Many books and health professionals encourage parents to feed their baby on demand.
This leads to mothers offering milk to their baby every time she wakes and roots around. The rooting reflex is a perfectly normal newborn reflex and one which they display almost as soon as they wake anyway, although it doesn’t always mean a baby needs to be fed immediately. With some perseverance you can usually delay the feed for a while, which will encourage her to take a bigger feed later. If a baby is fed every time she wakes, then she is likely to turn into a snack feeder, which can lead to terrible problems with wind or worse – colic and reflux – which will affect her ability to sleep well.
Breastfeeding mothers are told if they demand feed their baby she will eventually find her own sleep routine and settle down with time. Although a very small minority of babies may do this (nothing is impossible), most babies will not, and will still be feeding two to three times or more over the core night period at the age of six months. This continues until the parents are so exhausted they ask for help and is a common problem I find parents are having when they contact me through the FREE advice service I provide via my Website.
In reality, most babies who are demand fed very frequently, spend less than half the amount of time on the breast at each feed than a baby in a three-to-four-hourly feeding routine would. This means that a lot of the milk that they are drinking will be mostly fore milk and not the important hind milk, that begins to come once the baby has spent 10 minutes or so on one breast.
The fore milk can be compared to a ‘starter’ in a restaurant. It whets your appetite but it is never going to sustain you for a decent period of time. Understandably, snacking on fore milk is never going to sustain your baby for a three-to-four hour stretch between feeds. Therefore your baby will wake again one to two hours later looking for more milk and likely just want to snack feed again, because she hasn’t built up a big enough appetite to need more.
Equally formula-fed babies who demand fed may only take a very small feed and then look to be fed a couple of hours later. This snack feeding on demand leads to a vicious circle of the baby waking constantly day and night to be fed. A newborn baby is able to manage one longer stretch of between four to six hours without a feed per 24 hours if she is mostly fed every three to four hours. The time you would try to plan this stretch is over the core night period between 11 p.m.–4 a.m. The longest stretch that you will get from a baby that is being demand fed during the day every one to two hours is a three-to-four-hour gap from one feed to the next, although it is more likely that she would rather continue waking frequently at night to snack!
Growth spurts occur roughly around seven to ten days, two to three weeks, six weeks, twelve weeks and sixteen weeks, give or take a few days either side of these ages. They generally last two to three days. During this period of time your baby will probably want a top-up between some of her feeds, despite taking a full breast or bottle feed earlier and possibly even spending longer on the breast at each feed or want extra milk from the bottle.
If you find that she is showing signs of being hungry, wont settle and you still have an hour or more before the next planned feed time then you should offer a feed.
I would advise, though that you treat the feed purely as a ‘top-up’ and attempt to get away with a short snack feed of up to 10 minutes on the breast or a 2fl oz(60ml) bottle feed. Then do your full feed at the usual time that you were planning to anyway. This ensures that you are always aiming to get your baby back on track again.
I would never tell any of the mothers that I work with not to offer their baby a top-up if they genuinely believe that she is hungry and needs an extra feed. A baby who is genuinely hungry will not be pacified by a dummy or being walked around and distracted. When they are that hungry, particularly during growth spurts, it is important to allow them the benefit of the doubt. I would recommend that you top-up as much as your baby requires during the day and in between daytime feeds, which should hopefully ensure that they stick to needing only one feed around 3-4am during the core night hours.
In loose terms you are still demand feeding your baby from the day they are born because you will never refuse them a feed if they are genuinely hungry. However, you are also trying to work towards a routine from the day they are born and encourage her to feed at particular times, which remain the same every day.
The breastfeeding guide that I encourage all of my mothers to use is the very same one that I used when breastfeeding my three babies. It gives your body a chance to get used to this new experience gradually. By building up the amount of time your baby spends on the breast in the first few days before your full milk supply comes in, your nipples are less likely to get sore. With your body only producing colostrum for the first few days, the only thing you will achieve by letting her suck constantly on the breast is very sore nipples, and it is so difficult to persevere through the pain of that and carry on with breastfeeding. I believe that this is the main reason why many mothers do not get beyond the first few weeks of breastfeeding their baby.
Below is an example of how much an average infants’stomach can take per feed on a daily basis. This may help to alleviate some of the perfectly natural worry among breastfeeding mothers about whether their baby is drinking an adequate amount of milk.
A bottle-feeding baby may end up drinking more than the above amounts at each feed, or you may find your baby drinks more than this when given expressed milk. As long as your baby is putting on a regular amount of weight then it doesn’t matter how much they are drinking at each feed. Sometimes the amounts may even vary from feed to feed or day to day. She will let you know the correct amount for her.
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Many thanks
Lisa
I would be interested to know what scientific evidence the claims in this post are based on as they seem to go against a lot of research findings generally associated with the topic.
Hi Karoline. The above is based on my 18 years experience with hundreds of babies. I work full time as a Maternity Nurse. We devise a routine that works for each individual baby and family. Nothing is set and stone. Although we work towards a routine, if baby needs feeding more frequently then they are offered a feed.
Hi,
I wish that I had read this before my baby was born! I now have a baby who is a snacker and wakes up every hour at night to feed for a very short time. I am trying to put my baby on a schedule by only feeding him feed every 3 hours. I am three days in but my baby still only feeds for a short amount of time with each feed. When do you think he should adapt and start drinking more? When should I become worried that he is not getting enough to eat?
Hi Anthea
It depends how old your baby is, as to how long it would take to establish a routine. Feel free to have a look at the posts on the free section of our forum. We also run a membership and advice service if you would like more personalised advice and support to guide you. Click on the forum tab at the top of the page or email me for more details. Good luck
What a load of rubbish! You are going against what babies are naturally supposed to do and traumatising many a baby and probably ending many a breastfeeding relationship. I am shocked you are a maternity nurse! I would be horrified if you were giving this advice you patients
I have helped to extend many breastfeeding relationships and every mother who has worked with me will tell you how happy and content their baby is and how much people comment on their calm temperament. Babies are never left hungry-we work towards a routine over time.
How dangerous to be offering this advice how do we build suply then?
My lb has been fed on demand since day 1. And I will continue to do so for as long as he feels necessary.
And guess what he has found his own pattern and sleeps from 9ish to 5ish. Why impose a schedule on a baby?
If you and your baby are happy with the daily routine you have found together that is absolutely fine. Without a rough guide to a routine each day many mothers find they get that long stretch you are currently getting in the beginning, but by about 14-16 weeks it all starts to deteriorate and baby will wake much more frequently at night to feed. This is usually related to not being able to self settle and won’t improve until they can do that and you can stop night feeding altogether.
It is not dangerous advice at all and none of the mothers I have worked with who would like to establish a routine have had supply issues because of it. They will happily express in between feeds or after if they feel it’s necessary and want to increase supply further, in preparation for growth spurts.
I am truly concerned with the misinformation provided in this post purely based on your personal opinion rather than evidence based research. It concerns me greatly that vulnerable sleep deprived women will read this and start ignoring their babies feeding ques with the likelyhood of seriously damaging the breastfeeding relationship between mother and baby. Please access a training update and start providing evidence based advice before your opinion further diminishes our already heart breakingly low breast feeding rates in the UK.
This information is not based on personal opinion, but is based on over 20 years of experience working with mothers and babies, including successfully breastfeeding my own 3 children for 6-7 months each and stopping because I chose to with it being the right time for us.
Many mums I work with actually end up breastfeeding for longer than they originally planned to because we find a routine that makes it very easy for them and their baby.
The BBE…
You clearly have no knowledge of breastfeeding and the dyad of a mother and baby. You are simply making a buck out of implying a clinical qualification makes you a parenting expert on topics you are vastly out of date on. Are you aware of recent research developments in infant neuroscience over the last ten years? Trained in attachment?
Can you provide evidence of your recent and up to date training in breastfeeding knowledge? Are you an IBCLC? Do you sign up to Unicef and WHO principles?
I am a CONSULTANT IN PUBLIC HEALTH with responsibilities for maternal and child health. And hence seek to increase breastfeeding rates for the benefit of the populations health. You and your advice will end many a breastfeeding journey resulting in increased morbidity and mortality and costs to the healthcare system (lancet published this breastfeeding symposium in early 2016, but of course you know that).
Please stop putting your income gained from such poor advice before the health of mothers and babies.
Me and my advice has actually helped extend the period that hundreds of the mums I work for end up breastfeeding for, because they find a manageable routine that they and most importantly, their baby is happy in. This is still loosely revolving around breastfeeding on demand, because their natural instinct as a mum to understand and respond to their babies needs, means they would NEVER not feed their baby if they felt he or she were genuinely hungry.
I would say 90% of the mums I come into contact with have chosen to breastfeed and a very high percentage, with the correct support post natally are still breastfeeding 6 months later.
My job has nothing to do with ‘making a quick buck’ as you put it-we all have a job to do and we all get paid for it-me as well as you. Anyone who has worked with me will tell you that I actually care very much about the well being of the mums and babies I work with and my job is to give them all the facts about the choices they have, without judging them and allow THEM to choose what is best for them and their baby. I then support that decision as best I can.
Hi i just purchased your book recently and was wondering what to do if my baby wakes before the 3-4am feed. I am following your plan and fed him last at 10.15am. Will i soothe with a dummy and try to get him to hold out until 3am?
Thanks x
Hi. It depends on the age of your baby. Can push late feed back to 10:30/11pm of baby is happy to wait until then and still sleeping. That will help them naturally push to after 3am in the night anyway. Feel free to email with questions if you need to, using the contact form. X
Hi my week old baby only feeds for about 12-15 minutes on one breast, my midwife says this is ok as she watched him feed and he feeds very quickly and my milk flows fast too. How do I know when he wakes hungry or when he just wants comforting? How do I try to stretch out the times between feeds if I don’t think he is hungry but he is crying?
Hi Amy-if you have a good flow and baby is clearly getting to the hind milk that is absolutely fine. You will know if he’s getting enough if he’s happy to do a good 2-4 hour stretch between feeds.
Wow Lisa, I’m so sorry you have had to deal with such harsh comments! I was just browsing on this during a night feed to find an answer to a question and came across these. I feel like I need to point out here that if I hadn’t have read your book and followed your advice I would certainly not have continued breast feeding my first child in 2014. It was so horrifically painful because she had lip tie – my nipples were shot (many a HV/midwife told me my latch was perfect. I’m pretty sure she kept slipping off latch due to the lip tie) and the let down pain was really awful. If I had been feeding on demand like I was told to I would not have coped. Feeding with a routine enabled me to have a decent rest between feeds. Also I knew what I was doing when, which meant I could plan my day better. In the end, we breast fed for nearly 9 months and she slept through between 11:30 and 7:30 from 10 weeks. She gained weight perfectly and was happy because she wasn’t tired. She is now a very happy, healthy 3 year old who has a great relationship with sleep
I’m following this with number 2, my question was simply whether you think 4oz is too much in her bottle at night? She takes it but I’m struggling to feed her a decent feed at 3am. Isn’t it too early to drop that one now? Xx
Sorry, I didn’t say, she’s only 3 weeks old.
Stick to continuing to offer it as normal, but like I said, don’t worry if she doesn’t want the whole 4oz. Just let her take what she wants. She may want a bit more as you get to the 6 week growth spurt, but once you pass that point, she will likely naturally be happy to drop it
Thank you and glad you have found my book and advice so helpful. 4oz is the max to offer for the 3am feed. Some babies won’t need all that and will be happy with 2-3oz and that’s fine. Can start to work on dropping it though if she seems like she’s ready to and showing the signs listed in the book. X
Hi Lisa, thanks for replying! Hope the twins are getting on well. It’s the 10:30pm feed that she’s having 4oz. The night feed is the troublesome one. She’s not really waking up for it whatever I do, she’s literally fed for 8 mins 13 seconds and I just can’t get her to have anymore, changed her any everything’ so I’ve given up. Hopefully she won’t wake in an hour! Xx
Hi Lisa, I just read your book. My son is 9 weeks old. Miraculously he pretty much sleeps through the night (from around 8:30pm until 5:30am approx). However, he hardly ever naps during the day and if he does it’s a catnap. As a result he is cranky, cries all the time and snacks constantly, desperate to go to sleep. It’s awful and we are all miserable. We need some sort of routine and I am intrigued by yours. However, I’m confused by your feeding schedule. Is the 10:30pm feed necessary or are they supposed to.work towards sleeping through from 7pm until 7am with no feed? If that is the case, they are only supposed to have 5 feeds per day… is that corrext? I’m willing to try anything as it surely can’t get much worse than this (during the day anyway!) But I’m just concerned that isn’t enough, as I was told 8-12 feeds a day (exclusively breastfeeding)? Any advice gratefully received and am thinking about getting in touch with you for a consultation too… thanks!