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Hello all,
We just had our first child 12 weeks ago and I am having to return to work two days a week. The first two days went well as far as the babe adjusting (and mom!) but we are having trouble with major overfeeding by the provider. She breastfed all her children and never used a bottle. She thinks that a baby cannot be overfed and I am having trouble encouraging her to stick to our schedule. I breastfeed on-demand while at home, but he pretty much has set himself into a routine of every 2-3 hours of feeding during the day. He eats around 8 times in 24 hours and the lactation consultant has estimated that he eats around 27 ounces in that time. The sitter watched him for nine hours this week and fed him 22 ounces of breastmilk!! She fed him 4.5 to 5 ounces every hour-and-a-half. She was reluctant to use the pacifier and said she thinks he is fine! I tried to explain to her that 1) that is too much food 2) I don't MAKE that much to support her overfeeding 3) If she overfeeds him when I am away, it negatively affects the breastfeeding by encouraging him to eat form the bottle instead of me. I really tried to get her to agree to TRY a schedule for a week and feed him every 2-3 hours of an appropriate amount, but she seems reluctant. I explained the importance of non-nutritive sucking and encouraged here to feed him around 3 ounces, then offer the pacifier, and offer the pacifier if he is fussy and just ate.
Any ideas or info that I can give to her that will get her to see that she is feeding him too much and that you CAN overfeed a breastfed baby with a bottle? Really want to make this work because they are awesome people and I feel really good about them watching our little one, but can't support the feeding schedule or keep making enough milk for that!
You are completely correct in all that you say. That is major overfeeding. For a breastfed baby, the rule of thumb is 1 to 1.5 oz per hour. For a baby that young, I would definitely keep the size of the bottles smaller too, like 2-3 oz at most. My daughter never took more than 3 oz bottles at daycare regardless of how old she was. Especially at that age, 5 oz is just not necessary. You don't want to stretch his stomach, because then he will need more milk per feeding to *feel* full, which just makes the overfeeding worse. But it also makes it hard on mom because you can't pump enough for that so you start supplementing bottles, and then baby wants that much at home when you are nursing and is unsatisfied at the breast so you start supplementing then too. It's a really easy downward spiral and is quite common. Or, if baby is getting all his milk in during the day, he won't nurse much in the evening when you are together - the opposite of reverse cycling. I would say to keep the bottles smaller, the nipples the slowest flow you can get, and offer a pacifier after feedings for comfort sucking. Also, I would recommend a baby carrier so she can wear him for comfort. He may just be missing mom and the milk is comforting. Encourage her to find other ways to comfort him. Sometimes it's hard for a nursing mama because nursing is our go-to way of comforting our own babies, so she may need some other ideas for comforting your son. A breastfed baby can comfort suck on the breast without feeding, but with a bottle they just keep eating and eating and that is why it is overfeeding.
Here is a link about how much baby should need while away: kellymom.com :: How much expressed milk will my baby need?
But bottom line - you are the parent and she needs to do what you want for your child. If she can't do that with feeding, then what else is going to be an issue?
I would explain to her that YOU ARE the parent and expect her to abide by your rules and guidelines. I understand that you don't want her to stop watching your child, but if she can't abide by this simple request, what will be the next thing she won't do?
Or you could try the route of "My pediatrician and I have decided on this plan and I understand you may not agree, but this is what the pediatrician has recommended, so this is the schedule we are using," as it sidesteps having to convince the sitter she's wrong and puts the onus of the disagreement on the ped, so she may be less likely to argue with you or take it personally.
I have used this strategy with unsolicited advice from persistent family members and have found it helpful, and my sister has used a similar strategy when her sitter was overfeeding my niece as a toddler.
I do agree with the other posters who note that YOU are the parent and the sitter needs to abide by your wishes for YOUR child, regardless of what she thinks would be more effective.
I agree with the other posters, if she is giving you a hard time about this you have to set your foot down now or she will continue to give you a hard time about other child care issues.
You are a new mom and I'm guessing not quite the outspoken type. Sometimes it takes us a moment to find our voice and speak up and say NO, ABSOLUTELY NOT, IT"S MY CHILD WE WILL DO IT MY WAY. THANK YOU. The sooner you find that voice the better for you and your child. You are just 12 weeks into motherhood at this point but trust me things like this will come up time and time again as you are raising your child and eventually you will need to speak up for your childs sake, save your self months or years of frustration and start now.
You don't have to a total b--witch about it but be firm and clear and don't leave it up for negotiation. I would also follow the advice of a PP who suggested you bring in all the bottles pre made so there is no confusion as to how much to give at each feeding, heck if you have a few minutes you can probably even label the bottles with the feeding times.
On another level, besides the over feeding I think I would start crying at the thought of all the extra milk you'd need to pump to keep up with her methods!! I always say, who ever said "Don't cry over spilled milk" never had to pump it themselves!!
If he is actually being overfed you would be seeing signs of it. He would be far more gassy than usual, spitting up more or even actively vomiting. He might even be quite irritable for no apparent reason. If he is showing these signs, then I'd discuss it with her to let her know this is what is occurring. I'd suggest telling her you want him offered 3-4 ounces every 2 hours to see if that changes his symptoms. I'd also suggest telling her that the doctor has suggested he use the pacifier in between feedings to also help with his sucking need.
However....having said that....
In my experience both as a nursing mother with my kids and as a child care professional, I believe there is really no good way to judge how much a nursing baby is actually getting while nursing.
Some babies are masterful at nursing and can pull out enough breast milk in 5 minutes to keep them full for 3 hours while others take 30 minutes to finish and be full for 3 hours. Every baby is different and the amount they get and/or need will vary widely.
The bottle nipple, on the other hand, is set for one flow type only and it doesn't matter how masterful the babe is at sucking, the nipple will only give what it is set to give.
We also know that a baby can definitely be more proficient in nursing than a pump will ever be. So however much is pumped does not necessarily correlate with what a baby may have gotten nursing for the same amount of time the pump is used.
That might mean a baby who drinks 5 ounces from a bottle in 15 minutes may actually be getting 8 ounces from the breast in 5 minutes because they are more proficient at the breast. It also means that a baby who drinks 5 ounces from a bottle in 5 minutes may only be getting 2 ounces from the breast in 30 minutes if they are better at a bottle nipple than the breast.
The bottom line is a baby drinking from a bottle with a provider instead of nursing with mom will often feed on a different schedule with varying amounts. Breastfeeding on demand means offering the breast for nursing and comfort and with you being away for many hours now during the day, his routine will definitely change.
As a comparison...the baby I currently keep would not eat more than 1 1/2 oz at each feeding and would never last more than 2 hours in between at 8 weeks of age while in my care, but he only nursed every 3 hours or so at home. My son on the other hand, would nurse every 1 1/2 hours but would down 4 oz from the bottle in 10 minutes and go for 3 hours in between at 8 weeks. Both very different schedules in nursing versus bottles.
HypoCore- I couldn't agree more with everything you posted! That is why this is so difficult. I know that I cannot really know how much he is getting from me when he breastfeeds. I also know that every baby is different! All that I can really go on is my instinct and his schedule at home. At home he never takes more than 3 ounces at a time from the bottle with my husband, and he rarely breastfeeds more than every 2.5 to three hours. He is, however, a muncher, and could hang out at the breast for 30 minutes just munching away! That is really all I have to solidly go on- but he has never taken bottles so frequently or in such large quantities with my husband. The sitter also stated that she gave him a bottle every time he fussed and never offered the pacifier or other methods of comfort! That is my main concern. My other concern is that when he came home, he screamed in a way I have never heard him scream before- he screamed for over three hours, ate minimally that whole night and next day, and woke up many more times than usual the next two nights with gas and discomfort (as judged by his sounds). We will see how it goes on Friday- I have typed up a guideline for what I would prefer, and some options if he gets fussy. I will give her what I feel to be an appropriate amount of milk and an emergency bottle- with instructions to call my husband to pick him up if she runs out. One step at a time! I expected that his routine might change in daycare- but I just don't feel good about 5 ounces every hour to hour and a half!
ICIBIU also guessed correctly at me being a new mom and not the outspoken type. My husband stated many of the same things that you all have and after having talked with the sitter at length, am typing up some information on bottle feeding as well as what I would *like* to see in terms of an amount of milk. I know that he may need more or less than I think, but I just really want to avoid another night like we had on Monday with the screaming and gas! Thanks to all for the input thus far and I will let you know how it goes.
If we do not get anywhere with the sitter- we may try having him stay home for a day with my husband and see what he does for him- that way we will better know how he responds when I am away, how he does with the bottle, and how much he eats. Thanks everyone!
HypoCore- I couldn't agree more with everything you posted! That is why this is so difficult. I know that I cannot really know how much he is getting from me when he breastfeeds. I also know that every baby is different! All that I can really go on is my instinct and his schedule at home. At home he never takes more than 3 ounces at a time from the bottle with my husband, and he rarely breastfeeds more than every 2.5 to three hours. He is, however, a muncher, and could hang out at the breast for 30 minutes just munching away! That is really all I have to solidly go on- but he has never taken bottles so frequently or in such large quantities with my husband. The sitter also stated that she gave him a bottle every time he fussed and never offered the pacifier or other methods of comfort! That is my main concern. My other concern is that when he came home, he screamed in a way I have never heard him scream before- he screamed for over three hours, ate minimally that whole night and next day, and woke up many more times than usual the next two nights with gas and discomfort (as judged by his sounds). We will see how it goes on Friday- I have typed up a guideline for what I would prefer, and some options if he gets fussy. I will give her what I feel to be an appropriate amount of milk and an emergency bottle- with instructions to call my husband to pick him up if she runs out. One step at a time! I expected that his routine might change in daycare- but I just don't feel good about 5 ounces every hour to hour and a half!
ICIBIU also guessed correctly at me being a new mom and not the outspoken type. My husband stated many of the same things that you all have and after having talked with the sitter at length, am typing up some information on bottle feeding as well as what I would *like* to see in terms of an amount of milk. I know that he may need more or less than I think, but I just really want to avoid another night like we had on Monday with the screaming and gas! Thanks to all for the input thus far and I will let you know how it goes.
If we do not get anywhere with the sitter- we may try having him stay home for a day with my husband and see what he does for him- that way we will better know how he responds when I am away, how he does with the bottle, and how much he eats. Thanks everyone!
Your answer is in the above post. What he was fed on Monday directly connects to how he was Monday night. Tell her what happened, how it affected you and what you suggest she do to help it not occur again.
Does she have a form that you fill out for her regarding preferred feeding instructions, napping schedules and diaper preferences? Does she provide to you a daily form filled out by her that tells you what he actually had/did in those categories?
If not, I'd encourage you to provide her with the first and ask for the second. If you want I can email you what I use if you DM me your email.
Having things in writing can be so very helpful on both sides, however I think you'll benefit more from filling out such a form than typing out what may come across as demands. None of us humans respond very well to demands....lol
I think that if the baby sitter is doing a good job, meaning that your kid is not in danger of being shaken, left alone, or put in the back of a pick up truck in a stroller, you are ahead of the game. Baby sitters are not always the "perfect" Mary Poppins that we may want...and if the baby is crying, and she is feeding the baby...or giving him a pacifier, that means she is taking care of him...meaning, you should be happy.
Time to give up some control here...if you want to control everything, quit your job, and stay at home with your child.
I personally, if I was a baby sitter, and a Mother like you, started giving me all kinds of grief...I would just show you the door...and believe me, it is HARD to find a GOOD babysitter...who actually cares for your child. She can easily find another baby to take care of...you can't find a good baby sitter that easy....
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