When do I stop waking to feed?

[miso_soup]

Disclaimer: new anxious first-time mama here!

Dylan is 12 days old today, and feeding really well. A bit of background: he was admitted to the NICU for 2 days post-partum for elevated bilirubin levels and hypoglycemia - the jaundice made him VERY sleepy, and I literally had to wake him every 2-3 hours for the first 10 days or so to feed, and fight to keep him awake at the breast. His bili levels are now back down to normal, and his glucose levels have been absolutely fine ever since that initial dip on his second day (they monitored him in the NICU for a 24 hour period just on my breastmilk, just to be sure). My ped is happy with his weight gain (he's already 6oz up on his birth weight) and his health in general, as am I. All in all he's a happy, healthy baby

So my question is: given that I had to wake Dylan every 2-3 hours during the first 10 days or so of his life to feed him (including during the night), I'm not sure at what point I can let him sleep and wake ME when he's hungry? I honestly don't mind waking him to eat if it's necessary (even during the night, although the sleep deprivation is a KILLER - he's taken to cluster feeding from between midnight and 4am this last couple of days!), but I don't want to wake him if I don't need to. I suppose I'm a bit paranoid because of the glucose levels thing, and I don't want to leave it too long between feeds - but I'm honestly not sure what the best thing to do is here. To wake, or not to wake? At what point can I put my trust in Dylan to let me know when HE's hungry?

I'm aware it's probably different for every baby, but I'd be really grateful for any insight or advice from other breastfeeding mamas on this issue.

Thanks in advance!

[Llyra]

I have had three jaundiced, groggy, sleepy babies, so I know the dilemma well. Here's what I've come up with, with mine. I would wake a baby to nurse for these reasons:
1. baby is still under birthweight
2. baby is still less than about 6 pounds
3. baby is waking to nurse fewer than ten times in 24 hours, until about two months, and fewer than eight times after about two months old
4. baby has slept more than six hours at a stretch, before about four months old
5. baby is not wetting or pooping in reassuring amounts
6. baby is not gaining weight, or weight gain is far below the average
7. baby's bili levels are still elevated
8. I myself am engorged or uncomfortable, or prone to clogged ducts
9. baby isn't having any periods of active alertness during the day

If baby is back to birthweight, and gaining well, and the bili levels are back down, and baby is nursing well otherwise-- I would let baby sleep, and be thankful for whatever sleep I got.

Are you sleeping with him nearby? I myself found that the only way to survive the sleep deprivation, especially with my twins, was to learn to sleep through feeds. Learning to nurse side-lying can save your sanity. I used to just plug in the boob, and then go back to sleep, and the baby would nurse until he/she was done and let go and go back to sleep, and I'd never even notice. I think I got more sleep than they did, once I worked out how to do it.

[Parker'smommy]

I wouldn't let a baby that young go longer than 6 hours...but that's just me. I'm also worried about SIDS. I have a 5 week old and I'm waking her after 6 hours because studies have shown that babies that wake more often have a less chance for SIDS. That's just one of the reasons why breastfed babies have lower cases of SIDS - because they wake more often to nurse. Also, I'm ready to burst by 6 hours and I don't want to get a plugged duct. But I know all too well that this sleepiness will pass soon and I'll be up all night long at one point

[mom2happy]

I would say- that young if he is not waking himself, 4 hours would be what I would do. I agree that 6 hrs would be very long.

[miso_soup]

Originally Posted by Llyra

I have had three jaundiced, groggy, sleepy babies, so I know the dilemma well. Here's what I've come up with, with mine. I would wake a baby to nurse for these reasons:
1. baby is still under birthweight
2. baby is still less than about 6 pounds
3. baby is waking to nurse fewer than ten times in 24 hours, until about two months, and fewer than eight times after about two months old
4. baby has slept more than six hours at a stretch, before about four months old
5. baby is not wetting or pooping in reassuring amounts
6. baby is not gaining weight, or weight gain is far below the average
7. baby's bili levels are still elevated
8. I myself am engorged or uncomfortable, or prone to clogged ducts
9. baby isn't having any periods of active alertness during the day

If baby is back to birthweight, and gaining well, and the bili levels are back down, and baby is nursing well otherwise-- I would let baby sleep, and be thankful for whatever sleep I got.

Are you sleeping with him nearby? I myself found that the only way to survive the sleep deprivation, especially with my twins, was to learn to sleep through feeds. Learning to nurse side-lying can save your sanity. I used to just plug in the boob, and then go back to sleep, and the baby would nurse until he/she was done and let go and go back to sleep, and I'd never even notice. I think I got more sleep than they did, once I worked out how to do it.

Thanks so much for including your guidelines - they make a lot of sense to me. Dylan doesn't fit any of those criteria at present (sleeping 6 hours at a stretch? I wish!!!), so I have tentatively started to let him sleep a little longer before waking him. Last night, I set my alarm for a 4 hour stretch, in case he didn't wake within that time. Alas, he woke on the dot of two hours, then the next two, then the next two and so on. In fact, he seems unable to sleep for more than two hours without waking and feeding - even though his feeds are short (10 minutes or so)! I guess this is normal for a newborn, but I do dream of that elusive 3 hour nap!

Regarding sleeping with him nearby - I have an Arm's Reach co-sleeper, so he's right next to my bed. I just kind of roll him out of that and onto me when it's time to nurse. I haven't yet experimented with side-lying nursing, because he has a tendency to spit up a lot at present too, and I'm finding that nursing him in a slightly more upright position helps him to keep the milk down. Hopefully his nursing patterns will settle down a bit in the next couple of weeks, and I can begin to experiment with different positions.