Mum’s Journey Poos, Baby Massage, Dairy Intolerance, Feeding Patterns and More, Part 2

Katie

So you told me in our texts that you’d like to talk to me about routines. Tell me about Sophie’s normal pattern of feeding and sleeping at the moment.

Lisa

So, Sophie feeds about every two hours, between 6am and 8pm. Then she sleeps all night apart from one feed around 2.30am to 3am.

She is mostly settled but has been having more awake periods during the day. She sleeps about 40 minutes each time during the day.

Katie

Ok, her feeding pattern sounds really normal.

She’s having about 8 feeds every 24 hours. That’s great, very normal.

Babies at this stage will feed anywhere from 4 to 13 times every day. This depends on their needs that day and also on how much milk their mum produces.

What we know is that babies tend to drink about 800ml every 24 hours from the age of 1 month up until 6 months of age!

They still gain loads of weight even though they are drinking exactly the same amount each day! It’s amazing, but true.

So if Sophie is drinking 800ml over 8 feeds each day, then she is probably drinking about 100ml at each feed.

Lisa

Yes that makes sense. I can express about 100ml from both breasts when I pump.

Katie

A frequent pattern in the daytime and less frequent at night is the routine Sophie has set for herself. This is what she needs to do in order to get enough milk in the day.

Babies may have routines where they do feed very “routine-like” – i.e. every 3 or 4 hours – but this is very rare. If we try and follow routines set in books for a baby who doesn’t want to feed like this we can end up causing low milk supply and babies who fail to gain enough weight.

If a mum’s breasts hold, say, 70mls per breastfeed, her baby will need to feed much more frequently to get its 800ml every 24 hours than their friend who has 150ml in her breasts at each feed. This mum will only need to feed half as frequently as her friend who has 70ml each feed.

We are all different. We cannot always know how much milk we make each feed… and we don’t need to either. Our babies are designed to set their own pattern of feeding from around 6 weeks.

Setting strict 4 hourly routines can ruin breastfeeding and make mums feel really low and upset.

The best way to know that the routine your baby has set for themselves is OK is to watch your baby each day. Are they still doing lots of heavy wet nappies and normal poos? Are they gaining weight well? If the answer is yes then you are both doing great!

If you have a baby who is really unsettled then, normally, these things would not be perfect either. Also, if you have a baby who feeds more at night than during the daytime after the first 4-6 weeks then it is important to seek help from your maternal child health nurse.

Lisa

So, it’s not a good idea to use the books which have routines in them?

Katie

It’s not ideal, that’s for sure. Of course it will work for some mums and babies but it’s likely those babies would have gotten into those routines themselves anyway! Hence the testimonials in those books!

But for a baby who needs to feed ten times a day to get enough calories, this is only going to be harmful to a baby’s growth and mum’s milk supply… it could also impact mum’s mental health.

The other thing that happens when mums try to use routines is that they quickly see it doesn’t work. This can lead them to begin to doubt their own milk supply and introduce a bottle of formula milk.

Of course, the baby then sleeps for 4-5 hours, which feels like bliss. But, in this long sleep time, the baby would normally have had two breastfeeds.

After a week or so of topping up with formula milk, mum’s body thinks she is weaning. So the body reduces her milk supply even more. So mum adds in another bottle of formula milk and “hey presto!” her own milk supply reduces again and again until she is left with very little breast milk.

Of course, we blame our own milk supply, not the routine or the formula milk! It’s a difficult cycle that many mums get into, without actually knowing why.

So, yes, be careful with routines! Sophie sounds like she has found her groove. This involves frequent day feeds… and a long sleep at night! That part is great!

Let me just touch on the 40 minute sleeps during the day. I want to ask you about her sleep/wake cycles to make sure you are not picking Sophie up mid sleep cycle.

What do you do when she starts to wake up from a feed?

Lisa

I might pick her up or rock her bassinet and pat her to sleep. Sometimes I just wait a bit longer and she puts herself back to sleep.

Katie

Sounds like you’re doing the right thing. If she is not crying full blown, try to just wait and see if she will self-settle again.

If she is making some noise or her eyes are open and she does not go back to sleep herself then try rocking the bassinet or patting her while hushing her. Let her know that mummy is here and to go back to sleep. Try to not make eye contact (if you can) as this may stimulate her to be awake. Of course she wants to look at your beautiful face and play with you!

Babies have different stages of sleep; deep and light sleep as well as REM sleep. Often babies – just like us – will “wake” in the light sleep and stir and make noise. The may even open their eyes, but this doesn’t mean they are ready to wake up yet!

Remember when you wake at night sometimes and look at the bedside clock but then soon go back to sleep. You probably remember it in the morning but this wasn’t when you were ready to get up. This was your light sleep phase.

We all have a sleep cycle. In the light phase we can wake slightly and then go back to sleep. With babies, if we rush and pick them up in response to their first movement/noise (after the first month of life) then we may be disturbing their sleep cycle midway through.

This may be why Sophie is only sleeping for 40 minute blocks. As Sophie gets older, she will have more and more alert time in the day but let’s see if those tips work to help her sleep longer for now.

Lisa

Sounds like a good plan. I’ll give it a go.

Katie

Super! Text me if you need anything before I see you in a couple of weeks.

Do you have any stories about poo, baby massage, dairy intolerance or feeding patterns that you would like to share? Let’s chat and support each other here or on the Medela Australia Facebook page!