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Should I still be waking DD to feed overnight?


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#1 indigo~

Posted 29 November 2012 - 08:42 AM

DD is 11.5w but only 5w corrected age as premmie. For weeks now I have had to wake her for the first overnight feed of the night.

I was letting her go no more than 4 hrs between feeds overnight on advice from special care when she was discharged. In the past week I have stretched this out to 5 to 5.5 hrs and have still needed to wake her.

She will then usually wake herself after3-4 hrs for the following feed. She doesn't sleep much during the day other than catnaps in my arms.

Just wondering if I should continue this or let her sleep? She's still only little, approx 4.2kg. It hasn't really bothered me as I would need to get up to express anyway as the boobs feel overly full after 5 hrs.

How do mums cope with full boobs when their bubs do start to sleep through? Do the boobs adjust or do you need to keep expressing? My supply is not great and I have to comp feed with EBM or formula top ups around 3 times a day.

Thanks

#2 Sir Dinosaurus

Posted 29 November 2012 - 09:09 AM

I'm not sure about waking to feed, I would go on advice of the midwife, MCHN as a premmie she may well need waking still.

As for the boobs - yes, they adjust - some quicker than others. I put a towel under me in bed as I always leaked, it takes me a few nights to adjust but dropping my day feeds takes me loads longer to adjust to!

All the best original.gif

#3 CharliMarley

Posted 29 November 2012 - 09:20 AM

I think I would wake her after 4 hours overnight, as she is still very little and her tummy is only as big as her fist and why pump all that good milk away, when your baby will take it. Mums are given extra energy during the months after birth, or so I am told. Is it the oxytocin or something that makes you calm. unsure.gif

#4 lucky 2

Posted 29 November 2012 - 09:42 AM

Oxytocin is usually a feel good hormone, there are the exceptions though.
As for waking, I'd talk to your LC or CHN, theoretically if a baby is well, feeding well, great output, growing normally then you do not have to control feeds, ie if baby can control intake/feed frequency and thrive then you can let baby feed to need.
Since your baby was a prem I'd think it is better to be safe than sorry and get advice from you health provider.
I don't think being 4+ kg is an issue if she feeds well, is is 5 weeks old adjusted and some babies of this age can have longer sleeps.
Check if it's ok for your baby though.
QUOTE
How do mums cope with full boobs when their bubs do start to sleep through? Do the boobs adjust or do you need to keep expressing? My supply is not great and I have to comp feed with EBM or formula top ups around 3 times a day.

Most mums don't have to worry about babies sleeping too much at this young age!
Since you have a undersupply I'd be up expressing for sure, if you didn't need to feed.
If baby does feed well then it might be good to have baby feeding regularly overnight, that might help supply.
Are you seeing a LC? If not is sounds like a good idea considering your supply issue.
All the best.

#5 indigo~

Posted 29 November 2012 - 10:18 AM

Thanks for the replies.

The local MCHN is also a LC and she suggested letting DD sleep and see how she goes. My gut instinct is to continue waking to feed though. Her next paed check up is mid Dec so I may keep going as I am and ask the paed what he thinks.

Re my supply, the MCHN/LC said that my supply is probably as good as it will get as I've been on motilium (and fenugreek and nursing tea) for around 10w now and bub BF all day long (every 1-2hrs, sometimes less than 1hr!) so can't increase frequency or express more than I am. I will usually only express now after her first overnight feed (getting 30-50mls) otherwise there would be nothing left for bub at her next feed.

When she's super hungry, I'll put her on each boob 3 times and she'll still be cracking it for more. That's when I'll offer a bottle top up and she takes it greedily and then looks so satisfied afterwards, poor chook.

Her weight gain is great though - last weigh in had put on 420g in 10 days so up 12% over that period. Makes me wonder if she really needs the top ups or just likes to feel full? She feeds so frequently during the day that she only gets smaller volumes. The overnight feeds are when she gets a good amount as they have longer to fill (plus prolactin higher).

#6 lucky 2

Posted 29 November 2012 - 10:35 AM

If you feel brave enough give your MCHN/LC's suggestion a go.
This means that you do a little controlled experiment, see what happens and if she does wake naturally and continues to have an excellent output and growth then the experiment is a success! If not then you go back to waking her.
I'd suggest that your MCHN/LC is best placed in understanding how your baby feeds and how to manage her intake and breast feeding, that is her expertise.
You are doing really well, if you do a couple of night trial how can it hurt if your baby remains well and you continue to have healthy breasts and nipples (ie not getting blocked ducts).
I understand what you are saying re ? supply is optimal, you have done everything to build it.
When bub is in the fussy phases how about keep switching sides, ie more than 3, I used to have to give up to 8 sides for dd as she would fuss and carry on. It helped increase her intake and my supply.
Sounds like you are getting excellent care and advice.
All the best.

#7 mandala

Posted 29 November 2012 - 07:00 PM

I would be tempted to try not waking her. That first sleep of the night is the deepest, and quality sleep is also important for growth. You might also find that if you are more rested, your supply improves.

My baby was also a little thing, and would have been around 4kg at 6 weeks. 420g in 10 days is fantastic!

At that stage I had oversupply - my undersupply started later. However I did have a few nights were I was woken up by painfully full breasts. I would get up, run the hot tap in the basin to get a warm, wet flannel, and put it on my breasts before hand expressing just enough to be able to get back to sleep.

#8 MrsSmith247

Posted 29 November 2012 - 07:14 PM

I woke my DD til about 4 months. She was born full term but quite little and I've always had a very volatile supply. Above all else, my instinct was it was best. It was more a dreamfeed for both of us than an actual wake up.

Do whatever you feel is best.

#9 indigo~

Posted 15 December 2012 - 09:00 PM

Hi again. Just an update from me and a follow up question.

I've been letting bub sleep and she goes for around 5.5-7.5 hrs some nights before waking. (Still not sleeping during the day but that's another issue.) She's now 14w or 7.5w corrected.

I've been getting up around 5.5-6 hrs from last feed to express but I've only been taking off 20-25 ml per boob just till they're not rock hard anymore.

Just wondering if I should be removing more or even draining them? I haven't as I can't predict when bub will wake up and I've wanted to leave enough for a decent feed.

I'm worried about affecting my supply as I've worked so hard to increase it.  I haven't had to give any formula top ups for over a week now. What should I be doing to maintain supply?

Thanks!

#10 lucky 2

Posted 15 December 2012 - 09:29 PM

Hi, thanks for the update original.gif .
QUOTE
I'm worried about affecting my supply as I've worked so hard to increase it. I haven't had to give any formula top ups for over a week now. What should I be doing to maintain supply?

It can be a helpful to have a weight taken when you make a change in diet (ie drop formula) and then get a weight taken, say, a week later and see how the growth is.
If baby continues to have a good output, ie plenty of pale wee and soft yellow poos (ie 2 or more each 24 hrs) and growing on breast milk alone then you do have the right amount of milk production.
And if your breasts remain free of blocked ducts and are comfortable then this is also a good sign that bfing if going well.
From what you have written things sound good but it would be safest to have a visit and weight check with your CHN.
All the best.

#11 ScarfaceClaw

Posted 15 December 2012 - 09:41 PM

I stopped waking DS well before 4kg! I think he was still under 3kg and  we went to demand feeds from about 8 weeks. He was probably waking 5 hourly overnight and 2-3 hourly feeds during the day.

Best way to maintain supply is to feed, and if baby is putting on weight and making lots of wet nappies you are likely to be doing well.
You may also notice a growth spurt coming up where they feed more frequently, that helps build supply too, esp if you don't comp feed, just offer the breast freely.

Good luck, this can be such a confusing time!




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