Feeding FAQ: 0-8 weeks – Breast Feeding

My twins of four weeks seem unable to go longer in the night without needing a feed

We followed the week one routine for two weeks, for our low birth weight twins born at 38 weeks and have been following the two to four week routine for 7 days. They have regained their birth weights, are over 7 pounds and gain 9 oz per week, with both consuming a lot more than 75 ml per pound weight.

Most awake times and day feeds go well, except the early morning feed. They usually wake between 2 and 3am and will not sleep longer. I usually wake with the first one, then pacify her with a dummy and hold her till the second one wakes. This takes between 10 minutes and an hour. I feed between 60 ml and 110 ml. They then wake again usually just after 6am. It makes no difference, a small feed or a big feed at 2/3am, they still wake before 7am. At 7am they will usually take another big feed. They take more than the daily requirement during day feeds, with big feeds at 10:30 pm and 7 pm. At 10:30pm I try to have them awake at least an hour. How can I get them to sleep past 3 am? I would prefer not to feed at different times as I am already not coping well with the lack of sleep.

At present they are having a mixture of breast, expressed and formula feeds. One of the girl’s won’t take the breast, the other will but from the amount I express in the day [around 300 mls] I feel she is not taking much.

The twin’s feeding is as follows.

Twin 1
7am breast, 40mls expressed, 20mls formula
10am breast, 40mls expressed, 50mls formula
2pm breast, 40mls expressed, 40mls formula
5pm breast, 100mls formula. Split feed but taken mostly at this time, the girls do feed well after the bath.
10.30pm 110mls formula
3am 90mls formula
Daily total approx 560mls
Weight 7lbs 12ozs. Birth weight: 5.13ozs

Twin 2
7am 60mls expressed, 50mls formula
10am 60mls expressed, 60mls formula
2pm 60mls expressed, 30mls formula
5pm 120mls formula, mostly taken at 5pm
10.30pm 110mls formula
3am 10mls formula
Daily total 610mls
Weight 7lbs 7ozs. Birth weight: 5.8ozs.

The girls nap at 9-10am, 12-2pm, 4-5pm and are settled at 7pm.

You have done exceptionally well to have got the twins on, to the routines so well already. If you look at the website you will see that Gina has written an article on Structure without Stress which explains that the routines can be used as a guide to work towards but you also how you need to take in the individual needs of your babies as well.

At their present weight the girls will still beneeding a feed between 2am/3am for a few more weeks. As they get bigger and able to take in more milk they will begin to stretch this feed to later in the night. Having been born two weeks early it is unrealistic to expect them, at their weights, to stretch out their night sleeping quite yet. The routines have to allow for the great variation in weights of babies 2-4 weeks old. If one of the girls wakes around 2am obviously looking a feed it would be better to feed her straight away and then wake the second baby, if she has not done so by the time the first is finished feeding. Often the second baby will wake halfway through the first one feeding and they can be fed in tandem, so limiting the amount time you are up feeding. As the girls do not have a great difference in weight they should be able to sleep for a longer stretch around the same age. It would be better to allow them to do this on their own, rather than pushing them too much at this early stage. A larger birth weight baby may be beginning to sleep until nearer to 4am by the end of four weeks but your girls may take slightly longer. Below is outlined a method for splitting the feed at 10pm which also may help them push on a little when they are ready.

It is also not unusual that they are then waking before 7am. If they are obviously hungry when they wake at around 6am you should feed them and then offer a small top up at 7.30am to keep them on track for the rest of the day. Keep this 6am feed as a night one. Use a dim light, little eye contact and only change them if it is really needed. Settle the girls back to sleep as soon as you are able to, even if only for 30 minutes or so before waking them again at 7.30am and beginning your day.

To help the girls have a better split feed at 5pm/6pm be aware that they may be getting too tired after their bath to want to feed properly. Try giving them 60-80mls at 5pm then sit them in their chairs with a dummy for a short time before having a time of free kicking with no nappies on, followed by their bath at 5.30/5.40pm. This can be a tricky time of day, especially with two babies to care for. Overtiredness can be a problem so don’t be afraid to move everything forward slightly. The girls may be bathed, fed and ready for settling at 6.30pm as many young babies are. Having a larger feed split over the hour and a half at 5pm/6.15pm really helps a young baby sleep well at night.

If you look through the FAQ’s for this age in the Sleeping section you will see that many young babies can be very sleepy at 10.30pm. The trick is to begin waking them early enough, often around 9.45pm so they wake naturally and fully. Keeping them awake from 10pm-11.15pm really can help a baby begin to stretch their night but only when ready. Again, splitting the feed at this time is a good idea. See page 138 of the Contented Little Baby Book which explains how to do this. There is also a question and answer at the bottom of page 86 of the same book which shows how a split feed and longer waking time may help later on in the night.