What to know about breastfeeding and sleep training
There is so much about the early days of life with a newborn that can feel very challenging. Feeding, and in particular breastfeeding, comes almost immediately when discussing the biggest struggles for moms in the first meeting of each session of The Chicago New Moms Group. While there are some for whom it all seems to work out smoothly, the majority find it way more difficult then expected. Breastfeeding a newborn involves a dual learning curve where you are trying to figure out what to do alongside your body trying to establish the process of making milk while at the same time, your baby is figuring out the experience of removing milk from the breast. This can all be complicated by an intense fluctuation in hormones and exhaustion and possibly anatomical barriers that many have never experienced before. Suffice it to say, it’s a LOT. In even the best of circumstances, I encourage moms to work with a lactation consultant to help set them up for as much success as possible. To find a lactation consultant in your area who is covered by your health insurance, please visit The Lactation Network’s website.
Once you have established breastfeeding, you may find that, as your baby has moved past the newborn period, breastfeeding has become inextricably linked to sleep. While this may work very well in the early months, it can start to become less effective at helping your baby sleep overall as time moves on. What I typically find is that nursing your baby to sleep at bedtime can be a great way to initiate sleep in the early months, usually before you reach 15 weeks, which is about when the dreaded 4 month sleep regression can begin. Prior to this point in time, you might be able to nurse your baby to sleep and that leads to a respectable stretch of 5 hours or even more of uninterrupted sleep. The wake ups that follow that stretch might be easily managed by nursing again and your baby is quickly back to sleep. Moving past 4 months, though, as you enter this new phase where your baby’s brain is now more alert and aware, nursing many not feel like it is all that effective, but you may not know what else to do. When this happens, I will often start working with families as they move past this regression at whatever point they feel like they can no longer keep doing what they have been doing as it isn’t working and everyone is exhausted.
The first thing that I am always clear about with breastfeeding moms is that breastfed babies can sleep just as well as formula fed babies. You do not need to end your breastfeeding relationship just because you would like to get some more sleep. Getting more sleep, by the way, is not a selfish parenting choice. Not only are you helping your child develop skills that they will need for the rest of their life, but becoming a more well rested parent improves your mental health and overall ability to function. This helps you feel like a better parent which, in turn, is good for your child. Remember: please put your oxygen mask on first so that you can then help others around you.
Changing sleep behavior when there is a nursing and sleeping association requires changing that feeding and sleeping association. Here are a few things that I always advise when working with breastfeeding moms:
#1 and very important—your daytime breastfeeding relationship does not have to end, just because you want to sleep more at night.
Separate feeding and sleeping, starting at bedtime so that feeding is happening at the beginning of the bedtime routine. When we are sleep training, the goal during that feeding is to ensure that your child is staying fully awake and isn’t drifting off during the last feeding of the day. When you are teaching your child how to fall asleep on their own at bedtime (which is a key first step of sleep training), drifting off during the last feeding can make it harder for them to then fall asleep on their own when you are attempting to put them down awake at bedtime soon after.
Whenever possible, get the non nursing parent involved. While many feeding plans that I make with parents of babies who are breastfed involve including some feeding overnight, there are going to be instances when the child wakes up and a parent needs to respond. If your child has any expectation of being fed at wakings and you are going into their room and not feeding, they are going to be SO angry and will have a hard time thinking of anything else. The breastfeeding association is extremely strong. While your child may not be particularly thrilled to see the other parent in that moment, it will be easier for them to learn how to fall back to sleep when the non nursing parent responds.
Think about what your child needs regarding feeding at night. This is different for every baby and I look at feeding very individually for every family that I work with. I am looking at what is happening during the day—is that baby very distracted and not all that interested in eating during the day and now getting all their calories at night when it is quiet and dark and they have mommy all to themselves? Is the baby hungry in the morning when they wake up? What does the pediatrician say about how much the baby needs to eat at night? Do the feedings overnight feel like full feedings or do most feel like snacks that are more about soothing and less about hunger? While some plans that I make with families involve not feeding in the middle of the night, for breastfed babies, the majority do include some feeding in order to help everyone feel confident that the baby isn’t hungry at night. This helps parents be consistent and follow through—the key to sleeping success.
If you are currently feeding a lot in the middle of the night and you are going to be backing off on the amount of feeding you are doing once you have started sleep training, it is likely that your very full breasts will wake you up at some point overnight. In order to prevent moms from getting clogged ducts or worse, mastitis, I will suggest that moms either hand express or use a Haakaa to take the pressure off enough in order to be able to go back to sleep. Fully pumping will tell your body you need to continue making so much milk overnight. It typically can take a night or 2 for your body to adjust.
When you are no longer nursing in the middle of the night, it is a good idea to pump before you go to bed. This has multiple benefits: it is “bonus milk” in that it is not a feeding that you are pumping to replace. This means it goes in your freezer stash to be used for another time. This will also help you be more comfortable overnight. And it can help your body’s overall supply in that you are still telling your body that you need to be making milk at some point at night regardless of the fact that you are no longer nursing in the middle of the night.
If you are a nursing mom and are looking to get more sleep while maintaining your breastfeeding relationship, reach out so we can talk about how to work together towards this goal.