Frantic baby feeding

Cluster Feeding Defined and How to Manage It

Cluster Feeding Defined and How to Manage It | Medela

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How To Manage Cluster Feeding And Fussy Evenings

Here, we're tackling cluster feedings and why your baby gets fussy in the evenings, so you can rest easy and learn tips for soothing your little one.

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Cluster Feeding - Causes and Solutions

It's not unusual to have a content, cooing baby one day and a fussy little one the next who is constantly demanding to nurse. Read on to learn about cluster feeding, what causes it, how long the stage may last, and what you can do to help your baby.

Fussy Baby - Is Your Baby Cluster Feeding?

Breastfeeding creates an unmistakable bond between you and your baby. This bond brings emotional security and comfort to your baby, while providing the best nutrition possible. So, it’s no surprise babies are eager to nurse often and enjoy that special time with you.

But even if you love that special time with your baby, many moms question whether their little one’s behavior is typical and how to manage frequent nursing demands. This is what's known as cluster feeding and it's why your baby tends to get fussy in the evenings. The most important thing for you to know? In most cases, your baby's behavior is completely normal.

What is Cluster Feeding?

Cluster feeding is when your baby has several feedings close together during a certain period of time, often in the late afternoon or evening. So, even though you are feeding your little one every couple of hours most of the day, cluster feeding is characterized by your baby nursing for short periods, coming off your breast, nursing a little more, fussing, nursing more, hiccuping, and so on and so forth. Don’t worry! It’s completely normal, and some babies may cluster feed every day.

Cluster feeding is most common in very young babies, but can also happen with older babies who have a tummy ache or are going through a growth spurt.

Can I Produce Enough Milk to Meet Baby's Demand?

A mother’s body is very in tune with her baby’s needs. For that reason, it’s always best to nurse whenever your little one wants to. Nursing or pumping often is the best way to maintain supply and ensure your baby is getting all the breast milk they need. And while many moms find cluster feeding difficult to manage, you should know that over time, your baby will nurse less often and for less time, especially after introducing solids.

Why Do Babies Cluster Feed?

You know the drill. Your baby is happy and content all day, and then dinnertime hits, and suddenly they become ornery, fussy, and seemingly inconsolable. This type of fussiness often goes hand-in-hand with cluster feeding. So, what gives? While it’s not totally clear what causes this common nighttime ritual, researchers have some ideas:

Baby is Overtired. It’s hard being little! If your baby isn’t getting plenty of nap time during the day, it’s not unusual for them to get tired toward the end of the day and then get fussy. And, unlike adults, babies aren’t able to calm down and just go to sleep. They rely on you to comfort them, snuggle them, nurse them, and help them relax so they can drift off to sleep.
Baby is Overstimulated. Many doctors believe evening fussiness is caused by your baby’s immature nervous system. Basically, what that means is that your little one isn’t used to all of the stresses and stimuli of everyday life, so they react to this overload by crying. Your best bet is to keep your baby close to you (or your partner!) by snuggling and carrying them, nurse them when they want to nurse, and reduce stimuli like bright lights, loud sounds, and busy or cluttered rooms.
Baby Growth Spurts. Your baby's little body is growing and changing fast! If they happen to be going through a growth spurt, they're going to want more nourishment and may begin cluster feeding. If that's the case, you may find your baby wanting to nurse every 30 minutes to an hour.

How Long Does Cluster Feeding Last?

A continuously fussy baby can become stressful. Don't worry, mama! Like so many other things, your baby will grow out of this stage and move on to the next. In fact, the good news is that many babies outgrow this fussy stage by 3 - 4 months old. In the meantime, be patient and know that every ounce of milk and love your little one gets is precious.

How to Stop Cluster Feeding

What makes cluster feeding even more challenging is that it often happens during your baby’s fussiest time. Your little one might nurse for a few minutes, then fuss, then take a little more, and so on. If that sounds familiar, try some of these soothing techniques to help calm your baby:

Move around. Whether it’s rocking, swaying or walking, sometimes motion can help soothe your little one.
Sing, hum, talk, or listen to soft music or white noise.
Hold your baby or wrap them in a sling or baby carrier to help them feel close and secure.
Reduce stimulation by taking your little one into a quiet, dark room or try swaddling them.

Don't forget to give yourself a break too! Fussy babies and cluster feeding can be frustrating, so it’s important to take a moment to relax. Hand your little one off to your partner or put them in their crib if they’ve finally dozed off, and go for a short walk, take a shower, or just sit by yourself quietly for a few minutes.

My baby fusses or cries when breastfeeding

By Kelly Bonyata, BS, IBCLC

Some babies will fuss, cry or pull off the breast during breastfeeding. There are a number of reasons why this might be happening. It’s pretty common to see this type of behavior at around 6-8 weeks, though it can occur at any time. If your baby is generally fussy (not just when nursing) see My baby is fussy! Is something wrong?

Determining the problem

Here are some of the problem-solving steps I go through when my baby is fussy at the breast or a mother asks me why her baby is fussing while breastfeeding:

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How old is baby? Most babies go through growth spurts during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months, 9 months, etc. Many babies are fussy during growth spurts.

Is baby working on anything new developmentally? Babies who are starting to notice the world around them can be notoriously distractible. Any kind of new developmental step that baby is working on can affect nursing temporarily, whether it be fussy nursing behavior or simply more frequent nursing.

When is baby fussing? To figure out the cause it’s helpful to pay attention to when the fussy behavior happens, both during the nursing session and during the day.

If baby is fussy right when your milk is letting down (or immediately after), there’s a good chance that the fussy nursing is related to a fast let-down. If baby is fussy before let-down, or a few minutes into nursing (and a while after let-down), then baby may be impatient for the fast flow of milk that comes with let-down. Fussing at the end of a nursing session (or what seems to be the end) may mean that baby needs to burp, or is ready to finish nursing, or just wants to suck (and doesn’t want to deal with a new let-down at this point), or wants to continue nursing on the other side or with a faster flow of milk.

If the fussy behavior is mainly in the mornings, it might be due to a faster than usual let-down if baby has just had a longer sleep period and mom’s breasts are fuller than usual. If baby is fussier during evening nursings, it may be due to the normal fussy time that most babies have during the evening. Although most babies don’t react to foods that mom eats, some do. If you eat a particular food at about the same time each day (or most days) and baby has a regular time where she fusses during nursing, try not eating that food for a week or two to see if things improve.

Does fussing occur on both sides equally or only on one side? Most moms have a faster let-down and/or a more abundant milk supply on one side than the other, so if your baby fusses more on one side, it may be due to these differences.

What else is going on with baby? Is she sick or teething? Is something new or different going on in her environment? Has she started solids or is she trying a new food? Is she exhibiting other symptoms besides the fussy nursing?

Below are discussions of some of the different things that can lead to fussy nursing behavior. Keep in mind that the problem may also be a combination of several things.

Does baby need to burp?

Many babies will cry, fuss, pull off the breast, etc. if they need to burp. Try to burp between breasts and after a feeding, but don’t worry if baby does not burp and is content. Breastfed babies overall don’t take in as much air during a feeding as bottle-fed babies do, so usually don’t need to burp as often. If baby has been crying before she nurses, or is so hungry that she nurses “frantically” or if mom has a fast let-down, baby could be taking in more air and may need to be burped more often.

Burping is usually only necessary during the first few months, though it may extend longer. Once your baby is moving more freely, she will be able to relieve the gastric gas herself. This usually will occur between the 4th and 6th month, but may be shorter in some children and longer in others.

If baby has a hard time burping, try burping more often during a feeding. The best burping position is one that applies firm pressure to the baby’s tummy. Placing baby over the shoulder way up so that there is pressure on baby’s abdomen often works well. Walking around while doing this might distract her long enough to get a good burp. You may even want to lie baby down on her stomach and burp her that way.

Growth spurt

Babies often pull off and fuss during growth spurts. Most babies go through growth spurts, sometimes called frequency days, during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 9 months (more or less). More growth spurt information in this link.

Distractible baby

If baby seems to be pulling off the breast at any distraction (real or imaginary), then see The Distractible Baby.

Forceful let-down

Some babies will pull off the breast soon after let-down if mom has a forceful let-down. Baby may be frustrated by the too-fast flow of milk with let-down. A too-forceful let-down can also cause excessive gas or spitting up/vomiting. There is more information here on symptoms of and how to deal with a fast let-down reflex.

Slow let-down

Some babies get very impatient if mom has a slow let-down. There is more information here on speeding up a slow let-down reflex.

Baby wants a faster milk flow

Even very young babies can be quick to notice that pulling off, kneading the breast, etc. can cause an additional let-down, and can facilitate a faster, easier milk flow. Some babies become impatient with the slower milk flow following the initial fast flow at let-down. This may or may not be related to a slow let-down.

When a feeding begins at the breast there are drops of milk. Then when the initial let-down occurs (several seconds to a minute into the feeding), the milk flow speeds up quite a bit. At that time it may drip very quickly, squirt, or even spray. Some minutes later it slows again and the baby must continue to suck vigorously in order to elicit further let-downs. This pattern can continue through successive, multiple let-downs as long as the baby is continuing to nurse vigorously. Eventually, baby will learn that the flow will pick back up again if she’ll only continue to vigorously suck/swallow.

With bottle feeding, the flow is instant and continuous. The baby is required to work very little. Once a baby has had a bottle, especially a lot of bottles, she may begin to prefer the ease of bottle-feeding over the work of breastfeeding. She may become frustrated at the breast after the first let-down occurs and the flow of milk begins to slow.

If baby is getting bottles you might consider putting them away, at least for a while. When you must use a bottle, only use a newborn nipple for as long as baby will tolerate it so that she never gets a really fast flow of milk from the bottle, but has to work a little more to get the milk.

Sometimes babies of moms with oversupply or fast let-down will also get very used to the fast flow and object when it normally slows somewhere between 3 weeks to 3 months.

It can be helpful to do some breast compression when this fussiness starts or right before you expect it to. This will help speed up the milk flow again. Once compression stops helping, try switching baby to the other side when she begins to fuss and back and forth again (after using compression) as you need to.

Baby is done nursing for the moment

If baby is fussing after she’s been nursing for a while, and you’ve ruled out other causes, she may be in the process of changing her nursing pattern. Babies become very efficient at the breast with growth and maturity. They can milk the breast in a lot less time per feeding session than they required before. Baby’s frustration may just be a sign that she’s finished and wants to move on.

On a similar note, an occasional baby will just want to suck at the end of a nursing session and the flow of milk with let-down frustrates her. You might see if offering her a finger or pacifier (if baby is older than 4-6 weeks) to suck on during these times seems to help.

Baby prefers one side

Sometimes babies will refuse or fuss at a breast when the let-down is slower or too forceful, or the supply a bit lower. They in turn will prefer the side which lets down more/less quickly and in which the supply is more bountiful. See also: Lopsided! What can I do?

Fussy in the evening

Many young babies tend to pull off and fuss at the breast in the evening. See the article Cluster Feeding and Fussy Evenings.

Teething

Teething can cause fussy nursing behavior, as some babies experience gum discomfort with sucking. Baby might start to nurse, but then pull off and cry or fuss and not want to nurse anymore. See Teething for more information and tips.

Thrush

Frequent pulling off the breast can be a symptom of thrush.

Stuffy nose

A stuffy nose can cause fussy nursing behavior. If your baby has a stuffy nose and is having a hard time breathing and nursing at the same time, see colds & congestion.

Allergy or food sensitivity

Some babies with allergies or food sensitivities exhibit fussy nursing behavior. Often when there is a sensitivity to something in mom’s diet, baby will come to the breast hungry but when she tastes/smells something in the milk that will cause her GI distress, she pulls off, bats her head back and forth, etc. Sensitivities to foods in mom’s diet are rare. If this is the problem, you will most likely notice other symptoms, such as excessive spitting up or vomiting, colic, diarrhea, rash, persistent congestion or runny nose, or excessive gas. More information on food sensitivities in babies and links to more allergy information can be found in my article Dairy and other Food Sensitivities in Breastfed Babies.

Low milk supply

Low milk supply can cause baby to be fussy at the breast. If you feel that your milk supply may be low, see this page for more info: Increasing low milk supply.

Reflux

Reflux can result in baby being fussy at the breast. See Reflux and Breastfeeding for more information.

Tongue-Tie

Tongue-Tie can result in baby being fussy at the breast. See Breastfeeding a Baby with Tongue-Tie (Resources) for more information.

"I was accused of breastfeeding a child and thereby killing him." Monologue of a mother who was banned from breastfeeding

Our blogger Lyudmila Chirkova is a mother of many children. On her blog, she shared a story about how she tried to keep breastfeeding her youngest son in a situation where everyone, both doctors and relatives, were against it.

I stood near the microwave and waited for the milk to be “sterilized” and the antibodies “leave” from it (yes, the doctors told me that milk can be “sterilized” in the microwave). There was a pop. I opened the door and found that about 30 ml of barely expressed 120 ml remained. I stood and sobbed, realizing that I would have to give the mixture again.

It all started like this: I have two children, the total experience of breastfeeding is 6 years, two of which I fed the children in tandem (that is, two at once). I was sure that I could do everything. It turned out not. My youngest son was predictably born prematurely. Ok, I was ready for this. At first I couldn’t feed - I also found out about this in advance. Rh sensitization is no joke: in many clinics to this day it is forbidden to breastfeed, fearing that mother's antibodies will enter the child's bloodstream, which is very, very dangerous.

Rh sensitization develops when the mother's blood type is negative and the child's is positive. Not always - in the first pregnancy, as a rule, Rh sensitization does not develop, but in subsequent pregnancy it is difficult to avoid this dangerous condition.

The danger of Rh sensitization is that antibodies in the mother's blood attack the hematopoietic system of the fetus, destroy red blood cells and thereby cause hemolytic disease of the fetus, and subsequently the newborn. The result can be both malformations and death.

In general, I honestly waited for the milk to arrive, drank (as a placebo and sedation) tea with fennel and anise, and then pumped every two hours. Meanwhile, my son was in the hospital at the other end of the city. Three weeks later, I took the cherished jar to the laboratory and gave insane money for an antibody test. A miracle happened: the pediatrician gave the go-ahead for feeding.

It was the happiest day of my life: I was allowed not only to take the baby in my arms, but also to put it on my chest. When after another 10 days I took my son home, I was the happiest mother in the world. The happiness lasted four days. On the morning of the fifth, we were sent to the hospital for a blood transfusion, where immediately upon arrival I was scolded by everyone who could: from the doctor on duty to the nurse with a loud voice, who put a catheter in the head of a newborn.

The only "treatment" for hemolytic disease of the fetus is cordocentesis - intrauterine blood transfusion to the child, as well as blood replacement or blood transfusion after birth. Until recently, it was believed that a Rh-negative mother should never feed a Rh-positive child, since "antibodies from milk enter the child's intestines and through thin walls again into the hematopoietic system, continuing their destructive activity. "

That's why we were sent to the hospital. And therefore, they considered that the reason was the very feeding.

However, recent studies have shown that antibodies in breast milk, when they enter the child's digestive tract, are destroyed, and they are not absorbed into the blood in the intestine.

Moreover, in the recommendations for the rehabilitation of newborns with hemolytic disease, breastfeeding is singled out as a separate item along with physiological and developmental care, depending on the age of the child.

That is, the development of late anemia requiring transfusion of erythrocytes (blood transfusion) is in no way associated with antibodies in breast milk and requires only hemoglobin control for three months, every 2-3 weeks.

I was yelled at, accused of breastfeeding and killing a child. My timid “the doctor allowed me” continued to be answered with a cry. But the worst thing was that my husband, who had previously supported me in everything, suddenly brought a jar of formula, a sterilizer and a bottle warmer.

A day in the hospital when you hold a child who is receiving a blood transfusion in your arms and cannot even comfort him is hell. I thought it couldn't be worse. I was wrong. We returned home with our son, and there was surveillance. Relatives watched intently as I prepared bottles of formula and my (sterilized!) milk. The main thing is no breasts! Every two or three hours I got up, washed the bottles, diluted the mixture.

My milk began to slowly go away: I simply didn’t have the strength to prepare formula and express every two hours. Around that time, this "pop" in the microwave happened - I wanted to feed my son at least "sterilized", but with my own milk, but I had to give the mixture again.

Two weeks later, I finally started breastfeeding. Secretly, at night

Every time I was afraid that I would be caught at the crime scene. Two weeks later, I simply didn't go to buy a new can of formula and stopped engaging in discussions with relatives. As a result, I fed my son until he was three years old. And all this time I was thinking why our doctors (not all, but many) are not aware of international protocols for managing such cases? Why do doctors believe that antibodies, for example, are "killed" in microwaves (no, they are not killed)? After all, if a mother with her first child were in my place, it’s not a fact that she would be able to save lactation or start it again.

By the way, when I was leaving the hospital, that loud-mouthed nurse asked cheekily, “Well, will you still breastfeed?” I answered: “Yes, this is my third child. I know what I do". As long as such nurses and doctors work in hospitals, the state can shout for as long and loudly about supporting breastfeeding and ban advertising of mixtures, but this will not help. Because mothers hear in maternity hospitals: “Why are you breastfeeding? Give me a bottle, so everyone will be calmer.”

Photo: Kseniia Vladimirovna / shutterstock / fotodom

You are in the "Blogs" section. The opinion of the author may not coincide with the position of the editors.

What to do if I lash out at my child

A parent whose needs are mostly met is likely to be able to restrain himself from yelling at his child's craziest behavior. Breakdown, as a rule, appears against the background of serious emotional exhaustion. It does not occur in one second, it is preceded by a period of accumulation of irritation, which appears due to deeper experiences - unsatisfied needs. This is the third layer.

First of all, of course, the basic human needs for rest, food, warmth and physical security must be satisfied. But the needs of another kind are also important: a person needs respect and love, acceptance as he is, success in something, the opportunity to develop. If a person is not satisfied with himself and his life, then any life situations can hurt him and cause aggressive behavior.

The deepest and most mysterious layer in our "jug" is the attitude towards oneself (or self-esteem). The foundations of self-esteem are laid in early childhood. Of course, self-esteem can change depending on life circumstances, but the base laid by the child's parents remains unchanged.

How to achieve inner harmony and avoid breakdowns?

Try to find out what causes your irritation and aggressive behavior towards the child. Maybe you didn’t get enough sleep or were tired, maybe you haven’t talked heart to heart with anyone for a long time. If the way to fix the problem is obvious to you, then it is better to immediately take up its solution: make yourself a daily routine in which sleep will be a priority. Massage, walks in the fresh air, meetings with friends, reading your favorite book - all this just seems like an empty pastime, but in fact they are sources of energy and vitality.

You need to learn to "hear" your needs. Of course, if in childhood your needs were not listened to and not satisfied, then it will be difficult for you to figure them out yourself. In this case, meditation, yoga classes, and a visit to a psychologist can help. Understanding needs is also important because it will help you better understand what your child needs.

If you feel negative feelings, tell the child directly about it. Julia Gippenreiter calls such statements "I-messages". Such a message contains direct information about the emotion that you are experiencing at the moment. For example, if you are annoyed by loud music in a child’s room, then it would be more correct to tell him about it: “I am annoyed by loud music” or “I am tired and want to be in silence, but loud music bothers me.” In "I-messages" it is important not to go to "You messages". For example, if you say "Your stupid music annoys me" - this will not be an "I-message" and will most likely lead to an aggravation of the conflict and an emotional breakdown. You can read more about the techniques of active listening and the use of "I-messages" in the wonderful books by Julia Gippenreiter.

It is also useful to know about some other techniques that you can use in situations where you start to feel negative feelings:

Switch to your breathing when anger is rising. Consciously lengthen the inhalation and exhalation, breathe more slowly and hold for a few seconds after each inhalation and exhalation;
When you begin to "boil" remind yourself that this is your child, whom you love very much, and you are an adult and self-sufficient person who is able to control your emotions;
"Traffic light". Agree with your child that before you start getting angry and screaming, you will say the following phrase: “My traffic light is already yellow and will soon turn orange.” This is a good way for older children to assess the upcoming threat and prevent its consequences. First, calm down yourself, and then bring the child to his senses. Hug him, explain in honest and understandable words what exactly made you angry. You should not blame yourself and be afraid that due to a single breakdown, the child will have a psychological trauma for life. It is much more important to analyze the causes that led to this condition and work to minimize them.
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