Feeding FAQ: 0-8 weeks – Breast Feeding

My 4-week-old only manages to go three hours between feeds in the night

My 4-week-old baby is really struggling to last longer than 3 hours between feeds at night time. He seems to be able to cope during the day, but at night he barely lasts 3 hours. He feeds very well and is gaining weight at the appropriate rate. He is currently on the CLB 4-6 week schedule and is consuming up to 720 ml a day.

I should add that he was born at 37.4 weeks: can this be the cause for him not being able to last longer between feeds?

Also, the CLB book provides guidelines on quantity of feeds only for up to 4 weeks. How do I work out the quantities required for my baby going forward? Please keep in mind that baby is big boned and has been consuming more milk on average per day than what is stipulated for his weight.
At present he takes 5am 150mls, 9am 120mls, 12.45pm 120mls, 4.00pm 90mls, 5.45pm 90mls, 9.30pm 150mls, 1am 90 ml.

By day he sleeps 5.30am- 8.30am, 10.30-12.30pm, 2.30pm- 4pm and settles at 6pm until 9.30pm.

Being born slightly early could be a factor in your son not going longer than 3 hrs at night. Also his routine in the day may also be contributing to this as well. The routine that your son is on assumes that a baby’s day begins at 7am. Many babies of your son’s age will still be needing two feeds in the night: i.e. 2am and 5/6am. To help him go a longer stretch in the night he will need to be woken at 7/7.30am to start his day. As your son is taking a full feed at 5am, he will need a small top up of probably about 60-90 ml at 7/7.30am followed by a time awake helping him to get to 10.30am for his next full feed.

By structuring his day in this way you will be able to put his daytime naps into place so he has about an hour between 9-10am, a longer lunchtime nap between 11.30/12-2.30pm and a shorter afternoon nap from about 4.15-5pm. This will help you set the split feed at 5/6 pm with his bath and he will be settled by 7pm. The knock on effect of having a slightly larger feed at 5/6 pm will be he will ready to feed again at 10/10.30pm rather than the earlier 9.30pm.

Making sure he is really awake at 10pm; keeping him up for over an hour at this time can help a baby sleep nearer to 3am. Splitting the feed can help. Wake him at 10pm and give him about 120mls. Then let him have a quiet kick in a light room before changing him and offering a fresh bottle at 11.15pm of about 60mls. Give this to him in a darkened room so he will settle back to sleep.

To calculate how much milk your son needs: allow 70ml (2.5oz) for each 500gr (lb) of body weight. A baby with your son’s weight of 3.90kgs will need about 650mls (22ozs) during the day. This number is then divided by the number of feeds he receives in 24 hrs. This is a guide only and some babies will need slightly more at some feeds, taking in slightly more overall, as your son is doing. Providing he is gaining about 6-8oz(200-300g) a week then the amount he takes in will be right for him.

Once you are aware how much he needs in 24 hrs, then make the 7am and 10.30am feeds larger than the 2.30pm. While he continues to have a split feed at 5/6 pm, the overall amount of this may be 10-20 ml larger than the others given in the day. If the 10pm feed is split then that also is slightly larger. The smallest feed should be the one given in the middle of the night, which should not need to be more than 120mls. Once you feel that he no longer needs so much in the night or he begins to be disinterested in having a good feed at 7am then very, very gradually begin to cut this back. See the comment about this on p149 of CLB.

The quantities given in the book on p 63 of Contented Little Baby Book are an example of how some feeds in the day are larger than others. It also shows that as the daytime feeds increase, especially those at 7am, 10.30am and 10pm, the night feed begins to decrease. Every baby is different and you need to adjust accordingly.