What is normal?
Normal newborn feeding cues
Why is my baby sleepy?
Wake your sleepy baby to nurse
Express milk for your baby
Avoid bottles and dummies
When to offer expressed milk
Don’t give up too soon
Your newborn baby needs to breastfeed effectively at least 8–12 times in 24 hours to gain weight and stimulate your milk production. Most babies nurse every 2–3 hours from the start of one feed to the next, with one longer sleep of 4–5 hours. ‘Cluster nursing’ is also common, where a baby breastfeeds on and off for several hours, especially in the evening. As well as breastfeeding and sleeping, your baby will probably also have periods of quiet alertness. Your newborn needs to nurse actively from one or both breasts at each feed. Offer the second breast after he seems to have finished at the first, although he may not want both sides at every feed. Look at our page Beginning Breastfeeding for more information.
Offer feeds generously. Don’t make your baby wait until he is desperate—by that point he is unlikely to feed well. In order of urgency, signs your baby is ready to feed include:
- Mouth movements, including smacking or licking his lips.
- Sucking on lips, tongue, hands, fingers, toes, toys, or clothing.
- Rooting, head bobbing or nuzzling against whoever is holding him.
- Fidgeting or squirming a lot.
- Crying—a late sign of hunger.
In the first few days, some babies are sleepy or uninterested in feeding. This can be especially true for small babies, after a difficult labour or birth, or if you received drugs for pain relief during labour. Jaundice or an infection may make a baby sleepy. Frequent breastfeeding helps prevent normal newborn jaundice becoming a problem. Your baby may sleep to conserve energy if he is not getting enough food. He may also sleep longer than is good for him if he is apart from you.
Getting a deep, comfortable latch is crucial. If your baby is not latched on well at the breast, he will have to work harder to get your milk. He may tire easily and fall asleep. Sometimes just a small adjustment to the way your baby comes to the breast can make a huge difference. An LLL Leader can provide individual suggestions tailored to your circumstances. If your breasts are engorged, gently hand express a little milk and/or ease swelling back with your fingertips to make it easier for your baby to latch on deeply and prevent you getting sore. Find an LLL group near you.
Seek skilled help early on if you are finding breastfeeding difficult or uncomfortable.
If your baby is too sleepy or groggy to rouse himself every few hours, you will need to wake him to feed to ensure he gets enough milk. This will be easier if your baby is in a light sleep cycle: watch for rapid eye movements under his closed eyelids, arm and leg movements, sucking activity and changes in his facial expression. See whether his arm shows some resistance to movement rather than being floppy and relaxed.
- Aim for him to feed at least 10 times in 24 hours.
- Encourage active nursing on the first breast, watching and listening for signs of swallowing.
- Use breast compression (see overleaf) to keep your baby nursing actively.
- Offer the other side in the same way. You can switch back and forth several times if it helps your baby stay awake and feed.
- Encourage cluster nursing whenever your baby is more alert.
Laid back breastfeeding positions and skin-to-skin contact are also very effective in helping a baby to rouse and feed. Your baby will need to feed in the night too. Keep him close by—day and night—so he doesn’t sleep too long and you don’t miss his feeding cues.
- Dimming the lights and keeping your surroundings quiet and peaceful.
- Keeping the room temperature at around 18°C or undressing him a little if the room is warm. Being too hot can make a baby sleepy.
- Unwrapping any blankets.
A baby often instinctively seeks the breast and attaches deeply and comfortably if he can snuggle up close to his mother’s chest for periods of time, even when sleepy or during light sleep. Try letting your baby lie on your body as you recline so both his chest and tummy are against you. This kind of ‘laid-back’ breastfeeding contact is known as Biological Nurturing™ and can be done skin-to-skin or with you and your baby lightly clothed—whatever is more comfortable and convenient for you both. Watch for signs your baby is stirring and gently encourage feeding. Spending time relaxing like this can make a real difference to how well your baby feeds and how much milk you make. Our page on Comfortable Breastfeeding has more ideas.
If your baby starts to doze at the breast, this technique will help him breastfeed actively and take more milk.
- Support your breast with one hand—thumb on one side, fingers on the other.
- Wait while your baby breastfeeds actively, his jaw moving all the way to his ear. When he stops swallowing, compress your breast firmly. Hold it squeezed until he stops nursing actively, then release your hand.
- Rotate your hand around your breast and repeat step 2 on different areas of the breast as needed. Go gently—this should not hurt.
- Switch nursing: try switching breasts at least two or three times during each feed—when he comes off the first breast on his own or when breast compression no longer keeps him breastfeeding actively.
If your baby isn’t responding
Express milk for your baby
Until he gets the hang of feeding you may need to do some work for your baby. If he is not latching at all, or is not feeding well and gaining weight, then expressing your milk will help establish milk production. The earlier you start, the sooner you’ll produce plenty of milk. On day one, expect to express small amounts of milk at a time: about 5 ml every couple of hours, to mimic your baby’s feeding pattern, increasing to about 30–60 ml each time by day seven after birth. Hand expression is often easiest at first but you can combine hand expression with pumping when your milk comes in.
You can give small amounts of expressed milk using a spoon, flexible feeding cup or syringe. Bottles or dummies can confuse your baby’s sucking technique, see our page on Nipple Confusion. Consult an LLL Leader about breastfeeding friendly ways to bottlefeed or about using a nursing supplementer. This device delivers extra milk through a tube along your breast as your baby nurses, avoiding the need for bottles. Visit our page When Mum Can’t Be There for more information on breastfeeding friendly ways to bottlefeed.
Babies may sleep to conserve energy if they are not getting enough food. Giving your baby your expressed milk after breastfeeding can help him overcome sleepiness and feed more effectively next time. But if you can’t get him to feed well at all, a little expressed milk before nursing may give him the energy he needs to breastfeed more effectively this time.
If your baby doesn’t respond quickly to your efforts to get him to breastfeed more often and more effectively, don’t give up.
Check with your doctor to eliminate any medical reasons and contact your local LLL Leader to find one-to-one breastfeeding help. You can find support and encouragement from breastfeeding mothers in your local LLL Group too.
Written by mothers of LLLGB. Photos courtesy of Ellen Mateer and Suzanne Tobin.
The Womanly Art Of Breastfeeding. LLLI, London: Pinter & Martin, 2010
This information is available to buy in printed form from our shop.
Copyright LLLGB 2016