Wakeful 4 Month Olds

August 2, 2011. Posted in: Nighttime parenting

by Jan Barger, RN, MA, IBCLC

Reprinted with permission from the author.

One of the concerns I have about some parenting books and pediatricians who give advice about sleeping infants is this: Baby starts sleeping through the night at, say, about 3 months — or at least sleeping 5 to 6 hours. Suddenly around 4 months, little Buford starts waking up at night to nurse. Mom is understandably distressed. Some books say “it’s a bad habit that must be stopped.” Her pediatrician says essentially the same thing. Someone else points out that since the baby slept through the night at 3 months, it is OBVIOUS that the baby CAN sleep and isn’t hungry. The book goes on to talk about how the baby is now manipulating the mother. The pediatrician says he’s big enough to go without eating at night. Grandma tells her to let Buford cry it out. So does the book. There may be different ways, but in essence, don’t pick him up and feed him….

Has NO ONE stopped to consider the developmental stage of the breastfeeding baby that begins at about four months and can go on to 6 or 7 months? Think about your four month old breastfeeding — what are they doing? This baby is on and off the breast — so interested in the world around him he can hardly stand it. “Oh look! There’s the dog! Hi, Mommy, I love you SOOOO much! The phone?! A car went by. The TV is on. Big sister comes into the room….hey, there’s just too much going on for me to concentrate on eating. I think I’m full now. I’ll see you later…..”

When I get one of these babies in my office, I have to observe the feed without saying a word to the mother. The entire feeding is done in complete silence so that the baby will EAT and not look around at me. How many times have you been told to go into a darkened, quiet room to get a good feeding? OK, now think about night time. Buford is really hungry — he didn’t eat well during the day. Nighttime is here; it’s dark, quiet, and he has mommy’s undivided attention. So he has a really great meal. Doesn’t take long — he’s pretty efficient by now. But it is down to business and complete.

But WAIT! Someone told the mother that the baby can’t possibly be hungry — just let him cry it out. Now mom’s milk supply diminishes because punkin isn’t eating well during the day — too many things going on, and he’s going through some new developmental stages (when Hildegarde is learning something new, she doesn’t nurse as well until the new skill is mastered). IF mom has kept Buford/Hildegarde on a schedule since day 1, then she will probably NOT be able to increase her supply — not with pumping, not with herbs. If she fed her baby frequently enough and laid down enough prolactin receptors in the first two weeks to a month, there is hope that we can bring the milk back up. But if she was truly “obeying” a schedule and only feeding every 2.5 to 3 hours, she may not be able to (depending on mom’s breastmilk storage supplies, etc).

Why don’t bottle feeding babies wake up as much at 4 months? Because by this time, mom has often handed the bottle off to baby to feed himself, and/or seats him looking out so he can check out the dog, the phone, the sibling, etc — and continue eating at the same time.

Please don’t deny that your breastfeeding baby is quite possibly very hungry at night at four months, even though they may have been sleeping through the night prior to this. Look at the feed — can you hear swallowing? Does your breast get softer? Is he EATING? Then don’t make him cry it out! He needs to eat….and he needs his mommy.

Jan Barger is a mom of three (ages 20 to 30) and brand new attached Grammy of one. Her other credentials include: Lactation consultant for a pediatric group in the Chicago ‘burbs, director of Lactation Education Consultants (an organization that provides education for those aspiring to become lactation consultants as well as ongoing professional education for IBCLCs). RN in maternal child health for over 30 years. Adjunct faculty at Rush University Medical Center in Chicago and at Wheaton College, Wheaton, IL. President of ILCA from 1990 to 1992, on the IBLCE Board from ’92 to ’94, and on the Exam Committee in 1998. Co-author of Clinical Experience in Lactation: A Blueprint for Internship, and contributing author to Counseling the Nursing Mother by Lauwers and Swisher.

Copyright © 1999 by Jan Renich Barger. No portion of this text may be copied or reproduced in any manner, electronically or otherwise, without the express written permission of the author.

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