Ask the Expert: Should I be Waking My Infant to Feed Him?

feeding newbornsThe neonatal period is exciting and dynamic, but it can also be full of worry. Whether formula feeding or breastfeeding, how can we know that Baby is getting enough nutrition? Or conversely, could he be getting too much? The concept of overfeeding infants is a hot topic now, especially among those experts who study childhood obesity.

Don't Stress: Early Weight Loss for Infants is Normal !

In the first two weeks, overfeeding is usually the last thing on our minds. We want Baby to get off to a good start and begin to thrive. But nearly all newborns start off by losing a significant amount of weight. As much as 8 – 10% of a newborn’s weight can be lost in the first 4 – 5 days of life. So, an 8 pound newborn may weigh as little as 7 pounds 4 ounces on day of life 4. And that may be okay. What parent expects their newborn to start off going backward on the scales?!

Why do Infants Lose Weight?

There are many reasons for that backslide. First, most babies are born a bit fluid overloaded. They need to unload some extra body water after birth. That’s why they sometimes look a bit puffy in that first photo op with Dad or Grandma. Secondly, feeding starts off slowly. Babies need to “figure out” how to feed effectively. We take our ability to organize a swallow for granted. But young infants need to learn that oromotor skill. And that can take time. Thirdly, breastfed babies get only about a teaspoon of volume per feed. That teaspoon consists of that critical colostrum in the first few days until Mom’s milk comes in. All that work and soreness for one measly teaspoon! It pays off in the end, but no wonder there is weight loss! And lastly, some babies get transiently and mildly dehydrated during this time. Only to slowly gain back the weight (and then some) when they finally figure it all out.

So, Should I Wake My Infant?

In the neonatal period, or until a baby gets “back to birthweight,” it is important to wake your baby at least every 2 – 3 hours to attempt a feed. Babies who are a bit dehydrated, get tired. Tired babies are less vigorous with their feedings and feed less often, leading to dehydration. You can see the potential vicious cycle.

Between 1 and 3 months of age, babies are often disorganized with regard to their sleep. Do you have a 6 week old that is thriving and sleeping through the night? Then shush and don’t tell your friends. This is unusual … and potentially irritating to the rest of us sleep deprived parents. In fact, the vast majority of young infants haven’t settled into a predictable sleep schedule yet. Not even close. In this age group you can expect one—more if you’re lucky—3 hour stretch of uninterrupted sleep per 24 hours. That means a lot of frequent feedings. Infants are still feeding 8 – 12 times per 24 hours. Yikes. When you do the math, that’s not much time off for Mom. Nutrition is critical during this period and both breastmilk and formula are specifically designed for young infants. Most infants need at least 20 ounces per day to meet their basic needs. And many infants can’t take more than 3 ounces per feed at this age. So most babies will self regulate, wake up when they’re hungry and feed on demand. However, if your baby isn't waking himself, it's up to you, Mom!

Short answer: Yes, if Baby isn't waking regularly on her own, wake her every 2 -3 hours to attampt a feed. Most infants need about 20 ounces of formula or breastmilk a day and take about 3 ounces per feeding.