Night-time breastfeeding

In the first days, and even weeks, the baby does not have an established rhythm of breastfeeding and sleep; episodes of wakefulness and sleep alternate constantly, with the total daily length of sleep decreasing from month to month. Frequent breastfeeds initially ensure steady milk production in the breast and its emptying.

In the first weeks, the secretion of prolactin, the chief milk production hormone, is the highest at night. The newborn's stomach is small and cannot take in a large amount of milk. Owing to its  composition, breastmilk is digested quickly, so the child becomes hungry again soon. By night-time feeding, the newborn gets a third of the total daily calorie intake.

Do you need to wake your baby for a night-time meal?

Sometimes your newborn may be so sleepy that he/she doesn't wake up often enough for meals and doesn't get enough food. This can become a vicious circle - the less the baby is fed, the more sleepy he/she gets. In the first six weeks of life, babies need 8-12 breastfeeds a day.
If the baby sleeps a lot during the day, do not create ideal sleeping conditions (silence, darkened room). As soon as you notice the first signs of hunger, it means it's time for a meal. During this period, it is important to follow the signs of good thriving and check the child's weight more often.

If your baby is healthy, over six weeks old and has gained enough weight, there is no need to wake him/her up for night-time breastfeeding, unless you feel great tension in your breasts.

How to prolong your child's night's sleep?

Here are some tips on how to prolong your child's night's sleep and reduce the number of night-time meals:

• Breastfeed often; try to increase the frequency of breastfeeding during the day and early in the evening; this allows the child to get enough calories during the day, without the need for night-time meals, which is one of the reasons for waking up at night.
• Gradually increase the child's waking time; bathe the baby and play with him/her in the evening, thus slowly adjusting his/her sleeping rhythm.
• If you go to bed a few hours after the baby, try breastfeeding at the time you go to bed. Most babies will suckle a little and then fall asleep again.
• If the baby wakes up at night for a breastfeed, feed him/her in a quiet, darkened room. Do not change the diaper unless it is very wet, if the baby has pooped or has a diaper rash.

After breastfeeding, put the baby back to his/her bed; it is not safe for a child to sleep with you in your bed!

Phasing out night-time feeding

Try not to use food to put the child to sleep; if you do so, later he/she won't want to fall asleep on his/her own. The presence of milk and other sugars in the oral cavity during the night leads to the decay of erupting teeth, with far-reaching consequences. Every bedtime ritual at night creates a habit, so the child will not go to sleep without it. If you are sure that the baby gets enough food during the day, try to stop giving a night-time meal to an infant older than six months.

Here are some tips on what to do to make this transition less abrupt:

• If your baby only briefly suckles at night (less than 5 minutes), try simply the night-time feeds and soothing your baby in some other way that you apply daily (rocking, singing, etc.). It may take a few nights for the baby to get used to this new routine. Be patient.
• If the night-time meal still lasts a bit longer and its duration is equal to that of daytime meals, longer than 5 minutes, you can gradually reduce the meal duration over 5-7 nights.
• There are many reasons why a baby wakes up at night. As you are already fairly tired from waking up at night, you often immediately offer the breast out of habit, and the baby develops the habit of comfort suckling. First try to calm him/her down in some other way. In most cases, when the need for comfort is the reason for waking up, you will calm the baby; sometimes he/she will be inconsolable until the breast is offered.
• One tactic is to have the father pick up the baby and calm him/her when he/she wakes up at night during this phase-out period.

Should you phase out night-time breastfeeding or not?

Every baby is different. Some will stop night feeding at four months, and some at two years old. Your baby will stop waking up at night when he/she no longer needs night-time feeds and when he/she is developmentally ready for it. You need to listen to your baby's demands and feel when the time is ideal to stop night-time feeding.

Phasing out also depends on the parents; if you are tired of waking up once or multiple  times every night, try phasing out after the sixth month, if the child is healthy and thriving. 

Whether you will view night-time breastfeeding as your baby's normal developmental phase or as a problem depends on your expectations. Wait until you get to know your child and his/her needs and desires.

If you have questions, dilemmas or doubts about breastfeeding, call the "Hello Baby" telephone counseling service of the Belgrade City Institute of Public Health at 011/7158-444. The visiting nurses on phone duty (24/7) will provide you with professional assistance and advice, and help you calm down.