Should I Breastfeed on Demand or Schedule Feedings?

How to encourage appropriate weight gain and build breast milk supply

Mother nursing baby at home
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The old adage "never wake a sleeping baby" can actually be poor advice if you are a breastfeeding mom of a new baby. While letting sleeping babies lie can be a workable strategy for older babies, spacing out feedings too far apart in those early weeks may decrease your milk supply and can keep your baby from packing on the much-needed pounds. Surely, these are the consequences you want to avoid.

How Often to Breastfeed Newborns

So you realize you might need to wake your baby for feedings, but how often? If you have a freshly born baby who is still below her birth weight, it is very important that you breastfeed her often. Many lactation consultants will advise that you aim to feed at least 10 to 12 times in a 24 hour period. Another way to think of it is to nurse about every 2 hours during the day with no longer than 4 hour stretches at night.

Be assured — at this young age, you can't "spoil" your baby or breastfeed too often. Also, during the first few weeks and during growth spurts, your baby may likely engage in what is called cluster feeding.

Cluster feeding is when a baby feeds as often as every 45 minutes to an hour for a period of several hours. Think of it as your baby's attempt to "tank up" for the night. It helps stimulate your milk supply, encourages weight gain, and also may get your baby sleep a bit longer (bonus!).

Once Birth Weight Returns

Typically, babies lose up to 7% in the first week and should return to birth weight by the end of the second week. Once your baby returns back to her birth weight and has established a good weight gain pattern, you can relax quite a bit. Rather than feeding by set periods of time, you can switch to feeding on demand.

The only caution with that recommendation is your baby still doesn’t know her days from her nights. That means she may sleep for longer stretches during the day and shorter stretches at night. If you want to try and savor the longer stretches of sleep for the night time, you might want to wake her after 4 hours during the day and see if she wants to feed.

Although your baby is not likely to establish a circadian rhythm (where she naturally sleeps more at night) until she’s 3 to 5 months, keeping her stimulated and feeding often during the day might help you avoid more frequent night wakings.

A Word on Scheduled Feedings

Some parents would argue that all babies should be put on scheduled feedings, pacing feeds at set periods of time.

The American Academy of Pediatrics, the Center for Disease Control and Prevention, and the World Health Organization share similar policies on breastfeeding. All of the organizations now recommend that healthy babies should be fed when they show signs of hunger rather than when a clock indicates "it's time."

The key here is for you to determine the difference between honest-to-goodness hunger cues and the typical fussiness that nearly all babies experience. You don't need to feed your baby at every whimper or hiccup, but certainly, do feed her when it is clear to you that she is hungry. Additionally, a way to avoid tantrums in older babies is to address their hunger needs.

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Article Sources
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  1. Fallon A, Van der putten D, Dring C, Moylett E, Fealy G, Devane D. Baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding. Cochrane Database Syst Rev. 2016;9:CD009067. doi:10.1002%2F14651858.CD009067.pub3

  2. Centers for Disease Control and Prevention. How Much and How Often to Breastfeed. Updated December 3, 2018.

  3. Ditomasso D, Paiva A. Neonatal Weight Matters: An Examination of Weight Changes in Full-Term Breastfeeding Newborns During the First 2 Weeks of Life. J Hum Lact. 2018;34(1):86-92. doi:10.1177%2F0890334417722508

  4. National Institute of Health. What are the recommendations for breastfeeding?. Updated January 31, 2017.

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