by Louis P. Theriot, M.D.
The Trained Night Feeder--
--Everything is dear to its parent. (Sophocles)
--Blessed are the sleepy, for they soon shall drop off. (Nietzsche)
There are few greater gifts in life than experiencing the birth of a child. There is no joy that can rival the feeling new parents get as they witness the growth and development of a new baby--the first smile, the first time the baby notices it's hand and grabs for an object, or the first time the baby coos. It is truly magic.
All too often, however, a new parent's joy is tempered by problems with sleep...or more correctly the lack of it. Generally speaking, babies get the sleep that they need. Their body demands it. Unfortunately, this doesn't always fit into our schedule or game plan. In many cases parents do have some control in setting the schedule to optimize the sleep pattern for their baby.
First of all, let's look at a common "sleep problem" that occurs in early infancy, the trained night feeder. Mrs. Davis brought her 4 month old daughter, Stacey, in for her well-check. Mrs. Davis was a first time mom who did it all by the book, and was doing a wonderful job. She was exclusively breast feeding and I complimented her on the fact that Stacey was well on her growth curve, the 90th percentile for height and weight. A tribute to successful breast feeding.
My compliment was met with indifference. The real problem, as mom saw it, was that Stacey was getting up three times a night to eat. Mom assured me, in no uncertain terms, that Stacey was hungry, and did, in fact, eat. After a gigantic yawn, Mrs. Davis told me this had to stop. She was a wreck and was suffering from chronic sleep deprivation. I tended to believe her as Stacey had crisp, penetrating blue eyes, and mom had bleary, blood-shot eyes with dark circles.
After getting more history, it turns out that Stacey was breast feeding around 10-11 times a day (in a 24 hour period). In a facetious voice, mom said that Stacey may as well be surgically attached. I assured her that the problem was correctable. Stacey had become a trained night feeder. In other words, the routine had evolved to the point where Stacey had become used to receiving small, frequent feedings.
Breast feeding is really a supply and demand reflex. The stimulus for milk production is the baby emptying the breast. The more that the baby eats, the more milk will be produced assuming that mom's fluid intake and nutrition is appropriate. Because Stacey eats every 2 hours, she gets 2 hours worth of breast milk...and then IS hungry in another 2 hours. There is no way she can make it all night without eating because she has been "trained" to be a nocturnal feeder. This is not to imply that there is anything wrong with this. The routine simply evolved. It was not something that Mrs. Davis did consciously. There may be exceptions to this, i.e. babies who do eat every 2 hours and can sleep all night, however, these are not very common.
The solution to Mrs. Davis' problem follows the law of supply and demand. Stacey has to become accustomed to drinking larger amounts of milk, less frequently. As a result, she will be content for longer periods of time, and hopefully sleep longer at night. Mrs. Davis was instructed to increase the interval between feedings to 2 and 1/2 hours. If Stacey became fussy at the usual 2 hours, try a pacifier, put her in a swing or walk with her, distract her with a toy or rattle.
When Stacey is put on the breast at 2 1/2 hours, she will eat vigorously and empty the breast. This will stimulate more milk production and in a short period of time, she will get 2 1/2 hours worth of milk. After this seems to be working, she can then stretch it to 3 hours, and so on.
As Stacey takes larger feedings, she will not need to eat so frequently. She will "consolidate" her feedings to 4-6 per day. It is important to know that she will still get the same amount of breast milk, the same number of calories and grow the same amount. It will just be distributed differently.
Mrs. Davis informed me after two weeks that Stacey was getting up only once, at 4 A.M. to eat. After a month, she was sleeping 9 hours throughout the night. I received a nice card from Mr. Davis saying how great it was to have his wife back.