Reflux or Over tiredness?
Could your baby’s reflux symptoms actually be over tiredness?
This is a really interesting case study about baby Zoe, who at 12 months old was still waking her mum every 1-2 hours over night, and only getting on average 6-8 hours sleep in total each night.
Mum came to us basically feeling like a broken woman.
She had been surviving on this amount of broken sleep for 12 months, and recently her family and friends and even her boss had started to notice the way it was affecting her mood, and just general well-being.
She was needing more and more sick days due to the exhaustion, and her friends felt she had lost her spark!
We had a big chat about Zoe’s sleep habits and mum explained she was feeding Zoe to sleep as that worked so well when she was a newborn, she had never really expected she would need to change anything.
Everyone told her the sleep issues were a phase or regression, or teething, and then reflux, but everyone she asked for help assured her the phase would pass.
Mum had seen a few Dr’s concerned Zoe had reflux because she had begun a habit or back arching and screaming whenever mum tried to hold her and rock her, and not feed her to sleep. She would then scream when put back in the cot, and this linked to her poor sleeping habits mum felt it must be reflux.
A course of losec at 10mg a day and Zoe’s symptoms hadn’t changed.
Since mum had tried medication for what she believed was reflux, we decided the next step was some gentle sleep training to see if actually the symptoms were more sleep related and lack of sleep related!
I did feel that the back arching can actually be a babies frustration and even anger at you when you are not giving them the sleep association they are used to such as feeding to sleep.
I wasn’t surprised she cried and screamed in her cot when mum tried to not feed to sleep, 12 months in Zoe only knew one way to sleep, and that was to feed to sleep.
Gently does it...
We decided to go with a more gentle plan than a cry it out based plan, even though mum was desperate for a fast solution.
The gentle sleep training is often better suited to children who have been fully assisted to sleep for a long time, as they have never had the opportunity to naturally develop any self soothing habits, therefore they need a bit of time to do this, and in that time they need a bit of support from mum, as she is all the child has known in terms of sleep.
Nights before Naps
Zoe was having two short naps a day in the car, and we decided to not work on those until mum was getting at least 6 hours sleep at night.
Our focus was night sleep for mum and Zoe, while still trying to get on top of the accumulation of sleep debt that Zoe had, which was contributing to her frequent wake ups at night.
We moved Zoe’s bed time forward by an hour!
Mum thought I was crazy the first night I spent with them.
But that night after just 25 minutes of sleep training Zoe slept until midnight!
She responded beautifully to the earlier bed time, and the new bed time routine which meant stories happened after dinner as mum felt these were winding Zoe up.
Her new bed time routine meant she went from the warm bath to her bedroom with dim lighting for a quick massage, PJ’s, breastfeed and teeth brushed in her room and into bed wide awake, but happy!
Zoe did a little back arching and screaming when picked up, but actually settled better when mum picked her up less, but spoke to her and sung to her more.
The reflux symptoms calmed right down as Zoe began to use her bunny comforter and move around the cot to settle herself. She only needed to be picked up 3 times, and was really only grizzling after 15 minutes.
Mum was pretty shocked that it did appear over tiredness was appearing like a reflux symptom.
Middle of the night
After Zoe’s mammoth sleep, she woke expecting to be fed to sleep, but instead was giving a feed, and then popped back to bed awake.
This time she had a little more sleep in her tank and a little more awareness, this meant the sleep training took an hour, and she was asleep just after 1am!
The back arching and pulling away from mum was a little more intense this time as Zoe desperately wanted to be asleep, but also was convinced she needed to be fed to sleep. remember your baby is tired, they want to go to sleep, and this can look like a very frustrated baby in the middle of the night.
Mum stuck with her mantra “Zoe honey it’s sleepy time, mummy is here.” And by the end of the hour Zoe was lying herself down and responding beautifully!
Mum went back to bed, and we thought we would see each other in an hour or so!
Zoe surprised us again and didn’t wake until 4am, at this point we were confident she was not hungry again, so mum was feeling more confident and like she had more resolve to see this through. Zoe was back asleep by 4.45am, and mum had to wake her at 7am!
Success in one night!
Night two was just as fun for mum and I.
We stuck with the same bedtime routine and since Zoe had still only had two 40 minute naps that day, we had the early bed time.
This time Zoe put up a bit more of a protest and took 45 minutes to settle, but her crying was much less intense and she was hardly arching or kicking off mum when picked up for a cuddle.
She was picking up her soft cuddly bunny more herself, and mum already felt she had done “less” to help Zoe settle herself.
Zoe slept past midnight and didn’t wake until 3am!!! Since we were sticking with a feed at night for the first stage, mum gave Zoe a feed and put her back to bed awake, but happy and calm.
This time it was only 20 minutes until Zoe was fast asleep. We crept out of the room and mum was ecstatic.
She could really see this working!
It was 3.40am, so blurry eyed we both crept off to bed.
I heard Zoe call/cry out at 5am, so mum and I stopped outside her room for a minutes and listened. It really sounded like a half asleep mantra cry and we were both happy to leave it and see if Zoe went back to sleep.
She did! Until 7am!
Two weeks after my double over night with Baby Zoe, and mum has discussed with the GP and is taking Zoe of the losec.
She was only put on it as a trial, and it turns out what cured her screaming and back arching and kicking was some sleep and beautiful self settling skills.
Mum is thrilled to not be needing the losec and even more so that both Zoe and herself are getting a full night’s sleep.
We dropped the night feed after week 1!
Zoe is a changed baby, she was pretty happy prior to sleep training, but mum can’t believe the difference, even her friends and Zoe’s day care staff have noticed.
We are still working on her second nap at the moment, but considering it is the final sleep hurdle in a massive gentle sleep program, mum is happy and Zoe will have consolidated her big nap in a week or so, she is just trying to work out her equilibrium of sleep that she needs.