First 12 Weeks: Week 3–Transcription and Resources

March 13, 2021

First 12 Weeks: Week 3–Transcription and Resources

Hello and welcome. I'm Laura Ellis and this is week 3 in my First 12 Weeks Series. In this episode, in addition to briefly going over fact-based information about infant sleep, growth, and development, I will give you some tips and advice specific to infant feeding and introducing a pacifier.

Hopefully at this point baby has passed their birth weight and you’ve been given the go ahead to let baby sleep. If so, you’ll likely notice that they will cluster feed or have a handful of feedings throughout the evening right before bed. They will most likely have their longest sleep stretch of the night first and then they will likely wake up hungry every hour and a half to four hours until morning. This week they also might start sleeping a bit less—about 14-17 hours total in a 24 hour period. Before you get too worried, most often the added awake time is during the day. Their wake windows, or time between naps, during the day might be closer to an hour rather than 30-45 minutes and some of their naps might be a bit shorter.

Baby will probably be more awake and alert this week. This is a great time to start introducing more tummy time and play time in between naps. Their necks will be a bit stronger this week, and they will likely start to lift their heads a bit to look around some. From personal experience, I generally like to do the most stimulating activities during the morning and less stimulating activities in the late afternoon and evening. I feel like babies tend to get more overstimulated more quickly later in the day, but I don’t have any statistics to back that theory.

This is just my opinion and is based on anecdotal experiences, but I honestly love week three because I feel like this is the time we start to really see some of baby’s personality start to shine through.

One quick thing to note is that this week, you might see some baby acne. It’s completely normal. If you do notice it, just try to keep it clean with water. Unless directed by your medical provider, you shouldn’t treat it with any creams or ointments, and definitely don’t pick at it.

Now let’s talk about feeding. I want to start off by acknowledging that many of you probably have some strong emotions and beliefs around this topic. I’m not here to tell you what is right or best because both of those insinuate that there’s only one answer, and that’s simply not the truth. If you ever want to geek out over baby related statistics, one of my favorite baby books is “Cribsheet” by Emily Oster. In the section around breast/chest feeding she looks at the claimed benefits of breast/chest feeding and then really digs into the least biased research she can find, which is a lot more complicated than it sounds. At the end of her research, the only scientifically proven benefits she could find were as follows:

Short-Term Baby Benefits

Fewer allergic rashes
Fewer gastrointestinal disorders
Lower risk of NEC (Necrotizing enterocolitis—most common in very premature babies)
Fewer ear infections (maybe)

There were no long-term health or cognitive benefits for the child. Benefits for Mom were a lower risk of breast cancer, and benefits for the world was lower methane production from cows.

[Oster, Cribsheet]

Basically, when push comes to shove, the biggest scientifically proven, long-term benefit of breast/chest feeding is that the feeding parent is less likely to have breast cancer.

I think breast/chest feeding is amazing and I would very much encourage it if possible, but I also recognize that there are many reasons why your family may choose feeding alternatives. I’m here to support you and your journey, not judge the choices you feel are best for your family.

By the end of week two, if you’re breast/chest feeding, you should have a pretty good latch figured out. If this isn’t the case or if breast/chest feeding is painful, I would highly recommend reaching out to a Lactation Consultant and if possible try to find an IBCLC, which is an International Board Certified Lactation Consultant. They’re honestly so incredibly knowledgeable and will definitely be able to help you figure out what’s happening.

You may have heard the term “nipple confusion,” but I honestly think it’s more about preference than confusion for most babies. With breast/chest feeding, there’s not a constant flow of milk, and one of the techniques we can use when bottle feeding that helps mimic the flow of milk from breast/chest feeding is “paced feeding.” When using this technique, baby is more upright and the bottle is held flat so that the milk is only halfway into the nipple. This helps them better regulate how quickly they’re eating and generally seems to be less overwhelming for baby (though that is a personal observation). I also highly recommend starting with a preemie or newborn flow nipple. The slower the flow the more successful you’ll be, and it will be less impactful on breast/chest feeding. On my blog, I will link a YouTube video that shows and explains paced feeding a bit more in depth.

If you’re feeling hesitant about introducing a bottle, there are several options options available, but the two most common alternatives are cup feeding which involves holding baby upright and letting them lap milk out of a cup, and finger feeding that involves taping a tube attached to a syringe to the finger of the adult feeding baby and letting them latch on to the finger and tube to suck the milk from the syringe. I will also find videos of these techniques as well.

Pumping can add a whole other set of issues and concerns. Pumping can be used to try to increase your supply, however too much pumping can create an oversupply which can lead to complications like mastitis. This honestly is a great thing to discuss with a lactation consultant. Anecdotally, many of the parents I’ve worked with have tried to pump just after baby finished eating, and that seemed to work well for them. I also love the haakaa, which is a manual pump that can be used on the side of the chest that baby isn’t nursing on to express milk.

When shopping for a mechanical pump, it might also be a good idea to check your health insurance benefits. Sometimes a medical grade pump is available through your plan depending on your area and provider.

If you’re choosing to supplement with formula, it would be a good idea to discuss options with your medical provider. Some formulas are better than others. There are a few European brands that are fantastic, but they’re pretty expensive. The most important thing to know about preparing formula is that it’s important to use boiling water when preparing it because it will kill the bacteria that can be living in the formula container. Then it should be allowed to cool to body temperature before giving it to baby. Formula can be prepared up to 24 hours in advance, and there are small jugs specifically for formula preparation that make it easy to prep several bottles at a time.

This week your baby will likely be eating 8-12 times per day (or about every 2-3 hours) and they will likely eat 2-3 ounces or 60-90 mL per feeding. So if you’re preparing formula in advance, preparing 16 ounces should be a safe amount to start with to make sure you’re not wasting much.

When preparing bottles, I always recommend starting with less than you think baby will eat. It’s always easy to refill a bottle, but it can be really frustrating if you have to throw milk or formula out. Once baby has started drinking from the bottle, the food should be eaten or thrown out by the 60 minute mark.

If you’ve held off on introducing a pacifier because you wanted to get breast/chest feeding firmly established first and make sure baby is growing on a healthy curve, you most likely will be wondering if it’s worth introducing it at this point. I personally would encourage it because pacifiers might reduce the risk of SIDS. Babies also have a strong sucking reflex and it can be a great tool when they need to suck to help soothe themselves but aren’t necessarily hungry. I generally like introducing it after baby has eaten and when they’re starting to get drowsy. If it falls out of baby’s mouth when the fall asleep, that’s completely fine. If you’re in the room, feel free to remove it from the bed, but don’t feel like you need to put it back in their mouth. I personally like using it as a tool for when baby is ready to fall asleep, but that’s not a firm rule by any means.

Lastly, I’d like to take a minute to talk about hunger cues. Just like it’s easier to get a baby to sleep before they’re really tired, it’s a lot easier to get a baby to eat if they aren’t too hungry. If they’re giving late hunger cues, this isn’t the time to introduce a new feeding method, but if you see some of the first hunger cues or if they’ve just woken up in a good mood, this would be a great time to try out a new option. Early hunger indications include rooting, opening their mouth, turning their head, stirring, and sticking out their tongue. Midpoint hunger indications include stretching, movement, and putting their hands in their mouth. Late hunger indications include crying, agitation, and turning red.

So, that’s it! That wraps week three. For a transcript of this episode and a list of resources, please visit my blog, which is 40winksncs.blogspot.com. If you have any questions or comments, please reach out through my blog or on Facebook @40winksncs or Instagram @40winksnewborncare. I would love to connect!

In my next episode, week four, we will discuss the 4 week wellness check and soothing baby.

As always I hope you have a wonderful week and remember to give yourself some grace because we’re all here learning together.

Resources: Week 3

Lactation Resources

https://kellymom.com/ages/newborn/newborn-concerns/alternative-feeding/

Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, from Birth to Preschool (The ParentData Series)

https://www.amazon.com/dp/0525559272/ref=cm_sw_r_cp_api_glt_i_91MRCAFCFG987AWKFTRQ

Paced Feeding—Carolyn Honea, IBCLC, CLC

https://youtu.be/j3-cq5GdlJo

Cup Feeding—The LA Lactation Lady

https://youtu.be/X2t57eNGMEs

Finger Feeding