired. Once he was over tired or upset, he didn’t have the control to calmly find his dummy and pop it back in.
I explained all this to mum, and she agreed that George didn’t show any more reflux signs, and it was a good time to get rid of his dummy and work on self soothing. She was nervous given his history with reflux and had heard that crying would possibly bring on his reflux. I reassured mum that we could minimize crying with gentle sleep training, and that we could pick him up to calm him down as needed.
George wasn’t happy that we took his dummy away, but within 2 days he was so much more well rested he was like a different baby. No more eye rubbing at 8am, and his late afternoon grizzles had stopped too!
We continued with the gentle sleep training, this helped us place a disassociation between the dummy and sleep, and create new associations with George’s lovey and his sleeping bag. Night 3 was a tough bed time settle for mum, and she rang me afterwards for a de-brief.
I explained that I felt George was having an extinction burst, and her super consistent approach was amazing, and had probably enabled him to really turn a corner. That night he woke for his feed at 11.30pm, and then we didn’t hear from him until 6.30am!
George’s naps took a few more days to settle into a nice rythym, and for George to learn to re-settle himself back into another sleep cycle. But he did!
By day 10 George was sleeping through the night and taking a 2 hour lunch nap every day, and he no longer needed his dummy at all!