Dropping 3-4am feed - unsure if I'm going about it in the right way.

[Sharon P]

Hi there,

I am not sure if I am posting in the right section. This could be better in nightwakings, so bounce me across if you think that would be better.

My DS is 6 months this week and we are trying to help him give up his 3-4am feed. He generally wakes at either 3.15am or 3.45am. He is fully breast feed and is not on solids yet, just started offering a taste, but not really swallowing yet.

Our routine goes something like this: it varies according to wake up time in the morning, I try to go 4 hrly from when he wakes and adjust towards the end of the day. In the last 1 - 2 months we have been battling terrible sleep patterns and have just got back to our prevous routine in last few days, The longer sleep in morning may be catch up for chronic sleep debt, will have to see if it sticks.

7am wake/play
7.30 feed/play
9am sleep
11.15 wake and feed then play
1.15pm sleep
3pm wake and feed then play
4.30-5pm pram catnap (30 mins)
6 pm bath
6.20 feed
6.45 sleep
10.30 DF.

He has been through a really shocking sleep stage since 4 months and as I said we have just got him back on track this week, after discovering that we were jumping in with shh/pat before giving him a chance to self settle. Anyway, we went to a sleep clinic last week that was very supportive of BW'ing ways in terms of responding to your child according to their cry (did not encourage CIO, but did encourage us not to run in as soon as he cries). He responded very quickly and went from a terrible sleeper to a model student in 1 day and returned to only waking once between DF and 7am (either 3.15 or 3.45am). We thererfore decided to see how he would go being resettled rather than feed at this time as he wasn't necessarily taking much, and I suspected he was using me as a prop. Also, any night feeding was also effecting his 7am feed. The first night we had to go in and comfort him for a minute or two and then he grizzled himself off to sleep without further intervention. The next 2 nights he woke but self settled without me needing to go in.

Since getting home though he has not been so obliging to drop the 3-4am feed. I have decided to try to resettle rather than feed. First night I tried for 50 mins and then gave brief feed and back to bed. Second night I tried for 60 mins and gave up and feed briefly too. Third night (last night) I tried w2s at 2.30am and he didn't wake till 4.10am (therefore 30-60 mins later than usual). DH and I then tired to resettle for 70 mins - at 50 min mark offered 1/2 ounce boiled water and then continued with resettling till he went to sleep. This was a huge achievement.

My question are:
1. Am I doing the right thing in terms of getting rid of this feed, as in the middle of all his crying I start to wonder, could he be hungry? He is over 18 pounds. Further, prior to the sleep difficulties he had slept through from DF to 6am about 12 times since hitting 3 months, up to 5 days in a row at one stage.

2. Does w2s help with this kind of problem. I tried it because I thought the wake time seemed habitual and that I had become his prop. I know it takes 3 days, what is the usual pattern of results before it takes effect?

3. Are there any other strategies I could consider. Unfortunately. lent both of my book out. Have noticed on the board wi/wo - but don't remeber what this is, but I wonder if it is similar to what we are doing.

Thanks for helping me with this. I really appreciate any guidance or support.

Cheers,

Sharon.

[Samuel's mum]

Of course, you are the only one there in the middle of the night and you have to listen to your mummy instincts but I have think you have given it a very good attempt to drop this feed and it seems as though he might still need it.

As you mention the bottom line is BW tells us all babies are individuals and we need to listen to their communications. From my experience on this board and in real life many many 6 month old babies (only just starting first tastes) will need a night feed in addition to the df.  Have a look at this poll :

https://babywhispererforums.com/index.php?topic=55035.0

and bear in mind this is talking about only an 8 hour stretch.

He's at an age where calories are being burned fast as he's becoming more mobile and grasping new skills. You should also be anticipating the major 6 month growth spurt very soon if you haven't already and this will lead to perhaps a couple of nights of extra wakings. If you want to minimise his feed to not affect 7am I would suggest a small amount of ebm or a short feed is better for his overall calorie intake than offering boiled water at his age.

WI/WO is the toddler version of pu/pd - so not appropriate in this case.

It's just my view - but I think if your gut instinct said 'could he be hungry?' then perhaps you were picking up something you should trust. Being 18 pounds is no guarantee he won't need a feed - infact larger babies with a larger muscle mass will logically burn more calories. My only worry might be that if you put too much emphasis on dropping this feed, you might find your milk supply is affected or worst case scenario you don't catch a growth spurt and have longer-term supply issues.

By all means try continuing if you feel it's right for him but don't feel you've failed or are unusual if he does need a night feed. I think you are giving it a long time - 50 minutes +. As I said experience tells me - yes, he could be hungry - but only you will know for sure. When solids are more established you may notice a shift (that's solids in addition to his present milk intake) but not everyone notices solids affecting sleep (I didn't).

[Sharon P]

Hi Samuel's Mums,

I just want to run a few confusing factors by you.  If Ethan needs this feed then that is fine. He is a very active boy and very muscley, so I am open to the possibility that it is hunger. However, I am confused by the following.

1. At night, his feeds are often (but not always) just gentle, slow sucking that tappers quickly. If I try to detach him he will start the sucking action again, but otherwise he just dozes on the boob. If I try to get him off quickly he will start to cry, even though he is barely sucking, and then eventually he lets me get him off and back into bed. My mummy instinct in these circumstances is that he is using me as a prop. I think he has a developed a strong feed to sleep association, due to recent sleep problems that really confused me and lead to some accidental parenting resulting in me feeding him 2-3 times a night (not counting the dream feed)? So is this hunger or am I a prop or is it both?

2. If we assume that Ethan is waking at 3-4am out of hunger, wouldn't he have woken ravenous this morning, after not feeding overnight. In fact, I had to go into him at 7.40am, he had woken 10 mins prior and was not crying for food and he feed calmly and in a bob on bob off fashion. This was similar whilst we were at the sleep clinic, he only took moderate feeds in the morning when I hadn't feed overnight.

3.

you might find your milk supply is affected or worst case scenario you don't catch a growth spurt and have longer-term supply issues

I thought that he would just take what he needs during the day instead.  I have always had good supply so presently it's not a problem, but could you explain what may occur, I don't want to fall into trouble unknowingly. What does the 6 month growth spurt look like?

[Samuel's mum]

1. At night, his feeds are often (but not always) just gentle, slow sucking that tappers quickly. If I try to detach him he will start the sucking action again, but otherwise he just dozes on the boob. If I try to get him off quickly he will start to cry, even though he is barely sucking, and then eventually he lets me get him off and back into bed. My mummy instinct in these circumstances is that he is using me as a prop. I think he has a developed a strong feed to sleep association, due to recent sleep problems that really confused me and lead to some accidental parenting resulting in me feeding him 2-3 times a night (not counting the dream feed)? So is this hunger or am I a prop or is it both?

2. If we assume that Ethan is waking at 3-4am out of hunger, wouldn't he have woken ravenous this morning, after not feeding overnight. In fact, I had to go into him at 7.40am, he had woken 10 mins prior and was not crying for food and he feed calmly and in a bob on bob off fashion. This was similar whilst we were at the sleep clinic, he only took moderate feeds in the morning when I hadn't feed overnight.

And equally if he was really hungry at 3-4am you'd have expected him to wake again through hunger not long after going back to sleep. With not even an oz of water filling him I doubt he would have made it to 7.40am if he was hungry.

As I say - trust mummy instincts. If you feel he's not actively swallowing and you sense he's using the boob for comfort then your hunch to keep perservering with dropping the feed is probably right. I guess the interesting phrase it - 'but not always' - do you feel then, that there are more obvious times when he is clearly showing hungry signs. And what makes those occasions different?

The 6 month growth spurt won't be hard to miss. The only problem might be if you are missing clear hunger signs and not allowing him to feed more frequently in order to build up your supply. It sounds as though you are well-versed in reading him so I didn't mean to worry you. An example of when a problem might arise is if a baby is waking during a spurt and is being given a larger amount of water which might be enough to satisfy him temporarily or enough to put him back to sleep and then a mother's supply isn't getting the signals it needs over those intense 2-4 days to increase production. When a feed is 'skipped' (e.g. a mother uses some frozen ebm from before the spurt) it just means the breasts won't increase the supply as required. Sometimes when babies are stretched beyond their hunger cues it can also mean they are less effective feeders when they get to the breast as their latch can be a bit more haphazard or they get tired more quickly or they take in extra air through desperately guzzling. When the growth spurt hits he will probably get hungrier in the day too but night feeds aren't uncommon.

My only other thought might be - as you clearly have a supportive DH - is that it might be less confusing for your LO if you do not go in initially. It's clear babies can smell and sense milk and if your DH has the skills I would perhaps try it. 70 minutes sounds like a very long time so whatever you can do to reduce that and hopefully everyone's distress would be good.

Just continuing reading your baby as you are. It's good to hear you are not completely against the concept of feeding him come what may. If you do feel boob=prop is an issue have you visited the props board? If he is using the boob to fall back asleep I would also have a look at the gentle removal method idea on the nightwakings FAQ (scroll down a bit to get to the gentle removal method) so if you do ever feed at night you can end with him falling asleep independently.

[Sharon P]

Thanks Samuel's Mum and Stacy.

So pleased to have both of your input as this has been really confusing me. First the update.

Last night (probably while you were replying to me) was interesting. I went in to stir him at 2.45am as part of trying to follow through on the 3 nights of that. Unfortunately, as he stirred he hit the rails of the cot and woke up. So I sat with him and patting him to help him fall back asleep. He found it hard, would be quiet for several mins and then cry out for 10 secs and then I would shh or pat him and he would be soothed again. After about 15 mins I left the room, knew he was not in a deep sleep but thought I'd see what happens. He was quiet for a while and then he started to cry a bit, it never got emotional, was intermittent and sounded similar to his way of falling asleep during the day. Sometimes it intensified a bit but this build up lasted a min or min and half and then there would be a pause and some more self-soothing kind of crying. This continued for about 20 mins and then he went off to sleep. He then woke a few times and cried for 30-60 secs, more like the self-settling stuff, about every 45 mins, until morning. I got up and went in at 7.10am and he was happy and he feed well, but not in a desperate fashion.

Anyway, I then read each of your replies and started to reply, tossing around all the various indicators re: whether or not Ethan is hungry and needs the feed. I am still not sure either way, but more than anything I don't want my beautiful boy to be hungry and need something from me and for me to decide he doesn't need a feed (no matter how carefully or genuinely I come to that conclusion). So from that point on the answer was simple. All I have to do is continue to feed in the night and then I can be sure that he is getting what he needs and just forgot about it for the moment. I will re-assess the situation in a few weeks, once we have gotten over the growth spurt and also gotten further along the way with solids.

Thanks so much for your input. It was really helpful to hear your perspectives.

Samuel's Mum - Just a quick question... I have now been exclusively breast-feeding for 6 mths. I plan to continue for at least another 6. However, I was wondering about the possiblity of introducing a bottle of formular for the DF (Stacy- I don't think he's ready for me to drop this yet as he wakes by 10.30 if I haven't got to him yet). I have avoided doing this up until now as I understand the benefits of exclusively breast feeding, but if he is now on solids, do I still need to stick to breastfeeding only or could I introduce a bottel of formular for the DF only? It would give me a chance to get to bed earlier without the need to express.

Stacy - Happy to tell you about the sleep clinic. It is actually referred to more frequently as 'sleep school' and if a fairly common opportunity/practice available through public and private hospitals in Australia. So far 20% of my mothers group have been and another 20% are on the waitlist or considering it. It is basically a 4 day/night stay in hospital with your baby and partner (generally welcome, but optional if they stay overnight or not). There are a team of mother craft nurses and they help with sleep difficulties in babies. Each school has it's own philosophy, os some can be better than others. I had no choice as the city I live in only has the public unit, but I was very happy with their support. Their approach was similar to BW'ing, in terms of the approach to settling was not based on watching the clock and letting babies cries for extended periods of time. Rather, they supported you to respond to your baby according to their cry. It is was an emotional cry you should be with you baby and sooth/calm/comfort in a manner that suits you (picking up and cuddling is fine, but your encouraged to settle bub in their cot as much as possible), but once they have been soothed leave and let them self settle. However, if your baby is crying to self settle or in protest or because they are over tired, they help you to know when to go in an respond and when to hold back. I am still learning this part, bu things have improved vastly.

Got to go, it's time for the DF and then off to bed for me.

Thanks again,

Sharon.

[Samuel's mum]

Samuel's Mum - Just a quick question... I have now been exclusively breast-feeding for 6 mths. I plan to continue for at least another 6. However, I was wondering about the possiblity of introducing a bottle of formular for the DF (Stacy- I don't think he's ready for me to drop this yet as he wakes by 10.30 if I haven't got to him yet). I have avoided doing this up until now as I understand the benefits of exclusively breast feeding, but if he is now on solids, do I still need to stick to breastfeeding only or could I introduce a bottel of formular for the DF only? It would give me a chance to get to bed earlier without the need to express.

It's true that now he is on solids you are no longer 'exclusively breastfeeding' so in that aspect adding formula will not be ending exclusive breastfeeding. However there are other benefits to keeping the df ebm or bm. Various reasons why bm is beneficial but for me the decider with the case of the dream feed (for those who have a choice of course) is the fact formula is significantly more cariogenic (i.e contributes to dental decay). Ebm contains a component called lactoferrin which kills strep mutans - the bacteria that causes tooth decay. Basically the bm stops the bacteria using the sugars in the lactose. Studies have shown BM raises the ph of the mouth only slightly more than water  - however when combined with food in the mouth the ph is higher so brushing before bedtime is important. Even without teeth yet a baby will start to develop the strep mutans cultures in the mouth and a df with bm will help to protect against future tooth decay. It's also true that using the breast has even greater benefits because it prevent liquid pooling around the teeth unlike a bottle (the milk is ejecting quite far back into the mouth beyond the hard palate).
I could go on about various other reasons to use BM but I would say to someone who was choosing to only supplement with one bottle of formula a day probably avoid it being the df if you can - unless you fancy some 'dream tooth brushing' afterwards! So just in terms of oral health - boob first, then ebm in a bottle. however this is just my opinion and there are lots of other things to consider - please feel free to tell me to get lost!

You can read more about breastmilk and tooth decay here. Dr Brian Palmer has devoted a lot of energy to its study:
http://www.brianpalmerdds.com/bfeed_caries.htm

[binxyboo]

My cousin had twins, and she lives in Australia, works as a nurse, and did that sleep school thingy with them when they were a few weeks old to get them on a schedule. I can't remember the exact name of it.