Breastfeeding: On demand or on schedule?
What is the best way to breastfeed? With a schedule or on demand?
Question:Peg Plumbo CNM
Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more
Many lactation consultants believe in "breast on request" and if you think about the physiology and psychology of infants, you may agree. Breast milk is metabolized and the stomach is empty in the newborn after about an hour -- sometimes up to two hours -- after a feeding. Because stomach cramps from hunger are a new thing for baby, any discomfort is interpreted as pain and a threat to survival. When adults get hungry, we start a complex process of planning where our next meal is going to come from. Of course, babies can't plan a meal, so they become fretful and cry. As the newborn matures and becomes more confident in his environment, he or she may be able to delay gratification because he knows that a full stomach is soon ahead. A baby who is required to wait for a scheduled feeding, may delay that trust or confidence.
Consistency is important, therefore, and if "scheduling" means feeding a newborn every two hours, that is about right. But it turns out that newborns up to a few months of age nurse about 12 times in 24 hours, but that does not necessarily translate to every two hours.
The breast on request philosophy is not just baby-centered. Mother may request a feeding when she is especially full or if she is going out for a while.
Some lactation consultants say that when babies wake up in the night and nurse for a few minutes and go back to sleep, they are not getting much of the hindmilk, which is richer in fat content. That is why some babies may wake frequently to feed again. They recommend making sure the baby is really awake and ready to nurse.
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