When babies are hungry, they display a variety of subtle and not-so-subtle cues. They stick out their tongues, turn their heads from side to side, open their mouths, squirm or wriggle, suck on their fingers or fists, and even cry.
Babies are more likely to feed well when parents respond to earlier feeding cues rather than waiting for their babies to cry. To ensure that early cues don’t go unnoticed, it is best to keep your baby close by. When babies and mothers are separated, opportunities to breastfeed are more likely to be missed.
Circumstances that may cause babies to be sleepy and feedings to be missed include:
- mother’s use of pain medication during labor or after birth
- newborn jaundice
- pacifier use
- birth trauma
- newborn illness
- preterm or near term birth (less than 37 weeks gestation)
By watching for signs that your baby is getting enough to eat, you can better decide how frequently you need to wake your baby to breastfeed. Signs that your baby is well fed include:
- 3 or more soft yellow stools a day by day five
- 6 or more wet diapers a day by day five
- urine that is clear or pale yellow in color
- appropriate gains in weight, head circumference, and length
- contentment after breastfeeding
Although feeding patterns can vary, it is common for breastfed babies to eat at least 8-12 times in each 24-hour period. You can be sure that your baby is getting the ‘right’ number of breastfeeds if you see all of the signs detailed above.
Some babies breastfeed often but ineffectively (removing little or no milk from the breasts), while others breastfeed well but not often enough. If your baby is sleeping for long periods of time and growing poorly, you may need to wake him every 1-3 hours during the day and at night to ensure that he gets the calories and nutrients he needs to grow.
Tips for waking a sleepy baby
Babies spend much of their sleep time in active sleep, during which they are easier to arouse, and once aroused, more likely to eat. By watching for signs of active sleep (facial and finger movements, eyelids fluttering, irregular breathing) you will know when your baby is more likely to awaken and eat. Babies don’t need to be fully awake to breastfeed, but they do need to be alert enough to remain attached and to transfer milk. Additional suggestions for waking a sleepy baby include:
- remove a layer of your baby’s clothing
- change your baby’s diaper
- massage your baby’s feet
- wipe your baby’s face with a warm washcloth
- place your baby flat on your lap, tummy up, with his feet near your tummy; supporting your baby’s whole body, lift him into a sitting position then lie him back down (repeat several times)
Waking a sleepy baby is one thing; getting him to breastfeed is another. Since most babies tend to fall back to sleep, the following tips may help you keep your sleepy baby breastfeeding:
- Compress your breast. Compressing your breast when your baby pauses from breastfeeding can increase the flow of milk and keep your baby breastfeeding. Begin by placing your fingers beneath your breast and your thumb on top. Gently squeeze your breast when your baby stops sucking and swallowing. Stop the compression as soon as he resumes breastfeeding. Repeat the motion until your baby no longer breastfeeds in response to the compression.
- Switch from side to side. Switching breasts and changing breastfeeding positions can help to keep a sleepy baby awake for a longer period of time. Mothers are usually advised to breastfeed well on one breast before offering the second breast to ensure that their babies get the calories they need to grow. If your baby is gaining weight slowly, you might want to change breastfeeding positions but not breasts.
- Hold your baby skin-to-skin. Holding your baby skin-to-skin while breastfeeding can help stimulate your baby’s natural instincts to root, attach, and suckle.
If your efforts to keep your baby awake are unsuccessful, express your milk by hand or with a pump. Milk expression will build your milk supply and the milk expressed can be used to “top-off” your baby—at least until he wakes up and begins to breastfeed well again. You can give your baby your expressed milk using a cup, spoon, bottle, or breastfeeding supplementer. Contact an International Board Certified Lactation Consultant (IBCLC) to discuss which option may work best for you and your baby given your individual circumstances. Read this if you are concerned about nipple confusion.
When is it okay to let your baby sleep?
As your baby grows and develops, his sleeping pattern will change. He will spend less time in a light sleep and more time in a deep sleep. His circadian rhythms will also begin to emerge around 2–3 months of age and your baby will be influenced by environmental cues such as daytime and nighttime. From this age onward, many babies have their longest sleep stretch at night. Your baby’s period of nighttime sleep will gradually increase as he gets older, although there may still be times when he wakes frequently at night to breastfeed. And remember, nursing at night is not always about hunger, sometimes your baby might just be seeking comfort.
Don’t be fooled into believing the old wives' tale that a bottle before bed will help your baby sleep through the night. The fact is, breastfeeding mothers tend to get more sleep at night than formula-feeding mothers (click here to learn more).
Most importantly, be patient. Even though you may start out having to wake your baby to breastfeed, before long, he will wake on his own and ask to eat. As long as your baby is growing well, you can follow his lead, letting him sleep for as long as he wants, especially at night.