You’re snuggled into a comfy chair and your baby is happily nursing. His sucking slows down and his body relaxes against yours as he falls asleep, your nipple still in his mouth. When your baby falls asleep while breastfeeding, it all feels very peaceful—but you wonder if it’s OK.
“I get questions about this every single day,” says Beth McMillan, an Ottawa lactation consultant. “And the answer is yes, and no. There are times when it’s fine, and there are times when it’s a concern.”
“Babies who are struggling to nurse effectively in the early days will sometimes fall asleep at the breast even though they haven’t gotten much milk,” explains McMillan. These babies may doze off after a short period of sucking because they get tired easily, or they may quit in frustration because they’re not getting the milk they want, and just go to sleep instead.
“Parents are often told that when the baby falls asleep at the breast, it means he’s full,” says McMillan. “They can be devastated to find out that, in fact, the baby isn’t gaining weight and that perhaps their milk supply is beginning to decrease as a result.”
The challenge, says McMillan, is that mothers are often looking to the clock for guidance, when that doesn’t really tell them much. “One baby can nurse for five minutes and have gotten plenty of milk, while another can nurse for 20 and then fall asleep even though he didn’t actually get much milk at all.” If your baby falls asleep during feeding, look for these signs that your baby is getting enough milk:
• The baby starts the feeding with open eyes and a focused, alert expression.
• After a short period of fast sucking, the baby is visibly swallowing after every suck, or at least after every couple of sucks.
• Your breasts feel noticeably softer and less full at the end of a feeding.
• If the baby has fallen asleep at the breast, her hands are open and relaxed and her arms hang down limply. If her hands are in fists or her face looks tense, she may still be hungry.
Concerned that perhaps your falling-asleep baby isn’t feeding well? Try switching to the other breast when the baby seems to be drifting off to sleep, or do breast compression (squeezing your breast between thumb and fingers as the baby sucks) to encourage more milk to flow. These steps may keep your baby nursing longer and more effectively. A La Leche League leader or lactation consultant may also help you figure out how to get breastfeeding working better.
Janet Darnell* was warned about letting her 10-week-old baby, Jason, go to sleep at the breast. “The public health nurse said he would never sleep through the night,” she says. But stopping him was easier said than done. Feedings became increasingly stressful as she tried to figure out when to stop nursing so that Jason would get enough milk but not fall asleep, and he began to anticipate having his meal interrupted.
“Babies are biologically designed to sleep at the breast,” says McMillan. “It’s clear from the composition of the milk and the baby’s hormonal response to nursing that babies are meant to go to sleep in association with breastfeeding. Human milk even changes over the day to have more sleep-inducing components during the evening and at night.”
Our culture, though, has different ideas. “Many people want babies to fall asleep alone, so mothers try not to let the baby fall asleep at the breast,” says McMillan. “But this often causes feeding problems. The baby may bite or clamp down on the breast. And the baby isn’t relaxed because he’s waiting to be stopped, and his whole sleep cycle can be thrown off.” She suggests keeping feedings relaxed, even if that means the baby falls asleep during feeding. Parents who want to put their baby to bed awake could then change the baby’s diaper or his clothing to wake him up again before putting him in the crib.
“You need the full picture to know if letting your baby sleep at the breast is a problem,” says McMillan. “Most of the time, it’s fine, but in some situations it can be a concern, Talking to a breastfeeding expert may be the best way to sort things out.”
* Names changed by request.