Sleep & the Breastfed Baby, Part 2
Last time, we talked about how it is not only normal for a breastfed baby to night nurse, it is also beneficial. Due to individual women's milk storage capacity, patterns will vary, but most women need 8+ feedings per 24 hours and no longer than a 5 hour stretch at night to maintain a full milk supply.
So what's a tired mom to do?
Here are our top 5 strategies to maximize milk supply AND sleep for babies under 6 months:
1. First, maximize daytime feedings so that you can get in as many of the 8+ feedings as possible in the daytime. Always feed your baby when she shows feeding cues, but you can also take initiative to wake and nurse your baby in the daytime if it has been two hours since her last feed. This helps her to differentiate day from night, and moves as many of her feedings into the daytime as possible. If baby tends to sleep for more than 2 hours at a time in the day, then keep baby unswaddled and avoid swings, bouncers and nests. Place a sleepy baby on hard, flat surface to encourage them to enter light sleep which will allow them to show feeding cues when they are hungry. Be responsive to evening cluster feeding, as that also helps baby tank up for the night and achieve 8+ feedings.
2. Initiate nursing baby when you go to bed for the night so that you can hopefully enjoy a longer stretch of sleep before the next feeding. Babies usually only have one long sleep stretch, and you want to take full advantage of it when you are sleeping too! A "dream feed" doesn't require your baby to be awake. Many babies will latch and suck during light sleep if they are put to the breast. For example, if you put your baby to bed at 7pm, do a dream feed around 10pm before you go to sleep for the night. Keep in mind that we do not recommend going longer than five hours at night without breastfeeding.
3. Keep baby within arm's reach of your bed and make night feedings relatively short, quiet, and dim (and entirely in bed) to help you both fall back to sleep quickly. If you notice your baby has stopped actively sucking and swallowing, take her off the breast and change her diaper right there in bed (have diaper and wipes on the nightstand). Offer the other breast after the diaper change. Many moms find safely bed sharing or a bassinet pulled up to the bedside to be an ideal way to maximize rest. Bed sharing can be an option for some to families that increases sleep, if done safely according to the Safe Sleep 7 guidelines pictured. The American Academy of Pediatrics recommends baby stay in the same room as you for at least 6 months to prevent SIDS.
4. Get your rest, too! Go to bed early - 8pm or 9pm is certainly not out of the question during intense periods of night nursing. Take a nap each day during baby's most reliable sleep period - maybe snuggled up together in bed. You may have to avoid caffeine before your nap in order to settle yourself down. Or, hire a postpartum doula who can help care for baby while you catch up on sleep. If you work during the week, arrange with your spouse to be able to nap or sleep in on weekends.
5. Gently introduce an age-appropriate nap routine between 2 and 4 months of age with an early bedtime. When babies aren't sleeping well in the daytime, sometimes this impacts the quality of their night sleep, too. Once you learn baby's sleep cues you can begin to anticipate them and put baby down around the same time each day for naps and bedtime. Start your day around the same time each day. Nurse baby before sleep (and maybe after as well) as part of her routine, to keep hunger from waking her up early, and to maximize daytime feeds (see #1). Breastmilk has sedatives and sleep hormones in it that help babies take better naps. Once baby is no longer actively sucking and swallowing on the second breast - or when she appears in light sleep - lay her down softly. Avoid nursing babies over 2 months into a deep sleep if you are trying to transition them towards independent sleep. Download the Huckleberry app for more guidance.
Need help figuring out your night routine or helping baby get days and nights sorted out? We can help! Book a consult for personalized advice. Also check out the book The No Cry Sleep Solution for gentle, breastfeeding-friendly ways of cultivating healthy sleep patterns. And remember - this to shall pass! Even without intervention children will begin to sleep through the night when they are developmentally ready.