My baby falls asleep while breastfeeding. What can I do?
My baby keeps falling asleep at the breast
Studies actually show us that the majority of babies feed at least eight to twelve times every 24 hours – and even more than that, sometimes. So, if your baby is very, very sleepy at the moment, it’s very difficult for your baby to then establish that healthy milk supply, and you know there can be lots of reasons why your newborn is sleepy at the moment – it’s certainly not an uncommon situation.
I certainly see lots and lots of babies who are really sleepy in the early first, or second, even up to the third week sometimes after birth. It may be that medications given during the labour caused him to be sleepy, it might be a slight infection, or jaundice, and sometimes it’s simply that the baby is not latching on so well at the moment and therefore not stimulating the breast, and not getting the flow of milk so fast, so then becoming more and more sleepy, and less interested in feeding.
So if this is the situation that you’re in right now where your baby is very sleepy, hanging out at the breast, not really doing a lot of active swallowing, and not producing the wet and dirty nappies as expected or even gaining weight (maybe even losing weight) there are several things that you can do:
So first of all, make sure he’s not too warm. Sometimes babies are so cosy and warm that they’re very happy not to wake up and feed. It might be that you just take that blanket off him, or even strip him down to his nappy – that can often wake up babies who are very, very sleepy. And watch out for the early feeding cues – even when he’s in a light sleep, your baby will still be able to feed at the breast, so give him every opportunity to do that.
It might simply be that changing your baby’s nappy, or lying him on a changing mat, holding him upright, any of these things can be useful to help him to wake up a little bit more. Sometimes just patting your baby’s back, or rubbing his hands and feet, all of those things are also useful.
But, I want to stress that one of the most important things you can do is to do skin-to-skin with your baby, so definitely stripping him down to his nappy, but lying him against your bare chest, and spending at least two hours doing this per day, as a minimum. All of this is going to help to boost the hormones that make milk, and it will also stimulate his breast-seeking behaviours. We know, actually, that frantic babies calm down in skin-to-skin, but sleepy babies can often start to wake up and start thinking about milk, and think about crawling down to the breast and latching on themselves, even.
It’s also important to know that studies have shown that one of the most common reasons for babies to be sleepy at the breast is because they have a shallow latch. I know we mentioned it, right at the beginning, but that is a really good reason to pay close attention to getting that latch as good as possible, you know… A deeper latch at the breast will really help. So, please look at the videos around positioning, and especially laid back, biological positions, that can really aid a baby’s breast-seeking behaviours.
If your baby is struggling to latch, it might be that you’ve got a little bit engorged, and when you get engorged (which is a general congestion of the breast) your nipple and areola will also get engorged. That can cause that nipple area to be flatter than it was – this can cause a real problem for latching as well, and if your baby is already sleepy, it’s a kind of double problem. So, learn about how to deal with the engorgement, so that you can allow your baby to latch as effectively as possible.
So it’s very likely that, once your baby is latched at the breast, (and that’s a great thing) if he’s a sleepy newborn, he is likely, after the first initial fast sucks to call the milk down that he will swallow rhythmically, swallow that milk -but as soon as the flow starts to slow at the breast he is very likely to fall asleep again, and he may have only really swallowed that first let-down of milk. Now, your body can make lots of let-downs on that side, and a sleepy baby isn’t likely to call those let-downs.
So, a really useful tool is to use your hand only – your hand is going to be used to do what they call breast compression. This is a technique that will help to push milk out of the breast, your baby will feel that milk hitting the back of his throat, and that will cause him to swallow. So, please look at the videos relating to breast compressions and use that technique all the way around the clock-face of the breast, and on the other side, until your baby starts to become more alert and able to do this himself.
And try to feed your baby every two hours, if possible. At least 10 times in every 24 hours, this will ensure that he’s getting all the milk that he needs.
Look at the signs to tell you that he’s getting enough, the wet and dirty nappies and the weight gain. And know that very soon, as the days go by, he will become more alert and start to do this himself.
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Version 1.1 published in March 2019. Next review date: Jan 2022
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