New DCB (4mo) who honestly has had such a rough time in daycare- gets 4oz BM every 2hrs but DCP want her to eat, play, sleep. So then she ends up crying every single day exactly 1hr after the bottle & only ends up sleeping 25min a day because shes hungry again. I tried to talk to DCP about it & they insisted that this is her schedule & it works at home. So this week after trying to play, bounce, put down for naps etc (knowing she is still hungry) I finally just gave her a bottle & then about 30min later she was tired & napped for 1.5-2hrs. It was working!! Then today, Mom writes in her book, "I worry that if she gets used to eating every hour I will be in trouble with my supply as I am killing myself pumping 6x a day to meet her needs. But I also dont want her to be too hungry."

Should I just continue what is working here in daycare? Today I have been following/documenting their schedule & DCB is sleeping 15-20min. in hopes that they see that its not working here. I honestly feel like this is one of those situations where Mom thinks that supplementing formula = bad.

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***25min. per nap not per day!

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Maybe try giving her 5 oz. It may help hold her over.

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4 months- have they started cereal? 4 mo drank 4/ 4 oz bottles a day. Now he is almost 5 mo he still drinks 4/ 4oz bottles but also eats cereal am cereal/ veg for lunch. 4 mo he napped about an hour in the morning and 2.5hrs after lunch at nap time. Now he snoozes for 25-30 min in the am and naps 3 hours at nap time (sometimes a little longer)
I don't get the eat, play nap every 2 hours.... that means she is only getting cat naps.
I guess I would go with the feedings and schedule that works for you.
As far as BM quantity goes, I would suggest that adding cereal in would help. I would also give her the number of a local lactation specialist that can help her increase her milk supply. (had one mom that adding in a beer (dark larger) significantly increased her production- but I wasn't the one to suggest it the lactation expert did!)

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I agree with the eat/play/sleep, but she needs to eat more. Also, it doesn't have to be a LONG playtime. Eat 5-6oz, play 5 minutes, (even if it's reading to her) and then down awake but drowsy for nap.

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Feeding cereal and solids is not recommended before 6 months.

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I would do what work for the baby and I would tell mom what I was doing. Trying to keep the baby in a crazy strict schedule is insane, babies schedules change all of the time. I would also feed until the baby is full.

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OP here-

when she first started she was getting 3.5oz & then DCM upped it to 4oz. I forgot to mention that she has reflux & throws up a lot so I dont think DCM will give her any more or add cereal just yet

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4 ounces every 2 hours is a lot of food for a 4 month old, imo. Are you sure the baby is crying out of hunger or maybe it is tummy pains from over feeding. I would feed 4-5 ounces, play 30-45 minutes, lay down awake and sleep 1-2 hours, repeat. (just to add, that is a 3 hour schedule that I listed. 1.5 hours for feed/play, 1.5 hours for sleep. just estimates on the time, but that's the general idea)

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I have a 4 month old dcg who has 4 oz about every 3 - 3 1/2 hours or so. Sometimes she guzzles it and other times she shakes her head away telling me enough.

But... I also don't allow parents to tell me how to schedule our day. I gently encourage a schedule that works for my group. I always find with infants that the come in, play, have bottle, nap, wake up, play, have bottle, nap, etc. I generally find that what works in day care (with a lot more distractions!) is completely different than what works at home.

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Is she on medication for the reflux? I hate to see infants in pain because parents don't like to push meds

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DCB is on medication, but still vomits quite a bit. I just feel like if she didnt want the bottle she would refuse it. But she drinks every last bit. & when I was giving her the bottles back to back (after trying burping, changing, repositioning, & trying to nap) she would then sleep for 1.5-2hrs. But when I follow the schedule that mom is insisting on, the child spends a good portion of the day unhappy & crying.

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4 oz bottles every 2 hours is a lot of breast milk for a 4 month old. I would suggest using paced bottle feeding.

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My grandson is 3 months old, and drinks 4 oz every 2 hours. He's sleeping 10 hours at night, straight through, so maybe he's just hungrier during the day....it doesn't seem excessive to me for the 4 month old. I always just fed mine when they were hungry, and they stayed happy and slept well. That's what I do here, too. I won't let them go hungry.

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Some babies will eat and eat and eat, so it's not always hunger. I would increase the bottle to 6 ounces and see if she drinks it and then plays and naps for longer. Does she sleep through the night? If so, then like PPU said, she may be getting her calories only during the day. I think every baby is different, but I'm not a fan of the two hour feedings at this age, because it doesn't allow for a good solid nap time. For newborns, it's fine, bc they usually eat, look around for a minute and pass out. But for 4 month olds, I want them to eat and play (tummy time, lots of floor play, ect) and still have time for a solid nap of at least an hour. If they are on a two hour schedule, they get the nutriotion, but imo, they don't get the quality rest, so 3-4 hours between feeding allows for that balance to be had more easily.

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That is true about the naps. My gs does take a 2 hour nap in the afternoon most days. He wakes up starving, lol.

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I have always made sure to feed an baby something before they nap, otherwise you have the exact result you are dealing with. Not to mention an exhausted unhappy baby.

I always feed when they wake, some babies aren't as hungry, some are and I always feed at least a couple ounces before they napped.

If mom's supply isn't good enough, she will need to supplement with formula. Period. Most, not all, but most breastfeeding mothers, especially when they feed on demand not a schedule will always produce enough. If not then they need to supplement and I would require it.

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I haven't cared for one this little yet, my youngest so far have been 9 months old and my own children are teens, so I'm wondering what is the thought process in having the baby play between eating and sleeping? Thanks in advance!

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I know cereal is not recommended for younger than 6 months in normal circumstances. BUT if the child is vomiting up all that she ate, she probably is hungry...
When my son was an infant he had severe gerd and could not keep anything down. His GI had me begin cereal at 4 months and it decreased the amount of vomiting. If you mix cereal with the breast milk in the bottle, it will thicken it. ime it works, not only with my own child, but those I have cared for as well.
Ask mom if she would consider this/talk to the childs doctor.

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Is dcm concerned about the reflux or her supply? Depending on what dcm's concern is, is how I would handle this.

Supply?

I would explain to dcm what you have been doing (adapting with dcg to the schedule that you have found to be working for dcg while she is in daycare) and that it may require dcm to supplement with formula or talk to a doctor or lactation consultant about increasing her supply.

Medical?

I would require documentation and work with dcm and dcg to accomodate her condition with a schedule that is supportive of those needs.

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All of the pediatricians here start cereal at 4 months. WIC and the food program also start cereal at 4 months. So I generally have parents starting cereal at 4 months. I have only had one parent wait until the 6 month mark but it is a p/t child and mom was a dedicated nursing mom. But by 10 months this child was eating table food and weaned herself. Thankfully mom was ok with that.
So as much as I would love to have all breastfeeding moms who wait until 6 months- between the docs and WIC that rarely happens around here.
Poor baby on the acid reflux. I have had several of those over the years.

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It's just a means of developing a routine for babies. They wake up, eat food, play, then take a nap (sounds ideal to me). If you repeat this process on a 3 hour time frame, it helps them sleep through the night as well, because they are getting their calories during the day for the most part, so at night, you let them sleep and wake naturally. As they get older, they tend not to wake for feedings in the middle of the night.

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Food program allows cereal between 4-7 months but does not require it until 8 months. Next year it will change to required at 6 months.

I have a dcb that just turned 5 months, DCM and I feed dcb 7 oz per feeding. If I don't he does not sleep well since he is still hungry. He is not on cereal and as DCM wants to wait until 6 months, I support this. Dcb is bf.

I recommend reading Kelly mom.com, she has the best breastfeeding advice. How to pump more, when to pump, how much baby will need.......

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I don't work my scheduled to the parents. I work the child into my schedule. It is what works for the child and I here. If the schedule mom wants isn't working then you find one that does. From the gist I get its not the amount so much but rather that the child eats and then is expected to play/stay awake and then nap....which is near the next feeding and the child is hungry again. Your option is one of two things....change the schedule to fit yours and the childs needs OR mom will have to produce more. I dunno about feeding every hour but maybe upping the bottle to 6 oz might help or even supplementing with some formula in the breast milk. Sometimes you have to tweek things to make it work. Its not about the schedule at home. Its about YOUR schedule there.

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I have one with reflux whose doctor told them to measure a little cereal into the milk. Has that been discussed with your family's doctor?

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UPDATE:

Yesterday the parents told me that they ended up having to feed her more frequently over the weekend. So they saw what was happening here at home. Today I brought up cereal to the parents after sending DCB home because I was unable to console her yet again We do paced bottle feeding, & most days she doesnt throw up when shes here, but it does happen some times. The parents told me to do just do whatever is working, so that was a relief

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Sounds like a growth spurt and sorry mom I do what is best for the child.

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