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Do formula fed babies cluster feed too


Cluster Feeding Your Newborn: Helpful Tips

If you’re breastfeeding, you might find that your little one sometimes keeps you busier than usual from time to time. Occasional sudden increases in the frequency of feeds, usually caused by growth spurts, are sometimes known as cluster feeding.

Cluster feeding affects breastfeeding moms in particular; however, formula-fed babies can also feed more frequently at certain stages of development.

Why do babies cluster feed? When does cluster feeding start? When might it end? What’s the best way to cope with a cluster-feeding baby? Keep reading for the answers to these questions and more.

What Is Cluster Feeding?

Cluster feeding is a term used to describe when a breastfed baby wants to be fed more often than usual at certain times of the day.

Every baby is different, so it’s difficult to define precisely when normal feeding crosses the line to become cluster feeding. As a breastfeeding mom, what you’ll notice is a marked increase in the number of feeds compared to what’s been normal so far.

But what does normal even mean, given that the frequency of your little one’s feeds tends to change anyway as your little one grows?

Well, right after birth, your newborn baby’s stomach is still very small, so in the first few days it’s normal for your little one to eat very often — perhaps every one to three hours — to get all the nutrients she needs.

Then, during your baby’s first few weeks and later when your baby is about 1 month old and 2 months old, her stomach gets bigger and she gradually starts taking more milk at each feed. The gaps between feeds also usually get longer.

If your baby starts cluster feeding, this trend is suddenly reversed. When this happens, it might seem as if you’re back to square one, and that your little one has reverted to the constant feeding you experienced in those first few days or weeks.

But don’t worry: Cluster feeding is a common and normal stage in your baby’s development. While it may be a little more tiring for you, it’s actually helping her grow and develop.

Why Does a Newborn Baby Start Cluster Feeding?

Bouts of cluster feeding can occur if your little one is having a growth spurt and needs more food to fuel this rapid development.

Despite their name, growth spurts aren’t always related to an increase in your baby’s size and weight; you could also see a spike in your little one’s appetite when she’s working on developing new mental or motor skills.

In the first year, babies tend to experience the most rapid growth in the first two months after birth, so there may be a higher chance of cluster feeding during this period.

A growth spurt often occurs at around the beginning of the second week, and another one is common between three and six weeks, but every baby is different. There’s no knowing precisely when your little one’s hunger pangs will strike, or how long the cluster feeding phase will last.

Do Formula-Fed Babies Cluster Feed?

The short answer is yes, they can. Although formula-fed babies usually feed less often than breastfed ones because breast milk is digested faster than formula, formula-fed babies, of course, also experience growth spurts — and the associated munchies — as well.

If you’re formula feeding your little one, there’s a chance that she may eat more frequently — and even cluster feed — during these periods, too; but it’s also possible that the interval between feeds will stay more or less the same and she’ll just want to take a little more at each feed. Paced bottle feeding is a good method to use if you prefer your baby having more control over the pace of feeding.

How Long Does Cluster Feeding Last?

Feeding patterns can vary continuously for as long as your baby is breastfed or formula-fed, but bouts of cluster feeding generally occur during the first few weeks and months after your little one is born.

How to Deal With Cluster Feeding

Bouts of cluster feeding can make those first few months — already a tiring time — seem more challenging, but it’s important to go with the flow and ride out those periods of more intensive feeding. Remember, the growth spurts won’t last forever.

In the meantime, try and get as much rest as you can in the “calmer” periods, and take steps to avoid getting sore nipples, such as making sure your baby’s mouth is deeply latched, and using different breastfeeding positions from time to time.

Rather than setting a rigid timetable for feeding your baby, keep an eye out for feeding cues — the signs that he’s hungry — and let him feed “on demand” as much as possible.

Signs that your baby is hungry include turning towards your breast (rooting) if he’s breastfeeding, as well as smacking his lips or putting a fist in his mouth and sucking on it.

Reach out to your healthcare provider or enlist the help of a lactation consultant if you need help with cluster feeding or any other aspect of breastfeeding.

Our downloadable go-to breastfeeding guide is also a great source of tips and advice.

How to Tell if Your Baby Is Still Eating the Right Amount

All the changes in feeding patterns that can occur during those first few months of your little one’s life can be confusing. If you’re at all unsure, check in with your baby’s healthcare provider.

In the meantime, here are some ways to check your baby is getting enough milk:

  • Pay attention to your baby’s feeding cues. If you’re breastfeeding, it’s hard to be sure exactly how much milk your little one’s had. Keep in mind that your baby’s feeding sessions can vary in length, and he’ll usually stop eating when he’s feeling full. If you’re bottle-feeding, you might be unsure whether your little one has gotten all the breast milk or formula he needs from the bottle. Signs that he’s still hungry might include putting his hand in his mouth or smacking his lips after draining the feeding bottle dry. Fidgeting or looking distracted mid-feed could mean he’s no longer hungry. As your little one’s feeding patterns become established, you’ll soon get to know his unique signals and cues.

  • Keep an eye on your baby’s growth. As long as your little one’s size and weight gain are on track, he’s probably eating the right amount. Your baby’s healthcare provider will be keeping track of all this for you.

  • Count those dirty diapers. What goes in must come out, so counting wet and poopy diapers is another way of keeping tabs on your baby’s intake of fluid and nutrients. After the first 5 days, around 6 or more heavy wet diapers and about 3 or 4 poopy ones every 24 hours is a good sign that your little one is getting enough milk. Incidentally, all those diapers — whether they end up filled with meconium, regular poop, or pee — could be earning you great gifts, discounts, and coupons. Download the Pampers Rewards app to get started.

Will Cluster Feeding Make My Breast Milk Run Out?

Your little one’s feeding actually stimulates milk production, so in most cases your body will ramp up the supply to meet demand during periods of cluster feeding.

Stress or illness may decrease your milk supply temporarily. Ways of overcoming these temporary glitches include staying hydrated, eating healthily, and getting a little more rest (if you can).

Some medications can also affect your milk supply. If you think a medicine that you’re taking could be reducing the amount of breast milk you make, talk to your healthcare provider. Your provider might be able to suggest an alternative medication for you while you’re breastfeeding.

If you think you might not be producing enough milk, you can always ask your provider or a lactation consultant for personalized advice on how to increase your breast milk supply.

Caring for a newborn baby is a full-time job and, just like any other rewarding occupation, it can have its more relaxed and its busier periods. For most moms, times of cluster feeding fall into the latter category!

But there’s a big upside to all of this: As you watch your little one growing and changing from day to day, simply knowing that each bout of cluster feeding is fueling the next stage of your baby’s development will make the extra effort seem worth it in the end.

Cluster Feeding Survival Guide | Ready, Set, Food!

Cluster feeding is a completely normal phase where your baby feeds more frequently, because they’re going through a growth spurt. Here’s what you need to know when your baby starts cluster feeding.

 

Does your newborn want to feed several times close together, often during the evening? This may be frustrating, but it’s completely normal --- it’s a phase known as cluster feeding. Here’s what you need to know when your baby has started cluster feeding, including tips for this often-tiring phase. 

What is cluster feeding?

Cluster feeding is when baby wants to feed several times during a shorter period (in clusters).

A cluster feed usually lasts for a few hours at a time, and looks very different from baby’s typical feeding habits. Baby might alternate between eating, crying and possibly resting several times in a 2-3 hour period. They might want to feed every 20-30 minutes within this timeframe.  

Cluster feeding is perfectly normal, so don’t be alarmed at the changes in your baby’s feeding routine.

Why do babies cluster feed?

Cluster feeding is a way for newborn babies to make sure they get enough breastmilk (or formula) when they’re going through a growth spurt, to satisfy their increased developmental needs. 

During this growth spurt, baby instinctively knows that feeding in clusters is the best way to encourage their mother to produce more breastmilk. Breastmilk production is all about “supply and demand” --- the more baby drinks, the greater supply their mother will have to meet their needs. 

If you’re breastfeeding, this doesn’t mean that you weren’t producing enough milk before. Rather, baby’s just entering a time where they need more milk, and the cluster feed helps your body respond by producing more.

Do bottle-fed babies cluster feed?

Cluster feeding doesn’t just happen with breastfeeding babies, because it involves a natural instinct.

Even though the reasons behind cluster feeding involve getting a breastfeeding mother to produce more milk when baby needs it most, many bottle-fed babies will also want to cluster feed. 

After all, all babies need more nutrients when they are going through growth spurts. And bottle-fed babies don’t always lose the instinct to take in those nutrients in a cluster pattern, just because they’re drinking from a bottle. 

So, although cluster feeding is most common in breastfed babies, don’t be surprised if your bottle-fed baby starts cluster feeding. 

Why does cluster feeding happen in the evening?

Experts don’t yet know why cluster feeds tend to occur in the evening or early afternoon (the period when baby tends to be fussiest). But they do have some theories.

Some experts think that babies’ still-developing nervous system makes them overtired or overstimulated, and that cluster feeding helps them relax.

Other experts believe that cluster feeding helps build mothers’ milk supply up during a time of day when it can naturally be slightly lower. Cluster feeding may help fight against that slight drop, so baby can get the nutrients they need before bed. 

 

How to know when baby has entered the cluster feeding period?

Cluster feeding usually starts around baby’s third week of life. Then, it stops, and happens again around baby’s sixth week of life. This coincides with baby’s major growth spurts. Of course, every baby is different, so they may not start cluster feeding at these exact times.

On average (outside of cluster feeding), your 0-8 week old baby will feed 8 to 12 times every 24 hours.But if baby wants to feed more often than that (especially closer together), they’ve probably started cluster feeding.

Even though cluster feeding can be hard to identify (since babies often don’t have a predictable feeding schedule), these signs may indicate that your baby has started cluster feeding:

  • Baby wants to feed repeatedly and constantly 
  • Even if they’ve already been fed, baby doesn’t seem satisfied with the feeding (especially in the evenings or later afternoons)
  • Baby eats more frequently, in shorter sessions than normal
  • Baby won’t stop crying until they’re fed
  • Besides the urges to feed frequently and the added fussiness when hungry, nothing seems “wrong” with baby
  • Baby is content during feedings
  • Baby still has the same amount of wet and dirty diapers

When they’re in the cluster feeding phase, baby will usually exhibit signs of hunger frequently during the evenings, even after they’ve already been fed. These may include:

  • Rooting (searching for the breast or bottle, or turning their head towards whatever touches their cheek)
  • Nuzzling against the breast
  • Opening the mouth wide 
  • Mouthing
  • Moving the fists to the mouth
  • Lip-smacking
  • Fussiness 
  • Becoming more alert

How long does cluster feeding last? 

Each cluster feeding period usually lasts for a few days at a time. Babies usually “grow out of” cluster feeding around 3 or 4 months of age (of course, every baby is different.) 

But if an older baby gets sick, or is teething, and needs the comfort of frequent feeding, they might cluster feed. Cluster feeding might also happen if an older baby goes through another growth spurt. 

Regardless of when it happens, if your baby’s “cluster feeding” lasts longer than a few days, you need to check their weight and call your doctor. This may be a sign that your baby isn’t getting enough calories.

How to deal with cluster feeding?

The most important thing to remember during cluster feeding is that it’s completely normal. Don’t try to stop the cluster feed. Rather, let baby feed as often as they need to and want to. 

Yes, cluster feeding can be frustrating, as it can be near-impossible to sleep when baby wants to feed every hour.  

But these survival tips may help make the cluster feeding period more bearable for you and your family. 

  • Don’t be afraid to ask for assistance when you need it.
  • If you’re breastfeeding and you’ve pumped breastmilk, or if you’re bottle-feeding, you could have another family member offer a bottle (or bottles). Then, use that time for self-care (such as a walk, a shower, or a few uninterrupted minutes to yourself), 
  • Keep water and nutritious snacks by your feeding area to stay nourished. This is especially important if you’re breastfeeding.
  • Get plenty of rest beforehand. Try to nap for a few hours just prior to when you expect the cluster feed.
  • Make sure you’re nourished and hydrated by eating a healthy meal, and drinking plenty of water, just before the cluster feeding time. 
  • Plan ahead in other ways if you can. Use the bathroom, and try to get comfortable in your feeding area, right before you think baby will want to cluster feed.
  • Plan to cluster feed in front of the TV so you can watch a movie or show that you enjoy. 
  • Or, plan to listen to an audiobook, podcast, or music during a feed. 
  • Practice feeding baby in a sling or carrier. That way, you’ll be able to walk around while you cluster feed. 
  • Call a friend or family member while you cluster feed.
  • Switch up your feeding positions frequently to keep from getting sore.
  • If you have older children, designate special toys (or shows) for them that they can only enjoy during baby’s feeding times.
  • Ask your partner (or friends/relatives) for help with cooking and housework during baby’s cluster feeding periods.
  • If you’re breastfeeding, don’t assume that cluster feeding means your milk supply is low. Also, don’t automatically assume that you have to switch to formula (or supplement nursing with formula). You’ll need to keep breastfeeding (or pumping) consistently to maintain the milk supply baby needs.
  • If needed when breastfeeding, consider pumping between feeds, or using “power pumping,” to help your body produce the milk baby needs during cluster feeds. This way, you’ll be able to offer some or all of the milk in a bottle during cluster feeding (or let someone else feed baby, freeing you up). 
  • If you have any concerns about breastfeeding during this time, consider talking to a lactation consultant. 

Mama Natural offers more tips for supporting yourself and your baby during cluster feeding. Note that these tips are largely geared towards breastfeeding moms:

How to soothe baby during cluster feeding times?

Cluster feeding usually coincides with baby’s fussiest times. They may cry a lot in between feedings, even though they’ll be satisfied during the feedings themselves. 

These tips may help you soothe baby during a cluster feed:

  • Move baby around while feeding (walk while using a sling or carrier, or gently rock baby). 
  • Sing or talk to baby with a gentle voice. 
  • Play soothing sounds (white noise or calming music). Turning on a fan may also create white noise.
  • Hold baby close to help them feel secure. Swaddling them may help as well.
  • Feed baby in a quiet, dark room to remove unsettling stimuli.
  • Try holding baby in different positions.

What is the difference between cluster feeding and colic?

When baby is cluster feeding, they may cry a lot, especially during the evenings, but they’ll be satisfied during feeding. 

However, if baby keeps crying for several hours per day, for no good reason, and feeding doesn’t satisfy them, they may have colic.

Colic crying can sound like screaming, while cluster feed crying will sound like baby’s normal “hungry” cry. Also, colic crying tends to peak at six weeks, continue without a break, and stop around three months of age (a different pattern than cluster feed crying). 

Please read this article for more on identifying and managing colic.

Wrapping up

Even though it may be frustrating, cluster feeding is a normal way for baby to get more nutrients during their growth spurts (and encourage you to produce more milk if you’re breastfeeding). Embrace this time the best you can, and follow the tips we’ve given to help make it more bearable. It will pass eventually!

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All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.   

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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 advice

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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 feed, 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,” explains Cathy. “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 do you know if a 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 had enough, 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

“Nobody 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,” says 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 Beyond the First Month: What to Expect

Literature

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 Obstet , Gynecol , & Neonatal Nurs . 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 ; - 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. 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):e3.

15 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev . 2014;15(12):4829-4837. - Lee D.P. et al., "Breastfeeding and the risk of ovarian cancer: a systematic review and meta-analysis of 40 epidemiological studies. " Asia Pas J Cancer Prev. 2014;15(12):4829-4837.

Dangerous Game: Feeding the Schedule

Emma Pickett ( Emma Pickett ) is a former primary school teacher. She entered the counseling profession when she became a mother herself; volunteered at the National Department of Health's Breastfeeding Helpline. She leads a maternal support group in one of the districts of London, since 2011 she has been advising as an IBCLC. Publishes articles on his website http://www.emmapickettbreastfeedingsupport.com/

Dangerous Game: Scheduled Feeding

In one way or another, new mothers are taught that there is a factor of great importance. This is the interval between the end of the previous feeding and the start of the next one.

It seems to be given a meaning that goes beyond reason. They see these magic numbers - 90 minutes, 2 hours, 3 hours - as a measure of something sacred.

And this is nonsense.

There are mothers who are relaxed at home and chirping in a cozy nest with their beautiful newborn. There is a disc in the DVD player, a cup of fresh tea is poured, I just chatted with my friend. Breastfeeding is going well. The weight is gaining. The child is satisfied.

But when a baby expresses a desire to breastfeed just 40 minutes after feeding instead of the expected hour and a half, they get upset, they get the impression that something is going wrong, something they are doing wrong. A friend's child endures longer. Doubts creep in.

We adults take a mug of tea, a glass of water, sweets, snacks. We respond sensitively and flexibly to our personal needs, which depend on the time of day, temperature, mood, and our energy level. Many go to bed with a glass of water or drink water throughout the day. I don't know any adult who looked at his watch and said, "30 minutes until my next drink of water. It remains to wait a bit." But we expect our growing babies to be governed by artificial notions of routine.

Last week I spoke to a young mother, she was completely PLEASED with her feeding rhythm, but at the same time she was worried if she should increase the interval between feedings, because "this is how it should be done." When I explained to her that this was not necessary, she became even happier than she was.

Where did these ideas come from? They didn't come from someone with a lactation education, not from a lactation consultant who did prenatal care, not from books written by pro-breastfeeding experts.

They came from popular baby care books, relatives and friends.

And they got there because of a fundamental ignorance about breastfeeding and the physiology of lactation. Often these ideas come from the middle of the 20th century. At the time, recommendations were based on formula feeding norms and pseudoscience. And it's all incredibly dangerous.

Until now, there are people around a nursing mother who are convinced that a child who has eaten after four hours instead of three will receive more milk. There are also people who believe that a mother should wait and keep the baby from breastfeeding until the breast is full. There are those who believe that if the baby wants to return to the breast after an hour, this may indicate a problem, in particular, a lack of milk.

It is terrible that the basic knowledge of how milk is produced does not reach those who need it.

So what is the norm? There are many rules.

The newborn should be breastfed at least 8-12 times a day. This means that someone will feed every three hours, and someone more than once every two hours. Some babies may breastfeed every 10 minutes for an hour. Some are 10 minutes every 2 hours, some are 40 minutes every 2 hours. The younger the child, the more likely cluster feeding Such a baby will be unhappy if the breast is taken away not for a few minutes, but for a longer time. Cluster feeding is especially typical for the evening.

A typical phone call to the national breastfeeding support service: "My baby used to sleep in the evenings, but now he is awake for 3-4 hours. The only thing that calms him is the breast. I feel like I don't have enough milk because it hangs on it for an eternity. So there's nothing there."

When a baby often changes from one breast to another, he gets a small amount of milk with a high fat content, and thus relieves tension at the end of a long day. Children know very well what they are doing.

Soon the rhythms will change again. Some children will start to do long intervals during the day, but not all.

One of the very popular baby care books (which I'd rather not name) gives a strong indication that frequent feeding may be acceptable during growth spurts, as this "sacred cow" of feeding intervals is of the utmost importance. A three-month-old baby can feed at intervals of three hours, but if they do not increase at 4 months, then God forbid. The same author believes that a woman can measure the amount of milk by making a test of her production through pumping, as if the amount expressed would be equivalent to the amount of milk that the baby sucks from the breast. But pumping and breastfeeding are completely different processes. What this author doesn't know about breastfeeding could fill an encyclopedia.

Particularly dangerous is this author's message that long intervals are "better" and "correct". This leads new mothers to doubt milk supply without any justification. After reading this author's fan forums, I know that many mothers end up supplementing with formula in an effort to achieve those magical moments.

Why?

Babies are losing exclusive breastfeeding, parents are no longer following the official recommendations of the Ministry of Health due to discrepancies with information from the child care book.

There are parents who choose formula for a variety of reasons. Some do it with joy, some with horror. But doing this just because you read the wrong information in a child care book seems like a real tragedy to me.

Our knowledge of breasts has changed over the past 20 years. Much of the selfless work has been done in Australia by scientists such as Prof. Peter Hartmann and Dr. Donna Geddes, Stephen Daly and their teams.

We thought that most women have more or less the same number of milk ducts, but on ultrasound we found that there are fewer than previously thought, and there are many variations. One woman may have 4 nipple holes, another 18.

There are also other discoveries, in particular about the capacity of the breast, and we must talk about them here. The baby partially receives milk that is produced during feeding, and partially - that which has accumulated between feedings.

Ultrasound showed that the capacity of the glandular tissue cannot be determined based on the size of the breast. Breast size is obvious, but glandular tissue capacity is not. The range of capacity of glandular tissue in women is huge.

One woman can store 80 ml in one breast, another 600 ml. And it's not a typo.

A woman with small breast capacity can produce enough milk in 24 hours and her baby will gain weight well. But these babies have to eat more frequently to get access to milk.

Will this mother have problems with her milk supply? No, absolutely not. Her baby may continue to breastfeed every two hours or more, throughout the day, for several months, feed in fractions at certain times, and perhaps wake up a couple of times a night to eat. Her friend's baby may feed less often and get the same amount of milk.

When breasts are full, milk production is reduced. When the breast is empty, we produce more milk. When babies eat often and from incomplete breasts, they receive milk with a high fat content. Frequent feedings are of high value.

And since human milk contains 3-5% fat, compared to some other mammals, which have fat content up to 40% and even more, it becomes clear why our children need to feed often.

But let's imagine a mother with small breast capacity reading this book on child care. She may become nervous that her baby wants to eat every two hours. She may try to increase the intervals between feedings in the mistaken belief that this will increase the baby's milk intake. Her breasts will be at their capacity for longer and milk production will slow down, the breasts will be signaled to reduce milk production.

In trying to increase the interval between feedings as suggested in the book, she can actually reduce her milk production in 24 hours and thereby harm herself and the baby.

What should we offer this mother who can't increase her intervals like her friends do?

The first is to congratulate her for feeding on demand. Luckily, she didn't know what to feed in the early stages of lactation, so her milk production is at its peak. Let's make sure the rest of the breastfeeding is going well: the feeding is comfortable for her, the baby looks satisfied after the feeding (although it may take an hour instead of three), the latching is effective and the positions are as comfortable as possible. If this is all true, and her only concern is that the magic interval is not being reached, we need to make sure she knows how milk is made. Perhaps she is one of those mothers who has small breast capacity and needs to feed more frequently over the course of 24 hours to increase the amount of milk the baby will receive. And, most likely, this is the only thing she can do. And what happens next depends on acceptance, approval and attitude.

Let her continue like this, ideally until 6 months of age, when her baby will get the most benefit from exclusive breastfeeding.

She will need more support to feed outside the home. She may need to learn how to feed in a sling or feed in different positions in different settings. She may have to wake up more often than her breastfeeding friends, although at night the intervals are longer anyway and she can rest. Safe co-sleeping to help her.

And this is only a matter of a few months. After the introduction of complementary foods, feeding rhythms will change. For several months, a person can cope with anything. Jars of cucumbers even last longer. We change our toothbrush less frequently. On the scale of our adult life, this is the blink of an eye.

What certainly won't help these mothers is the relentless demand to increase the intervals between feedings. Allegedly, if they let the baby cry for 15 minutes, then he will get more milk, and their life will change.

I will tell you about myself. My children under 6 months of age paused for no more than two hours during the day and not much longer at night. In the book where I wrote everything down, I read that at three months I fed the baby about every 90 minutes. I learned to feed on the go. I went to friendly companies and friendly places and invited guests home. I read about co-sleeping practices that have no doubt saved me a lot of problems. And thankfully, I never felt like anything was going wrong. I just trusted my body. I trusted my child and we worked as a team. I sat at home on the couch and fed relatively often, enjoying movies, ate healthy and not very snacks and everything was fine. This did not last long, and the benefits of this exclusive breastfeeding will be much longer .

Why should the clock tell me how to be a mother? I'd rather listen to my child.

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