My baby has been feeding for 4 hours
10 breastfeeding questions answered by a lactation expert
Confused about how long to breastfeed your baby each time? Wondering whether you should put her on a schedule, wait for her to cry, or wake her up? If you're new to breastfeeding, you probably have questions. Lactation expert Kathy Kuhn has the answers.
How often should I breastfeed my baby?
Most babies will breastfeed 8 to 12 times in 24 hours, from their second or third day of life until they are three to six months old. Feedings are not usually spaced evenly around the clock. Most babies will vary the time between feedings and the length of time each feeding takes. The average amount of time a breastfeeding session takes can vary from about 10 minutes to about 45 minutes.
Should I wake my baby for feedings?
For the first few weeks of life, I usually recommend that Mom wake the baby to breastfeed at least every two to three hours, measured from the start of one feeding to the start of the next, during the day and evening hours. It's okay to let the baby take one longer stretch of sleep at night if she is able to do that.
What if my baby wakes before it's time to feed her?
You should not make your baby wait until two to three hours has passed if she is crying or actively sucking on her hands, or otherwise showing interest in breastfeeding. If your baby wants to breastfeed sooner than two hours, it's always appropriate to breastfeed at that time, even if the last feeding just ended a short time ago. You don't need to worry that the breast is "empty"; since your breasts make milk continuously, there's always more milk available for your baby.
Should I feed my baby for a certain number of minutes per breast?
Don't remove your baby from the breast. Allow him to tell you when he's done with the first breast. You'll know he's had enough when he removes himself or when he stops sucking for longer than a few minutes. There's no specific amount of time he should spend on each breast. If he wants to take the second breast, that's fine.
If not, that's okay too. It's important to allow your baby to determine the end of the feeding to allow him access to the higher fat, creamier milk that usually comes near the end of the session. If you remove the baby after a specific amount of time you may hinder his ability to get enough of the creamier milk.
When can I stop waking my baby for feedings?
Once breastfeeding is well established, your baby has been to the pediatrician once or twice and you have been told that she's growing well, you can begin to feed her only when she asks to be fed. You can stop waking her for feedings, if you'd like, as long as she continues to grow well and produce plenty of wet and dirty diapers.
How will I know when my baby wants to breastfeed?
Your baby will "cue" you, or tell you she needs to be fed, by sucking on her hands, making mouthing movements, rooting with her mouth wide open, making little sounds or crying. It's often best to breastfeed when she signals you with the earlier, more subtle feeding cues, rather than waiting for her to cry.
Once she's crying, you may find it's harder to get her onto the breast and you may need to calm her first before she can breastfeed.
Why does my baby want to breastfeed so much in the evening?
It's expected and normal for your baby to choose a time when she wants to have very, very frequent feedings. This is commonly called "cluster feeding," during which she typically has long feedings with short breaks between. She might breastfeed almost nonstop for several hours. She may also be fussy or unsettled during cluster feeding time. Understandably, some parents get the wrong idea about this behavior and think that it means Mom has a low milk supply. It's important to remember that the way your baby behaves is not a reliable sign of how much milk she's drinking.
How much should newborns eat?
The most dependable way to judge the milk supply is by your baby's growth pattern and diapers. If she's gaining well then she's getting enough milk, no matter how fussy she might be or how long she might cluster feed in the evening.
On a daily basis, your baby's diapers are the best indicator of whether she's had enough to eat. From age five days up to six to eight weeks, she should have at least five or six sopping wets and three or four palm-sized yellow bowel movements every 24 hours. After six to eight weeks, some babies develop a pattern of fewer bowel movements but should continue with at least five or six sopping wets along with a good weight gain.
Why do breastfed babies vary their feedings so much?
We don't know all the reasons, but it's probably connected to changing fat levels in mother's milk. The amount of fat varies somewhat from feeding to feeding and within each feeding. If some time has passed since the last feeding, the milk at the beginning of the feeding is lower in fat (like skim milk), then it becomes more like whole milk, and then high in fat (like cream) toward the end of the feeding. When feedings are more closely spaced (as in cluster feeding), they're higher in fat. Your baby needs to get this creamy milk to help her grow well, and to help her brain develop.
Happily, many babies will take a longer stretch of sleep right after they cluster because getting the creamier milk helps to slow the digestion and makes the baby feel fuller. It's okay to let your baby take this longer stretch of sleep after a cluster. You don't need to wake her up in two to three hours at that time '- just enjoy the break!
Shouldn't I put my baby on a feeding schedule?
Research indicates that trying to manipulate a baby's natural feeding pattern too much '- especially trying to make her wait longer for the next feeding—can lead to problems like low milk supply and poor weight gain in the baby. The longer between feedings, the greater the signal to the breast to reduce its production of milk. Frequent breastfeeding helps ensure an ample milk supply and good health for your baby. Variety is the spice of life when it comes to breastfeeding patterns! Natural patterns and rhythms will emerge, and you'll get to know your baby exceptionally well by watching her instead of focusing on the clock.
A version of this story originally appeared on iVillage.
Cluster feeding...when is it normal? When is it not?
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Cluster feeding…that exhausting time when our babies are on and off the boob CONSTANTLY! We have all heard this term and understand that babies cluster feed, yet there is still a lot of mis-information out there about this topic. There are people who will state that cluster feeding is not normal (false) and then other people who will say that cluster feeding is always normal and nothing to worry about (false). The truth is somewhere in between and is about LOOKING AT THE WHOLE PICTURE when assessing the situation.
The truth of the matter is that in MOST cases (statistically speaking) a baby who is unsettled and looks for the boob immediately upon putting them down (even if they just breastfed), is actually just a baby who wants to be cuddled and breastfed, not a baby who is starving.
On the flip side of that, a baby who is at the breast constantly on and off all day and night and rarely doing anything but crying whether you’re holding them or not, is not normal. Confused yet? Here is my list to help clarify when cluster feeding is normal, and what it’s not!
*Just an important side note…these are all normal if the WHOLE PICTURE looks normal as well. Gaining weight as expected and nappies (diapers) are meeting the minimum output in a 24 period. It’s always about looking at everything that’s going on when you are assessing a baby and their breastmilk intake.
The “witching hour” (or HOURS!). I remember when my mother mentioned the “witching” hour to me as a new mum. I had never heard this term and was so thankful that she mentioned it. “Babies get really cranky in the afternoon and breastfeed a lot”, she told me. I could kiss her now for saying this simple sentence to me. Most babies will do this.
I’m surprised if someone tells me their baby doesn’t do this! After the first few weeks once your baby “wakes up” a bit, you’ll probably find that your baby will start to do this too. This is not an indication in of itself that your baby is not getting enough milk. It just means that your baby needs some extra cuddles and breastfeeds. It can last for a few hours, usually starting in the later afternoon hours. Best to get skin-to-skin and pop your baby in a baby carrier. Breastfeed in the bath with your baby or bounce on an exercise ball while feeding them. This is an important time for your baby to have unrestricted access to your breasts.
Cluster feeding when sick, thirsty and/or exhausted! For mothers who have been breastfeeding awhile, they’ll all be able to point to a time where cluster feeding happened for a specific reason. Sickness, thirst and exhaustion are just some of them. A baby who is sick will be seeking comfort from breastfeeding and often times will be the only thing they can tolerate while they are fighting a bug.
When it’s really hot (like where I live in Australia!) your baby will probably breastfeeding really frequently as well. And of course exhaustion! Breastfeeding brings a baby or toddler to an instant state of relaxation. When they are tired they’ll usually breastfeed much more frequently, sometimes a few times within an hour…or never let go!
Cluster feeding during developmental milestones and teething. When your baby is learning how to do something (crawl, walk, talk) their breastfeeding can go into overdrive with even more frequent wake ups at night! The good news is that this is totally normal. Our babies brains develop so rapidly and breastfeeding brings comfort, familiarity and security to our growing children.
A baby who wakes and looks for a breastfeed if you put them down, but sleeps happily for their nap if being held. This is not a baby who is hungry, this is a baby who is needs some extra cuddles.
If your baby happily sleeps in your arms and not in cot…congratulations! You have a normal baby! Here is why I think the invention of the crib ruined motherhood for us all…
Anytime your child feels like torturing you. Enough said. Grab a cup of coffee and put your feet up. Make sure you have your phone and remote in hand! And good luck. ♥️
Book a breastfeeding consultation with Meg NOW!
NOT NORMAL Cluster Feeding*Just a side note…if all of the other things are looking normal about this baby (weight gain going well, nappy output perfect within the 24 hour period) then there could be something else going on unrelated to the volume of breastmilk intake such as tongue tie or food intolerances.
An unsettled baby who is crying even right after being fed and immediately looking for another breastfeed, after MOST feeds. This type of behaviour is not normal if it’s happening frequently.
AS mentioned previously a bit of a “witching hour”…or hours can be completely normal, however a baby who is on and off the breast MOST of the time day and night is not normal and a good indicator that something is going on related to their breastmilk intake (remember look at the whole picture!) or something else going on.
Not having periods of awake times and sleep times as expected. Babies sleep a lot. We all know this! However babies also wake to breastfeed, wake to look around for a bit and babies usually try to throw in a 2am wake up period for an hour just to hang out with us and bring us to the brink of insanity. HOWEVER a baby who is awake all the time or very sleepy all of the time is a baby who might not be getting enough OR have something else going on.
A baby who is breastfeeding for up to an hour or more at EVERY or MOST feeds, 24/7. This is a really important one. Babies will breastfeed anywhere between 5 minutes to 45 minutes-ISH.
And the time spent at the breast can change between each feed for the same baby. BUT if your baby is taking an hour or more at every or most feeds then this can be an indication that they are not effectively and efficiently removing the milk. Time to get an IBCLC or volunteer breastfeeding counsellor to help you look at the whole picture and assess whether or not your baby is getting enough milk.
Cluster feeding combined with reflux symptoms (vomiting large amounts, “silent” reflux, very gassy, wheezing, gagging, choking etc.) A baby who has reflux symptoms and is seeking comfort from the breast very frequently to help relieve these symptoms is a baby who needs a thorough evaluation by and IBCLC and/or your GP. With my first born his symptoms ended up being caused by my huge over-supply! This is just one of the many possible causes though. Please head here for more info on reflux and here for vomiting/spitting up.
All of this doesn’t have to be confusing! There are a lot of scare mongering articles out there about infant feeding.
The good new is…it’s not rocket science! 🙂 If you are concerned about your baby’s breastmilk intake and whether or not they’re getting enough, please head here to go through the checklist.
Book a breastfeeding consultation with Meg NOW!
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Why does the child constantly hang on the chest? ❤️ KIDY.
eu - Not enough milk?
- Temporary crises
- What to do in temporary crises?
“My baby just hung on my chest. I know what to feed demand, but he demands endlessly. What to do?!" - is the most common question to lactation consultants. It turns out that the phrase "the baby is hanging on the chest" means different things for everyone.
It happens that mothers expect that the baby will ask for a breast every 3-4 hours, eat 15 minutes, and sleep the rest of the time. And the requirement of the breast once every 1.5-2 hours, as most newborns do, is alarming. So: if a baby of the first months of life asks for a breast every hour or two and, having received it, eats up to half an hour, then this is not “hanging”, but the normal behavior of the baby. Over time, the baby will begin to ask for breasts less often, but for now you need to wait.
For the mother's body, frequent feedings are also useful: they help a good contraction of the uterus, prevent the development of postpartum complications and regulate the total amount of lactation so that the mother does not experience milk stagnation. It happens differently: the baby asks for breasts in 2-3 hours, but, having received it, eats for an hour or even longer. This may be a variant of the norm, but the situation can be improved. Also, carefully look at the general state of affairs with feeding, if the child lives in the rhythm of “an hour I eat - an hour I rest” or spends more time on the chest during the day than without it.
Not enough milk?
Usually the first thing a mother thinks about is that if a newborn is constantly hanging on her chest, then she does not have enough milk. Absolutely not necessary! But you need to check this version. And only weight gain can reliably show this.
Do not rush to get upset, this can be fixed!
- Have a lactation consultant look at your feeding.
He will suggest ways to improve, assess whether supplementary feeding is needed and whether lactation should be stimulated. - If a consultant is not available, look for improved attachment to the breast. Often this is enough for the breast to begin to be better stimulated to produce milk, and the child to suck out this milk better.
- If the baby has gained a kilogram or more in a month, then we are not talking about a lack of milk. Most likely, you can think of a temporary crisis ...
ATTENTION - this is a very important point!
Often mothers are asked to express milk, evaluate breast size, etc. for testing. But these are all very unreliable signs that are different for all women and they don’t talk about the amount of milk. In mothers, the breast reacts differently to pumping, the amount of glandular tissue is different for everyone (in a small breast it can be much more than in a large one, where adipose tissue predominates).
The only thing you can really trust is how your baby grows and gains weight.
For the first 3 months of life, an increase that indicates a sufficient amount of milk - from 500 grams per month or more.
If a child gained 500-700 grams in a month, but he had to hang on his chest for hours, the mother needs to work on organizing breastfeeding, otherwise the situation usually worsens later. If your baby added less than 500 grams, then, alas, he really does not have enough milk.
Temporary crises
These are situations of a sharp increase in breastfeeding or a sharp increase in the duration of feeding. Every nursing mother faces this, it’s just that someone understands what is happening, someone gets scared, and someone simply, out of ignorance, takes steps to stop breastfeeding.
Crises are caused by various reasons:
- Adaptation crisis when new circumstances appear in the baby's life .
Usually adaptation crises: the second week of life, moving or going to work, travel. The baby is trying to calm down and regain confidence in her mother's support through more frequent attachments. The crisis can also be provoked by internal factors: for example, a child is preparing to fall ill, and through an increase in attachment, his body fights the disease with the healing elements of breast milk. Babies also tend to hang on their chests before any kind of developmental leap (usually new skills, such as crawling or walking). Mom's milk and attention give the baby the strength to conquer new heights. - Growth spurt crisis . These growth spurts are tied to certain periods of a baby's life: about three weeks, a month and a half, three months, six and nine. During such periods, many children actively grow. For such rapid growth, babies need more nutrition than usual, so they quickly empty their breasts, which gives mothers the impression of “missing milk”.
In fact, there is milk in the chest, just on crisis days the child eats it much more energetically and is ready to constantly ask for breasts, to eat more and more.
- The most seemingly obvious option to supplement with formula often becomes a “red flag” for the mother’s body: you don’t need so much milk, the child manages anyway. As a result, milk production really begins to decline rapidly.
- In a crisis situation, it is important not to panic, but for a couple of days, literally lie down with the baby in bed and patiently feed, shifting from one breast to another as it is empty. You can drink hot tea, use lactogons, but this is not enough without frequent feedings. And most importantly, crises are a very short-term phenomenon, they rarely last longer than 2-4 days!
What to change?
Let's go back to the most common situation with "chest hanging": the baby gains weight only slightly above the lower limit (500-700 g in the first three months of life or 400-500 g in the next three months).
When, with such increases, the child is applied to the breast every 2-3 hours for about half an hour, this is expected. But if the feedings are more frequent and longer, then sucking is ineffective: the baby sucks out a portion of milk for a very long time, enough to eat.
What to do?
- Adjust breastfeeding to the so-called “asymmetric” . When feeding, the breast should be captured deeper from below than from above: the main working parts of the baby's mouth (lower jaw and tongue) are located below, and stimulation from this side should be maximum. This method of application allows the baby to receive milk most efficiently and stimulate the breast to produce new milk.
Bring the baby to the breast at such a height that the nipple is at the level of the spout. On the chest, form a crease with the nipple in the middle so that the thumb is on top of the crease and opposite the baby's nose, and the index and other fingers are below, parallel to the baby's lower lip.
When a child feels a breast nearby, he reflexively opens his mouth and throws his head back; then the nipple, which was at the level of the nose, will be directly opposite the mouth. And at this moment, the fold from the chest must be directed into the child's mouth, trying to make the nipple point upwards into the sky. If everything is done correctly, then the baby’s head will be slightly tilted up when sucking, the chin will be tightly pressed to the chest, and the nose is either completely free or touches the chest only with the tip. If the chin does not touch the breast, but the nose is pressed into it, then this is just inefficient sucking, in which the baby has to suck for a very long time to eat, and even the nipples can be injured. - To increase the amount of milk received per feeding session and reduce the application time, make sure that the feeding is effective . It is a mistake to continue to keep the baby on the chest after he has already emptied it.
If the baby has eaten the bulk of the milk from the breast and continues to suck, receiving drop by drop, a teaspoon in five minutes, then it is not surprising that he will not be particularly full after an hour. At the same time, if the mother simply transfers the child to another breast, during the same time the baby will receive a full, good portion of milk and eat much better!
“But I heard that the breast should not be changed often, otherwise the baby will not receive hindmilk,” mothers object. Alas, this recommendation has created a lot of problems where they could have been avoided: it only applies to situations of excess milk production. If the lactation is so profuse that the baby has to swallow the lighter foremilk for a long time and actively before he gets to the fatter hindmilk, this makes sense. But if there is not much milk, then the child eats both the anterior portion and the fatter posterior portion, and after that continues to squeeze the last drops out of the breast for another half an hour, instead of receiving the second same portion from the other breast.
..
Pay attention to the baby's sucking rhythm to help you navigate the timing of the breast change. Forward, more liquid milk flows freely, the baby swallows it quickly and actively. Then the rhythm of the sips slows down, for several sucking movements there is only one swallowing. When the baby has to make 3-4 sucks before swallowing, it means that he has reached fatter and thicker milk.
A little more - and the rhythm is already five or six sucks per sip, the chest is almost empty. At this point, squeeze the breast at the base with one hand, which will squeeze the rest of the fatty hindmilk into the ducts. After the baby swallows a little more actively, but when his throat slows down again, it's time to change the chest.
Sometimes during times of crisis, it is necessary to transfer the baby from one breast to another several times during one feeding. But this is more effective and will give the child more benefit than keeping him all this time on one breast.
When the baby begins to eat better, you will soon notice that the total feeding time has become shorter, and weight and height gains are better.
And don't hesitate to contact our consultants for help!
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What is normal breastfeeding? | Interview with Dr. Jacqueline Kent
It can be difficult for new mothers to understand if breastfeeding is going well, so we decided to ask the expert if it is possible to talk about the norms when it comes to breastfeeding.
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Dr Jacqueline Kent , Research Fellow , Hartmann Human Lactation Research Group:
Jacqueline joined the University of Western Australia research group in 1986 and received her PhD in 1999.
She is currently researching the biochemical and physiological aspects of breast milk synthesis and release in search of scientific information to help mothers breastfeed longer.
Dr. Jacqueline Kent and her colleagues have been studying breastfeeding for many years. As it turned out, for all mothers and babies, this process occurs in its own way.
What were the most surprising results of your research?
Variety. It turns out that the limits of the norm are extremely wide.
We are used to textbooks that say that an infant should eat 8-12 times a day and gain 150 grams per week. But babies don't read textbooks and do things their own way! Some gain weight more slowly, others very quickly.
We followed exclusively breastfed infants aged one to six months. As our studies have shown, on average, a child is breastfed 4 to 13 times a day, and the duration of one feeding varies from 12 minutes to 1 hour. 1
How much milk do breastfed babies usually consume?
According to our research, the amount of milk consumed by baby
ranges from 54 to 234 ml per feeding.
1
Sometimes it seems to the mother that the baby ate well, but when weighed, it turns out that he ate very little milk. And it happens the other way around: the child is distracted, breastfeeds for only a few minutes and still eats 100 ml of milk. Even if the baby is restless, this does not mean at all that he is malnourished.
All babies are different, but they all get as much milk as they need in one way or another. One needs 500 ml of milk per day, while others eat up to 1356 ml!
By the way, boys on average eat 76 ml more milk per day than girls. The main thing is that you have enough milk, and the baby will decide when and how much he will eat.
Should I offer my baby a second breast?
I advise offering the second breast to the baby after the first has been completely emptied. If he accepts it, then he hasn't finished eating. If not, don't worry. Let the baby decide for himself - only he knows when he is full. According to our research, 30% of babies get enough milk from one breast, 13% eat from two breasts at each feed, and 57% from time to time.
1
How do you know if a baby is getting enough milk?
In my experience, mothers often blame themselves for not producing enough milk. Ask yourself: Is my child growing? Is he putting on weight? Is he cheerful? Is his skin healthy? How often does he get diapers dirty? If the answer is “yes”, then the baby is getting enough milk, no matter if he eats a lot or a little.
What is the most common misconception about breastfeeding?
Mothers usually think that the older the child gets, the more often
he needs to be fed and the more milk he will eat. They are often surprised to learn that between the 4th and 26th weeks, total milk production normally does not change. 2
In the first few months, the baby grows very quickly and his metabolism is accelerated. The milk that the child consumes during this period is almost completely used for growth and maintenance of metabolism.
Between the ages of three and six months, metabolism slows down and growth slows, so the same amount of milk is sufficient for the baby.
In other words, the baby does not have to consume more and more milk as they grow older. On the contrary, feedings become shorter and less frequent, but at the same time the child receives the same amount of milk, because he suckles better.
Do studies say anything about the age at which breastfed babies start sleeping through the night?
Most babies need to be fed at night.
The baby's stomach is not large enough to go all night without a feed, and breast milk is digested very quickly. Therefore, it is natural for the baby to wake up at night - and this usually continues for at least the first six months. Feeding at night is normal. When you feed your baby at night, do not even hesitate - all over the world at this moment other mothers of babies of the same age are doing the same. Be patient - it usually only lasts a few months. 1
What worries new mothers the most during the first few weeks of breastfeeding?
The most common concern is whether the baby latch on correctly, sucks well, and is full during feeding. Often mothers also worry about sore nipples. The main thing is to find the right position for feeding from the very beginning and ensure that the baby is latching on correctly. Practice shows that this significantly affects the flow of milk and the convenience of feeding.
What breastfeeding symptoms should be of concern?
Milk production usually returns to normal levels two weeks after delivery. If the child does not begin to gain weight on the fifth or sixth day of life, it's time to sound the alarm. You should contact your doctor to make sure that milk is being produced and that its composition is changing from colostrum to mature breast milk.
What advice would you give to a new breastfeeding mother?
Try to have skin-to-skin contact with your baby as soon as possible after delivery. If possible, feed your baby within the first hour of life, or at least breastfeed. As soon as possible, contact a specialist to correct the position and grip of the breast during feeding and thus avoid damage to the nipples.
Feed frequently. Young mothers do not immediately succeed in correctly recognizing the signals that the child gives. Be sure to feed your baby on demand, and not at set intervals. Offer the breast as soon as you notice any signs of hunger - as a rule, the baby suckles better when he is calm. If he cries, it is more difficult for him to take the breast. If you are not sure what the child wants, offer him the breast. He decides whether he wants to eat or not.
To learn more about Dr. Kent's research, download infographic "How to determine the limits of normal when it comes to breastfeeding" or see it below.
Literature
1 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).
