As a maternity nurse, I will typically come into contact with new parents several months before their baby is born. Often they will be keen to discuss baby routines and there tend to be two types of parents: ones that want to follow a strict parent-led routine and those who want more of a baby-led routine - a more relaxed approach.
They might have read about a number of different routines - perhaps a No Crying routine (whereby you pick up and comfort the baby whenever it cries) or maybe a Controlled Crying routine (whereby you effectively leave the baby to settle themselves) or they may be interested in the Gina Ford approach (which dictates exactly when your baby should be eating, feeding, and sleeping).
I prefer to work for those who are looking for a more-relaxed regime, those who are happy to let me advise them on how to settle their baby in or steer things where they need a little help.
Every baby is different, but all things being equal, it mainly comes down to feeding and sleeping. For the first few weeks after birth and up until maybe four weeks old, a baby will be feeding eight to ten times in a twenty-four hour period. Your baby could be one that wants to feed with gaps of two hours or maybe even three hours or more - you won't know until your baby comes along - and yes, this is naturally going to involve day times and night times!
Of course, after feeding they get sleepy again, and even though I am not a strict routine person, I always advise that - if the baby is still sleeping - it is best to wake them to feed after around three hours (perhaps three-and-a-half hours maximum) and to not let them go over this during the day. I find that otherwise, the baby will end up waking more in the night, as they will still need to fit in all their feeds. This way the night feeds can be kept to a minimum and we pave the way for them to sleep through the night when they are a little older.
Everything is a balance - I am a great believer in a relaxed routine and not a strict one - but essentially, nobody wants to be getting up-down-up-down-up-down all through the night. It seems quite obvious to me that in the longer term if you want to get the baby sleeping through the night, that the more they feed during the day, the better.
Initially, when the baby's first born it may take up to forty-five minutes to feed. Beyond that though, I believe you need to stop. I have had mums who have had the baby fall asleep on her, and then they don't want to wake the baby up. They then find they are lying there waiting for the baby to wake-up naturally and want some more. I find that the trouble here is that this 'snacking' just goes on and on and on. I always advise that what you need to do is to wake them up: to get on with it, and be done with it. Of course, sometimes it's difficult to wake up a sleeping baby, it really is. You just have to try, to keep persevering. In time your baby will become more efficient and feeds may only take ten to fifteen minutes.
My job will adapt to the individual situation. It can be about bringing the baby to mum for breastfeeding during the day and then looking after bottle-feeding at night. But every job is different. Sometimes I will sleep in the same room as the baby so that I am right there when it wakes and can take the baby to mum, or bottle-feed. Other times I might simply be sleeping in a room adjacent to the parents with the baby and I am not really needed in the night at all. I am just on hand if there are any problems and, for example, to support the mother if their partner is away a lot or they have no other family around to support them.
There might be mums who will have an issue with latching on or a baby that doesn't want to feed. We'll discuss it - and come to a solution. It might mean some breastfeeding and some bottle-feeding. A few babies can decide that they actually don't want to breastfeed anymore and that they prefer the bottle - they've discovered that the bottle offers 'easy milk' and they don't have to work for it as hard as they do when they are breastfeeding. I don't advocate avocate going straight to the bottle and will always advise with positions and techniques to help achieve breastfeeding success if possible. Of course, a lot of babies just love to breastfeed and love the comfort of being so close to mum anyway. If you're reading this and won't have the benefit of a maternity nurse, but do have any issues with breastfeeding, then you could look to employ the temporary services of a lactation consultant as and when needed to help resolve them.
As an experienced maternity nurse, I try and provide wise counsel to mums. I work with a lot of high-flying career women who are used to being in control of everything and everyone around them. They are usually very intelligent people too, but a newborn baby is a very different proposition and can be someone you just can't control and reason with in the same way.
Some days just won't go quite according to plan - and some will go nothing like the plan - and that's just the way it is, but of course, new mums can get very upset about it. I do try and explain that you can plan things, but they may not work out exactly as you want them to.
I had one mother who was lovely and the baby was on a great routine - he was sleeping through the night after three months, and feeding every few hours during the day. Then they arrived here from the US. And even though the baby was jet-lagged, he did an amazing job and was still going to bed at six or seven o'clock in the evening which I never expected him to do.
The thing was he was waking up more often and wanting to feed every two hours or so. I realised that the answer was simply that it was so hot here, and he was thirsty. I said to the mum, you're hot and thirsty, and drinking twice as much, he needs to do so too! I explained to the mum that this was especially important because in the hot weather her milk would also adjust and become more watery and would quench his thirst.
Things can be very simple. Just think about what you'd like in a routine. If you were going to have a bath before bedtime you might have some nice lighting, some gentle music, and want to quiet down and chill out. With a baby it's the same, everything is easier with a relaxed routine. I think a lot of what I do is common sense. A lot of the time the baby is feeling what you're feeling.
Being gentle and calm in the morning is also important too. A lot of parents feel they should go in to see the baby first thing and make a huge fuss and try to make the baby laugh and smile, but it's not something that any of us might really cope well with as we are waking up. No-one really wants someone in their face like that, making a huge excitable fuss. Not even your baby!
I try and get the message across: be gentle and relaxed, and you are more likely to not have a stressed baby, but a relaxed and happy one, settled into a nice routine.
Laura Panico, a London-based maternity nurse, who frequently works and travels with international families adapting to life in the UK
She is registered with Maternally Yours and Knightbridge Nannies or can be contacted direct here