Nighttime Feedings

By: Dr. Maurice Levy

General

Many mothers complain that their babies feed more during the night than during the day. This is normal, since babies do not know that nighttime is a time to sleep. It takes babies time to adjust to day and night patterns. Being able to sleep through the night is a developmental stage and night waking is temporary as children do grow out of this stage.

According to some sleep experts, babies should develop good sleep habits at around 6 months of age. However, each baby is unique and it is impossible to say when your baby will sleep through the night. Some babies sleep through the night at an early age, while some will not.

Environment & Sharing Sleep

• Nighttime feedings should include minimum stimulation, fuss and/or communication.
• Change your baby's diapers before feeding him in order to avoid moving him around too much, since this makes him more alert after a feeding.
• Minimize the amount of distractions at night by closing the door, turning off the light, etc.
• Unless your baby is bothered, avoid waking your baby at night to change his diapers or for any other reason - unless suggested by your doctor (to increase weight gain and the need to feed more frequently at night).

PARENT CONCERN: Should I sleep with my baby in the same bed?

This is often questioned due to the risk of rolling over your baby and the risk of death. To compare the risk of SIDS (Sudden Infant Death Syndrome), one needs to compare babies who died when they were in bed with the parents, in a crib close to the bed, or in a separate room. Because the cause of SIDS is unknown and due to various other factors, it is hard to definitively assess the risk. You may discuss the recommendations about bed sharing when feeding at night with your doctor. However, some studies show that SIDS is more likely to occur among infants who co-sleep with their parents when the parents indulge in recreational drugs or alcohol.

Feeding & Sleeping at Night

• In the early months, it is normal and especially desirable for the baby to nurse during the night as you respond to his needs; it also increases your milk supply, decreases early morning engorgement, and helps your baby with weight gain difficulties.
• Listen to your baby's hunger cues and do not assume that he is not hungry.
• Many mothers find it easy to manage feeding at night if they keep their baby in bed with them or if the baby sleeps in a bassinet or crib right beside the bed.

The following are suggestions to help your baby develop nighttime sleep patterns (not in the first 3 months):

• Make the most of your baby's daytime (waking time) hours to help associate daylight hours with play, feedings, and wakefulness.
• Try to feed more during the day (depends on your baby) and sleep longer periods during the night.
• Feed your child frequently in the evening, closer to the time of sleeping or right before he goes to bed.
• Be aware of overtired signs (e.g. quiet, losing interest, fussing, etc) from your baby.
• Allow your baby to fall asleep on your breast, since this is known to be one of the easiest ways for most babies to relax.
• When your baby sleeps during the day, use a carriage, cradle or bassinet. However, when he sleeps at night, place him in a crib to help make the differentiation between daytime and nighttime.
• Change sleeping arrangements to find out what works best for your baby. For example, some babies sleep better when they are close to the mother.
• Sometimes, sleepy sounds such as lullabies and calming CD's help your baby sleep through the night (especially when played all night). Rocking chairs or swinging motions help the baby fall asleep as well, as this provides your baby with a feeling of comfort and security.

PARENT CONCERN: I was told that formula-fed babies sleep longer at night - is this true?

Formula is digested differently than breast milk, and many parents report that the need to feed frequently at night is less in formula-fed babies than in breastfed babies.

While this may be only partially right, you may try to ensure the following for a breastfed baby to help your baby sleep for longer periods of time at night:

• Baby is latching on well.
• Increase the amount taken during the feeding to help him sleep longer.
• Use compression to increase the amount of milk the baby receives at the breast.
• Finishing the first side before you offer the second breast allows your baby to receive plenty of high fat milk to allow him to go for a few hours between feedings.
• Gradually stretch the hours between feedings so that he eventually sleeps through the night.

About the Author: Dr. Maurice Levy, an eminent pediatrician, has 30 years of day-to-day medical experience in hospitals and in his active pediatric primary care and consultation clinic. Former Chief of Pediatrics and currently Head of Pediatric Research at North York General Hospital, Dr. Levy has trained and worked in various hospitals across the globe. Along with his medical degree and specialty in General Pediatrics, Dr. Levy has received various specialized diplomas and received numerous awards and publications. For more information, visit: www.babyandtoddlerhealth.com.