Sleeping FAQ: 9-12 months – Night Waking

9-month-old Megan’s reflux wakes her at 4am every night without fail

Hi! I am desperate for a full night’s sleep. We have 2 girls – Ella, 21 months and Megan, 9 months. Ella has pretty much always slept through (except when there is a full moon!)

Megan is a different story. At seven months she was diagnosed with reflux (prior to this, the doctor and health visitor ignored it – then we insisted on seeing a specialist privately). Symptoms were: a very strong cough, sick a lot, slow to take a bottle, can’t eat lumpy food (only very puréed).

She wakes up EVERY night at 4am screaming and rigid. We have tried cranial osteopathy, homeopathy, more protein, protein before bed, carbs before bed…

To fill you in on Megan: she currently weighs 20lbs.

Feeding times are: 4 am bottle, 8am breakfast, 11am bottle, 12.30 lunch, 3pm bottle, 4:30 tea, 7pm bottle. Bottles are all 8oz and she doesn’t always take it all. She takes about 15 minutes to finish a full bottle. She is on SMA Gold (tried SMA staydown before she was prescribed Gaviscon), teat size 4 (Avent).

Solids – all she can eat is puréed food (she has a very strong cough from the reflux so anything lumpy she coughs and rejects). Breakfast – Weetabix mixed with lots of milk and fruit purée. Lunch and tea are puréed versions of whatever her sister has (pasta, fishfingers soup etc). Waking time – I put her to bed every 2 hours. At nursery she has much less sleep (about 1 hour a day). At home for 4 days a week she has a 2 hour sleep in the morning then one after lunch and then a nap at about 5pm. She settles herself to sleep and her bedtime routine is bath at 6:30pm and bed by 7pm. She always wakes at night between 4-4:30am. She wakes up screaming, arching her back and is inconsolable until we give her a bottle then goes straight back to sleep in her cot. We have tried everything from leaving her to scream to rocking her. She is rigid and now we can only assume that, as it is almost the same time every morning, that it is just when her stomach is empty acid comes up.

Please help! We have had about a week’s full night’s sleep since she has been born. She is the most gorgeous happy little thing apart from at 4am and the odd day here and there when the reflux is bad through the day.

Thank you!

Caroline

You have our every sympathy over Megan’s reflux. Have you discussed with the specialist you saw about this early morning problem? Sometimes a slight change in medication can help, especially as she was diagnosed two months ago.

Megan appears to have her longest sleep in the morning, especially when at home. By moving the two hour nap to lunchtime she may not need her sleep at 5pm and settle still by 7pm. She is possibly being woken by her reflux at 4am as she is in a much lighter sleep. By moving her longest sleep to midday she will be more rested for the afternoon, but not too overtired by bedtime. Many babies in the second half of the first year start to cut back on their daytime sleep. Helping them to cut back at the right times will prevent them from becoming overtired as they get more physical.

Try cutting back on her morning sleep by 10 minutes every few days until she is sleeping about 30-40mins. When she goes down at 1pm she should settle for a good 2 hours and then wake really refreshed for the afternoon. If she can then make it through to 7pm happily you may find her early morning waking will improve. As long as she settles to sleep happily at bedtime and you don’t feel she is exhausted then I would try to cut out her 5pm nap.

As Megan gets older, hopefully her reflux symptoms will begin to subside and she will be able to cope better with her swallowing. This will help her to accept larger portions of food at a time and begin to cut back on her milk intake. If possible, I would make another appointment with the specialist to discuss her growing needs.