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Toddler sleep case study - Sonny

Posted by Karen Faulkner on
Toddler sleep case study - Sonny

Sonny was my hardest toddler sleep case in 2017

As a baby whisperer of 19 years that is not an accolade that I give away lightly. When I received the email and call about Sonny I went a little pale and wondered, 'Can I help this little boy and his family?'

Mum reached out tentatively, asking me if I'd travel to Jervis Bay, 3 hours South of Sydney, to help her. I like a challenge and love a good road trip combined with work, so why not.

Shannon asked, 'Hello, we are looking for in-home/overnight sleep training for our 2year old son. We are located in the Shoalhaven. Please advise whether you can assist us. Thank you'.

Email to Lisa

Shannon replied to my Office Angel, Lisa with more info.

'Thanks, Lisa, and what's the general procedure each night? We are extremely sleep deprived. Our son has slept through only twice in 2years. He wakes on average 4 to 5 times a night, on a bad night we've seen every half hour. He sees a sleep Paediatrician in Corrimal as well as another sleep Paed in St Leonards. He's undergone a sleep study which wasn't successful as he didn't sleep lol. He's been trialled on three different types of medications to no avail. The specialists ordered an MRI, lumbar puncture, blood work and urine sampling trying to find the problem as he also very delayed in his development. He just recently had his adenoids out to see if that would improve things. Sadly we're not making any progress. We have been to Tresillian and the Canberra equivalent, QEII, with no success. We also have difficulty with his behaviour and eating is a constant battle. During the day does Karen work with us on other issues? As you can tell we've been through a lot and I don't think we're in a position to implement sleep training strategies ourselves so we feel it needs the attention of a professional like Karen. Unfortunately,I feel that if I were left to handle it, I would cave in out of sheer exhaustion and guilt.

Shannon'.

Sonny had an MRI

I was basically the 'last chance saloon' before Sonny was put on seriously strong sedation. Chloral hydrate had been mentioned. The thought of this sent shivers through me. In my nurse training, I seem to remember seriously disturbed psychiatric patients being prescribed this sedation.

http://www.aboutkidshealth.ca/En/HealthAZ/Drugs/Pages/Chloral-Hydrate.aspx

It was a chance conversation with the MRI nurse that led them to me. Whoever this angel was, thank you on my behalf. She'd said something along the lines of, "If anyone can help your boy and family, it's Karen from Nurture Parenting'. 

Sleep training

Night one - 1st November

I arrived at 2 totally exhausted and emotionally drained parents, both were on medication for anxiety and depression. Dad sobbed. Now when you see a man cry it's so much more poignant and heart-rending. It had brought them both to their knees. Sonny was having six bottles of 200MLS of full cream milk every night. As a result, his bedlinen and sleep clothes had to be changed up to three times each night. Sonny had hardly any speech. The doctors were querying was he on the spectrum? I've had similar cases before but nothing quite as bad as this one. He was eating hardly any food, it was a 'baby birds' appetite. I call these children milkaholics because they are.

I explained to Shannon and Darren what we were going to do, what to expect and how the 3 nights would pan out.

Night one was understandably tough but I was ready. This is what happened.

Bed 7:40 pm 200 ml bottle milk & asleep 20 mins crying & standing in cot

Awake crying 10:10 pm, resettled and asleep 10:55 pm angry and pushed me away from the cot, banged his feet on end of cot, white noise turned down

01:43 cried out and re-settled

04:50 am awake & crying resettled himself within 3 minutes

05:09 wet ++ changed clothes, added a top (he was cold) and changed nappy resettled within 10 mins

05:45 am awake & crying, resettled quickly within 10 minutes

Woke at 07:15 am for the day

Night two

We took away all his milk feeds, including the bedtime one.

Bed 6:45 pm asleep within 60 mins - tried jumping out, he was very angry

Woke 10:30 pm resettled within 20 mins

Woke 1:30 am resettled 20 mins

Awake 05:30 am asleep 05:40 am put blanket on him as he was cold

Awake for the day at 6 am

Night three

Bed 6:30 pm asleep 7:00 pm, tried jumping out ++

Woke 8:40 pm resettled self

Woke 9:45 pm put Zippee dee sleeping bag on back to front and hooded top on top, v angry ??++ asleep 10:45 pm

Awake 12:05 am asleep 12:14 am

Awake 01:12 am asleep 02:15 am

Awake 04:30 am resettled self at 04:42 am awake 04:50 am resettled 05:40 am asleep ?

When you've got an angry toddler trying to jump out of a cot, a sleeping bag is a must. Mum didn't have one so luckily her friend had one (Zipadee Zip) that covered his hands as well as his feet. I was feeling a bit dubious about it but it was a diamond and stopped his wanting to jump out antics.

https://www.sleepingbaby.com

This is what happened over the next few weeks...it was nothing short of a miracle.

Diary of Sonny and his sleep

Thought I'd let you know that Sonny only took about 10 mins off fussing at nap time and slept 2 hours. He's eaten really really well today too! Massive brekky of avocado toast, half a banana and a fried egg, a yoghurt for morning tea, butter chicken and rice for lunch and about to try him on penne with homemade ragout with some hidden spinach. It's all go here in the food department lol

(me) Woo hoo Shannon ? that’s a big win! Go you!! Loving the menu, nom nom ?

Yeah sure is! Fingers crossed for tonight. Hoping I can get him to have some fruit salad and mascarpone too Yay!! Are there bananas in the fruit salad? ? I’ve updated Lisa on this afternoons nap ??? she’s most happy ? Rejected the fruit salad. Oh well. Last night same as previous. Two wakes. One at midnight and one at 5am. I wasn't able to get him back to sleep for the 5am one. After an hour he was still standing up in the cot despite falling asleep on his feet numerous times. Darren had to leave for work which meant I had to get him up and dressed for Daycare.

(me) Hello Shannon, That was a good night 5, 2 wakes are a big improvement and it’s not even a week yet. Yes I had a feeling fruit salad may not work! Too healthy. Go to my handout I sent via email. There’s a banana and chia delight with organic cacao and coconut milk. It’s like a chocolate mousse. A lot of babies love this recipe and it helps sleep ? Also French toast and pancakes are also a winner

Thanks Karen I've got everything for the banana and chia pudding except dates. Will omitting them affect it too much? I've got dried apricots? Or I've got figs? Put figs in Shannon Done? Fingers crossed ?? Received the books too! Thank you xx

(me) Looks good Shannon?

Bad start to the night. An hour and 20 minutes to get him down. I'm having trouble getting him to lie down. He was really irate and screamed continually. He fell asleep on his feet a few times. As soon as he'd lie down he'd be instantly angrier and straight back up again. Is there something I should be doing to have him lie down sooner and not get to the point of him falling asleep standing?

(me) This is a typical night 5 escalation night Shannon. Let him come down from standing. It’s his last standoff before he gives into you both Take your time and Sonny will lie down when he’s ready. This is incredibly normal. I’d have been surprised if night 5 wasn’t tricky The baby I’m helping tonight also refused to lay down!! ? it’s their determined nature

In the end I got out of the chair and sat on the floor right where he would normally lie his head. He still stood up as I don't think he'd realised I'd moved so I touched his leg and he laid down next to my hand Did I do the right thing? I tried to remove my hand as soon as he had stopped crying and he got up again So I did the same thing and this time only put my hand near him and slowly moved it away

(me) All ok and well done. Take your time and leave your hand there until he’s fully asleep.

Okay great Is it better for us to sit on the floor from the get go?

(me) No always start on the chair

Okay thanks How many escalation nights are there?

(me) Just this one - night 5 is usually it!! He’s testing you See this one through and you’ll be ok. Lol so he's delayed his night 5 by one day He must have forgotten and he's picking up on night 6 Aha never one to conform!! ?

Hi Karen really good night last night! Took only 20 mins to go down at 7. Woke at 12.30 but wasn't really crying, more whinging so we waited it out. He'd fall silent and then start back up again and we went in and found he'd pooed so had to get him out to change him. Put him back and he went back to sleep in about 15 mins. He then woke once more, can't remember the time, but put himself back to sleep without us going in! He then slept until 7:15am.

(me) Yay YAY!! ??????? that is awesome Shannon. Now you’ve seen that he can do this it will really help you both. I’m v happy for you ? Less than 10 mins of crying at bedtime tonight ?? Yay Winning ???????

Hi Karen, unfortunately, last nights good luck didn't continue. He woke at about 12.30 and settled within 30 mins but then woke repeatedly until about 2.30am so I gave him some Nurofen as I thought he might be in pain. He then screamed until 3.40am and only laid down when I put my hand in the cot. Bit of a setback but hopefully not something he'll continue with

(me) All ok Shannon, as I said there will be some up and downs until this gets sorted. Big problems don’t go away so quickly. You did well?

Hi again, so he was pretty upset at bedtime and carrying on quite a bit. As soon as Darren put a hand on the mattress and Sonny laid down straight away next to Darren's hand and was fast asleep. Is this bad?!? I'm worried he's developing a new sleep association

(me) The hand is ok, next week though it must go

Okay thanks

9th November

Hi again, so he was pretty upset at bedtime and carrying on quite a bit. As soon as Darren put a hand on the mattress and Sonny laid down straight away next to Darren's hand and was fast asleep. Is this bad?!? I'm worried he's developing a new sleep association The hand is ok, next week though it must go Okay thanks ?

(me) Hello Shannon, How are you guys going the past 2 nights and days? I’d love an update. Karen ??

Hi Karen, sorry for some reason I didn't get a notification of this text. Last night was quite hard. He had us up from 1 am until 3 am The previous night he woke twice. He's taking quite a bit of time to settle in the middle of the night wakes. He's also refusing nap time for us although apparently, daycare has no issue Would email be better to chat with you Shannon? That’s twice that’s happened now (they live in a rural area with variable phone and internet reception). This will take a month to improve Shannon. You’re doing really well and twice is better than 6 x. Take the wins. This will get better. How is the food going?

(me) The days he’s refusing naps are they resulting in more tricky nights? Days can take longer than nights to improve. He’s probably napping at daycare because there are other kids napping so it models behaviour. Hi sure my email is seagalea@gmail.com He's eating really well. Thrashing machine! Last night he ate a whole adult sized portion frozen lasagna lol

(me) Great Shannon ???

After the lasagna he had 5 slices of watermelon and a yoghurt squeezie lol

(me) Wow!! Who is this boy??!?

Lol I know! A few days ago he ate 3 bananas And they were huge Hi, thank you for sending Sonny the Shapeeze kit. He really likes it ? Only one wake last night ?

(me) YAY Shannon #winning ??? that makes me v happy for you guys. I’m v happy he likes the Shapeeze kit they’re so good. I’ll update Lisa on last nights win ?? well done you two ? so v proud of you for sticking at it ? xx ?

He takes a bit to go back down but I think he's got some molars coming in as he's sticking his fingers in his mouth and drooling so when he does wake and after 30 mins and he's still not down I've been giving him Nurofen and a by more Melatonin and putting some SM33 on his gums and after that he's been going down within 10 mins

(me) He’s the right age for his molars, yes I agree. It might be worth giving him nurofen as soon as he wakes?

Yes, that's what we're doing now in the hope that it will kick in within 15 mins and he'll be back down within 20 mins and so far so good. He slept from 7.30 pm to 4 am last night!!

(me) YAY Shannon, much better. This is a huge improvement. You guys are getting some v good sleep finally 

Hi Karen, so we're leaving tomorrow morning for our 10 day holiday. Bit nervous about rocking the boat with Sonny's sleep. Any words of wisdom? He'll, of course, be in a foreign environment and not his own cot and we'll be staying at 3 different places

(me) Let’s chat on my way to my overnight visit. I think a pep talk on the phone will help

Hi Karen sorry I missed your call. I'll text you in the morning and we'll speak then. Thanks Shannon

(me) All ok Shannon ? I’m free to chat for the next 15 minutes Shannon. I’m in a meeting from 9 am

Hi Karen, how does 6 pm work for you?

(me) Perfect Shannon ?

Hi Karen are you free now? Got him down in 10 mins Karen ?

(me) Winning YAY ???? How was last night Shannon?

22nd November

Hi Karen, a bit odd really. He started out fine and first wake was about 11.30 and he was more whinging standing up and then started throwing up. After that went back to sleep pretty quickly but kept waking and vomiting Very strange I assumed he had gastro but he's fine today. He's refused his day nap today though

(me) Is it teeth? His back teeth could be coming through??

Would that make him vomit? He wasn't too upset But he did feel warm

(me) Yes it can The increased stomach acid causes it

Ill admit I was a bit naughty and ended up putting him in bed with me after a while as I'd given him Nurofen and didn't want him crying and vomiting it up. That was at 3.30 am until 6 am

(me) All ok Shannon

I've been trying to get him to nap all day as we've got a family dinner to go to tonight Is it worth trying for a nap still? Even a catnap?

(me) I wouldn’t Shannon. Without a good meal in him it will be v tricky

Okay no worries so just play it by ear tonight and leave early if he's showing he's too tired? We weren't expecting to be home until 8.30 and he's been up since 6 am. We're in the car He's just fallen asleep. Is that okay?

(me) You can’t stop him Shannon, give him at least 40 minutes

Ok cool thanks 

25th November and a family holiday to Melbourne

(me) Hello Shannon, How is your holiday going? I hope all is good and you’re having a lovely time away ? how is Sonny going with his sleep? Is he on track?

Hi Karen, things have been a bit hectic. The wedding we're attending is tonight and as of last night I've contacted gastro so I was up all night vomiting. Thankfully a doctor came and has given me stematil injection. Funny thing is Sonny slept in a portacot in a hotel room with us last night and he SLEPT THROUGH! Well, just about anyway. He slept from 8.30pm to 5.30am

(me) Poor you that is awful Shannon. Hope you’re feeling better v soon. Well done on Sonny and the sleep through though! YAY!!

Hi Karen, he slept through on the night of the wedding too and last night as well. He's going to bed a bit late, 9ish though but so far really good! Woohoo!! 

(me) I’m at Dr Oliveira’s talk, she’s a lovely lady. Very interesting talk. Is it ok if I introduce myself to her and mention Sonny? I’m not going to go into any detail obviously.

Of course ? She knows Sonny well. She'd be really interested to know how he's doing. I keep meaning to email her

(me) I spoke to her last night Shannon and she is so happy for you guys. I had a good chat with her. Are you back in Jervis Bay or still holidaying?

Still in Melb. Going home tomorrow. Last night was difficult. He was hard to put down and then woke a lot. At about 12.30 he was pretty hysterical. Darren's Dad ended up taking him and singing to him. I think he was really hot as it's pretty hot here and the holiday house we're staying in didn't have air conditioning in the bedrooms. We've cheated a bit since being here but hopefully we'll get back to it when we're home. So far though he doesn't seem to be changed by it

(me) Probably overtired Shannon. When they’re overtired they wake a lot. Once you get back go back to an earlier bedtime I think that will help a lot

Okay cool thanks 

(me) And yes you can get back to this Shannon. He’s proved he can sleep through so that will help spur you on 

1st December and big changes

For sure ? Omg Karen tonight he didn't cry when I put him in the cot!!!! He's been in such a good mood today. So happy and sweet and eating like a thrashing machine. He had fish and chips for dinner and then before bed had a heap of frackers with hummus. I read his goodnight moon book as usual and then put him in the cot and he didn't cry, just yawned rolled over and went to sleep. We've gotten rid of the sleep sack as it's been so hot lately (especially when we were in Melb) and I've let him take two toy cars to bed. ??? He slept 10.5 hrs straight last night Woohoo 

(me) you’re winning Shannon and it makes me not just happy but quietly ecstatic for you guys 

Went to bed without crying again. Two nights of no tears. Loving it ? Another sleep through 

(me) Hello Shannon, How are you going with Sonny? Where are things up to? Karen ?

Hi Karen, he's doing really well! He slept through last night and has slept through on most other nights as well. He's talking so much more. He's pretty miserable in the mornings though but this morning we ignored him when he woke at 5am and he must have gone back to sleep because we woke at 7.20 and couldn't hear him. We went in at 7.30 and he was quietly sitting playing in his cot. Completely different temperament all morning. No crying and really happy. Loves his croissants for brekky lol Still sleeping like a champ Wakes max once a night

(me) What a change in 6 weeks Shannon ? loving his appetite for croissants ? nom nom ? lucky boy ? How are you guys going? You must be feeling so much better. Is it ok if I write a blog about your story, Shannon? I can change names if you like? And I’ll run it by you before I post? Sleep ???for Christmas ? is everything ?????? Yes that'd be great ? No need to change names ? We're feeling so much better. Sleep is an amazing thing. Thank you for everything It’s a pleasure Shannon, you were my top case of the year and what a way to celebrate ? and end the year ❤️ Happy Christmas Shannon, Darren & Sonny ??????I hope you’re having an awesome ? Christmas ? Xx

Hi Karen, Merry Christmas to you and family as well, from two very grateful parents xxx

(me) Gorgeous photo Shannon. Happy New Year Karen (I slept through last night) Love, Sonny Happy New Year Shannon and what a great way to end 2017 and start 2018, a Sonny who sleeps through the night. YAY! Tell Sonny I’m very proud of him as I am of you guys Xx

Best happy ever sleep story in quite a long time.

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