I need ideas for a schedule for a four month old, partially breastfed baby. By partially I mean mom nurses him when she is home. When I work I give him pumped milk, if there is enough, or formula if there isn't. He eats every 3 to 4 hours when I have him. Every hour or two with mom. I also need help with sleeping... he fights himself awake and will scream for two hours and nothing will settle him down. I'm trying to break his habit of sleeping in my arms. The day usually goes like this: baby wakes at 7am and breastfeeds, 8 great feeds, 8:30 short nap, 9 breastfeeds, 10 sometimes breastfeeds, 11 eats again, 12 sleeps usually for 15 to 20 minutes, wakes himself up, fights sleeping for 2 hours, screams until about 3, eats again and will sleep for 3 hours if being held, if not, repeat of the morning. I suspect he is not hungry all the time, he is nursing in the morning and would be OK with a pacifier, but I don't think I can convince mom of this. I also think he can be left to cry a little bit but I don't think mom will go for this. Ideas please? - Anonymous
I wonder if perhaps Mom is eating something that is passing through her breast milk that is not agreeing with the baby's system. Maybe onions, chocolate, spicy stuff? Maybe you can ask her.
ReplyDeleteOP, I feel for you if Mom won't let the baby cry it out a little bit.
I have worked for parents like this and it is HELL trying to sleep train their child.
It sounds like Mom isn't producing enough milk. No baby should eat that often. Every two hours is the norm, and at 4 months he should be started on cereal.
ReplyDeleteI think he's using the breast as a pacifier. A lot of babies do this--they aren't really hungry but are eating (or just sucking) for soothing. He needs to be broken of this habit and you are not the one to do it. It is very hard to get a baby on a schedule when the parents won't go for it.
ReplyDeleteKat, I don't know if you've heard the latest recommendations but the AAP has recently changed their stance on introducing solids. They are now saying to delay it until 6 months.
Actually, mom feeding on demand (which is what it sounds like she is doing when she's there) is exactly the correct way to maintain or increase supply. If she pumps while she's away, she's doing all she can to produce milk.
ReplyDeleteBreast milk passes thru the baby's system much more quickly than formula as well. And if baby is not nursing/eating at night, he needs to "tank up" during the day to sleep thru at night.
If mom is willing to be used as a paci (which also might be the case occasionally), then all you can do is ask if you might introduce a non-human paci when you are there.
As far as the sleeping goes, is baby swaddled? If not, is he jerking awake due to reflex movement, or just having a hard time relaxing in a crib? Does he have a minimal naptime routine? Have you tried using a heating pad (or hot water bottle) set on "low" in the crib before laying him down - removing the heat element first and checking the sheets temp, of course. Human arms are much warmer than a cold crib sheet!
And how much awake/alert playtime does he get? From what you posted, it sounds as if he is being asked to nap for a lot of the time and not getting any "active" time.
When my charge was 4 months old, he was on a 3 - 4 hour feeding schedule. He'd wake, I'd change him, get the bottle ready, feed him, burp him, and then we'd have a little quiet play, more active play, quiet play, and then bedtime routine and nap. He didn't just eat and sleep!
Op here. He does play between feeding. The supply is adequate. Sorry my wording was strange. Thank you for the suggestions. I'm not sure it was what I'm looking for. I guess I'll keep looking, but thanks anyway.
ReplyDeleteI agree with others that the baby is eating too often (and probably not getting enough each time). When my charge was that age (and younger) the same thing was happening. Her mom would feed her every hour or so, and she slept best in someone's arms. Whenever I fed her (I gave her 2 to 4 oz at a a time, depending on how much she'd take) she slept much more soundly. I did also start swaddling her because she would sleep for 1/2 hour at a time and startle herself awake (she sleeps like a champ now). Her parents don't swaddle, and I know she doesn't sleep as well for them (naps or at night). I also know they don't feed her as much as I do. She's almost 8 months now and still only gets 2 to 3 oz of formula or breast milk at a time. I'm just saying, try to feed your charge a little more at a time. And try swaddling. Also, keep in mind, mom might like spending all that time bonding with baby. Whatever you do, make sure the parents are on board as well.
ReplyDeleteI'm taking care of a five-month-old in a similar situation, hooked on the boob and refusing to nap during the day. I've introduced a pacifier and I also feed him more but at less intervals; he gets three bottles a day, two breastmilk and one formula. Each is six ounces a pop, three times a day (about once every three hours). Mom ONLY breastfeeds first thing in the morning and before bed at night, even if she's home all day.
ReplyDeleteHe was refusing to sleep at all during the day and still doesn't nap in the morning, but with the addition of the pacifier and more food, I can generally get him down in the afternoons these days for at least three hours.
Good luck!
Also, I swaddle him and place him in the swing with music playing for nap times. Do you have anything like this?
ReplyDeleteWe'd be happy to give you more ideas if you want to clarify what you're looking for!
ReplyDeleteMeanwhile...
OP, it's possible that he's "snacking" from mom, and therefore not getting the fatty hind milk, just the fore milk. That might contribute to his frequent eating and lack of sleep with her, and might also cause you issues since he'd be hungry despite frequent feeds.
(FYI, fore milk is like skim milk, hind milk is like whole milk. Baby needs both to stay full and be satisfied.)
How long does he nurse? How long on each side? Does your MB say she feels as if he empties her on at least one side per feeding? If he eats for 5 minutes per breast and she doesn't feel he's emptied at least one side, you might suggest she nurse longer on at least one side.
Tales that is actually helpful. I will ask her I know he typically nurses for only a short time. There is only one feeding he eats and is full. She wants him on a schedule mostly to help with the sleeping because he'll wake up half way through a nap hungry . Hell take 6 oz expressed milk every 3 to 4 hours. The problems come when I start midday and work late its hard to know how much he has eaten with mom.
ReplyDeleteRight now he wakes up about 7 every day breastfeeds then some days does the nursing an hour or so later. It's the second and third feeds that I think he doesn't really eat. He'll play sometimes take a short nap around 9 wakes up after about 40 minutes plays falls asleep at 10:45 waked at 11 ready to eat but is still tired and continued like that until 7 when I give him a bottle and goes down for the night. He sleeps great at night. Rarely wakes up. I guess I'm looking for ways to bring more order during the day and help him sleep a little better
Also he hate to be swaddled so we put him in the sleeper sacks
ReplyDelete