There is a big difference...one is probably sleepy due to some intervention
at birth and needs to be woke up to feed because the cues are not going to
happen until it wears off.  Or there could always be a real problem.  (One
case I never forget is the baby who would not wake to nurse and mom was told
by doctors, nurses, and family to leave him alone...hungry babies wake up.
Well, at a home visit trying to help this baby latch what I observed was a
baby who COULD NOT WAKE up.  She took him to the emergency room where he was
diagnosed with a heart condition, flown to a different hospital and received
emergency surgery.  Then he could wake up.)  We need to remember that babies
should not be sleepy and be sure nothing is wrong that is making them sleepy.
 Then teach moms what do.

On the other hand there are totally healthy full term babes who simply like
to sleep.  They cue to feed, but the cues are missed.  These are the ones
that mom is just assuming no crying means no hunger.  Babes are in a crib
across the house, not skin to skin, not in the same room as the family so
cues can be noticed.  These babies don't need a clock, but they do need a
better guide than just babies wake for hunger.  Well, maybe they do, but if
you have to be there to notice it.  My initial post was about these
babies...the ones who are fine, but born into families typical of the
US...beautiful nursery for the baby to be in completely separate from mommy.
Even a bassinet in the same room with a quiet baby doesn't always cut it.  My
last baby scratched at me to nurse, patted me, never cried or made a sound
and never woke up to eat, just patted scratched and waited for me be in the
right place for her to find her milk.  Unless the sleeping arrangement is
honoring biological behavior of mammals...I believe the cues and needs to eat
are altered or simply go unnoticed. So since we are working with the reality
that  co sleeping is not the norm in some cultures and is even actively
discouraged in others, we have to work with what the family will trust...a
clock.  But I also agree the correct words should be "offer".  Possibly the
baby really is not hungry and if when offered shows no interest, than okay,
but at least offer.  I think we can teach that without having moms anxious
when their babies won't nurse enough. And at any rate, I would rather be
comforting a mom with a healthy baby gaining well and doing great who won't
wake to eat at night, than trying to re build a milk supply with a baby not
gaining because mom let him sleep to long without feeding him.

Pam MazzellaDiBosco,  IBCLC   FL,USA

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