Feeding FAQ: 4-6 months – Breast Feeding

Can a low-weight 18 week baby’s sleep be helped by feeding?

We had our first baby, Evie, 18 weeks ago and generally she has settled into your routines, which we have been following since day one. She has always been small and has regularly gained only 4oz each week; she had 2 weeks where she gained 7oz and 1 week where she lost 1oz. Her birth weight was 7lb 1oz and she now weighs 12lb 1oz. I am breast-feeding, but my partner gives her formula at 10.30pm and again when she wakes in the night, around 5am (we introduced formula at 14 weeks). We do, however, have a few concerns. Firstly, she struggles between 4pm and 5pm, as she will not nap unless she is in the car. She is tired and fractious, and seems to want to sleep, but should we try to enforce a nap and, if so, how? Secondly, would you expect Evie to wake in the night because of her weight? As a result of her not yet going through the night, we don’t feel we can move forward on the split feed before her bath, cutting out the 10.30pm feed or starting her on solids.

Evie was a good weight at birth, but she has not been gaining the 6-8oz a week that is expected during the first few months. I believe that she is still waking in the night because she is genuinely hungry. I suspect that this is also the reason why she is not settling for the late afternoon nap. To avoid her getting so irritable late afternoon, I would suggest that you bring the 5pm feed forward to 4.30pm so that she can have a short nap at that time. You may find that bringing this feed forward has a knock-on effect and she becomes hungrier at 10pm; this is not a bad thing, because a bigger feed then may make her less likely to wake up hungry at 5am. You do not say if she is sleeping well at lunchtime; if not, I would suggest that you bring the 11am feed forward to 10.30am and give her a top-up breast-feed just before her lunchtime nap.

I would stick with a split feed at 4.30/5pm and 6.15pm until she is sleeping through the night regularly to nearer 7am. This could take a few weeks yet, as her weight is low for her age. The recommended age for introducing solids is now six months, although many health officials are saying that it is fine to wean a baby between four and six months if they are showing signs of needing to be weaned. Evie is not showing any of the signs and I would not advise that you wean her yet. I would, however, suggest that you try to increase the amount of milk she is drinking during the day, so that she may no longer need to wake up for a feed at 5am. Another way of increasing her milk intake is to wake her at 10pm for the feed and then keep her awake slightly longer in order to give her a top-up at around 11/11.15pm. This, of course, would mean that she is having three split feeds a day, but if it helps her to sleep longer in the night and improves her weight gain, I think it would be worth trying for a couple of weeks.