Recommendations on infant feeding have been changing over time. Years ago it was recommended that babies eat every 3 hours. However, it is now known that the correct way to feed a baby, whether breastfeeding or formula in a bottle, is on demand . That is, when the baby wants to eat and the amount he wants. Most babies wake up to claim their feeds, but there are some who are more sleepy or ask less. Is there no need to wake them up? Are there any exceptions to this rule? The Kassing method: how to give the bottle the closest thing to breastfeeding.
The first hours of life
Right after birth, the baby has a period of one or two hours when he is very awake, very alert. It is the so-called golden hour ( golden hour in English). If we leave the newborn in skin-to-skin contact with its mother, it will be able to locate the breast and crawl to it to latch on, thus performing the first feed.
Subsequently, most enter a period of sleep, remaining asleep for a few hours. It is called physiological torpor and they can be asleep between 8 and 12 hours. The Breastfeeding Committee of the Spanish Association of Paediatrics is not in favor of forcing the baby to eat at this stage, but it is in favor of promoting skin-to-skin contact and being attentive to the first signs of hunger , so that the baby can take the chest as needed.
The first days of life
Newborns usually take between 8 and 12 feeds a day in the first days of life. It is important to pay attention to early signs of hunger (crying is a very late sign so don’t wait for him to cry), and give him the opportunity to eat every 2-3 hours .
Some babies are very sleepy for the first few days of life; it is advisable to put them skin to skin to stimulate them and allow them quick access to the breast. No studies have been found that specifically assess how to manage these sleepy newborns. The Breastfeeding Committee of the Spanish Association of Paediatrics does state that, in some of these cases, it may be necessary to try to wake them up to feed (undressing them or giving them a gentle massage on the soles of their feet). Glover , in his article, recommends doing it if 3-5 hours have passed since the previous shot. If a baby is excessively sleepy, it should be evaluated by a pediatrician.
After these first days of life, when breastfeeding is already well established, it is a healthy full-term baby who gains weight and demands his feeds, there is no need to wake them up to eat. They will wake up and claim food when they need it.
One of the most frequent fears that leads to waking babies to feed them is hypoglycemia. Hypoglycemia is a drop in blood sugar concentration .
A transient drop in glucose occurs in most healthy term infants after birth; those levels gradually increase in the following hours, even if they are not fed. It has been seen that newborns are capable of producing glucose in other ways and, in addition, the neonatal brain is capable of using other sources of energy to function.
Thus, the Academy of Breastfeeding Medicine (ABM) states in its protocol number 1 that healthy term and breastfed newborns do not develop hypoglycemia even if they spend several hours without eating unless there is an underlying problem.
Babies at risk of hypoglycemia
So far we have discussed healthy full-term newborns, in whom it seems that hypoglycemia does not develop even if they spend several hours without eating. However, some babies are more susceptible to hypoglycemia.
In this group we find premature babies , children of diabetic mothers , those born with low birth weight, those with very high birth weight and those who have suffered intrauterine growth retardation (IRG).
Babies who have suffered perinatal stress (asphyxia, acidosis), have a serious infection or those who have a specific disease or malformation (such as Beckwith-Wiedemann Syndrome, inborn errors of metabolism, adrenal insufficiency, etc. ) are also at greater risk . .).
In short… When is it necessary to wake the baby to eat?
In most cases, it will not be necessary to wake the baby to feed since healthy full-term newborns tend to self-regulate and ask for feedings when they are due. However, it may be necessary to wake up to eat at:
- Very sleepy babies who do not claim feedings in the first days of life.
- Babies who have lost a lot of weight after birth. Normally, newborns lose weight after birth, at most 7-10%, and regain it after 10 days of life. If weight loss is important, it is likely that the pediatrician will recommend feeding him frequently, even if this requires waking him up.
- premature babies .
- Babies with low birth weight, CIR, or very high birth weight .
- Children of diabetic mothers .
- Babies with specific diseases that predispose to hypoglycemia .
In any case, it is important to individualize and for the pediatrician to assess each specific situation.