Due to the current social distancing, I have some extra time. Ironically, I am choosing to write about time! I receive lots of questions about time: How much time at the breast? How much time between feedings? How long should I pump?
So much emphasis is put on this topic, but honestly, I don’t find it to be a huge factor in determining how well breastfeeding is going.
It all comes down to quality over quantity. If baby is at the breast, but not drinking efficiently, or not drinking at all, then time doesn’t really matter. If there is not quality milk transfer happening, then it doesn’t matter how frequently you wake the baby to feed, or how long you keep baby at the breast.
Frequently I hear:
“I am waking baby every X hours and keeping them awake to feed for at least Y minutes, but they are very sleepy. It’s hard to keep them awake.”
Often, these babies are losing -or- not gaining weight well.
When I am talking with a mother in this situation, the two biggest things I will assess and focus on are milk supply and latch. Are there issues with milk supply that could be causing baby to refuse the breast and not be getting enough calories? Is baby latched well enough to nurse and transfer milk? Drinking video.
If latch is poor, and transfer is slow: then they will fall asleep and be hard to keep awake.
If milk supply is low: babies tend to refuse to latch or fall asleep quickly at the breast.
So often, it has nothing to do with milk supply, time at the breast, or frequency of feedings. All too often, it comes down to the latch. Once baby is latched better, they can better handle the flow, they are more awake and active at the breast, and you can hear audible “drinking” and swallowing. At this point, they typically will drink until they are full, feed when they are hungry, and weights will eventually improve.
This is why it is so important to seek lactation support early on before milk supply is affected by a poor latch and lack of milk transfer (milk supply blog).
While I don’t suggest moms to stare at a clock and timer all day long, we have to set some guidelines and occasionally nudge these newborns along. I want to see 10-12 feedings per day with some clustering being ok -and- even normal. The time between a feeding could be very short (clustering) or vary between 1-4 hours. Babies will feed better when they are hungry and when they initiate feedings.
The composition of breast milk changes throughout the day and can even fluctuate some with daily hormone changes of the mother, causing each feeding to be slightly different. This is exactly why a breastfed baby should be fed on demand and not by the clock. Clustering has a purpose and allows babies to get ready for a longer sleeping stretch (maybe one 3-4 hour stretch) or make up for a long sleeping stretch.
In conclusion, we have to make sure baby is gaining weight, is happy and healthy, feeding 10-12 times per day, having plenty of wet and stool diapers, and that the latch is efficient. Because if the latch is not efficient, then time at the breast doesn’t matter.
Let’s be honest, taking care of a newborn is exhausting and there is just not enough time in the day. But if feedings are taking too long, feedings are too frequent, or something just doesn’t feel right, please reach out and seek lactation support!