How can I get my eight-week-old daughter to take bigger feeds in the day?
I have two problems. I have been following the routine for five weeks, and while I have needed to adapt it slightly to suit my daughter, she is still feeding very little and only manages short naps during the day. She settles at 7pm, and although she needs to cry herself to sleep, she is down until I wake her for her 10:30pm feed. Lately she has been waking much earlier for her middle of the night feed and will only take 1oz. I don’t want to drop this feed as she only grazes through the day. The maximum she takes is 19/20oz on a good day. As a result, I struggle to do anything in the day, as she is so unsettled; she will only nap in her bouncy chair, and even then for no more than 45 minutes. Please can you help? Any advice would be welcome.
At present she feeds at 7.30am 2-4oz, 10.30am 2-3oz, 2.45pm 3oz, 5pm 2oz, 6.20pm 2oz, 10.45pm 4oz and 3am 2oz. She weighs 4.64 kg (10.3lbs). She naps at 8.45-9.30am, 11.30am-12.30pm, 1.30-2pm and 4.30-5pm. She settles at 7pm.
The small amount of formula that your daughter is taking at each feed is probably the reason she is unable to settle well to sleep. Getting her more used to being in her cot for daytime naps will help, but this will take time and persistence on your part.
To help increase her overall milk intake, try to split some of the feeds, offer her top-ups and give her mini breaks half way through. Also, allow her to wake fully at 7am before offering her the bottle. Let her have 2oz and then give her a break of 20 minutes. You could use this time to change her or let her have a kick on the floor. Then offer her the bottle again and see if she will take another 2oz. Once the feed is over, encourage her to have some more time kicking, or let her watch you from her bouncy cradle while you eat breakfast. By 8.30am she will probably be tired. Babies of this young age can often only stay awake for 1-1.5 hrs before becoming tired and needing to sleep. By keeping them up too long, they can become overtired and fight sleep, which means they are unable to settle properly or sleep for any length of time. Take her to her room at 8.30am and check her nappy. Draw the curtains and blinds and, if you are still half swaddling her, then prepare her for her nap. In the darkened room hold her close to you, but with no eye contact, and try not to sway, pat or shush her. She may fuss and squirm a bit. Some mothers use a dummy at this stage to help their baby calm itself, but if you do this it is best removed before sleep to prevent any associations forming. You will feel her becoming relaxed and heavy in your arms. This can take between 10 and 20 minutes, so be patient. It may help if you do some deep breathing, in the same way as you were taught in preparation for birth. This will help you to relax, which your baby will also sense. Once you feel she is really relaxed (you may notice her eyes heavy with sleep) lay her down in her cot and tuck her in securely. Use a sheet lengthways across her body and secure it on both sides with rolled towels. Give her 10 minutes to settle on her own in the same way as you do at 7pm.
For a question and answer about settling a baby, look at p86 in the Contented Little Baby Book. You may need to teach her how to fall asleep alone, and this can involve some short periods of crying. Providing you check on her every 5-10 minutes, and use the same method for settling her at other naps, she should learn how to put herself to sleep fairly quickly.
At 10.30am you could split the feed into two halves and offer her 2-3oz at 10.30am followed by another 2oz at 11.15am. Giving her this feed in two stages will help increase her intake and also make it more likely that she will settle for a longer nap at 11.30/45am. Again, settle her in a dark room in the same way. The feed she has at 2.30pm can stay in place and also the split feed at 5/6pm. You could try to encourage her to take nearer 3oz at both these times to help increase her intake.
Rather than leaving her until 10.45pm, wake her at 10pm and offer her at least half of the usual amount she drinks. Make sure she is well awake before beginning this feed. Then allow her some time awake, perhaps kicking quietly on the floor. By 11/11.15pm she will be getting tired, so change her and offer a fresh feed of 2-3oz. Give this in her room with the lights dimmed so she will settle back to sleep soon. This approach should help her to take a bigger feed at this time.
Until her intake increases during the day, you must keep the middle of the night feed, even if it is small. If she is able to settle with 1-2oz and is willing to wake and feed at 7am, she still needs it. Once she shows signs of not being so interested in her 7am feed, you will know that the time has come to cut back. Do this very slowly, gradually decreasing the amount offered, so she continues to increase her daytime feeds. See p149 in the CLB book, which explains more about how and when to drop the nighttime feed.
It can be hard work to get a reluctant feeder to take enough milk for their needs. You may need to experiment with a faster flowing teat to make sure she is not becoming tired sucking on one that is too slow for her. This small adjustment can make a difference to how well a baby feeds.
Keep working on the settling techniques, and encourage her to take as much milk as she is able by offering it to her little and more often.