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Wouldn’t it be great if your baby came with a manual! One of the hardest tasks of the early days is to understand your new baby’s language. While each baby is unique most babies shared a common unspoken language in the early days. Reflective function or the ability to read and understand your baby and respond appropriately is the most important skill of early mothering. By reading your baby well you will know what he is feeling and thus how to respond. Your baby will feel secure in the knowledge that he is understood and bonding is enhanced. If your baby is feeling happy and ready for interaction, he will make eye contact, coo and smile (if he is old enough). When your baby shows these signals, you know that stimulation and interaction will be well received. In this state, the calm alert state, your baby will be making connections in his brain and learning will occur optimally. Your baby is happy and calm. On the other end of the continuum is the crying state. This signal is obvious and no explanation of what crying sounds like is needed. Your response to the cry will determine how long your baby will cry for. When your baby cries, first respond by asking why: Is he hungry? – feed if three to four hours have passed. Younger babies or those not gaining weight may need more frequent feeds. Is he comfortable? – look at the temperature of the room and whether your baby is appropriately dressed. Is he ill? - if your baby has been the a cheerful fellow and the crying is excessive or out of character, take him to your doctor to rule out illness Is he tired? – babies need to sleep very frequently. Be sure to watch his awake times and put your baby to sleep frequently before he becomes overtired. Reference Baby Sense for how long your baby can be awake between sleeps for his age. Is he over stimulated? – this is the most common cause of crying and requires you to remove him from the stimulating environment and give him down time with calming activities. Long before your baby starts to cry due to over stimulation he will give warning signals that he has had enough. A new born will descend to crying and a toddler to chaos if you miss these signals. By watching for your baby’s signals you can respond before he begins to cry: Sucking hands Looking away and loosing interest in toys Holding hands together in the midline Grizzling or moaning Arching his back Pushing you or a toy away These warning signals are important forms of communication that help your baby keep himself calm and well regulated. When you see these signals, help your baby calm himself by letting him suck on his hands, giving him a dummy or removing him from the busy environment that is stressing him. You baby may also be tired and need to be put down for a sleep. Watch for your baby’s precious signals and respond appropriately, giving him the security that you respond to his needs. By Meg Faure

Night feeds are simply a part of early parenting. All babies need them in the early days and all babies outgrow them in time. What you should expect at different ages? Prem or sick babies sick and under weight babies If your baby is born with higher needs than most babies, for instance if your baby is born prem, is ill or failing to thrive, you will be advised to wake your baby at night. In these circumstances, you may be told to wake your baby three hourly at night or to wake your baby at specific times. This is the only circumstance when babies should be woken at night. Be sure to keep these night feeds very calm and subdued so that your little one settles back to sleep as soon as possible. As soon as she is on the track to gaining weight nicely, ask your health care provider when you can stop waking her. Newborns If your newborn is a healthy little one and is gaining weight, there is no need to wake her at night. Allow her to wake on her own and do not be tempted to follow advice to wake her for a ‘dream feed’. Dream feeds are not conducive to setting the stage for good sleep long term. You can expect your newborn to wake 4 hours after falling asleep for a feed and then three hours thereafter until morning. If your newborn does sleep for longer stretches, it is absolutely fine to leave her to wake on her own. Some babies sleep through as early as 6 weeks and this is fabulous and no need to worry that she is stretching so long without a feed. 2-4 months By two to three months most babies are stretching for 6 -8 hours before needing a night feed and then three hourly thereafter. If your baby wakes more than this, try to cluster feed in the evening before 8pm to top her up so she sleeps for longer. Two or three extra little snack feeds at this time can help. If she wakes consistently three hourly at night and yet is gaining good weight, you can start to stretch your little one with a dummy or a little water at the first night waking. Be sure to do all night feeds quietly and calmly and not to burp your little one for longer than 5 minutes. 4 -6 months Many babies regress in their night wakings as they approach 4 months. If your little one was stretching to the early hours before needing a feed and suddenly picks up the 11pm feed again and is generally hungry, it may be that she is not fully satisfied nutritionally. Initially reintroduce the feed she is waking for. If this night waking persists and your baby is hungrier during the day too, it may be time for solids. By now your baby will have stopped soiling her nappy at night and it is fine to leave a wet nappy on for the night, without a change, if your baby has not poo’ed and does not have a tendency for nappy rashes. By not changing the nappy and keeping night feeds quiet, you have more chance of your little one settling off to sleep immediately after the feed. 6 months – 18 months Soon after 6 months of age your baby should be sleeping through the night without needing nutrition – this means 8-10 hours of uninterrupted sleep. If your baby needs a feed at 4am, do so quietly in her room. If your baby over 6 months of age still wakes for feeds frequently at night: Introduce or increase the protein in her day meals Offer a cluster feed or top up feed after bath Pat and sooth her back to sleep if before 12am Use white noise such as the Baby Sense Womb to World CD or MP3 Offer an iron supplement if she is anaemic You may need to break the habit, if your little one wakes repeatedly to snack on the breast throughout the night. Toddlerhood No night feeds are needed before 6am. If your toddler feeds at night, she is likely to be a fussy solids eater during the day. It is time to explain that she doesn’t need milk or you can say: “The Kitchen is Closed”. Keep the reason concrete and consistent. By Meg Faure

You have just dropped off to sleep and through a haze of dreams hear your baby cry out again for a feed. Your blood turns cold and you ask how is it possible and how long did she stretch this time. But you are up and awake and blearily stagger across to her to feed her. The big question is what is the best ‘night time feed strategy’ to ensure a calm feed, make sure your baby settles afterwards and to set the stage for good sleep habits later, once the night feeds diminish. There are a few critical elements of night feeds that can make the difference between a baby who settles straight back to sleep and one who fusses and niggles until the next feed is due. Do not wake your baby for night feeds. Common logic says if you wake your baby before 12 she won’t wake in the wee hours for a feed. While it may be true in the early days that a feed at 10 means she sleeps from 11 to 3am so that you are not up between 12 and 2 am, it frequently results in sleep disruption later on. By not letting your baby develop her own sleep patterns you may be facing a baby who wakes at night when older. Environment – A key to peaceful settling after night feeds is the environment. The night feed environment needs to be a dark and quiet as possible so that your baby only wakes sufficiently to feed and then is calm enough to fall back to sleep. Do not use a night light. Put a passage light on outside the room so you can see what you are doing but as far as possible don’t expose your baby to bright lights. Do not take your baby out of the sleep space Interactions Keep all interactions between 6pm and 6am muted. Don’t make too much eye contact, play with or stimulate your baby. As tempting as it may be to elicit that smile or little baby giggle, try to resist it. You want your baby to think that at night things are very boring and not worth being awake for. Try to stay awake for the feed. Feed your baby sitting up in a chair or at least sitting up in bed. In this way you stay as awake as possible and are conscious of how well your baby is feeding. Encourage her to feed well by waking her a little if she drifts off to sleep half way through the feed. If you feed lying down you run the risk of falling asleep and will wake wondering if your baby has fed for long enough or whether she has in fact been feeding well the whole time or if she will wake in half an hour hungry again. Burping When your baby is done with a feed, lift her and burp her for a very short time. Do not stimulate her when you do so. Firm, slow strokes of the back will get the burp up and keep your baby calm. If the burp does not come up within 5 minutes, put your baby down to sleep. The biggest cause of unsettledness at night is not a windy/gassy tummy, it is being kept awake in the middle of the night while mom pursues that reluctant wind. Changing nappy Do not change your baby’s nappy at night unless it is soiled. If your baby has only passed urine, leave the nappy for the next feed. Changing nappies wakes your baby up fully. Huggies have a really nice but expensive night nappy with extra absorbency. These nappies mean that more urine is held for longer periods and there is less risk of the nappy leaking at night. Use cheaper nappies during the day but invest in a really good nappy for night time. Afterwards After the feed and short burp time, wrap your baby and put her down. If she doesn’t settle to sleep immediately, keep your hand on her until she settles to sleep. The deep pressure will help to keep her calm. Instead of lifting your baby let her niggle a little with you are patting or holding her. If she is very unsettled in the middle of the night, place her in a sling and pace the floor in the dim light until she is asleep. Rescue The most important thing is that when she sleeps at night you sleep too! So as soon as she is asleep, jump back into bed, drink a big glass of water. If you don’t instantly fall asleep, take a Rescue Remedy tablet. Rescue is a wonderful natural remedy that helps you fall asleep with no negative affects to you or your baby. From a sensory perspective as well as from experience, this is the best road to sleep for you at night. The early days are completely exhausting and sleep is the supreme desire of most moms. Remember to keep perspective and know this sleep deprivation does end! By Meg Faure

Feeding and sleep are the two biggest subjects of infancy so it is no surprise that when it comes to getting a good night sleep, the issue of ‘when to feed at night’ is the most frequent question. When will my baby stop needing night feeds? In the early days your newborn needs nutritional support at night. She needs to feed almost as often at night as during the day. By six weeks old, most babies have dropped the evening feed and sleep for a good six hour stretch – so you can expect your 6 week old to wake for her early morning feed, just after 12. By four months old most babies are waking between 3 to 6 am for a feed only. Much to your horror, after four months old your baby may start to wake a little more frequently as a demand for nutrition increases. Shortly after six months old when your baby is on full solids (including protein) you can expect a ‘full night sleep’ again – 10 straight hours. Older babies and toddlers should not need any feeds in bed as this will disrupt their day appetite for ‘real food’ and may damage their teeth. If your older baby or toddler wakes at night, you can offer them water but avoid offering milk. Should I wake my baby at 10pm for a dream feed so that she doesn’t wake me at 2am? Simply stated, this is a bad idea. As much as 10 pm is more convenient for you, the same is not true for your baby. Babies develop sleep cycles best when left to establish them on their own. Linking sleep cycles is a critical skill. When you wake your baby at night, you disturb this natural development of sleep cycles and secondly you end up with a very sleepy feeder who may not feed well and then wake anyway at 2am. I often see babies who are waking habitually for a 10pm feed, simply because their mum woke them every night when they were young. How do I keep my sleepy baby awake for long enough to feed well? When Alex was a baby she was such a sleepy feeder. 5 minutes into a breastfeed, she would fall asleep. I would sing the old song: “Wake upsleepy dreamer, oh what fun it's been, for a day dream believer and a home coming queen” Of course it drove me mad because I knew that if she did not feed well at that night feed, she would wake a few hours later. The eternal challenge of a newborn – to stay awake for long enough to feed well when all this wonderfully sweet, sleep inducing milk is being consumed! Milk, especially breastmilk induces sleep. Breastmilk is full of Oxytocin, a hormone that has been associated with inducing sleep. The best way to keep your baby alert for a feed if she is a sleepy feeder is to talk to her, make her cool by undressing her legs and if necessary stroke her bare feet or cheek with a piece of wet cotton wool. Night feeds can be a real challenge. To summarize the top 5 tips for dream feeds: Do not wake your baby for a dream feed, unless told to do so for medical reasons Do not feed your baby while she is asleep, lying in her cot Undress her legs if she is too sleepy to wake adequately for the feed Expect to have to reintroduce one night feed between 4 and 6 months of age, especially if you are delaying introducing solids until closer to 6 months old. Do not offer milk feeds at night once your baby is on full solids Here’s wishing you and your baby, Peaceful Nights! By Meg Faure

Almost every mom’s greatest challenge is a full night sleep in the first year! We crave sleep and look forward to the day (or night) when we know no one will wake us at 2am for a feed, nappy change, cuddle or dummy! In an attempt to get a full night’s sleep, many a mom will look to formula feeds to help her little one ‘sleep through the night’. The big question is does breastfeeding negatively affect sleep? The answer is that how and what your baby is fed will affect her sleep BUT a breastfed baby can sleep just as well as any other baby. Here are the ways breastfeeding affects sleep: The breastfed newborn is more likely to fall asleep on the breast My newborn keeps falling asleep on the breast. Each time I feed her, she sucks well for about five minutes and then before I know it, she is away with the fairies - fast asleep. Not only is this frustrating as I wonder if she has got enough food to last her for the next three hours, but I am also worried that we are developing a bad habit of her always falling asleep on the breast. Please help. Milk of any sort induces sleep but breast milk is all the more likely to send your baby to sleepy land. The reason is that breast milk is full of Oxytocin, which this is one of those happy hormones that make you really drowsy. In addition, the work of sucking is a calming motion and many babies use sucking to fall asleep. So between the sucking, sweet taste of milk and the hormones, it’s no wonder our newborns fall asleep on the breast! The good news is that this is unlikely to result in poor sleep habits in a newborn because newborns do not have long term memory until around 4 months of age. To manage this concern as your baby approaches three months of age, rouse your baby as you take her from the breast. As you burp her, wake her up a little and then settle her into her bed so she can self sooth to fall asleep in this drowsy state. At around 4-6 months of age, your baby’s nutritional needs change and you may need to adjust your feeding pattern. My baby is 5 months old now and is breastfed, except for a single formula bottle feed, which she has at daycare at about 2:30 pm. She generally goes three hours between feeds, as she gets hungry and very cranky if we try stretching her between feeds. She has slept beautifully in a routine since she was about 8 days old, and goes to bed at approx. 6:30 at night. She used to sleep all the way through until 6 am, then the onset of summer turned it into 5 am, and now it's closer 4 am or even, like this morning, 3:30 am! She actually wakes us up with her babbling and crowing, which goes on for about 5 to 10 minutes, after which she gets bored, and starts crying. I then feed her and put her to bed (with some difficulty sometimes) until about 5:30 am when she wakes us in the same way. People are saying she's hungry - but she never appears hungry otherwise - what do you think is happening? At your baby’s age and without solid food in her diet, it is quite appropriate for her to be requesting a feed at night and so you are doing the right thing by breastfeeding her at night. When she wakes, listen to her ‘babbling and crowing’ and only respond once she is crying – this will give her the chance to resettle to sleep if she is able to. Encourage the use of a sleep soother and always have it available to her should she need comfort. Put her in a special night nappy at bedtime, as she may be waking because she is wet and uncomfortable. If you do have to feed her, keep it as business like as possible - no lights on, no nappy change and no chatting. Put her straight down after the feed and she will be more likely to go back to sleep with ease. If she starts consistently waking earlier and earlier, then introducing solids may be on the cards, so do ask your clinic sister for advice. Breastfeeding at night can become a habit that wakes your baby when he is past the age when night feeds are appropriate. My baby is eight months old and wakes up roughly every 2 hours. She is a very light sleeper and is woken up by the slightest sounds, like her dad’s snoring. She sleeps in her pram next to my bed as I only have one bedroom in my house. Once she’s up, she will only go back to sleep if I breastfeed her to sleep. I tried giving her water or juice to drink but she turns her head away and cries until she gets the breast. To be on the safe side, your doctor needs to rule out any medical problems that may be causing her to wake so frequently. Check with your well baby nurse that she is getting enough nutrition in the day, and then you will know for sure that she does not need feeding in the night. Night feeds for an eight-month-old baby should not be necessary. Until you are ready to take the step of no longer offering her a feed when she wakes, no sleep training will work, and she will never learn how to self sooth. Do not feed to settle her, no matter how much she is crying. Rather hold her, rock her (offer her sips of water if she has been crying for a long time and may be thirsty). It will take her a few nights to learn to fall asleep without a feed. When she is falling back asleep in your arms (without a feed), then start putting her in her pram when she is merely drowsy, but not asleep. Always pick her up and console her if she won't settle with a few pats and soothing words. Only put her back in her pram once she has stopped crying. If you want to change things, you have to follow through on this in a consistent manner. Try to focus on the positive benefits of teaching her to go to sleep on her own, rather than getting bogged down with your fatigue now. By Meg Faure

Reflux really does play havoc with our baby’s sleep and causes them to fuss more and may even result in feeding issues at times. Here are a few tips to help you cope with reflux: Occasionally reflux is related to lactose intolerance and it is worth just trying to rule this out. If you are breastfeeding, cut out dairy in your diet for a week and see if that helps. If you are using formula, try a lactose free or soya variety. Use the Losec as it really does help. Feed in a quiet sensory environment and keep your baby upright after the feed. Over stimulation causes increased likelihood of positing, as does lying horizontal. Raise the head of your cot mattress with a wedge and let your baby sleep on his tummy when you are around. • Make sure you stick to the awake time appropriate for your baby’s age as he may be over stimulated and thus not falling into a deep sleep. Don’t worry about holding your baby to help him sleep, you cannot spoil your baby at this age. But whenever he is comfortable enough to be put down, put him down to sleep. Once he is asleep use white noise and a weighted blanket to help him sleep a little deeper.

We frequently do see that the defrosted breastmilk is not happily taken and the reason is normally the defrosting method. My son is refusing defrosted breast milk, what now? We frequently do see that the defrosted breastmilk is not happily taken and the reason is normally the defrosting method. If breastmilk is defrosted too quickly by heat then parts of the milk sour before other parts are fully defrosted. If breastmilk is defrosted out the fridge too slowly it may also cause some souring if the room temp is too warm. The best way to defrost breastmilk is in small quantities in the fridge overnight and prior to feeding leave at room temp for 1\2 to 1 hour depending on how cool or warm it is. By Kath Megaw

Pediatric dietician, Kath Megaw has tips to help moms achieve their goals of breastfeeding: Research published in Pediatrics (June 5, 2012) shows that while 85% of mother intend to breastfeed exclusively for 3 months or more, less than 33% actually achieve this. Pediatric dietician, Kath Megaw has three tips to help moms achieve their goals of breastfeeding: Eating a healthy diet is vital to breastfeeding success. Sufficient food and protein foods like meats, chicken, eggs and beef will go a long way to ensuring an adequate supply of breastmilk. Demand feeding in the first few weeks will stimulate milk production and enough milk will settle your baby into a nice rhythm from about 6 weeks. Enlisting someone to help you and your baby latch properly in the early weeks will in 95% of cases prevent sore cracked and bleeding nipples. By Kath Megaw