Q: Our 6-month-old daughter now only breast-feeds for a few minutes at a time in the afternoon and evening and this makes her wake up three to five times in the wee hours to get her long feedings. I'm exhausted. She began doing this at 4-5 months of age. Her pediatrician suggested that I breast-feed her in a quiet room without distractions but that doesn't work.
The doctor is more concerned about her slow weight gain than her wake-ups. She was just under eight pounds at birth and has only gained six pounds, so he told me to give her cereal twice a day.
What else can I do?
A: If you were writing your own baby book, you could use your little girl as a classic example.
Once a child's eyes focus well and she's familiar with her immediate environment, the world begins to drive her to distraction. This distractibility usually kicks in around 4 or 5 months, occurs in the daytime -- when she can see everything -- and goes away after a few weeks, but in the meantime it can make a baby mix up her nights and days.
You can change her ways: When you feed her in the afternoon and the evening, find a dark, quiet place. Close the curtains and even move your chair in front of an open closet so she can only see boring overcoats, or throw a shawl over the two of you while she nurses, to get the day to look like night. Be quiet while she nurses and keep your eyes closed. The less eye contact she makes with you, the less she'll play around.
Your baby should get seven to eight nursings every 24 hours, for she needs more nutrition in her first year than she ever will again. You may be able to boost her intake -- and her daytime feeds -- by offering her the breast whenever she sucks on her fingers or a pacifier. Some babies get so busy they forget to nurse unless they're reminded. A little more weight also may help her sleep better. According to the American Academy of Pediatrics (AAP), most babies double their birth weight at 6 months and triple it in a year.
Although the AAP doesn't recommend solids before 6 months -- since a younger child is more apt to be allergic to a food or to digest it poorly or to spit it out -- your daughter will be old enough for fruits and vegetables as soon as she eats a total of a half-cup of cereal a day. Only try one new food at a time for five days, however, so you'll know if she's sensitive to it. She also needs plenty of fresh air and exercise to make her sleep better. Bicycle her legs every day and put toys near her -- but not too near -- so she will be tempted to reach and stretch and maybe crawl to get them.
To expand your parenting knowledge, check out "The Nursing Mother's Companion" (Harvard Common Press, $12.95), by Kathleen Huggins; "The Complete Book of Breastfeeding" (Workman, $10.95) by Marvin Eiger and Sally Wendkos Olds, and "Child of Mine" (Bull, $16.95), by Ellyn Satter. They're packed with good information.
Questions may be sent to email@example.com or to Box 15310, Washington, D.C. 20003.