Responsive feeding
How often should babies, toddlers and children breastfeed? On demand? Every 2-3 hours? 8-12 times per 24 hours? On a parent, doctor or sleep consultant’s set schedule? The simple answer is none of the above, a child should always be fed responsively.
What is responsive feeding?
Responsive breastfeeding is how a mother responds to her baby’s cues, as well as her own desire to feed her baby. Feeding responsively recognizes that feeds are not just for nutrition, but also for comfort and bonding. It’s feeding a baby on demand, while offering additional feeds whenever you or your baby/child may feel like it. The wonderful thing about exclusive breastfeeding at the breast is that you can’t overfeed your baby, so go ahead and breastfeed as much as you and your baby want to.
When a mother and baby are left to follow their biological instincts, to truly feed responsively, they won’t be able to tell you how often or how long they breastfeed, they will however be able to tell you that they’re in sync with each other and that they breastfeed as often as needed, which will usually be quite frequently. Studies have found that babies on average feed about 10-14 times in a 24-hour period, although some may feed less, and some may feed more frequently.
Babies are intelligent and will cue to you when they’re hungry, in the early weeks it’ll be things like rooting, stirring, opening their mouths, smacking their lips, bringing their hands to their mouth, and as a late sign, crying. After the newborn period, they may no longer show the same hunger cues, so it’s up to you to learn your baby’s cues and to offer breastfeeds frequently too.
Newborns will usually breastfeed 8-12 times or more during each 24-hour period. With 8 being the minimum number of times that you should feed your newborn to ensure that you establish an adequate milk supply and to ensure that your newborn is receiving adequate amounts of milk. It’s important to note that these feedings will rarely be at the same intervals such as every 3 hours for each 24 hours or every 2 hours during the day and every 3 hours during the night as many people may promote. Newborns will feed as needed on their own schedule which could look something like every hour for 4 hours, then every 3 hours for the next few hours, then some cluster feeding for 3 hours then once every 2 hours. This is all very normal. It’s okay if your baby has moments of very frequent feeding and a few bigger gaps in between some of the feedings.
As long as your newborn baby is fed responsively as they need it, feeding at least 8-12 times during a 24-hour period, during both the day and the night, is having adequate amounts of wet and dirty diapers based on their age and is gaining weight and growing as expected, everything is perfect, and you can continue to follow your baby’s lead.
It’s important to remember that a big part of responsive feeding is to offer a feed to your baby if you feel like you or they may need one. Never force it but offer if you’d like. Especially if it’s been a while, 3+ hours. A baby can’t overfeed when they exclusively breastfeed directly at the breast, even if they breastfeed 20 times a day.
Some babies may not cue for hunger in the first week or two though, especially if you had a medicated or traumatic birth or if the baby has any health or neurological complications. Strong pain medications can also cause sleepiness in newborns. In this case, it’s even more important to ensure you feed your baby at least 8-12 times in a 24-hour period for the first few weeks, during both the day and the night, more if possible. Try and offer as frequently as you’d like.
Should I wake my baby to feed?
This is a tricky one. Most babies will wake by themselves as needed. Babies will usually cluster feed in the evening before having a 4 hour stretch of sleep and then wake every 3 hours from there, on average, it does vary from each individual baby. Frequent feeding during both the day and the night are equally important and night feeding helps ensure that you build a good milk supply, your baby is getting enough milk and it helps to protect your baby against SIDS. Many babies don’t wake by themselves though, for the same reasons as above and this is why many lactation consultants will encourage you to wake your baby for feeds. Everyone will have a different opinion on how often and for how long this should be done.
My recommendation is that your baby will most likely wake by themselves as needed, but if they don’t and to be safe or if your baby is swaddled or you use a white noise machine or a pacifier, set the alarm for every 3-3.5 hours. You don’t have to completely wake your baby, you can dream feed them, which is when you feed your baby while they’re asleep. If they won’t dream feed though you’ll have to wake them.
It’s usually fine to let your baby sleep without waking them from around the 4-6 week mark. By then they will be on a good weight gain pattern as expected and things like birth trauma and medications used during and after labor is no longer a concern. Most babies will wake by themselves at this age.
Once you do leave your baby to sleep and you have a baby who tends to sleep big stretches of 6+ hours which is very rare in the first few weeks, working in at least 1 dream feed in the middle of that big stretch for another week or three will be a really good idea.
It’s also especially important to offer enough opportunity for your baby to feed very frequently during the day to ensure they’re taking in all the milk they need so your milk supply and their weight and growth won’t falter.
It’s important to remember that most babies will continue to wake frequently to feed well into their toddler years and this is not only normal, but healthy too. Night feedings are just as important as day feedings.
For how long should I ensure my baby has at least 8-12 feedings in a 24-hour period?
As always, feeding responsively, as you and your baby need to, while ensuring your baby has enough wet and soiled diapers in every 24-hour period, your baby is gaining weight and growing as expected and they’re happy, healthy and meeting their milestones.
Once your supply has been established, around the 6 weeks mark, you no longer have to count the number of feeds that your baby has in a 24-hour period. They don’t have to be feeding 8-12 times in a 24-hour period, although they probably will as that is what’s biologically normal for them to do. Babies may now take bigger feeds less frequently, or feed as frequently as before, both are normal. Babies who are allowed to feed responsively will very rarely stay consistent with their feeds. They will go through phases of cluster feeding and through phases of less frequent feedings. It will go up and down. As long as their diapers and growth are as expected, everything is fine.
Just as a reminder, around the 4-month mark, babies become very aware of their surroundings and may forget to feed or struggle to finish a feed. This is usually temporary, but you may have to remember to watch them closely for hunger cues and to offer additional feeds frequently. It may be helpful to feed your baby in a lightly dimmed room with little distractions.
When a mother and her baby are allowed to feed responsively, the baby will feed very regularly during both the day and the night, well into the second or even third year. They will go through phases of cluster feeding and then feeding less frequently than usual. This is biologically normal.
Summary
Feed responsively based on both you and your baby’s/child’s needs for both food and comfort.
Never withhold the breast or time a baby on the breast. Do not feed on a schedule.
During the newborn period and while your supply establishes, do ensure your baby has at least 8-12 feedings in a 24-hour period, during both the day and the night. After the first few weeks you no longer have to count the feedings, you can just follow you and your baby’s lead.
Do wake your baby for feedings during the first few weeks.
If at any time you feel unsure about anything or there is an issue, contact an International Board Certified Lactation Consultant (IBCLC) to assess you and your baby and help you with a feeding plan that’s best suited for you.
Additional information resources:
Milk intake and frequency of feeding in breast fed infants
Looking for cues – infant communication of hunger and satiation during milk feeding
