Breastfed Baby Night Waking

My experience of this has been nine times out of ten hunger is the primary cause – even if baby drops right back off to sleep again the second a nipple is found. Suspect hunger more than you think you should.

Most people it seems to me wildly underestimate how much a BF baby needs to feed. Think how much you would need to eat yourself if you were trying to double your weight every few months. If night waking is a sudden change then a growth spurt* or mental developmental period* may be the cause. But if it’s a more long term thing, ask yourself has my baby has got to that distracted stage*? Do they always concentrate while feeding,  or are they distracted during daytime feeds by their curiosity in the world.

If there’s any possibility it’s the latter, then before you try anything else to get them to sleep, I seriously urge you to try offering a feed twice as often during the day. If it’s feeding related there’s a pretty good chance you’ll see a change. Make a dramatic change like this in the day and the change at night should be more clear cut. Pick a day when you haven’t got too much on to give it a go.

It works for growth spurts too.

Why? What’s my evidence for this? When we had a particularly bad growth spurt (4 months) I tried this and it worked wonders! The first night was hourly feeds all night. Day two I made a concious effort to offer feeds hourly, and though she wasn’t really asking yet when it was offered she was very interested. Night two we got a lot more sleep. Day three was busy and I couldn’t do the same again. Night three we were back to hourly feeding. Day four I reasserted my efforts and night four was again better.

Out of growth spurt territory, before N started solids, we recognised this sleep pattern: feed hourly after going to bed, waking up to 3 times, then a longer sleep would start. This I think is the distracted baby’s equivalent of evening cluster feeding in a newborn. If I fed frequently enough during the day I could make it go away. But I really do mean frequently!

After N started solids the cluster feeding shifted to the middle of the night. My interpretation of this is she would be full from dinner (slower and harder to digest) at the start of the night. Then as capacity in her digestive system opened up later on, if she hadn’t had enough calories during the day the hourly feeding would begin.

Further evidence comes from two friends who were both convinced their babies woke every two hours in the night for comfort and it was just a habit. One tried cry-it-out, formula before bed, … everything under the sun. But both finally got some sleep by breastfeeding way more during the day.

One reason they were confused as to whether it was hunger or not, was sometimes the babies fell asleep without really feeding as soon as they found the breast. I have experienced this sometimes too. My interpretation here is that tiredness and hunger compete and on these occasions tiredness wins… but only until the next light sleep phase when hunger causes another wake up.

So how can I know N is hungry, not awake for some other reason? One clue is if she can not be comforted back to sleep by her dad, or will not stay asleep/be put down after this. Tiredness and hunger needs are competing, so when N is tired she will happily fall asleep again with daddy, but if she’s hungry it prevents that turning into deep sleep and she wakes again. This is  what we have often observed in our daughter.

So back to the frequent day feeding. To be honest I rarely avoid night feeding completely nowadays even though I know how. It’s actually very hard to concentrate on feeding so frequently in the day if you want to get any housework done, or go out somewhere. And actually if N slept all night through I’d have unpleasant engorgement preventing my sleep instead. But if we have a few too many tiring nights and I need more sleep, I remind myself to make more feeding efforts during the day. It encourages me to rebalance our lives a little. N’s job after all is to grow!

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N had always been a good sleeper at night, but at 3 months stopped napping easily during the day. I say easily, it was pretty difficult to get her to nap at all. And it kept getting worse. Culminating in an embarrassing incident where I turned up to a course with the health visitor with an inconsolably screaming baby. She’d slept a grand total of 15 mins between waking in the morning and 2pm so was horrendously overtired, and yet all my efforts that day, including walking to the course in the sling, had completely failed.

I later recalled hearing (from a breastfeeding councillor) that it is around this age melatonin kicks in.

Wading through the baby sleep books on Amazon, and boy are there a lot(!) showed there are surprisingly few on daytime sleep.

I settled on The No Cry Nap Solution by Elizabeth Pantley, and The Ninety Minute Baby Sleep Program by Polly Moore.

Pantley’s books are largely about sleep associations in one way or another: how to break one association like feeding to sleep or rocking and replace it with another. It was interesting and at the time I thought it helpful, but looking back I realise I never used any of her techniques. The section on sleep cues was helpful and it felt like a safe read because of the clear No Cry ethos, but as to analyzing what times of day and sleep associations your baby had for naps, well there weren’t really any.

This is where the appallingly named 90 Minute “Program” came in. Looking beyond the title, I bought this book on the basis of some great Amazon reviews… and they were right. Moore explains when your baby needs a nap. Not based on arbitrary times of day, or some schedule an adult has designed, but working with their natural inner alertness cycle. You guessed it, that cycle lasts 90 mins.

At 4 months this alertness seemed to matter a lot to N, and she needed to be getting close to the 90 minute minimum to nap at all. She would nap for half an hour every at the end of every single 90 minute cycle, fitting in 4 or 5 naps a day! Now at nearly 9 months we are on multiples of 90, and it’s more a case of avoiding the alertness peaks, with sleep pressure (length of time awake) contributing with similar weight. Essentially I imagine two graphs: sleep pressure increasing linearly, and alertness varying sinusoidally. There is some flexibility with this way of doing things which helps with fitting in naps with getting out the house. For example I know currently the earliest N will nap is 2:30 after last waking, and the latest she can comfortably manage is about 4 hours or so. She has often fallen asleep anywhere between 2:30 and 3:30, but very rarely in the maximum alertness window between 3:30 and 4 hours. There is also a slight bias towards drifting off when the alertness curve is falling. Recently before bed has become slightly different to other times and she needs a minimum of 3 hours. Her personal best however was an amazing 6 hours before bed one evening achieved in good humour with surprisingly no upset.

You could feasibly combine this
90 minute thing with any going-to-sleep technique or philosophy. So it’s surprising then that more people don’t know about it. It’s really helpful if you don’t start the day always at the sane time and prevents the monotony of a fixed routine while at the same time giving enough predictability to make your day workable. I can’t imagine how we’d do things any other way.

A thoroughly recommended read, the descriptions of sleep at different ages really rang true for us, but you may wish to use your own judgment regarding the author’s opinions on how your child should or shouldn’t be parented to sleep.

Which brings me to the final point I have learnt on this topic. It was really from reading in so many places that you shouldn’t feed your child to sleep, because you might have to hold/feed them for their whole nap, that I realised I could do this. I spent some weeks trying to put N down after she fell asleep (following the wait for floppy advice from Dr Sears), and just got frustrated when her nap finished 15 minutes later after all that effort. Then along came a growth spurt (4 months?) and I just fed her through her naps because it was easier, I was tired, and it gave me a brief rest. Since then I have given in to this easier way of life and I actively look forward to sitting on the sofa for 45 mins, an hour, or maybe two, relaxing while she naps on my lap, occassionally switching sides. I have a smart phone now, so I check my email, search the web, buy provisions, or I catch up with some TV on subtitles. All those things I need to do can now be done while N is awake, and I hope it’s good for her to see me active.

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