Should I wake my baby to nurse during the night?

Ask Anne…

Question: My baby is 6 weeks old. I’ve been setting an alarm for every  4 hours since the start of each feeding every night. Usually he wakes up before that to nurse, but occasionally he will still be asleep after 4 hours so I will wake him to eat. Is it best to continue waking him, or should I wait for him to wake up on his own before I nurse him? How long can babies go between feedings, and can it hurt my supply to go longer periods of time?

Answer: Mothers are often told to wake their newborn for feedings, and there is a good reason for this. Newborns are notorious for sleeping through feedings, and it is easy to assume that a sleepy baby is a full, satisfied baby. “Demand” feeding begins after the baby is a week or two old, has regained his birth-weight, and your milk supply is well established. A healthy baby who is older than two weeks is not going to sleep through feedings – he will most definitely let you know when he is hungry!

Once he is gaining weight steadily,  you can let him set the pace for feedings. It really doesn’t matter whether he nurses every two hours or every four, or whether he takes one breast or two, or whether he nurses for thirty minutes or five minutes, as long as he is having good urine and stool output and gaining weight.

All babies will start gradually stretching out the intervals between feedings, from 2-3 hours, to 4-5 hours, and then up to 6-8 hours or longer over a period of time. The ‘official’ definition of ‘sleeping through the night‘ is a 5 hour stretch. Some babies will reach the magical ‘sleeping through the night’ milestone sooner than others. The human body is amazing adaptable, and if the transition is made gradually, your breasts respond to the lack of stimulation by making less milk, so you experience less fullness. Just as some moms leak a lot and some hardly at all, some will experience more engorgement and fullness than others.

If your breasts are so full that you feels that you may be developing plugged ducts, you may want to apply heat and express some milk to relieve the pressure, but don’t pump too much – you don’t want to send your breasts the signal to make more milk than your baby needs. Nursing mothers will find that as the intervals between feedings increases, the softer their breasts feel and the longer they can go without becoming engorged.

Breastfed babies will regulate their own intake. They all sleep through the night at some point, and the milk supply will adjust to meet the demand. If your supply decreases, your baby will nurse more often to build it up (cluster feeding). With a 6 week old who is stretching out the intervals between feedings, you don’t need to set an alarm. Just relax and follow a baby-led sleep and feeding schedule.

Anne Smith, IBCLC
Breastfeeding Basics