Recommendations for infant feeding have changed 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, both breastfeeding and bottle formula, is on demand . That is, when the baby wants to eat and how much he wants. Most babies wake up to claim feeds, but there are some more sleepy or less demanding. In no case should they be awakened? Are there any exceptions to this rule?
The first hours of life
As soon as it is born, the baby has a period of one or two hours in which it 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 up to it to latch on, thus making the first feeding.
Later, most enter a period of sleep, staying asleep for a few hours. It’s called physiological lethargy and they can be asleep for 8 to 12 hours. The Breastfeeding Committee of the Spanish Association of Pediatrics is not in favor of forcing the baby to eat at this stage, but it does favor skin-to-skin contact and be attentive to the first signs of hunger , so that the baby can catch the chest as needed.
The first days of life
Newborns usually take between 8 and 12 feedings a day in the first days of life. It is important to pay attention to the early signs of hunger (crying is a very late sign so we should not 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 chest. No studies have been found that specifically evaluate how to handle these sleepy newborns. The Lactation Committee of the Spanish Association of Pediatrics does affirm that, in some of these cases, it may be necessary to try to wake them up to feed them (by undressing them or by gently massaging the soles of the feet). Glover, in his article, recommends doing it if it has been between 3 and 5 hours since the previous intake. If a baby is excessively sleepy it should be evaluated by a pediatrician.
After these first days of life, when breastfeeding is well established, it is a healthy term baby gaining weight and demanding their feedings, there is no need to wake them up to eat. They will wake up and claim food when they need it.
Hypoglycemia
One of the most frequent fears that leads to waking babies to feed them is hypoglycemia. Hypoglycemia is a drop in the level of sugar in the blood .
In most healthy term newborns there is a transient drop in glucose after birth; those levels gradually increase in the following hours, even if they are not fed. Newborns have been shown to be able to produce glucose in other ways and, in addition, the neonatal brain is able to use 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 go several hours without eating unless there is an underlying problem.
Babies at risk of hypoglycemia
So far we have talked about healthy term newborns, in whom hypoglycemia does not seem to develop even if they go several hours without eating. However, some babies are more susceptible to hypoglycemia.
In this group we find premature babies , children of a diabetic mother, those born with low weight, those with a very high weight and those who have suffered delayed intrauterine growth (CIR).
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, congenital errors of metabolism, adrenal insufficiency) are also more at risk. .).
In short … When is it necessary to wake up the baby to eat?
In most cases it will not be necessary to wake the baby to feed since healthy term newborns tend to self-regulate and ask for feedings when they are due. However, it may be necessary to wake up to eat to:
- Very sleepy babies who do not demand feedings in the first days of life.
- Babies who have lost a lot of weight after birth. Typically, newborns lose weight after birth, a maximum of 7-10% and regain it after 10 days of life. If weight loss is important, the pediatrician will probably 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.
In Babies and more | Five signs (other than crying) that tell you that the baby is hungry
