Should I wake my sleeping baby to breastfeed?

I meet many mothers who are convinced that you should never wake a sleepy baby; other mothers worry when their baby doesn’t wake to eat at least every three hours. Mothers often tell me that they receive conflicting advice regarding  about infant sleep. Like in real life, the answer is complicated and can vary depending on factors such as a baby’s age, weight gain and your breast fullness.

 

Newborn period

The first two weeks of life are most fragile time where an infant is rapidly developing and initiating breastfeeding. A mother’s milk volume increases in volume gradually and vary from mother to mother significantly. Mothers who delivered by cesarean section or struggled with breastfeeding in first days are more at risk for delayed lactogenesis II (milk coming in). During this time mothers may need to watch their baby’s wakeful periods closely to ensure that they eat at least 8 times in a 24 hour period.

Typically, on the day of birth babies are awake and feed quite well during initial two hours after birth. The several hours after that infants can be quite sleepy and uninterested in eating. I often remind parents that their baby was in “all-you-can-eat-buffet” for 9 months and might still be quite full. This is the time where parents might want to attempt to wake their sleepy baby and offer their breast to avoid baby becoming  difficult to feed later.

If baby did not wake up in the last three hours, parent can try:

– Undressing baby

– Changing their diaper

– Massaging their tummy

– Change their position

– Movement such as picking them up, laying them down, rolling them from side to side

– Stroking their feet or palms

– Stroking their cheeks or lips

– Placing them skin to skin

– Trying again in 30 minutes

 

Second night

After this prolonged sleepy period, newborns often go into a feeding frenzy and want to nurse all night long. Usually this happens on night two of their life. When parents are as tired as they can be and are really looking forward to sleep, babies have a different idea. They respond with stress as soon as  their parents try putting them away to sleep in a bassinet or crib. Newborns have their days and nights mixed up and sleep much more during day time hours. You may recall that your baby was much more active in your womb during the night than during morning hours when you rocked them to sleep. It will take some time to reverse their jet lag.

 

If all goes well, feeding any time your baby is awake and shows signs of hunger is the best approach. Trying to put them on a schedule can make breastfeeding really frustrating for both mother and baby. Just make sure they are waking up and feeding at least 8 times in 24 hrs. If they aren’t feeding regularly, request support from a lactation consultant to assess the feed and milk transfer and contact their health provider.

 

Infants typically lose 5-10% of their birth weight in the first few days of life and should return to birth weight around day 10. During this time, you should wake your baby if they don’t feed for more than 4 hours. It’s common for newborns to have one longer sleep stretch of about 4-5 hours during the day. Good indicator that your baby is getting an appropriate amount of milk is their stool changing to a yellow color around day 4-5.

 

What if your newborn is feeding well, has return to his birth weight and sleeps for extended periods? At this time, I would ask yourself: Can I trust my baby to let me know when their ready to eat? If the answer is yes, then by all means you can let them lead and communicate their needs before you feed them. If you are using an app to track all feedings and diapers, it’s a great time to stop using it and focus on just enjoying your baby and feeding on demand.

 

Few things to consider:

 

Breast fullness

 

What about your breast fullness? Will you get plugged ducts and mastitis? This is an important question to ask. Are you prone to clogged ducts? Are you frequently uncomfortably full? If you answered yes, then you might want to feed more often. You might not need to wake your baby up. Often they will dream feed and continue sleeping. Another option is to hand express or pump to keep your breast comfortably soft. Soon your body will get used to the new routine. Our bodies are quite amazing in this regard.

 

 Milk production

Some mothers might notice a drop in their milk production when they nurse any less frequently. For you it might take some troubleshooting to determine how often you have to nurse to maintain your milk production at the optimal level. Some mothers can go many hours without expressing and be fine, some, will need to remove milk more frequently. Proceed with caution and listen to your body.

 

Period

 

If your menses did not return yet, it may return when you space your feedings more. Remember, if your period has returned or you’re not nursing exclusively around the clock or your baby is older than 6 months you can’t count on breastfeeding as a reliable way to prevent another pregnancy.

 

Plugged ducts or mastitis

 

If you prone to plugged ducts, you might need to be careful when changing your routine abruptly. Making small and slow adjustments would be a wiser approach. Cold compresses or cabbage leaves might help reduce the swelling. You should monitor your breast and take appropriate action when you feel you need it. You may consider trying a supplement of lecithin. More on that here.

 If your baby is sleeping longer stretches at night and their gaining well, enjoy it. It might not last for very long time. Nothing about breastfeeding and infant sleep is permanent. As they go through different milestones and developmental stages, their behavior and needs change. Focus on trust and relationships, be there for them and you will get through the ups and downs of living with an infant.