"Am I Awake or Asleep?" My Baby Wondered.

He was a big baby. Jerry was born by emergency c-section two weeks early when his mom started to bleed during early labor. Although he was a full 9 lbs 3 ounces at birth, his entrance into the world a few weeks early presented him with a few extra challenges.

Jerry seemed to "never know what he is doing," his mom explained. He would fuss and appear ready to eat. He'd get to the breast, take a few sucks, then fall back asleep. Mom's breasts were full, so she would pump while Jerry slept. Jerry would wake up in forty-five minutes, cry inconsolably, and Mom would have to give the pumped milk since her breasts had not filled up again. In one hour the process started again. Mom's milk supply was down, the baby seemed hungry, and Mom's nipples were sore. It was time to stop this downward cycle before Mom gave up on breastfeeding.

Mom's story suggested a baby who had not yet developed clear "Resting" and "Ready" Zones (see http://www.hugyourbaby.com/skills.html). It is common for a baby born early to need his mom's help to figure out whether he is really awake or asleep. In addition to needing this help, Jerry was also a baby with VERY active, "Active Sleep," which was being misunderstood by his mom as waking up to eat.

I had hoped to see this behavior in action, and I wasn't disappointed. As Mom and I spoke, Jerry started to stir on the exam table. He cried suddenly and began to jerk his arms about but never opened his eyes. Since he had just eaten one hour before, I swaddled him and spoke quietly to him instead of putting him immediately to Mom's breast. He squirmed and fussed for a full five minutes. Then Jerry relaxed and fell back into a deep, peaceful sleep for another hour and a half. Now he stirred again and repeated his performance. However, this time Mom swaddled him and spoke quietly to him; he calmed down, opened his eyes, and started to root around. He was now in the "Ready Zone," ready to eat. Mom put him to her breast, where he nursed a full twenty minutes and became calm and content as he gazed up at his mother.

It's normal for new parents to feel confused as they attempt to read an infant's early body language. Howver, learning to help a baby in "Active Sleep" calm back down and sleep a bit longer can be crucial for breastfeeding success. As Jerry's mom practiced what we had discovered together, her supply of breast milk increased, her baby thrived, and she settled into a new comfort zone herself. Mom's timely action to help her child organize his sleep and wake cycles will really pay off in the months ahead.