Can you help me sort out night feeds for 20week old?

[Pushonregardless]

Looking for a bit ofreassurance as I'm a very unsure and very tired FTM

DD is 20 weeks old. Never been a good sleeper but not shocking. Largely due to feeding issues in the early days I think. Started doing good stretches with just a 3am feed at 3 months ish, but all went to pot at 4 months after a 4 week long cold ð???

She's been waking every 2-3hrs or so and feeding but then very disturbed and unsettled between. In the last two weeks this seems to have settled to a very reliable pattern of bedtime routine and feed, down at 7. Always up for another feed at 8. (Frustrating but has always done this since the cluster feed days.) Then 1am and 5am feed. I know this doesn't sound bad but I would really like to get back to one feed, for a couple of reasons.

We had a very tough time with BF which resulted in big weight loss. Switched to mixed feeding at 2months as things weren't improving. (That's a whole different story that I'm still devastated about) Then slowly moved to FF and EBM in the last two weeks. Now that she's mostly on formula I thought she might be able to do less night feeds? She's currently taking 8 in 24hrs which seems a lot (previously did 6 or 7). Although, they average at only 150ml a time. She's been drinking so much at night that it felt like she was starting to take a big proportion of her calories at night. It also meant she was drinking so much at night that she would be soaked through with urine by 5am (this doesn't happen when she has one feed).

Second reason for wanting to change is that the 5am feed means she doesn't want her morning feed when she wakes between 7-7.30. This makes mornings a little unpredictable, which is a shame as aside from the nights she's in a pretty good routine in the day of feeds about 3-3.5 hrs apart and three or four naps (about 45-60 mins in length at around 9am, 1pm and 4pm). I think this is ok? I know they are short but hoping they will lengthen in time.

Anyway, I've been trying a 10pm dream feed the last two nights. As you'd probably expect, she's woken both nights out if habit at 1am and 5am and settled after either just a shout or 10 mins of crying and patting from me. She's then fed at 3.30 which is fine. She then wakes earlier than before at 6.30.

So, very disturbed nights at the moment but I think I should persevere as I'm hoping she will change back over to the 3am ish feed and stop waking at 1 and 5. Or is this naive? Would you keep trying?

Also, any ideas on that 8pm feed after she has one at 6.30 then down at 7? It confuses me as although daytime feeds are well spaced, the way it works out means that she has a feed v close to the bedtime feed, so I would think this would mean she's tanked up well for the night? If I try to stretch it out she loses it a bit and bedtime is hell. But instead what happens is that she is generally so tired by the bedtime feed, she falls asleep and only takes a small feed. Therefore up again at 8. Have tried everything to keep her awake including an extra catnap later on.

Rough example day:

7.30-wake
8.30 -feed
9.30-nap
12-feed
1-nap
3-feed
4-nap
5.30-feed
6.45 ish -bath, feed, story etc
7-bed
8-feed

It doesn't feel as well spaced as you might expect for a 20-weeker but she's a mini 9th percentile baby. Am I doing this all wrong? Sorry it's been a bit of an essay.

My recommendation would be to change to a 2 hourly routine through the day - making much more regular feeds and naps through the daytime. Aim at first for 7 feeds per day.

You can start playing around with the daytime feeds once she is not waking in the night for milk - which she will do if fed more frequently through the daytime.

So, every two ish hours (you don't need to clock watch, just whatever suits as an approximate):

Feed
Awake
Nap

Start the process of nap time (I would use a bouncy chair & dummy in the daytime at this age) about an hour after the feed. Expect the sleep to last anywhere between 20-60 minutes.

FATE this is all fair & well but not all babies want to eat so frequently, especially not if formula fed. My DD (15 weeks) will point blank refuse to feed til its been a good 3.5-4hrs. If I try & offer it sooner she chomps on the teat & spits it out at a push will drink a much smaller volume, so overall consumption is unchanged.

I agree baby probably needs a little more daytime sleep though, particularly to avoid her falling asleep during the bedtime feed. Good news OP is that you are nearly at the point where her naps should start to lengthen ! Once she is having a longer lunchtime nap she should manage the afternoon better. Have you ever tried to resettle at the 8pm waking without feeding? I wonder if this waking is more likely overtiredness related rather than hunger, especially since you say - she is tanking up.

If this were me, I would first of all try & see if she will go slightly longer between her midday & afternoon feed. Stretch this to 3.5hrs (do it slowly 5-10mins every few days) & she will likely take a slightly bigger feed. This in turn should shift that next feed a bit later. This would mean she eventually feeds at 3.30pm and 6/6.30pm which means you have consolidated those 2 feeds before bedtime into one. Giving that last feed slightly earlier should also hopefully avoid her falling asleep during the feed. She should take a better feed meaning you can rule out hunger at 8pm. I know you said she's struggled when you've tried to stretch her before but from what you say it sounds like it could be due to tiredness. If she's only having a short nap at 4pm, doing that bedtime routine a touch earlier & getting her into bed slightly earlier, around 6.30pm might help.

My DD actually does similar to what I've described above. Feeds at 7am, 11am, 3pm and then 6/6.30pm (depending on how tired she is). She generally wakes in the night anywhere from 11pm-2am and then again between 4-6am. We do actually have the same issue if she feeds at 4/5am - I cannot for the life of me get her to eat in the morning. Its often 10/11am before she will accept a feed, but I just wait for her to say she is hungry & go with it! I know having done this before that the nights will eventually sort themselves out, but as FATE says, only when she consumes a bigger volume in the day.

You just need to work out what way will work best for her. Good luck!!

Thank you both!

Omama as you say, there is no way I would get her to eat every 2hrs now. Sometimes she does as the day wears on but she will definitely only feed when she's ready she hits the bottle away if not. Also, I don't actually want her to 'graze' like that as when I've tried it I think her overall consumption actually goes down. This is because she never gets the chance to work up a proper hunger and will then only take small amounts. So I'm not sure if that will work. If I do as you suggest by consolidating those two feeds am I not effectively dropping a feed and then feeding less?

I wondered about the daytime amount of sleep. FATE-she does follow that pattern herself already. She naps one hour after every feed. I don't see how I can get in another nap? Also, I worked hard on getting her to nap in her cot for a week and now she goes down brilliantly without a fuss at the first sign of her rubbing her eyes. Not sure why I would need a bouncy chair? She's never ever slept in hers and won't take a dummy.

Yesterday she napped for 45mins in the morning,60mins at lunch then 2hrs from 3.30 until 5.30. That's the best she's ever done. But made no difference to her sleep she still fed at 8 and then had dream feed at 10. Despite this she woke at 2am and was awake until I gave in and fed her at 4am. My husband slept downstairs and I got no sleep. I'm so stressed. I just don't know what to do.

Am I expecting too much? Will she just do it herself? Am I just creating another bad habit with a dream feed?waking for a feed I can totally accept but it's the hours of wakefulness and grumbling when she's not hungry that are keeping me up all night.

Thanks so much for your help

Wrt consolidating the two feeds, yes you are effectively dropping one, but the idea being by spacing them out more she should take a bigger volume at each feed so overall consumption is thereabouts unchanged. I find dd will take nearer 6oz if properly hungry whereas if not will only take between 2-4oz. Certainly for us, it makes a big difference.

What did she do during her lengthy wake up last night? Was she crying or grumbling? If just grumbling, do you keep lights off & leave her to it, giving her a chance to settle?

WRT the dream feed, tbh I wouldn't bother. It sounds like she is more unsettled since starting it than she was before. We tried it with my ds in an effort to get him sleeping through & found it made no difference to his night wakings so we stopped altogether & just fed him when he woke. Over time it got later & eventually stopped altogether, probably around when he was weaned. then replaced by chronic early waking but thats another story