2.0 - Why Follow a Routine?

Sources

1. The New Contented Little Baby Book by Gina Ford
2. Guide to Childbirth by Wong Boh Boi
3. Guide to Breastfeeding by Wong Boh Boi
4. Guide to Childcare by Wong Boh Boi
5. Successful Breastfeeding by Kang Phaik Gaik
6. Your Baby’s First Year by American Academy of Pediatrics

Strict Four-hourly Feeding Routine Vs Feeding on Demand

1. Breast milk is easily digested and it usually takes about 1.5 hours for your baby to feel hungry again. It is not unusual for your baby to feed up to 10-12 times a day. In contrast, infant formula takes a baby up to 4 hours to digest.
2. Therefore, once your milk supply is established (about 3-4 weeks), it is a good idea to get your baby to settle down into a set routine that involves waking him up 3-4 hours during the day to feed. At night, leave your baby to feed on demand. Feed him only if he wakes up and demands for milk. If your baby feeds more often in the day, he is likely to sleep longer at night. So do try to start a routine that your baby can settle into.
3. Begin to develop a routine before bedtime. Repeatedly experience a strong sensation (like a sponge-bath), followed by soothing time (like applying a but of moisturizing lotion and reading or singing) and then a final feeding in the evening followed by a short bedtime story, can help signal to your baby that the ‘longer nap’ is coming.

Disadvantages of Strict Four-hourly Feeding Routine

1. 6 feeds a day in the early days are usually not enough to stimulate a good milk supply.
2. Babies need to feed little and often in the early days; restricting feeding to 6 feeds may lead to your baby being short of his daily intake.
3. Babies between 1-week and 6-week usually need at least 30 minutes to reach the hind milk.
4. Hind milk is at least three times higher in fat content than fore milk, and is essential for satisfying your baby’s hunger.

Disadvantages of Feeding on Demand

1. Many newborn babies do not demand to be fed. Mothers are lulled into a false sense of security that they have a baby who is easy and sleeps well.
2. In fact, what they have is a very sleepy baby who normally, 2-3 weeks down the line during growth spurts, he will start waking up more often and demanding more milk than the mother is producing (mother’s milk has not come in due to less suckling in earlier days). A pattern quickly emerges of the baby having to feed every couple of hours, day and night, in order to have his daily nutritional needs met.
3. This is often one where the baby is feeding so much in the night that when he does wake up for feeds during the day, they tend to be short, small feeds. The mother then becomes exhausted from several night-time wakings and not managing to rest enough during the day.
4. Exhaustion and stress reduce the mother’s milk supply.
5. Babies who continue to need to feed 10-12 times a day after the first week often become exhausted from lack of quality sleep that they become even more tired, and feed for shorter and shorter periods at each feed.
6. Exhaustion can lead to the mother being too tired to concentrate properly on positioning the baby correctly on the breast for any length of time.
7. Poor positioning on the breast is the main reason for painful, and often cracked and bleeding nipples, which again reduces how well the baby feeds at the breast.
8. A sleepy baby left too long between feeds in the early days reduces the mother’s chances of building up a good milk supply.
9. A huge number of demand-fed babies do not automatically fall into a healthy sleeping pattern months down the line. Many continue to wake up and feed little and often. They often invariably end up being fed to sleep.
10. This creates a whole other set of sleeping problems, where they have learnt the wrong sleep associations and cannot get to sleep without being fed.

Solution: Follow a Routine

1. Sleepy babies should be awakened to feed after every 3-4 hours during the first few weeks of life (or until they have regained their birth weight and your pediatrician says it's ok to let him sleep at night), so that they have a minimum of 8 feedings in the 24 hours.
2. Allow your baby to continue nursing on the first breast as long as desired (about 30 minutes on first breast). When he spontaneously stops for a pro-longed period or withdraws from the breast, burp him.
3. If your baby seems sleepy after the first breast, you may want to wake him up a bit by changing his diaper or playing with him a little before switching him to the second side to offer him second breast for at least 10 minutes.
4. You should alternate from feeding to feeding the one he uses first.
5. By 6-8 weeks of age, many newborns have one sleep period of 4-5 hours.
6. Establish nighttime sleep patterns by keeping the room dark, warm, and quiet. Don't turn on a bright light for the nighttime feeding. If soiled or wet, change his diaper quickly and without fanfare before this feeding and put him right back to sleep afterward.
7. By 4 months, many babies are sleeping 6 hours or more at a stretch without awakening during the night.
8. Be aware that the early introduction of pacifiers is associated with a shorter duration of breastfeeding.