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How Often: Breastfeed on Demand or Scheduled Feedings?

How to Encourage Appropriate Weight Gain and Build Breast Milk Supply

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Updated May 21, 2014

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The old adage "never wake a sleeping baby" can actually be poor advice if you are a breastfeeding mom of a new baby. While letting sleeping babies lie can be a workable strategy for older babies, spacing out feedings too far apart in those early weeks may decrease your milk supply and can keep your baby from packing on the much-needed pounds. Surely, these are consequences you want to avoid.

How Often to Breastfeed Newborns

So you realize you might need to wake your baby for feedings, but how often? If you have a freshly born baby who is still below her birth weight, it is very important that you breastfeed her often. Many lactation consultants will advise that you aim to feed at least 10 to 12 times in a 24 hour period. Another way to think of it is to nurse about every 2 hours during the day with no longer than 4 hour stretches at night.

Be assured - at this young age, you can't "spoil" your baby or breastfeed too often. Also, during the first few weeks and during growth spurts, your baby may likely engage in what is called cluster feeding. This is when a baby feeds as often as every 45 minutes to an hour for a period of several hours. Think of it as your baby's attempt to "tank up" for the night. It helps stimulate your milk supply, encourages weight gain, and also may get your baby sleep a bit longer (bonus!).

Once Birth Weight Returns

Once your baby returns back to her birth weight (typically babies lose around 7% in the first week and should return to birth weight by the end of the second week) and has established a good weight gain pattern, you can relax quite a bit. Rather than feeding by set periods of time, you can switch to feeding on demand.

The only caution with that recommendation is your baby still doesn’t know her days from her nights. That means she may sleep for longer stretches during the day and shorter stretches at night. If you want to try and savor the longer stretches of sleep for the night time, you might want to wake her after 4 hours during the day and see if she wants to feed. Although your baby is not likely to establish a circadian rhythm (where she naturally sleeps more at night) until she’s 3 to 5 months, keeping her stimulated and feeding often during the day might help you avoid more frequent night wakings.

A Word on Scheduled Feedings

Some parents would argue that all babies should be put on scheduled feedings, pacing feeds at set periods of time. However, the American Academy of Pediatrics, the American Dietetic Association and the World Health Organization now recommend that healthy babies should be fed when they show signs of hunger rather than when a clock indicates "it's time". The key there is for you to determine the difference between honest-to-goodness hunger cues and the typical fussiness that nearly all babies experience. You don't need to feed your baby at every whimper or hiccup, but certainly do feed her when it it is clear to you that she is hungry. Additionally, a way to avoid tantrums in older babies is to address their hunger needs.

Resources

Saxon TF, Gollapalli A, Mitchell MW, and Stanko S. 2002. Demand feeding or schedule feeding: infant growth from birth to 6 months. Journal of reproductive and infant psychology 20(2): 89-99.

Shah PS, Aliwalas L, and Shah V. 2007. Breastfeeding or breast milk to alleviate procedural pain in neonates: a systematic review. Breastfeeding medicine 2:74-82.

Woolridge MW. 1995. Baby-controlled breastfeeding: Biocultural implications. In: Breastfeeding: Biocultural perspectives. P. Stuart-Macadam and KA Dettwyler (eds). New York: Aldine deGruyter.

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