After the first three months, many mothers start to settle into a bit of a rhythm with their baby and begin to feel like life has become a bit more predictable. Then around four months (or anywhere between three and six months), babies seem to change all over again, sometimes becoming more fussy, sleeping differently, and often being more distractible when nursing.
These outward differences are a sign of the big developmental changes happening in your baby right now. Sometimes this period lasts a couple of weeks, sometimes longer. Nursing is still very important to your baby and you can find imaginative ways to keep him nursing effectively, even with all the excitement of the world around him. This phase does pass, and babies emerge much better able to multi-task and to nurse while doing other things.
So what happens to a baby at this time?
Every baby is different, and as with so many other developments, every child does things at their own pace. Around four months you might be witnessing the beginning of lots of changes in your baby’s physical abilities. They might have much better head control and they may be able to sit up when supported. You might also notice more social skills developing, such as smiling, cooing or babbling. Babies may also start bringing their hands to their mouth simply to explore and play, so it may not always be a feeding cue, as it was in the past. There are lots of changes on the inside too, as their brain develops: their vision is now much better, and they can more easily pick out different sounds. Sometimes babies may also start teething at this age, which can occasionally lead to temporary changes in nursing behaviour.
Distractibility while nursing
The impacts of these changes can often be felt in the breastfeeding relationship. It may seem as if your baby has started nursing for much shorter periods of time. As babies get older they become much more efficient feeders, and a feed that may previously have lasted around half an hour may now take a significantly shorter time. However, the distractibility that starts at around four months for some babies may mean breastfeeds become more sporadic, especially during the day. Babies might suckle for a few moments, then turn their head at a new sound, go back to nursing, then stop to smile at mum. You may feel worried that your baby isn’t getting full feeds, especially during the day.
You can find ways to help baby to have longer/fuller feeds. For example, some mothers take their baby to a quiet or darkened room to nurse. This helps by reducing the amount of distraction so that the baby can focus on nursing. Similarly, some mums try feeding in a sling, or with a cover like a muslin, so that their baby can be less distracted by what’s going on. Other mothers find that gentle movement, like bouncing on a birth ball or sitting in a spinning chair, help to keep the baby focused.
In some cases, no matter what you do, daytime feeds are just less effective for a while. So, instead, you may want to focus on getting a good feed at nap times when baby may feed to sleep. Night-time nursing becomes really important too. Perhaps because it is already dark and quiet and babies are more sleepy, many mums find that their baby often feeds better at night during this time. While it may be worrying if your baby is taking less milk during daytime feeds, it is often helpful to think about their intake over a 24-hour period. Many babies instinctively take more milk at night anyway (sometimes referred to as reverse cycling) if they are nursing less in the day.
You may find this distractible period hard, because your baby no longer seems comforted by the breast to the same extent, and instead seems eager to do other things. Rest assured, your baby still loves you and enjoys your milk; you are still the centre of their world. It is just that your baby’s brain is changing in wonderful ways and it has not yet matured enough to allow them to multi-task effectively. This phase will pass and your nursing relationship can continue for as long as you wish.
Sometimes a distractible baby might start to suckle, and then twist their head to look at something interesting, which can be painful! Some mothers find it useful to begin nudging babies towards gentle nursing behaviour at this time. If baby pulls away without unlatching, mothers can gently unlatch baby and remind them that they can’t nurse and turn their head. Even though they can’t speak their understanding is growing all the time, and by repeating these messages babies understand what behaviours are acceptable.
Changes in sleep
As well as nursing differently, other things like sleep can be affected. A baby that may have been sleeping longer stretches may start waking more frequently at this time. Brain developments at this stage may mean they spend less time in the deeper phases of sleep. Research shows that sleep is not a linear development and it’s common for babies and children to go through periods of more and less frequent waking. Babies will wake for lots of reasons. Sometimes because they are hungry (especially if they have nursed less during the day), but also because they are processing new experiences from the day, because of separation anxiety, illness, or simply to feel a connection with a caregiver. Teething pain can be another reason: babies may have uncomfortable gums and may wish to nurse more for pain relief, particularly at night when there is less to distract them.
This can be a tiring period for mothers and parents. You may want to make some short-term changes to catch up on rest – perhaps going to bed earlier, finding a chance to nap during the day, or choosing to co-sleep with your nursling.
Not the time to introduce solids
There is a common myth that exclusively breastfed babies who are nursing less and waking more around this time might be doing so because they are hungry and breastmilk is no longer enough for them. This is not true. For the exclusively breastfed baby, breastmilk is the only source of nutrition required until at least the middle of the first year, and well beyond in conjunction with solid food. There is no need to introduce formula milk at this time. There is no evidence that introducing baby-rice or thickeners will help babies to sleep better. In fact, it may be harmful to introduce solid food before your baby’s gut has fully matured.
As babies get bigger and become able to reach and grasp for things, they may start to grab the food that you are eating. Babies also start to use their hands much more to experiment and will frequently put their hands in their mouth. Again, these are not a sign that they are ready for solid food. Getting teeth through is also not a sign that your baby is ready for solids or that he no longer needs to nurse. Evidence suggests it is better to wait until baby is showing other signs of being ready for solids, like being able to sit up unaided for short periods of time. You can read more about starting solid food here.
The UK Department of Health recommends exclusive breastfeeding for the first six months of a baby’s life and states that breastfeeding can continue to benefit your baby along with solid foods for many months after.
The World Health Organization strongly recommends exclusive breastfeeding for the first six months of life and it states that after that breastfeeding should continue, along with complementary foods, for up to the age of two years or beyond and as long as mutually desired.
Distractible older baby
Sometimes babies can also become distractible between around eight and ten months. Again, this is related to normal developments that the child is going through. Sometimes parents think distractible babies at this age are weaning. Research shows that it is very unlikely that a baby under one year will self-wean. Nursing remains very important to your baby. Many of the same tactics that worked for a four-month-old may work again; for example, keeping external stimulus limited when nursing. An eight-ten month old baby will be drinking water and having some solid foods, and you may find they eat more or less during this period. Babies may also wish to nurse more at night for a while.
For some babies the developmental changes that happen around four months mean that they may become more distractible while nursing. Nursing is still very important to your baby and sometimes you may need to try some imaginative solutions for a short period in order to help your baby get full feeds. Babies may also begin to experiment with their hands in their mouth a lot more, or reach for food. This does not necessarily mean your baby is hungry, or that thickeners, baby rice or solids need to be introduced. Research shows that waiting until at least the middle of the first year is ideal to ensure your baby’s gut has matured.
As with so much else, this is a phase that will pass. If you’re finding it tricky and you’d like some support, or simply to hear from other breastfeeding mothers in similar situations, you might like to join your local La Leche League Group. You can find your nearest group here.
Written by Rhiannon Butterfield, LLL Cambridge, August 2020