Starting a feeding schedule

C

CherA

Registered User
My baby is 6 weeks old and he's been exclusively breastfed. So far I've been feeding on demand so the pattern can be very irregular (sometimes 3 hrs in between feeds and sometimes it can be as frequent as just 1 hour in between) I'd like to start develop a more regular feeding schedule for him but don't know how to do it. People around me suggest I should strictly follow 2.5 - 3 hrs in between feeds and if so I need to wake him up if he oversleeps and starve him even he wants to be fed earlier than that. My boy cries so fierce if he doesn't get his milk when he wants it, while he doesn't open his mouth if I intentionally wake him up in his sleep. Any advice on this?

Do babies automatically lengthens the break in between feeds? And how should I train him to sleep longer during night time?
 
Some babies are much easier than others to fit into a schedule and some can manage schedules much earlier than others. If your baby is very upset when you try to change his feeding patterns he may not yet be ready for the change.

Babies between birth and three months old usually feed between 8 and 12 times in 24 hours. We deliberately phase it this way and not every 2 to 3 hours because babies are usually not regular. Part of the day they will feed regularly, part of the day they sleep a little longer and part of the day they make up for the feeds they have missed while asleep.

Often you find that they will be quite regular in the morning, have lots of cluster feeds in the late afternoon and evening and sleep a little longer at night. Remember that a baby that sleeps for a five hour block is consisted medically to have slept though the night.

Last night I attended a lecture about breastfeeding given by Prof. Peter Hartmann. (This man is a great hero in breastfeeding research and over the last ten years has helped us more fully understand how the breast works.) In his lecture he told us about a recent study of breastfeeding patterns amongst Australian mothers and babies.

All the babies were between 1 month and 6 months old. The majority of the babies (64%) woke up between 1 and 3 times to feed during the night. The number of night time feeds didn?t change between 4 weeks and 26 weeks. Only 36% of the babies didn?t feed at night. Your baby?s current feeding patterns are very normal and nothing to worry about.

Have you managed to breastfeed lying down yet? Mothers often find this the best way to feel more rested. If not, I suggest trying in the middle of day in the middle of a double bed (so you won?t worry about the baby falling off the bed). If you have difficulties please contact me and I?d be happy to help.

Best wishes,
SARAH
2548-7636 or [email protected]
 
Thanks Sarah! After reading your message I realize that my boy has actually been very cooperative. Like you said, he is usually regular during day time (2.5 - 3 hrs) and gets a little more fussy at night (after 8 or 9pm) before his last feed at 12am or 1am. During this 'fussy' time of the day he's usually awake and needs more frequent feed (feed every 1 hour or so) and cries if he doesn't get it. Some people advised me to express milk and feed him with bottle at the final feed. This is to ensure he is full enough to sleep through the night (like you said, sleep for 5 hours). But the difficult thing is I cannot quite tell which feed is the 'last feed' and therefore don't know the right amount and time to feed. Sometimes at 12 I thought he will fall asleep right after feed, but in fact he may stay awake till 1 or 2am, so obviously 12am is not his last feed of that day.... I hope you get what I mean.

I actually contacted Margarita from LLL last week. She also advised me to breastfeed lying down during night time, to let baby get used to this 'night feed posture'. I have been trying and it does make me feel more rested on the spine. But I find it difficult to latch on as baby moves a lot and I cannot ensure he's sucking deep enough instead of just the nipple.

In what ways should I gradually put baby on a more predictable schedule rather than feeding him according to his demand?
 
Before you establish a routine think about what sort of person you are. Do you really like routines or is it just that being a new mother is a little overwhelming? Think about the sort of lifestyle you enjoyed before you had children.

• Did you like to do that same things round about the same time everyday? Are you happy to always get up at 7:00 am, having lunch at 12:30 pm, have a tea break at 4:00 pm and dinner at 7:30 pm every day?

• Or are you actually happier with flexibility and spontaneity in your life? Maybe you do always have dinner at the same time – anytime between 6:00 pm and 9:00 pm?

This difference is important because if you were a scheduled person before children you’ll find having your children on a routine helpful. If, however, you were a person who tends to like things loose and open to change you may find a routine confining. The main problem I find is that one parent likes routines more than the other and conflict can result!

Things that can help to establish a routine are:

• Work towards a bedtime routine. About an hour before bedtime calm the baby down. Don’t stimulate him. Try a bath, softly singing or music and a massage,. (My grandmother told me to always change the baby into nightclothes.)

• Many books will suggest, “Feed him, then cuddle and put him down. The baby should be awake when placed in the cot so that he can learn to put himself to sleep.” This may be true but it takes away one of the best joys of breastfeeding – your baby falling asleep at your breast. Also it is healthier for your baby to do lots of sucking and to fall asleep sucking. Babies need more sucking to develop than they can get by drinking milk alone.

• As soon as your baby is able to look at pictures establish the routine of a book before bedtime.

• When feeding at night use only a soft light. Don’t have a radio or television on. Be brisk and business like with the feeds, avoiding stimulating the baby.

• Only change night time nappies if very wet or dirty

• Try to take the baby out after one of her sleeps at least once a day.

• Set aside play and stimulation time each day.

• Tell your baby what you are doing. They quickly learn what “let’s change your nappy” or “bath time!” means.

• Give baby a bath at the same time each day.

Remember that as your baby grows he will manage to fit in with your family circumstances. If you are very routined person you will build in routine without thinking too much about it. If you are a very flexible person the baby will learn to be flexible too. And if you’re in the middle liking some things fixed and others flexible your baby will get used to that too.

Best wishes,
SARAH
 
Breastfeeding lying down

When breastfeeding lying down the same points for a good latch are needed as when sitting up:

Mother is lying on her side facing the baby


  • The baby’s body should be straight and his front should be touching the mother.
  • The baby’s neck should be flexed back so that his chin is coming towards the breast first.
  • Line up the baby’s nose with your nipple.
  • When the baby opens his mouth wide gentle pull him towards you holding at the top of his back between the shoulders.
  • Once the baby is latched on you should be able to see that his chin is deep into your breast and the baby’s nose is away from your breast.
  • Often it is possible to see the areola at the top of the baby’s mouth near his nose.
  • The latch should feel comfortable for the mother.

The most common problems with the latch are:


  • Baby’s body not close enough to the mother’s body
  • Baby’s mouth in line with the nipple when he started to latch – this causes the baby to get more of the breast into his mouth at the top than at the bottom.

Hope this helps,
SARAH
 
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Hi Sarah, thank you very much for the information. Very helpful indeed. Regarding the breastfeeding position, one very frequent difficulty I come across is that my baby keeps moving his body. He struggles a lot and moves his head a lot making me so difficult to position him for a proper latch on. Whenever I tried to pull his head towards my breast, he struggles and shakes his head and ends up he won't be able to suck deep enough into the aerola part. Is this a common problem at all?

Regarding the issue of feeding routine, I am a rather scheduled person. I do things at more or less the same time every day. Of course I enjoy the flexibility and sudden call from baby for feed. The thing is I don't stick with baby all the time. If his feeding pattern is more regular I can plan ahead what time of the day I can be away for couple hours, AND if I want to take him out with me I can estimate when I need to find a good place to feed him before he cries too fiercely (HK is not a very breastfeeding friendly place) Also, in two months' time I will get back to work so wondering if I should start the training earlier. I'll try your advice to try establishing a routine. Thanks again!
 
Dear CherA,

It is really very difficult to explain positioning without being able to see the baby at the breast. I find it hard on the telephone but it is nearly impossible on a forum like this. If you would like to meet face-to-face so that I can actually see your baby feed please contact me on 2548-7636.

You mention, “Whenever I tried to pull his head towards my breast, he struggles and shakes his head and ends up he won't be able to suck deep enough into the aerola part.”

Are you holding your baby’s head? I’ve found that breastfeeding is much smoother if you hold your baby at the top of the back, below the neck and in between the shoulders. This allows the baby’s head to tilt backwards (the best position for feeding). Often mothers hold the baby’s head and this can cause problems. The first is that by holding the head stops the head from tilting backwards and makes the baby come straight to the breast instead of with its chin first. The second is that there is a reflex on the baby’s head which makes the baby pull backwards against the hand if you hold the back of the baby’s head. (If you don’t follow what I’m trying to explain here I recommend a face-to-face consultation – we have a meeting in Happy Valley tomorrow. Details at http://www.lllhk.org/Meetings.html)

Your baby is only six weeks old. It is a little young to be expecting the two of you to have a routine that you are happy with yet. You return to work in another two months. Your baby will go through many changes before this happens. (Even if you were on a brilliant routine now there is no way it would be the same in another two months.)

Think about what your baby was like at one week, then at three weeks and now at six weeks. I bet there have been changes. These changes will continue. And remember a baby who is three and a half months old is easier to look after than a baby who is only six weeks old. Try not to worry too much about the future and to enjoy your baby more at the moment.

We will organize some more tea breaks in the New Year. Try to come along to one of them – it will give you more confidence to breastfeeding in public when you are doing it with lots of other breastfeeding mothers.

Best wishes,
SARAH
 
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Hi Sarah, regarding the breastfeeding position, I actually hold the back of the neck and his upper back to latch on. It's only that baby always tries to face up. It seems to me he doesn't feel comfortable with it. However, I've tried your advice to line up baby's nose with my nipple. That helps! I'll practise more on that.

Missed the LLL meeting yesterday. Will definitely keep track on the meeting schedule and try to join the meetings and tea breaks next time.

As for the feeding schedule, as you said, baby is still young. I'm back to demand feeding again but try to get him sleep longer overnight.

Thank you again for your advice!!
 
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