Breastfeeding and Sleep

Breastfeeding and Sleep

Though many jokes are made when a woman is pregnant about the sleepless years she has coming, no mother can be completely prepared for what life will be like with a new baby. While having a baby is a huge blessing, it may not always seem that way -especially in the middle of a night when a mother is exhausted but still awake with her nursing baby. And yet, while a lack of sleep is a huge issue in our western culture today there are many things mothers can do to maximize sleep at night. Here are 6 important reminders about sleep and a new baby.

  1. Babies aren’t supposed to sleep through the night.
    Their bodies need nutrition and physical touch at very regular intervals throughout the day and night to grow and develop properly. Breast milk is created to be digested quickly (twice as fast as formula) because babies need to eat often to grow their bodies and brains. Did you know a baby’s brain will triple in size during the first year of life? Breast milk is uniquely designed for rapid brain growth. If newborns slept through the night they wouldn’t get the nutrition they need to grow and develop as they should.
  2. We need to adjust our mindset.There is not a problem with your new baby who is up all the time wanting to nurse. This is how she was designed! Wanting to nurse all the time is not a problem that must be fixed but a reality that must be embraced. Rather than trying to change our babies, we need to change our expectations. The challenge is to figure out how meet your baby’s needs while meeting your need for sleep as well. Rather than buying into our culture’s belief that breastfeeding has to be synonymous with lack of sleep, we need to help new moms figure out how to do both well.
  3. If your newborn does sleep through the night regularly this should be a red flag.
    Sleepy babies can be babies in distress. They may be reserving their energy and sleeping more when what they really need is more food so they can grow and thrive. When someone says their new baby sleeps through the night, we shouldn’t wish ours would too. Rather, we should be concerned about the baby that sleeps so much!
  4. Co-sleeping does not carry the same risk factors for every situation.
    Fear has driven mothers today to do everything possible to keep their babies out of their bed. Doctors and health care workers actively tell mothers that their babies could die if they fall asleep together. While this is true and, sadly, happens far too often in western culture, it is also true that many breastfeeding families fall into an extremely low risk category when bed sharing is practiced using the “Safe Sleep Seven.” 1 What the western establishment has failed to tell mothers is that, under certain specific criteria, bed sharing with your baby may be the least risky option for your family.  Parents must be given all the facts to make an educated and informed decision. Families should know the following information:
    • 70%-80% of breastfeeding mothers will fall asleep with their babies at some point and creating a safe environment is much better than falling asleep on a couch, recliner, or other unsafe surface 2 In fact, even if a breastfeeding mom decides she never wants to fall asleep with her baby, it is imperative to create the safest nighttime breastfeeding environment possible, in the event that mom falls asleep while nursing.
    • Mothers who don’t co-sleep are at significantly higher risk of early weaning (and there are many known and well documented risks to formula feeding that can affect a child’s health over the course of his lifetime)
    • Situations where we hear of babies being smothered by sleeping in an adult bed usually have not followed the “Safe Sleep Seven” bed sharing guidelines. (Bed sharing should only occur if all of the “Safe Sleep Seven” criteria are met: exclusive breastfeeding; no drugs, alcohol, or tobacco use by either parent; no pets or other siblings in bed; covers are low on the bed and there are no cracks, unsafe surfaces, or possibility of baby falling out; baby sleeps on back when not nursing; unswaddled; and he was a full-term, healthy baby. Mothers instinctively use the cuddle curl position to protect baby as she sleeps (which is an innate protection mechanism). 3
    • When a mother and baby sleep beside one another (not in a side cot attached to a bed) their breathing patterns mimic one another so that mother is aware of baby’s sleep cycle and they sleep/wake together. This greatly reduces the risk of SIDS. 4
    • The very act of breastfeeding reduces a baby’s chances of SIDS …and since we know that mothers and babies who co sleep will breastfeed longer and that they will fall asleep together at some point whether planned or not, perhaps we should change our mindset. Rather than saying bed sharing is always dangerous, and then having exhausted moms fall asleep in very unsafe environments with their babies, we must do all we can to inform parents about the dangers of SIDS and how to create safe sleeping environments that encourage breastfeeding and bed sharing so both mothers and babies can get sleep. (The four biggest risk factors for SIDS are baby sleeping on stomach, smoking in household, leaving baby unattended, and formula-feeding.) 5
  1. Co-sleeping does not spoil your baby.
    Your baby has just spent the last nine months in the most amazing “bed sharing” space possible. And now we expect this new baby, who entered a new and unknown world, to not only sleep at night but sleep in her own space? Sleeping together or nearby will not spoil your baby or teach him bad sleeping habits. Babies need to be with their mothers. Babies need breast milk. And babies need lots and lots of physical touch. Mothers need sleep. It just makes sense that these can be safely combined for many families, just as has been done throughout the history of the world.
  2. Night nursing establishes a mother’s milk supply and helps her sleep.
    Night nursing is not only important for babies’ growth and development but also for a mother’s milk supply. Prolactin is a hormone that helps to build and maintain a mother’s milk supply and prolactin levels are higher at night. Nighttime nursing helps to establish a strong milk supply for the duration of breastfeeding. 6 The act of breastfeeding also produces oxytocin in a mother’s body, which helps her to relax. So not only does nighttime nursing help establish and maintain a mother’s milk supply, she is also more relaxed and can dose back off to sleep easier.

So, new mama, relax. Follow your maternal instincts. Don’t worry what the sleep experts and parenting books say…your baby hasn’t read them anyway. Enjoy your baby. Cuddle your baby. Nurse your baby. Hold your baby. Unwrap that tight swaddle and embrace all the hours each day you get to spend bonding and breastfeeding. Contrary to what our pop culture might try to convince you of, you are not spoiling your baby. All too soon you will be on the other end of raising your children and will wonder what happened to these early days.

You may also enjoy reading Getting Rest with a Newborn and Nighttime Nursing: My Story.

Getting Rest with a Newborn

Getting rest with a newborn!  It’s one of those things we all need. . . everyday. . . and yet seems impossible to get enough of when you have a new baby.  But a new baby does not have to be synonymous with exhaustion.  I have four children and I’ve tried a lot of different things to get rest since becoming a mom (some have worked, some have failed miserably).  Here are some strategies to help you get rest when you have a new baby.

  1. Breastfeed. On Demand.
    Did you know solid research shows that moms who breastfeed their babies actually get MORE sleep than their formula-feeding counterparts?  Perhaps its because a mom must arouse from sleep much more to mix, feed, and then sterilize a bottle, or perhaps it’s because a mom is so in tune with her little one that even if she’s not giving the bottle she usually wakes thinking of her baby (and then must deal with pumping and/or engorgement).  But breastfeeding on demand also satisfies your baby’s needs, allowing him to find contentment and peace knowing his needs are met. . . and by the person he loves most in his big, new world.  Nursing on demand also helps to protect against engorgement, which allows mom to get rest when the opportunities arise since she won’t be in pain from too much milk.
  2. Co-sleep.
    Sleeping with your baby nearby, whether in the same room, in a side-sleeping cot, or bed sharing (when all safety criteria are met) will allow for more rest for mom while baby breastfeeds throughout the night. For families that choose to bed share, it is essential that all of the “Safe Sleep Seven” criteria are met: exclusive breastfeeding; no drugs, alcohol, or tobacco use by either parent; no pets or other siblings in bed; covers are low on the bed and there are no cracks, unsafe surfaces, or possibility of baby falling out; baby sleeps on back when not nursing; unswaddled; and baby is full-term and healthy. Mothers instinctively use the cuddle curl position to protect baby as she sleeps (which is an innate protection mechanism). 1 We know that when mom and baby are sleeping together, mom exhales carbon dioxide which stimulates baby’s breathing. While there are always risks with exhausted mothers, newborn babies that eat throughout the night, and sleeping options, the evidence of SIDS deaths shows that the four biggest risk factors involve smoking, baby sleeping on stomach, formula-feeding, and baby unsupervised during sleep. 2 Families need to be aware of the safety precautions that should be taken for safe bed sharing, as well as hazards that can occur if mom falls asleep with baby on a couch or other unsafe surface.  The risks of early-weening due to exhaustion and the known dangers of formula feeding must also be weighed in regards to sleeping space.  Bed sharing can not only be practiced wisely, but also with exceedingly low risk for families that meet all seven safe sleeping criteria. 3
  3. Nap when your baby naps.
    Though it’s tempting to try to get other things done when your baby is napping, try not to do too much too fast after having a baby and make resting while your baby does a priority.  Researching on the internet, using social media, cooking, cleaning, etc. can all wait.  If you have other children you are caring for, allow them to have a “quiet time” at some point each day as well.  Whether they learn to play quietly in their room, read books, or watch a video, it is okay for them to have this down time while you and your baby rest as well.
  4. Let others serve you.
    Now is not the time to be supermom!  Accept all offers of help whether it’s cleaning your house, doing laundry, cooking meals, or going grocery shopping. . . don’t turn anything down.  Let your spouse, family, and/or friends help you out while you focus on feeding your baby.  And, don’t feel guilty about “not doing anything.”  You are doing a lot!  You are feeding and nurturing a new life!
  5. Get a sling.
    Sometimes a new baby doesn’t want to nurse, but doesn’t want to be set down either.  A baby can get so overly tired he finds it hard to then go sleep.  A sling or wrap can allow your baby to snuggle in close to mom (and hear her comforting heartbeat) while you still have two hands to get other necessary things done.  Sometimes these rests are just what your baby needs to be able to sleep better at night and throughout the day – sleep begets sleep.

Nighttime Nursing

Nighttime Nursing

Nighttime nursing is a hot topic among new moms, primarily because it seems to be synonymous with lack of sleep. This was certainly true for me with my first three kids! When I had my daughter in 2006 I had read and prepared not only for her birth but also parenting. Most of what I read strongly urged helping your baby “learn” to sleep and finding a “sleep schedule” quite early on. There was even great evidence stated as to how babies who sleep better are smarter and perform better in school. I was sold. I mean, who doesn’t want to help their child achieve their fullest potential?! At the same time, I was also sold on breastfeeding and knew that I was not about to supplement with any formula.

After my daughter was born, it quickly became apparent she had not read those same baby scheduling books. In fact, not only was she up all night wanting to nurse but this was also the time when she wanted to smile, coo, and play! Thankfully, she was my first child so I actually could sleep during the day when she slept. Each night I would nurse her and then put her in her bassinet, which was in our bedroom. I was determined she was not going to sleep in our bed, but by the second or third feed in the early hours of the night that seemed silly and by morning I would wake up with her beside me, snuggling away. As wonderful as it seemed, I still thought the “experts” had to be right and wanted to have her sleep in her bed. What I didn’t know is that babies consume 20% of their total daily milk intake during the night. Her nighttime nursing was perfectly normal for a new baby. Over the months she stretched out the length she slept before waking until she was pretty regularly sleeping from 11 p.m. until 6 a.m. Around 6 months old I moved her to a crib in her room and when she woke in the morning I’d nurse her on an extra bed in her room where we’d both fall back asleep together. This lasted until she was almost two years old.

When our twins were born my world was turned upside down. They were 7 ½ weeks premature, we were living in Egypt, and we brought them home when they were just one week old. Since they were preemies, they slept all the time and I had to wake them for every single feeding. Night nursing really wasn’t the issue – it was 24/7 feeds, pumping, feeding that led to total exhaustion. I’ve written more about their birth and nursing stories in other posts.

As our fourth child was on the way I knew I was going to have to get sleep at night if I wanted to be able to parent my other, very active, children. From the very first night this little one slept in bed with me. I made sure we met all of the criteria of the “Safe Sleep Seven” to create a safe sleeping environment (exclusive breastfeeding; no drugs, alcohol, or tobacco use in the home; no pets or other siblings in bed; covers were low on the bed and there were no cracks, unsafe surfaces, or possibility of baby falling out; he slept on his back when he wasn’t nursing; unswaddled; and he was a full-term, healthy baby ). 1 Being an experienced nursing mom, breastfeeding while lying down came easy. I would rouse from sleep enough to help him latch on and then fall right back to sleep. I felt well rested each morning (even though he nursed throughout the night) and had many people volunteer that I didn’t look like I had a new baby. The very next statement was typically about whether he was sleeping at night. Most would then look at me with pity, as if they felt sorry for me my child was in our bed and not on a parent-led sleep schedule. Our culture thinks breastfeeding and sleep are contradictory for a new mom, and prizes scheduling a baby in order to sleep. Yet, babies haven’t read these books, nor were they designed to sleep through the night at early ages.  Babies are made to breastfeed and,  current research shows that nursing moms get more sleep than their formula-feeding counterparts. 2

Having done it both ways, I can surely say that creating a safe sleep environment and tucking my baby in bed with me was much easier and less stressful for our situation. I neither had to worry about getting my child on a sleep schedule nor get up and down throughout the night in order to breastfeed. We both got sleep, he got as much breast milk at night as he needed, and we both woke up rested and ready for the day.



Co-Sleeping is a broad term that can encompass anything from bed-sharing, a side sleeper attached to your bed, nearby Moses basket, or separate crib/cot in the corner of your bedroom.  Many use the term interchangeably with bed sharing but, in actual fact, it is broader than just bed sharing.

Research shows that even when moms and babies do not purposely plan to bed share, 70-80% of breastfeeding dyads will bed share at some point during the first three months. 1 Therefore, care should be taken to ensure a safe sleeping environment even if a breastfeeding mom does not plan to fall asleep with her baby.

There are many factors that help to make bed sharing safer and, armed with information, some families will choose to co-sleep but not bed share.  This still allows for many advantages to breastfeeding and will help a new mom maximize the amount of sleep she can get.  Whether baby is in a side sleeper attached to your bed or crib on the other side of the room, many mothers will scoop their baby up when he awakes, nurse him lying down in bed, and then return him to his separate bed once nursing is done.  Though there is more up and down throughout the night than if baby stayed in bed with mother, it still doesn’t take too much arousal to quickly get baby and lay back down to nurse.  Sometimes baby’s father may agree to bring baby back and forth during the night allowing mom to remain in bed.  Regardless, co-sleeping means baby is nearby and you can hear her awake before she is upset and crying, as what happens many times when baby is in a separate room. The Academy of Breastfeeding Medicine’s Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding says, “Because breastfeeding is the best form of nutrient for infants, any recommendations for infant care that impede its initiation or duration need to be carefully weighed against the many known benefits to infants, their mothers, and society….There is currently not enough evidence to support routine recommendations against co-sleeping.” 2 Co-sleeping allows you to respond to your baby’s needs quickly and helps both mother and baby maximize their sleep.

You may also be interested in reading about why it’s important to nurse at night, breastfeeding and sleep, and my story of nighttime nursing.

Getting Started Breastfeeding

165427_10100153832465781_360474928_n As you are getting started breastfeeding, there are many breastfeeding basics you can do to create an environment for success.  Women have been breastfeeding their babies since the beginning of the human race, and its only been in the last century that anyone has used artificial infant formula. When there were no alternatives, almost every mother breastfed her babies successfully.  (And those that couldn’t would still have human milk through a wet nurse.)  I say this to encourage you. . . you can do it!  Here are some things that will help you with getting started:

    1. Prepare for the birth of your baby.
      Read books, make a birth plan, and choose your doctor/birthing facility wisely.  If you are giving birth in a hospital, try to find one that meets the BFHI (Breastfeeding Friendly Hospital Initiative set out by the World Health Organization) requirements.  We know that the type of birth you have affects breastfeeding so make a plan for how you’d like your birth to go.
    2. Have minimal intervention, as natural a birth as possible.
      A natural and unmedicated birth leaves you and your baby ready to start breastfeeding strong.  Did you know that a healthy, unmedicated baby has innate instincts and reflexes that if placed on your belly can push himself up and latch onto his mother’s breast unassisted?!  It’s been termed the breast crawl and is quite powerful to witness.  A natural birth allows you to immediately begin skin-to-skin time with your baby and helps him to be alert, able to latch, and suck well for his first breastfeed.
    3. Hold your baby skin-to-skin immediately following birth.
      Do this for at least the first 2 hours, before your baby is bathed, weighed, or even wiped off.  This is critical bonding time for you and your baby as your body has many thriving hormones that allow you to bond and absolutely fall in love with your new little blessing.  Skin-to-skin helps regulate your baby’s temperature, stabilize her heart rate, stabilize blood glucose, reduce crying, stimulate self-latching, and coordinate sucking at breast.  For the mom, skin-to-skin helps to regulate her temperature, increase oxytocin levels, develop adequate milk volume, bond with her baby, increase her confidence, and decrease breastfeeding problems.
    4. Delay screenings, baby checks, bath, etc. until after first breastfeed.
      You can never get the first two hours after your birth back and all the key baby checks for a healthy, full-term baby can be done while on skin-to-skin with her mom.  Postpone everything else and enjoy these precious moments with your new baby.
    5. Room in with your baby.
      The best way to get to know your new baby is to spend time together.  Keep your baby in your room with you so you can see early feeding cues your baby gives and nurse on demand.
    6. Practice safe co-sleeping.
      Co-sleeping allows you to maximize sleep while allowing your baby to nurse on demand.  Rather than having to get up every time your baby wakes and go to another part of the house, it is much easier to nurse and take care of your newborn’s needs while bed sharing or in the same room as mother.  Follow safe co-sleeping guidelines. And remember, your baby hasn’t read all those parenting books about scheduling sleep and feeds. You’ll find it a lot less stressful if you just follow your baby’s needs and go with it.
    7. Have support in the first weeks after birth so you can concentrate on feeding your baby. 
      Your job is to feed your baby.  Treat yourself as  queen. . .prop pillows around you to be comfortable, have a remote, book, and cell phone nearby, as well as a glass of water and snack.   And, accept all offers for help around the house with cooking, cleaning, and taking care of older siblings.  Now is not the time to keep a spotless house and or to cook gourmet meals.  Enjoy your new baby and take time to rest and nurse often.
    8. Breastfeed often and on demand.
      It is normal for your baby to nurse often.  If you have a sleepy baby, make sure to wake her up and nurse at least every three hours. It is also normal for babies to not only want to nurse for hunger, but also nurse for comfort (“non-nutritive sucking”).  Even non-nutritive sucking offers milk, builds your supply, and allows you to bond.  Offer both breasts at each feed and nurse until your baby comes off satisfied.
    9. Don’t settle for breastfeeding pain.
      Breastfeeding should not hurt.  If you have pain or sense something is not right, seek help from a qualified Lactation Consultant (ideally an IBCLC – International Board Certified Lactation Consultant). Seek help sooner rather than later!
    10. Find a mom-to-mom support group.
      For help and encouragement, try to find a local breastfeeding group such as La Leche League.  You will meet other moms who are at different places in their breastfeeding journey and it can be a wonderful encouragement and support for you.
    11. Know what’s normal. . . and what’s not.
      For example, all babies loose weight after birth.  It is normal to take up to 2 weeks to gain this weight back.  It doesn’t mean you don’t have enough milk.  Or, after your baby is born you have colostrum (the thick, rich, antibacterial first milk) for the first 2-4 days before your milk begins to come in.  This is normal and it helps your baby pass meconium (the dark first poo) and help against developing jaundice.  Just nurse often and on demand to encourage your milk to come in strong.
    12. Find a pediatrician who is supportive of breastfeeding.
      And don’t hesitate to find a new one if you find out yours just gives lip service to the importance of breastfeeding.  If you want to nurse your baby and you or your pediatrician have concerns, seek a lactation consultant before turning to artificial infant formula.
    13. If you sense there is a problem, work to build your supply by expressing (either by hand or with a pump).
      You can offer this additional milk to your baby via syringe, cup, or bottle.  But, building a strong supply of milk is important.  Don’t wait until your supply dwindles to begin pumping if you have concerns about your supply or how much your baby is eating at each feed.
    14. Trust your body to make milk.
      Your body knows what to do and it has been getting ready throughout your pregnancy.  Have confidence in your body’s ability to make milk.  Relax and don’t stress.  Also, don’t supplement with formula just because you don’t think you have enough milk.  (This is a slippery slope and will just about guarantee you won’t have enough milk.)  Believe in your body and nurse your baby on demand so your body gets the message to continue to make milk.  Remember, an empty breast makes more milk!  Not only does your body know what to do, but your baby also has an innate ability to latch on to your breast and nurse.
    15. Finally, through it all, remember why you want to nurse your baby.
      Realize nursing is more than just giving your baby amazing milk. . . it is also a wonderful bond that you share and will grow throughout your lives.  Lots of skin-to-skin and cuddling with your baby not only has a positive impact on breastfeeding, but also on your mothering relationship.  Cherish these precious moments as your little blessing will grow so fast.  You cannot spoil your baby by nursing too frequently, cuddling too much, or sharing too much skin-to-skin time.  Your baby just spent the last nine months in your womb having every need met immediately.  Continuing to meet her needs (food, love, cuddles, nurturing) are exactly what she needs.

Bed Sharing with a Toddler

bed sharing with a toddler

What our bed sharing has become – mattresses on the floor and revolving door for any kid(s) who come to our bed.

Through the past 8 years – over the course of having 4 children and 6 international moves – we’ve had all sorts of sleeping arrangements. From our first child and the traditional – baby sleeps in the crib while tired exhausted, breastfeeding mom gets up for every feed…and then puts baby back in crib – to our fourth child where we never bothered getting a crib at all, we’ve tried it. I’ve written about our last baby and how much easier it was to just put him in bed with us from the very beginning here.

Bed sharing with our fourth child - his bed was ours.

Bed sharing with our fourth child – his bed was ours.

But how do you practice bed sharing with a toddler? We are told by most everyone that bed sharing with a newborn will lead to SIDS (though this is absolutely not true when the Safe Sleep 7 are practiced). At least sleeping with a newborn can mean a better night’s sleep for a new mom. But a toddler? Kicking, tossing, turning, restless sleep…by this point mom’s space in the family bed is usually just a smidgen, squashed in between everyone else.

Bed sharing with our twins - age 2.

Bed sharing with our twins – age 2.

When our family increased from one child to three, we decided to get a bigger mattress. Going from a queen to a king made a huge difference. By the point we took this plunge we had 2 toddlers and a preschooler. Most of the time they would start off the night in their own beds, but any assortment would end up in our bed throughout the night. Having a king size mattress – and one without box springs so it was low enough to the ground they could easily crawl in – really helped us to enjoy bed sharing. It also provided a great, big mattress once our fourth arrived so he could easily call our bed his own.

But once he started rolling around, things became more complicated…especially naptime. We set up a pack n’ play at the foot of our bed so if we weren’t in bed he could still have a safe place to sleep without rolling off. Little did I know he was going to love having his own space. He enjoyed napping in “his” bed. During the night he began tossing, turning, kicking, and pushing after nursing, “asking” for his own space. As soon as I’d get up and lay him on a separate mattress he’d smile, relax, and dose off into restful sleep. What?! Yes, I’m serious. By this point in our bed sharing journey, I was completely happy with having him (and any other assortment of children that wound up in bed with us at night) in our bed. But this little guy wanted his own space. So for a year we kept a pack ‘n play in our room and I’d get up and put him in bed with us when he wanted to nurse, and then return him to his bed at his request.

Though I was nursing lying down and falling back asleep as he fed, I didn’t like the fact he’d wake me up when he was done and push and point to his bed…it required me to get up twice for every feeding. I was tired. So, in an effort to help him sleep well, and to keep me from having to get up and down throughout the night to nurse a toddler, we came up with the idea of putting mattresses on the floor. We were in the midst of yet another move and would only have a full-size mattress for a season. We decided to put our mattress in one corner and his on the other – with a sea of pillow in between. Now, when our toddler wakes and wants to nurse, he actually comes and crawls into bed with me. If he falls asleep afterwards that’s great – it makes for one happy mama! (Sometimes he will roll onto the pillows I have mattress-high beside the bed and make a new “bed” there.) If not, I’ll dutifully take him back to his mattress where he goes right back to sleep. I love that he doesn’t even make noise when he wakes…he’s such a big boy he knows he can just crawl off of his mattress and into ours. I usually wake briefly to feel his sweet body snuggle up to me, but then fall back asleep.

Now our bed sharing has turned into co-sleeping.  I know these days are short and I’m treasuring them all, even when our now “big kids” – all school-age – want to come to our bed for cuddles. One day, all too soon, they will be grown up and out of our home. The musical mattresses game that we play now will become memories I will cherish forever.

Breastfeeding Twins at Night

Breastfeeding Twins at Night

Getting Sleep:  One advantage of lying down while nursing twins.

Getting Sleep: One advantage of lying down while nursing twins.

Getting rest with a new baby in the house can be challenging . . . and doubly so when you have two (or more) new babies.  Breastfeeding twins at night is not only important but it can help you get more sleep than formula-feeding.  Here are some tips and strategies to help.

First, begin with reading this information about getting sleep with a nursing baby.

Additional sleep strategies with twins:

  1. Sleep with babies in your room
    While nursing at night, make sure to have your babies close by.  While there are pros and cons to having twins sleep in the same bed as you, you definitely want them nearby.  For some moms this means bed sharing and for others it means having a side cart or crib(s) in their room.  Either way, babies are close by and can nurse on demand without mom having to walk to another room transferring babies in and out of bed as they wake at night.  .
  2. Don’t wake the other baby at night
    As long as weight gain is good, your milk supply is strong, and your babies are nursing effectively, don’t worry if only one wakes at a time to nurse – especially at night.  Though you can nurse twins lying down, it does tend to be easier to nurse just one baby lying down at a time.  If there are ever those times when  just one baby wakes, lie on your side with your baby next to you and he can nurse and you can go back to sleep.  If the other baby wakes later, you can switch two babies out – either sliding him over or returning him to his bed and bringing the other baby to lie beside you and nurse.  The important point is to nurse on demand for each baby – but don’t worry if they don’t need to nurse at the same time.
  3. Keep everything you need nearby
    On your nightstand, make sure to keep water, a snack, music, a book, phone, iPad, remote, a diaper – whatever you might need if you are awake during the night.  Anything that allows you to rest in bed and not have to get up is helpful.
  4. Have plenty of pillows handy
    Make sure you have plenty of pillows on your bed so that you don’t have to get them from the couch or other daytime “nursing station.”  Propping plenty of pillows around you while nursing twins allows you to relax more easily and rest no matter what position they nurse in.
  5. Keep the lights low and don’t change diapers unless necessary
    You want to encourage your babies to fall back to sleep easily after nighttime feeds so make sure you don’t have lots of lights or noise around them.  Only change diapers (nappies) if it is essential.

You will get into a rhythm quickly and find ways to get rest in the most unlikely of circumstances!  Just remember, no matter how tiring it is, taking care of 2 (or more) babies is going to be exhausting no matter how they are fed.  Breastfeeding just allows a wonderful way to nurture your babies as well as allowing you as much sleep as possible with two new little bundles of joy in your home.

How Much Milk Does My Baby Drink?

How much does my baby drink during a day?

A healthy, full-term baby typically drinks between 25-32 ounces in a 24 hour period between months 1-6.1   This amount remains consistent during months 1-6. So, if you are producing enough milk for your 6 week old then you have enough to exclusively breastfeed your 6 month old as well!

Around the sixth month mark many babies begin to eat solids, resulting in their milk intake slowly declining. However, it is important to note that solids should not replace breast milk during your baby’s first year of life – only compliment your milk.

How much milk will my baby drink while away from me?

Between months 1-6, most babies drink 25-32 ounces a day. If your baby nurses 8 times in a 24 hour period, this is roughly 3 oz per feed.

However babies, like adults, may eat more during one meal and less another. Also, some babies reverse cycle when they are away from their mom during the day – they may drink less milk and then nurse much more frequently when with mom in the late afternoon, evening, and throughout the night.

Safe bed sharing or co-sleeping can be a tremendous benefit in this situation so you can still get rest while your baby gets milk! You will learn what volume of milk your baby needs while you are away, but these numbers can serve as a guide. For example, if you are away for 8 hours, you may need 12 oz (4 – 3 oz feeds, 6 oz – 2 feeds, or something in between). Send extra milk the first few days until you find a rhythm and know about how much your baby needs.

The First Week

You’ve planned and prepared for you new little blessing and the time has finally come – your baby is here!  What should you expect during the first week after birth?

Following Delivery

6959630279_bd936a1d85_bWhether your labor and delivery was completely natural, an emergency cesarean section, or something in between, it is important to hold your baby in skin-to-skin contact immediately (or as close thereto as possible) following birth.  Delay all non-essential checks of baby that cannot be done while baby is in skin-to-skin with mother until after the first breastfeed. (With a cesarean delivery the mother will need help holding baby.)

Babies instinctively know what to do.  When labor is unmedicated, babies can be placed on their mother’s stomachs and will actually crawl up, find the breast, and spontaneously breastfeed on their own.  It is called “the breast crawl” and it quite powerful to watch!  However, even if you choose to lay your baby directly on your stomach and breast and help him attach, the important thing is bonding together, skin-to-skin, without interruption until after the first breastfeed.

The first 24 hours

During the first 24 hours, hold your baby in skin-to-skin contact as often as possible.  This helps to establish a mother’s milk supply and encourage a baby to nurse on demand.  You cannot spoil your baby and you cannot nurse your baby too often.  Nurse on demand – at least 10-12 times in a 24 hour period.  Rooming-in with your baby while in the hospital will help facilitate frequent nursing.

If your baby is sleepy (which is especially common if there were any pain medications during labor or baby is preterm) then it is important to wake your baby to feed him.  There should not be longer than one 4-hour stretch of sleep in 24 hours; otherwise your baby should nurse at least every 2-3 hours.

Breastfeeding should never hurt, even in the beginning, so if you are experiencing pain seek out help.  If you are in a hospital setting, ask to see the lactation consultant.  If you are in a birthing center or at home, talk with your midwife about what could be causing the pain.  The majority of the time the pain is caused because of an issue with positioning and attachment.  The earlier you are able to sort the problem the less likelihood your nipples will be damaged or your baby will learn a poor latch.

During the first 24 hours, your baby should have at least one dirty diaper and one or more wet diapers.  A newborn baby’s stomach is very small.  Thick, rich, colostrum is all he needs for the first few days until a mother’s milk comes in.

The First Week

Practices begun in the first 24 hours should continue during the first week.  Keep your baby nearby while he is sleeping so you are aware of when he wakes and his early feeding cues.  Spend as much time in skin-to-skin contact as possible.  Consider co-sleeping in the same room or even bed sharing.

After birth, a baby shouldn’t lose more than 7% of his birth weight.  However, a more accurate weight assessment is 24 hours following birth rather than immediately afterwards. 1

What if I experience engorgement?

Sometime between days 2-5 a mother’s milk will come in.  Nursing often will help her from becoming engorged.  Other ways to help with engorgement in the early days include draining one side fully then offering the other side.  At the next feed, begin by offering the side that was offered last in the previous feed.  Breast compressions during nursing are also helpful.  If a mother’s breasts are still very full and painful she can hand express to stop the pain.  Most importantly, do not give supplements!  Engorgement and oversupply can quickly change to a low milk supply for your baby once supplements are introduced.

How do I know if my baby is getting enough milk?

This always seems to be a concern for breastfeeding moms – though it should not cause worry.  There are several ways to ensure your baby is receiving enough milk.

  1. What goes in must come out.  Make sure you baby has enough wet and dirty diapers.
  2. Weight gain.  Though it is normal to lose 7% (sometimes up to 10% of birth weight) a baby should have gained his birth weight back by 2 weeks old.  (The only exception may be if there was a breastfeeding issue that has been corrected and weight gain is now occurring, but may take a little beyond 2 weeks because it was not identified initially.)  Once a baby reaches his birth weight, it is typical to gain 30-40 grams per day.  Over time you will be able to chart your baby’s growth.  Make sure to use the World Health Organization Growth Charts because they are the only ones based on breastfeeding as the norm. (These should be used for both breast and bottle-fed babies.)  Your child should follow his growth curve.  If he was born in the 2nd percentile, for example, this is all he needs to follow.  This is his normal.  There are big babies and there are small babies. . . all that is important is that your baby follows his percentile.
  3. Observation of breastfeeds.  Is he content following nursing. . . at least for a few minutes?  Do you notice an active suck-swallow cycle?  These are important signs your baby is feeding well.

If you have any concerns, seek qualified lactation support immediately!  A minor problem could have a detrimental impact to long-term breastfeeding if left alone.

Breastfeeding after the First Week

By the end of the first week you may begin to see some basic rhythms or patterns emerging with your baby.  Though he still sleeps the vast majority of the day, you may notice that in the late afternoon or evenings he clusters some feeds together, nursing very frequently over a few hour period. 1

Rhythms, rest, relationship

522049_10100153833199311_422754318_nBreastfeeding and mothering may seem completely natural or totally foreign by this point, but both mother and baby still need lots of rest, nourishment, and bonding time together.  It can be more challenging if you have older children, but being able to rest during the day and night, whenever your baby is asleep, is important for a new mother to recover from birth and inconsistent nighttime sleep.  Mother and baby are establishing sweet rhythms in their relationship, where mom is able to nurture and meet her baby’s needs and her baby begins to learn this strange, new world through the comforting touch and gentle love of his favorite person in the world.  The bond that is forged in these early days will grow and be nurtured over a lifetime.

Now is the time to accept all offers of help – let your husband, partner, family, or friends cook, help out with older children, clean, and serve you.  Your job is to relax with your baby, provide love and nourishment for his every meal, and enjoy this tiny new life in your arms.

Feeding Patterns

A newborn baby is born with a stomach capacity the size of a small marble.  This is perfect for the tiny amounts of colostrum that are available that first day.  However, every day his stomach capacity grows (as does a mother’s milk supply) and by the end of the first week babies are able to take in between 10-19 ounces/day. 2

As a mother continues to feed her baby frequently, her supply continues to build.  During the 2nd and 3rd weeks your baby is increasing his daily intake to around 20-25 ounces.  He is also increasing the number of feeds and duration to stimulate his mother’s milk supply to continue to grow.

By five weeks, babies take in an average of 3-4 ounces at a feed and consume 25-35 ounces in a 24 hour period. 3  This is about the same amount a baby will continue to need during months 1-6.  Once solids are introduced, a baby slowly begins to take in less milk.  Thus, if a woman can develop a full milk supply and feed her 5 week old she should have enough milk to also feed her 6 month old.  It may seem that a bigger baby needs more milk but this is not the case with breast milk!

Growth Spurts

As your baby goes through growth spurts he may have a few days where he will take in more milk.  This is no problem for a breastfeeding mother who nurses her baby on demand.  Your body will adjust to your baby’s needs and quickly produce more milk if required.  An empty breast makes more milk so as your baby nurses more frequently your body gets the message to increase milk production.  When the additional milk is no longer needed, your body will also adjust back down.

Growth spurts can be at anytime, but babies typically go through growth spurts at 3 and 6 weeks, and 3 and 6 months.

One side or both?

It is completely normal for your baby to nurse on just one side, nurse on both sides, or sometimes nurse on one and other times nurse on both at each feed.  All babies are different; all mothers are different.  Sometimes a baby is hungrier and wants to nurse on both sides whereas other times he fills on just one side.  It is important to allow your baby to nurse until he comes off the breast and then offer him the other side.  If he doesn’t want it, no problem!  The next time he nurses, begin with this other side.  As you settle into a pattern, your milk supply will adjust to your baby’s needs and desires.

Ebb and Flow of Milk Supply

It is common for moms to find they feel their breasts are quite “full” in the mornings and “empty” later in the day.  Though there may be less milk later on in the day (especially for western moms with our nursing patterns) this milk tends to have a higher fat content, which can fill a baby more quickly.  No matter how “full” the breasts feel, a baby can always get milk.  Though it may not always be the flow he desires, there is always milk!

There is no need to worry about whether your baby is getting enough of the high fat content hind milk.  If you are nursing on demand and making sure to offer both breasts, your baby is getting everything he needs.  Over the course of a 24 hour period he will get just the right amount of nutrients.

Help. . . My baby wants me more in the evenings!

It is common for babies to be fussy in the evenings.  Using a sling to hold your baby while you still have hands free to do other things can be an important tool during these weeks.  From 2-8 weeks, your baby has more waking hours than when he was first born yet doesn’t yet have the coordination to play or interact with his world yet.  It can be an intense time wondering if you will always have to hold him so much and when you will ever be able to cook a meal again!  This phase usually passes quickly.  Even by 8 weeks, your new baby will usually enjoy laying on his back on a play mat for at least a few minutes as he begins to learn how to interact with his world on his own.

And what about sleep?

Breastfed babies sleep about 14 hours a day.  But did you know that mothers of exclusively breastfed babies get more sleep than their formula or mixed feeding counterparts? 4  Breastfeeding at night is important. Safe bed sharing or co-sleeping can be a tremendous help to both breastfeeding and maternal rest.  Around 6-8 weeks, most babies begin to follow a circadian rhythm of sleep where their longest stretch of sleep of the day is during the night.