ON BECOMING BABY WISE (4th edition)
Text in pink is from other sources
Text in orange is from my own experience
Chapter 1: Your baby needs a family
- Baby should grow up in a loving family. Should be able to watch how you and your partner spend time together. Baby is not the center of the universe (even though it feels like it!)
Chapter 2: Feeding philosophies
- Child-led feeding (on demand)
- Clock feeding
- PDF= Parent direct feeding. Learning to observe and distinguish when the baby needs to be fed. It is not every time she cries. It also doesn’t have to be when the clock says.
Chapter 3: Babies and sleep
- Establish a schedule with the EWS (Eat-wake-sleep) cycle
- First 8 weeks: Feed every 2.5 – 3hrs
- Most baby wise babies STTN (sleep through the night) by week 7-8!
- nursing baby to sleep
- rocking baby to sleep
- shared sleeping
- Put baby in bed while still awake. She needs to learn to sleep on her own.
Chapter 4: Facts on feeding
- Avoid snacking, focus on full feedings!
- 5 – 3hr intervals in the beginning
- Feed within the first hour of birth
- First 7 or 10 days= forget about the clock, no schedule, just focus on full feedings and no snacking. Keeping baby awake during feedings, and EWS cycles. To keep baby awake: massage palm of hand, cold hands, cold wet towels, etc.
- After the first 10 days= Go for a 2.5 – 3hr schedule.
- 10min each breast, then 5 and 5. (15min each breast)
Chapter 5: Monitoring your baby’s growth
These are signs to watch for that show your baby is growing healthy:
- Week one
- 8 feedings in 24hrs
- Over 15min in each feeding
- Listen to the swallowing
- Yellow diapers
- Week 2 – 4
- 8 feedings
- 2-5 yellow diapers
- 6-8 pee diapers
- clear urine
- strong suck
- grow in length
- Week 5 and above
- 1 large diaper a day or every 3-5 days.
- Weight gain:
- Birth – 2 weeks: regain birthweight
- 2W – 3mo: 2lbs per month or 1oz per day
- 4-6mo: 1lb per month or ½ oz per day
- Double the weight by 6mo
- 1yr: 2.5 to 3 times her birth weight.
Chapter 6: Establishing your baby’s routine
- Week 1 will be hard. Just focus on keeping the baby awake during feedings.
- In order to be flexible later, you need to have a routine established first.
Phase 1: Stabilization
- First week:
- Don’t watch the clock.
- Focus on full feedings
- Keep baby awake during feedings.
- After 10 days:
- 5 – 3hr routine
- Weeks 2-4:
- 8-10 feedings every 24hrs
- During the day, wake baby up if needed to feed.
- During the night (after 10 or 11pm): Don’t wake baby up, let the baby wake you up. But don’t let baby sleep more than 5hrs. When feeding at night, there is no EWS cycle. No wake time. Just feed and put back to sleep.
- Weeks 5-8:
- 5 – 3.5hr routine
- Establish DWT (Designated Wake Time) or first feeding of the day.
- DWT Should be when the routine starts. Open curtains, say GOOD MORNING with a smile, etc.
Establishing DWT, and what to do if the baby wakes before DWT
- 15 min before DWT: just give the paci, let her cry.
- More than 15min before DWT: feed like a MOTN (middle of the night) feeding. With no eye contact, lights out, just feed a few minutes and put back in the crib. Sounds silly but put back in the crib. And at DWT (even if its only a few min later), you get them out with lights on, smile, etc. This will help to establish the DWT.
- There can be a 15min margin on waking up 15min before or after DWT
- The 45min intruder appears! It appears at 7W, 8W, and 4mo. 45min into the nap, the baby awakes.
- If baby is hungry, feed him and adjust your schedule.
- If baby is not hungry, help him transition into sleep again.
- (swing, rock, anything! Remember the sleep hierarchy!)
Babies can only stay awake for a short time (including feeding time!). After 2months or so, they can be awake for half the time of their cycle.
Phase 2: Extended Night
9 – 15 weeks
- Extended sleep of 9 – 10 hours
- 5-7 feedings
- Drop the late night feedings
- If during the day you find your milk supply is low, don’t go more than 9 hours without nursing or pumping!
Phase 3: Extended Day
16 – 24 weeks
- Introduce baby to solids
- Continue 4 – 6 liquid meals (milk)
- Sleeping 10 – 11 hours at night
- Baby’s meals match family’s breakfast, lunch and dinner by 24W.
- 4, 5, 6 liquid meals are at bedtime, late morning, and late afternoon.
- 4-6 feedings so you don’t lose milk supply.
- Read on becoming Baby Wise II: Pretoddler
Phase 4: Extended Routine
24 – 52 weeks
- Each meal has a liquid feeding
- Additional 4&5 feedings between meals
- Required liquid feedings at bedtime
- 2 naps that are 1.5 or 2.5 hours long
How to drop a feeding
- Stretch from 3 to 3.5 or 3.5 to 4hr routine
- If you constantly have to wake baby up to feed, this is a sign that he can go longer between feedings.
- Move to a 4hr routine at 3 or 4 months of age.
- Drop the MOTN feeding at week 7 – 9.
- If the baby is waking up at the SAME time every night, he is “stuck” at that night time feeding.
- Drop the late feeding at 3mo by moving it closer to the last feeding each day.
Establishing a routine
- Pick a day to stay at home and give full attention to baby.
- Start your day at DWT and observe baby closely.
- Put down to sleep at first sign of fussiness. If baby sleeps rather fast, this is your indicator of how long waketime should be. Although most of the time, wake time tends to be longer as the day goes.
- Let baby wake on his own (from a good nap)! This will be your indicator of how long your baby can go (2.5 or 3hrs).
- Repeat for every cycle.
Chapter 7: Waketime and naptime
- Examples of wake time activities (remember, eating is part of wake time): singing, reading, bathing, take a walk, playing, massage, pictures, mobile, gym, swing, infant seat, playpen.
- Naptime is needed for development. It is not optional.
- When on a 2.5hr routine, nap should be 1 to 1.5hrs long.
- When in a 3 or 4 hr routine, nap should be 1.5 – 2.5 hr long.
- Are awake for only 45-50min. Then put down for a nap at the first sign of fussiness.
- 2 month olds
- Have 1.5hr long naps
- Drop MOTN feeding
- Common for BW babies to wake up at 5am and talk for 1 hr.
- 3 – 5 month olds
- Drop late evening feeding
- Have 3 naps of 1.5 or 2 hrs long.
- 6 – 16 month olds
- Drop late afternoon/early evening nap at 6mo
- Has 2 naptimes, one in the morning and one in the afternoon.
- Naps are 1.5 – 2 hrs long
- 16 months and older
- Only one afternoon nap 2-3 hours long.
- Is sleeping 10-12 hours at night.
- In order to have a happy baby, mom decided when nap starts and ends.
- After you put baby down for sleep, if he wakes up, don’t assume nap is over. Let him go back to sleep.
Chapter 8: When your baby cries
Babies cry! When they are tired, sick, bored, frustrated, out of routine, too much food, or just because!
Abnormal crying times:
- During feedings
- Immediately after a feeding (30min)
- Wakes up early out of a sound nap
See if any of these has happened:
- Not getting enough food, or doesn’t get it fast enough
- pain cry (trapped gas, needs to burp, your diet, milk quality) Gripe water and gas drops!
- Combination of above
- 45 min intruder at 7 and 8W, or 4mo.
- Growth spurts… feed baby more often! Add a feeding during the day!
- Just before feeding
- Put down for a nap
- Late afternoon / early evening
If hungry, FEED!
Let them cry. Get to know their cry (length, sound, etc) so that when it’s different you can intervene.
Chapter 9: Colic, reflux, and the inconsolable baby
Fussy baby: cries and is then calm
Colic babies are irritable all the time: 20% of babies are colicky at 2-4 weeks to 3 months. The cry is piercing, tummy distress, inconsolable cry, folds legs, flailing arms and gas.
There is no medical concern but it is hard for the family! What can you do? Each baby is different. Swaddle, bathe, vibrating, change formula, watch your diet if you are BF, avoid gassy foods (broccoli, cauliflower, cabbage, onion, garlic) dairy, caffeine, alcohol. Pacifier, burp frequently, change bottle nipple, burp with chest on your legs and massage the back, feed in stress free environment (avoid TV, noise, etc)
Reflux and GER (Gastro Esophagal Reflux): Asymptomatic. Spitting up, no medical treatment needed because baby is growing and is not fussy.
GERD (Gastro Esophagal Reflux Disease): DOES Cause pain and/or poor growth.
Reflux: Epiglottis is weak and food with acid comes up. (heartburn). If it escalates it is said to have GERD.
Applying BW: Feed every 2hrs in a calm place. Wake time he is held. Wrap baby, no bouncing, jiggling, or excessive patting on the back. Burp frequently, feed in calm environment, prop baby up after feeding for 30min. Mattress inclined. If a feeding lasts more than 45 min, pause in between with a nap.