How to Navigate the Relationship between Breastfeeding and Sleep

As a nursing mother, it is essential to nurse on demand for at least the first 6-8 weeks. Nursing on demand for as long as the first three to four months is even ideal.  This will ensure that you have established an adequate milk supply.  Sleep should be on the back burner during this crucial period, but you can get started on great sleeping habits early on in your baby’s life. As time goes on you will want to learn about how to continue your breastfeeding journey while managing to get more shut eye at the same time, and that’s what we’re going to talk about today.  I know that it was confusing for me to learn how to deal with sleep obstacles and breastfeeding at the same time.  Throw sleep regressions and developmental leaps into the mix and things get tricky!

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Let’s talk about why breastfeeding should be the priority in the beginning.  Then we will learn about the mutually dependent relationship between breastfeeding and sleep and challenges that arise.  Some of the obstacles that you might be facing include, how to break sleep associations, how to know if your baby was getting enough and is ready for less nighttime nursing, and what you can do to try and cut back night feedings.   I will provide some action items that you can start using to promote more sleep while still achieving your breastfeeding goals.

Newborns

Why You Shouldn’t Work on Sleep (Yet!)

Because newborns need to eat 10-12 or more times per day to gain weight, stay hydrated and send signals to mom to create an ample supply, no sleep training should be done for the first 12-16 weeks.  In addition to the success of breastfeeding, sleep training should not be done this early because newborn babies have not yet reached the milestone of self-soothing, and they do not produce their own melatonin.

The first 4 weeks of life (and for those struggling with supply, even a bit longer) should be solely focused on breastfeeding.  Around the month one there are gentle ways that you can start setting the stage for healthy sleep habits.  Establishing these kinds of routines and habits now may help with sleep later in baby’s life.  There are so many variables and things to learn about newborn sleep and finding a complete resource, especially one that focuses on healthy habits, promotes breastfeeding and takes into account unique situations like colic, and the reality of newborn sleep can be really difficult to find.

An Amazing Resource

I found the e-book, Essential Keys to Your Newborn’s Sleep to be an absolute game changer when it comes to mastering newborn sleep.  They lay a foundation of realistic expectations and by learning so much about sleep and feeding (both breastfeeding and bottle feeding) early on in your baby’s life, you will be confident that you are doing everything you can to promote healthy sleep.  You will also feel prepared to deal with sleep hiccups as your baby grows and goes through developmental changes.  You can purchase this book outright, or for an option with more value, consider joining the members area of the Baby Sleep Site where this book, co-authored by the site’s passionate creator and a lactation consultant, can be found.

You’ll not only have access to this particular e-book, a $40 value alone, and many more, but you will have access to a library of articles.  There are many specific articles that focus on newborn and baby sleep, and breastfeeding and sleep.  You will also have access to dozens of sample schedules and tons of other resourceful and well-researched articles.  My favorite part is that any comment or question you leave on an article or e-book within the members area is answered by one of their on-staff sleep consultants.  They provide thorough and specific answers and even offer live chat at scheduled times throughout the week.

The value in knowing you have a wealth of resources available as your baby’s sleep and feeding needs change will leave you feeling more confident.  You will know exactly how to best achieve much needed sleep for the whole family in a way that you feel comfortable with.

Focus on Feeding your Baby on Demand

Once you feel like you have established a supply and as your start introducing a bottle and planning for when your maternity leave ends, you can start actively encouraging healthy sleep habits for your baby.  Until then, on demand feeding needs to be the priority in order to ensure your baby is getting enough to eat, gaining weight, and your supply is adequate.  Newborn babies need to feed 10-12+ times per day and should be entitled to feeding for as long as desired.  Even when they are ‘comfort nursing’ important signals are being sent to your body to promote production.

Trina has written a thorough and informative, yet easy to understand, article all about The Science Behind Milk Production.  I know for me, understanding the ‘why’ often makes me more motivated to execute something I need to do.  Understanding supply and demand is no exception.  This will help you nurse as much as possible and know that your supply is building!

Starting out with breastfeeding is challenging and is a learning curve for you and baby.  The only way for you both to master it is through constant repetition.  You need to learn the latch, how to trouble shoot, the way production works, how to identify hunger cues, how to deal with your sleepy newborn and how often to nurse.  Head over to this article for a Complete Guide to Breastfeeding in the First Week.

Something I learned from one of the lactation consultants on The Baby Sleep Site is that most mothers can go about 5 hours at night without their supply being affected.  This is important to know to help rationalize those constant nighttime feedings.  Your supply might tank without them!  Any length of time without nursing at night may or may not affect your supply. It is probably not worth the risk in the early months of breastfeeding when establishing your supply is your top priority.

Have Realistic Expectations

One of the biggest issues I have with a lot of the information and articles out there about sleep is that they set unrealistic expectations.  This is a problem that is plaguing mothers in our society.  I think everyone has that one friend or relative who’s baby slept 8+ hours their first night home from the hospital.  I’m here to let you know that this baby is 100% the outlier!

For all intents and purposes, ‘sleeping through the night’ for your newborn, and what should be consider a large chunk of sleep for them is around 5 hours.  This is an average and there will be a wide range of normal.  At this point in time, you need to embrace the sleep that your baby does get and do everything you can to promote sleep.  You also want to ensure that their days and nights are not reversed.  We will discuss this more below.

Learn About Newborn Sleep Cycles

The very nature of newborn sleep makes it extremely difficult for them to achieve long stretches of sleep.  This is because their sleep cycles are very different from adults until they ~4 months old.  This is known as the 4 month sleep regression.  Until then, your baby only has two sleep phases within each sleep cycle.  They are known as “active sleep” and “quiet sleep”.

Your baby enters the “active sleep” phase first, and this phase is most similar to our REM sleep.  During this phase, baby is more easily woken.  The duration of the active sleep phase is around 20 minutes.  They then transition into the “quiet sleep” phase which lasts an additional 20 minutes.  Once a sleep cycle completes, your baby will need to bridge themselves into the next sleep cycle which can be quite difficult for them.  This is especially difficult for babies during the day or at night if they still have their nights and days confused.

To read more in-depth information about newborn sleep cycles and why this often results in newborns taking short naps, read my article full of tips to lengthen your newborn’s naps.

Help your Baby Sort Out Days and Nights

Why does this Happen?

One of the first positive things you can work on in regard to your newborn’s sleep is to help them sort out their days and nights.  Your baby is used to being in the dark and cozy womb for 9 months where they were not yet on a circadian rhythm.  Often, when your baby is in the womb they are ‘sleeping’ during the day to the sway and motions of you going about your daily activities, and more active and ‘awake’ when your body is still (often at night).  While this isn’t always the case, it can lead to baby’s being born a bit confused about when to sleep.  You can sort this out and promote longer stretches of sleep at night from the start by making daytime bright and exciting and keeping nights dark and boring.

What to Do During the Night

Choose a time of night to consistently dim lights to indicate “nighttime” to your baby.  Babies are most likely not ready for an early bedtime until later on so choosing a time around 10pm is realistic.  Many nursing babies between 0-3 months tend to cluster feed in the evening hours.  During these cluster feeds baby tanks up on food so choosing a time after this is beneficial.  Beginning at your chosen time until “morning” keep the room darkened.  If you do need light, use a dimmable nightlight and avoid eye contact and talking with your baby.

Keep your baby swaddled during night feedings and only change their diaper if they poop.  Wet diapers do not need to be changed at every waking unless baby has a rash.  When baby wakes, always offer a feeding and then soothe them back to sleep.  By keeping nights dark and boring your baby will start to fall into the rhythm of the days.  They should also start doing their longer stretches of sleep at night.  Keep in mind this may be as little as 1-2 hour chunks, or could be in the 4 hour or slightly higher range.

What to Do During the Day

On the flipside, make the days bright and interesting and nurse your baby roughly every 2 hours.  Be aware of your baby’s need for sleep and respectful of their threshold for stimulation.  Your baby’s daytime sleep is essential to getting those longer chunks of sleep at night and babies under 4 months old often have very short tolerances for how long they can be awake before they are overtired.  Some research suggests that awake times for babies this young can be as short as the length of the last nap and rarely would a baby this young be awake for more than 2 hours without becoming overtired and overstimulated.

For more information about awake times and figuring out when to put your baby down, read our article all about nap schedules.  If you are not quite ready for a “schedule” (and I use this term very loosely for a baby this young) then learn more about tired signs and awake signs in babies 0-4 months old.

Realistic Night Feeding and Sleeping Expectations by Age

Like I mentioned in the newborn section, sleeping through the night means something different at every age.  Achieving sleep and feeling good about the sleep you and your baby are getting relies on having realistic expectations.  Aim to develop an understanding of sleep at every age and developmental stage.  It’s also important to realize that there is no one quick fix because your baby is always growing and changing developmentally.  What works at one age may not still work at another age or may need to be revisited.  Your baby changes and learns so much in the first year of their life.  They are going to need your constant support and love to get through all of those changes.  With each sleep ‘hurdle’ comes a new and exciting skill or change in your baby.

Nursing Isn’t Just about Calories

As a nursing mom, comfort is a huge part of nursing, so you should expect that night nursing is going to ramp up during times of big change, illness and teething.  When your child is working on a new skill like rolling, standing, or crawling they are going to look to nurse more not only because of the extra energy they are exerting, but because all of this takes a ton of mental work and is very frustrating.  All of this is to say that even if you do have a 5-month-old that is sleeping long stretches, it might change at any moment and it’s best to go with the ride and always revisit the basic foundations of good sleep which include a great sleeping environment, bedtime routine and consistency.

Let’s Look at Averages

Any good sleep resource is going to consider averages when advising you on how to best go about getting more sleep for you and your baby.  This is important for promoting breastfeeding and supply, ensuring that your baby will continue to gain weight and thrive and to keep your expectations grounded.  Newborn babies feed on average every 2-3 hours at night and should be fed on demand should they wake up more than this.

Newborn feedings should always take priority over sleep which we discussed in the newborn section.  From 3-4 months there is a wider range of normal.  The average is 2-3 evenings per night, which depending on how long your baby is having “nighttime sleep” will range from every 3-6 hours.  This month should also be considered on demand feeding and you should prioritize feeding over sleep.  It isn’t until after 4 months that you can reasonably or safely consider any sleep ‘work’.  The 5-6-month baby wakes for 1-2 feedings, the 7-9 month baby, again on average, is waking once maybe twice for feedings.  From 10-12 months the average may be sleeping through the night or waking only once, and over a year there are generally no nighttime feedings.

The key word here is average.  Your baby may be on the low or high end of this spectrum and remember that those nursing sessions, listed here as ‘feedings’ do more than just provide calories, but essential comfort and reassurance as well.  This should help you understand where your baby’s sleep habits and night nursing habits fall on the spectrum and give you an idea of how to start working on it.  Its also worth mentioning that these are average wake ups for feedings and not necessarily wake-ups in general that don’t involve eating which might be even more prevalent during times of teething, illness, or during developmental leaps.

Night Weaning Strategies (full and partial)

As a nursing mother who is working on sleep, it is easy to think that night weaning is the key to more sleep, especially with an older baby.  Before you make this decision you need to make sure that night weaning is:

• Something your baby is ready for
• Will result in more sleep

Night weaning is dropping feedings that are happening during the night.  It is most successful with babies who are only waking once or twice a night because they are clearly hungry and are easily going back to sleep on their own. Night weaning is probably not your most effective first plan of attack if they are waking far more frequently than the average. If this is the case you should first learn about sleep associations.  You should work on helping your baby soothe themselves to sleep independently before working on eliminating night feeds.

Trina’s article about helping your baby nap alone (6-12 months) has a lot of great information about breaking sleep associations.  All of the information can be applied to night time sleep as well. Let’s talk some strategies that you can start to use once you have determined that it really is eating that is waking your baby and not another sleep obstacle.

Daytime

It is important to look at daytime to plan for nighttime.  While night weaning is definitely its own unique thing, sleep obstacles are all very interrelated.  Therefore having knowledge on a variety of topics is essential to figuring it all out with confidence.  Before you attempt night weaning, look at your feeding schedule during the day.  How often is your baby nursing?  If they are eating solids, put an emphasis on offering your baby nutritious foods in addition to any daytime nursing.  You should also make sure that baby is not overtired by introducing an age appropriate nap schedule and bedtime.  Read more about this in our article about setting a nap schedule based on individual needs.

Be vigilant about getting those daytime nursing sessions in so that daytime is meal time instead of night.  If your baby is a distracted nursling this may be contributing to more nighttime feeding.  Combat this by finding darkened, ‘boring’ places to nurse your baby during the day.  When I was with N at the library, I would go into one of the rarely used conference rooms right around the corner from the play area and flick off the light.  This allowed me to nurse her while we were out and about, which was usually unheard of for my very curious baby.

Consider adding a few extra nursing sessions (every 1 to 2 hours) in the evening to help baby tank-up before bed.  Remember to keep these feedings as separate from bedtime as possible to avoid associations (see more information below)

Set A Goal

Keeping the averages in mind, you will decide if full or partial night weaning is the right strategy for you.  The plan you use at night is most likely only going to be successful is there are no sleep associations with nursing already in place.  The first step is spending a few nights tracking and recording when your baby is waking up.  Hopefully a pattern will emerge.  Based on this pattern and the averages you can decide what your goals are.  Do you want to consolidate two wake ups into one?  Are you trying to eliminate the last wake-up?

Steps to Take

Your plan will look similar whether you are aiming to night wean completely or consolidate feedings.  On the first night you are going to go in at their typical wake up time and nurse baby as usual.  Then you are going to try to slowly start pushing the first feeding back by 30-60 minutes to reach the desired chunk of sleep time OR until you are bridging them to the next typical wake-up or fixed feeding.  If you feel like your baby is having a negative reaction to this plan, it may require that you do shorter intervals of increased time (15 minutes).  Conversely you may find that baby begins to do this naturally.

You may find that by pushing the first feeding slowly back, the second (or third feeding) will naturally disappear as they become more accustomed to sleeping longer without eating.  If baby wakes before the planned feeding, use strategies that help them get to sleep or self-soothe that do not involve feeding.  It may be helpful for the non-nursing parent to handle these wake-ups or to promote waiting until the desired time.  At the desired time, the nursing mom would step in.  The idea is that as baby is going longer without eating during the night, they will embrace the transition and learn to make up those calories during the day.  By going about this gradually your baby will experience a sort of “comfortable decrease” in calories as opposed to going cold turkey and having a few really tough nights.

Breastfeeding Sleep Associations

What does it look like?

There is probably only a true breastfeeding sleep association if your baby cannot fall asleep unless they are on the boob.  I also want to emphasize that even if they are doing this it is 100% developmentally normal.  If it is not something that is a problem for you then it will likely resolve on its own much like any other milestone.  However, if this sleep association results in your baby waking every hour during the night, they are unable to nap independently, or if it makes your unhappy or frustrated for any reason, then there are ways to work on it.  By working on breastfeeding sleep associations, you may improve nighttime sleep in the process.

How do I work on this?

To handle this sleep association, you want to try to slowly disassociate bedtime with nursing. Now, your baby might take okay to a big change, like moving the last nurse of the day to say, the downstairs living room, before even starting the bedtime routine.  But, it might have to be a super gradual process where you are literally separating by minutes at a time.

If the big switch isn’t going to fly, then start by trying to remove baby from the breast just as you are noticing their eyes flutter.  This is known as the “drowsy but awake” window.  You want them to be slightly awake so that when they are falling asleep it is happening in their own space, independently.  This may require that you gently nudge baby to wake them before putting them down.  If they begin to cry and this makes you uncomfortable, attempt to soothe them in another way, or if necessary put them back on the breast and repeat.

This may take many tries but eventually you should be able to put them down without having fallen asleep at the breast.  Once you are having success with this, move the nursing session to be slightly earlier in the bedtime routine, say before books, or before you put their sleep sack on, or whatever your order may be.  Over time the association will break.

What it Looked Like for Me

For N, around 6 months was when I decided that breaking this sleep association was important to me.  The main reason was so that my husband would also be able to put her to bed.  I accomplished this by doing exactly what I outlined above.  I nursed her until she was only drowsy.  Additionally, I would gently stroke her or give a light bounce to make sure she was staying awake throughout the feeding.  N would often get upset when I would lay her down so we added in bouncing on a yoga ball as step to separate nursing and sleep.

For the next few weeks, I would nurse N then I would bounce her on a yoga ball to sleep.  Then we slowly worked on bouncing her on the yoga ball until she was only drowsy, and then less and less bouncing.  Around 10 months we were able to lay her down in her bed awake, say a sleep phrase “night, night I love you” and leave the room.  This timeline may sound long, and in the process, it was.  But the small victories along the way kept us going and we never had to use a quick-fix or cry method, which for us was important.  You should definitely do what best suits you and your family to ensure everyone’s needs are being met.

Now let me just say that this all sounds so ideal when I type it out.  It was a lot of frustrating work and there were nights where we relapsed because fast sleep was what we needed and it wasn’t worth the fight.  But with consistency and time it did work and it will work for you too!  We had some other essential factors in play including a great sleep environment and a solid bedtime routine that we started around 3 months.

Other Obstacles

Sleep Regressions

This is the fancy name for points in your baby’s life when huge developmental changes (both mental and physical) will create sleep challenges.  On average they happen around 4 months, and then again somewhere in the 8-10 month range, and again around 18 months.  While your baby is learning a new skill, life is frustrating, challenging and exhausting for them.  You may see an increase or uptick in the amount of nursing (particularly for comfort) that your baby is doing.

Four Month Sleep Regression

The four-month sleep regression is unique because it is a shift in the type of sleep that your baby gets.  Their sleep cycles will change from those of a newborn to be more similar to the type of sleep cycles they will experience for the rest of their life.  If your baby is around 4 months, was previously sleeping in larger chunks and is suddenly up every hour or two, or sleep has suddenly gone off the deep end in some other way, then your baby is most likely going through this huge developmental shift.

For N, this happened two weeks before her 4 month ‘birthday’ which happened to fall around Christmas when we were staying in a house with about four other families.  N woke up every hour on the hour unable to get back to sleep without assistance for all three nights that we were there.  My sister-in-law knew instantly that the 4 month sleep regression was what was going on.  You can read all about this sleep regression in Trina’s article: the four-month sleep regression.

8, 9, 10 Month Sleep Regression

The 8,9,10-month regression has more to do with developmental and physical changes.  These sleep regressions while equally frustrating, were something that we had to just kind of ride out.  N would wake up in full on “party mode” almost manically practicing whatever the given skill was: rocking on her knees, pulling up to stand, babbling the same consonant sound over and over and over again.  What we found most helpful was to keep her room darkened and try our best to not engage but to allow her to get the practice out of her system.

Honestly, I don’t know if that is a realistic answer or solution for other families and I wish I had found a better answer.  The problem is that it is hard to find solutions out there that specifically deal with developmental night waking and how to handle it.  Just another example of why one-size fits all sleep answers are just not practical or sustainable!

And more…

Because the nursing relationship is about so much more than just calories, any transition, change, illness or discomfort is going to result in more nursing.  These situations are all unique and specific advice can be hard to find.  All families are different and all parenting and sleep philosophies are valid.  You can find answers that respect what is important to your particular family.  The problem is that finding reputable and expert resources, especially for these more unique scenarios, is even more challenging than finding more general sleep advice.  This is why Nicole, the founder of the Baby Sleep Site, has a staff of sleep consultants with expertise in areas from breastfeeding to developmental delays to make sure that there is a high-quality answer and resource for you.  No matter what your home and sleep decisions may be there is knowledge and help out there.  Just a few examples are:

• Traveling
• Changing Childcare
• Daycare and Sleep
• Room Transitions
• Co-Sleeping
• Sickness

No One-Size-Fits All

I think it almost goes without saying that navigating sleep as a breastfeeding mother is hard!  There are so many variables and even determining what you need to work on is frustrating.  Sleep is ever changing and depending on what your baby is going through they may need some redirection or support even if they were already sleeping through the night prior to now.  For more information about this read Trina’s article, The Sleep Myth that Set Me Up for Failure.  This article discusses the ways that sleep is constantly changing and emphasizes how there really is no one-size-fits all plan.

Create a Plan

Now that you have read this overview on the topic and understand the interrelationship between breastfeeding and sleep, your next step is to create a plan.  Establish what your realistic goals are and what you can start today to get on the track of better sleep.  Remember that the first step is to take a few days to really observe what is happening.

Write down details about:

• how long it takes to put your baby down
• what they are doing as the fall asleep
• when they are waking up
• how long awake times are
• what they are eating during the day

Once you can see the big picture you can better figure out where to start. You might want to work on associations that are making bedtime and subsequent wakeups a challenge.  Maybe you want to consolidate or drop night feedings.  Perhaps you want to start by working on naps and awake times to promote better nighttime sleep.  These are all just ideas and jumping off points for you to figure out your baby’s unique sleep needs and solutions.

Continue educating yourself

Check out what else we have to offer in our sleep section and breastfeeding section.

Please leave a comment below with any specific questions or comments, we love hearing from readers. Knowing that we can support and educate your individual challenges is why we are here!

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