Feeding Routines

By Krista Gray, IBCLC. Last updated February 10, 2013.

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What does it mean to nurse on demand vs. schedule feeds?

In the strictest sense, nursing on demand means that a mother doesn’t set a clock to when her baby should feed, nor limit feeds, but nurses her baby whenever he is hungry.  This includes wanting to snack or comfort nurse (also known as non-nutritive sucking and has many health benefits of its own).  In contrast, scheduling feeds means that a mother nurses roughly every two- three hours and, if a baby is fussy in between this time she finds other ways to soothe baby – whether through a pacifier, holding, rocking, or possibly even letting the baby cry-it-out.

Is it healthy to schedule a breastfed baby’s feeds?

Different babies have different needs.  Some can take in enough milk during a feed to supply their needs for a few hours; others need to eat much more frequently to grow and thrive.  Breastfeeding is like a dance that mom and baby do together – she follows her baby’s cues and her baby rests in what she provides.  However, when a schedule is introduced to this beautiful dance it can disrupt the flow and cause many pitfalls.

A one-size-fits-all schedule to breastfeeding can be detrimental to mother’s supply, too.  A schedule, which is supposed to bring order, can bring tremendous stress as the baby is always fussy and unsettled and/or a mother’s milk supply dwindles.  Rather than trying to follow an arbitrary feeding schedule it is better for both mom and baby to focus on feeding together, resting together, and being in sync with one another.

So, while some babies may be able to thrive on a schedule, others will have growth faltering and other developmental problems.

What is wrong with my breastfed baby. . . why doesn’t she sleep as long as my friend’s baby who is given formula?

Scheduling breastfeeding along rigid lines is not healthy for a mother’s milk supply or a growing baby’s needs.  Many books have been written detailing how babies should eat every 2-3 hours and suggest various strategies for dealing with hunger between scheduled feedings.  While formula-fed babies may be able to cope with a more rigid schedule, breastfed babies usually do not – and for good reason.  While breast milk is easily digested in 48 minutes, it takes almost double the time, 78 minutes, to digest the same amount of formula.1 This is why a formula-fed baby seems to sleep longer between feeds – her body is having to work much harder to digest the meal she was fed.  Many times a baby will sleep so that all the body’s effort can work on digesting the foreign substance.  In this case, appearances can be deceiving.  The breastfed baby isn’t more unsettled, she is just acting normal according to her body’s needs.

How does scheduled feeding impact a mother’s milk supply?

Every woman’s body is different and so is her breast milk capacity.  Therefore, scheduling breastfeeding for a mom without much glandular tissue (which can hold milk) will cause low milk supply and ultimately early weaning.  Breast size does not determine how much milk a mother has either.  The law of supply and demand is at work:  an empty breast makes more milk.  So a mother that feeds on demand will make more milk for her baby than one who only feeds every few hours.

Are there benefits to nursing on demand than simply nutrition?

Not only does breast milk digest quickly so that a new baby needs to nurse frequently, but the very act of nursing, which requires touch and holding, is a normal and important part of growing a healthy baby.  Your baby doesn’t just nurse for nutrition; she also nurses for comfort – to be held close to and often by her favorite person in the world – her mother.

What if I am breastfeeding and exhausted and just need sleep?

A mother should learn her baby’s early feeding cues – such as moving arms to face and rooting – and feed on demand.  She should nurse in positions that are relaxing for her so she can doze off and get rest while feeding her baby.  A mother’s most important job in the first weeks after having a baby is to feed this new life; all other household chores, cooking, etc. are secondary.  Accept all offers to cook and help with laundry, housework, and caring for older children.  That way, the new mom can rest while her baby is resting.  At night, consider bed sharing, co-sleeping (in the same room), and/or having your partner help with diaper changes, bringing baby to mom to nurse, etc. Research shows that breastfeeding moms get more sleep than their formula-fed counterparts.2  Research also suggests that breastfeeding moms are more sensitive to their baby’s needs.3  Rather than trying to create an unnatural schedule that could harm the breastfeeding relationship, focus on feeding your baby on demand, having help with other tasks, and resting as you nurse your baby throughout the night and day.

Show 3 footnotes

  1. Cavell B. (1981) Gastric emptying in infants fed human milk or infant formula Acta Paediatrica Scandinavica. 70(5):639-41
  2. Tackett, KK. (2010) Nighttime breastfeeding and maternal mental health Hale Publishing http://www.ibreastfeeding.com/content/newsletter/nighttime-breastfeeding-and-maternal-mental-health
  3. Pearson, RM, et al. (2011) The impact of breastfeeding on mothers’ attentional sensitivity towards infant distress Journal of Infant Behavior and Development. 2011 Feb;34(1):200-5.
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