Feeding FAQ: 0-8 weeks – Breast Feeding

How can I get my 3.5-week-old into the routines as well as caring for my twins?

I have been trying to get my baby son of 3.5 weeks into the 2/4 week routine. The problems I am having are as follows:
1) We can follow the routine during the day and then problems start at night.
2) He has a brother and sister both age 2 and a half. It is very difficult to try and fit both routines in.
1) Feeding and routines: My son is exclusively breast fed. He is gaining plenty of weight, so I don’t think there are any problems with supply. For the past two days I have finished his first feed by 7.30am, I have kept him awake until 8.45am and then tried to settle him. He has then stayed awake until 10.30am and has cried for feeding, on the first day and on the second day he did fall asleep at 9.00am and slept for 1 hour. I fed as per the routine and settled him at 11.30am. He then woke at 1.00pm and wanted more milk. He was unsettled then for the rest of the 2 hour period. He fed again at 2.00pm and then stayed awake until 4.00pm We went for a walk and he slept for 1 hour. He fed at 5.20pm and then at 6.30pm and he was asleep at 7.20pm. I thought things were going okay until he woke at 9.00pm and he would not settle until he had a feed. I gave him only one breast. He settled back to sleep again. I planned to push the 10.30pm feed to 11.30pm but he woke at 10.30pm, wanting get more. He finally settled at 11.45pm. He then woke every 2 hours and wanted milk. I have followed all of the advice as given in your book. I am offering both breasts, and he has at least 20 minutes on the first, and more often enough 15-20 minutes on the second, at every feed.
2) My son has a brother and sister who are both 2 and a half. From 6 weeks old I had modified the CLB routine slightly in order to accommodate twins and breast feeding, but both followed it well, and the routine has been maintained through out. How do I fit in the CLB routine with the twins. Please can you give me some advice as I am already exhausted, my husband is going back to work tomorrow and I do not know how I am going to cope with the twins and trying to get my son in the routine.
The daily progress chart I have given is for a typical day. My son feeds 6.30am 20 minutes one side, 7.15am 4 ozs expressed milk, 10.30am 25 minutes one side then fell asleep, 12.30pm full feed, 2.30pm full feed, 5.20pm 25 minutes one side, 6.30pm 20 minutes second side, 9pm 20 minutes one side, 10.30pm 15 minutes one side, 25 minutes second side, 1.30am 20 minutes, 3.30am 15 minutes.
He naps 9-10am, 10.30-11am, 11.45-12am, 1.30-2.30pm, 4-5pm, 7-9pm, 9.30-10.30pm, 11.45-1.30am, 2-3.30am, 4-6.30am.
His birth weight was 8.13lb and he now weighs 10lbs.

Although your son is gaining weight well it would appear that he is not taking a full feed each time, especially in the later part of the day. This could be due to your supply being lower at this time. As you are also caring for the twins in the day you will be tired by 5/6pm.
It would be a good idea to top your son up with a couple of ozs of expressed milk after you have fed him at 6.30pm to ensure that he settles to sleep until at least 10pm, allowing you to rest and eat a good evening meal. Some mother’s find it easier to replace this second part of the split feed entirely with a bottle of expressed milk especially when trying to cope with other children at this busy time of day. Trying to balance the needs of your new son along with his brother and sister, who will also need you at bedtime, will not be easy. At this time of day they will need you to spend time with them, so giving an expressed milk feed may make this easier for everyone.

Hunger is usually the cause of a baby of this age being unable to settle to sleep or waking after a shorter sleep than you feel is needed at the time.

If possible express at the first feed of the day, at the 10am feed and before the 10pm feed to help with your supply. Again, the 10pm feed could be an expressed feed, perhaps enabling you to go to bed early and letting your husband give it. This will help your son take in a good feed and so begin to sleep until nearer 2/2.30am.

Another reason for his rather frequent feeds could be his latch is not quite right. This would mean he will not take in a full feed and your supply will not be getting the message of how much milk to make for the next feed. If possible have your latch checked by a breast-feeding specialist to make sure your son does fully empty the breast each time, thus encouraging your supply. Some babies of this age can take 30-35 minutes to fully empty the first side and so getting all the hind milk which should help him settle for slightly longer between feeds.

Dealing with three small children is not easy and you will only have short times in the day when you can rest. Make sure you eat and drink well to help with your supply. As the twins are in a good routine your priority is to try to stretch out your son’s feeding times throughout the day.

Have a look at Gina’s routine and the routine written for mothers especially on the website. This shows how to cope with a toddler and a baby. Obviously with twins you will need to adapt this a little, but have seemed to managed this before. Keeping yourself as well rested as possible is very important. Try to use the time when your older children are resting/sleeping in the day to have a rest yourself, rather than rushing around the house. Giving a feed or two of expressed milk during the later part of the day will also help all of you. Being very organized and planning ahead will also help you in the everyday details of life. Plan meals for a few days in advance, prepare nightclothes and bath things just before feeding at 2pm when the twins are having a quiet time and make sure you have a drink and a healthy snack around 5pm to give you energy to get through the busy time of tea, bath and bed.