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Breast feeding sleepy baby


Baby Falling Asleep at the Breast? These 5 Tips Can Help!

Most newborn babies will wake regularly and frequently to breastfeed. However, there may be times when your newborn baby needs to be awakened to breastfeed.

For example, there may be medically indicated reasons why a baby may need to be woken to feed such as Jaundice, congenital heart disease, illness or your baby may not be gaining adequate weight...

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Is Falling Asleep at the Breast Normal?

Babies are biologically programmed to fall asleep at the breast. Falling asleep at the breast is a normal behaviour and is mostly due to a hormone called cholecystokinin or CCK. CCK makes your baby feel full and sleepy and it is released in your babies gut as soon as they start sucking.

Younger babies generally have higher concentrations of CCK which can make it harder to keep them awake during a feed. This is a perfect system if your baby is waking frequently and feeding well but for the baby who is needing to be woken or to be encouraged to feed it can be a challenge.

So how do you keep a sleepy baby awake at the breast? There are some simple but effective things that you can do to help

Try Skin-to-Skin Contact

Keeping your baby in the skin-to-skin position can help ignite your baby’s natural feeding instinct and encourage them to feed. After all, if you are in the kitchen, you want to eat! Babies can easily find the breast in this position and may spontaneously feed.

Skin-to-skin contact also allows you to notice subtle feeding cues that otherwise may be missed. Your baby may only make a slight wiggle to signal to you that they are ready to feed and if you are holding them closely on your chest you are more likely to notice.

Learn Your Baby’s Early Feeding Cues

Understanding your babies feeding signals and feeding them when they are showing early ready to feed signs can help them to feed better. Check out the Australian Breastfeeding associations Feeding cues article for pictures of early and late feeding cues.

Compress Your Breasts

While your milk is flowing your baby will be actively sucking but once the flow of milk slows down your baby may slow down or stop sucking altogether. By gently compressing your breasts you will be encouraging your milk flow to continue… and this can help your baby to begin sucking and swallowing again. Read more tips on helping your breast milk flow. 

Dr Jack Newman demonstrates breast compressions in this YouTube clip:

 

Switch Sides

Your breasts work simultaneously, so, when you are feeding on one breast, the other side is also experiencing a letdown.

Once your baby begins to fall asleep, switch sides so that there is a fresh supply waiting for them. You can repeat this several times (switch back and forth between breasts) because you have more than one letdown per feed.

Changing breasts can make it easier for a baby to fill their tummy when breastfeeding. You can also mix it up by switching sides and use breast compressions together

Use Gentle Stimulation

If your baby falls asleep and stops feeding (it's possible for babies to continue feeding while they are sleeping), gently stroking their hands and feet can stimulate them to stay awake for longer.

Sitting your baby up and giving them a gentle back rub can also help to wake them up and it gives them the opportunity to expel any trapped wind that they may have. If that fails, changing your babies nappy mid feed can rouse them enough to feed some more.

Babies are all different and all feed in different ways so what is “normal” for one baby may be different from another. If you are concerned about any aspect of feeding it is essential that you seek help early and it is always important that you follow your health practitioner’s advice.

As a general rule, if your baby is having at least six very wet cloth nappies or at least five very wet disposable nappies of pale urine, 3 or runnier bowel actions in 24 hours then you can be assured that your baby is getting enough milk.

For more information contact:

  • Your General Practitioner
  • An International Board-Certified Lactation Consultant
  • Your Maternal Child Health Nurse
  • The Australian Breastfeeding Association

Have you ever had a baby that always seemed to fall asleep at the breast? What did you do to improve the situation? Let’s have a chat and support each other here or on the Medela Australia Facebook page.

Sleepy Baby – Why And What To Do

Nobody likes to disturb a sleeping baby, but sometimes a baby can be too sleepy for their own good. At times like this they may need you to take action.

Your newborn baby needs to nurse actively for one or both breast at each feed. Offer the second breast after they seem to have finished at the first, although they may not want both sides at every feed. 

What makes a baby sleepy?

Recovering from birth: In the first few days, some babies are sleepy or uninterested in feeding. It’s especially true for small babies, after a difficult labour or birth, or if you received drugs for pain relief during labour.

Jaundice or an infection may make a baby sleepy. Newborn jaundice is normal but frequent breastfeeding helps prevent it becoming a problem.

Not enough milk: Your baby may sleep to conserve energy if they are not getting enough food. They may also sleep longer that is good for them if they are apart from you.

Is my baby too sleepy?

To gain weight and stimulate your milk production, expect your newborn to: 

  • Breastfeed effectively at least 8–12 times in 24 hours
  • Feed actively from one or both breasts at each feed, swallowing regularly.
  • Nurse at least every 2–3 hours from the start of one feed to the next, with one longer sleep of 4–5 hours.
  • Have periods where they breastfeed on and off for several hours, usually in the evening.
  • Gain weight from day 4 and regain birth weight by about two weeks.

Look at our page Beginning Breastfeeding for more information. If your baby is too sleepy to do all these things they may need your active help to ensure they are nursing effectively and getting enough milk.

Is my baby getting enough milk?

A baby may lose up to 7% of their birth weight during the first few days. From around day 3-4, expect them to start gaining, and to regain their birth weight by 10-14 days. Many breastfed babies gain around 200-235g (7-8oz) as week for the first 2-3 months. If you baby consistently gains less, or they haven’t regained their birthweight by 14 days, seek skilled help to assess whether they are getting enough milk. What comes out is a sign of what has gone in, so counting dirty nappies can be a useful guide between weighing sessions. For more information to help you know if your baby is getting enough milk in the first few days, you could read our article here about signs of effective feeding in the early days. And then after the first few days, this article will help you decide if your baby is getting enough milk.

AgeDirty nappies per 24 hours
1-2 Day1 or 2 greenish-black tarry meconium poos
3-5 daysAt least 3 green transitional poos
5+ daysAt least 3-5 yellow, loose unformed poos the size of a 2p coin or larger
Remind your baby to nurse

If your baby is too sleepy or groggy to rouse themselves every few hours, you will need to wake them to feed to ensure they get enough milk. This will be easier if your baby is in a light sleep cycle: watch for rapid eye movements under their closed eyelids, arm and leg movements, sucking activity and changes in their facial expression.

  • Aim for your baby to feed at least 10 times in 24 hours, including at least once at night
  • Encourage active nursing on the first breast, watching and listening for signs of swallowing.
  • Use breast compression (see below) to keep your baby nursing actively.
  • Offer the other side in the same way. You can switch back and forth several times if it helps your baby stay awake and feed.
  • Encourage cluster nursing whenever your baby is more alert.
  • Give expressed milk if they aren’t feeding well.
  • Keep them close by—day and night—so they don’t sleep too long and you don’t miss their feeding cues.
Also try
  • Dimming the lights and keeping your surroundings quiet and peaceful.
  • Keeping the room temperature at around 18°C or undressing your baby a little if the room is warm. Being too hot can make a baby sleepy.
  • Unwrapping any blankets.
Newborn feeding cues

Signs of interest in feeding include:

  • Mouth movements; smacking or licking his lips
  • Sucking on lips, tongue, hands, fingers, toes, toys or clothing
  • Rooting, head bobbing or nuzzling against whoever is holding them
  • Fidgting and squirming a lot
  • Fussing
  • Crying – a late sign of hunger.

Do offer feed generously.  A newborn won’t find it easy to feed well, if they have to wait and reached late hunger signs.

Helping your sleepy baby

Positioning and attachment

Getting a deep, comfortable latch is crucial. If your baby is not latched on well at the breast, they will have to work harder to get your milk. They may tire easily and fall asleep. Sometimes just a small adjustment to the way your baby comes to the breast can make a huge difference. An LLL Leader can provide individual suggestions tailored to your circumstances. If your breasts are engorged, gently hand express a little milk and/or ease swelling back with your fingertips to make it easier for your baby to latch on deeply and prevent you getting sore. See our longer article about Positioning and Attachment for more help on how to help your baby latch well, feed effectively and be comfortable for you.

Copyright Suzanne Tobin

 

 

 

 

 

Seek skilled help early on if you are finding breastfeeding difficult or uncomfortable.

Laid back breastfeeding

Try letting your baby lie on your body with their chest and tummy against you as you recline at about 45 degrees. If they can snuggle up close to your chest for periods of time, even when sleepy or during light sleep, they will often instinctively seek the breast and attach deeply and comfotably even during light sleep. This can be done skin-to-skin or with you and your baby lightly clothed. Watch for signs your baby is stirring and gently encourage feeding. Spending time relaxing like this can make a real difference to how well your baby feeds and how much milk you make.  Our page on Comfortable Breastfeeding has more ideas.

Breast compression

If your baby starts to doze at the breast, this technique will help him breastfeed actively and take more milk.

  • Cup your breast with your hand, near your chest wall, thumb opposite fingers in a C shape. Keep your hand well back from the nipple area.
  • Wait while your baby breastfeeds actively, with their jaw moving all the way to his ear. When they stop swallowing, compress your breast firmly.  They probably start swallowing again. Hold it squeezed until they stop nursing actively, then release your hand.
  • Rotate your hand around your breast and repeat step 2 on different areas of the breast as needed. Go gently—this should not hurt.
 Switch nursing

Try switching breasts at least two or three times during each feed—when your baby comes off the first breast on their own or when breast compression no longer keeps them breastfeeding actively.

Express milk for your baby

Until your baby gets the hang of feeding you may need to do some work for your baby. If they aren’t latching at all, or is not feeding well and gaining weight, then expressing your milk will help establish milk production. The earlier you start, the sooner you’ll produce plenty of milk. Hand expression is often easiest at first but when your milk comes in combining hand expression with pumping can be most effective.  

Giving expressed milk

First, encourage your baby to nurse at both breasts. Watch for swallowing and use breast compression an switch nursing until they stop drinking and start to doze.

Next, give your baby expressed milk until they have had enough. (For more on how to give additional milk, our article here). Giving your  baby your expressed milk after breastfeeding can help them overcome sleepiness and feed more effectively next time.

Then, once your baby has settled, express from both breasts switching back and forth and using compressions and hand expression to get the available milk. Store this milk in the fridge ready for the next feed.

Aim to complete this process within about an hour.

Avoid bottles and dummies

You can give small amounts of expressed milk using a spoon, flexible feeding cup or syringe. If you decid to use bottles for larger amounts, you can give the bottle in a way that helps protect breastfeeding. For more information on ways to give your baby milk and bottles see our article on Bottles and other tools. An alternative is to use a nursing supplement: this acts like a straw to deliver extra milk through a tube along your breast as your baby nurses, avoiding the need for bottles. Our article Nursing Supplementers explains more.

Don’t give up too soon

If your baby doesn’t respond quickly to your efforts to get him to breastfeed more often and more effectively, don’t give up. Keep your baby fed, Keep your supply protected and Keep your baby close. You may find our article on Getting breastfeeding back on track after a tricky start helpful. Check with your doctor to eliminate any medical reasons and contact your local LLL Leader to find one-to-one breastfeeding help. You can find support and encouragement from breastfeeding mothers in your local LLL Group too.

Written by mothers of LLLGB. Photos courtesy of Ellen Mateer and Suzanne Tobin.

Further Reading
Comfortable Breastfeeding
Positioning and attachment
Engorged Breasts – Avoiding & Treating
Hand Expression of Breastmilk
Is my baby getting enough milk?
My Baby Needs More Milk
Nursing supplementers
Jaundice in Healthy Newborns
Getting back on track after a tricky start – the Three Keeps
My baby won’t breastfeed
Bottles and other tools

Other websites
Biological Nurturing™: www. biologicalnurturing.com/video/bn3clip.html
Natural Breastfeeding Position video, Nancy Mohrbacher:
Benefits of skin-to-skin contact: www.kangaroomothercare.com

Books
The Womanly Art Of Breastfeeding. LLLI, London: Pinter & Martin, 2010

This information is available to buy in printed form from our shop.

Copyright LLLGB 2020

Updated June 2022

Breastfeeding after 1 month: what to expect

Do you know when breast milk production stabilizes? And how does the frequency and duration of feedings change as the baby grows? You will find answers to these questions in our recommendations for breastfeeding after the first month.

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Congratulations: You made it through the first month of breastfeeding. Your breast milk has reached full maturity 1 , its production stabilizes, and it leaks almost or not at all from the chest. Don't worry, it's not getting less milk, it's just that your breasts are better able to produce and store it now. 2 At the age of six weeks, your baby will begin to please you with his charming toothless smiles, and by two months you will already have 500-600 feedings behind you. With a favorable development of events, problems with latch on by this point will already be resolved, and you can simply enjoy the convenience and benefits of breastfeeding.

When does breastfeeding decrease?

"Normal" feeding frequency for babies aged one to six months varies considerably, with some needing four feedings a day, others asking to be breastfed 13 times a day. 3

“From the age of one month, the amount of milk a baby consumes per feed increases, so that he can go without food for longer,” explains Cathy Garbin, a recognized international expert on breastfeeding, “A baby’s stomach grows, so he eat more at one time. In addition, mature milk allows him to stay full longer.”

Feeding can last from 12 minutes to one hour -
the habits of babies vary so much! 3 But if the child is gaining weight and falls within this range, there is no cause for concern.

What is most surprising, no matter how often the baby eats, he consumes approximately the same amount of milk per day - both at one month and at six, when it is time to start complementary foods with solid food. 4

“However, sometimes the baby eats more and sometimes less, especially when he is unwell. It’s better to just listen to his needs,” Katie explains.

Is breast milk enough for the first six months?

Yes. Breast milk contains everything a baby needs for the first 90,023 six months of life—exclusively breastfed babies don't even need to drink more water! 5 Until about six months of age, a child's digestive system is simply not adapted to the digestion of solid food, and he will be able to drink cow's milk only after a year.

In addition, breastfeeding during this period prepares the child for further development. It strengthens the muscles of the mouth, develops the jaw and helps straighten the teeth 6.7 . All this will come in handy when the baby begins to eat and talk. And because what you eat and drink affects how your breast milk tastes, your baby discovers new tastes even before he starts eating solid foods. 8

In addition, when your baby is sick, your body produces breast milk that is
rich in antibodies that help fight infection. 9 In other words, milk continues to protect the baby for many months as he grows and becomes more active.

Breastfeeding is also very comfortable once you get used to it. Claudia, a mother of two from the UK, notes: “No need to sterilize a mountain of bottles, prepare formula, carry it all with you, warm it up - in general, breastfeeding turned out to be very convenient, especially when my babies grew up and we began to leave the house more often. ".

At what age does a breastfed baby start sleeping through the night?

Waking up at night is normal for babies. Most babies between the ages of one and six months consume a fifth of their daily milk requirement at night, so nighttime feedings should not be neglected if you want your baby to get the required amount of calories. 3

"It really depends on what you mean by 'sleep through the night'," says Cathy. "And it's better than waking up every two hours anyway! I have met infants who, starting at six weeks old, fell asleep at 19:00 and woke up at 7:00, but most continue to wake up frequently at night after this age. All children are different."

In Wales, a study of more than 700 infants showed that almost 80% of children aged 6 to 12 months wake up at least once a night, and 25% of them wake up three times or more. And it did not depend on what type of feeding the child is on - breastfeeding or artificial. 10

And if nighttime awakenings are unavoidable anyway, breastfeeding is at least comfortable! Maina, a mother of two from Australia, agrees: “You can even take a nap while feeding in the middle of the night - both the body and the baby do their job on autopilot. No need to plan, measure, sterilize anything - ready-made food at the right temperature is right in your chest. I think it's ideal."

My child wakes up more often. Perhaps he is hungry?

Around four months of age, a baby's sleep patterns change as they develop deep and light sleep phases like an adult. Because of this, he may wake up more often at night. “At four months, sleep is more of a problem than feeding,” Cathy admits. “It can be exhausting, but try to adapt and be patient.”

Some call this " a four-month sleep regression ", but "progress" is more appropriate here. From the outside it may look like a step back, but in fact the child is approaching an important stage of development. He learns quickly, begins to become aware of the world around him, his perception is sharpened and, perhaps, there is anxiety about being separated from his mother. Crying when waking up and being able to eat milk cuddled up to mommy’s chest is a way for a baby to calm down. 11–13

Resist the urge to “supplement” your baby with formula or start solid foods early
in an attempt to improve his sleep. Breast milk contains
hormones that make you sleepy and help you both relax
. Research shows that breastfeeding mothers actually sleep longer at night than mothers of formula-fed or mixed-fed babies
. 14

How does teething affect breastfeeding?

Teething usually begins around four months of age. When a baby has gum pain, he becomes restless, throws his chest and cries. All this, of course, is unpleasant.

However, breastfeeding can be an excellent sedative.
Studies have shown that babies who are breastfed
during the vaccination period cry less and forget pain more quickly. 15 Breastfeeding during teething can have the same calming effect.

An unpleasant side effect may be the child's attempts to try out his new teeth on the mother's breast. “Sometimes children flirt and bite their mother’s nipples. This can be felt in advance by how the behavior of the child changes when feeding: before biting, he removes his tongue, explains Cathy, “Usually this is not a problem and only happens a couple of times. It is enough to stop feeding, affectionately say that biting is not good, and the baby will soon leave this fun.

How to continue feeding if you have to be separated from the baby?

It happens that during the first six months, when the baby is still fully breastfed, the mother needs to be away for several hours - or even longer if she has to go to work or go away on business for a couple of days.

But this does not mean that you should stop breastfeeding. You can still feed your baby healthy breast milk - just express it and have someone give it to your baby when you're away. Here's Katie's advice:

“Start expressing milk a couple of days in advance, in small batches, 40-60 ml at a time. So you will have the necessary supply for the time of your absence, but at the same time the amount of milk produced will remain the same.

If you have to return to work, check with your employer about your daily schedule. Many mothers breastfeed their babies in the morning, evening and night, and pump milk at lunchtime to relieve discomfort and create a reserve for the next day.

This usually turns out to be much easier than one might think, and today many companies are well placed to do this, notes Cathy. “Breast pumps make it easy to solve this problem.”

Natalie, mother from the USA, shares her experience: “I feed Dylan as soon as he wakes up, and sometimes again before leaving for work, in order to maintain milk production and not lose contact with the child. At work, I pump twice the next day (in my absence, he eats two bottles of breast milk), and after work I rush home for the evening feed. I don't pump on the weekends - we resume regular breastfeeding."

Can breastfeeding continue after the introduction of solid foods?

When your baby begins to show interest in food and can sit up on his own - usually around six months of age - it's time to start solid foods. However, it is not necessary to stop breastfeeding, Cathy explains: “A baby’s iron stores during pregnancy are depleted by six months, so he needs additional sources of this element.

Start complementary foods with solid foods, but remember that breast milk remains a more important source of calories and nutrients until the baby is eight to nine months old. By this time, he will be eating much more solid food, but he will still need to breastfeed four to five times a day. By 12 months, the frequency of feeding may be two to six times a day. All babies are different, and many of them at this age are still getting half their daily calorie intake from breast milk.”

Don't forget that breast milk can be added to solid foods, such as cereals and purees, so that the baby can taste the familiar taste. If possible, use milk expressed just before feeding (not thawed) and add just before serving to keep bacteria and nutrients alive. 16

You may be pressured by others to stop breastfeeding when your baby is six months old, but the longer you breastfeed or pump milk, the better for you and your baby.

How long can I continue breastfeeding?

“The World Health Organization recommends breastfeeding along with solid foods until at least two years of age because it plays an important role in supporting immunity,” says Cathy. feels bad".

At eight months, the baby sometimes breastfeeds four times a day, but by one year old, the frequency of feedings can be reduced to two times a day. You yourself will understand which feeding regimen is more suitable for you and your baby. For example, Jane, a mother of two from the US, breastfed until the age of two: “I breastfed when I was at home - in the evenings and on weekends, when the children wanted to be close to me,” says Jane, “It helped a lot when they were sick . Breastfeeding has become my favorite form of comfort."

“When my son got a little older and bolder, he still often asked me to breastfeed him - as if to calm down and gain strength,” recalls Amy, a mother of two children from Canada, “When he happened to hit or skin his knee , breastfeeding was a wonderful way to comfort him.”

If your baby is over a year old and you are still breastfeeding, people around you will probably tell you that this way he will never wean. But if children are not pressured, they usually refuse to breastfeed themselves between the ages of two and four. 17

“I didn’t intend to breastfeed for so long, but as a result, I still breastfeed my four-year-old daughter and 22-month-old son,” says Suzanne, mother of two from the UK, “I breastfeed my youngest before and after work, and in I express milk on business trips. The eldest daughter likes to breastfeed a little before bed or when she is upset - this is a great way to make contact. When I get tired of it, I remind myself what great benefit and comfort it brings them. I now plan to pursue a baby-initiated end breastfeeding strategy — let them decide when to stop.”

For more information on what to expect and lots of tips and tricks, see our guide Breastfeeding Problems After the First Month.

Literature

1 Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am . 2013;60(1):49-74. - Ballard O., Morrow A.L., "Composition of breast milk: nutrients and biologically active factors. " Pediatrician Clean North Am. 2013;60(1):49-74.

2 Kent JC et al. Principles for maintaining or increasing breast milk production. J 2012;41(1):114-21. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol and Neonatal Nurse. 2012;41(1):114-121.

3 Kent JC Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.

4 Kent JC et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breast Med . 2013;8(4):401-407. - Kent J.S. et al., Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Brest Med. 2013;8(4):401-407.

5 Almroth S, Bidinger PD. No need for water supplementation for exclusively breast-fed infants under hot and arid conditions. Trans R Soc 1990;84(4):602-604. - Elmroth S., Bidinger P.D., "No need for supplementation of exclusively breastfed infants in hot, dry conditions." Trans R Sots Trop Med Hyg. 1990;84(4):602-604.

6 Victora CG et al . Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet 2016;387(10017):475-490.

7 Peres KG et al. Effect of breastfeeding on malocclusions: a systematic review and meta - analysis. Acta Paediatr. 2015;104( S 467):54-61. - Perez K.G. et al., "The impact of breastfeeding on malocclusion: a systematic review and meta-analysis". Akta Pediatr. 2015;104(S467):54-61.

8 Mennella JA, Beauchamp GK. Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics. 1991;88(4):737-744. - Mennella, JA, Beauchamp, GK, "Maternal nutrition influences the organoleptic properties of breast milk and infant behavior." Pediatrix (Pediatrics). 1991;88(4):737-744.

9 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl immunology. 2013;2(4). - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4).

10 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.

11 Infant sleep information source. [Internet]. Normal Infant Sleep Development; December 2017 [cited 2018 Feb] - All about baby sleep. [Internet] "The development of normal sleep in a child", December 2017 [cited February 2018].

12 Baby sleep science. [Internet]. The-Four-Month-Sleep-Regression-What-is-it-and-What-can-be-Done-About-it. March 2014 [ cited 2018 Feb ] - The science of baby sleep. [Internet], "Four-month sleep regression: what it is and what to do about it." March 2014 [cited February 2018].

13 The Myth Of Baby Sleep Regressions – What’s Really Happening To Your Baby’s Sleep? [Internet]. Pinky Mckay ; December 2017 [ cited 2018 Feb ] - "The Myth of Baby Sleep Regression - What's Really Happening to Your Baby?" [Internet]. Pinky McKay, December 2017 [cited February 2018].

14 Kendall - Tackett K ET Al . The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. Clinical Lactation . 2011;2(2):22-26. - Kendall-Tuckett K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.

15) Harrison D et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev . 2014;10. — Harrison D. et al., "Breastfeeding for Relief of Medical Pain in the Neonatal Period." Cochrane Database of System Rev. 2014;10:CD11248

16 Czank C et al. Retention of the immunological proteins of pasteurized human milk in relation to pasteurizer design and practice. Pediatr Res . 2009;66(4):374. - Zhank S. et al., "Retention of immunological proteins in pasteurized milk depending on the technique and practice of pasteurization". Pediatrician Res. 2009;66(4):374.

17 Weaning from the breast. (2004). Paediatr Child Health, 9(4):249–253. - "Weaning from the breast" (2004). Pediatrician Child Health, 9(4):249–253.

Breastfeeding in the first month: what to expect

Not sure how to establish lactation and increase milk production? If you need help, support, or just want to know what to expect, read our First Month Breastfeeding Recommendations

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The first weeks of breastfeeding are a very stressful period. If at times you feel like you can't handle it, know that you are not alone. Feeding your baby all day long is completely natural and helps produce breast milk, but can be quite tiring at times. Be patient, think about yourself and remember: after the first month, when milk production stabilizes, it will become easier.

How often should a baby be breastfed?

Babies are born with a small stomach that grows rapidly with increasing milk production: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large chicken egg. 1.2 Let the child eat as much as he wants and when he wants. This will help him quickly regain the weight lost after birth and grow and develop further.

“Be prepared to feed every two to three hours throughout the day. At night, the intervals between feedings can be longer: three to four or even five hours, says Cathy Garbin, a recognized international expert on breastfeeding. Some eat quickly and are satiated in 15 minutes, while others take an entire hour to feed. Do not compare your breastfeeding regimen with that of other mothers - it is very likely that there will be nothing in common between them.

At each feed, give your baby a full meal from one breast and then offer a second one, but don't worry if the baby doesn't take it. When the baby is full, he lets go of his chest and at the same time looks relaxed and satisfied - so much so that he can immediately fall asleep. The next time you feed, start on the other breast. You can monitor the order of the mammary glands during feeding using a special application.

Why does the child always ask for a breast?

The first month is usually the hardest time to breastfeed. But do not think that because the baby is constantly hungry and asks for a breast almost every 45 minutes, then you do not have enough milk.

In the first month, the baby needs to eat frequently to start and stimulate the mother's milk production. It lays the foundation for a stable milk supply in the future. 3

In addition, we must not forget that the child needs almost constant contact with the mother. The bright light and noise of the surrounding world at first frighten the baby, and only by clinging to his mother, he can calm down.

Sarah, mother of three from the UK, confirms: “Crying is not always a sign of hunger. Sometimes my kids just wanted me to be around and begged for breasts to calm them down. Use a sling. Place the cradle next to the bed. Don't look at the clock. Take advantage of every opportunity to relax. Forget about cleaning. Let those around you take care of you. And not three days, but six weeks at least! Hug your baby, enjoy the comfort - and trust your body."

Do I need to feed my baby on a schedule?

Your baby is still too young for a strict daily routine, so
forget about breastfeeding schedules and focus on his needs.

“Volumes have been written about how to feed a baby on a schedule, but babies don't read or understand books,” Cathy says. - All children are different. Some people can eat on a schedule, but most can't. Most often, over time, the child develops his own schedule.

Some mothers report that their babies are fine with scheduled feedings, but they are probably just the few babies who would eat every four hours anyway. Adults rarely eat and drink the same foods at the same time of day - so why do we expect this from toddlers?

Offer your baby the breast at the first sign of hunger. Crying is already the last stage, so be attentive to early signs: the baby licks his lips, opens his mouth, sucks his fist, turns his head with his mouth open - looking for the breast. 4

What is a "milk flush"?

At the beginning of each feeding, a hungry baby actively sucks on the nipple,
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5

“Nipple stimulation triggers the release of the hormone oxytocin,” Cathy explains. “Oxytocin is distributed throughout the body and causes the muscles around the milk-producing glands to contract and the milk ducts to dilate. This stimulates the flow of milk.

If the flushing reflex fails, milk will not come out. This is a hormonal response, and under stress it may not work at all or work poorly. Therefore, it is so important that you feel comfortable and calm when feeding.

“Studies show that each mother has a different rhythm of hot flashes during one feed,” Kathy continues, “Oxytocin is a short-acting hormone, it breaks down in just 30-40 seconds after formation. Milk begins to flow, the baby eats, the effect of oxytocin ends, but then a new rush of milk occurs, the baby continues to suckle the breast, and this process is repeated cyclically. That is why, during feeding, the child periodically stops and rests - this is how nature intended.

The flow of milk may be accompanied by a strong sensation of movement or tingling in the chest, although 21% of mothers, according to surveys, do not feel anything at all. 5 Cathy explains: “Many women only feel the first rush of milk. If you do not feel hot flashes, do not worry: since the child eats normally, most likely, you simply do not understand that they are.

How can you tell if your baby is getting enough milk?

Since it is impossible to track how much milk a baby eats while breastfeeding, mothers sometimes worry that the baby is malnourished. Trust your child and your body.

After a rush of milk, the baby usually begins to suckle more slowly. Some mothers clearly hear how the baby swallows, others do not notice it. But one way or another, the child himself will show when he is full - just watch carefully. Many babies make two or three approaches to the breast at one feeding. 6

“When a child has eaten, it is noticeable almost immediately: a kind of “milk intoxication” sets in. The baby is relaxed and makes it clear with his whole body that he is completely full, says Katie, “Diapers are another great way to assess whether the baby is getting enough milk. During this period, a breastfed baby should have at least five wet diapers a day and at least two portions of soft yellow stool, and often more. ”

From one month until weaning at six months of age, a baby's stool (if exclusively breastfed) should look the same every day: yellow, grainy, loose, and watery.

When is the child's birth weight restored?

Most newborns lose weight in the first few days of life. This is normal and should not be cause for concern. As a rule, weight is reduced by 5-7%, although some may lose up to 10%. One way or another, by 10–14 days, almost all newborns regain their birth weight. In the first three to four months, the minimum expected weight gain is an average of 150 grams per week. But one week the child may gain weight faster, and the next slower, so it is necessary that the attending physician monitor the health and growth of the baby constantly. 7.8

At the slightest doubt or signs of dehydration, such as
dark urine, no stool for more than 24 hours, retraction of the fontanel (soft spot on the head), yellowing of the skin, drowsiness, lethargy, lack of appetite (ability to four to six hours without feeding), you should immediately consult a doctor. 7

What is "cluster feeding"?

When a baby asks to breastfeed very often for several hours, this is called cluster feeding. 6 The peak often occurs in the evening between 18:00 and 22:00, just when many babies are especially restless and need close contact with their mother. Most often, mothers complain about this in the period from two to nine weeks after childbirth. This is perfectly normal and common behavior as long as the baby is otherwise healthy, eating well, gaining weight normally, and appears content throughout the day. 9

Cluster feeding can be caused by a sharp jump in the development of the body - during this period the baby especially needs love, comfort and a sense of security. The growing brain of a child is so excited that it can be difficult for him to turn off, or it just scares the baby. 9 If a child is overworked, it is often difficult for him or her to calm down on his own, and adult help is needed. And breastfeeding is the best way to calm the baby, because breast milk is not only food, but also pain reliever and a source of happiness hormones. 10

“No one told me about cluster feeding, so for the first 10 days I just went crazy with worry - I was sure that my milk was not enough for the baby,” recalls Camille, a mother from Australia, “It was a very difficult period . I was advised to pump and supplement until I finally contacted the Australian Breastfeeding Association. There they explained to me what was happening: it turned out that it was not about milk at all.

Remember, this is temporary. Try to prepare dinner for yourself in the afternoon, when the baby is fast asleep, so that in the evening, when he begins to often breastfeed, you have the opportunity to quickly warm up the food and have a snack. If you are not alone, arrange to carry and rock the baby in turns so that you have the opportunity to rest. If you have no one to turn to for help and you feel that your strength is leaving you, put the baby in the crib and rest for a few minutes, and then pick it up again.

Ask your partner, family and friends to help you with household chores, cooking and caring for older children if you have any. If possible, hire an au pair. Get as much rest as possible, eat well and drink plenty of water.

“My daughter slept a lot during the day, but from 23:00 to 5:00 the cluster feeding period began, which was very tiring,” recalls Jenal, a mother from the USA, “My husband tried his best to make life easier for me - washed, cleaned, cooked, changed diapers, let me sleep at every opportunity and never tired of assuring me that we were doing well.

If you are concerned about the frequency of breastfeeding, it is worth contacting a specialist. “Check with a lactation consultant or doctor to see if this is indicative of any problems,” recommends Cathy. “Resist the temptation to supplement your baby with formula (unless recommended by your doctor) until you find the cause. It may not be a matter of limited milk production at all - it may be that the child is inefficiently sucking it.

When will breastfeeding become easier?

This early stage is very special and does not last long. Although sometimes it seems that there will be no end to it, rest assured: it will get easier soon! By the end of the first month, breast milk production will stabilize, and the baby will become stronger and learn to suckle better. 2.3 Any problems with latch on by this time will most likely be resolved and the body will be able to produce milk more efficiently so inflammation and leakage of milk will begin to subside.

“The first four to six weeks are the hardest, but then things start to get better,” Cathy assures. It just needs to be experienced!”

The longer breastfeeding continues, the more benefits it brings, from saving on formula and improving sleep quality 11–13 to boosting your baby's immune system 14 and reducing your risk of certain cancers. 15

“When you feel like you're pushing yourself, try to go from feed to feed and day to day,” advises Hannah, a UK mom. “I was sure I wouldn’t make it to eight weeks. And now I have been breastfeeding for almost 17 weeks, and I dare say it is very easy.”

Read the resource Breastfeeding After the First Month: What to Expect

Readings

1 Naveed M et al. An autopsy study of relationship between perinatal stomach capacity and birth weight. Indian J Gastroenterol .1992;11(4):156-158. - Navid M. et al., Association between prenatal gastric volume and birth weight. Autopsy. Indian J Gastroenterol. 1992;11(4):156-158.

2 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation . Am J Clinl Nutr . 1988;48(6):1375-1386. at the beginning and at the peak of lactation." Am F Clean Nutr. 1988;48(6):1375-1386.

3 Kent JC et al. Principles for maintaining or increasing breast milk production. J 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

4 Australian Breastfeeding Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]

5 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Human Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Different Types of Electric Breast Pump Stimulation. J Human Lact (Journal of the International Association of Lactation Consultants). 2003;19(2):179-186.

6) Kent JC et al . Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.

7 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

8 World Health Organization. [Internet]. Child growth standards; 2018 [cited 2018 Feb] - World Health Organization. [Internet]. Child Growth Standards 2018 [cited February 2018].

9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018].

10 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206.- Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206.

11 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2017 Feb] - Department of Health and Human Services [Internet], "Breastfeeding Facts from the Chief Medical Officer", Jan 20, 2011 [cited Feb 2017]

12 Kendall-Tackett K et al. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. clinical lactation. 2011;1;2(2):22-26. - Kendall-Tuckett, K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.

13 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.

14 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk.

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