I meet all these mums and as long as that mum is happy and her baby is gaining weight I don't feel the need to intervene. Believe me, if it's not a problem for you then it's not a problem for me either!
However, should you decide it is a problem and the wheels have well and truly fallen off, then I will do everything in my power to help you get a great night's sleep.
Small babies and premature babies
These babies need very regular feeds as they have very little body fat. Regular breast feeds are important to keep body temperature and blood sugar stable, as well as getting the baby to grow and develop. I remember 16 years ago in the UK a mum showing me Gina Ford's Contented Little Baby book. And a routine to get her 2-week old 2.5KG newborn sleeping through. I nearly had a pink fit, as we say in England. Needless to sa,y I told her no way was this safe. Until 3KG is reached, 3 hourly feeds are the go. After 3 KG it's OK to feed 4 hourly and that includes overnight.
Can you have a routine with a new baby?I’m not a fan of strict routine as I think it’s important to get to know your baby. And what their natural feeding and sleep-wake cycle is like. If we start putting our need for routine on a young baby I think we can really affect that rhythm. This then impacts on feeding. It takes a few weeks before breastfeeding becomes established. So to make a baby have a routine is not helpful for good and responsive milk supply and production.
Once babies start to gain weight, feeding is established and supply is good then you can look at a pattern of behaviour. That is most likely around 2-3 weeks of age but it is different for every individual mum and baby. You cannot do baby sleep learning if the baby doesn’t have enough milk or if the baby has reflux or colic. It’s important to manage the underlying issue and return to sleep learning oncethe baby is ready and well. Effective breastfeeding, and I mean good long nutritive breastfeeds. and also adequate amounts of infant formula, if bottle-feeding, are really crucial in managing sleep. If your baby is hungry and doesn’t have a full tummy then they are not going to sleep.
It’s important to note that in this age group I’m looking at sleep promotion – this is most definitely not sleep training. It’s Baby Sleep Learning.
What do I mean by baby sleep learning?Helping your baby learn to self settle before four months of age with no sleep crutches will lead to sleeping through naturally. Here's a loink to see my last blog on that pesky four month sleep regression to avoid baby sleep coming undone.
Maintaining breast milk supplyNight feeds help increase breast milk production. Prolactin, the feeding hormone in the pituitary gland increases in the early hours so night feeds are very important, certainly up until 3-6 months old. It's also important to express at night if you need to increase your milk supply. It's incredibly normal for a baby to need a couple of night feeds and as long as they're having good rest in between, even another 1-2 feeds is still considered very normal. Babies aren't small forever and it's important to go with your baby rather than try and force a routine on them. You might also be interested in a blog I have on 10 foods that increase your breastmilk supply
How can you get baby to sleep longer at night?There are many urban myths around sleep and I’m going to break a few of them here. Have you heard the one that says, ’Never wake a sleeping baby’? This is by far my most favourite one to break! OK, so what does it actually mean? I’d never wake a baby in the middle of the night to feed. I’d certainly demand feed at night especially if they’re over 3kg and thriving and breast-feeding is well established.
However, in the day time that’s a rule that needs a bit of breaking. If you allow your baby to sleep long periods i.e. for 4-6 hours at a time then your baby is not getting their quota of feeds in daylight hours. Then what happens is your baby has to make up for the lack of feeds and will wake frequently all night. Yes, babies that are breastfed do need night feeds but not 2 hourly. It is possible to reset their clock by feeding frequently in the day. A newborn that is breastfed I’d recommend around 2-4 hourly feeding and a formula fed baby 3-4 hourly feeding. I’d also expose them to daylight when awake, to reset their body clock/circadian rhythm and provide a darkened room for sleep, both day and night.
The more a baby feeds in the day, the better they will sleep at night. So, if you only feed 3-4 times in the day and let them sleep for 4-5 hours at a time then it makes sense that they will most probably be awake all night and wanting to make up on their feeds at night time.
Getting days and nights mixed upAfter 3-4 months old some babies may only feed 5 times a day and ‘sleep through’. Babies sometimes cry when they are re-settling. If we intervene then we may be upsetting their natural rhythm. We sometimes pre-empt feeding by just letting the baby make a few smacking of the lips noises and then we reach over, pick them out of the crib and feed them. This is especially likely to happen at night. We may do this because we don’t want them to cry and wake our other halves.
What we are doing by doing this is resetting and interrupting. This creates a new rhythm and it is not their rhythm. When we do this what happens is a baby who is out of sync, and then the baby will feed more often and before we know it they are feeding every 2 hours! Disaster.
Know that it is very normal for your baby to have their days and nights mixed up. Once baby has reached six weeks, feeding is well established and your baby is thriving and gaining weight, it’s OK to gently change this pattern. If it goes on past a week and looks like it’s more than just a growth spurt or wonder week then it’s OK to try the following. Wake baby after around 2 hours of daytime napping to encourage a rhythm to your day and regular feeding. This is not forcing a routine on your baby. It is moulding behaviour to establish a positive day pattern.
I've been interviewed by Essential Baby on this topic and you can read up on my more detailed strategies at this Facebook link to Essential Baby: When babies confuse night and day