Baby Won't Sleep


My son is 4.5 months old and having some major sleep issues. I'm going to try and summarize but would love some ideas on what I can try.

Since he was born he's had sleep issue on and off but mostly normal baby stuff. He slept well in a swaddle early on, then started rolling in the swaddle so I transitioned him to the Baby Merlin's Magic Sleepsuit. We had to do some sleep training (cry it out) in the sleepsuit, but after that he was sleeping about 7:30pm-7:30am with a dream feed at 10:15, and 3-4 hours napping during the day.

On Wednesday, October 9 I stopped the dream feed cold turkey (and started offering him more during the day). For 2 nights he slept very well, though woke earlier than normal (6 and 6:45am).

The issues started on the 3rd night, Friday, October 11 (he was 4 months old October 3). He woke in the early morning screaming and was up for 2 hours. We went in to soothe him after an hour of crying since this was so abnormal. He was so distressed that he started rolling over in the sleepsuit and we decided he could no longer sleep in it. That night we decided to transition him to pajamas and a sleepsack. Every night since then there has been some problem. Some nights he will take an hour to fall asleep, some nights he will wake at 3:30am and cry for 2 hours. On Friday night he woke at 3:30 and would not go back to sleep until after I finally fed him at 7am. I tried feeding him a few of the nights but didn't want to offer a full feeding so it did not help.

I breastfeed him the first feeding of the day, then he gets bottles of pumped breastmilk the rest of the day and a bottle of formula at bedtime. He has 5 total feedings per day. the last few days he has had over 23 oz. just from the bottle plus about 15 minutes breastfeeding.

The possible culprits I've considered:
4 month sleep regression
transition out of swaddle
rolling (he rolls onto his tummy and it's as if he's forgotten he can roll back. most nights he ends up sleeping on his tummy. Whenever I go to him I generally do NOT put him back on his back)
too hot/too cold
he has had a cold for the past 2 days
schedule is off (but this one is hard to pin down - his schedule was good but since he's been sleeping so poorly I think he's tired
feeding related/growth spurt
reflux (he may have had mild reflux and was taking Zantac but stopped a few weeks ago)
other digestive issue (I switched him to formula at bedtime a few weeks ago and it may not be sitting well.)

Any feedback or ideas will be appreciated. Thanks!

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