Expert Advice

Breast-Feeding Schedule

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q
I have a three-week-old daughter. She seems to breast-feed every hour, and at night, it's worse. I am up from 12 midnight to 6 a.m. and then it seems she is ready to sleep in the morning. I'm also tired so I try to sleep while she is sleeping. Will she get on a better schedule, or do I need to make an adjustment?
A
First of all, it is wonderful that you are breast feeding as there are so many advantages for both you and your baby. Breast milk is the perfect food for the baby--it lowers the risk of having allergies and helps protect from infection. Besides forming a most special bond between you and your baby, breast feeding also helps your womb (uterus) to return to it's normal size more quickly and may help you lose some weight.

An infant generally regains her birth weight by two weeks of age and then gains four to eight ounces a week, doubling the birth weight by about four months of age. Babies tend to nurse at least eight to twelve times in a 24 hours period, having six to eight wet diapers and two to three bowel movements during the same time.

Now to answer your question. Try to relax! It does not sound like you need to make much in the way of adjustments at all. Your baby may just be having what has been called an "appetite spurt." These are times of crying and apparent gluttony on the part of an infant which usually occur at eight to twelve days, at three to four weeks, at three months of age, and at other times on occasion.

The best thing to do for this is actually more frequent nursing to increase your milk production to meet the changing needs of your infant. The more often you feed the baby, the more milk you will make. These spurts do not last forever and she should get on a better schedule.

I do recommend limiting a feeding to ten to fifteen minutes per breast, which helps prevent irritated nipples or infection of your breast. If you feel that the breast feeding is still not going well for you or the baby, I would contact your baby's doctor, as it is important to get the nursing back on track.

Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

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