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Watch the baby - not the clock

My clients are often told by well-meaning pediatricians, nurses, midwives, friends, mothers-in-law, and even sometimes IBCLCs or other lactation professionals, “Nurse the baby on each side for X minutes”. This starts the mother off on (potentially) the wrong path and a skewed vision to have about her new breastfeeding relationship. What does this magical number of minutes mean? Does it mean the baby transfers an appropriate amount of milk? Does it mean that any nursing done past that X number of minutes is wasteful? Useless? That limiting the number of minutes will make breastfeeding easier? Does it mean the mother/baby will sleep more/better/longer? Does it mean you won’t set up any “bad habits” by nursing a baby to sleep *gasp*?

Nope. It doesn’t mean any of those things. It’s a widely spread myth that is founded in no solid evidence based information. Nada.

“How long should I nurse on each side?” is a question I hear fairly often, however.

The honest truth is – for a full-term, healthy baby you can trust that baby to know when s/he is full/hungry. Babies don't have hard and fast rules. Some may nurse for a long time, others may nurse quickly - the SAME baby may have both short and "long" turns at the breast. Cluster feeding may be preferred by the baby several times a day. Babies know when they are hungry and when they are full.

The “rules” of thumb still apply in those early weeks. You want to aim to put the baby to the breast at least 8-12 times per 24 hours and watch their diaper output to ensure they are having the appropriate amounts of wet/poo per day. 8-12 times in 24 hours works out to “about every 2.5 hours” with a possible one “longer” stretch of sleep per day (4 hours, if the baby will give it to you – ONCE – ONCE per day). It is usually best practice to at least offer the second side and let the baby decide if they want to nurse or not. (Some babies will want to nurse on the second side, other babies will be full and happy after one side. Again, no hard and fast rules with this and if you're letting the baby lead the way you can't go wrong!).

The babies who might need a little clock watching are sometimes the late-preterm babies (34-37 weeks) who are latching well but might not be self-rousing every 2-3 hours as needed to transfer an appropriate amount of milk per day. Other babies who may need a little clock watching are babies who have had some sort of birth trauma (instrument birth, malpositioned babies who may be sore/hurting), babies who were born to mothers who were using pain medications for labor or postpartum pain, babies who are not well latching/transferring milk who are at higher risk of jaundice issues – those babies do need a little clock watching.

Lastly, breastfeeding is NOT just about THE MILK. Yes, THE MILK is precious and wondrous and amazing. Yes! Babies were NEVER hungry in the womb though. They have never experienced anything but continual feeding and warmth. If they want to suck – let them suck! Maybe I’m channeling a little inner Antoinette or something, but really. Let them nurse! Feeding at the breast is about so much more than the calories the baby gets from the precious milk. Limiting time at the breast per some random number of minutes diminishes the amazing at-breast relationship to little more than just eating a plate of potatoes in 3 minutes (or less!).

One word of warning for limiting time at the breast: It CAN diminish a supply. Does it always? Nope. It can however. The early days of breastfeeding actually calibrate the breasts to determine how a milk supply will look and work for the entire course of that lactation relationship.

If you need clinical lactation care and live in the metro Atlanta area (Henry County, GA and surrounding areas), please contact me for an appointment. Best, Angela 678-432-7917

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