Recently I visited a colleague who had her first baby. The baby was 8 weeks old and sported a gorgeous shock of dark hair. Mum was typically tired. As we devoured my other friend’s amazing raspberry scrolls there were lots of questions. At one point it dawned on me that my colleague was still doing things she was told do in hospital 8 weeks later. This resonated with my clinical Post-Doctoral Fellow who was lamenting similar scenarios she had seen in practice.
One limiting and tiring practice in the early days is long feeds of more than 20 to 30 minutes. Watching my friend’s baby at the breast, she started feeding and gulping milk (mum has a great supply) then she happily slipped into a dozy, cuddly, sucking style consisting of long pauses and very short bursts of sucking. When the baby started to detatch from the breast this stimulated her to start sucking again. The mum assumed that the baby was still hungry and was still receiving milk from the breast.
It seems my friend was told to let the baby detach from the breast herself which, on more probing, was understandable as the babe had lost 10% of her weight after birth and there was some angst around her consuming adequate volumes of milk in the early days. However, at 8 weeks of age baby was consuming plenty of milk but happily spending lots (and lots) of time at the breast without actively feeding. Exhausting to say the least.
So intuitively, or not so, watching the baby and detaching her after the initial nutritive sucking (fast and furious, or slow and steady) and some non-nutritive sucking (those gentle sucks and long pauses) is a strategy to help mum cope with frequent breastfeeds without jeopardizing breastfeeding. Often it is expected that the baby will spontaneously detach from the breast but that isn’t always the case. Other signs that the baby has finished feeding include both non-nutritive sucking (those gentle sucks and long pauses) and disinterest when the second breast is offered. Of course, if it is convenient and enjoyable to both mum and baby for the baby to stay at the breast, intermittently sleeping and feeding over an extended period, this is fine – but it is not necessary for every feed.
What does the research say? One study ‘Does breastfeeding method influence infant weight gain’ showed babies put on less weight when they we left to detach from the breast on their own. The same study also showed that long feeds was linked to lower weight gain. Our study ‘Ultrasound Imaging of Infant Sucking Dynamics during the Establishment of Lactation’ shows that babies feed for around 16 to 20 minutes on average in the first 4 weeks. By 10 weeks we found the length of the feed reduced to around 10 minutes (‘Longitudinal Changes in Suck-Swallow-Breathe, Oxygen Saturation, and Heart Rate Patterns in Term Breastfeeding Infants’). So, what does this mean? It means when babies appear to be finished with active nutritive sucking at the first breast you can switch them to the second breast. This increases the chance of the baby taking more milk in less time. It also ensures the baby receives the volume of milk he/she needs, and that milk supply is maintained. Further, getting the balance will improve the breastfeeding relationship and the mum’s wellbeing.
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1. Walshaw, C.A.; Owens, J.M.; Scally, A.J.; Walshaw, M.J. Does breastfeeding method influence infant weight gain? Arch Dis Child 2008, 93, 292-296, doi:10.1136/adc.2006.107102.
2. Sakalidis, V.S.; Williams, T.M.; Garbin, C.P.; Hepworth, A.R.; Hartmann, P.E.; Paech, M.J.; Geddes, D.T. Ultrasound imaging of infant sucking dynamics during the establishment of lactation. J Hum Lact 2013, 29, 205-213, doi:10.1177/0890334412452933.
3. Sakalidis, V.S.; Kent, J.C.; Garbin, C.P.; Hepworth, A.R.; Hartmann, P.E.; Geddes, D.T. Longitudinal changes in suck-swallow-breathe, oxygen saturation, and heart rate patterns in term breastfeeding infants. J Hum Lact 2013, 29, 236-245, doi:10.1177/0890334412474864.