BF on demand - how often should he demand?

[mootthing]

Hi, can anyone help me. I have a 2.5 week old son - my first - and we have just been signed off by the midwife and left to continue on demand breastfeeding. However, I'm concerned that he doesn't wake up and demand food often enough. He certainly feeds voraciously when he does wake, but sometimes he'll go for 5 hours or more without feeding if we don't go and poke him and from what I've seen this isn't usual with such a young baby. Any advice? Should I be trying to make him feed more often?

Thanks

hi it depends on lts of factors. why dont you copy your post onto the breastfeding thread where there are experts. good luck

I have bf 3dcs and I still don't really understand when they are demanding to be fed. With ds1 I don't think he was demanding enough in the first few weeks and I think that my supply suffered because of that. With dd and ds2 I didn't let them go longer than 4 hours during the day without waking them to feed but I didn't wake them at night. At that age they were probaby feeding 3 hourly during the day and about 4-5 hourly at night.

If you are getting plenty of Wet * nappies and he is happy when he is awake... probadly fine, but you can try waking him up if you want to try getting him to feed more often.

• its bit hard to tell if a disposable nappy is wet, as they are sooo good at absorbing wee.

Agree try the BF section but also if wet nappies and weight gain then don't worry, midwife is happy, baby is happy so you are doing a great job. My DD sometimes went that long but also had occassions where she wanted it every hour.

That's reassuring, thanks. He does seem to have a very hungry period in the evening when he feeds almost continually from 7pm - 10pm, or even later. This has always been the time when he was most active, even in the womb, so perhaps he just likes his main meal then?

Lots of feeding in the evening is VERY normal. So normal it has a name - cluster feeding. It is not a sign of low supply/baby not being satisfied/etc. It is a sign the baby wants lots of fatty milk. The more frequently milk is removed from the breast the high the fat content. Conversely the longer the gap between feeds the lower the fat content.

This is why milk is sometimes refered to as fore/hind milk. The first of the milk to be removed has been there the longest and if you 'squeeze' a bit out after a feed it will be thick and creamy looking because it has just been made.

So, your guess that he likes his main meal in the evening is correct. He's tanking up on the good fatty kind before bed!

Keep up the good work and you are doing really well. Just treat the cluster feed as an excuse to put your feet up and get lovely things to eat/drink brought to you by DP

Oh forgot to add if he is having 6-8 wet nappies and the wee is fairly pale, tongue/lips moist (not dry/cracked), fontanelle not sunken, alert when awake and not lethargic/listless/floppy then he is getting plenty. Some babies are very efficent feeders from even an early age.

How ever if he is awake and hasn't 'asked' for a feed for a while it can't hurt to offer. If he turns you down, he turns you down.

Verity, what you said about fat in milk and foremilk v hindmilk is not true or misleading. Mootthing, look out for TikTok, an experienced bfing counsellor, for advice. She will probably pop up soon. Search her in old threads, this is the type of thing that comes up all the time.

NoTart- see here chart with full/empty breast comparison and here for detailed explanation. These links back up what I said.

In fact there is now a school of thought that wants to get rid of the terms fore/hind milk as it is just a continuum rather than a switch at some point during a feed. I was only using those terms as they seem to be fairly well understood (foremilk = thirst quenching & hindmilk = fatty/filling).

Hi Verity, thanks for those links, fascinating subject isn´t it!

I still have my doubts though and disagree on a few points ; )

Babies in the womb are lulled to sleep in the daytime when the mother is running around, busy and distracted by life. We feel the baby more in the evening because we´re sitting down relaxed so the baby wakes up. There´s no link between this time in the womb and wanting to cluster feed.

Cluster feeding comes about because less milk is produced in the evening compared to other times of day and increases again after rest. So it is related to a (temporary) inefficiency in milk production. Surely if the milk during cluster feeding was particularly fatty and therefore more calorific, less would be needed than at other times of day and baby would not feed comparatively more. It just doesn´t seem to make sense to me. Food for thought though!

I don't think there's any harm in offering the breast once every 3-4 hours or so. I have often offered with my DDs rather than waiting until they demanded, just because it fitted into my life better (eg. I would feed DD2 before picking DD1 up from nursery).

NoTart,

I agree with what you say about in-utero behaviour but unfortunately I don't agree about there being an ineffeciency in production in the evening.

Milk flow may be slower but milk production isn't any slower. If a large volume of milk is in the breast at the start of a feed it will flow faster than if milk is being made AS the baby is taking it.

I know it seems intuitive that slow flowing milk/softer breasts = low milk supply/poor quality milk but under normal circumstances it in fact equals high fat milk.

If you (i.e. the mother) suspects a slower flow is upsetting her baby breast compressions can speed up the flow to see if that helps settles the baby.

I have a 9 week old ds exclusively breastfed, and although he slept alot during the day, I used to wale him up every 2 hours to feed him, and he wpuld go longer between feeds on a night.

He now feeds every 2 hours during the day, but sleep from 6.30pm until 7.30am waking up only once or twice to feed.

My theory, is that the more the get during the day the better they sleep on a night

It works for us and for dd 3 years ago.

Cluster feeding on an evening is also normal. DD used to feed between 6-9pm constantly, but ds feeds between 5-7 constantly.

Hi again Verity..

I don´t equate cluster feeding with poor quality milk.. it´s a terrible shame when young mums give up bfing because they think they juzst don´t have enough milk, awful!

You make a good point that flow is slower rather than production, this is really something for unconfident mums to remember.

Is your point re cluster feeding producing fattier milk scientific fact? I have never haeard it before.. It is difficult to know what the facts are around bfing don´t you think? I was always furious and confused with the crappy and blatantly false advice was given by hcps..

interesting discussion! It's not a bad idea to encourage your lo to feed more than every 5 hours in the day so that he fills up more in the day and doesn't need so much feeding at night (that's the theory anyway!) If he is feeding voraciously when he wakes, isn't floppy, and is a good colour he probably isn't suffering from a hydration/blood sugar point of view.

If you want to check how wet nappies are, you can either weigh the used nappy on digital food scales or pop a piece of cotton wool into the new nappy and see how wet it gets.

NoTart - in general feeding frequently leads to the baby getting more hind milk, which is higher in fat than fore milk. Women with babies who are getting too much fore milk (lots of wind, possetting and green poos) are advised to feed repeatedly on one side for a couple of hours. The more frequent feeding from one breast leads to the baby getting a greater proportion of hind milk. I believe there are studies about the changing composition of breast milk. Perhaps one of the bf counsellors on mumsnet could give you the references.

Hi NoTart,

Here's one study I found on fat content of breast milk. In this study they linked the degree of emptyness of the breast and the fat content of the milk, i.e. the emptier the breast the higher the fat content.

Quote:-

Fat content of the milk at different times of day reflects the higher degree of milk removal during the day and evening and the higher degree of fullness in the morning and night. The changes in fat content of milk from the beginning to the end of the first and second breasts of a paired breastfeeding described by Woodward et al 34 can be explained by the degrees of fullness that we have calculated. The lower fat content of milk from the first breast at the beginning of the breastfeeding that they measured reflects the mother's starting to feed her infant on the fuller breast, and the higher fat content of milk from the first breast at the end of the breastfeeding reflects the higher degree of milk removal from the first breast.

This can be found in the study under the heading 'Fat Content of Breastmilk' about 2/3rds of the way down the page.

Obviously this is just one study but it was published in the journal 'Pediatrics' so has been peer reviewed/scrutinised/etc.

Hopefully that satisfies some of your scientific requests!

Great talking to you about this. It's lovely to have an intelligent discourse (as opposed to talking about elephant trunk poos with my DD1 )

Going back to the OP, are you carrying him in a sling or putting him in a moses basket or something?

I would wake him if I were you, aim to feed him every 2 hours at least, that way you know he's getting plenty of milk and not sleeping too much.

Hi! Yes, fascinating subject isn´t it, interesting link Verity, need to print it and study carefully when dc in bed!

I thought I had studied bfing quite well in prep for dd2 but see I have so much more to learn. It makes me annoyed that women are not given quite basic info re bfeeding before being sined off by midwife. It´s just terrible that so many women think they don´t have enough milk and give up bfeeding, more due to a lack of confidence than anything else.

My DD was like this, moothing. She would sleep for hours and then feed like a nutter when she awoke. Such a sleepy girl after my insomniac boy! I was worried.

She was thriving though and her nappies were wet and dirty. She started to wake up more around ten weeks and she would certainly let me know when she was hungry.