Breastfeeding

The constant nurser

Why some babies need to nurse more frequently than others

Classic textbook nurser

Some babies seem to have read the instruction manual. Erin Lalonde’s first baby, Amelia, was “a classic textbook nurser,” she says. “She nursed for about 20 or 30 minutes, every two to three hours, just like the books say.” Lalonde thought she had this breastfeeding thing all figured out.

But when her daughter Evelyn was born two years later, it was a different story altogether. Says Lalonde: “Evelyn was a five- to 10-minute nurser, one side, every hour, if not sooner. In fact, she just seemed to need constant touch and lived in the sling most of the time.”

Grace Wilson’s son Spencer apparently read the same book Evelyn did: “Right from the start, he nursed every hour or so, with occasional two- or four-hour stretches between feedings,” says Wilson. Her doctor expressed concern that he was nursing too often. But Wilson talked with a La Leche League leader who reassured her that Spencer was doing just fine.
Why do some babies nurse so frequently? “Because, biologically, that’s what babies are supposed to do,” says Winnipeg lactation consultant Linda Romphf. “The truth is our expectations of breastfeeding babies are very unrealistic. If you talk to women from countries where breastfeeding is very common and normal, they’ll tell you this is how most babies behave.”

Romphf points out that “babies who nurse more often ensure a plentiful milk supply and their gut is constantly bathed in human milk, which reduces infections and later chronic illnesses.”

Those are all good things, but they don’t explain why your cousin’s baby nurses only every four hours and still seems to be getting plenty of milk and all those health benefits, while yours is clearly starving after an hour. One possible reason: differences in milk storage capacity.

Australian research by Peter Hartmann, president-elect of the International Society for Research in Human Milk and Lactation, has shown that while most women can make plenty of milk for their babies, some can store more milk per feeding in their breasts than others. Women who store smaller amounts of milk will need to nurse more frequently. One way of looking at it: It’s as though I’m trying to fill an eight-ounce measuring cup with water using a teaspoon and you’re filling an identical cup using a tablespoon. I’ll need to “feed” the cup three times for every one time you spoon the water into your cup.

Large storage capacity

But having a large storage capacity doesn’t guarantee less frequent feedings: Your baby’s stomach size and temperament also seem to be important factors.

Melanie Walsh-Fraser, whose three children were all very frequent nursers, points out that babies nurse for reasons other than hunger. “Sometimes it’s more for comfort or because they need help to fall asleep.” The fussy, sensitive baby may need a lot more comfort nursing than his more placid brother. As Romphf says, “The world is a strange and scary place to these babies, and they instinctively seek out comfort at the breast.”

Despite this reassurance that frequent feedings are normal and healthy, it can still be worrisome for new parents. Walsh-Fraser recalls a neighbour telling her that she should try to “hold off” feedings by walking and jiggling the baby.

Parents may be advised to supplement feedings with formula, as Grace Wilson was, promoting the common worry that frequent nursing is a sign of insufficient milk production. Looking for signs of milk intake can be very reassuring to parents: Wilson’s son was gaining one pound every week for the first three months, so clearly he was getting plenty of milk without any formula supplements. And Walsh-Fraser’s baby was nicknamed “Monsieur Verrrry Poopy” because he seemed to be constantly filling his diapers, another sign that a baby is getting enough to drink. See “Is Baby Getting Enough Milk?” for more signs.

OK, your baby is gaining weight well and you’re willing to accept that frequent feedings are normal. But how the heck do you get anything done — and what if he’s nursing just as often at night too?

Tips

Here are some tips from parents who’ve been there — and survived:

• Try carrying the baby in a sling. Baby can nurse in the sling (with some practice) and you’ll have your hands free to do other things.

• Nap with your baby if at all possible. If he wakes to nurse and you feed him right away, he may go back to sleep again and you might be able to eke out another half-hour or more of rest.

• Keep your baby close to you at night, to make those middle-of-the-night feedings easier.

• Lower your expectations of yourself. This may mean pulling back on some activities and chores. “I went down to doing laundry once a week, except for the diapers, and supper was not on the table when my husband got home,” says Lalonde. “Thank goodness we had a dog to keep the floors clean!”

• Remember that breastfeeding is interruptible. If your baby has nursed for five minutes on one side, and your toddler needs your help or you’re dying for a bite to eat, you can tuck the baby in the sling and go contend with the issue. She’s going to be nursing again soon anyway, so it isn’t a big deal.

Perhaps the best tip of all is to seek out supportive friends. Romphf says, “When you have a constantly nursing baby, what helps the most is having other breastfeeding mothers who can give you some empathy and support and practical tips.”

Walsh-Fraser agrees: “It was very reassuring for me to hear that this doesn’t last forever and that things get easier as time passes.”

Is baby getting enough milk?

Most babies who nurse frequently are getting plenty of milk, but what if yours isn’t? Here are some signs that may indicate low milk production or that a latch problem is preventing the baby from getting enough milk:

• Baby is gaining weight very slowly.
• Baby nurses for long periods and never seems satisfied.
• Baby is having fewer than two substantial bowel movements daily (after the first few days and before six weeks).
• Mother’s nipples are very sore or appear misshapen when baby lets go.