Should I wake my baby to feed? | Ask An LC
Read time | 5 minutes
"Dear Shondra,
I've got a question regarding whether or not I should wake my newborn up to eat. My son is three weeks old and breastfeeds for 20-40 hours every 3-4 hours during the day. We also offer a bottle of expressed milk once at night so that my husband can take over a feeding session, and I can rest. In total, he's at the breast 5-6x per day. At our last doctor's appointment, my son's pediatrician gave us the okay to feed him on demand at night, but I am unsure if I should still be waking him frequently during the day to feed him. At the moment, if he doesn't wake up within 3.5-4 hours during the day, I will wake him. Is it okay to start feeding him on demand?"
Like you, many parents look forward to the day they can stop worrying about waking their newborns and feed on demand. Often, though, similarly to what it sounds like you might be dealing with, along with the anticipation of cue-based feeding comes anxiety about whether or not it's okay to start following their baby's lead.
From over here in 'blog land,' it's impossible for me to tell you whether you should or should not continue to wake your baby up to eat. I don't have enough information, and it would be both irresponsible and unethical to say yay or nay, one way or another.
Schedules more times than not lead to not breastfeeding challenges. It may contribute to you not reaching your breastfeeding goals, a decrease in supply, or both, so if you notice your baby showing hunger cues, offer the breast. Many babies will cue very frequently to feed, sometimes more than once in a 2-hour span, which may lead parents to worry that they don't have enough milk. Or parents, in response to the frequent cueing, may try to delay feeding to get closer to the 3- hour mark, by doing soothing techniques or providing a pacifier.
Since you're asking this question, it sounds like the situations above don't apply and that your baby values his Z's. While I can't tell you precisely what you should do, I can tell you the criteria we generally look for in deciding on whether or not it's okay to suggest cue-based feeding for sleepy babies.
Generally speaking, it's okay to stop waking your baby to eat when they
have regained their birth weight and have done so within the first two weeks
have an upward trend of weight gain, gaining about an ounce per day (~7 ounces per week)
have 6-8 wet diapers and 2+ stools daily (in 24 hour period)
cue to eat at least 8 x per day
& have no medical conditions, are full-term, and healthy
In your situation, though we're missing information on weight gain and diaper output, based on the fact that he's only eating 6-7 x a day (including the bottle for the night feed), if you did decide to rely on him to set the frequency, he may not cue at least 8 x a day.
Swaddling or pacifier use may hide hunger cues or encourage baby to sleep more often or for longer, so if you're using them, reducing the frequency may help get you closer to initiating feeds less often.
Sometimes early hunger cues can be missed, and depending on your babe's personality and health, he may or may not progress to later hunger cues. As soon as you notice him bringing his hands to his mouth, rooting, or any of the other early hunger cues, it's best to offer the breast, even if he's in a light sleep.
You won't always have to wake him up to feed, but depending on your specific situation, it may not be the right time to stop doing so at this moment.
The other thing that's worth considering, before I wrap up this post is managing your supply. Some babies can gain fine, eat 8 + times a day, have appropriate diaper output, and sleep for 6 hour stretches.
Though it's not the norm, some parents, after switching to on-demand feeding, may find themselves faced with the dilemma of waking babe up to eat or not due to engorgement.
Typically, I suggest my clients don't exceed 4-5 hours between expressing/feeding, even at night time. While your baby may be perfectly fine snoozing for 6 hours straight regularly, you may find your supply starting to dip if you don't add at least one middle of the night feed/pump.
Keeping that in mind will help you navigate nighttime feeds and help you determine whether or not allowing him to set the frequency for feedings is the right thing for him and your breasts.