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Why Breastfed Babies Wake During the Night

By Rita Brhel, Hastings, Nebraska

The question “Does your baby sleep through the night?” is as old as the hills. Given that interrupted sleep is a major stressor for new parents, this question makes sense. The transition that happens in those early weeks would undoubtedly be easier if they would be able to get a good night’s sleep.

But for many mothers, asking the question, “Does your baby sleep through the night?”, may suggest that a baby can, and should, sleep through the night without waking.  It may be reassuring to know that not sleeping through the night is normal for babies.

Physiologically

In the book Sweet Sleep (Wiessinger, West, Smith, & Pitman, 2014), we learn about “normal” infant sleep, that is (to quote from the book), “Most babies don’t ‘sleep like a baby.’” Newborn babies are not biologically designed to sleep through the night. They are designed to breastfeed. Breastfed babies need to nurse at night. The ease of digestibility of breast milk ensures optimal growth and immune development when the baby is nursed frequently.

A newborn baby has a need for almost constant skin-to-skin contact. Nurturing touch, closeness to the breast, and sensitive responsiveness—even without considering the benefits of breast milk—provide for the infant’s vital physical development. Oxytocin alone, a hormone created by the body after direct skin-to-skin contact and nurturing touch, has a host of purposes for the growing baby. Encouraging latch and building milk supply are but two ways that promote bonding between mother and baby. That’s partly why mothers can be so willing to forego continuous nighttime sleep to care faithfully for the newborn baby’s frequent needs.

A lengthy gap of more than three hours between nursing sessions—in the first few weeks—can affect the milk supply. Going too long without breastfeeding or milk expression can literally trick the mother’s body into assuming that less milk is needed! The Womanly Art of Breastfeeding (8th Edition, Wiessinger, West, & Pitman) states, “A full breast has already started to slow down production.”

If one is doing “everything right” (such as, putting baby to the breast often, not watching the clock, letting the baby finish the breast) during the day, it may be perplexing to feel that the milk supply is going down. Often, upon investigation, you may find that you skipped one or more night nursings or your partner was eager to bond with the baby by giving a bottle. This otherwise kind act can inadvertently sabotage your milk supply. Both members of the breastfeeding duo need those nighttime nursings!

Psychologically
Before modern times, human babies’ survival was at risk without the constant physical contact needed by newborns. Separation may not be as dire now in our Western society, but all babies are born with this innate need to be close to mother and to cry in protest when separated. Sometimes mothers are told that the crying is manipulation; however, crying is one way that babies communicate. The baby may be communicating discomfort and maybe anxiety when separated from mother in those early weeks. For the newborn, physical closeness is as much of a need as breast milk or warmth. The Womanly Art of Breastfeeding reminds us that “mothers are hardwired to respond because it’s Nature’s design to keep babies protected, cared for, and thriving.”

A crying baby who protests physical separation may become quiet. A newborn who “learns” to stop crying after waking at night may be laying down “no one cares” pathways (WAB). The baby is also “learning” not to expect a response to her needs, which include the need to breastfeed.

The bottom line is: when a breastfeeding baby wakes at night and gives cues to breastfeed, mothers are encouraged to always offer to nurse at that time.

The next question might be, “How can a mother make sure she gets enough sleep to function the next day?”

First-time mothers can also take advantage of the recommendation, “Sleep when baby sleeps.” The Womanly Art of Breastfeeding provides other suggestions to help you to meet your baby’s nighttime needs. Here are a few of those ideas – get all the help you can, limiting visitors, nurse lying down or in the laid-back position as much as possible, and go to a La Leche League meeting.  A meeting is a place where you can “complain” without hearing that you should just wean.

The American Academy of Pediatrics recommends that all infants room-share for ideally the first year of life. There are many reasons for this, but among them is to help mothers continue to breastfeed. Sleeping in proximity and breastfeeding reinforce one another.

Mothers who choose to bed-share as part of their nighttime parenting can refer to the Safe Sleep Seven discussed in Sweet Sleep to assist in creating a safe sleeping environment. The Safe Sleep Seven as well as additional bed-sharing resources are available on the LLLI website at http://www.llli.org/sweetsleepbook/tearsheets.

Most importantly, partners, grandparents, pediatricians, and, really, all of us—need to recognize the pitfalls of asking if baby is sleeping through the night yet and to learn what healthy newborn sleep looks like, before offering advice to support a new mother.

References and Resources

  1. The Womanly Art of Breastfeeding, 8th Revised Edition. Schaumburg, Illinois: La Leche League International, 2010; 63-67, 114, 123, 133, 349-52, 411, 449.
  1. Mohrbacher, N.Breastfeeding Answers Made Simple: A Guide for Helping Mothers, Hale Pub. 2010.
  1. Colson, S. Biological nurturing: the laid-back breastfeeding revolution. Midwifery Today Spring 2012; Issue 101.
  1. La Leche League International. Biological Nurturing or Laid Back Breastfeeding”llli.org/btissue5pg04.
  1. Colson, S. What happens to breastfeeding when mothers lie back. Clinical Lactation. Fall 2010; Vol. 1.
  1. Biological Nurturing FAQ’s – www.biologicalnurturing.com/pages/faq.html.
  1. United States Department of Agriculture (USDA) Loving Support Through Peer Counseling curriculum.
  1. “Beyond Best Practice: Creating a Supportive Environment for Breastfeeding Mothers” conference. Lincoln, Nebraska. Oct. 25, 2016.