Feeding FAQ: 3-4 months – Breast Feeding

My 3mth son is constantly unhappy long before feeds are due and he finds it hard to settle to sleep

We started the CLB routines when my son was 10 weeks old, and in order not to be too harsh, we put him on the 4-8 weeks routine first and gradually advanced to the 8-12 weeks routine.

My son is always fretting after his morning nap. He never sleeps more than 45 minutes and is usually awake after 30 minutes. For the first time in 4 weeks after putting him on the routine, I gave him 40 ml expressed milk and 60 ml formula milk this morning (On normal days, I breastfeed him first and then offer him formula milk after that. He usually takes about 40-50 ml of formula milk. However, I realized that since introducing him the bottle, he’s not sucking so ell when breast feeding , so I am in doubt how much he actually gets when he is latched on. That’s why I gave him expressed milk this morning, so I know precisely how much he is eating). Like other days, he frets almost immediately after he is awaken today. We try to entertain him and as time goes by, nothing seems to interest him at all. I then started to breastfeed him almost at 10:45, and by then I can see that he’s hungry. As I do not wish to fall into the trap of demand feeding, I always drag till 10:30-10:45 before giving him milk. But it means he is unhappy for about an hour. He is usually unable to wait until his next feed and will show signs of fretting – usually his noon feed and late evening feed. Should I do a split feed?

My other problem with him is, he fights sleep, every single time he is being put down. The only time he does not do it is after his last feed at around 22:45. He can cry and scream up to 30 minutes. We don’t comfort him anymore after he is being put to bed. And I always wait until he does not want to drink anymore before stopping feeding him which means he shouldn’t be hungry. For 4 weeks, he has just been fighting sleep and it does not seem to have improved at all. We used to hold him in our arms or sling until he fell asleep, and many a time, he just woke up again, and we had to continue the same until he eventually fell into a deep sleep without waking. We simply do not want to do that anymore. How can we ensure that his crying will shorten? It really hurts to hear him cry and scream like that. He sleeps in a baby “cabin” (used together with a push pram). For your information, he has been sleeping right through the nights the past 5 days.

My son feeds at 7am breast feed followed by 40-60mls formula, 10.30am breast feed followed by 70mls formula, 2.30pm breast feed followed by 70-80mls of formula, 6.15pm breast milk followed by 110mls of formula, 10.45pm milk from 1breast then 60-100mls formula. He weighs 5000gr.

He sleeps at 9-9.30am, 12-2.30pm and 4.30-5pm. He settles at 7.30pm.

When you first decide to follow the routines it is sensible to begin, as you did, with a routine for a slightly younger baby. Once you feel that your baby is ready to move on to a routine for his age then by all means do so. But some babies may not be ready and so should stay on a routine more in keeping with their needs, despite their age. In time they may catch up, but the routines are a guide to work towards rather then to try to force onto your baby, if they are not quite ready. Take a look at Gina’s article Structure without Stress.

If your son is fretful and hungry when he wakes from his morning nap then feed him, rather then trying to make him wait, which must be upsetting for both him and yourself. Splitting the feed is a good idea. If you offer him the breast feed at 10am and then his top up bottle around 10.45am he should be much happier. This is not demand feeding him as he is genuinely hungry and needs to be fed if he is showing these signs.

The feed he has in the late evening could also be split, especially if he is waking earlier for it. Again, give him the breast feed when he wakes and, if you like, let him have a short break, with a quiet kick before offering his top up formula feed. This will ensure he has taken a good feed and he should continue to sleep through the night as he has begun to do.

Mixed feeding (i.e. giving both breast milk and formula at one feed) is possible but it may make things easier for you and your breast milk supply if you began to fully formula feed him at certain feeds, such as the 10pm feed, and fully breast feed him at others. Giving top ups at every feed can lead to a decrease in your overall supply as the breasts don’t get the message as to how much is needed at each feed. If you wish to continue breast feeding mixed with formula then take a look at Gina’s detailed guide to this in Contented Baby to Confident Child, page 11. If you feel that your supply is low at present and he is not taking sufficient at each feed time, follow the plan for Increasing your Milk Supply on page 52 of The Contented Little Baby Book.

The problems that you are having with your son settling to sleep could well be a combination of both hunger and of him having developed the association of being rocked to sleep. Once you have tried to increase your breast milk supply and feel that he is taking between 150-180mls at most feeds you may find your son settles better. This is the average amount of milk a baby of your son’s weight needs. Some babies may take slightly more than this, some slightly less, but that is the figure to keep in mind at present.

Before settling your son at 9am and midday for his naps offer him a top up feed either of expressed or formula milk and see if this helps him to settle better. Once he is better at settling and sleeping for the amount of time he needs you can drop these top ups.

Make sure that you take him to his room at least ten minutes before he is really showing signs of tiredness and have a quiet wind down time with him. As he appears not to be ready to wait for the timings of feeds indicated for babies of 8-12 weeks he may also be ready to sleep sooner than the times you have been using. Many babies of this age can only stay up for and hour and half before needing to settle to nap again. Be guided by his needs and move the timings accordingly.

Change his nappy and then hold him whilst you talk to him quietly, perhaps looking from the window for a few minutes. Close the shades and curtains which will signal to him that nap time is coming. Sit with him in the darkened room letting him gradually calm and relax with you. Try not to talk too much to him at this time, nor keep eye contact, but hold him firmly against you. Once he is sleepy eyed, put him down in his “cabin” and tuck him in firmly. Leave the room and close the door behind you. He may take another 10-15 minutes to fall asleep and cry whilst he does so, but the sort of grizzly cry which babies make as they are calming themselves into sleep. It is a skill they need to learn. If he cries loudly and the cries continue in strength, rather than diminishing, then go back in to reassure him after 10 minutes. It is unfair to leave a baby of this age to cry for long periods without reassuring him of your presence. The sound of your voice and a couple of strokes on his head will let him know you are there. You may need to do this a couple of times before he finally sleeps. Once you have eliminated hunger, and are getting him down in his “cabin” whilst he is sleepy but not overtired, the crying should begin to lessen. Nobody likes to hear a baby cry, and although some do protest when put down for a sleep this should begin to shorten as they get more used to settling alone, providing they are not overtired and they are not hungry. Once your son has become more used to settling himself to sleep you will be able to put him into his “cabin” whilst he is more  awake but he will still need a time of quiet before going down. This helps him relax and calm himself if he has been active and busy on his play mat. A baby learns to associate this wind down time with sleep and so gets better at settling alone. It may take a while for your son to unlearn the association he has of falling asleep whilst being held.