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Right On Cue

Can You Breastfeed on a Schedule?
By Gwen Morrison

In a 1997 statement on breastfeeding, The American Academy of Pediatrics (AAP) recommends that newborns should be nursed whenever they show signs of hunger. Those signs include increased alertness, activity, mouthing or rooting. Some call this 'demand feeding,' while others classify it as 'feeding on cue.'

Whatever they call it, letting Baby call the shots on feeding times might seem daunting for some mothers, especially those comforted by schedule. With the right information and preparation, even the most routine-laden mothers can lessen any anxiety they feel when feeding on demand.

A Demanding Schedule
"She'll regulate her own food intake, provided you offer the breast at least every three hours," says Ann Douglas, author of The Mother of All Pregnancy Books: The Ultimate Guide to Conception, Birth, and Everything In Between (Wiley, 2002) and The Mother of All Baby Books: The Ultimate Guide to Your Baby's First Year (Wiley, 2002). "Your baby needs to nurse frequently in order to learn the breastfeeding ropes and help build up your milk supply."

Nancy Mohrbacher, an International Board Certified Lactation Consultant (IBCLC) in Arlington Heights, Ill., and co-author of The Breastfeeding Answer Book (La Leche League International, 1997, explains that while milk production is being established during the first six weeks, research indicates that the more times per day the milk is drained from the breasts, the more milk is produced. "Limited feedings by following a schedule during this critical time can limit or reduce a mother's milk supply," she says. "Also, babies are not normally comfortable feeding at set intervals during their first six weeks, because their stomachs are so small."

According to Mohrbacher, the normal feeding pattern during this early period is called "cluster nursing." This means that babies tend to cluster their feedings close together, showing feeding cues every hour or less for part of the day and then going for longer stretches at other times of the day.

"New mothers who are unaware that this is normal often wrongly assume that they don't have enough milk," says Mohrbacher. "What's important during this period is not that babies go two to three hours between feedings, but that babies get the right number of feedings overall."

The AAP states that the normal amount of feedings per day means that Baby should have eight to 12 feedings every 24 hours. The best way to accomplish the necessary amount of feedings is to practice 'on cue' feeding.

"Fortunately, once babies grow, the period of cluster feeding ends, and they tend to naturally settle into a more regular feeding pattern," says Mohrbacher. "As Penelope Leach, a noted British baby expert, says, 'Over time the behaviors that drive parents crazy change, but they do so when and only when the infant's physiology has matured to the point that she is a settled baby rather than a newborn. The we-must-do-something approach is likely to prolong the process, as well as make it more painful for both parents and infants.'"

Got Milk?
In The Mother of All Baby Books, Douglas outlines how unique each breastfed baby's feeding patterns are. There are significant variations in terms of the length of a typical feeding and the duration between feedings. Some newborns are just slow nursers who like to eat every two hours, she says. This may make it seem that you are breastfeeding nonstop.

"One feeding schedule will never be right for all mothers and babies because of individual differences," says Mohrbacher. "One difference that research has only begun to explore is 'breast storage capacity,' which is the amount of milk a mother's breasts can store between feedings."

Mohrbacher explains that a woman with a large storage capacity, which may or may not be related to breast size, may be able to space out feedings comfortably because she can store more milk in her breasts without feeling full between nursing sessions. "Full breasts signal the body to decrease milk production as well as put mothers at risk for plugged ducts and mastitis," she says. "Also, because the mother with a large storage capacity has more milk in her breasts, her baby can take more at a feeding, keeping him comfortable for longer stretches."

Research indicates that women with smaller storage capacities produce plenty of milk for their babies, but they need to feed more times per day.

Go With the Flow
"If you're the kind of person who thrives on schedules or routines, you'll find those early weeks and months of motherhood to be a whole lot less stressful if you accept the fact that your new 'routine' may mean no routine at all," says Douglas. "Your life won't always be this unpredictable. Before you know it, your baby's sleeping and eating patterns will begin to fall into some sort of reasonably predictable routine."

"I always breastfed on demand," says Angel Dickson, a mother of two from Maine. "My kids were good nappers, always happy. People used to say they were the most content babies in the world."

Mohrbacher suggests that new mothers who are frustrated with the cluster feeding during their normal sleeping hours and taking long sleep stretches throughout the day need to remember first and foremost that it is completely normal. "Babies tend to be born with their days and nights mixed up," she says. "Hopefully, knowing that her baby's frequent feedings do not mean there's something wrong will alleviate some of the anxiety."

Another way that new moms can minimize some of the stress is to ensure that they sleep when the baby sleeps – where it is possible. This is usually not as easy when there is more than one child, unless you can all nap together.

"To maximize sleep, a mother should learn to nurse lying down so that she can rest while the baby feeds," says Mohrbacher. "This is one benefit of breastfeeding that many don't think about. No one has to be fully awake while Baby feeds. It can take a little practice to get good at this, but it is well worth the effort."

Here are some key things to remember when you feel overwhelmed by the lack of routine during those first few months:

  • Keep your sense of humor. Laughter is truly the best medicine for stress.
  • Keep a positive attitude. Accept the reality that most of your time will be spent nurturing your infant.
  • Let the housecleaning go for a while; the sweeping can wait.
  • Accept any offers of help that come your way, and take that time to sleep.
  • Find distractions where possible to manage the stress. Learn to breathe deeply.
  • Simplify your life wherever possible.
  • Play soothing music in the daytime while nursing. Enjoy your baby!

Adjusting to a new baby is difficult at first, but with practice, things will feel normal and natural. Breastfeeding nurtures a baby both nutritionally and emotionally. It creates an ongoing bond between mother and child. So relax and enjoy your special time with your baby. Before you know it, you'll be longing for those quiet moments of closeness you once shared while nursing.

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About the Author: Gwen Morrison is a freelance writer.

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