Do I have PPD/PPA or am I sleep deprived?

[seal87]

@iwantchristmore28 This sounds like the 4 month sleep regression that is hanging on due to sleep associations. Is he being fed to sleep or does he go into his crib sleepy but awake and he settles to sleep without feeding. It sounds like he is using feeding to connect his sleep cycles, which is actually pretty normal for a 4 month regression. But it might be the reason he's waking so frequently.

Your daycare should be telling you exactly how much he has eaten and how long he has napped every day. At this point, you can try and get more in him if he didn't eat much at daycare and put him down to sleep early, if he took crap naps. Wake windows at 5 months are about 2.5 hrs max, and he should probably still be doing 3 naps a day. If he wakes from his 3rd nap at 5 pm, his bedtime (bathed, fed, in crib, lights out) should be 7:30. You can try to do a dream feed at 10 pm if you are concerned he's waking at night out of hunger.

If, after all that - daycare ups his feeds, his naps at daycare are ok, he eats a lot when you get home. you do a dream feed - he still is waking frequently at night, then feel free to do some gentle sleep training.

 

[wifeandmom]

@iwantchristmore28 Had a terrible sleeper and PPA/PPOCD. I did one week of Ativan at night to reset my sleep around 5 or 6 months postpartum. It is gentle/mild enough that you can wake up and do a feeding (unlike ambien), but quiets your brain enough to let you go back to sleep. After that week, I started Prozac and was good to go after. Son is now 2 years old and I am off all meds.

2 other things that helped:

1) no access to my phone if he woke up for less than 20 min. That phone light is badddd for getting back to sleep.
2) going to bed when he did and sleeping as many shorter stretches as possible. I never saw my husband and never ate more than a snack for dinner for 4 months, but it helped get more rest than if I waited to sleep until later.

Daycare and reverse feeding/cycling at home is real. Good luck!

 

[chrismissionarytrue]

@iwantchristmore28 I am also an attorney with a toddler and a four month old. I’ve had the same problem with not being able to sleep and these two things have helped:

1) Loop earplugs. They are super comfortable for sleeping (I has tried using my AirPods with noise cancellation but they hurt my ears). They are lifesavers for falling asleep when there is noise and staying asleep when it’s my husband’s turn to get baby.

2) I keep a notepad next to my bed. When I can’t fall asleep because my mind is racing, I make my to-do list/ write down any thoughts about work or what I have to do tomorrow. My mind loves to write full emails in the middle of the night. So I write down on paper or on the notes app what I am thinking about.

Good luck!

 

[iwantchristmore28]

I wanted to provide an update after my doctor’s appointment today. We are trying an extremely low dose Ambien for nights I’m not on baby duty and a low dose Xanax for nights I am on baby duty. If getting more sleep (which is the goal with this combo) doesn’t help me feel better, we will talk about SSRI’s at my October annual appointment.

 

[tdehaan22]

@iwantchristmore28 I added a tiny bit of cereal to my son's bottle at night when he was 4 months old.

He slept from 8:30pm until 6:30am. Once I started solids at 6 months he always slept through the night even when teething.

The only time he didn't sleep through the night was if he had a runny nose.

 

[relentlesswoman]

@iwantchristmore28 This is exactly how ppd was for me. It was more like anxious thoughts, because even if my partner had the baby I could not get the sleep I needed. It only took abput 2 days because it made me sleepy and once I got the sleep I was better. Was on it 3 months.

 

[iwantchristmore28]

@relentlesswoman What were you prescribed if you don't mind me asking?

 

[relentlesswoman]

@iwantchristmore28 Sertraline (zoloft)

 

[dee5674]

@iwantchristmore28 Zoloft helped me a lot the first few months postpartum. Also - CBD gummies let me sleep. If I don’t take them, I’m up in the middle of the night and unable to get back to sleep for hours (I’ve been that way ever since my first, who’s now 3). I was taking unisom which was making me super groggy. With the gummies I can sleep and actually wake up refreshed.

 

[poustinia]

@iwantchristmore28 Echoing what other people have said - baby's sleep changes in the 4-5 month range. We did Dr Ferber sleep training around 19 or 20 weeks and it was a game changer for us. Continue to encourage the daycare to ensure he is eating enough during the day and I would recommend Dr Ferber. This would be a great weekend to do it with the holiday on Monday.

I went back to work at 4 months and I was wondering how on earth I was going to make it but the sleep training got her back to sleeping for long stretches and helping me feel more rested.

 

[losted]

@iwantchristmore28 This happened to me when my first baby was around 4 months. Didn’t go to the dr until 6ish months, wish I had gone sooner. I was rx’d Trazadone and it worked starting night two. I was still able to wake up and feed my baby safely, but able to fall back asleep and not anxiety spiral about how little sleep I was getting or my to do list. Safe for breastfeeding and pregnancy. I did taper off easily when I was about halfway through pregnancy with my second.

 

[radish]

@iwantchristmore28 So I only mention this because you said you notice daycare is not pushing the amount of ounces you’d like during the day - while normally a great sleeper, if my 10 month old does not get the ounces in that he needs during the day at daycare, I know I’m in for at least one wake-up the night, likely around 2:30 am (his bedtime is 6:30 pm - 7:00 pm ish). What I’ll do to try to string together that sleep better for him is offer a dream feed before I go to bed around 10:30 pm. Literally pick him up, immediately offer the bottle before he’s awake, he eats the entire thing while he’s asleep, replace the bottle nipple with a pacifier and place him back down. He rolls over and goes back to sleep and that’ll often buy me an uninterrupted rest of the night. I know that won’t work for all, but I thought it was magic when we first started doing it so just wanted to mention Incase you’re not already. Maybe you could go to bed a little earlier and husband could try the dream feed? At least for a bit so you can catch up and feel human a few days in a row.

But, sleep regressions are always a possibility too of course. For us we know the difference between lack of calories during the day and regression because he’ll go straight back to sleep after he eats.

I’m about to have my second baby right after my first turns one (I know ) and I feel like I’m just starting the sleep deprivation over again, but I promise there came a point when he slept through, and you will sleep again. It’s so hard while you’re in it though, sending you all the good sleep vibes.

 

[arkofthecovenant]

@iwantchristmore28 Solidarity!! I love all the comments you’ve gotten and highly recommend professional feedback. You & your doctor know you & your baseline best.

To me, it reads like sleep deprivation and that the “insomnia” triggers anxiety (which may or may not benefit from medication). This is a chapter that is AWFUL with sleep, 4 month “regression, overnight feeds, and too young to “sleep train.” Highly recommend resources from Taking Cara Babies for sleep hygiene help. We used most of techniques, except we breastfed to sleep (until kiddo stopped latching) and it worked for us.

I suffered through working on way less sleep than usual and felt like a zombie…anytime I could get the full stretch of 6 hours at once, I’d feel like a new human. I think you need a reset - sleep somewhere else for a night if budgets allow, take a day off, get some family or a night nurse to stay at home with baby, use ear plugs & white noise & blackout curtains, whatever you need for a fresh, full night to reset your brain. That would be my priority first, before adding any medication - I think most good providers will want to know how you feel again after a full night’s sleep.

Hang in there!! It does get better, my kiddo is 3 and I regularly sleep 8 hours again!

 

[grace4nan]

@iwantchristmore28 So your baby's sleep is par for the course. Very normal. You could sleep train and that should help. Your baby will wake up less, and therefore you will wake up less. If you sleep train it will be very hard to continue sleeping in the babies room.

Alternatively, can you afford a night nurse ? Someone who will do the overnight feedings for you so that you can just sleep?

 

[itsgo0d]

@iwantchristmore28 Just want to throw out there that sleep deprivation can absolutely cause depression and anxiety, and I can’t speak to whether or not meds will help if the sleep issues are the main cause, but perhaps they’ll help with the racing thoughts. I am so sorry about the sleep regression! My son was bad from 6-8mo and 10-12. I was so tired I was in pain. It was a major contributing factor to my decision to go down to part time before baby 2.

My PPA started when my daughter was 10 weeks and I began having panic attacks after her tongue tie release didn’t work and I was having severe anxiety about her eating. I wouldn’t be able to go back to sleep after she woke up at about 2-3am to eat.

A few notes about Zoloft (if that is your only choice if you’re BF—otherwise maybe consider lexapro) in that insomnia is a very common side effect and lasted for me for about a week. I also have had bad GI symptoms with Zoloft, and that is common. I absolutely noticed it making me more flat as well—like yes my racing thoughts and sleep issues stopped but I also felt like I didn’t really feel “joy” anymore. I am now doing 25mg every other day, which is very low, and it’s better! Best of luck!

 

[diane44]

@iwantchristmore28 I had PPA. It got really bad at about 5 months. My daughter wasn’t a good sleeper and I was getting more and more exhausted. After two more months of barely getting through the days and sleeping less and less, I had a night where I couldn’t sleep at all. My husband took me to the ER and I got on Ativan for 6 weeks, then I transitioned to Zoloft and Trazodone for a year. I didn’t love being on meds but they worked. I was still breastfeeding so I timed the medication after the last evening feeding. My daughter is fine and I am fine. Roughest time of my life. I never had any scary thoughts or behaviors, just the total inability to sleep.

 

[jzeetv]

@iwantchristmore28 Watch for intrusive thoughts and feelings of gloom and doom and loss of interest in life. I had insomnia in the mornings and could never sleep past 5 am even if my baby was still asleep. I knew something was wrong when my thoughts went to super dark places, not just the normal laundry list of tasks that needed to get done, but scary things that alarmed me.

 

[skyblue77]

@iwantchristmore28 My son slept really well from 3-4 months. Then suddenly at 5 months he started sleeping so terribly. I’m talking down for bed at 8pm, then he’s wake up around 11pm right when my husband and I were getting ready for bed. Had to rock him to sleep. Then he woke up every 2 hours and sometimes it took forever to get him back down. This lasted until he was freaking 9 MONTHS. It was so awful. He’s a great sleeper now, but I feel like I’m still recovering from that.

All this to say, it’s temporary. It absolutely sucks, but it won’t last forever. Get rest when you can and make sure you and your husband are supporting each other. Personally I can’t survive off of less than 7 hours of solid sleep. Like I get sick with continued lack of sleep and I get pretty severe anxiety and depression as a result. But I wouldn’t medicate that. Sleep is the best remedy.

 

[velasquezethan60]

@iwantchristmore28 I had a very similar experience - and I think it was because he wasn't getting enough food at daycare he was trying to compensate for it by feeding at night. He dropped from 90th percentile in weight to 35th in a month at the daycare we were both sick for 2-3 weeks of that). I kept telling them to feed more often but they would give him only about 2-4 oz / feed, at best. They were just annoyed he was taking so long to drink his milk. Hired a nanny instead and things have been a lot better. Having a nanny comes with its own set of cons, but overall in this regard it has been helpful and less work for me since I didn't have to prep his bottles every day. Sleep deprivation caused a lot of issues consequently, so highly recommend taking care of that as soon as possible.

 

[madoc55]

@iwantchristmore28 I had PPA and PPOCD with auditory hallucinations brought on by sleep deprivation - our son had reflux so didn’t sleep for more than 2 hours at a time until 4 months, then he woke every 3 hours, by 7 months 2x a night slept through around 9 months… in the end I count myself extremely lucky, but like you, even as his sleep improved, mine didn’t because I couldn’t fall back asleep after feeds at all. What ultimately worked for me was alternating nights (I pumped and used donormelk) with my husband, and zolpidem. Part of my treatment for the PPA/OCD was taking a zolpidem on my night “off”. I didn’t want to do it but it really helped me in the end. By 4 months their brains change such that they can do 5-6 hour stretches and they run off of body fat at night (sounds like you are getting those) but if you can’t fall back asleep, well, it doesn’t matter if they sleep like a champ. Another thing you can try is a structural dream feed - for example a big bottle at bedtime (170-250ml) then 150-170ml at 23.00 or whenever you go to bed. Some people even push the dream feed to midnight and themselves sleep between girls example 21-24, then dream feed. In any case, if you have the spoons I’d explore the zolpidem with your doctor, and alternate nights. If you can afford a night nanny that can also be a wonder and help you build up your own capacity to sleep again. Then you could get say 3-4 nights off a week and build up from there. Best wishes to you, sleep is such a tough and important struggle!