Feeding patterns in the early days
About the only thing that can be said about early feeding patterns is that they were extremely varied. Most of the women decided to feed their baby without restriction, which meant that they took the cues for feeding time from their baby*1. Several said that the baby just slept and fed in the early days. Many of the babies fed frequently, both day and night, in the first few weeks until they began to sleep for longer periods and stretch out the time between feeds. Most women offered both breasts at each feed while some found that their baby was contented with only one. The length of a breastfeed also varied with some babies being satisfied very quickly and others lingering over their feeds.
- Age at interview:
- At the time of interview, this 37 year old, White British woman was breastfeeding her 11 month old son. A pharmacist/university lecturer, she was married to a pharmacist.
Yes I think it's funny I have memories [laughs] of when I came home of certain music that was playing at the time, there are a couple of CDs that I really can't listen [laughs] to now, and it's because I suppose those first few days are hard, you know, the baby needs frequent feeding, especially when they are breastfeeding as I understand it, so every one and a half to two hours Michael was needing a feed. And it didn't last a long time, it wasn't a long drawn out affair and he was only taking from one breast at a time, so I was having to remember which one it was last time so [laughs] I remembered to put him on the right one the next time. I remember the night being the hardest part, my husband is probably the greatest advocate of breastfeeding because he never had to do a night feed [laughs]. So he thought it was the best thing since sliced bread and certainly in the, in the first few nights Michael was next to the bed in his little crib and my other half slept elsewhere just so that he could, you know, keep compos mentis, as long as one of us could, because I was up and down, you know, sometimes I didn't know what time of day it was, but it was a good investment and Michael seemed happy, Michael never, he didn't sleep an awful lot, you know, we'd, sort of in all the classes before we had the babies they were saying, 'Oh newborn babies sleep for sixteen hours a day'. And all the rest of it, and Michael was more like eight to twelve if we were lucky, and, and so he was quite demanding and, you know, he was just trying to, I just remember feeling very sorry for him because sort of thinking this, you know, you, you're in this bright light, you know, world, you don't really know whether it's day or night and that was one of the important things that we were grappling with in those first few days that, he didn't know, you know, it was just a twenty-four hour cycle for him. So it was just, you know, keeping those things in the front of your mind sort of, you know, and just knowing that it wasn't going to go on forever like that, that things would start to stretch a bit more as he started to get, a bit more, nutrition then, you know, it made it worthwhile, but they were hard those first few days.
How did you know when to feed him?
Well it was feed on demand, that's what I'd always been told so he would [laughs] well actually when I think about it, that was quite a good question, I mean he would, he would certainly make a dive, you know, he knew what [laughs] he was looking for, he would dive for that area [laughs]. I suppose it, it's a process of elimination I seem to remember it being, it was, okay he's crying, why is he crying? You know, what are the possibilities? Is it that his nappy's dirty? You know, when did he last have a feed? But we'll try him anyway so it was, you know, looking at the different possibilities, I seem to remember that feeding was always the first one unless there was a very obvious smell [laughs], and then after that it was just seeing whether, you know, and in the end whether it was just boredom, or just needed a hug so it, it was a process of elimination but I expected it to be frequent so, and yes just on demand.
- Age at interview:
- At the time of interview, this 34 year old, White British woman was breastfeeding her 15 day old daughter. A human factors engineer/ergonomist, she was married to an engineer.
Sophie was just placed on me and she lay there and probably for about an hour, an hour and a half and just, like, she, I think she breastfed, I wasn't really aware of it, but she definitely suckled and, I think did latch on and in my notes they've said that she was feeding for about an hour. As I say I wasn't totally aware, she was just lying there and then my husband would pick her up and give her a cuddle if she got a bit sort of, and then put her back on me so that was, sort of for four hours I was in there. And then we were taken up to the antenatal recovery part of it, antenatal ward, I was put in a transitional care unit because she was premature and because she was a healthy weight and seemed to be feeding fine we were left to our own devices, and sort of not given any special attention. And so then the first, first day she slept a lot of the day, I can't really remember how frequently she fed, probably every two or three hours I think. But there was a lot of lying around just watching her sleep and during the night as well she kind of, she just would wake up, sort of start to cry a little bit her mouth would go, she would suck her sleeve and that would be a cue to feed me. And so that was sort of the routine sort of throughout the night as well. The first night I think was alright, she did feed periodically and I slept periodically, I don't remember very much of it, the second, second days and things we had, again a lot of sleeping during the day and a bit more frenzied activity during the night the midwives were very good because they'd come and, sort of in the end they did take her away just for a couple hours to let me sleep and then brought her back, just when she really was very hungry, because they, they thought maybe she'd just got into a bit of a routine of smelling me and stuff, I'm not really sure, but that was, that was sort of the, the time in hospital. And then day three my, my milk started to come in, up to that point it was just the colostrum, and that was a very strange experience, you know, you, you sort of, your breasts just go rock solid, just absolutely stretched within an inch of their lives, and then the sort of milk appears and during that third night we had a bit of a tough night because Sophie was doing everything she was meant to be, by encouraging my milk to come through by wanting to be fed lots. But we had, you know, continual sort of every hour, every half hour I think for a period of three hours her wanting just to, to feed a bit more and, you know, I didn't really know it was my milk coming through. I couldn't tell the change but, you know, that was her and so that was, you know, that was hard because it was just an unknown, you know, when your, when your nipples are really sore and your breasts are really sore and you're not really sure what on earth's happening. That was quite, quite hard because I didn't know whether I was giving her enough or whatever but, she seemed, she seemed fine and we, the next day she'd settled down after the night because she definitely sleeps more during the day than at night. And we had a normal day again of her sleeping three plus hours, I think, and then waking up for a feed and then feeding of, you know, feeding for a while and then going back down and that was the sort of case for the first three or four days.
Okay, and were you offering both breasts at each feed?
I wasn't actually, she, she feeds for about ten minutes was her maximum to start with and then she'd just go, go down and she wouldn't want any more. I mean when she, she begin, or began to sort of not settle immediately I'd try wind her although she hasn't been a very windy baby. Recently being a whole fifteen days old she's now, you know, maybe a bit windier than she was initially but I did take her off and then put her back on the same one and that seemed to be fine. Now
Some women, mostly with a first baby, kept a diary of how often they were feeding as a way of keeping tabs on what the baby was doing and putting things in perspective, especially when they began to wonder how long the frequent feeding would go on for. One woman said to her husband, “Well if this is parenthood, we're never going to survive this” and another described, “One very, very difficult night [laughs] where my husband and I looked at each other and said 'we should have got a kitten' it would have been easier”.
- Age at interview:
- At the time of interview, this 26 year old, White British woman had a 2 year old daughter whom she had breastfeed for 2 years. A Peer Counsellor Programme administrator, she was married to a head waiter/plasterer.
She fed very often I remember she fed a lot but, I think that's one of the things that I went in expecting, you know when I, even before, even without practically thinking about things, I knew that a baby could feed you know every half an hour, they are young they need a lot of food, they need re-filling quickly. So, I think, I remember that one day, writing up a diary because she seemed to be feeding all the time, and just writing down times of nappy changing and things like that, and, actually she was only feeding like every hour which, when you, when you've not really got anything else but your baby as a focus, it's not really that much. At night I don't think she, I don't think she fed an amazing amount and it slowed down quite gradually but over a fairly short period of time I'm sure in the first couple of days she was feeding, just as she'd feed in the day, I think it was around every two hours, although I never clock watched so it was never an exact time and I'm sure she did that at night as well but I was never, overly affected by that because she was so close and getting her in and out wasn't ever a problem. And then, she just gradually cut down her feeds so that she was just not feeding very much in the night at all.
So she slept longer between feeds?
Yeah she slept longer between feeds but then she went a little bit longer in the day between feeds as well but once because she learnt night-time very quickly, may be it's because she was so close so we never had to turn the light on, so it was everything was done in the dark so, she did associate the dark with her sleep time so I mean, maybe it was that, that's what I personally think it was but, but you just never know.
Did you change her in the night?
In the first couple of weeks I changed her but breastfed poo's, breastfed babies' poo's don't have as you know the same effect on their bottoms so if there was a time when I was overly tired and I knew she had pooed, I could leave her until the next time and it she was never I mean she never ever got sore it's only recently that she's ever got sore so, I did change her a couple of times but even then I had everything next to me and we never turned the light on I'm fairly lazy once I get into bed [laughs] and I, reluctant to get up and turn the light on and things like that so.
So the nights were very low key?
Yeah, yeah, we never, and because, my husband was always next to me asleep, although he's quite a heavy sleeper I didn't know how, you know, how much he could be pushed to wake up and he had work the next morning and things like that so, even if I did talk to her, it was very quiet very calm voice because I didn't want my husband to wake up, so everything was kind of kept quite quiet and mellow at night-times.
One father spoke about being surprised at how frequently the baby fed and thought that his expectations came from a bottle feeding culture (see 'Reflecting upon breastfeeding' and 'Thinking about the wider breastfeeding environment').
- Age at interview:
- At the time of interview, this 38 year old, English Caucasian man had a daughter aged 12 years and sons aged 6 years and 16 months, all breastfed. An estate agent, he was married to a registered child minder & school administrator (Interviewee 03).
Any problems with the feeding that you remember?
It was very frequent I think.
Were you surprised?
Yes, it was, it was something that we were surprised about I think as anything you kind of assume that things will go in an in a natural, in a normal course you feed every four hours and you, and you know things just sort of go along in the usual way, but it, reality isn't like that, you know, baby wants to feed when baby's hungry and, and really it was just something that the two of them got on with when as and when it was necessary but yes, more frequent that was the only, that was the only yeah sort of surprise I guess.
Where do you think the idea that it would be every four hours comes from?
Obviously that comes from bottle manufacturers and feed manufacturers, that's what what's expected isn't it? You give a baby, you give a baby of X weight a certain amount of milk at a certain time [laughs] of course babies don't quite work like that, unfortunately they can't read.
And you can't measure what they take?
And you can't measure what they take.
A few women had special reasons for being more prescriptive with their feeding, such as being very ill themselves or having an ill or sleepy baby. One woman set an alarm clock to wake her to feed her baby at night*2 and another, whose baby would not attach, expressed her milk regularly. One woman had a premature baby in a German hospital and she continued the set pattern when she went home.
- Age at interview:
- At the time of interview, this 40 year old, White British woman had a son aged 3 years whom she had breastfed for 6 months. A teacher, she was married to a university lecturer.
Well because I took warfarin at the time then it was actually heparin when I was pregnant, but my heparin levels weren't checked and I was over-herparinised so my blood was eight times too thin, so then I started to bleed or whatever it was internally and I had to have the caesarean opened up again, and it all had to be pumped out. So I think a double caesarean was part of the reason that my milk didn't come through, I mean, in the hospital it was quite challenging in that I was there for about ten days after the baby was born and there were other mothers who were breastfeeding, apparently really easily and I was thinking 'I don't seem to be able to get enough milk here' I now understand that I was actually so ill and so weak, so I think I lost two stone after the birth, I just lost weight really quickly and I just didn't have enough to make milk and to keep myself going. I didn't realise that at the time though. Perhaps if there were to be another time then I'd be easier on myself, more understanding but there was a, there was one night in the hospital I remember it distinctly, when the baby wouldn't stop crying and my husband was in the hospital with me and we were going up and down the corridor trying to soothe the baby and I eventually went to one of the midwives and said, 'Look what do you think?'. And she said, 'Well I think that he's starving actually, I think he's really hungry, he's trying to breastfeed off your chin at the moment,' [Laughs]. And I had him over my shoulder and he was trying to breastfeed off my chin, so, I just didn't have enough milk at the start so we needed the formula and then because my husband was able to do that and it was quite nice for him, so we just left it like that and perhaps twice a day he'd have a formula feed rather than a breastfeed.
Certainly my consultant said it was the most positive thing, the best thing I could do for the baby. He also said that giving the baby a routine was the best thing I could do for the baby, and also for us. And I think that was very true so that's something that, now, if the, if the child wakes up in the night then he's not happy about it so he's used to his twelve hour sleep now and that's it. Which is fantastic for us actually, fantastic. But I think that was something that was established very early on. We needed because of our circumstances, we needed to know when he was going to sleep, and when he was going to be awake, and we had to establish that from a few weeks old.
So how did you establish that routine? Can you remember?
I used to wake him up so that he didn't have too many hours sleep at that time, so he'd then perhaps have two hours awake and eventually have another sleep and then a little bit of time awake, another sleep, so I don't know anyone else of my friends who's done it like that actually'
So how frequently'
'but for us that was great.
'do you think you were feeding, breastfeeding during the day'
Well it certainly'
'when you came home?
'was more than every four hours. So, you know, I mean that was a problem at the start that I was so weak and I was also doing feeds as well.
- Age at interview:
- At the time of interview, this 30 year old, Indian woman was breastfeeding her 15 week old son. She also had an 18 month old son whom she had breastfed. A pharmacist, she was married to an analyst programmer (IT).
In the end I ended up doing what I wanted to do mix match of everything that everybody had told me and then just getting on with it because nothing seemed to be working so I couldn't get any worse well I didn't think I could get any worse and things did seem to be getting better after ten days so I just carried doing what I was doing and lying down when breastfeeding and it worked in the end. Not my best of memories.
What was happening to the baby's weight at this stage?
The baby was putting weight on fine, very well he was a good weight to start off with anyway he was his weight was very well.
So he was getting the milk obviously?
It just wasn't suiting you the way he was getting it?
No, he I mean for a breastfed baby he was doing very well he was feeding every four hours he'd sleep for four hours and at six weeks he was sleeping through so as a breastfed baby he did very well so and his weight gain is fine.
So he put himself on a four hourly schedule?
Yeah. I mean, yeah, again because of conflicting advice or different advice from different midwives some midwives were saying to me, 'Well you must wake him up to feed him after every four hours'. Some were saying, 'Well if he's asleep he's happy and content leave him asleep,' and in the end I resorted in doing a mix match again of both some days I'd wake him up after four hours to feed and then sometimes I just let him be.
*Footnote 1: Breastfed babies have a wide range of normal feeding patterns and a healthy baby who attaches well and enjoys unrestricted breastfeeding will soon find his/her own pattern. There are health benefits for both mother and baby of frequent, unrestricted breastfeeding in the early days.
*Footnote 2: It is not necessary to wake (for extra breastfeeds) a healthy baby who is developing and gaining weight satisfactorily.
Last reviewed September 2015