Feeding FAQ: 0-8 weeks – Formula Feeding

My 7 week old needs a full feed at 5am; this makes it hard to keep on track

My 7 week son is following the routines well and now sleeping at night through till about 5-5.30am. He is not satisfied with only a small feed at this time and will not resettle without a full feed. He sometimes will not go back to sleep even then (he is definitely not fooled by water). This makes it difficult to keep on track for the next sleep and feed – although I’m trying hard. His room is fully blacked out. The 10.30pm feed is sometimes difficult and he often refuses to take more than 4oz.
We are using Colief for severe colic that kicked in at 4 weeks – despite the routines (tried Infacol, gripe water etc to no effect). He is much better on this, although still difficult to wind.
He weighs 10lbs 7ozs. He feeds at 5am 5ozs, 7.30am 2ozs, 10.45am 5-6 ozs, 2.30pm 5ozs, 6.15pm 5-6ozs, 10.30pm 4-5ozs.
He naps in the day at 9-9.45am, 12-2.15pm, 4.30-5pm and is settled by 7pm.

It is not unusual for a baby of this age to begin to get through the night in this way. When he wakes at 5am you must treat the feed as a night feed. Feed by a very low light, keep eye contact to the minimum and only change your son if it is really needed. As soon as he is winded settle him in his cot again. As he gets bigger he should be able to get on further until the 5am and 7.30am feed become joined into one around 7am. This may take another week or so. There will come a point if he begins to stir around 6/6.30am when you could try water and a cuddle and see if you can get him to wait until nearer 7am.
Being awake and taking a good feed at 10.30pm will help towards getting to nearer 7am. With a baby this young you may need to begin to wake him around 9.45pm in order for him to take a good feed and be awake for a length of time. It sometimes helps to split this feed.

Begin to wake your son at 9.45pm and once he is wide awake offer him 3ozs of feed. Then let him have a break of about 30-45 minutes. During this time you can let him have a quiet kick in a reasonably bright room, but just be careful not to over-stimulate him. At 11.15pm change him and offer a second fresh bottle of 3ozs. Give this to him in his room with the lights dimmed and then settle him for the night. This should help him have a slightly larger feed and the longer awake time may help him to push on in the night.

Feeding FAQ: 0-8 weeks – Formula Feeding

My 2.5-week-old daughter does not settle after her 10.30pm feed

My daughter has settled well into the routine as detailed in the Contented Little Baby Book. However at day 10 she started developing problems after the 10.30-11.30pm feed. She takes the feed well (currently 3-4oz) and is awake when put into her cot and swaddled. She then cries intensely for 1-2 hours, wailing as if she has a severe pain. If I go in to her and lift her she stops crying, but once laid down into her cot the intense crying starts again. I have winded her and given her Infacol. Eventually she settles herself or may cry through to the next feed as happened on one occasion.
She does cry down at the morning and afternoon nap times but settles very quickly. The crying after the 10.30-11.30pm feed is far more intense than this.
Could you suggest what might be wrong and what I might try to help her settle more quickly after 11.30pm? I have looked at the sections on Colic and Reflux but the symptoms are different as she feeds well and gets wind up.
She is quite a sleepy baby but feeds well at every feed.
Her ‘poo’ is also concerning as it is runny with white bits in it (sorry!). I did wonder if she might have an upset stomach.
She is fed at 7am 4ozs, 10.30am 4ozs, 2pm 3ozs, 5pm 3ozs, 6.30pm 2ozs, 10.30pm 4ozs, 2.30/3.30am 3ozs. She weighs 8.11lbs.
She naps at 8.30-10am, 11.30-2pm and 3.30- 5pm. She settles at 7pm.

A baby who is as small as yours should not be left to cry for a long length of time. There may be a couple of reasons why your daughter is upset at this time. The first is hunger and the second is not being tired. To help her settle better at this time try splitting the feed in the same way as you do at 5/6.30pm. This will help her overall intake and a period of being awake as well should help her to settle better for the next part of the night. All babies under the age of 4 months do need a spell of being awake between the hours of 7pm and 7am. As your daughter is quite a sleepy baby in the day letting her have a further spell awake in the late evening should help the problem.
To help her take a bigger feed, wake her at 10pm. This may take a time as some small babies can take up to 20mins to wake fully. You may need to begin at 9.45pm by putting on the lights and undoing her swaddle. Let her come round naturally and then bring her down to a well-lit room where there is some background noise such as the TV or radio. Once she is fully awake offer her 3ozs and then wind her and give her a break. During this time let her have some kicking time under her mat. You do not want to stimulate her too much but you do need to keep her awake until 11.15pm. If she is sleepy let her have a kick on her change mat, with no nappy on during the time you change her. At 11.15pm take her back to her room and lower the lights. Offer her a fresh bottle of milk containing another 3ozs. As she probably first fed about an hour ago it is safer to make up two separate bottles for this feed so eliminating the risk of stale milk lying in the teat. Swaddle her before feeding so you are able to settle her down as soon as she has winded.
A formula-fed baby may not have so many stools a day as a breast-fed one and on the whole they are slightly more solid, but still are fairly soft in their consistency. If you are concerned about the contents of her nappy take her to your doctor’s, preferably with a fresh specimen for him to examine.

Feeding FAQ: 0-8 weeks – Formula Feeding

Do we wake my 4 week daughter for the 10.30pm feed?

I am trying desperately to get my daughter into your routines. She is pretty good and we usually manage for her to have roughly the right amount of sleep during the day.

Feeds are a bit hit and miss, the times are fine but how much she will take at each feed varies. At nighttime, we give her a split feed around 5-7pm and then settle her at 7pm in her cot. She will sometimes wake up on her own around 10-10.30pm but sometimes she will sleep on until 11 or even later. Should we be waking her up at 1030 if she does not wake on her own? Surely if she feeds at 10.30pm rather than 11pm then she will wake earlier in the night?

She usually sleeps from 11pm-2am and then wakes for a feed, then wakes again around 5am for another feed. She demands a lot of food in the night (last night at 2am she had 5oz – any less than this and I cannot settle her). She doesn’t feed very well at 11pm although we have tried keeping her up for longer and changing her etc to try and keep her awake. She is quite difficult to settle after the 5am feed and then does not feed well at 7am.
She feeds at 7am 3oz, 10am 4oz, 2pm 4oz, 5pm 2oz, 6.15pm 3oz, 11pm 3oz, 2am 4oz, 5.45am 2.5oz. She weighs 7lbs 10ozs.
She naps at 9-10am, 11.30-2pm, and 4-5pm.

The reason that a baby is woken around 10.30pm is to encourage the longest stretch of sleep to fall in the middle of the night. If you were to let her sleep on at this time she may wake at midnight and then again at 5am. Unless you are prepared to stay awake until midnight you will be up twice in the night. At present, you are still having to feed at 2am and 5am/6am which is totally normal for a baby of this age and weight. She will continue to want a full feed in the middle of the night for several weeks more, but should begin to stretch out the time of it to later as she gets bigger.

If you begin to cut back on the middle of the night feed too soon you will not get her sleeping on until nearer 7am which is the aim. See page 155 of The Contented Little Baby Book.

To sleep a longer stretch in the middle of the night your daughter needs to be awake long enough to feed well at 10pm/10.30pm. Many babies can be sleepy at this feed. The best way to deal with this is to wake them earlier, before they have fallen into a deep sleep. This usually happens after 10pm if they are asleep by 7pm.

It can take a while to wake a sleeping baby, so start early. Go into her room at 9.45pm and switch on the lights, undo her swaddling and remove any covers on her. Busy yourself in the room and go across to her from time to time. As she starts to stir, encourage her by stroking her forearms and talking to her in a normal, not hushed, voice.

Look at page 86 of The Contented Little Baby Book for a question and answer about using the split feed at this time. There is also a description of it on page 138 of the same book.

Your daughter does not take a very big feed at 5am so hunger could be the cause of her not settling well. This feed can be a full one and then the baby settled back to sleep until 7.30am when they receive a smaller top-up feed to get them through to 10am. A lot of babies seem to prefer to do this in the early weeks. Treat the 5am/6am feed as a night time one, keeping eye contact to the minimum, the lights low and only changing her if it is absolutely necessary.

Use the routines as a guide to work towards. Your baby may be happier on an earlier routine and not ready to move on to the one for her age until another week or so. This often happens and, as long as your baby seems content when awake and is settling easily and sleeping well, then follow the timings which seem to suit her needs best.

Feeding FAQ: 0-8 weeks – Formula Feeding

How can I manage to bath my 7 week twin girls at 5.45pm and stay with in the routine times?

I am generally happy and successfully applying and following the routine. I do, however, have a big problem with the bathing time at 6pm. I simply don’t manage to bath both girls in the given time frame. This might well be due to me being a new mum and handling twins being very stressful. At first, the twins really enjoyed their bath but the more I am trying to manage the tasks, on my own, within the time frames given in the book, the more stressed I get as I find it impossible to do so. It seems as though the twins are picking up on my stress and enjoy their bath less and less.

I got so frustrated that I skipped the bath today only to realise that it was impossible to keep the girls awake after their 5pm feed and they were not hungry for the 6:30pm feed.

I was now wondering if it is possible to only bath one twin a day and take it in turns or can I adjust the times – and if so, how? Is there any advice on how to achieve the task better (e.g. can I use the same bath water for both twins to save time or e.g. is there a particular easy to use bath / bathing method I could use?)

My twins feed at 7am 100mls, 10.15am 130mls, 2pm 95mls, 5.15pm 100mls, 6.30pm 60mls, 10.15pm 100mls, 2.30pm 100mls.

They nap at 8.30-10am, 11.30-2pm and 4-5pm. They settle at 6.45pm.

Bathing newborn twins alone can be a daunting task. There is no reason why you cannot bath each one every other night until you feel that you can manage both of them together. If you want to bath both girls on the same night then, if you are staggering their feeding times, so one is 15 minutes ahead of the other, you may like to bath them one after the other.

In order that they are not so tired and more able to take their bedtime feed begin the 5pm feed slightly earlier. Wake one twin around 4.45pm and give her 80-90mls. Let her sit in her baby chair or play under the gym whilst you feed the other twin the same amount. Aim to be in the bathroom by 5.40pm at the latest. If you want to bath both girls, have baby chair in the bathroom and possibly a dummy. You may not like the idea of using a dummy but, when coping alone with small twins, it can be useful to use a dummy to help you remain unstressed at certain times of the day.

Prepare the bathroom whilst they are having their lunchtime or afternoon nap. Lay out two sets of night clothes, nappies, plenty of towels, two dummies, any creams used and two baby flannels. You may like to have a changing mat in this room as well. Make sure that the bathroom is warm enough for them to feel comfortable when undressed. With twins you may find it easier to use the main bath and have two of the towelling type bath chairs available. These provide support for the babies and, although you cannot let go of them completely, you will be able to have one hand free to wash each baby.

Warm their bedtime feed and place the bottles in an insulated bag so the girls will not have to wait for their feeds to be warmed once they are dressed. Before starting bath time take the bag, and any bibs or muslins used, to their nursery or the room where you feed them.

Undress the girls and allow them to have a free kicking time with no nappy on whilst you run the bath. The twin who fed first at 5pm needs to be bathed first. Let the other twin continue kicking if she is happy to do so. If the second twin becomes fractious then you can use the dummy to help her wait her turn. At this age having a bath does not take long so your first daughter will only be in the water 5-10minutes.

If the girls seem apprehensive of the water make sure it is warm enough for them. Using the towelling chairs enables you to have a deeper bath which will be more comfortable for the babies than a shallow one. Use one of the baby flannels soaked in the bath water to lay across the baby’s tummy. This can help her feel more secure. Once she is finished in the bath take her out and wrap her up in a warm, dry towel. Put on her nappy and then let her lie and kick whilst her sister has her bath. Providing neither twin has any kind of infection, or skin condition which could be contagious, there is no reason why they cannot be bathed in the same water. If your bathroom is well heated, and you have plenty of warm dry towels to hand, the twin who was first bathed should be fairly happy to have a short kick. If she is distressed, use the dummy to calm her as you bath her sister. Once the second twin is bathed take her out and dry her. Getting two babies dressed can be difficult if they are now ready for their milk and bedtime. Use a dummy when you need to and leave any clearing up of the bathroom until you have settled them for the night. Dress them both and take them to the room where you feed them. If the twin who was fed second at 5pm is able to wait for her feed you may still be able to keep the staggered feeding going and settle the first twin in her cot before feeding the second. If they are both tired then feed them together. As the 5pm/6pm feed is in reality one feed split into two the second half may be smaller than usual. Providing they settle well at 6.45pm and sleep until woken for their 10pm feed then they are taking in enough milk for their needs.

If you decide to bathe the twins on alternate nights then still begin to feed them around 4.45pm and follow on with the above sequence. The twin who is not having a bath may still enjoy some free kicking time with no nappy on whilst her sister is bathed. You can then dress them both after the bath has finished and follow on with the feeding as before. Again, having a dummy with you can help if one of the babies becomes fractious.

As the twins grow bath time should be less of an ordeal for you all. Being organized and starting in plenty of time should help you feel more confident and enable the girls begin to enjoy this time of day more.

Feeding FAQ: 0-8 weeks – Breast Feeding

Should I change to first-stage formula when weaning my 8 week old?

I tried to breastfeed but contracted mastitis twice which involved hospital stays in the first three weeks after Anna’s birth. Since then I have successfully been expressing milk and feeding her, but now need to wean her onto formula. I am aiming to get Anna formula fed by three months.
I bought Anna formula for hungrier babies as I assumed her frequent feeding was due to a large appetite. I have since read on the website that expressed breast milk contains less hind milk and therefore babies drink more of it. I am now concerned that as I begin to introduce more formula- one bottle extra per week, that this may be the wrong kind. Is her digestive system up to “hungrier baby” formula or should I get first stage-formula instead? At present she is having one feed of SMA White every few days if she needs more than I can produce.
At present Anna has 7 feeds a day at 06.00,09.00,11.30,14.00,18.00,22.30, 03.30 of about 5ozs of expressed breast milk giving her a daily intake of 34oz. She weighs 12 lbs.
Also will she need to start drinking cooled boiled water as the formula feeds increase. If so, when and how much?

As Anna will be totally formula fed in a few weeks it is probably better to wean her onto the first stage milk. Both this and the one for “hungrier” babies contain whey and casein. The proportions though are different. A first stage milk will contain more whey which is closer in its resemblance to breast milk, whereas the ones marketed for “hungrier” babies contain more casein. It is supposed to take longer for a baby to digest but that is not always the case.
Some mothers use both types, preferring to use the formula for hungrier babies at 10.30pm in the hope it will help their baby to sleep for longer in the night. For all other feeds they use the first stage formula.
Sometimes in the early days of moving from breast milk to all formula your baby may become constipated, as their digestive system gets used to the slightly different consistency. Giving her boiled water between feeds should help this.
Bottle fed babies can become thirsty so make up a 4oz bottle of boiled water along with her feeds for the day. Many babies won’t accept water unless it is at room temperature or even slightly warmed. As the bottle contains no milk you may leave it out of the fridge.
Offer water to Anna at least once a day. A good time is mid-afternoon. Beware of offering her water too near to a feed time as it could take away her appetite. She probably will only take half an ounce to an ounce unless the weather is very hot. But keep trying every day as it is important that she gets used to having water, especially when totally formula fed. If she really won’t accept it try the waters marketed especially for babies which have a very slight flavour such as peach added to them.

Feeding FAQ: 0-8 weeks – Breast Feeding

Express milk from day one?

My first baby is due soon and I’m looking forward to using your routines. Should I begin expressing milk from day one?

Expressing milk serves two purposes: it provides extra milk for when your baby goes through growth spurts at three weeks and six weeks. During the growth spurts you simply express less milk, automatically ensuring there is extra for your baby. Secondly, following my plan on p.52 of The New Contented Little Baby Book will tell you when to express in order to increase your milk supply, should it run low.

After the birth you should follow the advice of your midwife and health visitor regarding feeding. But I personally recommend that a baby should be fed three hourly at least during the early days if excessive night-time waking is to be avoided. These times are three hours from the beginning of the feed to the beginning of the next feed. If you find that your baby needs feeding long before the three hours, he may need to be offered both breasts at each feed. I also advise that if a baby is hungry long before the times I recommend it is common sense to feed him, but also advisable to get to the root of the problem as to why he is not taking a full feed at the times recommended on the routines.

To determine whether you have a low milk supply you should look at how much your weight your baby is putting on each week, and whether he is happy and content most of the time. If your baby is over one month and low milk supply is already a problem then the plan for increasing your milk supply should see a big improvement within six days. For babies under one month, if you follow the expressing times laid out in the routine, it should be enough to increase your milk supply.

On page 108/109 I explain how to steer your baby towards a routine. Obviously you must assume that after the birth when your baby cries he is probably hungry and feed him. Once the milk is in, usually between 5 and 7 days after birth, and he is managing to go three hours from a feed to the beginning of the next feed and is gaining weight, you will find that you can make a start on the routine for week one. The routine includes expressing times, beginning at week one. Remember to eat well, rest when you can and accept help when it’s offered, as exhaustion is a big contributor to low milk supply. Good luck with your new baby.

Feeding FAQ: 0-8 weeks – Breast Feeding

How do I put a newborn on the feeding routines?

Firstly, thank you very much for the New Year Greetings and the signed copy of The Complete Sleep guide which arrived yesterday. My baby is due next week and I have a couple of questions about feeding before using the routine for a baby at one week. What do I do from day one? Having read Chapter 3 of The New Contented Baby Book, you say that I need to feed for 5 minutes each side every three hours until my milk comes in. Around day 3-5 I should have increased the sucking time to 15-20 minutes and offer both breasts if my baby needs feeding before 3 hours are up. Do I follow the ‘Routine for increased milk supply’ from when my milk comes in or is this from day 1? This routine lasts for 5 days only. Then should I start the routine for a baby at one week – even though time wise, my baby will be 10 days old? Am I just getting myself confused?
I look forward to your reply as I am I very keen to get your routines right from day one and enjoy a contented baby!
Sincerely,
Tracy

I hope this arrives to you in time for your baby’s birth.
Here is a feeding plan for you which should help in the next weeks.

Day 1-3: Feed every 3 hours from both sides, building up your time. This should help your nipples become used to your baby’s sucking and help the milk come in which usually happens between day 3-5. By the time your milk comes in your baby should be sucking 15-20 minutes each side.

Day 3 –5: Once your baby is receiving milk rather than colostrum you still need to feed little and often but he may be content after one side which will take him 20-25 minutes to empty. If he then is content for the next 3 hours you will know he has had enough. You may have to wake your baby for some feeds but your breasts need the constant stimulation to get the message to make milk – supply and demand. Your baby should be able to sleep one longer stretch -possibly 4 hours – and this will hopefully happen at night if you wake him throughout the day. He will need feeding every 3-31/2 hours from 6am to midnight (ie. 6 feeds). How long he goes between feeds depends on his weight. A 6lb baby will need to be fed every 3 hours rather than 31/2 until his weight is up a little. A baby weighing 7-8lbs, if fully draining one side, should begin to settle for 31/2 hours by the end of the first week.

Remember to time your feeds from the beginning not the end as the baby begins digesting straight away, so if a feed takes 50 minutes the next one will be due about 2 hours later.

The plan for increased milk supply does not need to be followed unless you feel you are not producing enough milk at each feed. Often this may happen after the first few weeks as you begin to be out and about more, exhaustion kicks in or your supply has not really established itself. You will know if this happens as your baby will not be satisfied after he has exhausted the milk from the breast(s).

Keep a written record from day one of your feed times and which side you began with as it is easy to lose track (tucking a piece of cotton wool or tissue inside the cup of your nursing bra is a good way to remind yourself which breast is next). Note how settled your baby was afterwards and, as he begins to stay awake for short spells, note down the time he is asleep again. By the end of the first week you may begin to see a pattern emerging. A baby over 7lbs at birth may well be able to begin to slip into the routine for the first week but a smaller one may need a few more days of 3 hourly feeds. Don’t despair if it takes you longer for the routines to begin to fall into place, keep trying. It is especially important to rest as much as you can between feeds in the first week, eat well and regularly and drink plenty of fluids – water, juice and milk being the best. That way you will build up your supply with help from your baby’s regular feeding. Getting into the habit of putting a large glass of water beside you as you begin feeding is a good way to ensure you get enough fluids to make the milk.

If you are in doubt about his latching or your nipples become sore get expert advice from a breast feeding councillor as early problems can frequently lead to a lack of supply in the coming weeks.

Feeding FAQ: 0-8 weeks – Breast Feeding

How do I know if my 14 day son is having a growth spurt?

I would like to know how I can tell if my baby is having a growth spurt. He is 14 days old and for the last 2 days seems to be feeding much more. He was 7lb 14oz at birth and did not lose any weight in the first 5 days, then after a further week he weighed 9lb, so is gaining rapidly. He is already following the 2-4 week routine, is breastfed apart from a bottle of formula at 10pm (where he has taken from 3-6oz – usually 4oz).
If he is having a growth spurt do I just express less in the mornings?
Thanks
Caroline

As a baby enters his third week he often has two or three days of feeding more, which is indeed a growth spurt. On average, growth spurts happen every three weeks or so.

In order for you to give him the extra milk he needs you need to cut down your morning expressing by about 1oz. Providing you are expressing at regular intervals your supply should be able to match his growing needs. If you feel that your supply is not meeting his needs or that he is beginning to need more feeds follow the plan for increasing your milk supply and rest as much as you can between feeds.

Feeding FAQ: 0-8 weeks – Breast Feeding

What do I do with expressed milk for my 11 day baby?

I have an 11-day-old newborn and wondered what to do with the expressed milk. Is it fed to the baby or stored for emergencies? I have also noticed that my baby is sleeping well but not always needing the amount of time on the breast that you suggest and not always demanding the second breast. He tends to posset when overfed. He is a bit of a barracuda when feeding – latching on fiercely, sucking hard and fast for 10-15 minutes and then not wanting any more. My nipples are very sore. He is feeding at all the times you suggest and sleeping at the right times too, except waking for an extra feed at 12:30 am. I have been doing the routine for a baby at two weeks for 2 days.

There are several questions involved here so I will try to cover all the aspects you need.
Firstly, you mention sore nipples. Have you had your baby’s position checked by a breastfeeding specialist (your health visitor will be able to refer you to a local breastfeeding counsellor)? Nipples become sore through a baby being incorrectly latched on. As your son is an efficient feeder he is getting his needs met but, by being told of small adjustments you can make to his position, the soreness should rapidly disappear and your son will be able to empty your breast even more efficiently. In my experience this is really worthwhile to do as soon as possible. Your son is gaining weight well and his needs will grow. In order to carry on breastfeeding as well as you already are it is vital to sort out this problem now.

As he is an efficient feeder he genuinely does not need to spend longer at the breast. As long as his weight gain is between 6-8ozs each week, he is settled and sleeping well between feeds and you sort out any positioning problems, be thankful he is so quick! As he gains in weight he may well begin to need the second breast. Be guided by his needs. If he is unsettled after a feed, or doesn’t settle well in the evening begin to offer the second side.

Once you have his position checked you may find he feeds better at 10pm and will lengthen his time in the night. Sometimes giving him a break mid-feed at 10pm, with a period of 20 minutes gentle kicking will encourage him to sleep longer in the night. Once he has had 10 minutes at the breast, change him and let him lie on the bed kicking. Then dim the lights and offer the rest of this feed. As he enters his third week you may well notice an increased appetite due to a “growth spurt”. This is the reason I advise expressing milk. Decrease your early morning expressing by 1oz to let him have his needs met. This is also a good time to introduce a bottle feed of expressed milk at 10pm. You will still need to express between 9:30-10pm but you could allow your partner to give this feed so you can get an early night. As your baby’s needs increase you may need to sometimes give a top-up at the end of the day to settle him. Having a good supply of expressed milk frozen is always reassuring.

Feeding FAQ: 0-8 weeks – Breast Feeding

1-month-old Grace takes hours to breastfeed

I am breastfeeding my month-old daughter, Grace, and she takes hours to breastfeed but still seems hungry. At 7am she takes 1-2 hours. The 10am feed lasts another hour and at 11.30am she keeps on feeding or will fall asleep for 10 minutes. She will happily feed all afternoon and again at 6pm. She does not sleep during the day unless she falls asleep on the breast. The 11pm feed can last an hour and this happens again at 3am. Sometimes she will settle back until 6-7am but other nights she wakes wanting more. Grace also screams all the time unless she is feeding or playing on the floor with her nappy off. She kicks her legs and clenches her fists. Could she have colic, possibly due to hunger?
Any advice gratefully received.

If you have been following the Contented Baby routine and expressing milk on a daily basis you should begin to use the stored milk to offer Grace a top-up after feeding for 45 minutes. It would appear that your milk supply is possibly low, although Grace is gaining weight. Use the plan for increasing your supply as laid out in The New Contented Baby Book on page 52. By the end of the day many mothers have a low supply due to tiredness, so I would certainly offer her a top-up at 7pm to see if she will settle better in the evening. You might also consider an expressed or formula feed at 10pm which could be given by your husband. This would allow you to express at 9:30pm and then have an early night so you are more able to cope with the night feed.
Have you also considered having her positioning checked? Some babies who are incorrectly positioned are unable to empty the breast effectively. This results in less stimulation and therefore lower milk supply for you and a vicious circle develops of long feeds and an unsettled baby.
Until you have sorted out your supply and had Grace’s position checked by a qualified lactation consultant, it will not be possible for her to settle properly to sleep. Ask your health visitor to give you the phone number of your local breastfeeding counsellor.
A baby who feeds on and off throughout the day may receive too much foremilk and not enough hindmilk which can result in colic. It is important to try to shorten the times of Grace’s feeds so you are able to rest in between them and begin to settle Grace for daytime naps and longer periods of sleep at night. Daytime sleep in her cot is important for her and you must beware of sleep association problems developing if she gets used to falling asleep on the breast.