Problems with increasing the quantity of breast feed

[A pair of Charlies]

Hi

Just nodding in agreement with everything Anna has said...it's all tied in together (sleep, eat, everything) so starting a consistent routine will tackle all these things at the same time.

Bottles of formula: I was told that a bottle of formula was the magic answer to STTN. But certainly didn't work for us and like-for-like, breast milk packs a lot more punch. If you wanted to offer a bottle so that you can get to sleep, I'd suggest expressing before the DF so that you can get to bed early and leave the DF to DH! By expressing, you're keeping your milk supply consistent, ensuring that your LO is getting the best nourishment AND giving DH a great bonding opportunity. When DH gave my DS his DF, he also had more luck at settling him for naps and (importantly) resettling him when he woke in the night. His gift in this area died off pretty quickly once he stopped giving the DF.

If you don't feel you've expressed enough for the night's DF, you could give formula for a night or to while you express and build some up. Not everyone reacts to the pump the same way. For me, it was usually 2 nights expressing per DF, so I'd use formula one night, EBM the next, formula on the 3rd night and so on. But still expressing everynight.

There was just one thing I did want to check: the 7 minute feeds. Is she only taking one breast each time or both? Is she finishing / emptying or just stopping. Is there anything else about her way of feeding that strikes you; squirming, fidgetty, distracted, making noises? Just trying to understand if there is anything that is stopping her feeding for longer?

Also thought the following might be helpful while you're getting your routine in place:
 * http://babywhispererforums.com/index.php?topic=62100.0
 *  http://babywhispererforums.com/index.php?topic=141660.0
 * http://babywhispererforums.com/index.php?topic=52878.0
 * http://babywhispererforums.com/index.php?topic=98183.0

Let us know how you get on. And if you're not having more luck with shh patt, just say and we can get you some help with that too.

HTH

Charlotte

[juliec]

Hi I found at first I was feeding my lo every 2 hours  because she was getting grumpy but actually realised she was tired and when I got into an EASY routine things started to fall into place more. My lo generally feeds for 7-10mins and so did my first lo, like yourself I do offer the other breast but generally she seems content on one side.
I think you need to try and get yourself into a routine and then things may sort themselves out.

[2yyiam]

Thanks for the further advice. I thought I would leave typing anything until the weekend was over and then report as to what happened as we continue to try and establish some sort of routine. I remain exhausted so please bear with me if some of the stuff doesn't make any sense!

Starting from Friday evening (20/02), we put our LO to sleep at 10.30pm (late I know, but that's how it worked out, and so we decided we would follow a 10-10 routine for now). She slept and I then gave her a DF at 12.30am just as she was beginning to stir and rub her face. The feed lasted 8minutes on one side and I then tried to burp her for a few minutes (she remained asleep throughout) and then laid her back into the cot.
She then woke up crying at around 4.30am and I gave her a feed then (didn't try ssh/pat as it had been 4hrs since the feed). She fell back asleep but then got up at 6.30am crying loudly. My husband tried to ssh/pat her and eventually she settled after 30mins only to wake up again 30 mins later (at 7.30am) crying. This time she didn't settle with ssh/pat and so I fed her again at 8am (for 6mins on one side) and then she slept till 11am.
At this point I gave her another feed (for 6mins) and then my husband stayed up and played with her for an hour or so in the bed. She then fell asleep at 12.30pm but woke up only 40mins later, refusing to be ssh/patted back to sleep. After sitting her up, she was wide awake and keen to play.
I held out from feeding her until 2.30pm (3.5 hrs since the last feed) by which point she was really irritable and trying to put everything in her mouth. After a 5min feed at 2.30pm, we kept her awake and active.
We had to go out and so waited until her sleep at 4pm (so between 11am and 4pm she slept only 40mins). This sleep lasted 1hr approx and so she was awake whilst we were out until 6pm.
When we returned home I gave her a feed at 6.30pm, again for 5mins, and she remained awake until 7.30pm. She then woke up 1hr later and then I fed her again at 9.30pm (she was hungry from the moment she woke up but I held off). This time she had a 9minute feed and then I put her to sleep at 10.30pm.
I gave her a DF at midnight and then we all went to bed.

Now in the early hours of Sunday morning (21/02), she woke up screaming at 3.30am. She was screaming really loudly, different to the previous times she had woken up. She was kicking her legs and rubbing her face. My husband changed her nappy and then tried to ssh/pat her back to sleep for one hour. She continued to scream throughout, stopping for a few seconds to catch her breath and then continuing with the screaming.
Finally at 4.30am I fed her and she fed for 7mins and then promptly fell asleep. She didn't give us much respite, as she was up again at 6.30am. Again we tried to ssh/pat her for an hour and she didn't sleep, so again I fed her a 7.30am for 5mins and then she woke up at 9.30am crying and refusing to settle. We had her in our bed, both shattered and asleep as she played between us as we both dozed off!
At 11am my husband once again played with her after I fed her for 5mins and she remained awake until 12.30pm. She stayed asleep for 2hrs (the longest nap by far this weekend) and then woke up. I fed her and then continued through a 3hrly cycle for the rest of the day.
In the evening we had to visit my husband's parents. Determined to stick to the routine, I tried to put her to sleep after a feed at 9.30pm at their house but she took 30mins to settle with ssh/pat. She eventually slept at 10.30pm and I gave her a dream feed at midnight just before we left the house.
Obviously, transferring her from bed to car seat and then back to cot, she woke up, but then fell asleep again after 10mins of ssh/pat.

However, last night was possibly the worst of the lot. She kept waking up every 2hrs, screaming and kicking. I tried to ssh/pat her but ran out of energy as the night progressed and then feed her to sleep every 2hrs or so from 6am onwards.

I think that's the best description I can offer of my weekend. I'm exhausted and I don't know if it makes much sense. Right now, she's just had a feed and is awake.

If anyone has the patience to read all that, their help and advice would be greatly appreciated. She never seems to last longer than 4hrs, but usually 3hrs, between feeds at night and won't feed for more than 7mins each time.

Thanks for the help.

[anna*]

(((hugs))) sorry you've had a difficult weekend.

First of all, if you're going to do a 10/10 day/night, you really do have to get up and start the day at 10, not 11.30. It needs to be the same time every day. Otherwise it is like having permanent jet-lag for your little girl.

Also, if she goes to bed at 10.30, 12.30 is too early for the dreamfeed it would need to be at least 3 hours since her last feed, and you would settle her with shush-pat if she woke before that.

How long did you try to settle her for at 7.30am? Did you settle her for her first nap with shush-pat?

When she woke in the night kicking and screaming it sounds like she may have been in pain with gas?

It's really difficult to tell what's going on - can you write out what happened in EASY format ie
E Eats what time
A Awake - how long
S Sleep - what time and for how long

I get the feeling she is overtired, which will make her night wakings worse, but I can't tell how much sleep she is getting.

anna
x

[2yyiam]

Thanks for getting back to me Anna.
I'm a bit more awake now, so let's try putting it into an EASY routine to make the situation clearer:

Friday-Saturday
Sleep 10.30pm (with DF at 1am)
Awake 4.30am with 5min feed then put back to sleep
Awake 6.30am, ssh/pat for 30mins > Sleep at 7.00am
Awake 7.30am, ssh/pat for 30mins unsuccessful
Eat at 8.00am for 6mins then sleep
Awake at 11am, feed for 6mins
Activity for one hour
Sleep at 12.30pm for approx 45mins
Awake at 1.15pm, ssh/pat for 30mins unsuccessful
Eat at 2.30pm for 7mins
Activity for 1.5hrs
Sleep at 4pm
Awake at 5pm and remained awake in pushchair
Eat at 6pm for 7mins
Activity for 1.5hrs
Sleep at 7.30pm
Awake at 8.30pm, ssh/pat unsuccesful after 20mins of trying
Eat at 9.30pm for 9mins

Saturday-Sunday
Sleep at 10.30pm (with DF at 12.30am)
Awake at 3.30am screaming and kicking, ssh/pat for one hour unsuccessful, crying throughout
Eat at 4.30am for 7mins, then immediately slept
Awake 6.30am, crying, ssh/pat for one hour, intermittant sleep and then waking and crying, then sleeping
Eat at 7.30am for 6mins then slept
Awake at 9.30am crying, ssh/pat for 20mins unsuccessful (too exhausted to keep going)
Awake in bed with us until feed at 10.30am
Activity for 1.5hrs with husband
Sleep at 12.00pm
Awake at 2pm (longest nap of the weekend)
Eat at 2pm for 7mins
Activity for 1.5hrs
Sleep at 3.30pm
Awake at 4pm, ssh/pat unsuccessful after 30mins
Eat at 5pm for 7mins
Activity for 1.5hrs
Sleep at 6.30pm
Awake at 7.30pm
Eat at 8pm for 6mins
Sleep at 9.30pm at in-laws house, took 30mins to settle (DF at 11.30pm for 7mins)
-transfer from bed to car seat and then to cot at home, settling after 10mins of ssh/pat-

Sunday-Monday
Even now last night is a big blur. She kept waking every 2hrs, crying. Sometimes kicking and passing wind (although that had not happened the night before when she woke up screaming). I tried ssh/pat for as long as I could muster the energy and then fed back to sleep each time.
Awake at 10.30am

So that to the best of my ability is the information over the weekend. I hope it makes more sense now? Obviously all the times aren't 100% accurate but roughly the same.

I agree that she probably is overtired, but how do I correct that, especially as it seems as if ssh/pat hardly ever works for her and she can't get to sleep?

Thanks for the help.

[anna*]

Great that she managed a couple of two hour naps! When she has her naps in the daytime, is she taking them in her crib and going to sleep independently (ie no paci, no nursing to sleep etc)?

What strikes me from your routine is that the A times are quite variable. Remember that A includes all the time they are awake, including feeding, diaper changes, winding down to sleep etc. At this age I would aim for her to be falling to sleep no longer than 2 hours since she last woke up, after a good nap, and 1.5hours or even less after a short nap. Looking at your routine it seems that on Friday/Saturday your first A times of the day were only 1.5 hours, and she then did a 45 mins nap which would indicate that she was perhaps undertired and could have stayed awake an extra 15-30 mins. But then later in the day, she is awake from 1.15pm until 4pm, which is 2.75hours, which will definitely leave a baby this young overtired.

Remember that the key to success with all of these techniques is consistency, and keeping a consistent routine will help her so much. For the times when shush-pat does not work for her you can try Pick Up Put Down - there is more info here: http://babywhispererforums.com/index.php?topic=69177.0
and here: http://babywhispererforums.com/index.php?topic=69178.0

The important thing to note with PUPD is that once you start at night, you don't stop until she sleeps. Don't do it for half an hour and then give up and feed. You do it til she sleeps, and then feed her at the next waking if you choose to.

What do you think?

[2yyiam]

Thanks for getting back to me again.

I think she managed only one 2hr nap over the whole weekend. She takes the naps in the cot, sometimes with the aid of a dummy, other times without. Everytime with ssh/pat to get her to sleep, ranging from 5mins to 45mins.

We've been trying to put her to sleep after 2hrs of being awake but sometimes she just refuses. For example, today, she had a nap at 1.30pm, woke up at 2.30pm. Tried ssh/pat for 40mins during which she slept intermittantly and then she woke up at 3.10pm, screaming and inconsolable for at least 20mins. I then fed her again at 3.30pm and she was hungry again at 4.20pm, so I gave her a 5min feed and she fell asleep at 5pm until 5.35pm on her own in the cot.
However, since then she has been irritable, wide awake and refusing to lie down. Her last feed was a 6.30pm and now she remains awake either very happy or very upset! Her sleep pattern is all over the place.

I acknowledge that we have been changing the times quite often as you can tell over the weekend, it's just been really difficult to cope. But from tonight/tomorrow, I'm going to be trying harder to get her to settle into a proper routine. But what do I do when she refuses to sleep as she is now? When she was awake for 2.75hrs between naps, it wasn't out of choice, she refused to settle down. PU/PD will be the next technique we try I guess.

Also, for the night, will we able to get to a situation where she can sleep through the night after the DF? The book seems to claim that after the DF she should be able to sleep through the night to the next morning feed, how will this be possible as she doesn't even get to 4hrs between feeds currently?

Lastly, you mentioned the possibility of gas, especially when she wakes up screaming during the night, I think this might be possible as there have been ocasions when she has been passing a lot of gas during the day with explosives poos! What would be useful to try and overcome this?
As I finish typing she is currently alternating between crying and laughing, she is definitely over tired!

Thanks for the continuing help!

[anna*]

In truth, lots of babies don't sleep through after the dreamfeed until they are somewhat older. For my own LO, he was 7 months, and then started sleeping 12 hours without feeding at about 9 or 10 months. However, from the situation you are in right now, I am thinking that doing a dreamfeed and then one addition quick feed and back to sleep would be totally reasonable and mean you were getting much more sleep than you are now!

Re the tummy gas, I would speak to your pharmacist. I'm not sure where in the world you are but you can probably buy drops that you will give before each BF which will help.

Unfortunately, the only cure for OT is lots of sleep. While you suspect she may be OT, I would aim to have her in her cot after 1hr 45 mins maximum (that is after a good nap) and asleep by 2 hours or less. Again, shorten the A time after a shorter nap. If she is fighting sleep, all you can do is keep doing shush-pat or PUPD for 45 mins. If still no sleep, take a break out of the nursery, feed if it is time, change diaper if necessary, do a very short A time and then go back and try the nap again. As she catches up on sleep she will fight sleep less.

((((hugs)))) this is hard work, but it will be worth it.