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Disclaimer: The information found in this post, on this blog, and within any breastfeeding resources created by Mom Makes Joy should never be a substitute for lactation advice or in-person assessment given by an appropriately credentialed healthcare/lactation professional.
We all want sleep.
I don’t begrudge you your eight hours, I promise. And I understand what it feels like to miss the uninterrupted nights you took for granted before you had kids.
I also take it (given that you’re reading this) that you’re breastfeeding, and maybe even having milk supply issues, sleep frustrations, or both. So you should know:
There are a lot of different “tricks” out there to get your baby to sleep. But not all of them are developmentally appropriate at the ages “they” suggest you do them. None of them are actually guaranteed to get you sleep. And many of them can actually harm your milk supply.
Here is some common sleep advice you might want to take a critical look at if you are a breastfeeding mom:
Please Be Advised: Breastfeeding can be a sensitive topic, especially for mamas who were not able to meet their breastfeeding goals for whatever reason, or mamas who knew they wanted to formula feed. As a breastfeeding advocate, I will always encourage a mother to breastfeed if that is her goal. Please do not mistake this for being against moms who choose formula or supplement with it. We are all doing the best we can with the information and support we have. Please read the following post with caution if breastfeeding is an emotional or sensitive topic for you.
“GIVE FORMULA AT NIGHT OR A ‘TOP-OFF’ BOTTLE”
First of all, there is simply no research to support that formula-fed babies sleep better than breastfed babies. Overall, they wake the same amount (source)!
Although formula fed babies do indeed tend wake a bit less frequently in the first few weeks, differences disappear quickly. Regardless of feeding style, research has shown both groups of babies get the same amount of sleep in a 24 hour period and are equally capable of developing sleep skills (source).
I know the prospect of there being even a chance that formula will help your baby sleep more soundly makes the idea of offering it tempting, especially when you’re tired.
However, infant sleep researchers hypothesize that this kind of deep sleep early in life makes it difficult for babies with undiscovered central nervous system deficits to coordinate breathing and eventually rouse from sleep in the event of breathing difficulty, making them more vulnerable to SIDS (source, source). In other words, a deep sleeping infant isn’t necessarily a desirable goal. Exclusive breastfeeding ultimately confers the greatest protection against SIDS–a 73% reduction of risk (source).
But it doesn’t stop there: Perhaps the biggest issue with offering formula at night so mom can sleep is the significant impact it can have on your milk supply.
You’ve probably heard it said that milk production is a matter of supply and demand, and this is true (source). When your body detects demand–through nursing or pumping–your body continues to make milk. If the demand decreases, supply decreases.
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When baby gets a bottle of formula at night, your body gets no signal (demand) that it needs to produce more milk. In order to protect your overall milk supply, especially if you are pumping for baby at work, you need to give your body this signal. In other words, you need to pump a full session (about 20 minutes typically) for every bottle of formula baby gets–at any time, day or night.
And this doesn’t only apply to formula bottles: Relying on a frozen milk “stash,” or offering a “top off” bottle of formula or breast milk before bed to promote sleep can also lower supply.
As you can imagine, pumping at night every time baby gets a bottle of formula or frozen breast milk is actually more work for you, not less. Not only do you need to sit there to pump, but now you have pump parts to sterilize and bottles to wash.
What if you need to supplement? If you are needing to supplement, speak with a qualified lactation professional (usually an IBCLC, since most pediatricians have little to no lactation training) about how to protect your milk supply in the meantime. An IBCLC can help you build your supply so that supplementation is no longer necessary, or she can help you maintain your current supply so that you do not eventually need to transition exclusively to formula. Every situation will be unique.
“TRY CEREAL IN A BOTTLE”
This is problematic advice for several reasons, the first being that it is an outdated practice, one that is no longer recommended due to being a choking hazard (source).
The second reason has to do, once again, with mom’s milk supply: Any food that baby gets without needing to stimulate the breast has the potential to lower mom’s milk supply.
On top of that, most infant cereal has fewer calories, less fat and fewer vitamins and minerals than human breast milk anyway, so cereal would be filling up the valuable real estate of a baby’s tiny tummy with a food substance that is less nutritionally dense than breast milk. Not to even mention that there is no research to support that cereal actually helps babies sleep (source).
And finally, there is the issue of early solids. All major health organizations now recommend waiting to at least six months of age–no longer 4-6 months–before introducing foods other than breast milk or formula. If baby is older than 6 months of age, he or she doesn’t need to take cereal in a bottle. And if baby is younger than that, they probably shouldn’t be eating cereal period.
“PUT BABY ON AN FEEDING SCHEDULE”
While it seems like a nice way to encourage “good” sleep habits, promote longer sleep stretches at night, and make your life a little simpler, feeding a breastfed baby on a schedule is not recommended by anyone who has really studied lactation.
Again, it all goes back to milk supply.
Breastfed babies are excellent at regulating their own milk intake, but they are also limited by a mother’s unique milk storage capacity.
To understand what I mean, it helps to think about a factory warehouse. A warehouse stores the items a factory produces. The factory workers will slow down and produce fewer items when they see the warehouse is running out of room to store them. If the factory workers empty out the warehouse every so often, the factory can resume producing items at a steady rate. If the warehouse size is small, it needs to be emptied out more often to make room for more product. If it’s a large warehouse, it can hold a lot more product before it needs to be emptied out again.
A mom’s breasts work the same way: If her breasts are full, milk production slows down, and if they are emptied, more milk is made. If she has a small storage capacity, her breasts need to have milk removed more often to keep up production than if she had a larger storage capacity.
A mom’s storage capacity does not put a limit on the total volume of milk she is capable of making (small and large capacity breasts can produce the same volume of milk in a 24 hour period). And it does not have anything to do with mom’s breast size (large breasts can have small storage capacity, and small breasts can have huge storage capacity) or how much she is able to pump (pump output is NOT a reliable indicator of supply or storage capacity).
The beauty of breastfeeding is that an otherwise healthy infant with a good latch who is allowed to nurse on demand will nurse exactly as often as they need to to maintain mom’s milk supply long term.
When a baby naturally starts to sleep longer stretches, your body will regulate to meet baby’s demand and you won’t need to do anything special to do anything special at night to protect or promote supply.
The system runs on autopilot!
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So this is how feeding schedules become problematic:
If a mother with a small storage capacity tries to get her baby on a feeding schedule, she might not be removing milk frequently enough to maintain her current rate of milk production over time.
The more immediate concern, however, is that baby may not have taken in enough milk at the last feed to get him to the next feed without being hungry.
Feeding on demand not only protects milk supply, but it keeps baby satisfied. Don’t forget–breast milk is easily and quickly digested, and breastfed babies simply need to eat frequently; this is especially true if mom has a small storage capacity.
Stretching out time between nursing sessions–or nursing less often than whenever baby cues–in order to conform to an arbitrary feeding schedule can have a real impact on your milk supply.
New research has found that breastfeeding mothers who nurse according to a schedule nurse noticeably less frequently–closer to 6-8 times a day compared to around 10-12+ (source). So it’s not surprising, then, that mothers who follow parent-led schedules tend to quit breastfeeding sooner than mothers who don’t (source).
People who tell you parent-led schedules didn’t cause a supply issue either lucked out by having a large storage capacity (one not as easily affected by a schedule) or never nursed long enough for the issue to surface (think back-to-back pregnancies).
If your goal is to breastfeed the two years or more that the World Health Organization recommends, this issue with feeding schedules is worth noting.
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“START SLEEP TRAINING”
It’s not a popular opinion, but it’s pretty factual: Our society’s standards for “good” infant sleep are little more than cultural norms masquerading as sleep science.
If you’re a breastfeeding mama, most run-of-the-mill, traditional sleep training methods (think cry-it-out, controlled crying, variations of the Ferber method, etc), can be problematic if baby isn’t getting the chance to nurse as often as he or she needs to at night to maintain milk supply. Some moms can make it work, while others–who may already be struggling to find time to pump while working or who may be dealing with latch or weight gain issues, for example–won’t be so lucky.
Help! My supply is already low! If you suspect you have low supply, speak with a lactation professional, usually an IBCLC, as soon as possible. Remember that milk production is a matter of supply and demand, so to increase supply the best course of action is to nurse and/or pump more frequently. In-person assistance may be needed and is always recommended.
If you don’t feel comfortable with cry-it-out sleep training methods…where does that leave you? Are you doomed to tiredness and insomnia?
No! My goodness, no!
There are a lot of things you can do to gently encourage great sleep without sacrificing your sanity, your parenting values, or your milk supply.
Many of these techniques require more information than I can flesh out in a few paragraphs at the bottom of this article, so this topic will eventually get it’s own post. But until then, here are some things to consider as you tackle sleep:
1) IS YOUR BABY’S SLEEP ACTUALLY PATHOLOGICAL?
Do some research into what normal infant sleep actually looks like. You may be surprised to find that your baby doesn’t actually have a sleep problem: Your baby just isn’t sleeping the biased way our culture says he or she “should” be sleeping.
It is normal for babies to wake frequently at night regardless of what they are fed. It is normal for babies to nurse at night, even throughout the first year or beyond. It is normal for babies to not sleep like adults.
Sometimes having realistic expectations, and understanding that a child’s behavior has a biologically wired purpose, is what a mom needs to figure out how to work with baby’s biology–instead of against it–so they can both get some sleep.
2) ARE HEALTH ISSUES OR DEVELOPMENTAL CHANGES AFFECTING SLEEP?
Does baby have a history of gas or reflux or poor latch? Could sleep apnea be an issue? Could a milk transfer problem be the reason baby is having trouble gaining AND waking frequently at night to nurse? Is baby going through a developmental leap that’s temporarily affecting sleep? Rule out or address these things before making modifications to help baby sleep.
The Wonder Weeks is a fantastic resource for new moms who want to understand what is happening with their baby developmentally. The app (which you can get for iPhone and android) will let you know when you can expect these developmental leaps, which can cause sleep disruptions.
3) IS BABY HAVING TROUBLE SLEEPING…OR ARE YOU?
Do you have difficulty falling back asleep when baby wakes? Are you up at night worrying about when baby will wake again? Do you already have a history of broken sleep or sleep apnea yourself?
Sometimes the issue isn’t baby–it’s us! Consider hiring a postpartum doula or inviting family to help overnight, and consider looking in to things you can do to fix your own sleep hygiene before working on baby’s. .
I DON’T LIKE MOST SLEEP BOOKS, BUT THESE ARE PRETTY GREAT:
Want to learn more about biologically normal infant sleep and how to gently influence sleep without affecting your milk supply? Give these resources a try:
Are you a breastfeeding mom that gets great sleep? Share your secrets in the comments!
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