Need help introducing 3 hour feed EASY in 14 week old

[angie33]

Hello, I am a single mother and I'm having trouble with my baby boy. He's 14 weeks old. I didn't implement any routine yet, have been feeding on demand. I have extremely low milk supply, but I am not able to give it up yet, so I put him to breast, he'll take about 10 ml and finish off with bottle. Sometimes a feeding takes up to an hour because of that mixed feeding. I've been logging his feeds for 5 days now, and trying to stretch them to every 3 hours. It's not working. He's feeding every 1.5 hours. Please help, how can I stretch that time? He will not take more milk, falls asleep on the bottle or fusses. Then I do some activity with him, then he either falls asleep for 20-40 minutes or stay awake till next feed. I am desperate for some time to myself and some stability in our lives. Also I noticed he started sucking on his fingers a lot, when offered milk or dummy or breast, refuses. Thank you, I appreciate any responses.

[creations]

Hello and welcome to BW forums

Feeding on demand is the best method when you are breast feeding. There may be some tips on the BF board about how to increase your supply, you can post there about feeding if you like, I know there are others in the community who have done mixed feeding too.

He might be sucking on his fingers because he is just exploring his fingers or finding out what the inside of his mouth feels like, if he isn't taking milk at these times he probably just isn't hungry, and I would expect him not to be hungry if he is feeding every 1.5hrs, he's not likely to want more food between those times.
I know you said it takes an hour to feed, how long is he at the breast and then how long are you offering the bottle and what is it that seems to be taking up the time?
Have you seen a doc about the feeding or perhaps had any support from a BF group?

In terms of getting some Y time you could do with getting the naps to be longer.  Naps do not necessarily need to be linked to eating. I know the EASY routine is eat activity sleep eat but it is not a requirement to eat as soon as they wake up and as they get older the S and E times shift anyway. You can begin looking at a sleep routine even if you are feeding on demand or if your LO can't make it to a 3hr E.
Often LOs stretch their E times because they are asleep and food is not their priority at that moment. If a LO is awake they are likely to be hungry sooner.
It is also possible to mis-read signals and think baby is hungry when he is tired or perhaps needs comfort and a cuddle.  It could be that if you focus on his naps instead of his feeding times the feeding will resolve (although I'd still post on BF if I were you, they can be a great help over there).

The way to begin EASY is with 3-4 days observation and recording the exact times your LO eats, sleeps, wakes and how long the activity time is.
When you have these you may begin to see a pattern forming where you didn't realise there was one, and it may also become apparent where you could nudge the routine into a more consistent pattern.

When you have your observations days you can post them here along with anything you noticed yourself and I can look it over to see how you might go about getting some better naps in.  When you post please try to use a format something like this:
WU 7.00 (morning wake up time)
E 7.00 (a note about any problems)
A 1hr 30 (how long from waking up to falling asleep)
E 8.30 (include all E times even if they are more frequent)
S 8.30 - 8.50 (if it is only 20 mins write the exact times, then a note about what you did next, if you tried to resettle etc)
and so on through the day including:
BT (bed time, the start of night sleep)
DF (dream feed)
NF (night feed)
NW (night waking not for food)
and through to
WU

It would also help to know a little more about where LO sleeps, what you do to get him to sleep and how you try to resettle.
Have you started shush/pat?
Have you read any of the baby whisperer books (there's lots of info here if you haven't but it is helpful to read at least one)?

Here is a link to Starting EASY, it's a good place to start
https://babywhispererforums.com/index.php?topic=186622.0

I spent my DS's first year as a single mum (his daddy had to move out due to mental health) and remember just how exhausting it was.  Being on your own is really hard work doing all the day shifts and night shifts too.  If you have family or close friends do ask for help so you can get a little time for yourself now and then.

[angie33]

Hello,

Thank you for your response,
Sorry it took me so long to get back to you, I've been trying to get an accurate log, which i managed partially.. it's difficult to keep accurate log so i chose days that had most data. Hopefully it tells you something, I can't make out any pattern out of it

I don't have any hope in breastfeeding. I've tried everything - pumping 8-10 times a day, hands on pumping, hand expressing, power pumping, hired 2 hospital grade pumps. I tried various supplements/galactogogues, 7 to be exact, and high doses of Domperidone. I checked my prolactin level, it was fine. I've paid for the lactation consultant. After weeks of her help, she said that my body is just resistant to everything. My body just isn't making milk. My gp said frankly that i should stop breastfeeding. I weighed Anthony before and after breastfeeding a few times, it's actually 0ml now, not even 10ml. So I'm thinking of stopping putting him to breast. I think I need that nudge, so if you tell me that the routine will work better if I stop putting him to breast, I would actually be grateful and finally make my peace with feeding.

To clarify, according to the formula for minimum amount of bottle feeding: weight 6.16kg x 150ml= 924ml. Divide that by 8 feedings, he's supposed to have 115.5ml per feed. He was doing 10-12 feedings, and eating about 60-100ml per feed, which was fine.

Now I started trying to feed him more per feed so he holds on longer. He's not taking as much as I would like. But the breaks are a bit longer. Actually I'm a bit worried because since I'm logging, he's eating much less than he should. I should mention that he was born small, and gained a lot of weight in the first 6 weeks, eating more than average. That's why it is unusual for him to eat much less than average.

I also shortened the time at the breast now to 20 min, so it takes only 30-40 minutes to feed.

How can I lengthen the naps? I live in a studio flat but have been getting him used to noises during daytime. But when he wakes up, he doesn't cry right away, lies for a few minutes and sometimes then starts fussing, then crying. Other times he's just laying there content. I tried to resettle him - using shush/pat but it doesn't work. When he's up, he's up. Few weeks ago I also started using the method from baby whisperer book to resettle him at BT (pick him up until stops crying, then put him to sleep again; works at night after a few times, but often he goes to sleep after first try). Before that I was just carrying him around and sometimes gently rocking.

Anthony sleeps with me, I can't afford the cot bed right now. He did sleep in moses basket for the first 3 weeks, then wouldn't stay asleep there, so I took him to my bed. I'm happy with him sleeping with me now, until I can get a cot bed, which will be in a few months. Hopefully the routine can still be implemented with my situation.

I am reading The secrets of a baby whisperer now, didn't know that there were more , what are they?


Unfortunately I don't have any support from friends or family. I don't have anyone that close or capable to ask. I am fine with that.

My log:

WU: 8:00
E: 8:15 breast only ->went back to sleep right away
E: 9:00
A: 1hr50 (9:00-10:50)
S: 10:50-11:45
E: 11:45
E: 12:25
A: 1hr15 (11:45-13)
S: 13-13:25
A: 2hr30 (13:25-15:55)
E: 14:55
E: 15:50
S: 15:55-16:10
A: 1hr20 (16:10-17:30)
S: 17:30-18:15
E: 18:30
A: 18:15-19:10
S: 19:10-19:20
E: 19:30
A: 25min (19:20-19:45)
S: 19:45-19:55
A: 35min (19:55-20:30)
S: 2030-tried to put to sleep as he looked tired, didn't work
A: 1hr (20:40-21:40)
E: 21:20
BT: 21:40 asleep on the bottle
DF: 2:30 breast
DF: 3:25
NF: 6:30


WU: 8:00
E: 8:30
A: 1h50
S: 9:50-10:10
A: 50min
S: 11-11:10
E: 11:30
A:
S:
E: 14:10
A:
S:
BT: 22:00
...


WU: 8:00
E: 8:10
A:
S:
E: 11:20
A: 1hr40
S: 13:00-14:00
E: 14:00
A: 2hr40
E: 16:40-> asleep on breast
S: 16:40-17:00 uneven sleep with short cry outbursts
E: 17:00-> asleep on breast
S: 17:00-17:40
E: 17:40-> asleep on bottle
A: 18:15-21:30 (3hr15)
E: 19:35
E: 21:00
BT: 21:30 -> asleep on bottle
DF: 4:30 breast


WU: 7:00
E: 7:10
A:
S:
E: 10:00 breast
E: 10:55
A: 2hr
S: 12:00-13:00
E: 13:00
A: 1hr20
S: 14:20-15:00
A: 1hr30 (15:00-16:30)
E: 16:00
S: 16:30-16:40
E: 17:00
E: 18:00
A: 1hr20 (17:00-18:20)
S: 18:20-18:20
E: 19:00
A: 2h40 (19:00-21:40)
BT: 21:40
DF: around 4:30 breast
DF: 7:00


WU: 10:00
E: 10:00
A:
S:
E: 12:00
A: 30min (12:00-12:30)
S: 12:30-12:50 driving
A: 2hr40 (12:50-15:30)
E: 14:15
S: 15:30-16:00 driving
A:16:00-not sure
E: 16:30
E: 19:00
BT: 21:40 after 20min resettling, fell asleep in kitchen cause cried when in bedroom
...


WU: 7:30
E: 7:30
A: 2hr15 (7:30-9:45)
E: 9:45-> asleep on bottle
S: 10:00-11:40
E: 11:40
A: 2hr30 (11:40-13:10)
S: 13:10-14:20 -> asleep on breast
E: 14:20
A: 40min (14:20-15:00)
S: 15:00-16:00
A: 1hr30 (16:00-17:30)
E: 17:00
S: 17:30-19:45
E: 19:45
A: 2hr (19:45-21:45)
E: 21:00
S: 21:45-22:30-> resettled by giving breast, fell asleep
DF: 5:00 breast
...


WU: 6:50
E: 6:50
A: 1hr30 (6:50-8:20)
S: 8:20-9:10
E: 9:20
E: 9:55
A: 1hr25 (9:20-10:45)
S: 10:10 tried to put him to sleep but failed
S: 10:45-11:30
A: 1hr 15 (11:30-12:45)
E: 12:20
S: 12:45-12:55
A: 50min (12:55-13:45)
E: 13:40
S: 13:45-14:15
A: 2hr15 (14:15-16:30)
E: 15:20
S: 16:30-17:30
E: 17:50
E: 18:20
...

I appreciate your help. Thank you so much,
Angie

PS.
I also wanted to ask you, how do S and E times shift when they get older? How long should a 4 month old baby sleep during day and during night?

[creations]

Hi Angie
Hugs, it's sounds like things are hard for you especially with not having any support you can call on and the struggles you've had with breast feeding.  I really feel for you.  It also sounds like you are very well organised, determined and strong so I'm sure you will push through all these difficulties just fine.

I am truly amazed at how many different avenues you have explored to get the BF going. I'm in awe I really am.  What an amazing Mummy you are to have tried all those things despite being exhausted (you must be!) and having no external support.  I can't tell you or nudge you to stop BF though. This is very much a personal decision, it is a hard decision too.  We can support you whatever you choose to do.
My own experience with BF wasn't great. I had been determined I would BF and didn't buy any of the bottles or sterilising gear.  Life doesn't always go as planned does it?  I ended up stopping by the 24hr supermarket at 10 or 11pm to buy supplies minutes after being discharged from hospital. I had such struggles, there were times I managed to pump enough BM to feed him purely BM with a bottle, times I thought he would finally take the breast and we could succeed... but in the end I made the decision at around 4 - 5 wks to move fully to formula. It was a very hard decision. I felt guilty and there were lots of tears. Having been through that I can only say you have to decide yourself based on your own situation and not be pressured by others one way or the other.  It sounds like you have pretty much decided to stop, if so, you need to know, that's okay. It is okay.

I'm not sure if you've been measuring just formula or breast milk.  LOs often take more breast milk than you can pump so measuring the amount you pump is not necessarily the amount he is eating when nursing (this is different to the information in the BW book. We use the most recent research on the forums and believe Tracy Hogg would have updated her advice if she was still with us).  Otherwise, all bottles need to hold enough so that he eats to his fill and there is 30ml (or 1oz) remaining in the bottle.  If he is draining any bottles you need to increase the amount offered, he knows how much he needs and will turn away or stop when he is full.
Some LOs don't take the "average" or "guidance" amount.  Lots of wet nappies and gaining weight is more important than exactly following the right amount.  I worried about my DS as he took around half the guidance amount of milk but he had good weight gain and maintained his birth centile line which is the guide to use.  Unless there has been a problem with weight gain, failure to thrive, or you have been told by a health professional to weigh more frequently, I would try to hold off from weighing so often. The guidance in the UK is to weigh not more than once per month, this is because daily fluctuations can cause needless worry.
LOs increase their intake hugely during growth spurts, when the growth spurt passes it can really feel like they are not taking enough, we get used to the larger amount then worry about it reducing. But this is normal.  Wet nappies and keeping to the centile line (or drifting one centile line either way is fine also) is important.

I would suggest reading up on safe co-sleeping if you haven't already.

Where does he sleep for naps now?  I am assuming not in your bed without you there as this is unlikely to be safe.  Babies can surprise you suddenly rolling when least expected or some how managing to work their way across an area when you thought they couldn't move at all. Even if you are in the room this could happen before you know it.  I would suggest making up a nap bed on the floor if there is no alternative.  Just a change mat on rug or carpet would be fine for now, that way if he rolls he can't fall.  Or if you have a pram/stroller inside the flat you could use that as a sleep place for naps with him secured in with the safety harness.

Could you get a pack and play second hand perhaps?  They can be much cheaper than a cot bed and I found ours a great help when DS started rolling, crawling and generally moving around, when he was walking too. I knew I could pop him in there for a few minutes whilst I showered or made dinner or went to the toilet... when they become mobile having a safe place to pop them is great help.  For example mine used to go in every  night for 20 min whilst I ran his bath, prepared his night nappy and pjs, made his milk, prepared his meds etc.  He knew the routine and was happy in there and I knew he couldn't get into anything dangerous.

I'm going to look at your routine separately in a little while.

[creations]

OK, sleep routine.
At 4 months the guidance A time is around 1hr 45 - 2hr, here is a link to guidance times by age:
https://babywhispererforums.com/index.php?topic=84884.0
Many LOs at 4 months are moving to 4hr E but not all.  Some do not manage 4hr E until they are closer to 6 months old.
If you are breast feeding on demand or feeding to sleep then E will be more frequent but we'd usually see a LO able to go 3hrs between E.
If E is shorter than 4hrs (3hr or moving to 3.5hr for example) you may need to track E and S separately, not a neat EASEAS but could be EASAEAS and that's fine.
At 4 months we usually expect to see 2 long naps (1.5hr to 2hr each) and a cat nap (30 - 45 min).

The frequent feeding may be due to needing a bigger feed or wanting comfort because of gas or reflux or because he is tired (not hungry) and needs to nap sooner or for longer.  Frequent feeding can also be due to "snacking" rather than taking full feeds.  It can also be linked to the habit of feeding to sleep (for comfort, this is considered a prop for sleep, you wean it when you are ready to tackle it).  All sorts of reasons really.  Because you have been trying to work out the BF and mixed feeding try not to worry too much about E times at this point. You do not need to make him wait for food.  It's possible that various aspects of the E routine may become apparent over the coming days/weeks and if/when you decide how you'd like to proceed with feeding.

For now I'd watch the clock a bit closer, some of your A times are very long for his age and on the whole are quite variable. This can happen when naps are short (he gets tired sooner than expected and nods off on bottle or breast) and can also happen when following sleep cues which can be quite variable in time.  For now I'd plan to:
- start your wind down for sleep with enough time so that he is asleep at around 1hr 45.  That's 1hr 45 since he last woke from a sleep.
- if he takes a nap shorter than 1hr 30 min I would reduce the A time to 1hr 30/35 and put down for the next nap a bit early
- if he takes a good long nap I would give a full 1hr 45 A time, if he appears not to be tired this can go up to 2hr but not beyond.
- I would use W2S (wake to sleep) to help him nap longer. W2S is usually timed based on when LO is waking, as your LO is taking some extremely short naps I will suggest for now you shush/pat throughout the entire nap to help him stay asleep.  You can still put him down for the nap but keep a hand on and resettle him as much as you can before he fully wakes.
Here is a link:
https://babywhispererforums.com/index.php?topic=223809.0
Look particularly at naps option 1 please. The idea is not to wake him but to sooth him through the sleep.

- if he wakes and it has not yet been 3hr since the previous E time I would not automatically feed him but wait to see either when he is hungry, or at the 3hr mark.  Feed earlier than 3hr if you see that an E time is going to clash with an S time.

I am reading The secrets of a baby whisperer now, didn't know that there were more , what are they?

That's fine.  Bare in mind Tracy is no longer with us, we use the more recent research on the forums wherever possible so some things may be different to the book.
There is a link somewhere with the titles, I wouldn't use up all your Y time reading them all though...one is enough for now

I also wanted to ask you, how do S and E times shift when they get older? How long should a 4 month old baby sleep during day and during night?

Hopefully I've answered this.  Don't worry about knowing all the answers right now. We are not going away and as your LO grows you can post about his changing needs.  I found this forum when my LO was 4 months old and I never left.

I also meant to say, you may need to dim your room for naps or perhaps you can look at the black out tents/covers that can be bought to go over a cot, travel cot, pram etc. This may help although many LOs I know learned to sleep in broad daylight.

Let's see how you get on with the suggested routine changes.  Here is you have more questions and certainly update when you need to.

[angie33]

Hi,
Thank you for your kind words. It means a lot from a person so knowledgeable. Yes, you are right, it was very exhausting to do all those things related to breastfeeding. Sometimes I was so tired that I swayed. But it's much better now since Anthony started sleeping more at night. Still, I want to make it even better Yes, I am determined in this matter and organised, which is very surprising for me because I'm usually messy in life But I do like to have guidance and examples, and know as much as possible on a given subject, that makes me feel better and with abundance or even overload of suggestions I am better able to choose what's right for me. It just works this way for me.

Regarding measuring breast milk - I bought a scale and test weighed Anthony several times before and after breastfeeding. The scale increment is 10g and it was mostly showing 0g difference, besides 2 times when it showed 20ml... so it actually is very low... and I forgot to mention maybe that he had a severe and thick tongue tie with almost zero mobility for 3 weeks before I went online and realised it. Until then I wasn't really pumping because everyone was telling me that the latch is "beautiful" which it wasn't. He was never feeding effectively Tongue tie was divided twice because it had regrown. So there were several factors contributing to my milk supply problem: baby's tongue tie, my age - 38 y.o., my labour was induced because of GDM (on insulin, it's gone now), and also significant amount of stress and emotional trauma during and right after birth.

As of now I only give him breast at night when he wakes up at 4-4:30, but he's taking it less and less, yesterday I had to give him a bottle because he wouldn't take breast or go back to sleep.

About the 30ml that's supposed to be left in the bottle - I try, but it's difficult cause of the wild range of amounts he's taking - so most of the time around 60-80 is left (out of 150 which I make, rarely he will drink this amount). I just weighed Anthony today and he actually went up a line in percentiles so I'm reassured because two months in a row he has good weight gain. Now if he could just eat less often

He's sleeping in my bed for naps but I made it so he can't fall (sort of barrier on 3 sides) and there's no pillows and soft surfaces so it's safe. The bedroom has no window so it's quite dark, even during the day.

I think the reason for feeding so often in our case is "snacking". Also I give him a bottle right before bedtime, so maybe that's a mistake, but he won't fall asleep without it. For example tonight I gave him 120ml in a bottle and he was still unsettled so after 10 minutes I made another 30 and he ate 10 of it and was fast asleep. I also noticed that since I started giving him a DF bottle around 12-1 am, he's waking up earlier and sometimes needs night feeds which he did not for past month. Do you think there's a connection there?

Thank you for the links. Very useful. I am going to start fully implementing your suggestions on Tuesday (we have some airplane travelling to do on Monday so don't want to potentially waste the effort). Fingers crossed

I should have mentioned this before, my "shush/pat" is a bit different - I shush and gently stroke his head when he's in bed; I pat him on his bottom only when he's crying and I'm giving him a cuddle. I hope that's still ok - it works just the same

I have a feeling that I will be writing again and soon with some BLW questions.

Thank you for your advice,
Angie

[creations]

Some times people choose not to do the dream feed because LO wakes for feeds anyway and the DF ends up like an additional feed. It's up to you, you can not do a DF and just see what time he wakes to feed instead.  Your DF is quite late at night, perhaps because up to now BT is late, you might find it more helpful when you change the routine a bit and have an earlier BT and earlier DF.  If not though you can drop the DF.
My LO wouldn't take a DF so he was always awake for it (initially he woke when I lifted him for the feed but after he woke habitually for this feed) but it was still really useful as it meant he did his long stretch of sleep after I went to sleep so I got the best stretch possible.

Safe journey Monday, hope he travels well for you.
Here when you need us x