Weird Medicine Healthcare for the Rest of Us

Note: I had canned this post as “too serious” until Dave and Casey had a baby, along with Brother Joe, Sister Dawn, and  pretty soon Travis and Lisa.  So I figured I’d go ahead and post it.   Back to testicles, warts, hemorrhoids, and eyeball injections next post 🙂  —Steve

When my wife and I had our first child, we took some classes and read a pile of books.  We found two things that really made a difference in our lives:  scheduling and swaddling (more on swaddling later).  When it was time to have our second child, we realized that we’d forgotten most of the things we did with our first baby (I say “we”, but my delightful spouse did the majority of the heavy lifting on this).  We made an appointment with a friend’s mother-in-law, Ms  Barker, who teaches a common-sense approach to baby care and feeding during the first year.  We picked her brains, took notes, and my wife wrote up this one-page baby instruction manual.   Ms Barker drew her inspiration from years of experience;  some of the wisdom here can also be found in expanded form in Ezzo’s “On Becoming Babywise” (see link below).

The logic behind this is simple:  a baby can relax if he/she knows what’s coming next.  Encouraging a baby to a schedule resuilts (most of the time) in a happy, well adjusted, relaxed baby.  If you’re into nothing but “on demand” feeding, this won’t be for you (and I’m a fan of anything that works…more power to you if you can pull off an “on demand” schedule!).  Interestingly, a lot of “demand” babies will put themselves on a schedule after a short time.  Babies crave predictability and structure.  A baby who never knows what’s coming will be a fussy baby.  If it’s feeding time and the baby cries, it’s pretty obvious that she’s hungry.  If you never have a  regular feeding time and the baby cries, you may never be sure why he’s crying without scrambling around with a trial-and-error approach.  That’s just too stressful for me.

Remember, these are just suggestions for getting your baby on a schedule.  Clear anything you read on the internet with your health care provider, and carefully assess to make sure any advice you read makes sense for you.  This schedule assumes a healthy, term baby, with no special feeding issues.  Babies raised on this schedule will normally be sleeping all night by week 6-9, with girls tending to sleep all night a little sooner than boys.

Sample Schedule

Important Notes To Remember: Keep the baby in a feed, wake-play, and then sleep order each cycle.  A 15-minute leeway can and should be observed when needed without any consequence. Remember to use your best judgment! This is not law; it is something to strive towards. Divide each cycle into two halves. The first half should involve feed and wake time. The second half should involve sleep time. A bedtime should be established very early on. 8 PM is a nice bedtime. The feedings after bedtime should be done with minimal lighting so that the baby is not brought to total alertness allowing for sleep to come back to him/her easier. The last feeding “tops the baby off” allowing for longer sleep time for baby (and family).

Remember to make sure that the baby is getting full feedings each meal. Watch out for snacking and using Mom or the bottle as a pacifier. Be careful to not let baby fall asleep while feeding.

Make sure baby is partially awake when you put him/her down. Babies need to learn how to fall asleep on their own. “Normal” times for baby to cry include: when baby is put down for a nap, when hungry/before feedings, and in the afternoon between 4 and 7. Try not to use sleep props (noise machines, night lights). The goal is to achieve natural sleep without crutches. Do not ever put baby down with a bottle.

SCHEDULE 1 – Birth to 6 weeks of age AND 9 pounds: This schedule consists of 3-hour cycles. Example schedule would be to feed the baby at the following hours: 7 AM, 10 AM, 1 PM, 4 PM, 7 PM, and 10 PM…baby may stretch out the middle of the night feedings to 2am/6am.   Work toward establishing a schedule similar to the above with one or two middle of the night feedings.  Let baby wake you up at night to feed, not going over 5 hours between meals if breast-feeding.

Natural fussy time for babies is late afternoon. It is fine if the baby doesn’t nap between the 4 and 7 PM cycle, or if he/she just takes a short nap.

SCHEDULE 2 – 6 weeks of age AND 9 pounds, to 12 pounds AND 10 weeks: This schedule consists of 3 ½ hour cycles except near bedtime (5-8 PM or 5:30 –8 PM cycle baby may not nap or may just take a catnap). Example schedule would be to feed the baby at the following hours: 6:30 AM, 10 AM, 1:30 PM, 5 PM, 8 PM, and 10:30 PM OR 7 AM, 10:30 AM, 2 PM, 5:30 PM, 8 PM and 10 PM.

Let baby wake you up at night, not going over 5 hours between meals if breast-feeding. The majority of babies will begin to sleep through the night during this schedule, meaning you can too (moms need to remember to watch their milk supply)!

Natural fussy time for babies is late afternoon.

The baby doesn’t need to sleep between the 5 PM and 8 PM feeding.

SCHEDULE 3 – 12 pounds AND 10 weeks to 14 pounds AND 4 months: This schedule consists of 4-hour cycles. (3 – 7 PM cycle baby may not nap or may just take a catnap) Example schedule would be to feed the baby at the following hours: 7 AM, 11 AM, 3 PM, 7 PM, and 10 PM Start baby on cereal (along with breast milk or formula) three to four times a day (discuss this with your baby’s doctor before starting cereal). When baby becomes well established on cereal, you can drop the 10 PM feeding. Most babies will sleep through the night without the 10 PM feeding at this point!

SCHEDULE 4 – 4 Months to 5 Months: This schedule is the same as the previous schedule (w/o 10 PM feeding) allowing for four meals a day, three of which will involve vegetables. Veggies are introduced here and given along with cereal and formula/breast milk. Start with yellow vegetables first introducing one new vegetable a week. After yellow vegetables have been well established move to green vegetables. Fruit may be introduced after both yellow and green vegetables have been well established. This will avoid a baby with a sweet tooth. You may also choose to wait until meats are well established before you introduce fruits. Limit fruit to one or two meals a day, only to be given after vegetables have been eaten.

Don’t fret if baby doesn’t like a vegetable the first time. Their tastes change and they may love it the very next day.

SCHEDULE 5 – 6 Months: This schedule begins with the previous schedule of four meals a day but ends in a transition into the family’s eating schedule (7 AM, 12 PM, 5 PM with a mid-afternoon snack and a 7:30 PM bottle). Once the baby is eating meat they will seem less interested in as many feedings. Meat is introduced in this phase and can be given at breakfast, lunch, and supper or at lunch and supper only. Meat is given with cereal, a green vegetable, and a yellow vegetable. Introduce one new meat to baby each week. When meat is well established the baby can be introduced to fruits, only after vegetables and meat have been eaten. Limit fruit to once or twice daily avoiding a sweet tooth.

As with vegetables, don’t fret if baby doesn’t like a meat the first time he/she tries it. Their tastes change and they may love it the next day.  Our kids hated meat the first time we put it in their mouth…the next day they were already used to it and loved it.

This will get you started!  Again, your doctor may have different ideas on when to start cereal, vegetables, and meats.  Whole cow’s milk should not be given until the first birthday;  use formula or breast milk instead.

Good luck and enjoy your baby!

Addendum:
Many people have asked me about Karp’s “5S” technique for calming a crying or colicky baby. This is a well-tried technique that can be found in “The Happiest Baby on the Block”; it attempts to reproduce the environment of the womb for babies under 3 months which almost always results in a calm baby. Here’s how it works:

Swaddle the baby tightly to reproduce the feeling of being in the womb
Put the baby on her Side on your knees (you’re sitting down of course) to reproduce position in the womb
Let the baby Suck on a pacifier or your (clean) thumb
Make a gentle Shusssshhing sound in her ear to reproduce the sounds of the womb (blood flow)
Swing your knees from side to side to reproduce movement in the womb

If this doesn’t work, it’s worth investigating why (dirty diaper, hunger, ear infection, etc).