Newborn baby constantly feeding

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My Baby Wants to Breastfeed All the Time! Is This Normal?

Frequent Feeds Are Very Common!

In the first few days after birth, it is very common for newborns to feed constantly, probably around 12 or more times per 24 hours. Newborn babies drink very small amounts frequently in the first 1-2 days.

Most newborn babies only drink about a teaspoon (5-7ml) of colostrum at each feed on day one. This is just perfect as their tummy is about the size of a cherry and holds about 7mls at each feed on day one! Perfectly designed!

By day two you start to make a little bit more colostrum at each feed and this gradual increase in milk each day stretches bub’s tummy allowing them to drink more.

Colostrum is a sugary delicious drink but it is not jam-packed with fat at this stage, which means baby needs to keep feeding very often to stay full up.

Remember, every time your baby feeds it helps your breasts build your milk supply in the first month. As your milk increases in volume, from around day 3 onwards, you will notice your baby starts to have longer sleep periods of around 1.5 – 3 hours mostly.

During the first month, newborn babies need to feed on average 8 – 12 times every 24 hours to ensure they are getting enough milk and that you stimulate the breasts enough to keep building your milk supply. One you have established a good milk supply in the first month you may find that your baby changes their feeding pattern again. Many mums report this happens around 6-8 weeks after birth.

After this first month, research has shown us that babies will breastfeed anywhere from 4-13 times every 24 hours, but most babies still feed on average 10-11 feeds every day.

Each mum and baby’s breastfeeding pattern is different and this is perfectly normal. It is just down to the levels of fat in your milk (and fat levels change throughout the day) and the amount of milk your breast can hold at each feed, as well as how your baby is feeling.

Babies Find Breastfeeding Relaxing

Most babies find breastfeeding very comforting and, just like if we feel upset a hug can do wonders. Likewise, a short extra breastfeed does the same for calming our babies!

Do not compare yourself with another mum and baby’s feeding pattern. It will most likely be completely different from yours. Trying to “force” your baby into strict routines often brings with it tears and stress for mum and bub!

There are, of course, some mums who say that a routine was the best thing for their baby. But these babies are probably the very small percentage of babies who naturally feed every 4-5 hours and would’ve gotten themselves into a strict schedule anyway!

For most babies, a strict routine does not work! Try and go with the flow, listen to your baby’s cues for when they would like a feed and feed them. Just like us, they will not stick to the same “routine” every day.

I bet you didn’t have the same things to eat, in the same quantity, at the same time, with the same glasses of water, cups of tea or snacks as you have today! So why do we think this is normal for our babies?!

Cluster Feeds Continue After the First Few Days

Most mums report that their baby feeds frequently and is unsettled more so during the evening hours, most commonly between 6 – 10pm. Mums often say that their baby wants to be held constantly and feed “all the time” and that baby cries when put down in their cot.

This is a very normal and common behaviour for babies who are otherwise content during other parts of the day, feeding and gaining weight well and are generally healthy.

Babies do have these periods of cluster feeding, often most present between 2 and 9 weeks of age, but of course some babies will have these periods for several more weeks and still be totally healthy.

Researchers think it is a developmental stage that all babies naturally need to go through. There are a huge number of processes going on in a baby’s brain in the first year. Babies can easily get overwhelmed or dysregulated in the first few months in particular.

Babies who are overtired or overwhelmed, find it hard to calm down by themselves in the first few months of life and need someone to help them. And what better way to be calmed than having a breastfeed, which of course is not just food, but also a pain reliever and a happy hormone giver!

Also, being held and rocked allows baby to feel safe and warm, like being back in the womb. So, it makes sense that they need to be held and fed so much in the evenings after a big day in the big wide world!

Normal Can Still Be Tiring!

Even though this is normal, it doesn’t stop it being exhausting. So, it’s important to note how you are feeling and coping.

Some of us have another person around to help us out, whilst other new mums have to manage alone during the cluster feeds. Regardless of your situation, it is important to realise that cluster feeding is normal.

If you are responding to your baby by holding them and feeding them, yet they are still crying in-between feeds you are not causing harm to your baby, you are still showing them love and they will calm when they are able to.

The other thing to remind yourself is that this is temporary. It is important to not place any demands on yourself during these times. Try preparing dinner at times in the day when baby is sleeping well and just re heat and eat when you can during the cluster breastfeeds!

If you have support, share the holding and rocking of baby with another person to give you a break. If you do not have supports around at that time, listen to your instincts; if you are starting to feel like it is all too much and you feel worried that you are not coping, place your baby safely in their bassinet and walk away to calm down for a few minutes, before coming back to hold baby again.

You could also try knocking on the door of your neighbour, who you know and trust, and asking them to hold your baby for 15 mins or so to give you a break.

Most people will understand and, if they have children, they will have gone through the same themselves. Doing this will not harm your baby, but, will give you time to relax a little and recharge.

If you are finding that you are not coping during other parts of the day then it is important to talk with your GP or contact PANDA http://www.panda.org.au/  for some extra help and support.

If you are concerned that your baby’s crying seems abnormal and you are worried if your baby may be unwell. Please get first line advice from these helplines (below). They will be able to give you support and further guidance:

Health Direct helpline (covers all of Australia) 1800 882 436

Maternal and Child Health Nurse 24-hour helpline on 13 22 29 (if you are in the state of Victoria)

Other Things Which Can Help to Relax Babies During Cluster Feeding Times

Skin to skin contact

Having a bath with your baby – only do this if you have another person to help you and baby in and out of the bath and keep you both safe.

“Rocking your pelvis like Elvis” – Whilst holding your baby, try some rocking and swaying moves whilst holding baby either upright, over your arm like superman or in a cradle hold. Each baby will be different in the positions they prefer. You Maternal and Child Health nurse can show you positions for holding and calming babies.

Carrying your baby in a sling. This keeps baby nice and close and creates a womb like environment.

As you rock your baby make a loud “shuuusssshhhh” noise. This is actually calming for babies as it mimics the sounds of being inside the womb.

Try taking 5 deep breaths with your eyes closed before breastfeeding baby to ensure you are relaxed and not tense.

Make sure you get extra sleep in the day time, even if you don’t feel like it make sure you lay down in a darkened, quiet room to rest your body and brain. Over the next few days you’ll soon be drifting off to la la land easily.

Lastly, remember that you cannot spoil a baby by holding them too much. All the information about spoiling babies came out of textbooks written in the early 1900’s!

We have known for years and years that holding and listening to your baby’s needs is the best thing to do, yet we still hear this very bad advice! So listen to your gut instinct and cuddle, love and feed your baby as they need it. This phase will pass and get easier over the next few weeks.

For more information head over to our Medela Australia Facebook page.

Do you ever feel like your baby wants to feed all the time, especially at certain times during the day? Let’s have a chat and support each other!

Feeding premature babies | Breastfeeding premature babies

Premature babies have a special need for breast milk, but it can be difficult to breastfeed them directly. Our expert advice will help you provide your premature baby with healthy breast milk.

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Professor Katsumi Mizuno, Department of Pediatrics, Showa University Koto Toyosu Hospital:
Katsumi is a Certified Breastfeeding Consultant, Professor of Pediatrics at Showa Medical University, and one of Japan's leading pediatric neonatologists. His research focuses on neonatal suckling skills, breast milk banking, and the use of breast milk for feeding premature babies in neonatal intensive care units.

Babies born before the 37th week of pregnancy are considered premature. ¹ The causes of preterm birth are not always obvious, but certain factors increase the likelihood of such an event. These include: twin or multiple pregnancy, certain diseases of the mother or fetus, as well as a history of premature birth. nine0003

Because premature babies spend less time in the womb, they are not mature enough and may be more susceptible to infection and disease. They often require hospitalization in the neonatal intensive care unit.

Why is breast milk so important for premature babies?

Breast milk is essential for optimal growth and development of term babies, but it is even more important for premature babies.

During pregnancy, the fetus receives important substances from the mother through the placenta, such as DHA (a fatty acid essential for brain and eye development) and immunoglobulin G (an antibody). nine0012 2.3 A premature infant did not receive all of these substances. However, the milk produced by a premature mother contains more fat and secretory immunoglobulin than mothers of full-term babies. ⁴

In addition, premature babies have an underdeveloped gastrointestinal tract, which can make digestion and absorption of nutrients difficult, so they need food that their sensitive stomach and intestines can easily digest. Breast milk contains enzymes that make it easier for the baby to digest, ⁵ as well as epidermal growth factor, which accelerates the development of the gastrointestinal tract ⁶ . Premature infants who are predominantly breastfed have much lower intestinal permeability than formula-fed infants, meaning fewer potentially harmful particles from the stomach and intestines enter their bloodstream. ⁷

Breast milk is so important for premature babies that if the baby's mother does not produce enough breast milk at first for any reason, it is recommended that the deficiency be replenished with donor milk rather than formula. nine0003

Does breast milk improve the condition of premature babies?

Breast milk contains protective substances that can prevent serious diseases that preterm infants are susceptible to, ⁸ such as severe infections, ⁹ retinopathy of prematurity (which can cause vision loss) ¹⁰ and bronchopulmonary dysplasia (chronic lung disease). ¹¹

The more milk your baby gets, the lower the risk of developing diseases. nine0012 12 Every additional 10 ml of milk per kilogram of body weight per day reduces the risk of sepsis by 19%. ⁹ The risk of developing necrotizing enterocolitis (a potentially fatal bowel disease) in premature infants who are breastfed is ten times lower than those who are formula fed. ¹³ That's why every drop counts!

Most importantly, premature infants who are breastfed are typically discharged an average of two weeks earlier than formula-fed infants. nine0012 14 They also have a 6% lower risk of readmission in the first year of life. ¹⁵

Breast milk has been proven to have a beneficial effect on mental and physical development in the long term. Studies show that low-birth-weight babies who are breastfed in the neonatal intensive care unit have an average IQ of up to five points higher than those who are not breastfed. ¹⁵ In addition, their cardiovascular system works better during their lifetime. nine0012 17

Will milk be produced if the baby is born prematurely?

Yes, the mother's body is ready to produce milk by the middle of pregnancy. After the baby is born and the placenta is born, the level of progesterone, the pregnancy hormone, drops, and the production of colostrum, the first milk, starts in the breast. This usually happens after the newborn is put to the breast and begins to suckle rhythmically, but if the baby was born prematurely, he most likely will not be able to latch on at first. nine0003

To replicate the sensations that trigger milk production, you can manually stimulate the breasts and nipples, or use a breast pump to express nutrient-rich colostrum for your baby. ¹⁸ Read below for more information on what to do if your premature baby is not yet able to breastfeed.

Breast milk usually comes in two to four days after birth, but if it was premature, the milk supply may be delayed. However, a recent study shows that moms who started pumping within one hour of giving birth had milk coming in as expected. nine0012 19 This is why it is important to start expressing breast milk as early as possible.

How to prepare if the baby is expected prematurely?

Visit the neonatal intensive care unit to see how it works and how premature babies are cared for. In addition, it will be useful to learn how breast milk is produced and secreted and why it is not only a healthy food, but also an important medicine for premature babies. Read more about this in our free e-book Surprising Breast Milk Facts .

What if a premature baby cannot breastfeed?

Many babies born before 34 weeks have difficulty coordinating sucking, swallowing and breathing. Until the baby masters these skills, nurses will feed him through a tube that is inserted into the nose or mouth and provides food directly into the stomach. In this way, the baby can be fed continuously until he is ready to breastfeed.

If your baby is too weak to latch on and suckle milk, you can use a breast pump* available at the hospital or maternity hospital to “do the job for the baby”. Breast stimulation with research-based technology, ²⁰ mimics the rhythm of the baby's suckling, plays an important role in starting and maintaining milk production in the first hours after birth ²¹ .

Milk should be expressed at the same frequency as term infants are usually fed every two to three hours, i.e. 8 to 12 times a day.

You can try putting a small amount of expressed breast milk into the baby's mouth with a syringe, or putting milk-soaked cotton swabs in the baby's mouth. ²² This is how your baby learns the taste of your milk, which will facilitate the transition to breastfeeding in the future. In addition, the protective substances that make up breast milk will help strengthen the local immunity of the baby's oral cavity. You can be involved in the care of your premature baby in a variety of ways - check with your healthcare provider for details.

Very low birth weight babies - less than 1.5 kg - usually need extra protein, calcium and phosphorus, so they are given fortified breast milk. In some countries, such additives are made on human milk, and, for example, in Japan, on cow's milk. nine0003

Recommendations for pumping milk

If the baby will be in the neonatal intensive care unit for a long time, neonatologists recommend using a double breast pump for pumping. I always recommend Medela Symphony*. Double pumping not only speeds up the process, but also produces an average of 18% more milk than pumping from each breast in turn. ²³

In addition, I advise you to create the most comfortable conditions for pumping. It is generally agreed that it is best to express milk during or after prolonged skin-to-skin contact with the baby (more on this "kangaroo method" below). Another good option is to sit next to the crib and watch your baby while he pumps. Oxytocin (the hormone that stimulates milk flow) is released when you look at your baby, touch him, smell him and think about him, ²⁴ Therefore, comfortable and calm conditions must be created for this in the neonatal intensive care unit.

What is kangaroo care for premature babies?

The so-called kangaroo method involves prolonged skin-to-skin contact between parents and infant. This is extremely beneficial for you and your baby, as well as for milk production. Skin-to-skin contact normalizes the baby's breathing and heartbeat, keeps him warm and allows him to be as close to the parent as possible. Kangaroo care is believed to have a beneficial effect on the health of premature babies, ²⁵ and it helps mothers express more milk ²⁶ and breastfeed longer. ²⁷ Skin-to-skin contact 30-60 minutes before feeding gives baby time to wake up and be hungry so he can eat without being forced.

What if the neonatal intensive care unit offers formula feeding?

Feel free to state that you want to breastfeed your baby instead of formula. If you don't have enough breast milk to feed your baby, ask the ward for help to increase your milk supply. nine0003

It is natural for mothers whose babies are in the neonatal intensive care unit to experience anxiety and stress. Sometimes these experiences interfere with milk production, so it's important to ask for any help you may need. Remember that you have the right to seek support. Your healthcare provider may be able to recommend a suitable lactation specialist, such as a lactation consultant, for you.

How to switch from pumping to breastfeeding? nine0018

At whatever gestational age a baby is born, if the baby is stable enough for skin-to-skin contact, it can seek the breast for sedative suckling. This is the perfect way for your baby to learn sucking skills before they learn to coordinate sucking, swallowing and breathing.

Babies love the smell of breastmilk, so you can put some milk on the nipple before putting your baby to the breast to make him want to suckle. He might even be able to suck some milk. Don't worry if your baby seems to suck very little - he learns every time. He can start with one or two sips and gradually move on to full breastfeeding. Until then, the baby can be fed through a tube, pressed to the breast, so that the taste of milk and touching the breast is associated with a feeling of satiety. nine0003

You can put your baby to the breast for sedative suckling as soon as you are ready for kangaroo care, unless your baby is suffering from bradycardia (slow heartbeat) or low oxygen levels in the blood. You can switch to breastfeeding as soon as the baby is ready for it. Gradually, he will gain enough strength to suckle longer and suck out more milk.

Literature

1 World Health Organization. Geneva, Switzerland; 2018. Media Centre: Preterm birth fact sheet; November 2017 [03/26/2018]. Available from : http://www.who.int/mediacentre/factsheets/fs363/en/ - World Health Organization. Geneva, Switzerland; 2018. "Media Center: Prematurity Fact Sheet"; November 2017 [3/26/2018]. Article at: http://www.who.int/mediacentre/factsheets/fs363/en/

2 Duttaroy AK. Transport of fatty acids across the human placenta: a review. nine0085 Prog Lipid Res . 2009;48(1):52-61. - Duttaroy A.K., "Transfer of fatty acids across the human placenta: a review". Prog Lipid Res. 2009;48(1):52-61.

4 Underwood Ma. Human Milk Formature North Am . 2013;60(1):189-207. - Underwood, M.A., "Breast milk for the premature baby." 1):189-207.

5 Pamblanco M et al. Bile salt - stimulated lipase activity in human colostrum from mothers of infants of different gestational age and birthweight. Acta Paediatr. 1987;76(2):328-331. - Pamblanco M. et al., "Bile salt-activated lipase and its activity in colostrum of mothers of infants of various gestational ages and birth weights." Akta Pediatr. 1987;76(2):328-331.

6 Dvorak B. Milk epidermal growth factor and gut protection. J Pediatr. 2010;156(2): S 31-35. - Dvorak B., "Epidermal growth factor in milk and gut protection". F Pediatrician (Journal of Pediatrics). 2010;156(2):S31-35.

7 Taylor SN et al. Intestinal permeability in preterm infants by feeding type: mother's milk versus formula. Breastfeed Med . 2009;4(1):11-15.- Theilon S.N. et al., "Intestinal permeability in preterm infants and its association with type of feeding: breast milk or formula." Brestfeed Med (Breastfeeding Medicine). 2009;4(1):11-15.

8 Newburg DS. Innate immunity and human milk. J Nutr . 2005;135(5):1308-1312. — Newburgh, D.S., "Natural Immunity and Breast Milk." F Int. 2005;135(5):1308-1312. nine0085

11 Patel AL et al. Influence of own mother's milk on bronchopulmonary dysplasia and costs. Arch DIS Child Neonat ED . 2017;102(3): F 256- F 261. - Patel A.L. et al., "Effect of breast milk on bronchopulmonary dysplasia and health care costs." Arch Dis Child Fetal Neonate Ed. 2017;102(3): F 256- F 261.

12 MEIER PP ET AL AL AL AL . Improving the use of human milk during and after the NICU stay. Clin Perinatol. 2010;37(1):217-245. - Meyer P.P. et al., "Optimizing the use of breast milk during and after a stay in the neonatal intensive care unit." nine0085 Perinatol wedge. (Clinical perinatology). 2010;37(1):217-245.