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  • Nelly Duprat RN

Sleepy Baby? Keeping Baby Awake While Feeding



Newborns spend most of their days sleeping. Your newborn might sleep 18 hours a day, waking to feed and maybe take in their world for a few minutes every couple of hours. Your newborn's tummy is tiny – about the size of a cherry at birth. The small size means that your newborn’s belly gets filled up pretty quickly and that they need to wake often to “refuel”.


These sleeping patterns are completely normal, but what do you do when your baby wants to sleep through feedings too? Some babies just love to snooze, while others might have jaundice or other health conditions that make them a little more lethargic.


As your baby grows, so does the size of their stomach, their attention span, and the amount of time they can stay awake before reaching that threshold where their little eyes close, and they drift off to sleep. It's frustrating, however, when you're a nursing mother who is struggling with keeping baby awake at the breast. If you’ve got a little sleepy head on your hands, here are few tips for keeping baby interested at the breast by gently stimulating him to nurse.


Keeping Baby Interested in the Breast


  • Switch breasts as you notice your baby starting to fall asleep (you may need to do this quite frequently at first)

  • Consider a football hold, which is a little less close to your body and less cozy than a cradle hold

  • Reduce excessive stimulation. It sounds contradictory, but newborns are so sensitive to some stimuli that they tune it out by falling asleep

  • Talk or sing to your baby

  • Remove extra layers to ensure baby isn’t too warm – skin to skin contact is best

  • Burp baby frequently, upright on your knee to avoid the cuddliness of your shoulder

  • Use a cool (not cold!), slightly damp cloth on the top of your baby’s head

  • Gently stimulate the crown of your baby’s head in a circular motion

  • Stroke the bottom of your baby’s feet

  • Stroke under your baby’s chin (this works wonders for my daughter)

  • Use breast compression to stimulate milk flow (see below)



Breast compression


If you’re having trouble keeping baby awake at the breast, one way to encourage alertness is to get your baby engaged in active sucking. The active sucking reflex helps keep baby alert enough to resist the sleepiness until after the feeding. The challenge is in getting baby to suck actively at the breast. Breast compression can help stimulate milk flow and keep baby engaged in feeding.


The technique of breast compression puts gentle pressure on the milk glands in your breast, encouraging an increase of milk flow through the nipple. This technique also stimulates the letdown reflex, which is crucial if you've got a sleepy nursling on your hands that isn't sucking enough to stimulate the letdown on their own.


With breast compression, as the flow of milk increases, the baby is encouraged to suck more actively. Babies stay more alert when they’re actively taking in more milk, and there’s a bit of reward system that happens here. As your sweet baby sucks and is rewarded with warm breastmilk, she seeks more - ultimately staying at the breast longer and taking in more breastmilk. Longer nursing sessions increase your milk supply, ensuring that the baby gets a nice full tummy every time she feeds.


Breast compression might take a little practice from a coordination standpoint, but it's a relatively easy technique to master. Here are the basic steps to follow:


  • First, begin by positioning your baby in one of your usual breastfeeding positions. Choose one where you’ll comfortably have a hand free.

  • Ensure baby has a good, solid latch

  • Watch your baby as he nurses to notice if he stops actively sucking

  • As sucking slows down, use your free hand to apply compression to the breast

  • Cup the breast, with your thumb on the top of the breast and fingers underneath

  • Ensure that your fingers are far enough away from the areola as not to disturb baby's latch

  • Gently press against the breast, applying light compression to the milk ducts

  • It’s not necessary to move your fingers along the breast in a “milking” motion – compression is enough

  • Do not apply so much pressure that the compression becomes uncomfortable for you


Babies tend to suck for about 10-15 seconds before a brief pause. Hold the compression on your breast while the baby is actively sucking. Release the compression during the break to give your baby time to relax her jaw and gear up for the next round. If your baby remains sleepy, continue with the compression to keep baby engaged in sucking.


Breast compression can also help you learn to hand express milk effectively. You might find, especially with a newborn, that latching and sucking to the point of producing the letdown effect can wear them out. Hand expressing a bit of milk before nursing can help increase the amount of milk ingested before they get too sleepy.



How Can I Tell If My Sleepy Baby Is Getting Enough Milk?


One of the most important things you can do for your sleepy nursling is to pay attention to their cues and learn their natural wake/sleep/eating pattern. While all babies require basically the same amount of nourishment, the patterns in which they take it can vary. This is, of course, a personal decision, but if you nurse your baby on cue, according to her needs, your baby is less likely to be sleepy at the breast. Some babies take in more at each feeding and can go longer; others take in less and need to feed more frequently. Babies have an incredible ability to self-regulate and tend to stay awake and alert when they’re ready to feed.


If your goal is to have your baby adjust to a specific feeding schedule, you may encounter times when they are more lethargic. Gently use some of the techniques suggested above to encourage baby to feed. If they are not yet quite hungry enough for a full feed, they may fall back to sleep after only a couple of minutes.


Whichever route you take, you want to make sure your baby is taking in enough milk, which can be a concern if your baby is sleepy. If you're genuinely concerned, discuss your worries with your lactation consultant or pediatrician. They can help you determine if your baby is taking in enough and if there are any underlying reasons why your baby might be sleepy at the breast (jaundice, fatigue from a poor latch, etc.).


Another way you can tell if your baby is getting enough milk, aside from weight gain, is to keep an eye on their output. The number of soiled diapers your newborn has per day is a good indicator of if they're taking in enough breastmilk during each feed.



During the first two days of life is when your baby is taking in colostrum. Colostrum is nutrient-rich and essential for your baby's health, but it isn’t present in the same quantity as breast milk that comes in after the colostrum is gone. Expect your newborn only to have a couple of urine soiled diapers those first two days, along with 1-2 diapers soiled with meconium.


Meconium is a dark sticky substance that will make up your baby’s first stools. It’s the product of everything your baby ingested in utero and usually takes a couple of days to clear out entirely before your baby’s stools become “normal”. A normal stool for a breastfed baby is loose, with a color that resembles brown mustard. The stool might also appear “seedy”. These little seedy looking parts are nothing more than undigested milk fat and are completely normal.


By day 4, your baby should be producing at least six wet diapers that are soiled with urine that is pale and odorless. If your baby's urine is dark, it's a sign that they aren't adequately hydrated and need to take in more breastmilk. By day 4, your baby should also be producing 3-4 stools per day. Note that this frequency will taper off over the next few weeks.


By a month of age, most babies develop their own pooping patterns, with some having stools every day and others going a day or two, some even longer. As long as your baby's stools are soft and passing with ease, these types of variances become more regular after the baby's first month of life.


Do You Have Questions About Breastfeeding? We Can Help.


Breastfeeding is both rewarding and challenging, and it’s a journey that can leave you with questions and uncertainties. Connecting with a support group that understands the beautiful journey of breastfeeding and some of the difficulties you may face along the way can help ease your concerns. Join a group of uplifting and supportive women who want to help you enjoy this very special time for you and your baby. Connect with us at the Luscious Letdown Breastfeeding support group on Facebook.


References


Stanford Children's Health. (n.d.). Retrieved from https://www.stanfordchildrens.org/en/topic/default?id=newborn-sleep-patterns-90-P02632

Diaper Output and Milk Intake in the Early Weeks. (2016, September 6). Retrieved from https://breastfeedingusa.org/content/article/diaper-output-and-milk-intake-early-weeks

Pearson-Glaze, P. (2018, March 7). What is Breast Compression? Retrieved from https://breastfeeding.support/what-is-breast-compression/

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