Questions about breastfeeding

[LHBryan]

I have a 4 1/2-month-old DD who's exclusively breastfed. I'm hoping some Moms who've BF (or are currently BFing) their babies will share their wisdom and experiences.

-I work FT outside the home, and DD typically gets 3 bottles during the day: one mid-morning, I nurse during lunch hour, then two bottles in the afternoon. Most bottles are 3.75-4 oz. According to the Kellymom BFing website, babies don't need more than 4 oz./feeding, regardless of age (due to stomach capacity, the fact that the composition of breastmilk evolves as the child grows, etc.). However, there are others who advocate greater quantities of milk as they grow (of course taking into account how much the baby wants) using a formula based on LO's current weight and # of feedings/day). Our DD currently weighs ~14 lbs, 6 oz., so this formula [weight x 2.5, then divided by # of feedings] would mean that she would take somewhere between 4.5 and 5.2 oz per feeding. She's not usually dissatisfied with 4 oz., but I think she would often drink more. How did/do you determine the amount of EBM per bottle?

-My next question may relate to the first. DD used to be a great night sleeper, waking once or twice to nurse. Around 8-12 weeks, she would often go 6 or 7 hours (even 8 1/2 once!) without eating. Around 3 months or so, she stopped waking just once and it became consistently a 2-waking/night routine. I've never really minded the wakings b/c she nursed about 10-20 minutes, then peacefully went back to sleep. I figured she's obviously hungry and at some point when she's ready she'll sleep longer stretches. In the past couple of weeks DD's been waking much more frequently and more hysterically probably for a variety of reasons (a cold, possible teething, swaddle weaning, developmental milestones etc.). During the first several bad nights, it seemed like I could soothe via nursing about half the time, but for some wakings she'd tolerate other methods (shhhing, pacifier, etc). I'm not quite sure how it evolved, but DD has now settled into waking at least 3 times to nurse, and she's completely inconsolable if I don't feed her. She hit my hand HARD last night to swat away the pacifier, then pinched DH when he picked her up to try comforting her.:eek: Actually last night wasn't so bad compared to previous nights--asleep by 7pm, awake at 9:15pm, 12:00am, 3:30am to eat, and up for good at 6:45am. So now I'm wondering if she's not getting enough to eat during the day or if she now can't fall back to sleep unless soothed by nursing. Or, it could just be she wants Mommy time. She does nurse fairly well during these feedings (~10 minutes or so), and as long as I nurse her she goes back down fairly easily. I certainly don't want to deprive her if she's hungry, but I also don't want to create a nightwaking habit and reinforce the nursing-sleep association. How often did your LOs wake to nurse around 4-6 months? Did starting solids help decrease nightwakings? Do our problems sound familiar? Are we developing bad habits?

-Lastly, is anyone familiar with the book [I]The Sleepeasy Solution[I]? Any reviews? The authors tout their technique as the happy medium between coddling and ignoring (their words, not mine), so I thought we might read it next weekend to see if it's worth implementing.

Any advice? Thanks.:)

-Laura

[food girl]

First of all, I know that you must be exhausted! Whew, reading your post made me tired!

I have breast fed my two girls and I am 10 mos into nursing dd#2. I would try giving her more during the day. You may be right that she's not getting enough during the day. I have never given bottles but I know from the sitter,husband grandma etc. that the amout both of mine would take would vary and they could and would take 8 oz at times. I would make up a big ol' bottle and see how much she will take.

I would pick one night time feed and just ignore the crying (probably the 9 pm). I am a firm believer in CIO. It has worked for us.

I'll think of you when I'm up at 3 a.m with my 20 lb baby. Don't "they" say that a baby can sleep through the night when it reaches 10 lbs? HA! We seriously need to let her CIO... :rolleyes:

Lisa

[sparrowgrass]

My youngest is 24 now (years, not months) but I do have some vague memories of breast feeding.:)

I think that 4 ounce thing is a crock, and makes no sense. Give the kidlet a big bottle for a couple of days, and see how much she drinks.

They will wake in the night if they are going thru a growth spurt, too, but that should be temporary.

[LHBryan]

Thanks so much for the feedback, Lisa and Sparrowgrass! If anyone else has advice, I'd love to hear it.

I think you both may be right about the 4oz rule being a crock, or at least not right for every baby. DD took 5 1/2 oz. from DH the other day no problem. Of course, then I got mad at him b/c I had just been reading about the 4oz. theory again.:o Interestingly, while I don't spend much time on the km boards, I have yet to read a post from a mom following the 4oz. guideline whose baby sleeps more than 2-3 hours a stretch.

Lisa--If she's still waking like this after I further investigate/address the bottle quantity issue, then I'm afraid you may be right about CIO for one of the feedings. Last night I think (sometimes the nights are so foggy!) it was 8pm bedtime (b/c she napped around 6:30), then wakings at 10pm, 1am, 3:45am, and up at 6:45am.

-Laura

[TLee4]

Laura,
I think the 4 oz thing is crazy too. Babies are self-regulating. I am BFing #2 right now (he's almost 3 mos). I went back to work last week. I make him 4 oz bottles, but tell the caregivers to give him more if he seems hungry! (Not that it's necessarily related, but he cluster-feeds a lot between 7-9pm, and most nights he sleeps through or eats once).

Terri

[sparrowgrass]

I never used a bottle, so I have no idea how much my kids took at a feeding.

If you have a scale, you could weigh her before and after breastfeeding, and know how much she ate.

I would rather err on the side of tossing some leftover milk than letting the babe go hungry and wake up all night.

[cchhbb]

What you might want to do is give her the 4 oz bottle and then have a 2 oz one in reserve. That way you can gauge how much she would like and not waste a lot of precious bm.

[ggs830]

Laura, I don't think the 4 oz. rule applies to all babies. As with all things, each baby is different, so I would experiment for a couple of days, and give Hannah varying amounts of milk. A good rule of thumb my ped. told me was that if your babe takes the milk w/o spitting up, then that's probably the amount she will take at each feeding. We topped out at 8 oz. with Shaelyn (at one point), and 6 oz. with Jahan using this rule.

As a PP said, I would rather waste BM/formula (and frequently do!) than let a baby go hungry. :)

[JanetB]

I nursed DS1 while working full time for 16 months - and I now have a very stubborn DS2 who is very reluctantly weaning at 16 months. By 4.5 months DS1 was taking at least 5 oz each feed in a bottle. You might want to try giving her a bit more - if you are producing it.

Also, I am a big fan of "The Happiest Baby on the Block" - but I also used "The No Cry Sleep solution" for info. For my boys the night feedings were the hardest to get rid of. I will note that DS2 the fact that he wasn't napping enough during the day was hurting his sleep habits. DS1 set himself up on a nap schedule - DS2 had to be forced into one - and this got his night wakings down to one.

Good Luck.

[honeygirl1971]

I don't have much advice for you since I didn't pump much and so DS just took as much as he wanted from the breast. But, I will say that from 6 mos to 12 mos we had lot of trouble with nightwaking. Sometimes we could get him to go back down without nursing, but usually he nursed at least once during the night. Often we could get up with him 2-3 times a night, though. I really, really think that he just needed to outgrow this phase--we tried CIO and a bunch of other stuff, and basically nothing worked until he was ready himself. I also think teething had a LOT to do with it. Now if he wakes up in the night, he almost always goes back to sleep on his own, but from 6 mos to 12 mos it really was tough. I read Health Sleep Habits, Happy Child, The No-Cry Sleep Solution, and all the stuff about nightwaking in Dr. Sears' book and got good tips from all the books, but no magic formula. I do think getting a good schedule, regular naps, etc. helps, and it's great if you've gotten your DD to take a pacifier (DS has never accepted one), but this might just be a phase that she needs to grow out of. I know that's not necessarily comforting, but the books sort of scared me into thinking he would be like this forever, and he wasn't. Around his 1st birthday he settled into a good sleeping pattern, usually 12 hours a night, 7pm to 7am. It is a lot easier to put him down in the first place now, too. In any case, I know how tough it is, and I hope you find a solution that works so you can get some more rest! :)

[Megan James]

Laura
My DD is 2 (today:D ) and I'm still breastfeeding her. We exclusively bf-ed until sometime in her 6th month. I worked part time and sent bottles to daycare. She would be there 5 hours inthe morning and I would nurse her before she got there. Some days she would drink one 4-6 oz bottle, a lot of days she would drink 2 4-6oz bottles. And some days she would still be hungry and my daycare lady would bust out another pack of frozen milk for a total of more than 12oz. DD is big for her age ~90%percentile height 50% percentile weight.

So my advice is let her have a bit more and somedays she drink it and somedays she won't. Somedays she may want it b/c she's hungry and somedays b/c she's msising you. In my book that's OK as long as she's the one "asking" for it and not someone giving it to her for other reasons.

Good luck

[LHBryan]

Thank you all for sharing your experiences! I feel much, much better.

The kellymom site has some really good breastfeeding info, but I think I'll stay over here.:) They are so emphatic about the 4oz thing (saying that giving more is overfeeding and the equivalent of a Thanksgiving meal!:eek: ), and I was really starting to question my gut. It's just so hard when I'm not around to see how DD bottle feeds. She's definitely growing and getting enough to eat, but I'd like for more of those calories to be consumed during the day if possible. I really don't mind a couple of night wakings to feed at this age, but now I fear she's "reverse cycling" where she gets more of her calories at night, possibly due to her preference for me (although she takes a bottle very well) or possibly due to the bottles being not quite enough. There's also the issue of distractibility at this age--she can really concentrate on eating at night b/c it's quiet, dark, soothing, and bare-minimum interaction. I don't feel I can address any sleep issues or "associations" until I feel confident she's getting enough to eat during the day. I've always told daycare and DH to give her whatever she wants--and to be flexible w/ the amount--, but DH is so routine-oriented (likes set quantities as his guide) and daycare seems overly cautious about wasting or thawing milk. Both say DD seems ok w/ 4oz. and doesn't usually complain like she hasn't had enough. But, DH says she will probably happily eat more and be more satisfied. For a while daycare was doing a strange snacking routine, giving her 1-2 oz. or so every hour in the afternoon, but I think it was just an easy way for them to address her fussy spells when she was overtired and refusing to take naps there. It seems like they're back to offering larger bottles every couple of hours.

However, I'm sort of ticked w/ daycare after yesterday. During the work day H generally takes 3 bottles if I nurse during lunch, 4 if not. The daycare set up is great b/c they let me keep a small freezer stash there. All I have to do is prep her first bottle, then take along a bag of fresh milk for them to use throughout the day. They can pull out frozen to supplement, and I always encourage them to use whatever they need. So, I took a 4 1/2 oz. bottle for mid-morning and told them to feel free to give her more b/c I'm concerned she's not getting enough to eat during the day. I went in at 11:45 to nurse, and told them there was enough fresh (5oz) for one bottle around 2-ish, and that I'd pull out a bag of frozen milk for them to use for a late afternoon bottle. Well, when I picked her up at 5:30, the freezer bag was still in the fridge untouched and she'd eaten only 4oz at 2:45pm. They thought she was hungry, but said they didn't want to thaw the freezer bag "all the way" since I was coming to pick her up.:confused: DD is the last to leave her room, so I didn't want to keep the teacher there so I could nurse. DD had to wait until we got home ~6ish to eat. No wonder she's eating a lot during the night if all she had during the work day is 8.5 oz and one sleep nursing session over lunch!

I love the suggestion about giving her the usual 4 oz bottle and having a 2oz on hand, so DH is trying that today. I definitely agree that settling into a good nap schedule should help with the nightwakings. Over the weekend I was able to get terrific morning and lunch-time naps (unprecedented 1-hour each morning and 2 hours each noon!!), but then let the late afternoon nap slide b/c of errands and a visit from friends. DD definitely needs the third nap. I'm also a big fan of HBOTB, and I read the No-Cry SS for nap problems but that was before the nightwaking problem surfaced. So, I need to check it out from the library again. Honeygirl, I'm glad to hear your DS is now a great sleeper after going through a lengthy nightwaking phase. DD does usually fall asleep on her own when I put her down for the night, so it gives me hope that she won't always need to be nursed back to sleep (or otherwise helped) when she wakes up during the night. The books do scare me into thinking I'm ruining her and preventing her from ever being a good sleeper! Last night she did take the pacifier and some brief shhhing/chest rubbing for two of the wakings, but then there were several others when only nursing would do.

DD is also a relatively big girl--at her 4 mo. appt. she was 50th%ile for weight and 95th%ile for height. And she's extremely active. I was shocked to find that many of her 6 mo. clothes I'd been saving for fall/winter fit perfectly now and probably won't much longer. Now that I'm thinking about it, back in July I did have her weighed after a feeding when we encountered some nursing issues. At 6 weeks, DD consumed 3 3/4 oz. in 10 minutes! She is a hearty eater and probably does need more! (Although DH just emailed that she was reluctant to eat this a.m. and only took 2.75 oz.... Ugh, I think she's enjoying our new nighttime routine!)

Oh, and Terri--since she's usually so tired when I come home from work (b/c of poor napping), she won't cluster feed before bed. I've tried a few times thinking that may be our answer. I tried last night to feed her a second time before bed, but she's so overtired she gets revved up and starts fussing and "wrestling" with the nipple.:eek: I put her down and she falls asleep within minutes. I think the 9ish and 12ish wakings must be her version of cluster feeding. She just wants to nap a couple of times in between feeds!:rolleyes:

Thanks again.:)
-Laura

[AvrilH]

I agree that she should have as much as she wants to eat during the day (which is how BFd babies eat from the breast, no?) It sounds odd to set a limit.

You did not mention when you returned to work. I've read (and my personal experience tells me) that babies will often reverse their eating schedule when Mom goes to work: The baby who once nursed a lot during the day and not through the night, will take what is absolutely necessary only during the day, and do more of their eating at night. Smart little buggers, aren't they?

I nursed my 3 boys for a total of almost ten years. Each of them nursed through the night into toddlerhood. As a working mom, I actually liked having the nighttime with them to stay really connected (I should mention that I co-slept with them, so I wasn't dragging my sleepy butt out of bed every night - probably makes a difference).

As well, I wonder if she is getting enough sleep during the day? I found that a over-tired baby makes for a restless baby at night. The better they sleep, the better they sleep, if that makes any sense.

[food girl]

I nursed my 3 boys for a total of almost ten years.


I would SO be bringing that up every Mother's day!:) :) :) :) :)

[Jessica]

I don't have any specific advice but wanted to send some support. I bfed my son for 13m and it was one of the hardest things I ever did. He was a terrible sleeper, too. I found that the No-Cry Sleep Solution helped me cope. Hugs to you--you are doing a tough thing.

[JenZen]

Re: bottles:

I BF both of my kids, and I worked full-time after they were each 3 months old, so I did a LOT of pumping. :) With DS, I remember giving him 5 oz bottles, but then again, it varied based on my production. With DD, they were most often 4 oz, but sometimes I made 5 oz or a little more. I would just ask the daycare ladies how quickly she drank the bottle and if it seemed like she needed more. If I made more on a particular day, I would make the bottles a little larger.

There were days when she only wanted 3 oz. ... it all just depended.

I think the big thing is to be in good communication with your providers. Keep asking them about feedings, and get their reading on whether the baby could stand for a little more at times. Also, I kept a bag or two of milk in the daycare freezer in case my kids had a day where they needed more.

Hope that helps!

Jen

[Bawstinn]

Honeygirl, I'm glad to hear your DS is now a great sleeper after going through a lengthy nightwaking phase. DD does usually fall asleep on her own when I put her down for the night, so it gives me hope that she won't always need to be nursed back to sleep (or otherwise helped) when she wakes up during the night. The books do scare me into thinking I'm ruining her and preventing her from ever being a good sleeper! Last night she did take the pacifier and some brief shhhing/chest rubbing for two of the wakings, but then there were several others when only nursing would do.

DD is also a relatively big girl--at her 4 mo. appt. she was 50th%ile for weight and 95th%ile for height.


I just wanted to chime in as another mom who breastfed and had a frequent nightwaker. Every night. We got it so that she woke up at 1 but then would get up again at 5 ready for the day. I nursed her at the 1 AM waking because it was the only way that I could get her to go back to sleep. She is a stubborn little one (takes after her dad, of course) and wouldn't stop screaming when I tried CIO (I broke at the 1 hour point despite 'everyone' telling me she'd stop). We even tried having dad give her a bottle rather than me nursing and it just didn't work. Anyway, when she hit a year it was as if a light went on. She stopped waking at 1 then gradually stretched it out so that she now sleeps 11 hours during the week and 12 on the weekend (she's almost 17 months).

As for amounts, I have a good sized little girl (she was 95% for both until she started crawling) and she was taking 4 oz when I first went back to work and quickly jumped to 5 and then 6oz bottles.

[LHBryan]

Thanks so much for your responses and support!

Jessica--it is so tough! I am very grateful I've been able to BF, so I feel sort of guilty complaining. Does your son still have sleep troubles?

Avril--I'm impressed! I returned to work on August 1, so I do think reverse cycling is part of it. Yes, they are smart little buggers! However, she will take a bottle at night and sometimes a pacifier (w/ no feeding first), so that's not the entire answer. I too enjoy many aspects of caring for DD at night since I'm not with her during the day. I think I could be very content with one, two, or even three wakings that are spaced out a bit. However, what I can't handle are nights like Monday w/ waking every single hour (starting at 8:30pm!) except for one barely 2-hour stretch. I'm a zombie the next day. Maybe I could handle it better if we were cosleeping, but we decided that wasn't right for our family. When we have a night like Monday though, I eventually just "sleep" in DD's room and feel less disrupted. (Oddly enough, she screamed the few times we've put her in our bed. And ever since ~10-12 weeks, she doesn't really like to be rocked, swayed, or even held to sleep.) DD definitely doesn't nap enough during the day (which we're always working on), and I too am a firm believer in the "sleep begets sleep" theory.

JenZen and Maria--Very helpful info. So, Maria, do you recall what you did to encourage your DD to just wake at 1am? And when you did it? After reading some interesting info about different infant temperaments, I have a feeling our DD will also just scream for hours if left to CIO. In theory I'm willing to give it a try at some point, but DD is very spirited, intense, and persistent so I really can't imagine she'd just stop crying and fall asleep.

We're still experiencing lots of nightwakings, but I'm hopeful we'll get this figured out by experimenting with some different techniques. She has been happily eating a bit more during the day (between 4 and 5 1/2 oz./bottle) and seems to be a little less interested in nursing w/ every nightwaking. Interestingly, DH gave her a 4 oz. bottle on Friday night at ~11pm, and she then slept a 5-hour stretch. She also did pretty well the next night after I gave her a bottle at 9pm. Then Monday night was terrible, but that was a day when DH couldn't get her to nap well. She definitely made up for it during the day yesterday w/ her best nap day ever. I'm thinking most of her problems stem from not napping well during the day and then being overtired at night when it comes time for a "last fuel-up" and sleep. The bottle takes so little effort and she can gulp it down easily. I would like to avoid always giving a bottle at night (we did it only those two nights) b/c I'm having a hard time keeping up w/ all that pumping, so I'm trying to keep her more alert when she nurses and nursing on both sides when possible. I'm also going to move her bedtime earlier to see if it helps at all. She always gets cranky and starts rubbing her eyes around 6-6:30, so it's pure selfishness on our part keeping her awake while we try to fix/eat dinner. It'll be interesting:rolleyes: to see how the upcoming time change will affect things too.

Keep the advice coming!

Thanks,

Laura

[Jessica]

Laura--My son is 17m and sleeps through the night, although naps can be hit or miss. At 4m, he still woke every hour or so and I was a zombie; my DH was not much better. We had no idea what we were doing. By 6-7m he was waking 1-2X a night for feedings and that felt like heaven. He slept through the night regularly around 10m.

[Bawstinn]

So, Maria, do you recall what you did to encourage your DD to just wake at 1am? And when you did it? After reading some interesting info about different infant temperaments, I have a feeling our DD will also just scream for hours if left to CIO. In theory I'm willing to give it a try at some point, but DD is very spirited, intense, and persistent so I really can't imagine she'd just stop crying and fall asleep.

I'm also going to move her bedtime earlier to see if it helps at all. She always gets cranky and starts rubbing her eyes around 6-6:30, so it's pure selfishness on our part keeping her awake while we try to fix/eat dinner. It'll be interesting:rolleyes: to see how the upcoming time change will affect things too.


Sorry to say there was no encouraging on my part. She just decided on her own that 1 AM (or so) was another feeding time.

Madeleine does have an earlier bedtime though - she has always gone to bed at 7:30. Between 6 and 6:30 she gets her bath, then we play/read until 7:30. When she was still nursing she did get fed right before bedtime.

The earlier bedtime was a little hard to adjust to. I am lucky if we get home from work by 5:15. To me, eating together as a family was important, so I've kind of adjusted my cooking so I can have something on the table fast, so we still have time to play after bath. I make big meals on the weekend and I rely on pulling from the freezer a lot during the week.

[honeygirl1971]

Just thought I'd jump back in and add a few things about sleep routines and nightwaking. When I moved DS's bedtime earlier (around 7 most nights), that DID help significantly. Your DD still probably needs 2 naps, but when we moved to 1 longer nap midday (from 12-2 most days), that also helped a lot. I always had a hard time managing the two naps--it was hard to get him to take them at the "right" time so the whole schedule didn't get messed up. Either the morning nap was too late and messed up the afternoon nap, or the afternoon nap was too late and messed up the early bedtime. Also, moving DS out of our room helped too. I kept him in our room longer than I had originally planned because he was still nursing so often during the night, but I this may have been part of the problem as well. I think my DH was waking him up, or maybe he was just waking up on his own, but since he saw us right there, he would start crying to nurse, be picked up etc., whereas in his own room he usually goes back to sleep on his own when he wakes up, unless he's got a dirty diaper or some other "reason" not to.

Eating together as a family is very important to me, too, but I had to let it go for the time being. With his current business, DH doesn't get home until 9-9:30, so I had no choice but to feed DS early and put him down. When he was in the bad nightwaking phase he was often "up" at 9 when DH got home, but that was never really "quality" time anyway since he would be fussy so I decided to change things. I want us to eat together, though, and I also want us to eat the same food (which is not the case now, since our dinner is never ready early enough for DS to eat it), so DH is planning on changing he schedule after the business is sold.