When to let 12-week old baby sleep and wake themselves for feeding

[MissABW]

Hi everyone!

I’d love your thoughts on a sleep question. My baby is 12 weeks and is hovering around the 9th centile line. I’m breastfeeding but have been expressing and giving a tiny expressed bottle at each feed too to help with weight gain; I’m phasing out expressing this week.

My question is: when can you leave baby to sleep and wake themselves for feeding? Due to the weight gain issues we always woke baby to feed around every 3 hours in the day and 3.5 ish at night but then recently started leaving him so on occasion he would go 4 or 4.5 hours in the night (he’s not necessarily asleep all that time, he might be playing for a bit then be asleep but this is the time between feeds). However this week again we were told to leave him one 4-hour stretch in the night - no longer, and only the one stretch of this length. Normally he would be up sooner anyway but it’s so so hard to wake him up when we’re all fast asleep on the rare occasions he would sleep longer. It feels like everyone else (online, baby group etc) is now letting their baby sleep! When do I get to comfortably do this?!

Thank you!!

Depends who told you to wake the baby for feeding. Do you trust this person?
You say the baby is holding weight along the 9th percentile. That's great. It's smaller than average, but if the weight gain is constant, it is healthy. If not entirely confident in the advice, I'd go for the extra sleep option.

Crikey. Who told you that, the HV team? I have a slightly prem baby just a week or so older than yours who’s now just between 2nd and 9th centile for his adjusted age, still below the chart for his actual age. He’s been under paeds til very recently for poor weight gain among other things, but even then there was no suggestion that I should wake him up! I had to wake him three-hourly for a few nights when he was born and it nearly killed me having to set alarms. You must be utterly exhausted, I would let him sleep how he wants now unless someone can give you a very compelling reason not to (which being on the 9th centile definitely isn’t - someone’s got to be on it!) During discharge the consultant was nothing but positive about the fact he’d found a line and was staying on it consistently. I do find HVs to be a law unto themselves though.

I wouldn't wake a 12 week old for a feed - ever! If your baby is growing along his percentile then he is doing just fine and doesn't need to be woken. He'll just have more at the next feed if he's very hungry.

A friend of mine was told never to wake her baby for a feed, his birth weight was below the 3rd percentile and he stayed there. He slept through from 9 weeks old and the paediatrician still said not to wake him.

I remember being given this advice with my first baby 22 years. I ignored it and ended up with a happy baby who slept well, and ate better because she wasn't tired.

I'm not an expert but I wouldn't wake a sleeping baby unless they weren't thriving. As long as they stay the same percentile they are thriving IMO

At 7 weeks a new, better HV suggested I stop waking my 2nd centile baby to feed in the night and just bf on demand. She said only if a baby was failing to thrive would they recommend waking to feed every 3 hours.

I’d seek a 2nd opinion if someone is still asking you to do this.

FWIW it took only a week for mine to learn to sleep longer stretches, she cluster feeds all evening, has a bottle around 9/10pm to fill right up, is asleep for 11 and wakes around 6 on average (earlier if hungry). It has coincided with longer daytime awake windows and her enjoying playing and interacting with us - 3 hours doesn’t leave time for much more than feed-change-nap.

They will absolutely let you know if hungry in the night!

Hi, congratulations on your new baby!
My baby is very similar, although now 20 weeks but she has been between 2nd and 9th centile since 8 weeks. We were advised by paediatricians and midwives to "dream feed" every three to four hours. Initially I would set an alarm to feed her but she always woke earlier anyway for feeding. Now at 20 weeks she wakes on her own when she's hungry and it's still between 3-4 hours. We've never had a longer stint than that.

Thank you so much for your responses everyone! The person who gave this advice is a health visitor but she is known to be THE bf expert in our area so she was someone whose advice I felt inclined to listen to :/ but I’ll try to seek a second opinion

Have there been concerns over your baby's weight gain? Did they lose significant amounts after birth? Any jaundice? Are their issues with your BF supply? I'm not a BF expert at all, but doesn't regular feeding/pumping help stimulate your supply? Personally, if there have been any previous concerns I would stick to the advice of a health professional rather than randoms on the Internet.

I was always of the opinion that you should never wake a baby to feed at night. But I had two formula fed babies who weighed 9lbs at birth and maintained a decent weight gain. So there weren't any concerns if I left them.

I was told to wake to feed to start with as DD was very small (below the 0.4th percentile) but also told I didn't need to once DD was on the 2nd (I think) percentile. Not that DD let me go long without feeding her, day or night, for the first six months of her life!

But I agree with PP - listen to health professionals, not internet ransoms. But also worth getting a second opinion from a health professional!

I’d only be worrying if your ds was dropping centile, which he’s not.

Dd was 9th centile from 6 weeks and still is - she’s 5 now. I bf on demand and certainly never woke her up.

A HV is never going to be an expert on BF, unless they are IBCLC trained. Take everything she says with a pinch of salt.

To grow they also need sleep. Don't wake the baby! Feed way more during the day. I had a phase of feeding every 30 mins.

Thank you all - really useful to hear your advice.

@Ostryga whoops I checked and the lady who gave me the advice is also a “ a Breastfeeding Counsellor and an International Board Certified Lactation Consultant (IBCLC)”

@TimmyNook Baby was 50th centile when he was born and had to be weighed often because he dropped 10.8% body weight (though I know up to 10% is very normal!) I was expressing after every feed for weeks to help baby as he was a bit sleepy on the breast but he’s better now so I’m thankful to be phasing it out. So hopefully he will get enough milk and he’s active enough to maintain my supply without pumping. I do worry that without those top ups of expressed milk he’ll dip below the 9th centile line but I’ll try to feed often during the day. There were no issues with jaundice

Oh I feel your pain, we have only just been given 'permission' to stop waking our 16 week old in the night after her early days weight loss.

I'd say definitely worth getting another opinion so you can make an informed decision, do you have local support groups run by bf counsellors or IBCLCs? I go to these a lot, they're really handy for asking quick questions of some very qualified people.

It may just be a transition but we are finding that our DD is struggling to make up for the missed feed during the day (we are mix feeding because of her weight issues so can see how much formula she is taking on top of breastfeeds). So you might end up wanting to play around with timings to get enough feeds in if your DS starts sleeping longer stretches.

Thank you @GrannieMainland and we’ll done on passing through the period where you had to wake your little one up!
Yes absolutely, it was actually at a breastfeeding clinic that I was given this advice by a bf counsellor and lactation consultant!

I'd say worth asking again or at least to understand the rationale - with hindsight I didn't ask enough questions because it's hard to seem like you're challenging professional advice. Eg are you looking for a certain weight gained, an amount of time on the same centile line, a number of weeks consistent weight gain. Good luck, I know how exhausting it is!

Even as a brand newborn I never woke up my daughter for feeds.

Thank you both! @GrannieMainland I’ll definitely ask what the rationale is, beyond just “for his weight”!

I was told to wake DD to feed every 4 hours until she regained her birth weight but that was all. I think that happened around 10 days then I stopped!

I was told to wake every 4 hours until they’d regained their birth weight. With DD that was about 10 days, with DS he never actually lost any weight so I stopped as soon as we were home from the hospital. In your case, given the weight gain issues, I think you’d be best asking a professional. If you want a second opinion to the HV maybe ask the GP for a phone consultation.

@LakeShoreD

I was told to wake every 4 hours until they’d regained their birth weight. With DD that was about 10 days, with DS he never actually lost any weight so I stopped as soon as we were home from the hospital. In your case, given the weight gain issues, I think you’d be best asking a professional. If you want a second opinion to the HV maybe ask the GP for a phone consultation.

Although GPs very very often have little to no training on BF....

@MissABW Are they now following the 9 centile line? How is nappy output?

I don't think I ever woke DD for a feed through the night, I think I did during the day if she'd slept longer than usual but if they're sleeping fine then leave them too it!

Thank you all for your responses!

@Harrysmummy246 He’s doing tons of wet nappies but has always found dirty ones s bit tricky - since he was a couple of weeks old, we’ve had a couple of A&E trips to help things along and now it’s around every 3-5 days. He’s following the 9th centile line but only just so it stresses me out!