This it is often a time of increasing stability and confidence for the parents. The baby will usually have reasonably stable sleep structures. In addition they are now old enough to handle more social interaction and travel. It becomes easier to recommence previous social and family interaction and responsibilities. Despite this the baby still responds well to an appropriate and reasonably predictable routine.
A common night-time program may be similar to this.
6.00 – 7.00 pm. Final feed completed and down to bed.
- From bed time on there is no contact until the rollover feed if it is still present. The rollover feedcontinues for many babies. A common question is when to stop this. While there is much variation, my rule of thumb is that. the rollover can be stopped once the child is on three meals of solid food per day where each meal is of approximately 1/2 cup in size.
- For those children who do not have a rollover feed and who continue to have a breast or bottle feed between 1 and 4 AM there is clearly a premium for the parents in deleting this as early as practical. Again for the majority of children this will relate to achieving sufficient daylight solid feeds.6.00 -- 6.30 am. (Type I waking).
- This is the first day feed.
- Make this a “full” feed which will usually be just milk.
- Put the child down as soon as possible and try to achieve a return to sleep. (This is referred to as the lastnight sleep)
- Occasionally some babies will wake fully and have a longer wake period. There is an advantage for themother in keeping this as short as possible.7.00 - 8.30 am. (Type II waking).
- As the children mature they are more likely to awaken at this later time. Some children will alternatebetween Type I and Type II waking; which is fine.
- For children who had a Type1 waking and then returned to sleep this will be their second day feed.
- Make this a “full” feed. This will be where the breakfast solids are given for most babies.
- This is followed by the first happy wake time (HWT) of the day. Please note that the HWT is still fairlyshort eg 30-45 – maybe 60 minutes after the feed has finished. Watch for the early signs of the ‘beginning of the end’ of the happy wake time. If the waking time goes too long the baby will have increasing amounts of trouble achieving sleep because of over - tiredness
During the day there are three day sleeps (if we have a perfect outcome.)
- 1. The first day sleep will often be early am e.g. 9 to 9.30 am. (Note that this sleep starts usually within about an hour of waking.) This sleep will be ideal if it is 2 to 3 sleep cycles long e.g. 90 to 150 minutes.
2. The second day sleep is early PM e.g. 12 noon to 1 pm . Again this is often 2 to 3 sleep cycles long. 3. The third day sleep is a ‘pre-dinner nap’ and may be 30-45 minutes and will often exist at 4 to 5 pm.
Milk is the main source of nutrition. Solid food is becoming increasingly important. During the day plan to feed solids at breakfast, lunch and dinner by five months. There is much variation between children as to the speed which with which they move from 1 to 2 to 3 feeds. There is also much variation in the volume of food which is consumed. A slightly simplistic statement which I have found useful is "a baby eats for the adult they will be rather than the baby they are". Thus as a rule of thumb a boy with tall parents and relatives may eat with remarkable vigour even by 4 or 5 or 6 months. Conversely a girl who is genetically going to be petite may have a much more relaxed and less demanding approach to solid food. It is important to allow the child to guide you with regard to volumes. A common area of concern is overfeeding. It is not my experience that children overfeed. If food choices include breast milk, formula, mixed vegetables, mixed fruits, cereals appropriate for babies and a range of other appropriate pre prepared foods my experience is that there are not later problems with obesity. The one exception is where the choice of foods is inappropriate. High sugar and high fat foods are inappropriate. Children can be quite "round" at this age and be tall and slim by two years of age. You can be flexible about whether you give milk or solids first from 5 – 7 months. Some children expressed a clear preference. By 7 months solids are first for many children.
Silent Nights by Dr Brian Symon