Sunderland boss Simon Grayson was left frustrated after seeing his defensive options reduced in the run-up to Saturday’s 1-1 draw with QPR.
Tyias Browning, Lamine Kone and Marc Wilson all missed out, with Kone suffering from a sickness bug.
The absence of the central defensive trio meant Grayson had to partner Billy Jones with John O’Shea at the heart of Sunderland’s defence.
Grayson said: “When I’m looking at the start of the week, I knew (Lewis) Grabban wasn’t going to be far away, I knew (Duncan) Watmore was going to play on Tuesday and be available, and I knew the international lads would be back and in good nick.
“(Callum) McManaman had a week’s training, so I was really confident because I knew we had the attacking prowess that could go and win us a game.
“Then on Tuesday, Tyias pulled a muscle and overnight Lamine gets ill. That doesn’t help you along the way.
“It’s small steps. It’s not going to happen overnight, but we’ve made a small progression and hopefully these small steps will lead to bigger ones.
“It was sickness and diarrhoea with Lamine. It’s something we’ve had within the group. We thought we’d cleared it all, but his kids have come home from school or nursery and decided they’re going to give it to their dad.”
Wilson, who has missed games with a groin injury, is expected back in training in midweek.