Feature Archive

Getting on a Breastfeeding Schedule

When to breastfeed your baby, how long, what to do about nighttime feedings, and more.

WebMD Feature

Reviewed By Charlotte Grayson

From almost the moment your baby is born, he or she is hungry. Many first-time mothers are surprised when baby is at their breast, ready to feed, as soon as 30 minutes after birth.

But how soon after that should your baby be fed again? And how often should he or she be eating in the days and weeks that follow? If you're not sure of the answers, you're not alone. Experts say establishing a feeding schedule is often confusing for new moms.

 

"I think one of the biggest surprises about breastfeeding is discovering just how often your baby needs to eat," says Carol Huotari, IBCLC, director of the Breast Feeding Information Center at La Leche League International in Schaumberg, Ill.

In fact, experts say many women worry that they aren't making enough milk simply because their baby wants to feed so often.

"They think that because their baby is eating often, or because their breast does not feel as full as time goes on, that they are not making enough milk, but this is almost never true," says Linda Hanna, IBCLC, program coordinator for Lactation and Prenatal Education Services at Cedars-Sinai Medical Center in Los Angeles.

 

So, what should you expect?

  • Because breast milk is so easy to digest, most breastfed babies eat more often than those on formula, usually between eight and 12 times a day. Frequently that works out to a feeding every one-and-a-half to two hours, usually around the clock for the first few weeks.

  • While crying is certainly a signal that your baby is hungry and ready for more, Huotari says that, when possible, you should never wait until your infant is this distressed before attempting a feeding. "Babies have really small tummies, so you should assume they are going to be hungry within two hours or less. If possible, don't wait until your baby is crying to begin feeding," Huotari says.

    The American Academy of Pediatrics adds that crying is a late indicator of hunger, so you'll want to breastfeed your baby before that point.

  • Earlier signs to look for include nuzzling against your breast when being held, opening their mouth as if to take your breast, making sucking motions, or putting a clenched fist into their mouth.

  • After you're on a regular schedule, feedings may drop to eight times a day (from 12). But the number of feedings could go back up as your baby goes through growth spurts or when he or she simply wants more milk.

Next: What if Baby Sleeps Through a Feeding Time?


 

Sleeping Through a Breastfeeding

 

While most babies won't have any trouble waking you in the night when they are hungry, this is not always the case. Hanna tells WebMD that some newborns are sleepyheads and don't routinely wake up to eat.

 

It's not a good idea to let your baby nap through feeding time until your milk supply is fully developed -- usually two to three weeks after breastfeeding begins, says Hanna. The same way your baby needs to eat, your breasts need to continue to release milk. The more milk that is expressed on a regular basis during the first few weeks of feeding, the more milk your breasts will continue to make later on.

 

"If your baby is not waking up for a feeding, don't wait more than four hours before waking him or her. If it continues, do mention it to your pediatrician," says Huotari. By the time your baby is about four weeks old, you can expect her or him to sleep up to five hours overnight without requiring a feeding.

 

1 Breast or 2: Which Is Best for Each Breastfeeding?

 

In the not so distant past, doctors advised women to switch breasts mid-feeding, allowing baby to start their suckling on one side and finish on the other.

 

Today, doctors know that each breastfeeding consists of two types of milk. Experts at the American College of Obstetrics and Gynecology say the first to be expressed is the "fore milk," which quenches your baby's thirst while supplying sugar, proteins, minerals, and fluid. The second, more filling, and hardier release is "hind milk." This is the creamy, high-fat, super satisfying and most nutritious milk, and necessary for baby's growth and development.

 

"If you switch breasts mid-feeding, you risk giving your baby only fore milk and no hind milk. So it's vital that you continue to feed until your breast is fully drained, then turn to the other breast for the next feeding," says Huotari.

 

Here's another bonus to breastfeeding one side at a time: The more watery fore milk often causes a baby to have cramps or problems with gas. If you stick with one breast per feeding, making certain your baby is getting hind milk, your baby will likely have less gas and be less cranky as result.

 

If, after completing a feeding on one breast and being burped, your baby is still hungry, Huotari suggests you go back to the original breast where you started the feeding. Turn to the second breast only after the original breast seems fully expressed.

Next: Is Breastfeeding Enough Food for Your Baby?

Is Breastfeeding Enough?

 

Among the greatest worries new breastfeeding moms have is whether their baby is getting enough to eat. In most cases, experts say you have nothing to fear because it's likely your breasts are producing enough milk. And if your baby is nursing at least eight times a day, chances are your baby is happily fed. One way to know for sure, however, is to use your baby's dirty diapers as a guide.

 

During the first seven days of life, Hanna says the number of dirty diapers should match the number of days since birth. So, when your baby is three days old, he or she should be dirtying three diapers. After seven days, however, your baby should require far more changes in a 24-hour period. "After the first week, four to 10 wet diapers daily is a good sign," Hanna tells WebMD.

 

Also note: If you are using disposable diapers that pull wetness deep inside the lining, it may be hard to tell if your baby is wetting the correct amount. When this is the case, use the weight of the diaper as a guide. If it "feels" heavier than a clean, unused diaper, then chances are your baby is wetting the correct amount, says Huotari.

In addition to wetting, your baby should also be having frequent mustard-color stools -- or dry dark stools that gradually lighten in color by the fifth day. What's normal to expect here?

"Anywhere from one to as many as five poop diapers a day is normal and essential," says Hanna.

Although dehydration is rare in babies, she cautions that overly dry, dark, or hard stools after the fifth day -- or a lack of any stool -- can be a sign of trouble. Mention these problems to your pediatrician as soon as possible.

 

"The one thing you don't want to do is give your baby water, even if you think they may be dehydrated," warns Huotari. Instead, she says, treat your baby to more frequent or longer breastfeeding sessions. The American Academy of Pediatrics adds that all breastfed infants need vitamin D drops daily to supplement the small amount in mother's milk. Ask your pediatrician about the drops, and how much to give your baby.

In addition, don't be alarmed if your baby seems be feeling lighter in weight during the first week of feeding. Nearly all newborns initially lose up to 10% of their birth weight almost immediately. If feeding progresses at a normal pace, your baby should begin regaining that weight around five days after birth, at the rate of about an ounce a day. Within two weeks, most babies are fully caught up to what they weighed at birth.

"You also must realize that breastfed babies have more lean muscle mass and less body fat -- so you might not necessarily see that chubby, cherub look that most people associate with a well-fed baby," says Hanna.

Be sure to schedule a checkup with your baby's doctor at three to five days of age and again at two to three weeks of age to make sure proper feeding and weight gain are maintained.

 

Finally, look to your own body for yet another sign that your baby is getting enough to eat. If your breasts feel soft to the touch after feeding, they are probably drained of milk, a good sign that your baby is well fed.

As for the length of time for each breastfeeding, Huotari says a session should last about a half hour, with baby at your breast suckling for about 15 to 20 minutes. As your baby's tummy begins to get full, you may notice your baby is pausing longer between swallows. This is a sign that feeding is winding down and your baby is satisfied.

However, if your baby stops swallowing or suckling after just 10 minutes, this could be a sign baby is not getting enough to eat, Huotari says. If this is the case, try to reposition your breast to make suckling easier. Make certain you are not blocking your baby's nose, which can make it more difficult for baby to feed.

 

Originally published Sept. 29, 2003.

Medically updated May 2005.

 

SOURCES: Carol Huotari, IBCLC, certified lactation counselor, manager of the Breastfeeding Information Center at La Leche League International, Schaumberg, Ill. Linda M. Hanna, BSN, RNC, IBCLC, program coordinator, Lactation and Prenatal Education Services, Cedars-Sinai Medical Center, Los Angeles. ACOG Educational Bulletin, Number 258, July 2000. British Medical Journal, April 14, 2001; vol 322: pp 929. American Academy of Pediatrics.

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Last Editorial Review: 7/13/2005 3:54:54 PM


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