Why would a six-month old infant still need to be fed every four hours through the middle of the night?

Written by Jesse Hackell MD

Ah, yes, one of the most vexing new-parent questions, brought on by, yes, six months of interrupted sleep, daytime drowsiness and increasing irritability.

Why, indeed?

The answer is that it is usually a habit engendered in the infant, learned by the repeated feedings that he or she has received at all hours of the night. But how, and when, can this habit be broken?

Remember, first, that no one—not the parent, not the doctor not the grandmother—can determine when and how much a baby needs to eat.

Only the baby knows that for sure, based on the body’s need for growth and maintenance. And worst of all, those needs are not the same every day—a baby’s growth is not the same from day to day, nor is his energy expenditure.

But nature built in a wonderful system for appetite control—if given access to food throughout the day, an infant will eat what he needs, and then stop. Healthy babies do not starve themselves; neither do they overeat, unless they have been taught to do so by repeatedly being fed when they are not asking to be.

Think of a baby’s nutrition needs—for protein and calories, mainly– in terms of a 24 hour day.

Based on internal signals, the baby will require a certain amount of nutrients during each 24 hour period. If you feed the baby every four hours by the clock, the baby will essentially divide these needs into six portions, and eat one portion at each feeding time—which might well lead to one or more middle-of-the-night feedings.

But if the baby gets larger feedings during the daylight hours, her needs will have been met by bedtime, and there will not be the same signals prompting eating during the wee hours.

This will not occur instantly, however. In order to prompt the baby to eat more during the day, he needs to be hungrier than usual for those daytime feedings. So the first step should be to begin skipping the early morning feeding, and allowing the child to cry himself back to sleep. Then when he wakes a few hours later, he will be ravenous, and eat more than usual—which in turn will lead to a longer break before the next feed, a hungrier baby again, and greater intake through the day.

Then on the following night, secure in the knowledge that your child has taken more food than usual that day, the tired and sleep-deprived parent can be comfortable forgoing the nighttime feeding yet again. And with a small amount of manipulation, voila—your baby has given up the middle-of-the-night chowdowns.

Dr. Hackell is a founding member of Pomona Pediatrics PC, a division of Children’s and Women’s Physicians of Westchester. He practices in the lower Hudson River Valley just north of New York City.

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3 thoughts on “Why would a six-month old infant still need to be fed every four hours through the middle of the night?

  1. With all respect–where is the science in all this? Actually it sounded OK until the last few paragraphs.

    The baby has a certain stomach capacity. When his stomach is empty because the contents have completely passed to the intestines, or when he gets a feedback signal such as lower blood sugar (or whatever the biologic signal of hunger is in the infant), he’ll be hungry again.

    I doubt you can change this by essentially depriving him of food when he is hungry. It also seems rather cruel to let him “cry himself to sleep.” And why do this for the first morning feed?

    This sounds like the kind of question you’ll get a different answer to from every pediatrician.

  2. Just based on experience–a baby who is fed every two hours will continue to take smaller feedings which last two hours; a baby “pushed” toward longer intervals will learn to take larger, longer-lasting feedings.

    The stomach capacity is very variable, and it will stretch to accommodate feedings.

    In no sense is this approach the only way to feed a baby; it is just an attempt to help a baby (and parents) get some longer stretches of sleep at night.

  3. Pingback: MDs on nutrition: “my eyelids are blinding me” « JRFibonacci's blog: partnering with reality

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