Tell me about top-up breastfeeds...high A times, hungry boy!

[jessmum46]

DS is 20 weeks now and EBF.  He rarely manages more than 3-3.5h between feeds and has 1-2 night feeds (no dreamfeed).  He also has pretty high A times for his age, getting on for 2.5h at times so we're starting to hit the issue of him waking early from naps because he's hungry.  I've managed once to feed like a night feed and resettle him but obviously that's not ideal.  So how do top-up feeds work without ending up snacking?  And how do you convince a distracted 4 month old to feed when he's not *really* hungry? 

A very rough day (though it varies) looks something like:
WU 6.30
E 7ish often not keen before, can be quite distracted
Nap 8.30/9 for 45-50mins
E 10 - often quite hungry for this one
Nap 11.45/12ish for up to 2.5h, *think we need to top-up before this nap*
E 1/1.30ish if wakes early, sometimes pushed out to 2/2.30
Catnap somewhere in the afternoon
E 4.30 but varies depending on when catnap happens
E 6/6.15pm and BT

Looking at that would I be better to delay his first morning feed until 7.30/8ish when he's really hungry?  Then maybe push the next one to 11ish and hope that gets him through the longer nap?  Or would a top-up at say 11.30am be a better option?  Creative ideas welcome!

[becj86]

I did a top up feed ~45min-1hr after initial feed. It worked well for us and only lasted a little while til we added solids. Also expressed off fore milk and kept to offer as a drink with solid meals later on xx

[goldmom]

I've got 2 suggestions, but I don't know if either will really work.

1 - try not to feed twice at night. For us, the multiple night feedings weren't being helpful with daytime feeds, so I've been trying as hard as I can to resettle at night without feeding (though we still have 1 nf that I'll be keeping for now). Back when DS2 was younger and was taking 3 nf's I started getting better naps when I started resettling one of his nf's, and I think it was related since it forced him to take more during the day (plus the 3x at night was more than necessary for him at that point when we stopped). I also feed at wake up in the morning (and I try to resettle if he wakes before 6:30) since this way, his next feed is closer to his nap wake up, I found the delay in feeding in the morning hard to maintain throughout the day.

2 - try as hard as you can to push off that first feed. Even if he seems to be waking hungry, it's possible he's becoming a snacker and needs to be pushed a little in order to take more at each feed.  With a 2.5 hour A time and a 1.5 hour nap, you'd have an ideal 4 hour easy. It seems like you're thinking of going from a 3 hours feeding to 2 hours or so, but it looks to me like you need to try gently pushing him to longer between feeds. I know pushing the feeds later isn't easy, but you can either try holding him while you wait to keep him a little happier, or try to resettle his nap, so that he's waking closer to 4 hours later than his previous feed. Resettling naps is so annoying! but with DS2 I found that he really needs the longer nap (he was doing 30 minutes for so long), and though it may take me 45m to resettle him, he will go back to sleep for 45m to an hour or so afterwards, after a few days, he's become more consistent with longer naps by himself (but not always). Sometimes I feel that if I do things with DS2 once, he will try for it again, so if I feed him at a weird hour at night, he'll wake up at that same time again the next night, but if I don't feed him again, he won't bother waking up at that time again. So it could be that if you keep feeding at 10am, then your LO is waking for that feed out of expectations to eat, rather than necessity. With DS1 we also found 4 months a successful time to start extending his naps by resettling him.

DS2 is now 18.5 weeks, and is about 16.5 lbs, he's exclusively BF, but has 2 EBM bottles during the day at his sitter's house (about 6-7 oz in each bottle). We're on about 3h 45m EASY with an A time of about 2 hours (give or take, his sitter isn't always consistent with this and his cn at the end of the day is usually after a much longer A time).

Not sure if these ideas will be helpful, but just things that have been working for us. Good luck!

[goldmom]

Oh boy, I just read Dr. Sears' article, and my advice was so contrary to what he wrote! But I really do feel for DS2 that the frequent feeding have not been helpful with his napping, and pushing him off really does keep him happier and better rested, vs the frequent feeding causing him to keep shortening his naps/ night sleep in order to eat more often. Since he's growing pretty big, I'm not really worried about the "starving" issue, and since your LO is also big, I figured you don't really either have to be. (My other 2 were also on a 4 hour easy at 4 months, and both were much smaller than DS2 is, and they still did great with it.)

[MasynSpencerElliotte]

We went to two naps with DD3 at this age so top ups were a must, I basically was feeding her 30 min or so before naptimes and then on wake up plus a nf or two. It did not ever seem like a snacking habit but then bf gave me an excuse to sit down and do nothing so I wasn't too worried! Lots of bf babies don't make the 4 hourly feeds at 4 months, none of mine managed it.

[*Ali*]

What about trying a too up feed half an hour after the initial wake up feed? Apparently the milk is fattier at that time too so really helps with the extra calories? Would he take it?