Do babies need to feed at night
Breastfeeding at night - La Leche League GB
Breastfeeding at night is one of the most discussed topics at La Leche League meetings, both in person and online. This is often because breastfeeding at night, especially in the early days, can be so important to establishing a successful breastfeeding relationship. It is also because of its inextricable link with the topic of sleep, which can be one of the biggest changes many mothers and families experience when they have a new child.
There is no doubt that caring for a new baby can be exhausting, especially if you feel you are not getting enough sleep. Understanding why breastfeeding at night is so important can help. There is a huge amount of both reliable and rather less reliable information on the internet and in countless parenting books about what infant sleep ‘ought’ to be like, and therefore what infant night-time feeding ‘ought’ to be like. This article is designed to give mothers and parents the information and reassurance they need to inform their own night-time breastfeeding approach, including some helpful tips on how to get more rest when you can.
Breastfeeding at night in the early weeks and months is normal and important
Babies wake to feed at night in the early weeks and months (and often beyond) for a number of important reasons. Breastfeeding at night is a vital part of establishing and maintaining a good milk supply and ensuring that newborn babies get all the milk they need to grow and thrive. Breastmilk works on a supply and demand basis: the more milk that is removed, the more milk your breasts make. For the majority of mothers, this means milk needs to be removed roughly every 2-3 hours in the early weeks. Although some babies may sleep for slightly longer periods overnight, perhaps 3-4 hour stretches, newborn babies will typically wake several times a night to feed. This also helps to ensure that you don’t get engorged breasts, which may lead to blocked ducts or mastitis.
Newborn babies often wake to feed because their bodies have signalled that they are hungry. However, newborns (and babies and children of all ages) also wake at night for many other reasons, including being scared or uncomfortable, being hot or cold, feeling the need for comfort and connection, and so on.
As adults, we have developed ways of meeting these needs ourselves – adjusting a pillow, having a sip of water, cuddling our partner. As babies have no way of independently meeting these needs, they rely on their mother or parent to meet them. Breastfeeding at night offers mothers a way of easily and conveniently meeting the vast majority of these needs in one go.
Lots of research shows that night waking is the biological norm for babies.i You can read more about it here as well as in Sweet Sleep, La Leche League International’s exhaustive publication on nights and naps for breastfeeding families. Research also shows that, overall, breastfeeding mothers get more sleep than mixed- and formula-feeding mothers. This is for a number of reasons, including the impact of natural hormones and chemicals released for baby and mother when breastfeeding at night. There is also a perception that babies who have formula milk sleep longer than breastfed babies. Evidence shows this is not the case.
ii “Despite the common perception that supplementing an infant’s diet with formula milk or solid food will promote sleep, a recent study found that there was no difference in the frequency of night waking between breastfeeding and formula feeding infants aged 6-12 months old. Infants who received more milk or solid feeds during the day were less likely to feed at night but not less likely to wake.”iii
Breastmilk at night
Research shows that breastmilk changes all the time, in response to all sorts of things, like the needs and health of your baby, temperature, and the time of day. For most mothers, breastmilk will gradually increase in fat content throughout the day. During the evening, young babies often cluster feed, taking in frequent feeds of this fattier milk, which tends to satisfy them enough to have their longest stretch of sleep. This cluster feeding in the early months may go on late into the evening when you were hoping you would be asleep, which can naturally feel exhausting.
Overnight, your prolactin levels – the hormone designed to support milk production – are at their highest. So, when your baby feeds frequently at night, the message to your body to boost milk supply is even stronger. Breastmilk at night is also high in the amino acid tryptophan, which in turn helps your baby to make melatonin, which is used by the body to develop its circadian rhythm (our internal system for recognising the difference between day and night) and to sleep better. Hormones produced while breastfeeding also help you to relax and fall more quickly back to sleep, which may be why you find yourself nodding off so easily while breastfeeding.
Given the fact that the hormones in night-time breastmilk help you and your baby to get back to sleep quickly, feeding babies to sleep is completely natural. A mother and baby’s bodies are designed to work in tandem this way. Breastfeeding your baby to sleep helps baby feel calm, safe and secure. Over time, babies stop falling asleep at the breast so easily, and eventually all babies or children stop needing the breast to fall asleep.
Sleep is not a taught development, and all children get there in their own time. So, while breastfeeding to sleep continues to work, many mothers find it a wonderful, loving and responsive way to help their children doze off.
Breast-sleeping / Co-sleeping
Safely sharing a bed with your baby, or having your baby sleep very close to you in a sidecar cot or similar, is one way of getting more sleep and rest. The majority of other mammals sleep with their young, and our own infants are hard-wired to expect this too. For many breastfeeding mothers, learning to feed lying down and being able to fall back asleep safely with baby is when things start to feel a lot more manageable at night. Some mothers may start out nursing their babies at night sat up in bed, but many soon find that mastering breastfeeding lying on their side can really help everyone to get more sleep, especially as baby gets a bit older and can latch on by themselves. Mums can feed from both breasts when lying on one side by simply tilting their body forwards more.
The same principles for getting a comfortable, deep latch apply when side-lying as when feeding upright. It may take a little practice, but overall it’s easier and less disruptive for both mother and baby at night. Research shows that breastfeeding tends to be more successful overall for mothers that co-sleep than those that keep their baby separated from them at night. You can read more about how to co-sleep or breast-sleep safely with your baby here
Breastfeeding at night after the early months
Many mothers go through patches where their baby may wish to breastfeed more or less at night, especially within the first year. This will be related to a whole host of reasons, including growth spurts, teething, illness, and learning new skills such as sitting, crawling and walking. Like so much else with babies and children, the frequency of breastfeeds at night is not a linear progression. Phases of increased night feedings are usually relatively short-lived and you may find that co-sleeping is a really valuable tool for managing those phases.
Increased periods of waking and breastfeeding around four-six months are very common and are not a sign that your baby is hungry and needs formula and/or solids. You can read more about this in our article ‘What happens at four months’
As your baby gets older and bigger, you may find that night feeding becomes much easier. While in the early days you may feel the need to switch on a light or sit up in bed in order to latch your baby comfortably onto your breast, as your baby gets stronger and learns to self-latch, feeding at night can be a simple matter of rolling over and putting the breast near your baby, who will manage the rest. Night feeds often become quicker too. Some mothers use breast compressions as a way of speeding up feeds. Being able to help their older baby back to sleep quickly with a breastfeed helps many mothers get the most sleep.
Coping with the challenges
Knowing that waking at night to breastfeed is positive for our supply and our baby, and that it is the biological norm, can often be reassuring for mothers and parents.
Nevertheless, sleep deprivation can be really challenging for many families. It can feel especially hard if your baby is waking more than your friends’ babies, or if they are an older baby still waking up more than you had expected.
New parents often get asked about their babies’ sleep and their approach to feeding at night. These conversations can sometimes lead to (unwanted) comments about what is normal, what you ‘should’ be doing, and how to ‘fix’ things. And if you are feeling really tired or at a low point, you may be thinking that you do need to find a ‘solution’ and try some of those suggestions. The many unhelpful sources out there setting unrealistic expectations may be undermining your self-confidence as a mother. Perhaps you’re wondering what a loving and respectful approach that suits both you and your baby would be?
First, it’s important to say that you are not alone. At any point in time there are hundreds of thousands, if not millions, of mothers up and breastfeeding their babies – of varying ages – at night.
A turning point for some of them is when they are able to relax their expectations of themselves and their babies a little. Some mothers also find that being constantly reminded of when they have been woken up is actually part of the problem, and they decide to ignore the clock and not to use their phones at night.
Being responsible for all the night-feeds can feel exhausting, or even unfair. Sometimes well-intentioned comments may suggest that a partner or other care-giver could feed the baby at night with a bottle. It can be useful to remember that the hormones in night-time milk make it easier for both you and your baby to get back to sleep quickly. And since the hormones in night-time milk are made at night-time, there is some evidence that giving your baby breastmilk expressed at other times does not always have quite the same effect. It is also sometimes easy to overlook the practicalities of another care-giver taking care of night-feeds. Mothers will often wake up when their baby does anyway, and may struggle to get back to sleep if they can hear their baby being upset while waiting for a bottle to be warmed up.
Most mothers will also need to pump or hand express milk during the night to protect their supply and avoid engorgement, so they are often awake anyway during the time their baby is being fed by their partner.
Even though breastfeeding at night may be the responsibility of the mother alone, there are lots of ways to get supported so that things feel easier. For example, sometimes dads and partners get up with the baby first thing in the morning to give mums some extra time in bed, which can make a big difference to how tired they feel. Good communication is really helpful – ask for help with other things where you can and be clear about the kind of support you need. It’s OK not to enjoy breastfeeding every second, and it’s OK to complain about being tired: that doesn’t mean you don’t want to do it, so you can explain that asking ‘Why don’t you just stop?’ is not helpful and that you’d rather be asked ‘How can I help you find time to rest today?’
If you are really struggling with tiredness, you may want to think of ways to adapt your own routines for a short while to help you get more rest – perhaps sleeping more during the day, or going to bed earlier when your baby has her first ‘longer’ stretch of sleep.
It can also be a great time to join an LLL group meeting with other breastfeeding mothers, as hearing that they are experiencing the same challenges can be really reassuring. Mothers often get bombarded with unrealistic expectations of infant sleep, and it’s precisely this misalignment of expectation and reality that can cause stress.
Another challenge that mothers may experience (usually once their baby is a bit older) is a feeling of nursing aversion or irritability, particularly during night-time feeds. These feelings can be very normal and are often linked to tiredness or feeling ‘touched out’. You may experience them more when your baby is waking or feeding a lot more frequently, for example when teething or feeling ill. You may also experience these feelings when there is a change in your own hormones, for example, during ovulation or your period. There is some anecdotal evidence that taking magnesium supplements can be helpful. Many mothers describe these feelings as irrational and usually short-lived; they can be a sign that you need to give yourself a little ‘self-care’ – perhaps asking for some more help during the day so that you can rest or focus on yourself.
Nursing aversion can sometimes lead to feelings of guilt about not enjoying breastfeeding, and make you wonder whether it is a sign you need to stop. There are some helpful information groups on social media where mothers share their nursing aversion experiences, as well as tips and tricks that helped them overcome those feelings. Like anything in life, you may not enjoy breastfeeding every moment of every day; that’s OK. Take things one day at a time, listen to your body and your baby.
Stopping breastfeeding at night
Breastfeeding at night meets a baby’s needs in a variety of ways. For many mothers, it’s the easiest way to settle their baby back to sleep when they wake at night, and they continue to use it for as long as it continues to work. It is not a bad habit and all babies eventually fall asleep and stay asleep without the breast. You may decide that you are happy with breastfeeding back to sleep, but you are feeling pressured by others’ expectations about what your baby ‘should’ be doing.
Some books suggest that after six months babies no longer need night feeds. Not only is this an arbitrary figure, taking little account of the different circumstances of different babies and families, but it also has no evidence to back it up. Sometimes, mothers worry that breastfeeding at night is what is causing their baby to wake up several times. This is not the case. Babies wake for lots of reasons and it is better to think of breastfeeding as a tool that meets the vast majority of those needs. Some sources claim that babies after a certain age don’t ‘need’ breastmilk at night any longer, but breastfeeding goes on meeting a baby’s needs for a long time. Many babies will continue to need the calories from night-time breastmilk, as well as all the other comforts that it brings, for some time after six months, and sometimes well beyond.
Some families may feel that their baby is ready to cut some breastfeeds at night or stop breastfeeding at night altogether. Generally speaking, the evidence seems to suggest that night-weaning is best left until after around 18 months.
Many mothers find that gently cutting down feeds at this point is much easier, as the baby is learning to talk and the mother can help to explain any changes. There is helpful information about approaches to cutting down night feeds here. Any changes are best approached gradually and respectfully, so that you can preserve the important close connection to the baby at night-time. As your baby gets older, you will discover ways of being responsive to their needs at night that might not include offering your breast every time. For example, you may find that you are able to try other things like rocking, patting and shushing before offering the breast. These may not work initially, but over time, as your baby develops, you may find that in some cases these soothe him back to sleep. As always, you are the expert on your baby and you’ll be able to assess whether your child is ready to stop breastfeeding at night, or whether it would be easier to try night weaning later on.
Conclusion
Having a baby, and eventually a toddler, can of course be exhausting.
Since responding to your baby’s intense needs at night can feel overwhelming, being able to access reliable information about infant sleep and night-time feeding behaviour can help you adjust your expectations. You may be happy breastfeeding your baby back to sleep as often as needed, yet you may feel pressured by well-meaning comments from friends and family about what your baby’s sleep ‘should’ be like. Sometimes spending time with others who understand what you’re going through, and who are supportive or your choices, can help you feel confident to make the decisions that work for you. Chatting with other mothers at a La Leche League meeting, in person or online, about what they found helpful, and exchanging ideas for getting more sleep may help you decide what’s right for you and your baby. Never forget that you know your baby best!
Written by Rhiannon Butterfield, LLL Cambridge. February 2021
Endnotes:
i Baby Sleep Info Source (BASIS) – Durham University
ii Brown A, Harries V. Infant Sleep and Night Feeding Patterns During Later Infancy: Association with Breastfeeding Frequency, Daytime Complementary Food Intake, and Infant Weight. Breastfeeding Medicine. 2015;10(5):246-252.
iii https://gpifn.org.uk/sleep-and-safe-sleeping/
Further reading:
Safer Sleep and the Breastfed Baby
I need some sleep!
LLLI: Safe Sleep Seven
The reasons why nightwaking is the biological norm
Letting babies cry: the science behind the studies
Sweet Sleep available in our LLLGB Shop
Baby Night Feedings by Age
Last updated: by Nicole Johnson, Founder and Lead Sleep Consultant
A very common question we get is when a baby can go all night without a feeding. This article will outline general guidelines about how many night feedings you can expect at each age for breastfeeding and formula-fed babies.
Night Weaning: What do the doctors say?
In my experience, pediatricians seem to disagree frequently with the answer to the question of when a baby can go all night without a feeding. If you have read any of the sleep books, there is Dr. Ferber who claims babies don’t need to eat at night after 3 months old. And, then there is Weissbluth who says that babies need 1-2 feedings up through 9 months old. Who’s right? They are both pediatricians with a lot of experience. Talk to your pediatrician and the answer will likely be even something different.
Night Weaning: In My Professional Experience
I have been a baby sleep consultant since 2008. Although I do really like Dr. Ferber’s book and learned A LOT from it, I cannot, in good conscience, regularly recommend night-weaning at 3 months old. I think that is extreme to think that all babies can do that, particularly breastfed babies. Some parents are lucky enough that their baby does it on his own that young or younger. But many parents simply aren’t that lucky.
When I work with families personally, I am not an extremist, and when it comes to hunger at night. I err on the side of caution. I know that it would be sooo much easier, for US parents to not feed at night. But there are adults who can’t go 12 hours without eating, so I am not sure why we expect our babies to. I am all for breaking sleep associations and promoting healthy sleep for our babies. However, I don’t recommend night weaning until your baby is showing signs that she is ready. DO keep in mind that this age varies from child to child. In addition, if you are breastfeeding, we have seen mom’s milk supply decrease rapidly and irrecoverably if she goes too long between feedings too soon.
Night Feedings By Age
Below are the number of feedings at night, at various ages, that are within “normal” range (in my experience) and don’t throw up a red flag that there is more going on than just a feeding:
Breastfeeding Babies, Combination Breastfed and Formula Fed Babies and/or Babies with Reflux
- Newborns to 3 months old: Feedings every 2-3 hours, on-demand
- 3-4 Months: 2-3 feedings per night or every 3-6 hours, on-demand
- 5-6 Months: 1-2 feedings
- 7-9 Months: 1, maybe 2, feedings
- 10-12 Months: Sometimes 1 feeding
- 12+ Months: Generally no feedings
Formula-Fed Babies
- Newborns to 3 months old: Feedings every 2-3 hours, on demand
- 3-4 Months: 1-2 feedings per night or every 3-6 hours, on demand
- 5-6 Months: 0-1 feedings
- 7+ Months: Generally no feedings
Obviously, growth spurts are an exception and you should feed as needed during those. Growth spurts are generally over within a week.
When to Night Wean
Now, I know that it can be difficult to tell when exactly your unique baby is ready for night weaning. That’s why I created a night weaning quiz, Is Your Baby Ready For Night Weaning? It’s very short – just 5 questions – and easy to take. If you’re struggling with whether or not your baby is ready for night weaning, I suggest you take this quiz. The response you get will help you determine whether you should move forward with night weaning, or if you might need to wait a bit and try night weaning later.
In general, a baby needs to be able to consume all of their calories in the daytime in order to be night-weaned. This typically happens around 4-6 months old for formula-fed babies and around 6-10 months for breastfed babies. And, there are ways to know when night feedings are necessary.
I typically recommend at least an attempt at night-weaning by 8-9 months old (or sooner if you feel your baby is ready), because often, it can be a chicken and egg problem. A baby needs a certain number of calories during the day and if he gets some at night, he won’t eat more during the day. And if he doesn’t eat more during the day, he needs it at night. So, sometimes, a baby really does feel hungry at night, but it doesn’t mean he can’t go all night without a feeding. It simply means he needs to adjust how much he’s eating during the day. The idea is to help him do this.
My Night-Weaning Story
I was a breastfeeding mom for the first year. I personally tried to night-wean around 9 months. With both my boys, they did continue to eat at night up through a year. They did sleep better after I nudged them in the right direction, so I was glad I at least tried at 9 months. When I attempted night-weaning my first son, he went from randomly waking at different times of night to waking around 5 AM just 4 times a week. This was a GREAT improvement!
Already Tried Night-Weaning and It’s Not Working?
If you’ve already tried night-weaning and it’s not working, there are several reasons this might be the case. Be sure to review 7 Reasons Night-Weaning Isn’t Working.
Need more Help with Night-Weaning? We’re here!
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Up to what age to feed the baby at night and how to replace formula
Infant formula is only a necessary replacement for mother's milk in the absence of sufficient lactation or underweight in the infant. In all other respects, the infant formula feeding algorithm remains the same as with breastfeeding. The baby also needs nightly feedings about every 3-4 hours. This is due to scientifically proven facts. Babies up to a year old have an accelerated metabolism, food is digested faster, and naturally, they experience hunger at night. Also, any anxiety of the baby at night forces him to demand his mother's participation, and of course - food as a sedative. There is even a theory that children are genetically woken up to eat to avoid "Sudden Infant Death Syndrome" in their sleep.
But also can't it continue indefinitely? The child grows, develops actively, from the age of 6 months receives a variety of complementary foods, and over time should form a normal daily routine. And for this you need to figure out: how to wean a child at night to eat the mixture in the most gentle ways.
Up to what age to give the mixture at night
Experts differ on this issue, but the average age when you can do without night feedings is nevertheless deduced. Infants with normal development can sleep peacefully at night without formula 10-12 hours from 9-12 months. Of course, if parents do not consider it necessary to restrict their child in nutrition, they can safely continue to feed their child at night and beyond. But they must be aware that, firstly, over time, these periods of eating become just a habit for the baby. And secondly, mothers should also think about their own well-being after sleepless nights. So, the approximate age of weaning a child from night feedings has been determined, it remains to find out how to replace the mixture for the night after a year for the first time of the transition to a new regimen.
Night formula alternative
Formula feeding formula is extremely nutritious and delicious for your baby. Therefore, the nightly replacement should be unequal, so that the baby subsequently feels that he does not need to wake up for such food. For these reasons, many mothers, thinking about how to replace the mixture for the night, use not the best products. It is strongly not recommended to use compotes or juices, because the ultimate goal is a complete and painless rejection of night food. In addition, fruit drinking can cause flatulence and abdominal pain - not the most favorable factors for restful sleep.
It is better to replace the traditional food at first with a well-diluted mixture, and then with pure water. At the same time, you need to try to slightly shift the period of falling asleep and provide the child with peace and a hearty dinner before going to bed. During the gradual transition to a new way of life, it is not necessary to immediately offer a diluted mixture to the awakened baby at night, it is better to try to calm him down in a different way - caress, rock him. And since night meals a priori will cease to be delicious food, the child himself will gradually forget about it, but the wise human body will be rebuilt anyway.
until what age to feed a baby at night
Breast milk is the ideal food for babies, so every mother should strive to maintain breastfeeding for as long as possible. But if for some reason it is impossible, it is important to choose high-quality breast milk substitutes and the optimal feeding regimen, close to the natural rhythm of breastfeeding. The younger the baby, the more often he needs food. Newborn children need to be fed several times at night, older children, from about six months, once. After a year, children can already sleep at night without waking up for feeding.
Why do newborns eat at night?
In the womb, the baby receives nourishment through the umbilical cord continuously, without separation between day and night. After birth, the volume of the baby's stomach is very small, so he cannot get enough nutrients and vitamins and minerals at one meal. Therefore, the baby needs to eat often, in small portions, so that there is no regurgitation and digestive problems.
Another argument in favor of frequent feedings is a very intensive metabolism in an infant. This is necessary to provide the body with the necessary building blocks and energy during a period of very rapid growth and development. In the first year of life, growth processes are maximum in speed, and in order for a baby to triple its weight by a year and grow by 50% of its original height, it needs to eat often and a lot.
Proper nighttime feeding of babies
Even 20 years ago there was a recommendation to maintain a break at night (from midnight to six in the morning), not to feed the baby. This was explained by the fact that the stomach needs rest, and you need to “deceive” it with some water or give it a pacifier. But today it is already known for sure that the stomach is equally active both during the day and at night. In early childhood, circadian rhythms have not yet been formed and the digestive system works around the clock.
Today, doctors recommend feeding a newborn on demand - he himself determines when to eat and how much milk to suck out for feeding. In the first 2-3 months, a child can wake up up to 3-4 times a night (between 9 pm and 6 am) to attach to the breast, up to six months - up to three times, after six months - once, less often twice.
- When breastfeeding, it is recommended to feed the baby on demand, including at night, giving up the practice of "hungry" motion sickness, the use of pacifiers or water.
- For mixed-fed babies at night, breastfeeding should be preferred. This will also help stimulate lactation in order to increase the amount of milk secreted during the day.
- Formula-fed infants should be fed every 3 hours. Let's say a break of 4-5 hours if this is a child older than 3-4 months.
Until what age should I feed my baby at night?
Many parents think that as complementary foods are introduced, the child no longer needs nighttime feedings, because he can be fed during the daytime. Yes, of course, the baby already receives more dense food - vegetable, cereal, meat complementary foods. But this does not mean at all that he will not want to eat at night.
In the daytime, children eat a variety of complementary foods, and at night they have a need to attach to the breast, to get enough of breast milk. After all, the number of attachments to the breast in the daytime gradually decreases, and babies can compensate for this by waking up at night to feed.
If a child is breast-fed, he may have 1 to 3 nightly feedings until the end of lactation (to fall asleep, actually at night, to calm down and fall asleep). If a child is on artificial nutrition, after a year, milk formulas are almost replaced by other products. Most often, children drink cow's milk or fermented milk products at night, special mixtures for children of the second year of life (“threes” or “fours”).
Most children under three wake up at least once during the night to eat. This is quite normal and does not require any radical intervention from the parents.
Should my baby be weaned from night feedings?
This issue is quite complicated and it is solved individually. Up to a year, if the child himself does not refuse night feedings, they should not be removed. After a year, this issue must be addressed individually, based on indicators of height and weight, the level of physical and neuropsychic development. If the baby was born prematurely or gained weight at the lower limits of the norm in the first year of life, it is worth leaving feeding in the second year so that the child receives more nutrients for growth and weight gain.
If a decision is made to wean a child from night feedings, one should not take radical measures, arrange battles with crying and tantrums. It is not worth practicing methods of the “cry and stop” type, they negatively affect the psyche, disrupt the baby’s sleep, provoke capriciousness, irritability. Night tantrums will not benefit other family members either.
To wean a baby from night feedings, it is necessary to create conditions when the child does not want to eat during the night. This is achieved by eating porridge in the evening, before going to bed. Complex carbohydrates are absorbed slowly, so the baby stays full longer, can sleep through the night without waking up. New, unfamiliar complementary foods should be introduced in the morning to help reduce the risk of negative reactions to food that occur at night and disrupt sleep.
