Feeding FAQ: 3-4 months – Breast Feeding

My daughter of almost 4 months old has started to wake earlier in the night and needs feeding to settle her back to sleep.

Up until 2 weeks ago, my daughter of almost 4 months old had been sleeping until 5am after her last feed of formula at 10:30pm. I had been following the core night method and she did manage to sleep through until 7am on two occasions. However, now she is waking up any time between 3am and 5am. She will no longer accept cool boiled water or a dummy but will only settle if I give her a full feed. Once I have fed her she will happily sleep until I wake her again at 7am.
Although she is still waking only once in the night, I don’t feel like we are making any progress and I’m worried that, now she is waking earlier, she may eventually start waking twice. Where am I going wrong?
I have thought about weaning as her hand- eye co-ordination is fantastic and she constantly has her fist in her mouth but she doesn’t cry after her feeds and she is normally happy to go 4 hours in between feeds.
Also I doubt her weight has doubled since birth, although I haven’t weighed her for a few weeks now.
I have kept her on the 3-4 month routine and still split feed at 5 and 6:30. I tried dropping the 5pm feed but she cut back on her 10:30pm feed and always woke before 4:30am. She sleeps no longer than 3 hours a day. Sometimes she falls straight to sleep and sometimes she needs to cry down for anything up to 15 mins.
She has always been a quick feeder and will not feed very long, but my doctor said this is because I have a fast letdown and she is a very efficient feeder (as was my last daughter).
Up until now these routines have been a life saver, as I experienced a lot of problems with my first child (now 2 years old) who didn’t have a proper routine and didn’t learn to sleep on her own until some drastic sleep training when she was 18 months.
My daughter is breast fed at 7.30am 5-10mins, 11am 10-15mins; this feed may be earlier if she hasn’t fed well at 7.30am. If she feeds for only 10minutes I will give her a 2oz top up of formula.
2.15pm 5-10mins, 5pm 5-10mins, 6.30pm 10-15mins, 10.30pm 5-6ozs formula followed by 5-10mins breast feeding.
My daughter naps at 9-9.45am, 12-2.15pm and settles at 7pm.

At present the guidelines suggest waiting until 6 months before introducing solids, which may mean that your baby will have to go back to feeding in the night if all of her nutrional needs are not being met during the day. It is possible that your baby is waking up earlier in the night because she is going through a growth spurt and she needs extra milk. During growth spurts we advise that the baby is encouraged to feed longer on the breast to help increase the milk supply and if needed introduce some additional milk feeds to meet the baby’s increased appetite. In your case we would suggest that, for several days, you bring forward the 11am feed to 10.15am and offer both breasts, followed by a top-up breastfeed just prior to the lunchtime nap. We would advise that you continue with the split feed at bedtime until your daughter is sleeping through the night from the late feed. Dropping the 5pm feed will result in her taking a bigger feed at 6.15pm, which could have the consequence that she takes a smaller amount at the late feed. This is something you should try to avoid until she is sleeping through regularly. We would also suggest that you bring forward the 10.30pm feed to 10pm and offer her as much of her feed as she wants, then keep her awake until nearer 11pm. At this point you should take ber back to the bedroom, change her nappy, dim the lights and offer her a freshly made top-up feed. The combination of having her awake longer and giving her a split feed, may help her go longer in the night. All of these suggestions will help her increase her overall daily intake, which should help her go longer in the night.

Additionally, check for all the other reasons why your daughter may be waking at 5am. If she is in a sleeping bag make sure she is well tucked in, using a cotton sheet and light cotton blanket if needed. Stretch the covers lengthways across the cot and ensure that a sufficient length is tucked under the mattress. Finally secure the covers down the sides of the cot using rolled-up towels. If she firmly is tucked in this may prevent her from waking fully when she stirs whilst in a light sleep in the early morning.

We would also suggest that you gradually cut back on her morning nap to around 30 minutes, eventually moving it on to 9.15am and then at around six months to 9.30am. Once you have moved the morning nap on, you should then move the lunchtime nap onto 12.30 to 2.30pm.

All of these changes should help her go longer in the night, and eventually sleep through the night. As her nighttime sleep improves, if you notice that she is cutting back on her 7.30am feed, then very gradually cut down on the time she feeds in the night. Reduce the time she has on the breast by a minute or two every other night. Providing she settles back to sleep quickly until nearer 7am you can continue to very gradually cut back on the middle of the night feed. If you reach a stage where you think she is waking through habit and not hunger, then you could try the core night method. But we must stress that the core night method should only be used if your baby settles back to sleep fairly quickly without a feed and then sleeps until 7am. If this does not happen we would advise that you continue to feed in the night until your baby is weaned.

If you feel that she is ready to wean before six months then we would advise you discuss this with your health visitor.