Should I be breastfeeding one side at a time?

Should I offer one breast or two?

Many breastfeeding mothers ask me how long their baby should feed at each breast?’

qThere is often confusion regarding whether it’s necessary to offer both breasts at each feed?

I believe the confusion has come about because historically, there have been a lot of regimented ideas about breastfeeding, where feeds were limited to a certain length of time on each side, and mothers were told to swap over to the second breast after a certain period.

There are many old school ideas mixed in with the new, and the sad thing is, a lot of those old ideas had no basis of evidence and were merely old wives tales. 

Before I make a blanket statement about whether it can be useful to offer one breast or two breasts, it would be good to talk about what happens when your baby comes to the breast to feed.

So first of all, let’s say your baby comes to the left breast, and does fast sucks initially – those rapid sucks send impulses to the brain.

The brain releases hormones, and those hormones act on lots of grape-like structures within the breast, where the milk is made and stored.

When the hormones act on these, milk is, in effect, squeezed out of both breasts at the same time. So this is commonly known as the let-down.

You may or may not feel the let-down. Some women have a strong initial let-down, and they can feel that quite forcibly.

Others will not feel it at all. Some feel it as a tingling. Some feel it stronger than that, and other women never feel it at all.

Whether you feel a let-down or not is immaterial, so don’t worry if you don’t feel the let-down.

The most reliable sign to prove that it has happened (the let-down) is that your baby, who was doing fast, sucks initially to call the milk down, suddenly feels the milk hitting the back of the throat, and because of this has started swallowing.

After a while, the pattern starts to become slower, more rhythmical, and swallowing may be heard.

The first let-down that happens usually has quite a high volume at the beginning of the feed.

As your baby starts to swallow, the volume will reduce after a while, and your baby will eventually start to do a little bit of flutter sucking at the end of the let-down when the volume is very low.

There’s quite a high content of fat there because of the low volume.

After your baby has been flutter suckling for a little while, this will then stimulate another let-down of milk.

Your baby can potentially call down an average of three to five let-downs in the course of a feed, on one side, if he works hard, and works through those patterns.

Once another let-down comes, you’ll see that slower, more rhythmical pattern emerging as your baby is swallowing again, and then the volume will decrease again, and so forth.

You may know that your milk supply is based on a supply and demand concept.

That means that as milk comes off the breast (so demand has gone in, and your baby has then swallowed that milk), your body will then make more milk on that particular side.

So every time there is an extra bit of emptying, more milk is made.

The first milk that your baby gets when he latches on after the initial fast sucks is high in volume but low in fat and calories.

Some studies show there is quite a variation in the fat content of the breast milk.

As the feed progresses, the fat content generally increases, too, so it’s good for your baby to be able to feed through as many of those let-downs as possible.

For other women, there may not be a variation.

Some studies suggest it is useful to allow your baby to be in control of the feed, for as long as he wants, to get the calories needed.

So it certainly seems important to allow your baby to stay on one side for as long as he can until he comes off himself, if possible.

Also, when your baby feeds from one side and calls the milk down with the first fast sucks, the milk lets down on the other side at the same time.

So in effect, calories are waiting for your baby on the other side!

Once your baby has come off the breast, either because he is an efficient feeder, or because you’ve used compressions to keep him on for as long as you can, it can be useful to offer the second side too.

Doing this will provide extra calories that he wouldn’t have had access to, had you not offered the second breast.

Offering both sides at each feed ensures that your baby will get more calories in one sitting. 

On the next feed, you can offer the second breast as the priority breast.

Let your baby feed as long as he can and let him come off on his own or use breast compressions if necessary, and then offer the first breast again to give those extra calories.

In this way, your supply will build up day after day and provide all the milk that your baby needs.

Now back to the question of how long your baby spends at the breast? There can be a real variation.

Most babies will feed anywhere between 10 to 30 minutes. We encourage mothers to do breast compressions in situations where her baby is only feeding for five minutes slots!

Or maybe the baby is spending more than forty minutes at the breast. That usually means that your baby is ‘hanging out’ a bit – a bit longer than needed, without some added extra swallowing going on.

So once again, breast compressions can be useful.

The truth is that as time goes on, you will see patterns emerging, and you will usually get to know your baby’s normal patterns. 

I also want to say that if the way you are feeding your baby now is working for you and you are not experiencing any difficulties, and your baby is gaining weight, then that is absolutely fine.

Finally, if you have an oversupply of milk, you may find that your baby is more settled when you only offer one breast per feed. All of these are normal variations.

 

Review dates, references & further resources

Review Dates

Version 1.1 published in March 2019. Next review date: Jan 2022

References

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