How About a Schedule

To have a schedule, it's the thing we all want when we have a baby. A schedule fills many needs. It gives us a much needed sense of order and control…something we are desperate for when our world has suddenly and completely turned upside down, and it gives us a sense of competency, when most of us feel like we have no idea what we are doing when we take our first baby home. Here's the truth, the vast majority of babies during the first twelve weeks of life are not on a schedule…at least the kind of schedule as most adults would define the word.

I said "majority". There are a few lucky parents out there who happen to have a baby whose temperament is such that they are naturally scheduled. Good for them. They are the lucky minority. Most parents will need to learn to adjust to the unpredictability of the newborn period. This can be a challenge, but it's a challenge that you as parents will need to master as opposed to expecting your newborn to master being put on a schedule.

Typically, the first 6-8 weeks of life babies will often have their days and nights mixed up, meaning they spend more time sleeping during the day and more time awake at night. Parents will often try to keep baby awake more during the day, with the logic that s/he will then sleep more at night, though this often backfires into a cranky, overtired baby. It's better to just keep daytime noise/light as normal, and to try and minimize light/interaction during nighttime awakenings. Parents find the use of a nightlight to change diapers to be helpful, so as to minimize stimulation during these nighttime awakenings as much as possible.

When it comes to sleep, there is wide variation as to when babies master sleeping through the night, which is defined as sleeping a 5 hour stretch uninterrupted. Just so you know, if your baby goes to sleep at 8pm and wakes up at 1am, he has slept through the night. So when someone asks that question that all parents of newborns get asked, you can say "Yes" your baby is sleeping through the night. (Even if you are up at 1am!) I know that most parents are really looking forward to "sleeping through the night" as defined as something more like 10pm-5am but you may need to adjust your expectations, at least until the fourth month of life when you can begin to consider options around sleep training.

As for feeding schedules, breastfeeding guidelines are clear. Babies should be fed on demand. This is good advice for babies who are formula fed as well. Any books/advice to hold off on feeding a baby who is showing signs of hunger in order to get baby on a regular feeding schedule should not be followed.

Feeding cues are

• Making sucking motions
• Arching the back
• Stretching the arms/legs
• "rooting motions"
• Uttering of sounds
• Eye movements under the lids
• Restlessness or slight fussiness
• Crying

When parents leave our postpartum units we counsel them to make sure to feed baby 8-12 times every 24 hours and to keep a feeding and diaper record so as to ensure that baby is getting enough to eat. If your baby is not producing the requisite number of diapers, call your pediatricians office. If it is on the weekend or outside of regular business hours, parents should have the on call pediatrician paged.

Ask any breastfeeding mom of a newborn and she will tell you that it feels like all she does is breastfeed, and there is no schedule. That's because in the early weeks, babies are not yet efficient at nursing and they get tired easily. They are also building mom's milk supply and go through frequent growth spurts.

However, all is not lost when it comes to schedules. My point is more to adjust your expectations and definitions, and don't judge yourself as failing if you don't have a schedule, because the truth is most babies are not on any regular set schedule during the first four months of life. You can however look for a pattern that may follow something like: baby wakes up, baby eats; baby is changed/plays/is held and within 1.5-2 hours of being awake is ready to fall asleep again. Newborns typically sleep best for naps and nighttime sleep when they are swaddled, so after your baby has been awake for 1.5-2 hours try putting him/her down to sleep again. This is a loose kind of schedule that seems to work well for many babies and is something you can try and apply to your little one. If it doesn't work so well, don't worry most babies' start to settle into a more predictable pattern at around 5 months of age all by themselves. Though fair warning, babies grow and change constantly especially during the first year, and so do their "schedules"!