Feeding FAQ: 8-12 weeks – Breast Feeding

At 8 weeks my son still is not managing the routine timings

Having followed the CLB book since birth, I am delighted that my son is sleeping through the night at 8 weeks. He settles from 10.30pm to 6.30/7.00am. Now I need to make sure that anything I do to address the problems I am currently facing, don’t ruin his night-time sleep.
If Callum wakes between 6 and 6.45am crying loudly, I tend to assume that it is hunger and feed him one side. I then settle him back until 7.30 when I offer him the second side. If he wakes at 6.30am and doesn’t finish feeding until 7.15am, should I still settle him back for 15mins? He is often not satisfied at this time with one breast, so should I give him the second and start the day?
By starting his day at 6.30am, he is tried and ready for a nap by 8.30/8.45am. He is woken from this nap at 9.45 but depending when he went down can have an hour rather than 45 minutes. Is that a problem?
The biggest problems I am having though, are with the 10.30/10.45am feed and the 5/6pm feed.
When I get him up at 9.45am, he is content to be washed and dressed but by the time we are downstairs at 10.10am he gets very ratty and wants to feed. I can rarely make him wait beyond 10.15/10.20am.
At 8 weeks the routine states he should be feeding nearer to 10.45/11am, and I am concerned that I am so far off this time. Why can he not go longer than 3 1/4 hrs? At present I give him 15-20mins at 10.15 and than offer him the second breast at 11am. Is this right or should I just ignore the crying and try and make him wait until 10.45am?
He is very sleepy at this feed, often falling asleep after the first breast. I strip him off and lay him on his play mat to wake. I tend to push him to take the second side to make sure he gets enough to get through his lunchtime nap. Is this right?
The lunchtime nap is good and he gets through the next feed and a play until 4.15pm when he is offered juice. He still naps from 4.30-5pm.
Not long after waking at 5pm he is hungry again and I often give him 10-15mins on one side so he can enjoy his bath. He then feeds well and is settled at 7pm.
My husband wakes him at 10.30 and gives a bottle of formula. This can be a struggle as he is sleepy and it can take over an hour. Just recently he has cut back to 4ozs from 5ozs, but still managed to sleep through. Is it ok that this feed is getting smaller?
I am conscious that he seems a long way from achieving the 8-12 week routine in several areas and wonder how to best go about getting him more adjusted to them.

At eight weeks your son has done very well to be sleeping through on a regular basis. Allowing for his needs for sleep and feeding, needs to be balanced with getting him into a routine suitable for his age.
You may find the best way to get him onto the timings is to move towards them in small increments.
If he wakes after 6.30am and is ready for the second breast after 7am, then begin your day. If this has the effect that he is ready to go down for a nap at 8.30am then let him have 45 minutes-1hr at this time.
Once he sleeps more regularly nearer to 7am, then begin to push this nap forward by 5 minutes every few days until he is going down nearer to 9am.
As he is very sleepy at his 10.30am feed and sleeping well at lunchtime, he is showing that he still needs nearer to an hour at this time. If his lunchtime sleep begins to be affected, then you would know to cut his morning nap back to 45 minutes.

Continue to give a split feed at 10.20/11am until your son shows more signs of being able to wait longer before he wants to start feeding. If he can be distracted and encouraged to wait 5 minutes longer every few days, then gradually you will get to nearer 10.45 pm. Leaving a baby to wait when he is obviously hungry is not advisable and not fair on him.
An idea to help you with his sleepiness at this time is to let him have a time under his gym or floor time when he first wakes at 9.45am. Then feed him from one side and wash and change him before offering the second side. Many babies enjoy the times on their change mats so this may encourage him to be more awake for his second side.
Keep the 5/6pm a split one if it means that your son enjoys his bath time better. Again you will begin to see when he is more able to wake at 5pm and be content to wait until after his bath before having a feed.
Providing your son continues to get through the night on 4ozs given at 10.30pm, don’t push him to take more. Keeping babies awake at this time can be difficult but it is worth doing as they usually sleep a longer stretch afterwards.
Allow him a good 15-20mins to properly wake up before giving him the first half. Let him have a kick without too much external stimulation, then change him and offer him the rest of the bottle in his room with the lights down low.
As your son is only just 8 weeks he has another four weeks to get nearer to the timings set out in the routine. It will come gradually and if you allow for his needs balanced with gently encouraging him on towards the timings, by 12 weeks you will probably find he has achieved them. He has been doing wonderfully so far.

Feeding FAQ: 8-12 weeks – Breast Feeding

At 8 weeks old my daughter will not feed long enough at the breast

During the day my 8-week-old daughter will not feed for long enough to keep her satisfied until the next feed. For the first few weeks she fell asleep after 10mins, then for the last couple of weeks she has been feeding for about 10mins then starting to struggle and jerk her head away, taking my nipple and stretching it (ouch), letting go, then frantically searching for it again, yelling if she can’t get it quickly enough, as if she’s ravenous. Then, after a swallow of milk, she wrenches her head away again, and so on, almost as if she doesn’t like the taste. This goes on until she loses interest altogether. I’ve tried switching sides (although the breast she’s on is not empty) but the same thing happens. Why is she doing this? Her intake is nowhere near what it should be, as within an hour she’s yelling for food again; daytime naps all have to be preceded by a top-up, otherwise she will yell for food before I’ve left the room. Even that doesn’t guarantee an uninterrupted nap. I’m very concerned that she has learned the wrong sleep association but she has always had this problem and I don’t know how to get her out of it. Incidentally, she is fine in the evenings, although is very hungry after her bath and is rarely satisfied after 45 minutes on both breasts, but will not take a bottle top-up from me (only my husband if he’s home in time). I usually have to give her a few more sucks on an almost-depleted breast at about 7.30 before she settles until the late feed: about 4-5oz of formula, which my husband gives at 11 o’clock. That usually takes her through until 4 or 5, although in the last 2 weeks she has slept through twice, waking and settling herself at around 3-4am, without my intervention. As we live in the USA, my daughter goes to the paediatrician every month, and we do not have a baby clinic or health visitor. The paediatrician, when I mentioned her eating habits, said that her feeding would get more regular between 8 and 12 weeks: I’m not convinced.
At present she feeds 7am, 10-15 minutes one breast, 7.20am perhaps 2 more minutes, 7.50am 2 minutes, 8.20am 5 minutes, 8.55am 2 minutes, 9.25am 10 minutes, same breast as before, 5 minutes second breast, 10am -6pm the same “snacking” every hour at irregular intervals until bath time. 6.15pm 20 minutes each side, 7.30pm 2 minutes on fullest breast, 11pm 4-5oz formula, 4-5am 10 minutes one. It impossible to know her overall intake but her weight gain is good. She weighed 8lbs 1 oz at birth and is now 11 lbs.
She naps at 8.50-9.20am, 12-1 pm, 2-2.30pm, 3.45-4.30pm and settles about 7.45pm.

There could be several reasons why your daughter is feeding in this erratic way. Firstly take her to the paediatrician and have her checked out for any signs of reflux. It can often result in this “bobbing” and pulling of the breast when feeding. She may not posset or bring back feeds for it to be present. If this is ruled out then you will need to look at other factors which may be causing this problem.
Look at your own diet and lifestyle to see if there is anything which could be affecting the taste of your milk. Garlic, chilli and curry [hot] and other strong flavours can affect the flavour, especially if eaten in large quantities. Keep a food diary of all you eat and drink and see if there is any relationship to the times when she is more fussy. It takes about 16 hours for the food you have eaten to be affecting your milk. Stress and too much exercise can, according to research, also affect the taste of your milk. Taking gentle exercise is fine but don’t try anything too strenuous until you have solved the problems you are having.
The rate of your “let down” reflex usually remains the same throughout the feed. i.e. if you have a fast “let down” your milk will flow quickly through out the feed. Your flow can slow down if you are very tense or anxious so make sure you are in a comfortable position before beginning a feed and make yourself relax by taking several deep breaths and releasing your shoulders. Sometimes a breast will not flow so evenly and releases the milk in “waves”. This means there will be a time when the baby receives no milk no matter how hard she sucks until the next “wave” flows. If the delay is long, perhaps as much as three or four minutes the baby becomes, understandably, impatient, cries, fusses and does not feed well. Moving across to the other breast can help, even though you know that the first breast has not probably emptied. You may have to move your baby from breast to breast throughout the feed as this is the only way they will receive a continuous flow of milk.
If you are regularly expressing you will be aware of your supply but also make sure that you daughter is latching on correctly each feed. If you have any soreness in your nipples [apart from them being pulled by her] whilst you are feeding it is likely to be caused by an incorrect latch. Seek advice from a lactation consultant who will be able to make any adjustments to help you. This in turn will help with your supply as your daughter will stimulate your breasts properly at each feed.
Keep trying to give your daughter a bottle yourself. Some babies will often not take it from their mother at first but it is well to preserve with this. There are a couple of things you can try to help her. Sit with her facing out from you rather than in the crook of your arm where she will be able to smell the familiar smell she associates with breast milk. Walking around whilst offering a bottle can also help as she will be distracted by what she sees around her. Keep the teat in her mouth even if she initially cries and keep “teasing” her tongue with it to encourage her to suck.

Feeding FAQ: 8-12 weeks – Breast Feeding

Due to my 11 week old’s reflux problems he is unable to stay on the routines

My son was a very contented newborn. He fitted easily into the routines; breast-feeding went fine. At 4 weeks he started getting very upset: crying a lot, no dirty nappies for 48 hours, hysterical when lying down, vomiting profusely, dehydrated. We took him to the GP, and he spent 48 hours in hospital being monitored, tested, and was put on a drip; he was diagnosed with severe reflux. He’s had two follow-up appointments. He is now on Gaviscon, Ranitidine (0.45 ml thrice daily) and Domperidone (2.2ml thrice daily).
He is much happier now; being sick doesn’t upset him nearly as much. But he is still very sick, and it’s almost impossible to stick to a routine. On a good day, we nearly get there, but have to spend longer feeding to make up for occasional large vomits than the routine suggests. On a bad day like today, the routine is utterly hopeless. He was very, very sick today, and was feeding non-stop between 6pm and 1am to make up for the milk he’d lost, and then fell straight to sleep at 1.30am when I put him to bed. My milk supply is fine on average days, too abundant on good days (I express then, a lot) and can’t cope on bad days, so we top him up with expressed milk. On a day when he was hardly sick at all, I had expressed 25oz, which gives an idea of how much he’s sick on bad days, I think. On the worst days (an average of once a week) he’s sometimes on a cycle of feeding and vomiting for up to 12 hours, with short naps in between from sheer exhaustion.
How can I introduce any kind of routine? How can I make sure he gets enough sleep without him getting dehydrated and hungry? (And me too, I’m utterly exhausted). I think he gets chronically over-tired; he’s sleeping on average only 9 hours a day including naps, and once he is really tired, he fights sleep as if it’s an enemy. He’s gaining weight at an average 3oz a week now, so he’s not getting too much milk, if anything, not quite enough. His latch and so forth are fine – he takes a full feed in about 30 – 40 minutes, if he’s not sick or exhausted.
I’ve filled in the forms, but because his intake varies so much depending on how ill he is, they aren’t particularly helpful. This was for today.
Feeding and sleeping: 7am, full breast feed 45 minutes, 8am profuse vomiting, 8.15am full breast feed 50mins, 9am 1 hr nap, 10.15am breast feed 25 minutes, 2pm full breast feed 40 minutes, vomiting on and off small amounts for next two hours, whingy with tiredness, dozing off. 4pm nap of 1hr 40 minutes. 6pm feeding on and off for 7 hours, vomiting on and off, dozing on and off. 10pm expressed breast feed 6ozs, 12am expressed feed 5oz,1.30am went to sleep in his cot, a little sick, sheets changed resettled and went back to sleep.

The amounts that your son is still vomiting despite the medication still seem to be excessive. Ask for another appointment to see the gastric specialist at the earliest opportunity. His low weight gain and the possibility of him becoming dehydrated again need to be attended to.
Feeding a reflux baby little and often can help them take better feeds. Look at the routines laid out for younger babies and even if you have to wake him from a sleep try to keep to those timings where feeds are about 3-31/2 hrs apart.
This will mean starting your day at 7am even if you have been up in the night a lot. Although it is tempting to let your son feed for 45-50 minutes at a time, on the times when he does, he seems to follow these longer feeds with profuse vomiting. Try giving him a break after twenty minutes on the breast. Sit with him quietly or let him sit in a chair in an upright position, making sure that there is no pressure on his tummy or that he is not bent at the tummy. This should help him begin to digest the milk before being offered the breast again and finish the feed.
Begin to settle him for his nap with a wind-down period beginning about 1.5 hrs after he woke so he does not become overtired and fight sleep. You may need to sit with him in his darkened room and hold him against you but with no eye contact until he is sleepy before putting him down.
Feed him again about 10am and again split the feed into two halves. This may mean you are finishing slightly later than the timings on a routine but it may help prevent these excessive vomiting sessions. Offer him a small top-up expressed feed before settling him for his lunchtime nap around 11.45am. This should help him have a good sleep during the middle of the day. Make yourself have a rest at this time and eat a proper healthy lunch.
If you can encourage your son to stay awake after his 2pm feed for some play time, it may help him settle better in the evenings. Split the feed at 5/6pm as described in the routines up to 6 weeks. This should help him take a good feed at this time. Wait at least 30 minutes before bathing him after the first half of the feed. Getting this bath and bedtime routine in place will help you get the rest of the day to gradually fall into place. A warm bath can help your son relax before settling to sleep for the evening.
If he will settle by 7pm after the second half of the feed you can have a good rest yourself, enjoy supper and offer an expressed feed at 10pm. Try to keep him awake a little at this feed so he will settle better at night.
If the prolonged sessions of vomiting still continue despite seeing your specialist again you may find the routine being put out. Keep trying each day with a 7/7.30am start and bath and bed by 7pm.

Feeding FAQ: 8-12 weeks – Breast Feeding

How can I get my 9-week-old demand fed baby onto the routines?

I have just been introduced to the CLB book and trying to put it into practice. Any tips for starting with a 9 week old baby? She goes to sleep after a feed between 7-8pm at the moment. She was sleeping until 3am but then started waking at 10-12.30pm, 3am then 6-7am. She feeds from one breast, but there is still milk remaining if I squeeze the breast. She is a very unhappy baby during the day; she is not content even after a feed and a fresh nappy. She cries a lot during the day. Should I be bathing and feeding her earlier? She does seem very unhappy when I bath her and this seems to be due to tiredness. At bedtime she will feed and fall asleep then when I put her down in the moses basket, she stirs or wakes but does settle to sleep on her own as she does during the night after feeds. She is now too big for the basket really and for the past few nights I have put the basket in her cot to get her used to her nursery and ready to go into her cot. She is putting on weight well; her nappies are still fluid but there are plenty of them. Sleeping during the day can be hit and miss. Feeding during the day is about every 3 hours but they can be earlier or later.

To get your baby into a routine look in the book at the 2-4 week routine where the timings of feeds are probably nearer to your daughters 3 hourly ones at present.
To start to fit her into a routine always begin your day at 7am no matter what has happened in the night. You may need to wake her and she may only take a small feed if she fed at 5/6am. But this will help you keep on track for the days feed times. Once you feel that she is pretty much on the routine and has been for several days move onto the next one, then work your way towards the one for her age. She may not get there very quickly but keep working at it. As well as the 7am start put the bath and bedtime routine in place.
Make sure she is always awake by 5pm if she takes a short afternoon nap. Feed her one side and then let her have a kick whilst you prepare for her bath. As she wont be so hungry she should enjoy this better. Offer her the second breast before settling her by 7pm.
You will probably need to wake her for the 10/10.30pm feed but then you can get to bed knowing she has fed well. She should then only have one night waking around 2/3am. The routine helps you structure her day so she receives enough feeds between 7am and 11pm to only need this one night feed. If she is totally breast fed she may need a feed around 5/6am for another few weeks. Treat this as a night feed, keep the lights as low as possible, keep eye contact to the minimum and don’t change her unless really necessary. Settle her back until 7am and then start the new day with the curtains open.
Keep trying to settle her at nap times having a quiet wind-down period of about 20 minutes in her room; she should be held in the dark with no eye contact and then settled in her basket or cot when sleepy but not soundly asleep. At this age a baby will be become overtired and may fight sleep if they are allowed to be awake for longer than 2 hours after waking. Some babies of this age are ready to be settled for their nap 1.5 hrs after waking.
In the routines you will see the mention of expressing. Begin to do this at the timings suggested for 2-4 weeks. This will help keep up your supply and also begin to offer you the chance to offer an expressed bottle feed or top up if needed. You will always have a few drops of milk in your breast but if it feels soft and smaller your daughter will have emptied it. Begin to offer her the second breast at each feed as her daytime unhappiness could be caused by hunger.

Feeding FAQ: 8-12 weeks – Breast Feeding

My 8 week daughter only feeds for a short while at each feed so is feeding little and often

I am experiencing great problems with the amount of time my 8 week daughter feeds for. She will feed for 5-10 minutes, then stops and refuses to take any more milk. We have ended up almost demand feeding.

If my husband tries to feed her at 10.30pm she will only take 1.5-3ozs. She has started to demand a feed between 3-7 times during the night. Feeding for 5 minutes only, as she does not properly wake. It is impossible to wake her fully. I have tried all Gina’s suggestions, but my daughter just gets very distressed but not waking.

Last night, I did not feed her at all during the night. I resettled her with a dummy [she has not had one before] and she went straight back to sleep. This happened three times. I woke her at 6.45am. She would only feed for 10 minutes. At her 9am nap today I had to settle her with a dummy, which she did easily. Normally she settles easily at this time as I have just fed her. I am worried that she is not getting enough to eat if I make her wait until the next set feeding time. I haven’t had her weighed but she is very chubby and in 6month clothes. She weighed 9lbs 6.5ozs at birth. I have lost my confidence so please help.

At present she feeds at 6.50am 3 mins, 7.03am 2mins, 7.35am 1min, 7.51am 1min, 8am 1min, 10.25am 8mins, 10.35am 1min, 10.50am 3 mins, 12.05pm 7mins, 2.25pm 5 mins, 2.35pm 4mins, 3.25pm 5mins, 5.17pm 5mins, 6.15pm 9mins, 10.20pm 8mins, 10.47pm 5mins.

My daughter naps at 8.55-9.30am, 10.50-11am, 11.15am -12midday, 1.45pm to 2.15pm, 4-5pm. She settles at 6.40pm until 10.15pm. At night she settles from 11pm-1,45am, 1.50-3.00am, 3.10-4.20am and 4.30-6.45am.

There are two things you need to look at carefully first before beginning to try to get your daughter’s feeding into a better pattern: your milk supply, and how slow or fast your let down and flow is. You also need to make sure that your daughter is latching on correctly at all feeds and is managing to empty at least one side. At her age, especially if you have a good supply and a fast let down, she will have speeded up her feeding times considerably from those when first born. It is not unusual at all for a baby over 6-8 weeks to only feed for 10-15 minutes, and some may take less time to get a full feed.

It appears though, despite looking as if she has put on weight, that your daughter is “snacking” and using the breast to comfort herself. This will lead to a cycle of your breasts not producing enough at each feed and her receiving only fore milk, which will not fully satisfy her and therefore make her unsettled between feeds.

If you feel that your supply is dropping, follow Gina’s plan for increasing it. See page 52 of the Contented Little Baby Book. You will know through expressing roughly how your supply is.

If you feel that your supply is fine and your let down quite fast then you may have to look at other ways to pacify your daughter rather than always feeding her on and off through the times she is awake.

At 7am in the morning allow her first feed from one breast. Your supply will be at its best then so she may receive all she needs in 5 minutes. Are you aware of her emptying one side at a feed time? In order to take enough of both fore and hind milk she must empty one side before being offered the second. Once she has had 5-10 minutes before 7.45am, providing she is winded and content, let her have some kicking time on the floor or time to sit in her chair. If she begins to fuss, don’t assume that it is hunger and offer her the breast again. Although you may not want to have to use a dummy excessively, using it during waking times to pacify a baby who likes to suck can really help. If she is feeding fast she will need some “sucking time” and a dummy will provide that. Begin to offer her a dummy to suck on after her feeding time of 7-7.45am. Before putting her down for her nap at 9am, offer her the other breast so she will settle well to sleep. She needs about 45 minutes.

From your notes it appears she feeds well at the next feed. Remember, she has speeded up now so 8 minutes could well be all she needs. If she is content after this and is happy to kick for a short space of time then offer her a dummy again rather than the breast, until she is ready to go down for her next nap at 11.30/45am. If she took one side at 10.30am offer the other before her lunchtime nap. Trying to get this nap the longest one of the day should be your aim. Have a look at the article Gina has written on the Lunchtime nap to see how you might best cope with this. If your daughter has never slept through this time for a longer stretch it would be worth trying some of the ‘assist to sleep’ techniques suggested, such as taking her for a pram ride over this time, so she becomes used to sleeping for a longer period of time.

In the afternoon, again be aware of offering her the breast too often. Set yourself a limit to the times you offer her the breast, and don’t feed her after 3.15pm. Once she has taken 8-10 minutes’ worth of a feed don’t keep pushing her to have more, unless you are aware that she is not fully emptying one side. Offer her a pacifier if she appears to be unsettled. Providing she has slept better at lunchtime she may well cut back a little on her afternoon nap, which could affect how often she is waking in the night. The split feed she is receiving at 5/6pm is fine and, as she settles well in the evening, she is obviously getting enough milk at these times to satisfy her needs.

A sleepy feed at 10.30pm is often the cause of unsettled nights. This subject has been covered quite a lot in other questions in the 0-3 months’ sections of both Sleeping and Feeding on the site. In Feeding : Breast Feeding, you will find two relevant questions: “My 6 week old daughter is restless in the evening and is waking earlier in the night” and “My 4 week old baby wakes at 6am, then feeds and naps all morning.”

Waking her by 10pm and then keeping her up until 11.15pm could well help the night ahead. If you husband is willing to do this feed then make it an expressed one and split it as described in:

Once your daughter is taking a better feed at this time you will be able to work on the night time waking. If she has taken a good feed at 10/11pm then she should be able to get to 2/3am before genuinely needing to feed again. If she wakes, or is unsettled before this time try to settle in another way, rather than feeding. Offer her some cool boiled water and give her a cuddle. Using a dummy throughout the night to settle her may mean she begins to associate settling to sleep with that rather then your breast which has been doing so up until now. Look in The Contented Little Baby Book page 148 for a description of the “core night” which is the method used to get a baby to lengthen the time between night feeds. She may still need to feed once in the night, even if only for a short feed before settling back well until nearer 7am. As you noticed the night when you didn’t feed her at all she still only fed for 10 mins at 6.45am showing that she is an efficient and quick feeder.

In order to really assess how your daughter is doing, and also so you can calculate how much she should be able to take at 10/11pm when offered an expressed feed it would be advisable to get her weighed. To get a rough idea stand with her on the scales at home and then weigh your self with out her. This will be an estimate only. In order to know that she is gaining on average 6-8ozs a week it would make sense to use your baby clinic once a fortnight to check on her progress. This knowledge of a steady gain will make it easier for you to assess her real needs between feed times which may be more sucking using a dummy than tiny snacks which will not fill her properly.

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.