Feeding FAQ: 3-4 months – Formula Feeding

Is my daughter of 15 weeks having enough milk in the day for hunger not to be the reason for her early mornings?

I am struggling to get my 15 week old daughter to take more milk during the day. I might be wrong but I think that she is waking early morning genuinely needing to feed. She has never slept through from 10/11pm. About a month ago she was waking as early as 2:30am, but then I was still breastfeeding and knew that I had problems with my milk supply. I was already topping her up with formula.
Since she’s now fully formula fed I have noticed her intake varies a lot each day, and I’m wondering whether she’s still not taking enough in the day.
The last 24hrs she fed : 5am 4oz, 7:30am 5oz; 10am 5oz; 11am 1oz; 11:45 3oz; 2:30pm 2 oz; 3:10 2oz; 5:10 6oz; 6:20pm 1oz; 10:30pm 7:oz
She woke again at 4:30am – I offered water ( she took 2oz) and she had 3oz. At 7:30 she took 7oz.
Is her waking due to hunger? Usually if she feeds at night before 4/5am she takes a full feed at 6:30am, although the last two days we have had to wake her at 7:30am for her feed. I normally offer water first, but she has only ever settled with that once (when she had taken 12oz between 10pm and midnight!!!). However the water/core night methods did seem to deal with the 2:30am waking, which is another reason I think that she may still be hungry.
I have tried split feeding at 10/11am, 5/6pm and 10/11pm. Sometimes she takes the first part of the feed and refuses the second. I use the faster teat when it seems she’s losing interest. When she’s very hungry the variflo teat is too fast for her – she chokes and spits and gets upset. I always try not to feed after the times per the book, but that doesn’t always work if I am offering a top-up.
She sleeps 9-9:30; 11:50-1:50; 4-4:20 (in buggy).
I allow 30mins max in the morning because she wakes during her lunchtime nap. I found that she sleeps better then, if she had 20-30min in the morning rather than longer.
I put her to bed at 6:45/50pm. She had been waking at 9:45pm but that has stopped in the last week or so and we now wake her at 10:30pm.
My questions are:
– how much should she be taking during the day? I thought for her weight it should be around 35oz? She weighs 14.6lbs.
– If I split the feeds is there a way of knowing how much to give as the first part, so that she’s still hungry enough to take the second?
– should I (try to!) increase the 2:30pm feed? What is the biggest that feed should be? The top-up at lunch time seems to affect her appetite at 2:30? Should I give her less at 11:45am?
– I’m aware that the 10pm feed should be getting smaller – but should I still increase this, given the waking?
– What else can I do to get her to take more at each feed?
Or is all this just because I may need to wean her soon?

Although you may feel that your daughter should be sleeping through the night by now, the way you are dealing with the night feeds will help her drop them once she is ready. When you know she is able to get to 4.30/5am, because she has done so for several nights in a row, make that your core night time. If she wakes before then only offer water and settle her back, even if she wakes again in an hour or two’s time. At 4.30/5am offer her water first, as you have been doing, and then give her milk to settle her back to sleep. Giving the water first will fill her a little so she takes less milk before settling. This, in turn, should help her take a bigger feed at 7/7.30am.

You are right in thinking her total amount in 24 hours should be around 35ozs and, by the figures given here, she does achieve that. The problem being that she is still needing the early morning feed in order to achieve that amount.

Rightly, you have tried the split feeds at certain times and, although this is fiddly, it is a way to get enough milk into a baby who is not quite able to take enough at one feed for her daily needs.

One thing you could try at the 7am feed is to wake her at 7am rather than 7.30am and offer her 3-4ozs, then give her a 20-30minute break until 7.30am and then offer her another 2-3ozs. If you could sneak in an extra ounce here and there during the day it should help her not need the 4-5oz feed she has been having at 5am. By having a slightly bigger feed at 7/7.30am she may be able to get through to 10.30am. This feed is a good one to split but, by starting later, you may be able to give it to her in two parts rather than the three. So, 4-5ozs at 10.30am and then another 3-4ozs at 11.30am. This would then replace the top up at 11.45am before her lunchtime nap.

As you have noticed, she is not so hungry at 2.30pm which is quite normal; this feed is often not as big as others in the day. By giving her the 10.30am feed in two parts she may be a little hungrier at 2.30pm but the 4ozs spread over the time you are giving it should be sufficient to get her through to 5pm.

The 5/6pm feed could be the one which needs adjusting as she seems reluctant to feed well at 6.30pm. She is obviously tired by then. Try feeding her 3–4 ozs at 4.45pm and bath her at 5.45pm. By 6.10/6.15pm she should be able to take another 3-4ozs which should help her settle well until 10.30pm. If you need to put her down at 6.30pm then do so. Again, you are right in thinking that the 10pm feed does not normally get any bigger than 6-7ozs. If you can help her balance the feed before 5/6pm so she is not taking the majority of this feed at 5pm, this should help her be able to manage with the 7ozs at 10pm. Some mothers make this last feed of the day with the “hungrier babies” formula. It may help a baby settle for longer through the night. Make sure she is really awake for the beginning of this feed, and during the break that you are giving her, before feeding her the second half. Let her have a kick on the floor. Although you don’t want to stimulate her too much, it is a good idea for her to be in a light room with some background noise. Have you tried the split feed from 10pm -11.15pm described on page138 of the Contented Little Baby Book? By making sure she is awake by 10pm and allowing her to stay up until 11.15pm before receiving the second part of the feed, she could well begin to stretch her sleep for longer in the night.

A baby should be taking full feeds, which are 8ozs, before needing to wean. The other indications would be showing signs of hunger long before a feed is due or as soon as it is over. It would be better if you work towards her taking better feeds during the day, and sleeping through to 6.30/7am, before considering this option.

Feeding FAQ: 3-4 months – Formula Feeding

Is there a way to push my 16 week daughter’s morning feed onto 11am?

My daughter is 16 weeks old and I am struggling to get her to stretch her 10.30am feed closer to 11am. I am convinced this is due to the fact that she only takes a very small feed at 7/7.30am. I have tried some of the suggestions on the website such as holding off until 7.30/8.00am to feed her, but she will still only take a very small feed (4oz) and even then she doesn’t take it all in one go. She already only takes a small amount of milk at 10.30pm and I am worried that if I start cutting that back she will wake up for a feed. She is pretty much sleeping through to 6.00/7.00am. She isn’t a particularly big eater anyway and I am lucky to get her to take 5oz each feed. The exception is the 5/6pm feed when she takes a split feed of 7oz before and after her bath. She will always take about 3oz and then I need to let her have a play for about 30mins/45mins before she will take the rest.

My daughter feeds at 7.30am 4ozs, 10.30am 5ozs, 2.30pm 5ozs, 5.30pm 7ozs split before and after bath, 10.30pm 3ozs.

She weighed 12lbs 2ozs at 13 weeks.

My daughter naps from 8.45-9.25am, 11.45-2pm and 4.30-5pm. She settles by 6.45pm.

Many babies do like a break mid feed. This is especially true of a baby who seems to have a slightly lower intake overall and it is a good way of ensuring that she does receive enough milk during the day for her needs.

Continue to feed your daughter at 10.30am if she is hungry then. You could also offer her a top up before she settles for her lunchtime nap, as a way of adding another ounce or so to her daily amount. On average a 12lb baby needs around 30ozs of milk during the day. Your daughter may have a smaller appetite than some babies and, providing she is putting on weight steadily and sleeping well, continue to feed her in the way you are, letting her take breaks mid feed.

Continue with the 10pm feed until she is well established on solids. It may only be 2-3ozs but it is needed by her for her overall total. If she feeds better half asleep, as in a dream feed, then continue in this way. It should ensure that she continues to sleep through to 6am/7am.

Feeding FAQ: 3-4 months – Formula Feeding

My 16 week twins were three weeks early and have slept an eight-hour stretch at night since they were eight weeks old

My twins were three weeks early and have slept an eight-hour stretch at night since they were eight weeks old. They seem to need a lot of sleep during the day and as long morning and afternoon naps keep them cheerful (they\’re very grumpy without them) without interfering with their night-time sleep I have kept them long.
Now they are 16 weeks I am hoping to drop the 10pm feed, but am not sure how to tell if they’re ready. For several nights they have gone through to 7.30am on 1.5oz at 10pm: if I don’t offer them the bottle again after they stop to wind they will easily settle again. But if I do offer the bottle again, they will still take up to 5oz at that feed. They never used to mind being woken at 10pm, but they are now becoming more and more bad tempered when I wake them, thrashing about and arching their backs (especially Beattie) when I try to feed them. I tried leaving them to go through once a couple of days ago, but they woke at 4.30am. They weren’t hungry then (and I think Beattie only woke up because Charlie was crying) and weren’t too hard to re-settle, so I suspect it was just habit that meant they woke nine hours after going down… but I’m now too scared to try again in case the waking in the night starts again. I’m not sure whether not to try again until they start on solids (which I don’t think will be very soon): all my friends’ babies started going through the night from 7 to 7 the first time they tried it. They’re so peaceful when I go in at 10pm these days I can hardly bear to wake them for the sake of an ounce!

The twins feed at 7.30am 7-8ozs, 11am 9ozs, 3pm 5ozs, 4.15pm 4ozs diluted pear juice, 6.15pm 8-9ozs, 10pm anywhere between 1-5ozs.

They nap at 9-10.30am, 12-2.15pm and 4.30-5pm. They are settled by 6.45pm.
Twin 1 weighs 15.1oz and twin 2 13lbs 13ozs.

Although you may feel that it is not worth waking the twins at 10pm for them to take only an ounce or so, it would be best to keep this feed in place until solids have been introduced. The reason being that a growth spurt can often occur around the 4 month mark. If your babies are only having four milk feeds a day their hunger needs are unlikely to be satisfied and, as a result, they may start waking early in the morning.

Many mothers find that by the time their baby is four months old they can “dream feed” at 10pm. Pick each baby up and feed them whilst they are still asleep. You will find that they will take a feed of several ounces and settle back to sleep with no resistance. It does not take long to do and should mean you will continue to have two babies who sleep well in the night and wake at 7.30am.

There is a case study in Gina’s Compete Sleep Guide, page 92, which shows what can happen when this feed is dropped too early. For a week or so your babies may sleep through but then begin to wake earlier and earlier with hunger.

The guidelines at present recommend waiting until nearer 6 months before weaning. Some babies may be ready a little earlier than this. The signs to look for are that your babies are taking full milk feeds at least 4 times a day (a full feed is 8ozs); taking full milk feeds and still showing signs of either not being satisfied with this amount after a feed or starting to demand a feed long before it is due, which could include waking earlier and earlier for the next feed; showing a great deal of interest in other people when they are eating; putting their hands and other objects into their mouths, exploring the tastes and textures; dribbling excessively and starting to chew on things.

If you feel that your babies are showing these signs and are not yet six months discuss with your health visitor or doctor when you should begin weaning.

Feeding FAQ: 3-4 months – Formula Feeding

My 13 week daughter still needs a small feed at 4am

My daughter is thirteen weeks old and still not sleeping through the night. She wakes around 4am each night. In addition she will not sleep more than 45 minutes at lunchtime despite trying all the methods in the CLB book.We have reduced her 4am feed to just 3ozs [1/2 water and ½ formula] as she refuses to drink water at any time of the day. For two weeks I increased her milk intake during the day but she still woke at night and she out on 22ozs in a fortnight. She started being sick a lot [she suffers from reflux and is on Gaviscon] so I have now reduced her feeds to those shown below.

In the daytime she has 3 naps all for 45 minutes. Again for the last three weeks I have held her, let her cry and even lay down on the bed holding her for the following hour but she still refuses to sleep more than 45 minutes. However despite this she sleeps well from 6.45pm until 7-8am each day only waking for her 4am feed and then goes straight back to sleep.My daughter takes feeds at 7.30am, 10.45am, 2.15pm, 6.15pm and 10.30pm of 5ozs. She has 3ozs at 5.00pm and her diluted feed of 3ozs at 4am. She weighs 12lbs 4ozs.

She naps at 9-9.45am, 12.15-1am, 3.45-4.30pm.

As your daughter is taking good feeds during the day it is sensible that you are offering her a diluted feed in the night. As she wakes at the same time each night, rather than randomly, she may well be coming into her light sleep and finds it hard to settle herself back to sleep. Try cuddling her first, to see if she will settle without a feed. If she cannot fall asleep then you need to keep offering this feed to her until she shows signs that she really does not need it any more. When you notice that she is waking later in the mornings or becoming less interested in her 7.30am feed you can begin, little by little, to cut back the amount you give her at 4am. It can take some babies a little longer to go without a feed through the night, especially when they have reflux, as they are unable to take too big a feed in the day without becoming uncomfortable and distressed.

Check that your daughter is well tucked in. Her Moro reflex may be waking her when she is in a light sleep, both at 4am and during her lunchtime nap. Use rolled towels down the cot sides to secure a cotton sheet or light cotton blanket placed lengthways across her. Even if she wears a sleeping bag, being firmly tucked in will help her to stay secure.

If you have tried all the suggestions in the Contented Baby book as well as those in the article on the Lunchtime nap then continue to give her the three 45-minute naps. It can take a while to really establish the longer sleep in the day but it is worth persevering. To reset her cycles, so she does stay asleep for longer than 45 minutes, you may need to do the same thing every day for one or two weeks. This might be holding her or taking her out for a walk in her pram. Being consistent, as well as persistent in the method you choose, will really help you. You may find she will sleep longer at this lunchtime nap once she is more active with rolling and crawling or once she is weaned. Every baby is different and has different needs. Use the routines as a guideline but also accept that your daughter may take longer to be able to follow the routine for her age.

Feeding FAQ: 3-4 months – Formula Feeding

My 3.5mth son is doing well on the routines except I cannot get him to sleep beyond 6am

Since I started my son on the routines, he has been brilliant. He sleeps beautifully at all the times he should and we have recently cracked the ‘waking after 45 minute problem’ at lunchtime and he now sleeps well for 2 hours. He still wants about 30 minutes in the afternoon too usually from 4-4.30. He is so tired after his bath that I just cannot keep him awake until 7pm, so he is normally in bed by about 6.40-6.45pm. If I don’t put him down, he just falls asleep either in my arms or on my knee.

He sleeps through from his 10.30pm feed until 6am really well, but I cannot seem to get him to go to 7am. If I feed him at 6am (at which point I breastfeed him) he only feeds for about 10 minutes and will then resettle until 7am/7.30am with no problem at all. This leads me to think that he does still need the sleep, and is not particularly hungry – so how can I get him to just sleep right through until 7am? I have also tried to keep him awake for longer at 10.30pm but it just doesn’t work. I have tried to split the feed allowing him to kick in between, but he is not interested in the second part of the feed and so wakes at about 4.30-5am and is quite hungry. If he has the full feed, he will take 8oz but then fall asleep straight away. Nothing will keep him awake.

When he wakes at 6am (which is always to the minute!), I have tried leaving him to cry (which had been successful with sorting out the lunchtime nap) but he just will not have it and works himself in to such a frenzy he will not resettle at all. Also, even after a small feed at 6am, it puts him off a good feed at 7am and so he wakes from his morning nap at about 9.45am and is really shouting! He will drink 7oz – sometimes more – without even pausing for breath.

My son’s feeds are 6am breastfeed, 7/7.30am breast feed, 10.30am formula 7ozs, 2.20pm 8ozs formula, 5.15pm breast, 6.15pm 6ozs formula, 10.30pm 8ozs. He weighs 16lbs 4ozs.

My son naps at 9-9.45am, 12-2pm and 4-4.30pm.

As your son wakes at exactly the same time every morning it could be from habit or from his being disturbed by an external noise whilst in a light sleep. As his sleep at this time in the morning will be quite light he could be disturbed by noises such as your boiler firing up, traffic noise from outside or light coming into his room under the door.

Look at the case study of Joseph on page 78 of The Complete Sleep Guide or page 42 of Contented Baby to Confident Child about a case where light woke the baby. If you do suspect his waking is through some external noise or light spend a night in his room to see if you can find out what it is.

If you feel that your son’s waking is through habit then make sure he is well tucked in. If he stirs from a light sleep he may be waking up as the result of his Moro reflex disturbing him. Make sure he is not too cold or hot or that a wet nappy is making him chilled in the early hours of the morning.

To get your son to sleep until 7am without needing a feed, you may need to make some adjustments to his feeding and sleeping patterns during the day.

It can be difficult to wake a baby for the 10pm feed. It is better to start to wake him at 9.45pm as this is often a time of lighter sleep than that after 10pm. Put on the lights and undo any coverings around him. It may take him 15-20 minutes to wake up properly. Make sure he is well awake before starting the first part of the feed. Let him have 5-6ozs. Encourage him to stay awake by being in a well lit room with some background noise. By 11.15pm he will be ready to sleep again so change him and offer him the last 2-3ozs in his room with the lights dimmed. By being awake for over an hour he may well sleep through the extra hour in the morning.

It would also help if your son could manage to get to 7pm before going to sleep. Move his afternoon nap on slowly, by five minutes every few days, so he is sleeping from 4.15-4.45pm or even 4.30-5pm. If you take him out for a walk at this time of day you may find that, as he is busy looking around, he will able to stay awake to this later time. He may catnap on and off in his buggy rather than having a longer stretch of sleep but this will still help him to stay awake until nearer 7pm.

The amount of formula your son takes at 2.20pm could be affecting his feeds later in the day. He needs to be taking a good feed at 6.15pm to set him up for the night. As he does not need a feed in the night the split 5pm/6.15pm feed can be dropped and all the feed given to him after his bath. If you are concerned about your milk supply dropping if you stop feeding him at 5.15pm consider breast feeding him at 2.30pm. If your son seems a little fractious after his afternoon nap offer him some water in a bottle. It is a good idea to get your son used to the idea of drinking fluids, other than milk, from a bottle.

Once you have put all these changes into place you may find that your son is waking nearer to 7am. If he still wakes at 6am offer him a drink of boiled water to see if this will settle him. If he still will not settle without a feed the water will help to fill him a little so you can give him a shorter breast feed which will increase his appetite for the 7am/7.30am feed.

Feeding FAQ: 3-4 months – Formula Feeding

My 3.5mth daughter has started to wake at 4am. Should I re introduce the 10pm feed?

My 3.5 month old daughter has been following the CLB routines for 3 months with varying degrees of success. The present problem is that she is waking at 4 in the morning and not able to settle herself back to sleep. I dropped the 10 pm feed at about 2.5 months as she was sleeping well from 7 pm through until 6.30am, this was fine for a while but now I feel that I dropped it too soon. I have tried to reintroduce the 10 pm feed but it leaves her very unsettled and waking at 4 am anyway and not taking her 7 am feed. This leaves me with a very grizzily baby for the rest of the day as she has never napped well in the day.
When she wakes at 4am she does not cry, just babbles to herself and if I look at her she smiles- it seems that she wants to play! Should I try to reintroduce the 10pm feed again, or leave her and hope that she will start to settle herself back to sleep in time.

At present my daughter feeds at 7am, 11am and 2pm taking 6-7ozs, 4pm, 3-4ozs and 6.30pm, 7-8ozs She weighs 15lbs.

She naps at 9.30-10am, 11.45-12.30pm, 2.30-3.30pm and 4.30-5pm. She is settled at 7pm.

Until a baby is weaned it is better to keep the 10pm feed in place. Between the age of 3-4 months a growth spurt takes place and your daughter will need this late feed to help her take in sufficient milk to meet the nutritional requirements for her age.

It also helps a baby under the age of four months to sleep for a long stretch in the night if she is awake for one short period between 7pm and 7am. If you can give a feed at 10pm/11pm and keep your daughter awake for 20-30 minutes you may find she is less likely to wake at 4am.

Trying to get your daughter to have one longer lunchtime nap, rather than two separate naps of 1 hour and ½ hour, may help her sleep through the night. Having this amount of sleep in the afternoon may be another reason for her waking at 4am. If you have had trouble resettling her after 45 minutes during her 11.45am sleep, take a look at the Lunchtime Nap article by Gina on the website to see what you can do.

When your daughter wakes at 7am let her wake up properly for 15-20 minutes before offering her a feed. By this age a baby will not be hungry the moment they wake.

As your daughter does not cry when she wakes at 4am, leave her to settle herself alone. Only go in to her if she does begin to get fretful. Give her a cuddle and settle her back again. Check that she is not waking because she is too cold. On chilly nights she may need one more layer such as a thin cardigan or long sleeved body suit if she is wearing a sleeping bag. Make sure she is well tucked in as her Moro reflex could be waking her from the light sleep she is in at this time of the day.

Feeding FAQ: 3-4 months – Breast Feeding

What is the best way to drop feeds for my 3 month baby without becoming engorged?

I want to avoid painful, engorged breasts when I begin to stop breastfeeding, which I plan to do when Leo is around 4mths old (he is 3mths now).
With my first child it took a long 2 or 3 months to give up, as I tried to drop feeds and only express a little to give relief.
Leo has just started to go through the night and I am finding it painful just dropping this feed. I don’t want to start expressing milk in the night, but I am awake with pain in the right breast and under my arm. The right breast is producing a lot more milk than the left. I only express a tiny amount (60mls) from the right side, now only in the evening as Leo has formula at 10.30 (160mls). Lately I have felt I could/should express more than this, as I am going to bed with full breasts and know that will cause a problem in the night. I have not increased the amount I express at 10pm as I have been trying to drop this feed for 4 weeks. How can I stop feeding more easily? I don’t really like breastfeeding, and I sometimes feel it is getting in the way of enjoying time with my baby.

Unfortunately, when you do have a good supply of milk it can take quite a while to stop feeding altogether. If you try to speed things up too much, you could become engorged and a bout of mastitis could follow.
Now that Leo has dropped his middle of the night feed and you were already trying to drop the 10pm, you are in the situation of missing two feeds in a row which has caused your breasts to become engorged and painful.
Although it may feel like regressing, begin to express more at the 10pm feed. Bearing in mind that Leo is taking 160mls at this feed and that your breasts will go on making milk during the night, it is better to keep this expressing going whilst you also start cutting back on the day feeds.
Are you aware of lying on your right side at night? This can often have the effect of causing the milk to pool and become blocked in the ducts. If you are still wearing a maternity bra at night, make sure it fits properly and the seams are not digging into your sides as this also can cause blockages. If you do wake in pain, rotating your arm round in circles can help ease the blockage and therefore the pain. Be aware of any painful lumps forming; massage them downwards towards the nipple especially when feeding.
As you do have a good supply, it would best to begin to drop feeds slowly. Once you feel an improvement in the middle of the night begin to drop the 10.30am.
Rather than dropping the feed all at once begin to feed him for 5 minutes less each day and begin to top him up with formula. It could take your breasts at least seven days before they register that they no longer need to make milk for this feed.
On page 56-57 of The New Contented Baby you will find an explanation and chart, which helps you see how to drop feeds gradually. By the time that Leo is taking all formula feeds in the day you should be able to stop expressing at 10pm.
Although it takes time, it is better to drop feeds in this way when you have a good supply, as the outcome will be less pain and discomfort for you in the coming weeks.

Feeding FAQ: 3-4 months – Breast Feeding

My 3 month daughter’s weight gain is low, she feeds less, and does not like a bottle

My 3-month-old daughter has been on Gina’s schedule since 2 weeks. She is generally a contented baby and sleeps well. I have 2 problems: the first relates to her low weight gain at about 4.7oz per week. She rarely seems hungry – even after sleeping through from 11pm to 6.30am. Since 12 weeks, she’s beginning to take shorter feeds on the breast (10mins) rather than in the past when it was closer to 15-20mins. She often seems uncomfortable and fussy during the feed (after 5 minutes) I have tried splitting the feed as well as giving the breast 15-20mins later in order to increase her intake, but she is often reluctant and doesn’t take any or only a little more (5 minutes on breast). Since I’m breastfeeding, I don’t know how much she is taking but suspect it could be between 2-3oz (this is the amount I get after expressing one breast). At 5 feeds a day, this level of milk intake is very concerning! The second problem I’m facing is getting her to take the bottle; I have tried introducing it since the 3rd week. Initially she did not seem to know how to “suck” as the milk would just flow out of her mouth. Now she can take no more than 2oz of expressed milk per feed from it and I have to be out of sight. I am not sure if this is because she is not keen on the bottle (and she could have fed more on the breast), or if this is the amount she is really contented with. In any case, I am really worried about her daily intake which I am certain is too low.

After 3 months many breast-fed babies “speed up” considerably and spend far less time at the breast. But they also can be more easily distracted and more interested in looking around rather than feeding.

Try to feed your daughter in a quiet room with no external noise such as radios and lots of conversation. Her weight gain is low, but if steady, it may be down to her metabolism to gain less than the “average” baby. Have you discussed these concerns with your doctor or health visitor?

When you express, it is unlikely you will express as much as your daughter can extract from your breast. Although it appears a small amount, she is probably taking more than that at a feed. Ideally, at her weight she should be having about 5ozs at a feed and is probably taking nearer to 4ozs.

Making her feeds more spaced apart, as you already have been doing, is a good idea as you can see she is taking a little more. In the extra 5 minutes that she is feeding, she will be taking quite a bit more milk.

Getting her used to a bottle will take time. It is not at all unusual for a baby to take a bottle from someone other than the mother. She associates you with breast feeding so sees no need to feed from a bottle held by you. This will get better as she becomes more adept at sucking. Once she readily accepts a bottle from someone else, then you can begin to offer them yourself.

The movements needed to suck from a bottle are different from the breast where the baby “laps” at the milk. At present the Baby BFree bottles are the only ones where the action needed to obtain the milk is as close as possible to breast feeding. It maybe worth obtaining one and seeing if you have any more success. From your notes it seems she is on a 6-12mth teat which may be too fast for her. If she is being overwhelmed by too fast a flow, she may just give up taking a feed. As her stomach is being filled too fast, she is feeling full before she has taken enough. Try a slower flow and see if she is better able to cope with taking more. Splitting a bottle feed into two halves could also help. Give her 2-3 ozs and then a break of 20 minutes before offering the last 2 ozs. Letting her sit in her chair inbetween could help her feel more settled.

Feeding FAQ: 3-4 months – Breast Feeding

What can I do to get my milk supply back for my 3-month-old?

I think I am running out of milk. The past 2 nights at 10pm I have expressed and got less than 1 oz; I usually would get 4-9oz. I started to follow the increased supply routine yesterday; when I expressed at 2pm today I only managed barely 1oz, and when I had fed her she was still hungry. Initially I thought the problem was only there at the end of the day – until now. I have expressed since she was born so I know what to do and usually have no problems. My health visitor told me to just give formula but I don’t really want to; I am worried that if I give formula then my milk will dry up more and soon she will be formula fed. I don’t know what to do.

A supply dropping low does not mean the end of breastfeeding – even if you have to use a little formula whilst you get things back to normal.

The reasons why it happened could be many. If you are very tired or have had an upset over something, your milk supply will go down. The problem is that once you realise it is getting low, you worry about it more and more – which is not good for the supply. It is very dependant on hormones which can still be very much in control still, even three months after the birth.

Follow Gina’s increased supply plan, but don’t be surprised if it takes more than 24 hours to begin to notice a difference. It is more likely to be three or four days. Really resting between feeds and whilst your daughter sleeps is very important. So is eating and drinking well. Make sure you eat a proper breakfast, lunch and supper and also have a small healthy snack at the 10am feed and also have something at around 5pm. The long gap between lunch and supper is not good for breast-feeding women who need to keep their energy levels up throughout the day. In the first few days of the increased plan try to do the minimum needed in the house so you really are sitting or lying down for a lot of the time. What ever it takes to get your supply back on track, is the most important thing you can be doing in the next few days.

At three months after birth mothers often becomes a little run down. The euphoria and all the fuss surrounding a new birth have all died away and you are now very much on your own, as any help you had has probably finished by now. Although your daughter is sleeping through the night now, you have weeks of broken sleep to make up for. All this can lead to you being very tired and low. Also you probably feel that life is back to normal and are doing much more rushing around more now that your daughter is in a good routine.

Your problem is probably for a variety of reasons. When you express try to relax and do not worry that you will not be getting enough; if you become tense your supply will not flow so well. It is not always easy when faced with a setback such as this, but giving a small amount of formula to get you through the next few days is an option. Use it at the 10pm feed so, if your partner will do this feed, you are able to get to bed early. Any milk you expressed then can be used to top up with in the day. As soon as you notice an increase in your supply, replace any formula top ups you may have had to give, with expressed milk.

Feeding FAQ: 3-4 months – Breast Feeding

How can I get my 15-week-old baby to take more milk?

I am finding it difficult to get my daughter to feed more at each feed. She only drinks 2-3ozs at each feed, occasionally 4ozs if she really wants it.
Her weight gain is dropping slowly. At present she weights 12lbs 2oz.The health visitor has advised me to demand feed her for a couple of days, but it has been terrible. She is very agitated at each feed and takes her time. I never know if she is really hungry this way or just distressed. On the routine she fed every 3-4 hrs, but would only have a small amount. On demand feeding it is even worse as she sometimes only takes 1oz. This was supposed to increase her weight.
She does have a bit of a cold and cough at the moment and demand feeding has put her sleeping all over the place, making her grumpy.
In the past she had problems with colic and a little bit of reflux. How can I get her better settled and to take more milk?
The report which follows is not a reflection of every day as she has been catnapping with demand feeding.
6.15am 4oz, 9.00am 2oz, 10.45 3oz, 2.25pm 2.5oz, 4.00pm 2oz, 5.50pm 3oz, 6.40pm 1oz, 8.00pm 1oz, 12.05 6.5oz, giving a total of 25ozs.
She slept 12.50am- 6.00am, 6.50-8.20am, 11.30am-12.15pm, and settled at 8pm-9.20pm.

The problems that your daughter is having with only taking very small feeds and becoming distressed during them, needs to be assessed by a doctor. As she has had slight reflux problems in the past, the re-occurrence of “silent” reflux needs to be ruled out. The “silent” kind means that a baby may not bring back up its feed but still be experiencing discomfort whilst feeding and therefore becomes distressed, refusing to take in any more. Talk to your doctor and explain exactly how she behaves in her feeds.
As your daughter has a bit of a cold at the moment, she may be having difficulty in breathing whilst taking in a feed as her nasal passages are blocked. Using saline drops before a feed can help this problem. Take her to the doctor to have her checked over, as this could also be affecting her ability to drink properly.
Once you have discussed your concerns with the doctor and he is happy for you to get back into some kind of a routine, try “splitting” your daughters feeds. When she feeds on waking in the morning, let her have 2-3ozs and then have a break whilst you change her, and let her sit in her chair for 15-20mins before offering her another 2ozs. This may help her to increase her intake a little. If you give her this break at all her feeds, you may find, although rather time consuming, she will end up having taken more milk over 24 hours than she is doing at present.