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Infant feeding

Get advice and support with infant feeding from other users here.

Original poster

How to time between feeds

26 replies

piazilla · 18/12/2014 11:56

I have a 3 week old who would sleep a lot longer if I let him! He was born at 37 weeks and promptly developed jaundice. I have been exclusively breast feeding and it's been quite tough to maintain due to his shallow latch ( and possibly my huge boobs lol)
My midwife is happy with his weight gain over time despite a doctor suggesting he wasn't gaining as he should and advising me to supplement with formula. I've stuck to my guns and now, instead of him going 4-5 hours between feeds, I wake him 3 hours from the end if the last feed (as per midwife advice) , and after 5 hours at night. He is being weighed again in 3 days , has loads of wet and dirty nappies, and is more and more alert with each passing day.
My question: should I time from beginning of feed to start of next feed, even if the entire feed takes over an hour, or go from end of one feed to start of another. I'm waking him up as it is , and I'm pretty sure midwife told me end to start is fine, but I keep reading that it is from start of feed to start of next feed! Help! So confused!!

OP posts:
PurpleStripedSock · 18/12/2014 12:43

Hi piazilla, I pretty much fed on demand with my baby and there is no way I would have woken a sleeping infant. I fed her when she woke and before she fell asleep again and then whenever else she wanted it. Why do you wake him, is it something the HV/Doctor has advised or something you've read in a book about how long a newborn should sleep etc?

I think most of the advice with a three week old baby is 'feed on demand' so that timings between feeds would be different for each one.

Micah · 18/12/2014 12:53

Feed him when he's hungry, not when it's "time"!

Don't get hung up on numbers. Weight, time, quantities, lengths. Look at your baby as a whole. I he happy? Weeing, pooing? Crying, sleeping? Developing normally? The numbers mean nothing on their own, if he has other, clinical symptoms then yes they can help tease out a diagnosis and aid treatment, but if he's happy and healthy they're irrelevant :)

Waking my sleeping baby to feed was counter productive anyway. If she was hungry she woke by herself, if I woke her she'd refuse to feed and get distressed because she was tired.

The best way to deal with weight queries is to stop weighing.

You sound like you're doing brilliantly, so carry on and ignore any "advice" that you don't think suits your baby. You know him best, and what works for some doesn't for others. Trust yourself :)

CountingToThree · 18/12/2014 13:00

The timing between feeds is from the start of each feed (sadly). If he is still jaundiced then it is important to wake him for feeds as it makes them sleepy and less likely to wake up when hungry. But at 3 weeks I'm sure 4 hours instead of 3 hours would be fine if overall weight gain is fine.

squizita · 18/12/2014 13:45

If there are concerns about jaundice or growth they do need waking to feed. The timing goes from the start.
Methods like compression and gently blowing on or stroking baby's cheek help if sleepiness interferes with feeds.

Original poster
piazilla · 18/12/2014 15:07

Thanks for all these replies!
What's bothering me is that while the doctor was concerned about his weight gain- it was the first time he had seen him. While the midwife had seen him 3 times and said that , while he had just gained 140g in a week as opposed to the recommended 150g - she was happy with his overall weight gain .
Just spoke to her now and she advised the end of the feed as I am feeding 3 hourly and would be feeding constantly if I went from the start of the feeds! I'll continue as I am and see what Sunday brings at the weigh in! FTM - can you tell?

OP posts:
TheGirlAtTheJingleBellRockShow · 18/12/2014 16:57

I've never heard of timing from the end of a feed, but if it works carry on!
Remember every baby is different - different shape, size, appetite etc. as long as he is feeding, gaining weight, peeing, pooping and jaundice resolving all is good!
My DD was premature and had prolonged jaundice. Didn't really resolve until she was 6 weeks old. She was EBF every 2 hours as that is what she demanded.

squizita · 18/12/2014 17:00

Gain is a "window" not a cut off. 150g is about 5 oz? No hcp I know worry until it's under 3 1/2 oz a week (my dd is 9th percentile and gains 3 1/2 oz a week - which follows her line!). Read your red book and look at the graphs for clarification.

However you do need to feed out that jaundice especially as there's not a lot of sunlight. My mw said take pregnancy vitamins (for bit d) and feed 3 hourly. So sounds like what yours told you. Smile

Original poster
piazilla · 21/12/2014 08:51

Gain for this week has been 125grams... I've been trying so hard! Mw thinks my milk supply might not be sufficient ! Hmm

OP posts:
MsBug · 21/12/2014 09:05

Dd was jaundiced and we were advised to wake her to feed every three hours - from the start of one feed to the start of the next. However she was prem so slightly less often may be fine for a full term baby.

The more often you feed, the more milk you will produce.

tiktok · 21/12/2014 09:12

piazilla, are you in the UK? You are getting some very odd advice and information.

A sleepy baby with a history of jaudice needs to be woken for feeds - you increase your supply and your baby's intake by feeding more often ie with the gaps between feeds being shorter....and the gap is measured from the start of the feed. I honestly can't understand why your midwife would say differently.

Leaving a baby without a feed 5 hrs after the previous one ended, which is what you are doing at night, is not normally frequent enough.

You'd expect a baby in your situation to feed about 8-12 times in 24 hours - some of the feeds might be cluster feeds, and close together.

And yes - he needs to be woken, until everything is fine, and then you can rely on his cues to tell you when :)

tiktok · 21/12/2014 09:15

If you are feeding 5-6 times in 24 hours - which is what I reckon is happening, that would not normally be enough for a 3 week old with jaundice. Increasing feeding frequency will boost your supply a lot, and his intake.

It's crackers your midwife is saying 4 and 5 hour gaps after the end of the feed is ok, and then suggesting your milk supply may not be sufficient.

Hope you get good help soon.

Original poster
piazilla · 21/12/2014 09:44

Hi tiktok ... Mw isn't saying 4 or 5 hours after end of each feed is ok, it's 3 hours after end of each feed. Also his colour is looking a lot better and she was saying he isn't really jaundice anymore . I'm not in the uk .. I'm not even retaining advice anymore and am so confused about it all. Next week if his gain is under 100g then I've been advised to top up with a formula feed at night , and in the meantime to pump for 5or ten minutes after feeding on my weaker side to stimulate more production

OP posts:
tiktok · 21/12/2014 10:31

Sorry, yes, I meant 4-5 hours after the start of the previous feed.

It's normally not sufficient for a baby of three weeks.

It's horrible to be so confused and conflicted.....but what you have been told is simply not helpful :(

tiktok · 21/12/2014 10:32

No one among the HCPs has suggested feeding more often to address weight gain.

Instead they have told you to add formula and/or express.

:( :( :(

Original poster
piazilla · 21/12/2014 10:47

I want to be fair here and say that me has been very helpful ... And I was feeding on demand every 4 hours from end of feeds- and was advised to up that to 3 hours from end of feeds ... So frequency of feeds has increased somewhat. I honestly cannot see baby going for 3 hour feeds from Start of feeds as things are now! I had to bath him and do a nappy change to get him to wake up just now... 3 hours after last feed ending . He just seems content with things as they are ... But isn't gaining so I know I need to change it - I'm just not sure how to get baby with the new more frequent program when he seems just to not be interested!

OP posts:
squizita · 21/12/2014 11:50

If he is sleepy my mw suggested stripping them off and feeding in just a nappy, and gently blowing on them like making a breeze. It worked when my dd was very teeny! Easier than a bath.

tiktok · 21/12/2014 13:57

Skin to skin, biological nurturing, breast compressions - all googlable :) All helpful to get more milk into sleepy babies :)

tiktok · 21/12/2014 13:57

Also switch nursing.

Original poster
piazilla · 21/12/2014 14:38

Ok great just did an hour of skin to skin - and will do same again tomo I had seen biological nurturing ... It helped me with my latch a little but baby got too warm and was dozing ( or milk supply made Him lose interest!) I'll definitely look up the other stuff .
They don't tell you just how hard it is do they!!! Thanks everyone ... I'll come back and say what worked in case there is another poor soul in my situation Wink

OP posts:
omama · 23/12/2014 08:10

OP my dd was born at 37 weeks, she was very similar & went long stretches without feeds, she ended up in nicu needing phototherapy for jaundice & a few days of being tube fed to increase her weight as she was refusing to bf.

We were advised to feed every 3hrs from the start of each feed. This was very important to a) flush out the jaundice, b) help her gain weight and c) boost my milk supply. I found it difficult as dd often didnt want to wake up at 3hrs so I used the tips suggested above (skin to skin, stripping baby off, nappy change & rubbing hands & feet) to wake her enough to feed. The nurses suggested I stick to the 3hr schedule until she had regained her birthweight, after which we could feed on demand.

She reached her birthweight last week at 4 weeks old & has suddenly woken up a lot more. She is now waking up for feeds by herself & typically wants to eat every 2.5-3hrs.

You might find that given another couple of weeks your ds starts to do similar & then his feeding patterns may change.

If not, so long as he has got over the jaundice, is following his growth curve & not losing weight, I dont think you need to worry, even if his weight gain is a little slow. And as pp said, formula topup is likely to be counterproductive, he needs to feed from you more frequently in order to boost your supply.

Original poster
piazilla · 02/01/2015 06:56

Hi again - I said I would come back and update! I took all the great advice I got here and started to feed every 3 hours ( from start to start) , only pumping on the "difficult" side occasionally , if baby hadn't fed for long on that side. Well it seemed to have worked - ds gained 400g in a week . Cue much rejoicing and self back patting .
Now, at 5 weeks , I am still waking ds for his three hourly feeds, during the day - and letting him go between 4-5 hours at night. He does not wake up independently for feeds, and when he occasionally does cluster feed, I need to watch him like a hawk for the signs of hunger.
He typically manages 20-30 minutes per feed, equally divided between both sides. However for the past few days, he shouts his way through the feed on one side! ( the originally "difficult" side. Might this mean the supply on that side isn't sufficient? Also , I would love to start feeding on demand , but ds is just not that demanding and I'm worried he won't continue gaining good weight if I let him call the shots! What's the longest I should let him go between feeds at this stage?

OP posts:
FreeButtonBee · 02/01/2015 07:04

Have you tried a different position on the difficult side (rugby ball style)? It might be he doesn't like his head position (I had this a lot!) and I found it helped

rememberingnothing · 02/01/2015 07:46

Well done you two. You could try compressions when he squawks. Might help. Keep going on that side though, more stimulation = more milk. Well done on the gain.

Original poster
piazilla · 02/01/2015 09:23

Actually I haven't tried a new position recently : I was just glad he was latching after so many weeks of faffiing! But I'll maybe try a different hold and see of it makes a difference!
Smile
I think I do breast compressions but it's just struck me that I've done my own interpretation of what that might be .. Must google it! Smile

Does 20-30 min feeds every three hours sound about right at 5 weeks? I'm so scared to let him go longer than that but maybe im being paranoid!

OP posts:
NotQuiteCockney · 02/01/2015 10:45

That sounds fine at six weeks, so glad to hear that upping the frequency of feeds has helped.

I would carry on as you are for the moment really. It sounds like it's working, why change it?

Re: the side that he squawks on. First, we do all have a side with more and a side with less. But fiddling with the position might help - as they grow, sometimes the hold needs to move a bit ...