Newborn Routine

I thought I'd write a little about our first week of Harper's life and what I did in regards to starting a routine. A lot of people think there is no point in trying to work on a routine at first, but I've had good results doing that with both kids now (wow, I can't believe I have two kids!). So, here is what I did:

Day 1: Breastfed baby as soon as possible (with a c-section this was about 30-45 minutes after they were born). My goal was to have them nurse at least 5 minutes on each side. Harper was a champ and nursed for 20 minutes or more on each side. I let her go as long as she could/would, figuring the stimulation was good for getting the milk to come in, and not knowing how much she would do later since newborns tend to crash into slumber land an hour or so after they are born.

Day 1-3: I fed Harper (and Z) on both sides for 10-15 minutes every three hours. If they woke up before three hours and gave the hunger signals (rooting, opening and shutting their mouth, licking lips), I would feed them sooner. Usually when they woke up before three hours, it was about 2- 2 1/2 hours. I focused on getting a good long feeding when I did feed them. Again, good for milk stimulation and for the baby, to get used to feeding a full meal (as opposed to a snack).

Approx. Day 3 or When Milk Comes In: When my milk came in (I actually used a pump to confirm, but that's probably not necessary. Usually you KNOW when the milk comes in, because it hurts, i.e., feels really full), I switched to feeding the baby on one side at a time. I aimed for 20 minutes or so, again, to focus on a full feeding. The advantages of using one side at a time are that it helps ensure the baby gets the full spectrum of milk goodness from the thin foremilk to the thick and creamy hindmilk. Also, it was helpful for me because with Z I got extremely engorged and it took almost a week to get better (where it wasn't painful pretty much all the time) and I had over productive or over active letdown. One solution for both is to feed every other side so that there is more time between feedings on that side, which slows down the production. Naturally, this wouldn't necessarily be the answer for someone who is having trouble with their milk supply, so be sure to talk to your doctor/nurses/lactation consultant.

Day 4 - 7: Still working on full feedings and aiming for 3 hour increments. I also picked my start time for the day and worked on getting the 3 hour increments started with that. There was a day or so I had to adjust the routine by increments to get there. That was especially necessary with Z who was very vocal about getting fed. Harper is more laid back and I have to mostly wake her up to eat, so it wasn't hard to let her sleep an extra half hour to get to the time I wanted.
Also, as always, watching for hunger cues for less than 3 hours. Especially in the first week, the baby should eat whenever they are hungry. The trick sometimes is knowing that they are hungry. I had a few times I fed Harper after only 2 hours. She ate okay, but not as much as usual. I think she was just needing soothing; she likes to suck, so the pacifier has been a help with that. She generally spits it out after a few minutes of strong sucking. Unless she starts working her mouth and fussing, I don't put it back in. I'm hoping this will help us avoid the baby crack issue Z had.

Post Day 7: At this point, I would probably be letting Harper go as long as she can at night. I'm waiting for her 2-week checkup this Friday to confirm she has gained her birth weight back. Then I'll go ahead with letting her go as long as she can, although probably not longer than 5 hours for breastfeeding reasons.
So far, I have let her go 4 - 4 1/2 hours in the middle of the night, but I shortened the interval on the feedings on either side to 2 1/2 hours so that I could land better on my 7am start time. As of now, Harper's routine is a feeding at 7am, 10am, 1pm, 4pm, 7pm, 10pm, 1am, 4am and back to 7am. Her sleeping is usually 1 - 1 1/2 hours after she wakes up to feed, for example, 8:15 or 8:30am for her first feeding of the day. This means she feeds for about an hour (which should be more like 45 minutes but I'm still working on that. She is a sleepy one!) and then is up for 15 minutes or so, depending on if she is giving me sleepy signals (such as yawning, blank stare in one place, etc.). Then, she sleeps for 1 1/2 - 2 hours.

Okay, so a typical feeding goes like this:
> 7am: Harper wakes up and we settle down to eat.
> 7:10am: after a good strong showing for ten minutes, Harper usually takes a break. I burp her and then she instantly falls asleep.
> 7:20/7:30am: I do all kinds of maneuvers to wake her up including rubbing hands and feet, changing diapers, sitting her up, taking off her clothing. This girl can sleep! She usually does 5 more minutes.
> 7:45am: I start to give up that she'll eat, so I get up to put her in a chair or change her diaper (if I haven't already). This is usually when she works on a poo. After that, I try one more time and she eats another 5 minutes or so.
> 8:00am/8:15am: Finish feeding and put her on a blanket or in a chair for some awake time. Z immediately jumps up to "entertain" her.

So, like I said, I'm working on making the feedings last only 45 minutes total including interruptions. And, I have to admit in full disclosure that I've let the start time for the day slip to 7:30am. It has been easy to switch her back to 7am when I need it, but I'm treading on thin ice, I think, with that one. So, starting tomorrow, I'm recommitting to the 7am wake time. Not picking a consistent start time for the day was a mistake I made last time.

Starting the Bottle: With Z, I started the bottle when he was 3 days old or so. With Harper, I waited more than a week, mostly because I just didn't get to it sooner. Both kids took well to the bottle, but I have to watch that they don't drink it too fast. Z was an epic hurler/spit up king. We fed him his first bottle and he drank it in about 4 minutes. We were pleased with our results. Then he spit it all back up. Harper is doing well with the bottle, but she did seem to have a little more gas with it, so we just have to watch that and burp her lots. Oh, and I tried to find a nipple that most closely resembled my nipple, which was a tip from a lactation consultant. And, I am very careful about getting the baby to have the right latch on a bottle just as on me. Don't want bad habits on the bottle coming back to bite me (kind of literally!).

Wow, that was a lot of info. Not entertaining stuff, but perhaps helpful for a new Mom out there somewhere. I remember feeling like no one ever gave me enough details with the questions I had. More on the aligning of Z and Harper's routine later.