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Should I Wake My Infant to Nurse?

baby's head held in mother's hand drinking bottle

Q. Sometimes I have trouble getting my 1-month-old to wake up to nurse, especially in the middle of the night. Is there something wrong, or is this normal baby behavior? And how do I know that he's eating enough?

A.Your experience is quite common. Another mom recently told me how challenging it was to feed her 3-week-old in the middle of the night. One time, her husband turned on bright lights and covered their daughter's legs in cold washcloths in a desperate attempt to awaken her to nurse. They were both sure she'd starve to death if she wasn't feeding on schedule. These attempts, though well-meaning, were unnecessary. Today, their daughter is a healthy 3-year-old.

Here are some reassuring facts. A 1-month-old should eat every two and a half to four hours. If a baby this age misses a feeding, he'll likely make it up at the next one. You can also gauge your child's food intake by making a diaper count; if your baby is wetting six or more diapers each day, he is probably getting adequate nutrition. Frequency of bowel movements is more varied: anywhere from one bowel movement with each feeding to as few as one every 48 hours is normal.

If your baby's pattern falls within these general ranges, and he is alert, responsive, and feeding vigorously when awake (and is steadily gaining weight), he is most likely doing fine. But if you notice a low diaper count, or several missed feedings in a row, or if your child seems very lethargic, call your doctor.

Keep in mind that a young baby's feeding and sleeping schedule will change from day to day as he begins to figure out day and night. You may find that this week your son isn't interested in nursing, but next week he is waking up every two hours on the dot. This variability is normal. Young babies should be fed "on demand," when they indicate they're hungry, so hold off on any sleep training and try not to have any firm expectations about feeding schedules until he is about 4 months old.

Over the coming weeks, as you get to know one another even better, you and your baby will eventually find a schedule that feels comfortable and familiar. Finally, keep in mind that as your baby becomes more alert during the day, this problem often subsides on its own.

Claire Lerner, LCSW, is a child development specialist at Zero to Three, a national nonprofit promoting the healthy development of babies and toddlers (zerotothree.org).

Originally published in American Baby magazine, March 2005.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.