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Should you put your breastfeeding baby on a schedule?
It’s one of the great debates of being a mom. When a mom asks about a breastfeeding schedule, she is probably thinking in terms of how often and when a baby eats.
New and expectant moms want to know which is better, on demand feeding vs. scheduled feeding?
Since feeding is part of the question, it would imply that schedules are primarily about feeding. However, baby feeding schedules are often very much about sleeping.
People discuss the pros and cons of breastfeeding on demand vs a schedule. There was a time though that a baby feeding schedule was not even a thing.
HISTORY OF BREASTFEEDING SCHEDULES
Scheduled feedings for babies was first introduced in the 19th century. This approach was in vogue for quite some time. Before that babies were fed when they were hungry.
While baby schedules worked for some little ones, they worked better for babies who were bottle-fed formula.
A nursing schedule for a breastfeeding mom was often a fast road to frustration.
I remember one of my nursing school classmates sharing how she was told by the hospital nurses that is was terribly disruptive to have to bring her baby to her in the middle of the night to breastfeed. Her baby was born about 50 years ago.
Another woman recounted sleeping past the scheduled feeding time, because her baby had too, and she was terrified something terrible would happen as a result of disrupting his schedule.
WHEN SHOULD YOU FEED YOUR BABY?
The American Academy of Pediatrics (AAP) recommends that babies be breastfed on demand (Source).
If you give birth in a Baby Friendly Hospital you will be counseled to feed your baby when it is hungry.
Instead of demand feeding, you might hear the term “cue based feeding,” which means you feed your baby when you see physical cues that he is interested in feeding. These cues include baby smacking his lips, sticking out his tongue, rooting, sucking on his hands.
The latest sign of a baby being hungry is crying. When a baby has reached the crying stage they have usually become disorganized. As a result, the feeding may not go well.
Mothers are encouraged not to wait for crying before feeding their baby.
WHO RECOMMENDS BREASTFEEDING ON DEMAND?
- The American Academy of Pediatrics is not the only organization that encourages breastfeeding on demand.
- The World Health Organization
- The International Lactation Consultants Association
- Baby Friendly USA
- The Academy of Breastfeeding Medicine
- The American Academy of Family Physicians
- Just about any other professional organization that makes recommendations about infant feeding.
The reason there is so much support of cue-based feeding is because it results in the best outcomes for babies.
- Babies lose less weight in their first few days.
- Breastfeeding on demand results in optimal weight gain
- It also is associated with better breastfeeding outcomes overall (Source).
WHO RECOMMENDS A SCHEDULE FOR BREASTFED BABY?
With all the evidence supporting breastfeeding on demand your next question might be, who the heck recommends a breastfed baby schedule?
There are some popular books out there that promote the idea that it is better to have a feeding schedule for baby. However, they don’t have any reputable organizations backing them up.
There also can be confusion because in the early days after a baby is born moms are told to make sure to feed at least eight times every 24-hours. A lot of people will do some quick math and say, “So you mean I should breastfeed every three hours?”
The reality is that babies don’t always eat at regular intervals. They also may have periods of time when they cluster feed. They may have times when they sleep a longer stretch.
Research has shown that babies need to eat a minimum of eight times each 24-hour period in order to get enough to gain weight at a normal rate. If you have a sleepy baby who is non-demanding there may be times when you will have to initiate a feeding.
Once a baby is demanding frequently enough to result in good weight gain you can usually let them set their breastfeeding routine.
NEWBORN EATING SCHEDULE
The frequency that your baby wants to eat will change, often. That change will be very frequent in the first week.
I tell parents when I see them in the first one or two days after the baby has arrived that it’s like they get a new baby every 12-24 hours, at least in terms of feedings.
Breastfeeding is going to get off to the best start if the baby goes skin to skin right after birth. When a mom keeps her baby skin to skin they do tend to want to feed frequently right from the start.
On a baby’s second night he will probably go through what is called second-night syndrome. This is when babies have stretches of time when they want to breastfeed constantly.
These feedings may be very short, with very short naps in between. If your milk doesn’t start to come in after the second night, which is very common, there may be a third night of this frequent feeding.
All of this frequent feeding is normal, healthy behavior. It helps your milk come in and encourages an abundant milk supply.
After the milk comes in babies will usually start to go longer periods of time between feedings. By the end of the first week your baby may have established something of a predictable nursing routine.
DISCOVERING YOUR BREASTFEEDING ROUTINE
You can see that there will be lots of changes in the first week. Try to follow your baby’s lead. With a healthy, demanding baby most mothers will end up with a plentiful milk supply and a baby who is gaining weight at a normal rate.
Some people have used schedules and it has worked well for them and the baby. Other people who try to get their newborn on a schedule find that they go from a happy baby who is gaining weight well to a fussy baby who is not gaining an adequate amount of weight.
BREASTFEEDING SCHEDULES vs ROUTINES
Once a baby has established a more or less predictable routine, it is important to remember that there are many things that can affect this routine.
- Growth spurts result in more frequent feeding.
- House guests
- A day of many visitors
- When baby is sick
- A busy day of errands.
Flexibility is one of the keys to being a happy mama. If you are trying to follow a rigid schedule, you may end up with an unhappy, frustrated baby, and an unhappy, frustrated mama.
WHAT IS A NURSING SCHEDULE?
Scheduled feedings go by different names. Some baby feeding schedules in reality just teach a mom to look at her baby’s natural routine and follow that.
Some baby feeding schedules are all about manipulating or controlling that routine by ensuring your baby has awake time before sleeping. Some schedule proponents recommend always playing with your baby after feedings.
I have yet to figure out how you play with a milk-drunk newborn, but that’s just me.
Some baby feeding schedules are created by only feeding the baby at certain intervals. Which means that there would be times when your baby would be hungry but you would refuse to feed her because it’s not time yet.
I know that a lot of adults get really grumy if they can’t eat when they are hungry. I think of it this way, say you were hungry and someone had a plate of warm chocolate chip cookies they kept waving in front of your face. They were telling you that you couldn’t have them because it wasn’t time. How would that make you feel?
I can’t imagine that someone who was formula feeding would take out a bottle and put it in front of a baby and then try to distract a baby from wanting to eat.
GOALS OF SCHEDULES FOR BABIES
Many feeding schedules are intended to encourag a baby to sleep long stretches, especially at night. It’s important to distinguish the goal of breastfeeding schedule. Is it weight gain, or sleeping?
And the truth is that when books or friends or sleep consultants talk about the baby sleeping longer, what they really are talking about is the parents sleeping longer.
Having a predictable routines is nice. But it can also be restricting, not only to a hungry baby, but to a busy mom.
Imagine that you are at the mall and you have finished your shopping and your baby is awake, but you’d like him to eat before the half-hour car ride home. You know the car ride will put him to sleep. However, the schedule says that he shouldn’t eat until you arrive home. It would be more convenient to feed him now and he’s showing some feeding cues. Doesn’t it make more sense to just feed him now and let him fall asleep in the car?
FINAL THOUGHTS ON BREASTFEEDING SCHEDULES
If you believe that a breastfeeding schedule will work best for you be flexible. There will be times that your baby is showing she is hungry and your instincts will tell you to feed your baby.
Listen to your instincts.
You know your baby, the proponents of schedules don’t.
At the end of the day, you’ll all be happier if you listen to your baby and your heart.
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.