I often hear parents say things such as “The baby falls asleep at the breast after 5 minutes” and “Our baby is so sleepy when they nurse they won’t take the 2nd side” also “My baby feeds for hours but is still hungry 10 minutes later.” It is common for babies to fall asleep at the breast while nibbling. However, falling asleep at the breast while nibbling means they are not drinking. When babies are falling asleep instead of drinking this can lead to longer feeds, decreased milk supply or nipple pain. The following strategies can be applied to shorten long feeds, and potentially decrease any present pain.
· Adjust the latch: Try to achieve a deep latch where your baby’s nose is at least finger-width distance away from the breast and the chin is tilted away from their chest. This will help them drain the breast more effectively. Even if you have a great milk supply your baby will have difficulty drinking at the breast if they are symmetric with their nose in the breast and chin tilted forward. Your baby should be able to look up at you with their head back, nose away with their lips flanged. Try and wait for your baby to open wide before they latch and bring them to the breast with pressure behind the shoulder blades and not behind their head.
· Introduce Breast Compressions: When you notice your baby is starting to slow down at the breast with less rhythmic pauses and increased quick shallow sucks introduce breast compressions to help them stay awake and start actively drinking again.
Breast compressions are done as far back on the breast as possible, squeezing and holding the breast the entire time the baby is drinking. Avoid a pumping motion. Just hold and squeeze either above, on the sides or underneath the breast to increase milk flow to your baby. Take a break when your baby takes a break and resume squeezing when they start to drink.
· Switch sides sooner and more often: We are often told to keep our babies on each side for 15 to 20 minutes regardless of how active they are. This apparently ensures that babies will empty the breast and get the hindmilk. The problem with this advice is if your baby isn’t awake and only nibbling then they aren’t draining the breast and they are not getting any milk. (https://ibconline.ca/information-sheets/protocol-to-increase-breastmilk-intake/) Follow your baby’s cues and switch sides once your compressions aren’t helping to create as much drinking. Continue to switch sides back and forth and compress as long as your baby is actively awake and drinking at the breast. Often in the evenings this can be very helpful when your flow naturally dips and your baby is a little fussier due to the slower flow.