Newborn baby constantly feeding
Cluster feeding | Pregnancy Birth and Baby
Cluster feeding | Pregnancy Birth and Baby beginning of content4-minute read
Listen
Key facts
- Cluster feeding is when your baby wants lots of short feeds over a few hours.
- Cluster feeding is very common, especially in the late afternoon or early evening.
- No one really knows why some babies cluster feed, but it may be a way for your body to boost your milk supply.
- If your baby cluster feeds, this does not mean that you don't have enough milk.
- Cluster feeding can be exhausting; it's a good idea to think of strategies to help you cope when your baby feeds frequently.
What is cluster feeding?
Cluster feeding is a time when your baby wants lots of short feeds over a few hours. It's normal and often happens in the early days of breastfeeding.
Cluster feeding is a normal behaviour for your baby. It's more common in the late afternoon or early evening, but it can happen anytime of the day.
It seems that some babies prefer to fill up on milk for a few hours then often have a longer sleep.
Why do some babies cluster feed?
There is no particular reason why some babies cluster feed. Some people believe it might boost your milk supply. If your baby wants more milk, then feeding more often will trigger your body to make it.
Is my baby cluster feeding?
If your baby is having a lot of short feeds close together over a few hours, you are cluster feeding.
If you are cluster feeding, you might also find that your baby:
- has short rests or sleeps between these feeds
- feeds for a few minutes then pulls off and on the breast
- cries and is fussy during this time
Common worries about cluster feeding
Cluster feeding can make you physically and emotionally drained. Many parents feel exhausted and frustrated. Some mothers say they feel like a failure, or that they lose confidence about being able to breastfeed.
You might worry that you don't have enough milk because your baby takes a long time to settle. You might also think your breasts feel empty.
But there is always milk in your breasts. They are never completely empty.
What can I do to make cluster feeding easier?
The first thing to remember is that this is normal. Cluster feeding doesn't mean that you don't have enough milk.
To make cluster feeding easier you can:
- relax and follow your baby's lead
- feed to their need
- look forward to a sleepy, settled baby after feeding
- try to rest in the early part of the day to prepare
- drink lots of water
- make sure you eat well — don't miss meals
- get as much family and partner support as you can
Things to look out for
Cluster feeding is a normal part of a baby's feeding routine. Talk to your nurse, midwife or doctor if your baby:
- is not gaining weight
- is not producing wet and dirty nappies
- is not settling after they have finished feeding
Where can I go for help and advice about breastfeeding?
For advice and support contact:
- a lactation consultant
- your family health nurse
- Pregnancy Birth Baby on 1800 882 436
- the Australian Breastfeeding Association Helpline on 1800 686 268
Speak to a maternal child health nurse. Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. This is a free service, and is available 7am to midnight (AET), 7 days a week.
Sources:
Australian Breastfeeding Association (Cluster feeding and fussy babies), Royal Australian College of General Practitioners (RACGP) (Infant and toddler nutrition), Royal Children’s Hospital (RCH) (Breastfeeding)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: May 2022
Back To Top
Related pages
- Breastfeeding your baby
Need more information?
Cluster feeding | Australian Breastfeeding Association
Baby feeds all evening? Witching hour, empty breasts, unsettled baby. It's usually all normal.
Read more on Australian Breastfeeding Association website
Is it really low supply? | Australian Breastfeeding Association
Fussy or crying baby? Soft breasts? Baby cluster feeding? Can't pump milk? It can be hard to know what’s going on.
Read more on Australian Breastfeeding Association website
Breastfeeding your baby
Breastfeeding is the most natural way to feed your baby, providing all the nutrition your baby needs during the first six months of life and a loving bond with your baby.
Read more on Pregnancy, Birth & Baby website
Breastfeeding Tips and Videos | Tresillian
Find videos and top breastfeeding tips to answer your questions, including how long to breastfeed, milk supply tips, and weaning your baby.
Read more on Tresillian website
Why do some mums stop breastfeeding before 6 months?
Most new parents know 'breast is best', but while more than 9 out of 10 babies are breastfed at birth, few mums are breastfeeding exclusively 5 months later.
Read more on Pregnancy, Birth & Baby website
How to increase breast milk supply
Find out what causes low breast milk supply, what is normal and how to boost breast milk production.
Read more on Pregnancy, Birth & Baby website
A day in the life of a newborn
Most babies will start to settle into a daily pattern of sleeping, feeding and playing, whether you follow what your newborn does or establish a simple routine.
Read more on Pregnancy, Birth & Baby website
Disclaimer
Pregnancy, Birth and Baby is not responsible for the content and advertising on the external website you are now entering.
OKNeed further advice or guidance from our maternal child health nurses?
1800 882 436
Video call
- Contact us
- About us
- A-Z topics
- Symptom Checker
- Service Finder
- Linking to us
- Information partners
- Terms of use
- Privacy
Pregnancy, Birth and Baby is funded by the Australian Government and operated by Healthdirect Australia.
Pregnancy, Birth and Baby is provided on behalf of the Department of Health
Pregnancy, Birth and Baby’s information and advice are developed and managed within a rigorous clinical governance framework. This website is certified by the Health On The Net (HON) foundation, the standard for trustworthy health information.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.
The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.
Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.
Support this browser is being discontinued for Pregnancy, Birth and Baby
Support for this browser is being discontinued for this site
- Internet Explorer 11 and lower
We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:
- Chrome by Google
- Firefox by Mozilla
- Microsoft Edge
- Safari by Apple
You are welcome to continue browsing this site with this browser. Some features, tools or interaction may not work correctly.
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.
Share this information
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.
3 Palmeira P et al. IgG placental transfer in healthy and pathological pregnancies. Clin Dev Immunol. 2012;2012: 985646. - Palmeira P. et al., Placental transfer of immunoglobulin G through the placenta with healthy and pathological pregnancy. " Klin Virgo Immunol. 2012: 985646.
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
9 Patel AL et al. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol . 2013;33(7):514-519.- Patel A.L. et al., "Impact of early breast milk on sepsis and health care costs in extremely low birth weight infants". Zh Perinatol (Journal of Perinatology). 2013;33(7):514-519.
10 Zhou J et al . Human milk feeding as a protective factor for retinopathy of prematurity: a meta-analysis. Pediatrics. 2015;136(6): e 1576-1586. - Zhou Q. et al., "Breastfeeding as a protective factor against retinopathy of prematurity: a meta-analysis." Pediatrix (Pediatrics). 2015;136(6):e1576-1586.
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. 13 Lucas A, Cole TJ. Breast milk and neonatal necrotising enterocolitis. Lancet. 1990;336(8730-8731):1519-1523. — Lucas A, Cole TJ, "Breast milk and neonatal necrotizing enterocolitis." Lancet 1990;336(8730-8731):1519-1523. 14 Schanler RJ et al. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. nine0085 Pediatrics. 2005;116(2):400-406. - Chanler R.J. et al., "Randomized Trial of Donor Human Milk Versus Prematurity Formula as a Breast Milk Substitute in Severely Preterm Infants". Pediatrix (Pediatrics). 2005;116(2):400-406. 15 Vohr BR et al. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. nine0085 Pediatrics. 2006;118(1): e 115-123. - Thief B.R. et al., Developmental Beneficial Effects of Breast Milk in the Intensive Care Unit on Extremely Low Birth Weight Infants by 18 Months of Age. Pediatrix (Pediatrics). 2006;118(1):e115-123. 16 Victora CG et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. nine0085 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet (Lancet). 2016;387(10017):475-490. 17 Lewandowski AJ et al. Breast milk consumption in preterm neonates and cardiac shape in adulthood. Pediatrics. 2016;138(1): pii : e 20160050. - Lewandowski, A.J. et al., "Breastfeeding in preterm infants and cardiovascular health in adulthood." nine0085 Pediatrix (Pediatrics). 2016;138(1):pii:e20160050. 18 Meier PP et al. Which breast pump for which mother: an evidence-based approach to individualizing breast pump technology. J. Perinatol. 2016;36(7):493-499. - Meyer P.P. et al., Breastpump Selection: A Scientific Approach to Customizing Pumping Technology. J Perinatol (Journal of Perinatology). 2016;36(7):493-499. 19 Parker LA et al. Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study. J Perinatol. 2012;32(3):205-209. - Parker L.A. et al., "Effect of early pumping on milk supply and timing of the second stage of lactogenesis in mothers of extremely low birth weight infants: a pilot study." J Perinatol (Journal of Perinatology). 2012;32(3):205-209. 20 Meier PP et al. Breast pump suction patterns that mimic the human infant during breastfeeding: greater milk output in less time spent pumping for breast pump-dependent mothers with premature infants. J Perinatol. 2012;32(2):103-110. - Meyer P.P. et al., "Pumping patterns that mimic breastfeeding behavior: more milk and less time for constantly pumping mothers of preterm infants." nine0085 J Perinatol (Journal of Perinatology). 2012;32(2):103-110. 21 Parker LA et al. Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med . 2015;10(2):84-91. - Parker L.A. et al., "Effect of early pumping on milk supply and timing of the second stage of lactogenesis in mothers of extremely low birth weight infants: a pilot study." nine0085 Brestfeed Med (Breastfeeding Medicine). 2015;10(2):84-91. 22 Lee J et al. Oropharyngeal colostrum administration in extremely premature infants: an RCT. Pediatrics. 2015;135(2): e 357-366. - Lee J. et al., "Oropharyngeal colostrum ingestion in very preterm infants: a randomized controlled clinical trial." Pediatrix (Pediatrics). 2015;135(2):e357-366. nine0085 23 Prime PK et al. Simultaneous breast expression in breastfeeding women is more efficacious than sequential breast expression. Breastfeed Med 2012; 7(6):442–447. - Prime D.K. and co-authors. "During the period of breastfeeding, simultaneous pumping of both breasts is more productive than sequential pumping. " Brestfeed Med (Breastfeeding Medicine). 2012;7(6):442-447. 24 Uvn ä s Moberg K Oxytocin effects in mothers and infants during breastfeeding. Infant 2013; 9(6):201–206. - Uvenas-Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206. 25 Boundy EO et al. nine0085 Kangaroo mother care and neonatal outcomes: a meta-analysis. Pediatrics. 2015;137(1): e 20152238. - Boundi I.O. and co-authors, "The Kangaroo Method and Its Impact on Newborns: A Meta-Analysis". Pediatrix (Pediatrics). 2015;137(1): e20152238. 26 Acuña-Muga J et al. Volume of milk obtained in relation to location and circumstances of expression in mothers of very low birth weight infants. nine0085 J Hum Lact . 2014;30(1):41-46 - Akunya-Muga, J. et al., "The amount of milk expressed by location and circumstances of pumping in mothers of extremely low birth weight infants." F Hum Lakt. 2014;30(1):41-46 27 Nyqvist KH et al. Towards universal kangaroo mother care: recommendations and report from the first European conference and seventh international workshop on kangaroo mother care. nine0085 Acta Paediatr . 2010;99(6):820-826.- Nukvist K.H. et al., "On the Universality of the Kangaroo Method: Recommendations and Report from the First European Conference and the Seventh International Kangaroo Method Workshop". Akta Pediatr. 2010;99(6):820-826. 28 American Academy of Pediatrics - Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics . 2012;129(3): e 827-841.- American Academy of Pediatrics - Section "Breastfeeding", "Breastfeeding and the use of breast milk". Pediatrix (Pediatrics). 2012;129(3): e 827-841. *RU No. ФСЗ 2010/06525 dated 03/17/2021 Not sure how to achieve lactation and increase milk production? If you need help, support, or just want to know what to expect, read our First Month Breastfeeding Recommendations Share this information 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. nine0003 Babies are born with a small stomach that grows rapidly as milk production increases: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large hen's 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. nine0003 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. 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. nine0003 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." nine0003 Your baby is still too young for a strict daily schedule, so “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. nine0012 4 At the beginning of each feed, a hungry baby actively suckles the nipple, “Nipple stimulation triggers the release of the hormone oxytocin,” explains Cathy. “Oxytocin is distributed throughout the body and causes the muscles around the milk glands to contract and the milk ducts to dilate. This stimulates the flow of milk. nine0003 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. nine0003 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. 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. nine0003 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.” nine0003 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. 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. nine0012 7.8 At the slightest doubt or signs of dehydration, such as When a baby very often asks to breastfeed for several hours, this is called cluster feeding. nine0012 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. nine0012 9 If a child is overworked, it is often difficult for him or her to calm down on his own and adult assistance 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 Camilla, 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. nine0003 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. nine0003 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. nine0003 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. 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 will most likely be resolved by this time, 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!” nine0003 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,” advises 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.” nine0003 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.-Neville M.S. 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. nine0085 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]. nine0085 9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018]. nine0085 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." nine0085 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. Read instructions before use. Consult a specialist about possible contraindications.
Breastfeeding in the first month: what to expect
How often should a baby be breastfed?
Why does the child always ask for a breast?
Do I need to feed my baby on a schedule?
forget about breastfeeding schedules and focus on his needs. What is a “milk flush”?
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5 How do you know if a baby is getting enough milk?
When is the child's birth weight restored?
dark urine, no stool for more than 24 hours, retraction of the fontanelle (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 will breastfeeding become easier? nine0018