Question:

My husband and I are expecting our second child. Our first, a healthy wonderful seven-year-old daughter is a Babywise baby. To this day, she has a great sleep schedule. Thank you for helping us teach such wonderful sleep habits that she is obviously still using after all this time!

Problem: I am not going to be able to breast feed this baby due to medical reasons. We want desperately to use the Babywise principles again with this baby; however, the book does not touch much on how best to do the schedule if using formula. It has been so long since our daughter was born and although I have read the book again, I am finding myself a bit overwhelmed. I want to make sure I feed far enough apart (but not too far apart) and yet, not sure if the hour awake and back down to bed after feeding is still correct for a bottle fed baby. Any advice would be greatly appreciated.
Answer:

There is great news for you. Applying the main principles of Babywise to formula fed babies is the same as for breastfed babies. About the only differences are, first, you know exactly how much baby is eating at each feeding and the second difference occurs when a breast fed baby goes through a growth spurt or begins to drop feedings and the concern here is more for mom than baby. A breastfeeding mother needs to give her milk production a chance to adjust when adapting feedings during the day to accommodate growth spurts or to dropping feedings (like when the middle of the night feeding is dropped) before dropping another feeding. Whereas a formula fed baby can move right along with what he is ready for by adding a few more ounces to his bottle.

The big key to using these principles with formula fed babies is not to try to rush the routine too quickly. When using formula, it is easy to fall into a routine of feeding every 4 hours at a very young age because baby is capable of eating enough to sustain him for a full four hours. However, like his breastfed counterpart, he is only able to handle fairly short wake times during those early weeks followed by a good 1 1/2 to 2 hour nap. By rushing the routine too quickly you can find a pattern developing that looks more like feed/wake/sleep/wake/feed. Baby wakes from a nice long nap, it’s been a good 3 hours since the last bottle but because he ate so much at the last feeding he’s not hungry yet. By the time he is hungry it’s time for the next nap and he’s likely to fall asleep at the bottle. He takes another nice nap but when he wakes it’s only been 2 hours since the last feed! If formula is offered, he’s probably not that hungry, but may take a little, and then he is ready for his next nap, falling asleep without adequate intake. The result, he wakes half way through the nap hungry. If a bottle is offered, he’ll take a little only to fall asleep at the bottle. Now you’re getting into a wake/eat/sleep pattern and the bottle can quickly become a sleep prop. See the problem?

To avoid this, work on keeping his routine at eat/wake/sleep. Put him down for a nap before he starts to get overstimulated so that he learns to put himself to sleep and learns to sleep a full 1 1/2 to 2 hours. When he wakes, feed him. If he has been eating every 4 hours, you’ll probably find that he won’t take as much as he had been, but if you add up all the ounces at the end of the day, should work out to be much the same.

As for the late night feeding: following the normal eat/wake/sleep cycles through the day, this feed should fall around 10:00 PM or so and will be the last feed of the day that you would purposefully wake baby for. However, if the timing is around 8:30 or 9:00 PM, then you may want to offer another ounce or two at around 10:30 PM or 11:00 for the last feeding of the day. To help determine the timing of the late night feeding, decide on what your goal for a morning wake time is and count back 8 or 9 hours. For example, if the goal is a morning wake time of 7:00 AM, that late night feeding would fall between 10:00 to 11:00 PM. For a baby receiving formula, it is still important to keep this late night feed until he is sleeping through the night. Better to drop that 3:00 AM feeding first than the 11:00 PM feeding!!!

The key to stretching time between feedings is based more on the baby’s capability of handling longer wake times and taking good naps, than it is baby’s ability to go longer between feedings. In the process of spending time loving and becoming a student of your baby, you will be able to discern how long he is able to stay up without becoming over stimulated :-)