Wednesday, November 25, 2015

Bringing Baby Home: Goals for the First Four Months

When I was preparing to bring my second baby home, I sat down and wrote out a list of goals to help me get through the first four months (and beyond). The goals below are what I focused on, and having these decided ahead of time was very helpful! So if you're planning on bringing a baby home soon - especially if it's your second baby (hello Keri, Kaleigh, and JoAnna!) I think you'll find this helpful. Enjoy!

{ WEEK 1 }
goal: full feedings
Every baby is a sleepy nurser to some degree, so keeping a baby awake enough for a full feeding can be a real chore. Be prepared to really put in work. Ideas for keeping awake: change diaper, undress baby, gentle tickle, something cold briefly against their foot, sit them up. If you have older kids, plan ahead for a family member to take over the bulk of your responsibilities with the older kids for several days (even a week!) so you can put all the energy you can find into full feedings. I focused on this from the first feeding with both my babies and they naturally fell into a 2.5-3 hour feeding routine within 48 hours.

goal: full naps
This is really easy at first, because baby spends something close to 20 hours a day asleep. Most newborns have no trouble sleeping anywhere, but try to respect their slumber and set them up for nice, long naps with minimal disruption. If baby cries during a nap at this age, do respond. Check for dirty diaper, hot/cold, gas/burp before assuming it's hunger (especially if baby has just had a feeding). If baby only wants to sleep snuggled up with mom or dad at this age, go with it. Your goal right now is still just full feedings and full naps.

{ WEEKS 2 - 4 }
By now your milk should be in (if you're breastfeeding), and baby has likely fallen into a 2.5-3 hour feeding schedule with 8-9 feedings within 24 hours. Baby may have even condensed night feedings as they start to take more milk during the day. So the next goals are:

goal: eat wake sleep
As baby starts to spend a little more time awake toward the end of the first month, start to implement eating, wake time, and then sleep - in that order. These are called "cycles". It's okay if every cycle doesn't go in that order, but make this the goal. Avoid nursing directly to sleep unless it's a middle of the night feeding. Start keeping notes of when your baby eats, is awake, and sleeps. This will chelp when looking for changes in eating habits, assessing wake time needs, and keeping track of how many total hours of sleep baby is getting within a 24 hour period. You can follow along with what my two babies have done here: A Year of Babywise Schedules.

During this time is when I start waking baby to eat if it has been 3 hours since the last feeding. I am aiming to get 8-9 full feedings in baby's tummy within a 24-hour period, and baby's tummy can only handle so much milk at one time (usually 2-4 ounces). So I will wake to feed baby at the 3-hour mark even if they are still sleeping. If baby doesn't get all the ounces he needs during the day because he was sleeping, he will surely be waking at night to eat to make up for the lack of ounces during the day. For my babies, this also included picking a desired wake time in the morning and desired bedtime in the evening - and always aiming to anchor baby's day around those two feedings. Again, you can follow along with what my two babies have done here: A Year of Babywise Schedules.

goal: day vs. night
Babies are born with their days and nights mixed up. Make sure daytime feedings are done with the lights on and/or in a room with natural light coming in. The more daylight exposure during wake time, the better. At night time, keep feedings dark and boring. Dim lights, no chit-chat, minimal eye-contact. Just a snuggly feeding, and then back to bed. Put baby to bed for the night after the feeding that falls around 7-8pm; any feedings after that time should be considered nighttime feedings and should be boring.

A word about nighttime feedings: some people put their baby to bed after the 7-8pm feeding and then don't feed again until baby wakes for a feeding. Others sneak in and offer baby a "dream feed" between 10-11pm. A dream feed is done in the dark and the baby is woken just enough to take a feeding and then placed directly back in the crib after the feeding. Then they let baby sleep until he wakes naturally in the middle of the night for a feeding.

goal: pause
At this age, consider pausing a moment when baby cries during sleep. If you've given baby a sufficient feeding, changed diaper, burped, and put baby down to sleep in a safe place - chances are baby is just making some normal noises during sleep. Pause - and listen. Get to know the different cries your baby makes. Pausing will be super easy if you have older kids - most of the time you will have to pause before responding to baby because you'll need a moment to secure your other kid(s) before ducking into baby's room to assess his needs.

{ WEEKS 4 - 12 }
goal: sleep routine
Once feeding are established and you've gotten to know my baby a little better, implement a sleep routine that is done before each sleep. It can be very simple: dim the bedroom lights, close the curtains (make sure the room is black), diaper change, sleep sack or swaddle, sing baby a song while gently rocking to the point of drowsiness, and then place baby in their preferred sleeping place (crib, swing, rock n' play, etc) and then leave the room. Even if baby wakes a few moments later and refuses to sleep anywhere but your arms, all is not lost. Each time you do the sleep routine is one more chance you give baby to understand how the sleep routine works.

goal: progress through newborn sleep hierarchy
The newborn sleep hierarchy is:
  1. baby sleeping when she should (by any means necessary)
  2. in her own bed (or swing or rock n' play is okay too)
  3. and then falling asleep (and back to sleep) on her own
Once you've got a sleep routine in place, assess where you are at in the newborn sleep hierarchy. Expect to stay somewhere between step 2 and 3 for quite a while. It's a work in progress.

My experience with this: with my son, we did CIO at 7 weeks old to get him firmly on step 3. Despite it working, I regret doing that. I think I was too afraid of bad sleep habits that I led with fear instead of instinct. Hindsight taught me there isn't one bad sleep habit you can't undo later, and I wished I would have been less strict with him as a baby. With my daughter, I was very consistent with the sleep routine and we ended up only needing to do CIO one time (literally one night) at 6.5 months old.

{ WEEKS 12+ }
goal: get through 4 month sleep regression
After the 3 month mark I just work on maintaining the status quo until the 4 month sleep regression has passed. My only goal for the 4 month sleep regression is to not introduce new sleep props. I do not try to break baby of any "bad" habits during the 4 month sleep regression. So - if at 3 months baby will only nap or sleep in the swing, but baby is taking full naps and sleeping well in the swing - then the swing stays until the 4 month sleep regression is over! After the 4 month sleep regression, begin working on getting rid of sleep issues that will not work long term.
Two articles I like that have to do with 4 month sleep regression:

By this time, baby's tummy has grown and is increasingly able to handle more ounces at a time. Which means baby has begun condensing feedings (especially at night!) because they are taking more ounces with each feeding. You can confidently help baby move away from night feedings at this time, and also consider if their day time feedings can be farther apart as well. Your goal is roughly 25 ounces of milk within a 24 hour period. If your breast feeding and not sure how many ounces baby is getting, consider offering baby a botle of breastmilk at the 2nd or 3rd feeding of the day to see how much they are taking. Then pump your milk for that feeding to see how much you are putting out. Neither are a perfect representation of exactly how much baby is getting from your breast during a feeding, but it will give you a ballpark.

goal: wean from "dream feed"
If you are doing a dream feed (the 10-11pm feeding), you'll want to think about weaning baby from this around this time if your baby has dropped all other nighttime feedings. My preferred method for weaning is offering only one side for a week, and then dropping cold turkey. If bottle feeding, just reduce the bottle size.

goal: transition out of swaddle
Somewhere around 4 months old you'll likely want to stop swaddling. Baby is probably working on rolling over soon, and the startle reflex is mostly gone. Even if baby loves the swaddle, once they start rolling you'll have to ditch it anyway so might as well start now and be done with it by the time baby starts rolling.

These are the priorities I focus on for myself the first 3 months after bringing baby home:
  • milk supply: extra pumping session, managing oversupply, nursing issues, etc
  • healthy diet: lack of sleep and poor diet is a lethal combo for your emotional stability
  • water: if breastfeeding, 8 ounces with every nursing session
  • physical healing: let those birth wounds heal!
  • say "no" to literally everything: ignore texts, don't return calls, maybe don't even check your email...there is nothing more important during this time than getting yourself, your baby, and your family stabilized 
  • no additional chores: if you have older kids, this will almost take care of itself because you will literally have zero time for anything extra and will care 0% about doing any chores
  • rest whenever you can: duh - but seriously, do it
  • establish routines and rhythms: as dad prepares to go back to work, do a practice day where you see what it will be like without his help, and if you have older kids try to sit down and map out what your day will look like so there is some semblance of routine and calm for all the kids and you know where the trouble points will be (maybe the kids watch a little extra TV during this season so you can work on those full feedings with baby)

Hudson Baby Swaddle Blankets (way cheaper than aden + anais!)
Soothies (for sore nipples during early breastfeeding)

For a complete list of what you need to welcome baby home, I recommend checking out Lucie's List.

This post contains affiliate links.


  1. Thank you for this post! One question--could you expand on "managing oversupply"? I feel like that has been a big issue with both of my babies, and though I totally understood Babywise so much better with my second, we still had a lot of challenges, and I think it was supply related...trying to figure out too much/too and advice, or just experience would be appreciated!


    1. This may sound cliche, but it's truly my best advice: I suggest you get in touch with a lactation consultant (LC). I suggest finding an LC that is also a nurse (over a La Leche League volunteer - but those gals are helpful, too, if there are no nurse/LCs in your area). Heads up that most LCs and LLL volunteers are going to promote feeding on-demand and may have negative views on Babywise. That being said, a LC came to visit me in the my hospital room after I gave birth to my son, she was also a L+D nurse. Her and another nurse hosted a drop-in breastfeeding support group on the hospital campus once a week, and I was an avid attender. She knew all about my choice to keep my baby on a schedule and she completely supported me in that and figured out how to help me manage my oversupply within the parameters of BW. I totally lucked out with her!

      Not sure how old your LO is, but your supply should naturally settle down between 6-8 weeks PP. Around that time, you will stop being so engorged all the time, but still have plenty of milk to feed at each session. With my son, there was a period of time around 5 weeks where I only fed him from one breast at each feeding. That really helped me supply settle down. Then around 7 weeks I switched back to doing both breasts at both feedings. I would pump in the morning after his first feeding, and then pump again at night right before going to bed (started doing this once he had dropped the dream feed, so I would feed him at 7pm, put him to bed, pump at 10, and then go to bed myself).

      I had oversupply with my daughter as well, but not as much as with my son. Again, my supply predictably calmed down around 7 weeks, and I briefly did the one breast per feeding with her for about a week around that time. I didn't pump in the mornings with her simply because I had a toddler to wrangle, but again my oversupply also wasn't quite as outrageous with her. I would still pump at night before bed until we were done breastfeeding.

      Hope something in there is helpful!