A couple of questions...

[Louismummy]

Hello,

I'm currently reading The Baby Whisperer and I wonder if anyone could help with the following questions?

PU/PD - my little boy will be 11 weeks and 5 days on Tuesday (planing on starting EASY properly on Tuesday) but I'm u sure if this is too early for PU/PD? The book says (p221) 'I use PU/PD on babies from the age of 3 months who have not learned the skills of sleep' however the heading to the PU/PD chapter 6 is called 'PU/PD a sleep training tool - four months to a year?

My little boy is breastfed and until now we've being doing this on demand. He doesn't have a routine as such, other than he is bathed at 6, and goes down at 7, sometimes he goes down awake and sometimes he has fallen asleep in my arms, but he always falls asleep very quickly. He normally sleeps until 2.00am and then until 6.30/7.00am. His daytime naps vary but are always very short and sometimes he can have as little as 2 x 30 min naps per day. Even with this amount of daytime sleep he is rarely grumpy providing I get him in the bath by 6.00pm... Any later he does get grumpy. I think he is textbook?

I started reading this book to help with introducing an expressed bottle but after reading I'm wondering if I should implement EASY in order to get longer naps? My husband isn't 100% we should be doing this as he doesn't think there is a problem? I'd prefer to get him on a schedule but I'm slightly concerned I'd be creating a new problem?

Over the last two days I've started preparing by loosely following an EASY sequence but he has only been napping for 40 mins which makes the cycle too short (I didn't want to start the PU/PD to increase the naps until I was sure this was correct) and I've also been dream feeding him at 11.00pm. Since following the EASY sequence and introducing the dream feed he still woke up at 2.00am, again at 3.30am, 5.30pm and 6.30pm which he has never done before? The book says this could be down to not getting enough food.... This does make sense as when I was feeding on demand I guess he would be getting more but how do I get him to take more without messing up the sequence..... He is always hungry and would always take more (he is a pretty big baby 14'7 3 weeks ago)

He also feeds very quickly, I presume I'd just reduce the suggested feeding time which would reduce the whole cycle length rather than increase the awake time?

Any advice would be appreciated..... Hoping to start on Tuesday so currently re-reading the book in case I've missed anything?

X

[Buttonbobs]

Hi there, I hope to answer all your questions but if I miss anything please ask

Re PU/PD, I found this quite confusing when I read the books too. The technique can be used from three months but so long as you are using an age appropriate version. I would try with shh/pat first though. Shh/pay is a more gentle technique and if it works, is potentially less disruptive to an LO. Have you read here?
Shush-pat - How to

If your son is very even tempered he may well be angel or textbook, have you done the quiz in the book?

While EASY does provide a structure it is not meant to be a schedule. As such, it isn't really that different from feeding on demand. You will still be following your DS's cues for hunger and for sleep etc, but as Tracy explains in the book, by always doing these things in a set order your baby will learn to understand what to expect next. Babies and children are like adults in finding comfort from knowing in the main what is going to happen next. It will also help you to be responsive to him, if he's just woken and has a dry nappy but he cries, it's likely hat cry is for hunger iyswim.

You won't be creating a new problem as you're already doing a great job at following his cues and feeding on demand is essential for getting BF started

When looking at an EASY, A time includes feeding - so whether your LO is an efficient feeder or whether he takes a long time the A time would still be the same overall including any play and nappy changes etc. it is also worth noting that many BF babies are on a shorter EASY than their formula fed contemporaries, it is all about watching the cues. Many bf mummies say their LO didn't move to a 4 hr cycle until solids were introduced.

I would suggest the main thing is not to feed t sleep so always making sure there is some A after the E ends and getting a really good wind down routine in place.

If you like you could write down your DS's routine for the next couple of days and post them here and we can help you shift towards a more EASY type structure from there.

You might find other useful threads to read here:
Sleep Training  - the early days.

I hope that helps

[Louismummy]

Hi Buttonbobs,

Thank you so much for your reply.

Yes I've read the sh/pat... I'll start off by using that and see how I get on.

I've done the quiz, we got 10 A's and 10 B's - I think he is textbook though.

Right got you, so the overall E+A time is the same so it doesn't matter about the feed time. We've started EASY today and I got him out of his bed at 6.30am
- so if we're on a 3 hour easy S time would be around 8 (depending on his cues) regardless of how long his E took this morning.
- E this morning took 11 minutes (that's normal, as well as him being an efficient eater I have a really fast milk supply and an overactive letdown) so we might well be on a shorter cycle until solids are introduced.
- during my A period does it matter if I top up on E? Because of my fast milk supply and overactive letdown LO often needs a break but may not be totally finished. I'd make sure there was A after the extra E?

(sorry I have read this but can't remember which chapter, trying to find it in the book) is wind down time (four s) taken from the A time or the S time?.... I realise it is just done after I've read his cues but I just want to know for when I'm recording all the E, A, S, Y, times.

I put LO down this morning at 7.45 and he is asleep by 7.50 - he normally sleeps for only 45 minutes so I'll go in and try and catch him before he wakes and start with shh/pat but if he wakes I need to shh/pat until either he sleeps or until total time is 1 hour 30.

Thanks in advance...

[Buttonbobs]

during my A period does it matter if I top up on E? Because of my fast milk supply and overactive letdown LO often needs a break but may not be totally finished. I'd make sure there was A after the extra E

It is quite normal for an LO to need a break for a burp and then back on etc but I would try to avoid feeding again as a totally separate session as this may encourage snacking and get you into a loop where DS doesn't take enough at one feed to last long enough to another full feed. IYSWIM.

is wind down time (four s) taken from the A time or the S time?....

S is from eyes open to eyes closed, so if he's awake during your wind down (which I would expect him to be really) the wind down is A time.

if he wakes I need to shh/pat until either he sleeps or until total time is 1 hour 30.

If he wakes, you shh/pat until he's well asleep again.

I have attached this average list of age-appropriate A times. These times are just average but the pattern is the same for all LOs. As they get older they'll be able to manage more A time before sleeping. A 45-minute nap can be an indication that he's not quite tired enough to take a full nap and you should try lengthening the A time by a little longer.

Average A times- BOOKMARK ME!

You are planning to go for 1.5 hours A time which is at the top of the average A times for your DS's age. If you get 45 min naps that you can't resettle on a regular basis then you may need to allow him a longer A time, but as you're just getting started on EASY I'd let that bed in first.

I hope this makes sense, please come back if you have more questions - good luck!

[Buttonbobs]

How're you getting on sweetie?

[Louismummy]

You were right.... I have a snacked on my hands.

He has started to wake at night every 2 hours for a feed. He goes right back off to sleep after he has fed. So he is definitely waking because of hunger. so i presume this is because he isn't getting enough calories in the day??

Our EASY tends to be more like EAESY.... How can I get him to take more food to prevent the extra feeds in the day and hopefully stop him waking in the night?

[Buttonbobs]

I would try moving that second E closer to the first and further from the S little by little ech day bad hopefully he'll start to take more and eventually drop one of the feeds as they get closer together. Does that sound manageable to you?

Together with this, you should probably decide not to feed at night more than once every 3/4 hours for example, so if he wakes after 2 hours you'll try and resettle him another way but if he wakes and more than your designated time has passed, you can feed him. I certainly would try to avoid feeding more often at night than you do in the day.

Having said that, do you think he could be undergoing a growth spurt, LOs tend to feed more during a growth spurt particularly when BFing to increase your supply.

I'm going to ask some BF eyes to take a look as I was FFing by this age so don't want to miss something for you.

[Fiver]

Hello

I was going to suggest that perhaps you'd hit a growth spurt as well.

As for the E times, if you're struggling with a fast letdown, you could always try out some of the tips in this FAQ and see if that helps him to stay at the breast for a bit longer during a single E period rather than having a top up some time later - Oversupply and Overactive (Forceful) Let-Down

[Louismummy]

Thanks for the replies.

Feels like he has been having a constant growth spurt for a few weeks now - how long do they normally last for?

We don't have a problem with an overactive letdown anymore... It's still fast but doesn't shoot out causing him to choke.

I only started this 3/4 weeks ago and prior to starting I'd been feeding on demand..... He had lots of feeds throughout the day so I guess it was always going to be difficult trying to make him go every 3 hours. Prior to starting he was almost sleeping though (from 6.30-4.30) I did try last week to go back to how we use to feed with the hope he would sleep better but he was still waking every 2 hours.... And I probably made things worse by going back?

I'll try and settle him in the night without feeding and see how I go.... It's difficult because we live in a flat with paper thin walls so I don't want to disturb the neighbours. Also he

Right I'll try and get back in to it tomorrow....

Just out of interest how long should a feed last for? I've started to express a bottle a day, should it take the same amount of time so I can estimate how much he has had during a bf? It does take him much longer to have a bottle. I don't know if that's because he is having more or because it takes longer

Thanks in advance x

[Louismummy]

I've just read the thread of growth spurts and it say bigger babies go through them earlier?? I'm getting him weighed tomorrow but he is about 17.5 pounds and 15 weeks tomorrow. They should still only last a coup,e of days though shouldn't they?
 

[Fiver]

When you say you've been feeding on demand, what do you mean?  Some people think that that means they should feed LO whenever they cry, but babies do cry for other reasons apart from hunger, so BW is about recognising when your LO is cuing for a feed as oppose to being tired or uncomfortable.

If you've been feeding him really frequently, you might want to try spacing them further apart a little more gradually, say about 5-10 minutes further in increments of a couple of days so that it's not such a shock to the system.

At 3m you would still be expecting him to have a NF or two, so don't be overly concerned about offering a feed in the night.

Just out of interest how long should a feed last for?

This is almost like asking how long a piece of string is   Each LO feeds for a different amount of time - some longer or shorter than others.  Expressing/pumping is not an indicator of how much milk a LO would take over a period of time simply because your baby will be more efficient and triggering the right hormonal responses to produce sufficient milk from you.

How big are the bottles you're offering?  Here's a rough guide as to how much he might be needing http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

[Louismummy]

Hi,

Thanks again for the reply (everyone is so helpful!!)

Yes, before I read the book I'd been feeding on demand and probably been misreading his cues sometimes..... From memory though he did always seem really hungry? When I fed him this way he slept from 6.30/7 until 4 and would then go back down until 7.30am

I started trying to make the changes just under a month ago and the night following trying to implement EASY he started waking every 2 hours? And he hasn't slept that long at night ever since.

He had 7.5 oz bottle of expressed milk this evening (I forgot to time how long it took but I reckon about 12/13 minutes.

When I feed him during the day it normally only lasts for about 7/8 minutes but he seems to be ready for his next feed before he goes down for his nap....

I'm still expecting a couple of NF's but it feels like we have gone about 50 miles backwards.

So when he wakes tonight for the first time I'll feed him, second time (assuming its close to the first feed) I try and settle him without feeding and see how I get on. I'll post tomorrow with an update.

Thanks again for everyone's help.

Xx

[Fiver]

At 3m, a 7.5oz bottle is probably a bit big.  Did you have a look at the expressed milk calculator?  That will give a better idea of how large a bottle to offer.  Good luck

[Louismummy]

I did start off with smaller bottles which are 5oz (I think) as soon as he finished he cried for more?? If it was too big why would he still wake at 11/12 for a feed? He is 15 weeks (was 3 months when I started this post)

Perhaps it isn't hunger then he is waking for in then night then?

Yes got the link thank you.... I'll see how many feeds he has tomorrow and work it out.

Thank you x

[Louismummy]

Last I feed him 7.5 oz at 7.00pm and he was asleep by 7.30pm he woke up during the night at:
11.30pm
1.30am - didn't feed
2.00am
3.54am
5.15am - didn't feed
5.45am
6.45am - got up (but surprise surprise he isn't hungry)

Shall I wait until after his nap until I feed him next?

He is sat laughing in his chair like butter wouldn't melt......

[Fiver]

If it was too big why would he still wake at 11/12 for a feed?

Because breastmilk is incredibly well and quickly absorbed, which is why BF babies need feeding (generally) more often than their FF counterparts.  Could upset after feeding be down to discomfort from wind or tiredness, for example, rather than for hunger, do you think?

[Louismummy]

Could upset after feeding be down to discomfort from wind or tiredness, for example, rather than for hunger, do you think?
[/quote]

He doesn't get upset after feeding?? ... He is just waking up in the night more frequently? I'm pretty sure it is hunger... Every 1-2 hours at the moment and he has been doing this for about 3 weeks... (Since implementing EASY)

In the daytime he has been having frequent and short feeds..... I'm not sure if this I'd the reason for the NW, others have suggested a GS but that shouldn't last for 3 weeks should it?

I have read back through the book and looked at possible reasons for the NW and I think it is hunger? I'm pretty sure it is hunger. Yesterday some suggestions from people on here was to try and settle him at night without feeding him (I was feeding every time he woke) i also wanted to increase the E time as this was very short (possibly because I was feeding him too often???) I listed NW from last night. At 1.30 and 5.15 I managed to settle him without feeding but on both of those occasions he woke just half and hour later whereas when I fed him he lasted much longer.... Which what makes me think its hunger.... And he dives on the breast like he has not been fed for days!

So my plan of action was to:
Try and decrease feeding on NW - managed to settle him back off twice last night without feeding.
Try and increase feed time and decrease feed frequency.

Today has looked like this:

6.45 up but he didn't want to feed due to earlier night feeds
A until 7.50
E - 7.50 until 8.00 (7 mins)
S - 8.12 until 8.55
A - until 9.30 (didn't want to feed right after sleep as they would be too close)
E - 9.30 until 9.36 (6 mins)
A - 9.36 until 10.30
S - 10.30 until 11.30
A - 11.30 until 12.10 (swimming lesson)
E - 12.15 until 12.25 (10 mins)
A - 12.25 until 12.45
S - 12.45 until 2.00
E - 2.07 until 2.22 (16 mins) longest ever!
A - 2.25 until 3.45
S - 3.45 until 4.32
E - 4.34 until 4.40 (6 mins)
A - 4.40 until 6.30
E - 6 oz expressed
A - 5 min story
S - 7.00

So these timing might look a little strange, he didn't want a feed when he got up (due to the night feeds) I was try to extend the amount of time between feeds and we had a swimming lesson which meant he went a longer period without E.

We've def had a lot less feeds today with a couple for a much longer period, so that is a step in the right direction! Lets see how he is tonight.

[Fiver]

He doesn't get upset after feeding??

Sorry, there seems to be some confusion, I was talking about the feeds where you said:

I did start off with smaller bottles which are 5oz (I think) as soon as he finished he cried for more??

As for this

on both of those occasions he woke just half and hour later whereas when I fed him he lasted much longer.

I would tend to agree.

Where have you got to in terms of how spaced BFs are during the course of the day, because all these NFs could be his way of either trying to make up for milk he's not getting during the day or to try to up your milk supply.

[Louismummy]

The penny has dropped..... I think I know what's up..... Why has this taken me so long to figure out?

When I took his expressed bottle out of the fridge I noticed the foremilk and hindmilk had separated, there seemed to be loads more foremilk to hindmilk. I estimate 85:15 so I got after I put him to sleep and finished my earlier post I got on google and we have quite a few of the symptoms:
Baby always hungry
Short feeding times
Fast weight gain
Feeding to often
Green poops
Lots of gas
Any breast feeding experts think this is the case? I might try and speak with someone at LLLI tomorrow.
 
This may be the reason for the NW for the extra feeds?

[Fiver]

You might want to have a look at this about the change from foremilk to hindmilk - http://thefunnyshapedwoman.blogspot.co.uk/search/label/hindmilk#

As it states in the article, what you are seeing isn't foremilk and hindmilk separated, just a layer of fat that has formed on top.  Foremilk contains fat too.
When did you express that bottle of milk?  If it was first thing in the morning, it is likely that there would be a larger quantity of less fatty milk simply because milk is more plentiful first thing (generally) and more fatty in the evening.  When you pump, are you continuing to pump after milk has stopped dripping or only after it's stopped "spraying"?

If you're having some of those issues, you could try some Breast compression to encourage some of the fat molecules out and LO to stay interested at the breast a bit longer.

[Louismummy]

I pumped it last thing at night.... The milk was almost clear.

It seems to spray for alot of the time I'm pumping.

Thank you I'll have a read of the blog.

X

[Fiver]

Do you get any spluttering with it as well?

[Louismummy]

A little but its mainly spraying.... It comes out pretty fast too, it only normally takes 10/15 minutes to express 7/8 oz.  I'm just about to pump now so I'll look closer.

 

[Fiver]

I was more thinking about whether your LO splutters at the breast.  It sounds like you might have a bit of a fast letdown and/or a bit of an oversupply.  More here - Oversupply and Overactive (Forceful) Let-Down

Sometimes then you do end up with a foremilk/hindmilk imbalance because there's so much milk there that LO isn't able to feed for long enough to get the optimal amount of fat and can sometimes end up feeding more frequently despite getting loads of milk at each feed, so it can sometimes seem like there's a problem with supply where one doesn't exist.

[*Ali*]

I think Amanda meant is your LO spluttering to cope with the flow or did I misunderstand that Amanda?

As Amanda mentioned, it is completely normal for there to be a thin fatty layer on the top of stored milk. There is a good picture here http://kellymom.com/bf/pumpingmoms/pumping/what-to-expect-when-pumping/ Fast milk flow doesn't help with dislodging the fatty molecules so taking measures suggested in the Overactive letdown FAQ Amanda posted earlier in this thread will also help.

I was also wondering how you are getting your LO to sleep? Is he going independently yet (in the cot awake and putting himself to sleep alone) or are you there doing something like shh pat or rocking to get him down?

It may just be coincidence that your LO started waking more often at night and not related to the routine changes specifically. Both my boys slept really well at night (7/8pm-5/6am) from about 6-8wo until some point between 3 to 4mo when they started waking a lot more often. This is really common for babies because in the early weeks their sleep is more continuous and they spend a lot of time in deep sleep. Some time between 3-4mo a baby starts sleeping more in 45 min cycles and spend much more time cycling between light and deep sleep and therefore wake more often. Some babies will settle themselves back into the next sleep cycle without fully waking. Other babies will wake because they are hungry, they are looking for a prop like a dummy, mummy's breast or rocking etc. or if they are in discomfort from wind or such. Many other reasons too of course.

Posted with Amanda...

[Louismummy]

Oh, I see! Sorry 

He sometimes splutters, but has been better when i manage to nurse on one side. We went along to our breast feeding support group who advised us to do this, they said I had an over active letdown. It doesn't spray in his face so much now so I presumed it had stopped..... Or he is controlling the flow better. 
We're experiencing:
Fast weight gain.
Short feeds between 5/8 minutes is normal.
Fussing. Off and on the breast
Take the 1st breast for a few minutes then refuse it but will happily accept the other.
Repeated mastitis.
Always hungry.
Waking every 1/2 hours at night.
Green poo
Sometimes can smell funny (which I understand can be due to lactose fermenting in the gut??)

In the main he does put himself to sleep independently. (In the daytime we use a dummy) at night I can literally plonk him in the cot and he will put himself to sleep. Same with the NW once he has fed, I just plonk him down and he is off. He does it himself in the daytime with the help of a dummy, I often wait with him until he is asleep and pull his dummy out.

I just read the symptoms and thought it sounded a lot like us..... And thought it also tied in with the NW?

Well I think we have done better today with feeding less frequently so I'll see how we get on tonight.

Thanks again for all your help x

[Fiver]

It does sound a bit like he's maybe started to control the flow a bit better, but is also now used to the speed of flow so that when it slows between letdowns he's either getting annoying that there's not so much coming so quickly or he's got wind in him that he wants to dislodge, hence the fussing and wanting to swap sides.  Either taking him off and giving him a chance to burp might be a plan, or trying some laid back feeding in order to use gravity to slow the flow a bit for him might help, and then putting him back onto the same breast.  I posted the breast compression link before, so you might like to try that if he's fussing and you're satisfied that he's not windy.

The mastitis would suggest that there are some issues with milk stasis within the breast, which could also be down to an oversupply alongside the overactive letdown.  Again, there is a lot of information about dealing with this within the oversupply/overactive letdown FAQ I posted before.

Can you go back to the BF support group you attended and get some IRL advice from them?  I always feel that as much as someone trying to help out online is great, there's no match to a face to face consultation.

[Louismummy]

Thanks again for all the advice - I'll have a read through the info today.

I went along to breast feeding support today and I'm not really sure it helped any? She isn't a fan of routines and said him wanting to switch isn't a issue and to just go with it, most babies go through NW and he'll grow out of it soon.

I've left a message from someone at LLLI so hopefully they'll call. They have a group once a month so I'll go to their next session.

In terms of the EASY routine continue with what I'm doing:
Decreasing the night time feeds by trying to settle without feeding
Increasing the time between feeds (we did manage a couple of hours between some feeds yesterday)

Thanks again for all your help x x

[Fiver]

Just take the spacing of daytime feeds really gradually.  If it's 2 hours, great.  See if he can manage 2 hours and 5 minutes the next day.

The great thing with BW is it's about following your LO's cues for hunger rather than trying to be on a rigid schedule dictated by the clock.