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Babies might be tiny, but they eat so much and so often -- every two to three hours. And if you're breastfeeding, your newborn may need to eat even more often (breast milk is digested more quickly than formula). Pediatricians and lactation consultants often advocate feeding schedules that, of course, moms want to stick with -- but what happens when baby is sleeping? Many moms agonize over the decision of whether or not they should wake their little ones for feedings.
And it's no wonder we're confused, since experts are divided on this issue as well.
"There is no need to wake a baby for feeding if the baby is healthy, born at term, and gaining weight well," says lactation consultant Leigh Anne O'Connor. That said, many newborns won't fall in this camp. At first, infants struggle to get the hang of feeding (and if you're breastfeeding, it can take a few days for your milk to come in). As a result, newborns often lose weight after heading home from the hospital -- which is why some experts urge parents to wake the baby until their weight is back where it was when he was born.
"For the first couple of weeks, until the baby is back to birth weight, we suggest parents wake their baby to feed every two or three hours in the day, and every three to four hours at night until he is back to his birth weight," says Cindy Leclerc, a registered nurse and lactation consultant. She also feels babies should be woken up to be fed if they were born premature, born weighing less than 5 1/2 pounds, jaundiced, or struggling with medical problems like an infection, since all of the above babies may be more delicate health-wise and could stand for more vigilance.
Another situation where parents should consider a wake-up call for their baby is if he (or the mom, and baby by extension) received some sort of medical intervention during the delivery or afterward.
"In this day and age of multiple intervention births and a cesarean section rate over 33 percent, the majority of babies are born with some medications in their system or will be subjected to pain medications post-delivery," says lactation consultant Tina Castellanos. "In the case of a sedated baby, the parents should be sure to wake the baby a minimum of every three hours for feeding."
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And even if baby and mom survived the whole process med-free, Castellanos still thinks her advice holds true, at least during those first two weeks of life.
"Ensuring that baby is eating vigorously at least eight times per day is important during this stage," she says. "That is approximately every three hours, from the start of one feeding to the start of the next. One longer stretch of sleep with this alert baby as long as other feedings are going well is usually acceptable."
Keep in mind a sleeping baby may be hard to rouse -- or be cranky on waking. If that happens, try stripping baby down to just a diaper and putting him skin-to-skin with the mom, which can provide both the comfort and stimulation he needs to focus on feeding. Or if baby drifts off again during feeding, try tickling his feet or walking to keep him alert.
When in doubt, keep an eye on baby's output (the number of dirty diapers) to gauge if baby is eating enough. On day one, there should typically be one bowel movement, two on day two, three on day three, then three to four bowel movements and three to six wet diapers a day going forward, says O'Connor. You can also gain peace of mind by weighing your baby; newborns should gain about one half to one ounce a day. And once you're through the woods of the first few weeks and baby's got a better handle on feeding, you can let him snooze to his heart's content.
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