Breastfeeding and baby sleep is a very hot topic among parents and caregivers alike. In this day and age, everyone on social media has an opinion about both breastfeeding and sleep training. New parents often wonder if they will ever sleep again.
While sleep is often limited during early stages of a baby’s life, eventually babies settle into a predictable pattern. As time goes on, the whole family gets the rest that they need.
There is no “one-size-fits-all” approach to sleep training that works for every family. It is also important to consider your baby’s age and feeding needs before undertaking any “sleep training” method.
Normal Sleep Patterns for Babies
While not every baby is the same, as a pediatrician I can tell you that we know in general how much sleep and food babies need at each age. In the early days of your baby’s life, uninterrupted sleep will be rare.
As the weeks and months pass, your baby’s night wakings should be less and less. In order to know how to resolve sleeping problems, first you need to know what is normal and expected.
0-4 Weeks Old
Young babies, whether they are bottle fed formula milk or take breast milk directly from the source, sleep for short periods of time. Nighttime feedings are mandatory at this age for your baby to get enough nutrients to grow.
After nursing, babies often fall asleep due to their full tummies and the warmth and coziness of being in their mother’s arms. It’s understandable why they would want to close their eyes and get in a little snooze after eating.
In addition, a newborn also requires many feedings per day and night due to their teeny tiny tummies as they can only hold so much milk. Also, a new baby has an immature sleep center in their brain and does not produce melatonin. This hormone regulates night and day cycles. Without it, a newborn has short sleep cycles, a lack of deep sleep and confusion about day and night.
In those early weeks, you can expect to be awake with your newborn every few hours around the clock for these reasons. Newborn babies require calories at night and sleep training is not recommended until they are older.
1-3 Months of Age
When your baby gets a little bit older, you can start simple routines that will promote healthy sleep. Establishing a consistent bedtime routine early in life can be as simple as a warm bath, book, feeding and then bedtime. Some families chose to use a sound machine to dampen ambient noise and allow your baby to be soothed to sleep.
At this age, babies will nurse and become full and fall asleep. As part of their healthy development, do your best to put your baby down for sleep when they appear drowsy but not fully asleep yet.
Breastfed babies tend eat more often than formula fed babies. Formula is harder for babies’ bodies process than breast milk, so formula fed infants typically take larger volumes of milk per feeding than breastfed babies. For example, a 3 month old formula fed baby might take 6-8 ounces every 3-4 hours, while a breastfed baby might take 4 ounces every 2-3 hours.
This means that breastfed babies may be more likely than formula fed babies wake up during the night for feedings. However, every baby is different and their sleep patterns can differ greatly at this age. Consistency is key as well as simple routines. In addition, make night nursing as boring and quiet as possible so that both you and your baby can return to sleep more easily.
4-6 Months Old
Breastfed babies reduce their nursing frequency after doubling their birth weight. This generally occurs between 4 and 6 months of life. As a result, their calorie needs decrease and their breastfeeding pattern changes. In addition, babies at this age are able to transfer higher volumes of breast milk in shorter periods of time.
At this stage, many breastfed babies sleep longer, around 6-8 hours overnight. While this might not meet your definition of sleeping through the night, this meets that criteria for this age group. You might notice a drop in your breast milk supply at 6 months if your baby is sleeping for too long of a continuous stretch at night.
Why don’t babies sleep all night?
Breastfed babies tend to nurse more at night when their moms return to work. They often prefer nursing over bottles, so they may not take many bottles at daycare or for the nanny and nurse more in the evening and overnight.
Additionally, at 4-5 months old, babies are easily distracted by their surroundings. They are curious about their siblings, people entering the room, and sounds outside. This curiosity leads them to nurse for shorter periods of time during the day, about 4-5 minutes per feeding.
However, their hunger catches up with them at night due to their busy daytime schedule. These are just a few of the breastfeeding changes at 4 months.
Babies at this age may also experience nighttime wakefulness due to temporary stages of fear, discomfort, and changes in routine. It is important for parents to understand that their babies may still wake up at night and should avoid having strict expectations of them sleeping through the night.
You can promote good sleep by
- Providing adequate calories during the day
- Establishing a comfortable routine
- Avoiding late afternoon or early evening naps
- Not taking a one-size-fits-all approach to sleep training
While doing these things consistently will definitely help promote night time sleep, don’t expect every night to be without interruption. As your baby is learning self-soothing skills, they may need your help with returning to sleep. Additionally, your baby may truly be hungry and need a feeding at night.
Age 6-9 Months
Babies are healthiest when they start solid food at around 6 months old. If the solid food includes protein and fats, breastfed babies may sleep longer at night and nurse less frequently. However, babies should still nurse 5-6 times in a day. This is where sleep controversies arise.
Should the baby be forced into sleeping all night or is it acceptable for them to breastfeed when they cry in the middle of the night? Many parents struggle with determining if the baby is hungry or seeking comfort while nursing.
As a pediatrician and breastfeeding expert, my advice for this point becomes more personalized to the individual family’s needs. Some babies need the nighttime feeding for enough calories, especially if they are slow in taking solids. Others nurse for comfort for a short time, just trying to go back to sleep or for a sense of security.
Before deciding that night time breastfeeding is unnecessary, I recommend discussing it with your baby’s doctor. You want them to check if their growth is sufficient and if there is any other reason for frequent awakening.
Nine-month-old babies often wake up frequently, regardless of whether they are breastfed or formula-fed. This is due to stranger and separation anxiety, as well as excitement about new skills like first words, crawling, or walking. Even babies who used to sleep well may start waking up multiple times at night during this age. Breastfeeding frequency for 9 month old babies changes as well and may lead to more nighttime awakenings until they get used to their new routine.
10-12 Months of Life
Breastfed babies at this stage are transitioning to adult food, modified to prevent choking. They usually nurse four times a day or more. If these babies are healthy and eating regular meals, they don’t need to nurse at night.
However, babies still seek comfort, company, and warmth by nursing when they wake up. Some moms nurse their babies back to sleep, while others seek advice on stopping nighttime nursing. Both approaches are acceptable, as long as the baby is growing and developing normally. While your baby may not need the nutrition from feeds at night, they may need a gentle nudge to return to sleep.
How does sleep training affect breastfeeding mothers and babies?
There is no right way to do most things as a parent. Thankfully, parenting choices look different for every family. You may not choose to sleep train your baby at all or you may decide that this is a necessary step to protect your own mental health.
Definition of Sleep Training
Sleep training has gotten a bad rap from many so called parenting experts. As a pediatrician, I define sleep training as teaching your baby independent sleep skills. We all need to have the ability to have healthy sleep habits and regular sleep cycles in order to be able to function in the world.
There are a variety of sleep training methods and not every recommendation works well for every family.
Sleep and Milk Supply
As a breastfeeding mom, your breast milk supply depends on frequent and regular breast emptying. For the majority of mothers, this can mean 6-8 times per day depending on the age of their baby and their storage capacity. Each mother has a different magic number of times that they need to empty their breasts in order to maintain a healthy milk supply for their growing baby.
The idea behind sleep training and maintaining a breast milk supply is that you get those nursing sessions in during the day, rather than over night. Some mothers need to continue night feeds in order to maintain their supply, while others do not.
For successful breastfeeding for many women, especially working mothers, may need to feed at least one time per night in order to maintain milk supply. If a baby sleeps longer than 6-7 hours, mom’s prolactin level decreases. Prolactin is the hormone that stimulates milk production. If a baby goes without nursing for a long time, like 8-10 hours, their milk supply may decrease. In addition, your menstrual cycle will return with night weaning if it hasn’t already.
How Can 127 Pediatrics Help You?
At 127 Pediatrics, we offer concierge level pediatric and breastfeeding care. If you are near Colleyville, Texas and would like to know more about our in person services, fill out a contact form on our website for a free meet and greet. If you are not close to our practice, but would like breastfeeding support, we offer an array of services. From free resources like this blog or our YouTube channel all the way up to paid resources such as our online breastfeeding overview course. We would be honored to be part of your breastfeeding journey.
© 127 Pediatrics, January 2024
Please note that this article is purely for informational purposes and should not be interpreted as medical advice.
Dr. Andrea Wadley owns and operates 127 Pediatrics, a pediatric and lactation practice in Colleyville, TX. She specializes in pediatrics, breastfeeding medicine and offers house calls only. Additionally, Dr. Wadley is the owner of the 127 Pediatrics Online Breastfeeding Medicine and Education Center. We have many free resources for breastfeeding mothers. Subscribe to our YouTube channel or download a free breastfeeding checklist.
