Routines

Neither on Demand, Nor Strictly Timed

Relaxed Routine Feeding

You will probably be encouraged to feed the baby “whenever he wants to feed”. This is rather difficult to work out when you have never had a baby before, and most people translate it to mean “whenever he cries”. However, sometimes a baby's cry does not mean hunger. It could be wind, or he could be tired. I think some guideline as to how often a baby should feed is a good idea.

The other problem I have encountered is the anxious mother who does not want to starve her baby. I met a young mother in the hospital whose baby was not feeding well. She was very sleepy, and the mother was afraid she would not get enough milk. How could she be sure? Should she wake the baby in the night to feed her more? I explained my method of feeding to her, and she went away re-assured and confident.

Before I had children I observed a demand fed child. He was about 12 months old. His constant whining and grizzling was an irritation to everyone around. Finally his mother sat down and fed him – his complaining was rewarded, thereby reinforcing the behaviour, and I was repulsed. I decided there must be another way, one that would produce a contented child.

I discovered that some people feed their babies on a routine. I read “Babywise”, which is a very sound book on the subject of routine feeding. It outlines why babies need to be fed in a routine. “Babywise” is not popular with a lot of medical personnel, because some mothers have taken it to the extreme and left babies to cry, when in fact they were sick. You need to think about why your baby is crying and act accordingly. The book states this clearly.

I do not, however, think you need to be terribly strict with a routine. I find it a good guide, and like to aim for it, but in reality it does not always work out exactly. If you are worrying about getting it all right, you will be tense and not enjoy your mothering experience. You would be better off demand feeding if that is what feels right to you, and trying to get into a routine makes you stress out. I want you to enjoy your baby, not be worried about not doing things a certain way. However, if you would like to get your baby into a routine read on...

A lot of demand fed babies get into a vicious cycle of being tired from not a long enough sleep, then falling asleep while feeding, so not getting enough to drink, then waking early and being tired from not a long enough sleep... The poor mother is exhausted from feeding the baby every hour or two, day and night. The baby continues to wake in the night for months, keeping both of them in a permanent state of tiredness and distress. The mother is told this is normal, and to expect it. It is no wonder so many people dread the “baby stage” and only have two or three children. This is not the way it should be! Just a few generations ago most women had large families of 8 – 14 children – 4 or 5 was considered a small family! How could they have coped with hand washing the laundry, growing a garden, cooking all the family's food, educating the children and all the myriad other tasks a pioneer woman routinely performed, if the baby needed feeding every hour or two day and night? Obviously the baby must have fitted into the family's routine. I have found this to be true in my own case. With seven children aged from 8 months up to 14 years, I also hand milk two goats daily, prepare and cook most of our meals from fresh food, and home school our children. I do not have home-help, other than the children (who do help a lot). However, my babies sleep when I put them to bed because I expect them to, and don't have time to fuss over them if they don't!

Most of the discontented babies I have observed I would say are over tired. When questioned, the mother almost always tells me that her baby does not sleep well, only having short daytime naps, or even none at all!

I call my method of feeding “Relaxed Routine Feeding” (RRF). A newborn will need feeding approximately every 3 hours during the day, less often at night. This means about 6 or 7 feeds a day.

In the beginning I aim for a three hourly daytime routine, but once he is regularly sleeping through the night (8 or more hours), and is on solids, this stretches to four hourly, and will drop to four feeds per day.

Until your milk comes in he may want to feed more often. This is normal and helpful to establish your milk supply. Do not hesitate to feed him whenever he wants to feed. (Do wake him, though, if he is wanting to sleep longer than 3 hours from the beginning of the previous feed).

Start at the same time each day. Wake him at the time you decide you want to begin the day. This is important, because it helps him get into a daily routine. Your aim is to get all the feeds into reasonably regular time slots, which will help him to be settled.

Newborns are usually sleepy. Don't allow him to sleep too long, but wake him 3 hours after the beginning of his last feed and feed him again. Otherwise he may want to sleep on and on, making 5 or 6 hours between feeds. Some mothers have bragged about this to me in hospital, but I know that they will be up most of the night as a result. Baby's long sleeps should be at night, and he often needs help getting them in the right place. He needs 6 to 8 feeds in a 24 hour period. If he doesn't get them during the day he will wake more frequently at night. Let him sleep as long as he wants to at night. I have never had a baby wake more than twice in the night, even in hospital.

You will want to be sure he is getting enough milk. Keep an eye on his eliminations – 6 to 8 wet diapers a day, bowel motions yellow and runny (after the meconium finishes). Watch his weight gain is within the normal parameters, and is following a steady uphill climb, not levelling off.

He should be awake no more than an hour at this age. This is a key, and must not be overlooked. Usually he will be awake less than an hour. Beware of him getting over-tired with visitors all wanting to hold him. Feeding should take about 20 minutes, burping, a diaper change and a cuddle, if he is happy a short time on the floor, then as soon as he starts to grizzle, wrap him firmly and put him back to bed. The feed should always be first, then playtime, then bed. While there are times it is handy to be able to feed him to sleep (such as when visiting), it is good for him to learn to go to sleep on his own. I knew a lady once who always fed her daughter to sleep, and when it came time to wean her at two years old she had dreadful trouble getting her to sleep without the breast. Often babies cry for a short time before they go to sleep. (In time, he will learn to go to sleep without crying). When you are not used to a baby crying, this can seem an eternity (especially at night). But it will not harm him to cry for a little while. Time it, and if he is still crying after 5 minutes, go in, give him a cuddle, then pop him back down.

Most babies like to be firmly wrapped at this age. In summer, use a light muslin wrap, and in winter a light baby blanket or shawl. A cloth diaper will work if you have nothing else. Lay the wrap like a diamond on the bed. Fold the top corner down to make a flattened top on the diamond. Place baby on the wrap, with his head above the wrap. Some babies like their hands up by their face, others prefer them by their sides. Fold the bottom of the wrap up over him, then firmly (but not too tightly) wrap each side of the wrap around him. He will be like a little cocoon, with just his head sticking out. Wrapping like this makes him feel snug and secure, giving him a sense of the familiar womb.

A tip my grandmother told me to prevent baby's hair being rubbed off on the bed sheet, is to place a satin pillowcase at the head end of the bed. It really works – several of my babies had long, thick hair, and it never fell out, nor rubbed off.

If his crying is high pitched, or if he has a whitish top lip, he probably still has wind. Try burping him again before putting him back to bed. If he is prone to wind or reflux you can prop his bed slightly higher at the head end but make sure his feet are at the bottom of the bed, so that he cannot slip down, getting his head under the blankets. I put a folded towel under the head end of the mattress which makes it just slightly higher than the foot.

Do not let him go to sleep before he has finished a feed. He will only wake early. Give him one side, burp him, and if he goes to sleep, changing his diaper will usually wake him ready to have the other side. You will get to know how long a good feed should take. Some babies are more efficient at drinking than others and will take all they need with 5 minutes on each side. Others will drink for 10 minutes on each side. I know some babies take an hour or more to feed but this should not be the case. He will get too tired if he is allowed to fuss around for too long. Sometimes babies will pause during a feed. This is fine, but encourage him to start feeding again before too long by stroking his cheek. You need to Know he has had enough, so that when you put him to bed and he cries you are not tempted to get him up again “in case he hasn't had enough”.

If he wakes before your next scheduled feed you can either:

• Leave him to cry a bit longer, thereby getting the feed closer to when it should be. Babies often stir in their sleep and may have a little cry, then go back to sleep. This is quite normal, so make sure he is really ready to get up, don't rush to pick him up at the first squeak. However, don't leave him too long or he will get too tired to feed
• Get him up and feed him early (try not to do this too often, or he will not get into a good routine).
• Take him for a walk in the pram if you feel he really should be asleep and you don't think he is ready for the next feed. Walking may put him back to sleep.

You will get to know your baby, and be better able to make informed decisions about his needs as the time goes by. Normally I would use the first option, then if he continued to cry or the cry grew in intensity I would use the second. I would use the third option if he was getting into a habit of waking early.

During the evening some babies (all of mine!) like to be at the breast almost constantly. It can be because your milk supply is diminished at that time of the day. With two of my babies I have expressed milk in the morning, after the baby's first feed, when I had plenty of milk. I pour the milk into a sterilized bottle and refrigerate until the evening, when I feed the baby the bottle. About 80 to 100ml seemed to work well. I only needed to supplement like this for a month or six weeks, then my own supply was enough in the evening. Make sure you only use your own milk. If you use a substitute milk powder you will make less milk, and not more. You will be on the way to weaning your baby. Also make sure you have a teat designed for newborns – a bigger hole will discourage the baby from working at the breast for your let-down, and he will want a bottle, not you! Some of my babies have not needed the supplement bottle, but they have still spent most of the evening “grazing”. I think this is fine, it is relaxing for me to sit and feed, and it seems to “tank him up” for a nice long sleep. Here I make an exception to the rule of only having him awake for an hour. I have had to do this because my babies simply would not settle to sleep at that time of day.

My babies usually wake around 6am, feed, straight back to bed. Wake 9am, feed, short wake time, back to bed. Wake 12noon, feed, short wake time, back to bed. Wake 3pm, feed, short wake time, twice a week bath-time, back to bed. Wake 6pm, feed on and off, maybe have another sleep (often a shorter sleep, about an hour), if so last feed begins at 9pm, (wake him if I need to), feed, then bed for the night. Let him wake on his own, usually about 2am, feed and straight back to bed.

Once he is in a good established routine in the day he will begin stretching the time between his night feeds. If he was waking twice it will soon drop to once, and within a couple of months he should be sleeping about 8 hours at night.

I have had several babies sleep 8 or more hours on the odd night at only 4 weeks of age, but regularly sleeping that long by 6 or 8 weeks. Some of my babies have taken longer, the longest being 3 months. Most have been sleeping 12 hours at night by 3 or 4 months of age.

Once he is in a settled daytime routine and is sleeping 8 or more hours at night you can leave him sleeping between feeds until 4 hours. He will likely be staying awake longer by now as well. He will probably have some longer daytime sleeps and some shorter ones – you will get to know when he is sleepiest. My babies have a short wake time in the morning, and a long morning sleep, with two shorter sleeps in the afternoon/evening. The time between feeds will be approximately 4 hours, but this does not have to be exact. I aim to feed at my mealtimes, plus one feed just before bed. For example: feed 7 or 8am, bed 9 or 10am, feed 12noon, bed around 2pm, feed 4pm, bed about 6pm, feed 7 – 9pm. The last feed starts out being a protracted affair, as I have mentioned. Eventually it settles back down to one decent feed at around 8pm. I keep these four feeds a day until baby is weaned. He will drop daytime sleeps as he gets older and no longer needs them. Remember the key – put him to bed as soon as he starts to grizzle, and you will find the sleeps fall into place. Usually when he has slept long enough he will wake up happy.

email Paulette: motheringadvice@gmail.com