When formula is life saving
Jenna was crying when I called her for her consultation.
She had just come back from the Doctors office, and had been delivered the blow that her beautiful 3 month old daughter Rosie, was still only gaining 50-90 grams a week.
Born on the 85th percentile, Rosie had dropped to the 5th percentile, and was being classified by her Dr as failing to thrive.
I listened to Jenna cry as she explained she had taken every herb available, she was pumping after each feed, despite nothing coming out. She was up feeding 2 hourly at night, and ensuring Rosie was at the breast at least 7-8 times a day.
Jenna told me how she felt like such a failure, she couldn't even feed her own baby, and on top of the stress of her daughter not gaining weight, she wasn't sleeping well.
This isn't surprising when you consider how closely linked feeding and sleeping are.
But isn't it crazy how much we blame ourselves for things which are entirely outside of our control?
We can't make our babies gain weight, yet we are riddled with guilt when they don't.
Jenna's Doctor had strongly suggested for Rosies health and well being, mum needed to start offering top ups of formula, and work towards getting 400-600ml of formula into Rosie on top of any breastfeeding she was doing.
We de-briefed and after a few deep breaths we had a plan.
Sleep couldn't be our main priority while weight gain was so low, but establishing a more consistent routine was a great place to start, while gradually increasing formula volume, and getting Rosie back on track.
After such a stressful 3 months Jenna was worried I would suggest we let her baby CIO, and there wouldn't be any options for her to improve the sleep, so she was relieved when I suggest we start by only working on her routine and not worry about settling.
Carry on rocking her to sleep........ words you would never imagine a sleep consultant would say.
I stayed in touch with Jenna over that first week as she increased the formula top ups, and Rosie was taking to the bottle.......like a hungry baby!
By the second week, Rosie was slipping into the nap routine I provided easily and the doctors were happy with the 210 grams she gained!
I was worried Jenna was becoming house bound, as she had spent so much time feeding and pumping over the last 3 months, and now with a new nap routine, I needed to show Jenna she could go out, and the wheels wouldn't fall off.
I challenged her to go for a walk for Rosie's 4.30pm nap each afternoon, and Rosie loved it. They left the house at 4.15pm and by 4.30pm Rosie was fast asleep, and Jenna was getting the exercise she had missed.
Next I explained how Jenna could take a bottle with her, and go to coffee group at 10.30am, she didn't have to stay home for all feeds anymore (no more pumping!). This went off without a hitch and Rosie still took her nap, despite only getting home at 12pm, after falling asleep in the car.
Jenna was relieved to see how she could have a life, and Rosie could still get her naps. A friend at coffee group had told her, the minute she booked a sleep consultant she wouldn't be allowed to leave the house anymore.
After 3 weeks, it was time to tackle the nights.
Despite 3 weeks of good weight gains, and formula volume increasing, Rosie was still waking 6 times a night, and this was becoming unsustainable for Jenna. She had realized that Rosie wasn't hungry at every feed, and was rocking her back to sleep several times a night, and offering a combo of formula and breast at other wake ups.
Jenna was worried I would suggest she drop all of Rosie's feeds now that she was close to 4 months old, and Jenna wasn't ready to night wean, she felt nervous and anxious about Rosie's weight gain, and she enjoyed the quiet breastfeeding at night.
But maybe we could ditch the rocking to sleep, and get a routine happening with these night wakes?
That's exactly what we did.
We worked on some gentle self settling to replace the rocking, and consolidated Rosie's breastfeed and random formula top ups into one full feed with a 150ml formula top up around 11pm.
Within 8 days Rosie was sleeping solidly, taking her feed and sleeping until 6.30am.
After nearly 4 weeks of working together Jenna decided to take a break and focus on enjoying what she had for a few weeks before she made a decision to tackle the naps or not.
Rosie was in a good routine, she was just being rocked to sleep, and often rocked back to sleep in her midday nap.
I heard from Jenna about 3 weeks later, Rosie was back up above the 50th percentile, but had become to resemble a bag of snakes when it came time to rock her to sleep.
With her new weight gains, came new strengths and new energy's, Jenna was ready to work on the naps!
We decided to use the same approach that Jenna has used at night for Rosie's naps.
Things were going well, and a week later Rosie was self settling for both her morning and lunch nap......BUT she wouldn't stop cat napping so the lunch nap was a hot mess, and there was no end in sight.
We chatted about the strategy and how gentle it was. The staying in the room with Rosie had been necessary for mum and baby a month ago, but now Jenna felt it might be over stimulating Rosie, especially as a re-settling tool, when bubs had already had a 45 minute sleep, and wasn't as tired as the start of the nap.
I couldn't agree more.
Could we switch techniques? Jenna inquired.
Yes! Don't think you are locked into the first technique you ever try, especially as bubs grows and develops and we change as parents. Making decisions based on babies temperament is ideal.
Thankfully getting out of the room and giving Rosie some space resulted in much LESS tears and after 3 days, a longer nap!!! 1.5 hours!
We were on the way to success.
This was a long journey for Jenna and Rosie, but starting formula, saving Rosie's life, then gradually improving her sleep couldn't be rushed, and shouldn't be rushed.
There is no ONE way or RIGHT way to improve your babies sleep.
The way that works for your family and your situation is the right way.