Something Kismet

There was something kismet about this client right from the very first phone call. I’ll admit I'm busy and I can't always answer my phone but something told me to pick up this call.

It was Jackie, at her wit’s end and in tears from pure exhaustion.

A SAHM with a toddler and a lockdown baby (Ruby’s now 10 months), Jackie was at breaking point.

Ruby was up 5-6 times overnight and neither Mum nor baby had managed a solid stretch of night-time sleep since she was born.

As we talked, Jackie shared Ruby’s rocky start in life and I found we had something important in common. 

Ruby had oral aversion from around 3 weeks old which was exasperated by hospital admissions, syringe feeding, force feeding medicines, and trying to bottle feed.

It took me back to my own baby’s experience with oral aversion. It’s so hard when you have a child who refuses to eat, and unless you’ve experienced it you can’t truly understand just how stressful and emotional it can be.

I knew I could help her and I was so glad I picked up her call. 

Not asking for much

Jackie wasn’t asking for much.

After 10 months of excessive night waking she just wanted better night sleep for Ruby and herself. She was hoping for fewer night wakes so they could both get longer stretches of sleep.

During Ruby’s time in the hospital Jackie was told to feed Ruby any time she could and so started an intense and exhausting feeding routine.

Ruby would only breastfeed when sleepy, in a dark room, just before sleep and Jackie still believed Ruby needed 3 solid meals, 5 breastfeeds a day, as well as every time she woke overnight. It left very little time during the day for Jackie to spend with her toddler.

Compounding this was Ruby’s oral aversion, which made her a very picky eater. A strong willed and determined baby, she would only feed herself – meaning Jackie was stuck making the same safe textured finger foods for every meal.

Nothing seemed to work

Jackie had been trying cry it out (CIO) with an independent sleep consultant with limited success. After three weeks Ruby was down to one night feed but was still waking five or six times in the night and crying for extended periods.

Things were so desperate Jackie had to turn off the baby monitor to try and get just a little sleep.

And who can blame her?

Ten months is a long time to have broken sleep! She was tired, emotional, and was racked with guilt.

I could see the problem right away. It was glaringly obvious to me. The previous sleep consultant hadn’t addressed the real issue's – Ruby’s feeding habits, and her feeding to sleep habits.

A simple plan

For very good reasons, Ruby was a picky eater and their routine had formed a strong feed to sleep association. The plan was simple.

• Focus on daytime calories – we didn’t want Ruby waking to feed as often overnight
• Get more iron in Ruby’s diet – iron is key to consolidated night sleep
• Break the feed to sleep association – no more breastfeeds right before naps or bedtime
• Continue with CIO – the other changes will support this method (Ruby was too resistant and stubborn for anything more gentle, so stubborn she would refuse to eat If mum tried to hard to convince to try new foods!)

Triggering changes

Understandably Jackie was reluctant to make changes to Ruby’s diet and feeding habits.

Jackie was worried that Ruby wouldn’t get enough calories and would backtrack on all the progress they’d made since her time in the hospital. She was terrified her baby would starve herself rather than try foods with new tastes and textures.

I understood Jackie’s concerns having been through an oral aversion with my own baby.

I reassured her that we’d offer Ruby safe textured foods and ensure her meals had plenty of carbohydrates, fats, and proteins to keep the hard won weight on.

But I explained it was key that we remove those feeds right before Ruby's naps to increase her interest in solids, and break that sleeping while feeding association, a double edged sword!

To help ease Jackie’s anxiety around reducing the frequency of breastfeeds I suggested she pump for any dropped day feeds to keep her milk supply up while we made these changes.

Progress in just three days!

Given Ruby’s history with feeding it was difficult for Jackie to trust in me to make these changes, but she was overjoyed to see progress in just three days.

Jackie couldn’t believe it when Ruby only woke once in the night and had to pinch herself to check she wasn’t dreaming when Ruby slept through the whole night for the first time.

Over two weeks of regular phone check-ins we saw amazing progress. Ruby didn’t lose any weight, was way happier trying more foods, consolidated to three feeds a day (solids and breastfeed) and one breastfeed overnight (sometimes none)!

Jackie was finally able to spend more time with her toddler and get some much needed sleep at night.

After getting to know Ruby’s story and addressing the underlying feeding issues, it took just a few simple changes to transform Ruby’s (and Jackie’s) sleep. 

I feel blessed that as a sleep consultant I had a lot more time to spend with Ruby and Jackie and finally get them some help after months of crying out for help and support from the medical system.

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