Demand or Schedule Feeding?

My Thoughts

Which is better. . . nursing my baby on demand or schedule feeding? The best way is to feed on cue. This advice is supported by much medical evidence, by La Leche League and lactation experts, by the American Academy of Pediatrics, and by many breastfeeding mothers.

Newborns should have frequent and unrestricted access to the breast. Here are some of the many benefits...

The more often you nurse your baby, the sooner your milk will "come in."

It can help alleviate or prevent engorgement. (I can vouch for this information being true... I nursed my daughter often, and when my milk "came it," I did not get engorged!)

"The baby who nurses early and frequently will be less likely to display exaggerated levels of jaundice because frequent feeding causes the meconium (the stool present in the baby's intestine at the time of birth and rich in bilirubin) to be excreted quickly and lessens the amount of bilirubin necessary for the baby to process." See Breastfeeding Answers: Jaundice
If a baby nurses often, his mother's milk will be higher in fat content.
Milk is made on a supply and demand basis... the more your baby nurses, the more milk there will be.
Babies who are getting sick may nurse more often... the antibodies in his mother's milk help him fight the sickness.
Babies go through growth spurts and will increase the frequency of nursing accordingly in order to increase the milk supply.
It's good to watch for pre-cry cues because crying can cause your baby to have an uncoordinated suck, making it more difficult to initiate feeding.
Sucking stimulates prolactin. The frequency of sucking has a greater effect on prolactin levels than the intensity of sucking, so frequent nursing builds up your prolactin. Prolactin, often called "mothering hormone," relaxes you and increases your milk supply. According to Dr. Sears, "Prolactin is probably the chemical basis of mother's intuition and may be one reason mothers have a more intuitive nurturing response to cries than fathers" (The Fussy Baby pg 54).
More reasons to come soon plus references.

What does feed on demand mean?

Feed your baby whenever he seems to want it--in other words, follow his cues. According to Dr. William and Martha Sears, RN, IBCLC, "Babies will demonstrate feeding cues for up to 30 minutes before they start crying."* How will you know he is hungry? What are his cues? The following list shows some ways your baby will let you know he needs to nurse:

Pre-Cry Hunger Cues

squirming,
increased alertness or activity,
making rooting motions,
snuggling or rooting at the breast,
clenching his fists by his face,
brushing a hand across his face,
putting his fist in his mouth,
sucking on his hands,
making sucking sounds or little sucking motions,

Late indicator of hunger...

crying

The American Academy of Pediatrics' policy on Breastfeeding and the Use of Human Milk states, "Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger."

It may seem to you that your baby gives these signals often... that's good. I can't stress enough that some babies will want to nurse *very* often. It is natural and normal for a baby to want to nurse every hour--sometimes more, and sometimes less. Your baby may even seem to want to nurse "all the time." One new mom put it this way, "My baby howls when she is not plugged in."

I want to make sure my baby eats often enough

As a new mom I wanted to feed my baby when she was hungry, but I was not very aware of her cues, and I had no idea how often breastfed babies need to nurse. . . so poor Ellen didn't nurse often enough at first (see my breastfeeding story). It's important to remember that milk is made on a supply and demand basis... the more your baby nurses, the more milk there will be. I suggest the following: 1) Become aware of what nursing cues are and follow your baby's cues, 2) allow frequent and unrestricted breastfeeding, and 3) nurse your newborn at least every 2-3 hours or 8-12 times in 24 hours.

If you want to keep tabs at first on how often your baby eats, perhaps if you have a sleepy baby or you have trouble reading your baby's cues (see next section), it may be helpful to know that the time between nursings is figured from the beginning of one feeding to the beginning of the next--for example, to nurse every two hours would mean nursing at 2:00 and then at 4:00 and then at 6:00, etc. Remember, your baby may want to nurse much more often than this... this is normal. Follow his cues and nurse him whenever he wants to nurse. Keep in mind that babies nurse for comfort as well as nutrition. When you feel comfortable that your baby is eating often enough, please consider throwing away your clock. In my experience, I found that watching the clock caused us a lot of unnecessary stress.

****Coming soon!**** Signs that your baby is gettting enough milk.

What if I can't read my baby's cues?

If you aren't able to tell that your baby is hungry until he starts crying hard, it can be helpful to realize that the best way to get to know your baby and to learn to read his cues is to keep your baby close by you... in the same room as you, in your arms, perhaps in a sling, and beside you in your bed.

Many mothers find it helpful to keep their baby with them as they do their day to day activities. If you wear him in a sling, he can be part of the action without always being the center of attention. If he stays in the same room with you, you will able to see his cues and respond to them quickly.

For instance, you may find it helpful to let your baby take naps nearby you (or you may want to take naps with him in your bed). If you keep him in the room with you, you can be aware of when he starts to squirm . . . you can go ahead and offer the breast then.

Responding quickly and consistently to the cues you are able to read in your baby will help give you confidence in your ability to meet the needs of your baby. It will help you to know your baby better, and you will be better able to read his cues. It can help you get to know your baby so well that you are even able to anticipate some of his needs.

Mothers who choose not to responsively meet the needs of their baby will start to loose their ability to do so. Mothering instinct needs to be cultivated and used, or it will grow weak.

It's important to remember that to a baby, wants and needs are synonymous. They are helpless and dependant, and we are older than they are--we can wait. If they are made to wait, they will not understand why. They have no concept of time. To them a minute is an eternity. A mother who consistently and responsively meets the needs of her baby will foster a deep trust and contentment in her child. As he gets older he will gradually learn to wait longer for his needs to be met. . . the trust his mother has fostered in him will help reassure him that his needs will be met.

Note: Make sure your baby is latched on and positioned correctly. Incorrect latching can lead to inadequate milk supply, and/or sore nipples. It should not hurt. Check out Attaching Baby to the Breast by Dr. William and Martha Sears, RN, IBCLC. This article discusses latching on and proper positioning. It goes through the whole process, step-by-step, and includes helpful illustrative photos.

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Resources on the Internet

On this website

Links to other sites

So I Nursed Him Every 45 Minutes By Elizabeth N. Baldwin and Kenneth A. Friedman
FAQ on Breastfeeding Frequency On La Leche League's website.
Scheduling, Routine, Flexibility, and Responsiveness: Muddling Through the Maze of Conflicting Baby Advice by Rebecca Prewett
But I Don't Want to Nurse All the Time OR Watch the Clock! by Rebecca Prewett
Examining the Evidence for Cue feeding of Breastfed Infants by Lisa Marasco, BA, IBCLC and Jan Barger, MA, RN, IBCLC
On Scheduling by Gaelen Billingsley
Can Your Baby Get Too Much of A Good Thing? The issue of "overnursing" and breastfed babies, by Marnie Ko.
"All nursing is beneficial, whatever the reason or frequency, and based on what we know about milk supply, it appears that the more often a mother nurses, the better." ~ Marnie Ko

"What scheduling actually teaches a child is that he is a helpless pawn in a confusing world. Babies can't read clocks! They have no idea what "every four hours" means. They have no concept of past or future. They know only that they are crying with hunger now, and no one is taking away the hurt." ~ excerpt from On Scheduling

Where to Get Help
Breastfeeding Questions
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**These are my opinions gotten from experience and reading. For medical advice, please contact your health care provider. He/she may refer you to a lactation consultant.**

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