Getting Started: Guidelines for Different Ages

The Baby Whisperer Solves All Your Problems
by Tracy Hogg, Melinda Blau

(Page 2 of 3)

Establishing a routine for the first time gets a bit harder as the baby grows, especially if you've never had structure. And because my first book concentrates mainly on the first four months of E.A.S.Y., some parents of older children find themselves at sea. At least half of my queries come from parents who have either tried another, less structured method, such as "on demand" feeding, or followed a different type of routine and found it lacking. Then they discover E.A.S.Y., and they wonder how to get started.

E.A.S.Y. is different with older babies, and on pages 39-46, I lay out a day-by-day plan that works with babies four months or older. Granted, babies' challenges don't necessarily fall into neat categories. As I explained in the Introduction, I have found that certain concerns seem to crop up in particular age groupings. In this review of E.A.S.Y., I will focus on:

Birth to six weeks
Six weeks to four months
Four to six months
Six to nine months
Nine months and beyond

I will offer you an overall description of each stage, plus a list of the most common complaints and their probable causes. Even where the complaints seem to center on a feeding or sleeping issue, at least part of the solution always involves establishing a structured routine if you don't have one, or tweaking the routine your baby is already on. The numbers in parentheses in the "probable cause" column indicate the pages in other chapters where you'll find more detailed explanations about what to do (so as not to repeat the information).

No matter how old your baby is, it's a good idea to read through all the sections, because as I will remind you repeatedly, you can't base strategies solely on age. Children, like grownups, are individuals. With a six-month-old baby, we sometimes see the same issues that crop up with a three-month-old baby, especially if the child has never had a routine. (Besides, if I don't constantly reinforce this point, I'll get letters from parents when this book is published, saying, "But my baby is four months old and she's not doing what you described...")

The First Six Weeks: Adjustment Time

The first six weeks is the ideal time to start E.A.S.Y., which generally starts out as a three-hour plan. Your baby eats, plays after his feeds, you then set the scene for good napping. You rest while he rests, and when he wakes up, the cycle starts again. But the first six weeks is also a time of huge adjustment. Your baby once lived in a cozy, climate-controlled place where he ate twenty-four/seven and dined in the seclusion of your uterus, and now he's been thrust into a noisy home with people bustling about. He is expected to get his nourishment from a nipple — yours or a bottle's. Life is dramatically different for you, too. Especially if you're a first-timer, you are often just as confused as Baby! And if it's your second or third baby, you probably have his siblings underfoot, complaining about that crying blob who's suddenly monopolizing everyone's time.

The baby doesn't have much control over anything at this point except his mouth, which he uses to suckle and to communicate. His existence is all about eating and suckling and crying. Crying is his voice, his only voice. The average baby cries somewhere between one and five hours out of twenty-four. And to most new parents, every minute feels like five. (I know, because I've asked parents to close their eyes while I played a two-minute tape of a crying baby. Then I asked them how long they thought they had been listening. The majority thought it was two to three times longer!)

We should never ignore a baby's cries or, in my opinion, let him cry it out! Instead, we always have to try to figure out what he's telling us. When the parents of young infants have problems with E.A.S.Y. it's usually because they're misreading their baby's cries. It's understandable: Here's this little stranger in your midst whose only language is crying, a lingo you don't speak. It's hard for you — a foreigner — to understand what he means at first.

Crying often peaks at six weeks, by which time observant parents have usually learned the language. Paying close attention to the baby's movement, they often act before the crying starts. But they also know what a hungry cry sounds like — a slight cough-like noise in the back of the throat, short to begin with and then as a more steady waa, waa, waa rhythm — compared to an overtired cry, which begins with three short wails, followed by a hard cry, then two short breaths and a longer, even louder cry. They also know their particular baby — after all, some are less vocal about their hunger than others. While some infants only fuss slightly and "root" or curl the sides of their tongue, others become absolutely frantic with the first hunger pang.

If you put your baby on E.A.S.Y. straightaway, I guarantee you'll learn her cues more quickly and be better able to determine why she's crying. Looking at your daily chart will help. Let's say, for instance, that she fed at 7 A.M. If she starts crying ten or fifteen minutes afterward, and you can't calm her down, you can be fairly certain it's not hunger. More likely, it's a digestive issue (see pages 109-115), and you know you have to do something that will calm her — not give her more food, which would only make her more uncomfortable. On page 26, you will find the common complaints.

E.A.S.Y. by the Pound

When the parent of a baby under six weeks has trouble with E.A.S.Y. I ask: Did you have a full-term pregnancy? Even if she says "yes," I ask: What was your baby's birthweight? E.A.S.Y. was designed for an average weight newborn — 61/2 to eight pounds — babies who generally can last three hours between feeds. If your baby weighs more or less, we have to adjust accordingly. As the "E.A.S.Y. by the Pound" chart on page 29 indicates, with an average-weight baby, feeds generally last twenty-five to forty minutes (depending on whether they're breast- or bottle-fed and whether the baby chows down or grazes at a more leisurely pace). Activity time (which includes a nappy change) is thirty to forty-five minutes. Sleep, allowing fifteen minutes or so for the baby to drop off, is 1½ to two hours. Such a baby would be fed at, say, 7, 10, 1, 4, and 7 during the day, as well as 9 and 11 in the evening (a strategy that helps eliminate the 2 A.M. feed; see "Tanking Up," pages 93 and 195). These are suggested times only. If your baby wakes up for his lunchtime feed at 12:30 instead of 1:00, feed him.

Babies who weigh more than average at birth — say eight to ten pounds — often feed a little more efficiently and take in more food at each feed. There's more weight on them, but you'd still keep them on the above three-hour routine. Age and weight are different things — a baby may weigh eight pounds or more, but developmentally he's still a newborn who needs to eat every three hours. I love to work with those babies, because I can get them to sleep longer stretches at night within the first two weeks.

However, some babies, because they're either premature or just smaller babies, weigh less at birth. They're not ready for the three-hour E.A.S.Y. plan. When parents bring them home from the hospital and try to put them on an E.A.S.Y. routine, the usual complaint is, "I can't get her to do even twenty minutes of activity time" or "She falls asleep during feeds." They want to know how to keep her awake. Simple. You don't — at least not for activities. If you do, you'll overstimulate her, and she'll start to cry. As soon as you calm her down, she'll probably be hungry again, because she's been crying, which uses up energy. And then you'll be utterly confused about her cries. Is she hungry? Tired? Gassy?

At night, smaller babies can only last four hours max at first, so they generally have to feed at least two times a night in the first six weeks. But if they go only three hours at a time, that's okay, too. They need the food. The fact is, you want little babies to eat and sleep a lot in the beginning, because you want them to get fat. Think of baby pigs who eat, snort 'round a bit, and then go back to sleep. All baby animals do that, because they need to gain weight and conserve energy.

If your baby is less than 6½ pounds, put her on a two-hour eating schedule at first: Feed for thirty or forty minutes, reduce the activity time to only five or ten minutes, and then let her go to sleep for an hour and half. When she's up, don't expect her to coo and goo at you — and keep stimulation to a minimum. By being fed every two hours and getting the sleep time she needs to grow, she will definitely gain weight. As your baby starts to put weight on, she will probably last longer between feeds, and you'll be able to keep her up a little longer, gradually extending her activity time. Where she could only sustain ten minutes up when she was first born, when she's 6½ pounds, she can stay up for twenty minutes and by seven pounds as long as forty-five minutes. While she's putting on the weight, you'll gradually lengthen the two-hour routine, so that by 6½ or seven pounds, she'll be on the three-hour E.A.S.Y. plan.

Six Weeks to Four Months: Unexpected Wake-Ups

Compared to the first six weeks at home — the classic postpartum period — during the next 2½ months or so, everyone starts to be on a more even keel. You're more confident, and, we hope, a little less harried. Your baby has put some weight on — even low-weight babies have often caught up by now — and is less likely to fall asleep during her feeds. Her feeds are still every three hours during the day, stretching a bit longer, though, as we get closer to the four-month mark (at which point they'll be every four hours; see the next section, page 33). She is able to sustain longer activity periods and is probably sleeping for longer stretches at night, too, say from 11 P.M. to 5 or 6 A.M. Her crying, which probably peaked around six weeks, now slowly starts to decline somewhat over the next 2½ months.

Here are the complaints I generally hear at this stage:

Common Complaints	Probable Causes
I can't get my baby to sleep more than three or four hours during the night.	She may not be getting enough food during the day, and you also might need to "tank her up" before bedtime (pages 93-94 and 195).
My baby was sleeping for five or six hours during the night, but now she's waking up more frequently, but always at different times.	Your baby is probably having a growth spurt (115-119 and 197-199) and needs more food during the day.
I can't get my baby to nap for more than ½ hour or 45 minutes.	You're probably misreading his cues and either not getting him to bed when he first shows signs of fatigue (181), or you're going in too soon when he first stirs, which doesn't give him a chance to go back to sleep on his own (189-190).
My baby wakes up at the same hour every night but never takes more than a few ounces when I try to feed him.	Habitual waking is almost never about hunger. Your baby is probably waking out of habit (191-192).

As you can see, the problem that usually presents in babies this age is a sudden, inexplicable (to the parents, at least) departure from the "S" part of their routine. Day and night sleeping can be erratic and trying — especially if a baby isn't on a structured routine. The parents wonder if they'll ever get any sleep themselves. Some night waking is naturally due to hunger — babies wake up when their tummies are empty — but that's not always the case. Depending on what the parents do in response to their baby's night waking and nap problems, their well-intentioned actions can lay the seeds of accidental parenting.

Say your baby awoke one night and you calmed her by giving her your breast or a bottle. It worked like a charm, and so now you think, Mmmm, this is a good strategy. Your baby liked it, too. But you're inadvertently teaching her that she needs to suckle in order to get back to sleep. Believe me, when she is six months old, much heavier, and still wants to feed several times a night, you're going to regret that quick fix. (You're lucky if you catch it by then — I've counseled several parents whose babies are nearly two, and they're still waking up several times a night for a comforting nip at Mum's breast!)

Four to Six Months: "4/4" and the
Beginnings of Accidental Parenting

Your baby's awareness is heightened now, and she interacts more with the world around her than she did a few months ago. Remember that babies develop from the head down, gaining control first over their mouths, then the neck and spine, arms and hands, and, finally, legs and feet (see sidebar, page 22). At this stage, your baby can hold up her head easily and is beginning to grasp at things. She is learning to, or already can, roll over. She can sit up fairly straight with your help, so her perspective is changing, too. She's more aware of patterns and routine. She has grown increasingly better at distinguishing where sounds come from and figuring out cause and effect, so she's much more engaged with toys that move and react to her touch. She has a better memory, too.

Because of these strides in development, your baby's daily routine naturally has to change, too — hence, my "4/4" rule of thumb, which stands for "four months/four-hour E.A.S.Y." Most babies are ready at this point to switch from a three- to four-hour routine. It makes sense: Your baby can play for increasingly longer periods during the day and sleep longer stretches at night. Whereas she used to wake up in the morning because she wanted a feed, most of the time now she wakes because of habit — her own internal clock — and not necessarily hunger. Left on their own, many babies wake somewhere between 4 and 6 A.M., talk to themselves and play a bit, and then go back to sleep. That is, if their parents don't rush in, which is how accidental parenting usually starts.

Your baby is probably a more efficient eater, too, so draining a bottle or breast may take only around twenty to thirty minutes. Including a diaper change, then, the E is forty-five minutes at most. But the A is different: Now she can stay up a lot longer, typically another hour and thirty minutes at four months, two hours by six. Many kids have a two-hour nap in the morning, but even if your baby wakes up after 1½ hours, she can usually stay up the extra half hour while you're getting her ready for her next feed. Around two or two-thirty, she'll want another nap, usually 1½ hours long.

On the next page is a side-by-side glance to show how E.A.S.Y. changes when your baby is four months old. You can cut one feed because she's taking in more at each feed, consolidate three naps into two naps (keeping the late afternoon catnap in either case), and thereby extend your baby's waking hours. (If you have trouble getting your baby to transition from a three- to a four-hour routine, you'll find a detailed plan for this transition on pages 39-46.)

The above are ideal days. Your baby won't necessarily conform exactly to these times. Her routine can be affected by weight — a smaller baby might only be able to do a 3½-hour routine at four months but will usually catch up by five, or, at most, six months — and temperamental differences, as some babies are better sleepers than others and some take less time to chow down. Your child might even veer from her own schedule fifteen minutes here and there. One day she'll have a shorter nap in the morning and a longer one in the afternoon, or she'll alternate between the two. The important consideration is that you stick to the eat/activity/sleep pattern (now at four-hour intervals).

Not surprisingly, many of the complaints that I hear most often at this stage have to do with problems in the routine:

Common Complaints	Probable Causes
My baby finishes her feeds so quickly, I'm afraid she's not getting enough to eat. It also throws off her routine.	The E may not be a problem at all — some babies are quite efficient eaters by now. As I explained above, you may be trying to keep your child on an E.A.S.Y. plan meant for a younger child — every three hours instead of four (see pages 39-46 to learn how to make the transition).
My baby never eats or sleeps at the same time.	Some variation in your daily routine is normal. But if he's snacking and catnapping — both the result of accidental parenting — he's never getting a good meal or a good sleep. He needs to be on a structured routine suitable for a four-month-old (pages 39-46).
My baby is still waking up frequently every night, and I never know whether or not to feed him.	If it's erratic waking, he's hungry and needs more food during the day (195-200); if it's habitual waking, you have accidentally reinforced a bad habit (pages 191-192). You also might have him on a three- instead of four-hour routine.
My baby makes it through the night but wakes up at five and wants to play.	You might be responding too early to his normal early morning sounds and have inadvertently taught him that it's a good idea to wake up so early (pages 189-190).
I can't get my baby to nap for more than a half hour or forty-five minutes — or she refuses to nap at all.	She may be overstimulated before naptime (pages 249-252), or this is the result of a lack of, or improper, routine (pages 224-230) — or both.

In addition to the above, we also see a continuation of challenges that weren't dealt with earlier. Those seeds of accidental parenting planted earlier now begin to flower in the form of both eating and sleeping problems (so don't forget to read the previous section, "Six Weeks to Four Months," if you've skipped it). The parents find themselves faced with multiple problems and can't see clearly through the chaos. In some cases, it's because they didn't tailor E.A.S.Y. to their child's more advanced development. They didn't realize that they had to go from feeding every three hours to every four, that wake-up times are longer, or that naps are just as important as nighttime sleep. In others, it's because of the parents' inconsistency. They've gathered conflicting advice from books, friends, from the internet or the telly and have been trying this strategy or that, constantly changing the rules on their baby, hoping that something will work. Additionally, Mum may have returned to work full- or part-time (see page 32). That and other types of household change can disrupt a baby's routine. Whatever the circumstances, the problem is usually worse at this age because it has been going on longer and, in many cases, because the baby has never been on a routine at all. Indeed, I always ask parents of children four months (and older) one key question: Has your baby ever been on a structured routine? If the answer is "no," or even "she once was," I tell them that they have to begin with E.A.S.Y. At the end of this chapter, pages 39-46, I give you a step-by-step plan for helping your baby make that transition.

Copyright © 2005 by Tracy Hogg and Melinda Blau

About the Author

Tracy Hogg obtained her nursing degree in England, specializing in maternity and neonatal care. Her uncanny ability to understand and calm babies led to her nickname "The Baby Whisperer." In 1997, she founded Baby Technique, through which she consults with parents individually, organizes and teaches group classes, and provides nanny training and referrals. She lives in Los Angeles and is the mother of two daughters. You can visit her Web site at www.babywhisperer.com.

Melinda Blau is an award-winning journalist specializing in family and health topics. She is the author of seven other books and countless magazine articles. The mother of two grown children, she lives in Northhampton, Massachusetts.