Falling asleep at breast and how long on each breast?

[NichyNoo]

My baby is 6 days old. I breastfeed him approximately once every 3 hours. However he falls asleep at the breast after about 5 minutes. I then spend 5-15 minutes trying to wake him up to finish his feed. When he falls asleep he is absolutely passed out. Tickling his throat and playing with his toes has no effect. I have to run his feet under the cold water tap (at the advice of midwives) to get him to suckle for another few minutes and keep on repeating until he has done 10 minutes on each breast or 20 minutes on one.

My midwife said he should have 20 minutes on each breast but this is impossible as a 20 minute feed lasts about 1 hour as I have to spend most of the time trying to wake him. Which is best - 20 minutes on one breast or 10 minutes on each? I find the advice differs from midwife to midwife and from book to book. I want to make sure he gets the hind milk.

Many thanks for any advice as I'm going crazy!!

I'm no expert but have found that some babies feed in 5 mins and some take an hour. 20 mins is a rather old-fashioned guidance.
Is he weeing & pooing regularly?
Is he gaining weight?
Does he wake to feed?

Most important, as long as he seems physically OK, is to keep offering at any opportunity, even if not a certain time after the previous feed. If you do that, you can't go far wrong.

Good luck, and I'm sure someone more expert will come along soon.

Yep - he wees and poos regularly (a few times per day). Not sure if he is gaining weight. He was weighed when we left hospital at 4 days old and he had lost weight after the birth but on the fourth day had gained some. We won't see health visitor for a fortnight so not sure if he is gaining now.

He does wake to feed approx every 2-4 hours.

Thank you!

NickyNoo - the pattern you are describing is perfectly normal in a baby of 6 days old. It would only be concerning if he was not gaining weight(babies should stop losing weight by about day 4-5 and from what you say this has happened with yours,so that's good :) )

Your midwife is incorrect in saying he should have 20 mins on each breast - this is incredibly prescriptive and makes no allowances for the wide range of perfectly normal, individual breastfeeding pairs. Can you speak to a different midwife and ask specifically about whether you should be tickling and trying to keep your baby awake by making him uncomfortable (the cold water running on his feet ??? )

You do not need to engineer the feed for him to get hindmilk. A well-attached, healthy growing baby who is removing milk effectively (and yours is showing all the signs of doing exactly that) needs no help to get what he needs.

Explain to the midwife you are going crazy and you have had to ask an internet forum for help because you have been made to feel under-confident and confused by all the questionable stuff you have been told.

I think it's disgraceful, to tell you the truth :(

My baby is 11 days old and was feeding in a very similar pattern to yours until a couple of days ago. She only ever managed 10 minutes per feed before falling asleep. I saw a bf support worker who said this was perfectly normal and not to worry. When my baby fell asleep at one breast I would try her on the other. Sometimes the activity would wake her up to feed a little longer and then I would start from that breast again next feed. Again I was told as long as there were 8 feeds a day and plenty of wet nappies not to worry. Last weigh in she had got back to birth weight and added some. Her feeding pattern has changed again now and she is feeding for longer. I miss the short feeds! Please don't worry

Mine too!

But when she was little found a good way to wake her was to blow a sharp breath at her! She woke and fed better then. Sometimes she would feed for 5 minutes, sometimes 40... like everyone else says, as long as they gain weight after the initial loss what you're doing must be right. They're all different after all.
Found the MWs advice to be contradictory a lot of the time. Even the way they wanted me to get her to latch on... could not get their method to work. Left alone with her for a night, we worked it out between us. Born weighing 5 15 and now is putting on weight and growing out of clothes.

Now she's 5 weeks she has 10 minute feeds and falls asleep on me every time.. the tricky bit is transferring her back to the cot when I need to move. Sleeps through the hoover and the builders but wakes up if she hears a foot step... contrary little buggers, aren't they?

You sound like you're doing fine.. don't worry

x

I agree that 20 minutes on each boob is really unrealistic and I can't believe that the midwife said that! IMO if he's making plenty of wet nappies and sleeping well then he's obviously getting enough to eat. I panicked a lot about DS not putting on weight, as I thought he wasn't feeding enough when he was first born. I only ever fed one side at a time, and at first he would only manage about 15 minutes of feeding. I was reassured when I saw the HV, and he'd put on 600g in just over 2 weeks! After a while he got more alert and was able to feed for longer and longer, and eventually I had to start offering both sides as he clearly wasn't getting satisfied by one side.

So, I agree with what everyone else has said basically - it sounds like you're doing just fine!

FWIW I never bothered worrying about the whole "hind milk" thing. I figured that DS would keep feeding until he was satisfied. Sometimes that was 10 minutes, sometimes longer. Everyone has a different let down speed and babies who differ in the speed they feed, so I really don't think there's any hard and fast rule about how long you should feed for. Do whatever works for you and your baby.

The 'hindmilk' thing is the thing that has posed me the most worries about bf. It was brought up at antenatal classes, again by the hv and I spent most of my time comfort suckling dc1 to make sure he got his hindmilk. I still don't really understand it. dc3 can sometimes spend 30mins on one side, sometimes 5 mins (age 7 weeks) and she poos a lot so she must be getting what she needs. Sometimes she does 3 mins on one side,refuses point blank to latch on again and then feeds efficiently from the other side.

There is huge misunderstanding about hindmilk. The misconceptions are in some well-known books, and somehow or other, training of midwives and HVs has got it wrong, too.

The facts are well-described at www.kellymom.com, I think on the pages called 'how breastfeeding works'.

Basically

• the breast makes one type of milk only (not two, or even three (FGS), as some books have it)
• the baby does not need to 'drill down' to 'the hindmilk' or be on the breast a certain time to 'reach' it
• a fuller breast has proportionately more watery milk ('foremilk') than creamy milk ('hindmilk')
• when the baby feeds on a fuller breast the more watery components reach him first - but 'foremilk' is still good stuff :)
• when the baby feeds on an emptier breast, the milk is proportionately higher in fat
• none of this needs timing, or engineering....the baby and your body sort it out without you really doing anything except responding to what your baby needs
• unless the baby is too sleepy, or underweight, 'responding' does not mean trying to get the baby to feed more or for longer, and it especially doesn't mean preventing the baby from falling asleep when he appears to need to
• in the early days and weeks, it can be helpful to make sure to offer the second breast to the baby so each breast is stimulated often, but it does not matter if the baby takes it or not as long as the baby is thriving. There is no justification for deliberately not offering, and deliberately repeatedly using one breast only, unless there is a clear case of 'over supply' which is bothering mum and/or baby.

HTH :)

Thanks Tiktok.Wish i'd known that 5 years ago!

Mine is the saem, she's a week old today. I was petrified I was starving her when I left hospital last week as the midwives told me I should be waking her up (cold water etc) every 2 hrs to feed, one told me if I didn't my supply would dry up within hours. So I was setting an alarm all through the night for the first 2 nights until I decided I was nuts and stopped.

She will sometimes feed every hour during the day for 5-10 mins a pop...other times she will feed for 30 mins a go. Some days she will go 3 hrs without a whimper. At night she is having a 'goodnight' feed at around 10-11pmish, then waking sometime between 3 and 4 for a decent feed and then between 7 and 8. The middle of the night feed takes an hour odd at least because she will feed for 10 mins then fall asleep. We'll change nappy, put down in cot, then she'll want up again. This routine isn't too bad, but am not counting my chickens that it'll last!

I do worry I'm not 'doing' it right, but she had exceeded her birth weight by day 5 (100g a day gain over the weekend!) so she is obviously getting something from it.

I keep reading on mumsnet about these unkind methods of waking babies up - yes, if babies are not thriving and are sleeping rather than feeding we might need to be concerned. But babies will almost always feed perfectly frequently if held skin to skin and responded to quickly when they make 'feeding cues'.They do not need splashing with cold water :(

It is crackers to tell a new mother that if she doesn't feed every 2 hrs her milk supply will dry up

Your baby's weight and her behaviour show you need have no concerns about her milk intake, MrsC2010 - when the dust settles you might want to contact the maternity unit and question them a bit....their techniques are unlikely to increase new mothers' confidence.

Yes, with advice like that from midwives MrsC, it's no wonder our bf rates are so low.

It amazes me how much out of date/wrong advice is being given out by midwives/hv's. Any other profession, and people would be pulled up on this. Women are given this advice when they are usually extremely tired, busy and quite vulnerable and are therefore less likely to complain or give feedback.

True, I came home feeling pretty crappy about myself I must admit. We're getting the hang of it now I think, though it is still early days and far from 'sorted' I think.

Another question, when you say breasts need to be stimulated around 8 times approx daily to keep supply up, is that 8 times per breast? Cause I do feed around that number of times per day but generally one breast per feed, meaning prob only 4 or 5 times per breast per day. Should I be using both breasts per feed?

My ds (now 9 mo, still bfing) was exactly the same, and I got the same load of flannel of hv and midwives. A lovely bf counsellor came to see me and said he just looked like a pretty efficient feeder to her, so if he was done in 5 mins he was done. So I just carried on and we were fine.

Echo all the points about weight gain and nappies, if those things are ok you are doing fine. Another point is that you are feeding every 3 hrs. If baby was not getting enough, he would be wanting to feed more frequently than this, would be more snacky I think. You might get phases of this anyway with growth spurts, but a hungry baby will always ask for more if there are no other problems.

Good luck, keep at it, it gets easier and less worrying as you go on!

Ps if you are worried, you can pop into a local baby clinic any time to get him weighed.

Firstly, do not clock watch. The amount of time or frequency of feeds your dc has does not necessarily indicate how well he is feeding. What is the most important factor is whether your baby has a good latch. My dd feeds on one breast until she shows signs that she is finished feeding. Sometimes she is obvious and will pull off and become fussy. Other times she will keep sucking but not be drinking. This is when I offer the other breast. I would not worry too much about your ds falling asleep at the breast. This is common. I fed my dd in a vest in the early days. I found that this gave us more skin to skin contact and also meant that she wasn't getting so warm that she was falling asleep. Don't listen to people who say that its bad to let your ds fall asleep at the breast. In my opinion, one of the best things about breast feeding is that it gives my dd so much comfort that it helps her to fall asleep. I don't think that this is a bad sleep association. I think its a benefit of breastfeeding to both babies and mothers. You will find that you ds's sleeping and feeding patterns will change alot. One week he will have feeds that last 5 minutes, other weeks they will last 40 minutes. As long as he is gaining weight and has plenty of heavy and dirty nappies every day you will know he is getting enough milk. The concept of feeding babies for 20 mins on each breast is outdated and goes against the feeding on demand principle. I have recently read jack newmans book and find his website to be full of great info.

You, your baby and your breastmilk have been designed and refined by millions of years of evolution. The best thing is to let your baby tell you when he's hungry (and he will!). You really don;t need to wake him to feed him.

The best advice I can give you is to do what comes naturally. If your baby wants to fall asleep, let him. Please don't try to wake him up, no wonder you feel like you're going crazy!

He will ask for milk when he needs it. Sometimes this might take a long time! Sometimes not long at all. Ignore the clock, please ignore any midwives who are over-prescriptive and tell you how many minutes you should be feeding If you trust that your baby will ask for what he needs, he will!

The midwives are overcomplicating things. I'm sure they mean well but personally I would take what they say with a big pinch of salt, it's very outdated advice.

I second looking at www.kellymom.com - a brilliant source of info on BF

Thank you for all the advice! He is definitely doing LOTS of poos and wees and seems full after each (albeit short feed).

Can I echo MrsC2010 question about breasts. Each of my breasts are only getting about 3-4 feeds of 10 minutes each per day. They are killing me! Should I try to express off milk to 'empty' them? I am scared that they will dry up and also they hurt a lot.

Thank you!

Nichy, have a good browse round Kellymom - it's really good advice.

The boobs often do get very engorged and painful in the early days. Maybe it's God's way of reassuring us we do have milk!! Anyway, I'd try not to express if poss, they should settle down. If it's getting difficult for the baby to latch on because they are too hard (I had this problem), then by all means express some off (usually just an ounce or so) till they are soft enough round nipple for the baby to suck. Don't worry about supply drying up, they will produce more/ less as the baby needs it.

Thanks - have had a good look around the Kellymom website. I've tried to hand express milk off whilst in the shower but nothing came out....grrr....very frustrating.

NichyNoo - keeping your baby close and skin to skin is likely to encourage her to feed more often and keep the breasts more comfortable. It does not matter that her feeds are short.

Expressing is sometimes helpful when breasts are very full and hard and the baby won't co-operate in reducing them....and if hard breasts seem to be contributing to the baby finding it hard to latch on.

But first choice should always be to give the baby a chance.

It is good policy in the first days and weeks to offer each side often.

Thanks for all the advice. I went to the baby clinic this morning and DS is putting on weight nicely

So it appears he is getting enough food! He is putting on weight, pooing all the time and seems happy so the health visitor said he must be getting everything he needs in the 5-10 minutes that he feeds.

:)

Fantastic!