is it hunger or habit

[marie7041]

I have been trying to figure out my lo's NW for a few weeks now.  I have adjusted his daytime schedule, worked on naps, stopped with the paci, etc.  I stopped the DF and am allowing him to wake up naturally to be nursed which is anywhere btw 10-12...he is still waking up around 2-3 am, I try to sh/pat and pu/pd and finally feel that he is hungry between 4am-5am.  This 4-5 am was happening whether I DF him at 10 or 12 or allowed him to wake for this late evening meal. 
 
I cannot tell anymore if he is truly hungry or waking out of habit.  He takes a full meal and then isn't usually hungry at his first morning feeding, but i feed him anyway.  I am not sure if its a growth spurt as he is not eating any more during the day.

I am having such a hard time diagnosing this problem so I am not sure if I should be feeding him or not.  If he doesn't stop crying I tend to give in and feed him b/c I feel he must be hungry.  I am pretty much at the end of my rope.  I have been on these boards all day long trying to figure this out.  I don't mind feeding him if he is hungry--but can't tell if I am the problem.  I feel awful.

He is almost 5 months, strictly BF.  Here is his usual schedule for the last few days: (keep in mind late evening is different each night)

E 7:30 am (have to wake from being up over the night)
S 9-11
E 11
S 12:30-2 (sometimes shorter)
E 2:30 pm
S 4-5
E 5:30
bath, etc.
E 7ish
S right after BF
E 10:45 pm
3:20-4:45 crying on and off, sh/pat
E 4:45 am
S 5am

I am sorry I keep posting questions--I just don't know what else to do anymore.  Its as if I don't trust my own parenting skills.

[momofclaire]

Marie,
If you really aren't sure, you could lessen the time you allow him to bf during that early morning feed. I would do it over a week period of time. At that point he may be encouraged to take more at his morning feed and you will be able to see by his reaction to less food overnight if it is hunger/habit/or prop.

Does that help and make sense?

Don't feel bad for posting questions. These boards are here for that.  Also, I know how hard it is when you keep questioning everything over and over.  My husband always tells me to just trust myself...but that is hard sometimes when you are dealing with a little one isn't it. It's like every little thing is so important.  Hugs. I've been there.
Myia

[rob1lu2]

Marie,

I know how frustrating this can be. I had the same problem with one of my LOs. And I didn't trust my parenting skills at all. Especially in the throes of it all. But be confident that you are searching for some answers and along the way you may find what you are looking for.

That said, would you say that he wakes at the same time every night? If he does, you may want to try wake to sleep to throw him off that schedule. It may just be habitual waking. Also, when you give in how long did you let him go? Five minutes, ten, forty-five?

It also looks like he is on a 3.5 hour EASY. By this age it should be 4. I know my girls were waking a lot at night when they were on the wrong EASY and once they went to 4 hours they self corrected. Could you start to extend his E/A times? Just be ten minutes at a time for a few days until you get to the four hour mark.

Does he take a pacifier? You could always try giving him thta instead of the breast and see what happens. If he continues to cry you'll know that it's hunger. I agree with Myia that if you gradually reduce the time you feed him at night, if he needs that nourishment he'll start to seek it during the day.

I know it's *really* hard to diagnose when it's late at night!

Post as much as you need. We are here for you!

Lu

[rob1lu2]

Marie,

Don't worry. You are doing fine! Slow but sure wins the race. We are here to help!

When he woke up at midnight, that sounds like hunger. When he woke again at 2/3, that sounds like habit. That's the one we need to break him of. Waking between 4/5 is really common b/c the body doesn't produce as much of the sleep inducing hormone. But you say he eats voraciously at tht hour. He might be going through a GS. I also see that you are strictly BFing him. Do you make enough milk for your growing boy?

I would definitely try to extend his A times during the day. I think him being on the wrong EASY could be contributing to the NWings. So, distract him with a toy, take him outside for a little bit (that always works wonders with my girls) if you have a dog in the house, have him entertain DS (my girls always instantly stop crying when they see our pooches), whatever it takes, ten minutes at a time, to extend him.

So let's say he isn't hungry when he wakes up at 7am. He doesn't take a full feed. You can still do EASY, that first E won't be so E. It will be more like eASY.  AND, if he's been waking for a few nights, I know you want to keep him on a schedule, by why not commit to three days of feeding him at 5 and then letting him sleep until he wakes up. Follow the routine, not the schedule, after that. I bet he will self correct in a few days. Does that make sense? So you feed him at 5, and maybe b/c he's tired from all the NWings, he wakes at 7:30 or 8 instead. What have you really lost? You start your day from there, he's a little bit hungrier because he slept in a little bit, and you put him down to bed for the night at the normal time. Let him catch up.

What do you think?

Lu

[rob1lu2]

Hi Marie,

Good work!

OK, so here's some things I'm thinking and some things I've been told.

If they wake up, and you are able to get them back to sleep, and then they wake up within the hour, *that's* hunger. So when he woke at nine, and then woke again at ten, and you fed him, that's correct. Same with the 12:30 and the 1:30. So he may be going through a GS. He's almost six months old, right?

There are two ways that I can think of off the top of my head to tell if you are making enough milk. I don't know where you are, what country or state, but here in San Diego they have breastfeeding "clinics" where you can take your LO, weigh him, breastfeed him, and then weigh him afterwards to see how much he took. These clinics are free and provide that service.

The other way you can do it (since he takes a bottle) is to pump for one day and only feed him EBM so you can actually see how many ounces he is taking. For example, you would normally BF him at 7 - so give him a bottle of EBM and then double pump as soon as you can after/as close as it would be to the normal BF. He would be able to extract about an ounce more from your breasts than you'll be able to pump, so you would calculate that.  Does that make sense?

So instead of BFing, you give him a big bottle of EBM - say six oz (since he's proven that he can drink 5.5 in the middle of the night). If he drains it, it means he needs to eat more, if he leaves some it means he needs less. And then pump and see how much you get. So let's say you get 5 oz pumped, then he would probably be able to drain 6oz from your breast, and you could calculate from there (drank 7 oz of EBM, only pumped 4oz - 2oz deficit, etc.) It's not an exact science, but it's a ball park.

If you find there is a deficit, then you can work on ways to up your supply - feeding him more often, feeding him both breasts, drinking Mother's Milk Tea, etc.

And by the way, if he drank ten ounces at night, that's a lot of food! We need him to start eating that during the day! To answer the title of your post, I would say your LO is hungry. And of course the reason he's not eating more during the day is b/c he's drinking so much at night. So we would slowly work on getting him to eat more during the day and eliminating the 1/2/3am feeding and the 5am feeding.

I will also say it's very normal for a five month old, especially a BF baby, to still need to eat at night. So don't beat yourself up about that. What we want to do is have him only wake to eat. Not wake, resettle, wake, resettle, wake, eat, resettle and repeat.

Do you give him both breasts during the day at every feed? You said you think he can go four hours between feedings. It will be interesting to see if he can.

Let me know what you think and how it goes!

Lu

[Bryony]

Marie - I'll ask one of the BF mods to have a look and see what they can advise.  I think pumping enough for all his feeds will be tough - a baby is so much better at getting milk out than a pump!

I will ask one of the BF experts to take a look and see what they can advise you.

Bryony x

[Samuel's mum]

  the reason he's not eating more during the day is b/c he's drinking so much at night. So we would slowly work on getting him to eat more during the day and eliminating the 1/2/3am feeding and the 5am feeding.

I will also say it's very normal for a five month old, especially a BF baby, to still need to eat at night. So don't beat yourself up about that. What we want to do is have him only wake to eat. Not wake, resettle, wake, resettle, wake, eat, resettle and repeat.

I agree with all this.

It IS normal for a 5 month old to eat at night first off (see the poll on our breastfeeding FAQ page). Increased night feedings can also sometimes happen at this age when babies get more distractible during the day and make up for it during the peaceful/less stimulating night.

And if he is accustomed to eating at night then that becomes a pattern which affects his appetite for the next day and the cycle continues.

And a growth spurt is definitely a possibility.

However I hope you don't mind if I go against the PP's advice just a little. While pumping and measuring milk can seem really appealing it's important to know it can have a big downside for many nursing mothers - an immediate knock on your supply. Pumps do not stimulate breasts as efficiently as a baby and lack a lot of baby's skills. For one thing they can't reproduce the baby's wave-like motion of the lower jaw which stimulates the hormone prolactin which governs supply. Even only one day of pumping and bottles could see an effect on your supply. So I'd really caution you going down this road. Plus babies are MUCH more efficient at draining breasts than pumps so in the vast majority of cases it takes more than one day of pumping to produce one day of milk. After only one day of pumping you could end up with a hungry baby who took less calories that day and a pair of breasts which have received a signal to reduce milk production - hardly an ideal.

I honestly don't think this is a supply issue. It's very obvious from his weight gain that you have an excellent milk supply. You just don't get weight gain like that otherwise. This is about a supply TIMING issue i.e. getting the milk in him over 24 hours at convenient times.
I would try and reduce the length of feeds at night. Then I would definitely have a go at trying to settle without the intermediate feed (the 2-3am one). See if you can settle him back to sleep using whatever techniques you normally employ during naptimes with a daytime EASY. If he has learnt that when he wakes at night the boob is the method to get back to sleep then that is a habit you need to break. You can use any method that feels right - some people in this situation use gentle removal:
 https://babywhispererforums.com/index.php?topic=52857.0
scroll down for the pull-off technique.

During the day try and get him to drain both breasts fully. Switch sides as you are if you wish but do try and return to the first at some point. You can use breast compressions to keep him motivated longer (see the breastfeeding FAQs for instructions).

[Bryony]

Marie

Emma's the expert on this - and will correct me if I am wrong - but I am sure he can be getting 7oz in 15 mins. A hungry baby can knock back a breastfull of milk pretty quick!  Mine certainly can.... she rarely takes more than 5 mins on each breast and I'm assuming she's getting enough milk as she's currently gaining the appropriate amount of weight on 4 feeds a day... 

Personally I would go back to nursing, based on Emma's advice - I would assume he's getting enough milk, he's just got into a habit of having some of it during a midnight feastie, so you want to try and wean off that 1am feed if you can.    Sounds like you do great with the pumping though - I can never get more than an oz or two!

Bryony

[Samuel's mum]

I feel pretty confident in saying he will be getting that much in the time. You are pumping a heck of a lot in that time which would indicate that normally he gets A LOT in a feed. Babies are more efficient than pumps and the fact your supply is used to producing those quantities suggests he has been demanding that much in a feed or even more.
It's not uncommon for a mother to only pump 2-3oz in that time BTW.

I would personally go back to nursing as that is best for your supply. And I would suggest trying to reduce the nighttime calories - ideally by completely eliminating the 2-3am feed and trying to settle in another way. But if he continues to wake (as the pp mentions) then feed but try and cut the length of the feed and take him off.

Continue to make daytime feeds as long and as 'thorough' as you can.

[rob1lu2]

    

So sorry if I gave bad advice. I was just doing my best with my breastfeeding knowledge. I certainly didn't mean to steer anyone in a bad/wrong direction!

Lu

[Bryony]

You give wonderful advice Lu - I don't know where we'd be without you on these boards

Bryony x

[Samuel's mum]

Lu - please don't feel badly

You gave tons of valuable support and pumping obviously did provide some answers here.
Lots and lots of people are unaware of how pumping and a feeding baby operate differently. You'd be amazed how many people think they are directly equivalent or even that a pump is better.

You offer great support and on these boards we are a team - and that's how it works well