You are comfortably seated or lying down and baby is nursing well. Then, she slows down and falls asleep at the breast soon after. You look at the clock and notice she has suckled for less than 10 minutes. Should you be worried she isn’t drinking enough milk?
Lactation counsellor Pamela Lim says babies suck fast in the first five minutes of feeding as they are hungry. The milk that flows out at the start is known as the foremilk. As baby continues breastfeeding, the milk’s fat content gradually increases. Milk at the end of a nursing session is called the hind milk.
Lim, who volunteers at Joyful Parenting, says this is why babies should preferably empty a breast fully before dozing off or switching to the other breast, to ensure they are full and able to put on weight. This should take them about 15 to 20 minutes on each breast.
But why do some babies fall asleep before they are completely satiated?
Breastfeeding support advisor Sharon Ow, who coaches new mums at Mummy Baby Care, says newborn babies are most likely to fall asleep on the breast while feeding. That’s because the first three months of life is usually considered their fourth trimester ― a time of great change as they have to get used to the different noises, lights, smells, sounds and sensations of the outside world.
Breastfeeding keeps them close to their mother’s bodies, so if they can’t get the milk, they may just go to sleep instead.
Newborns get tired easily if they cry for prolonged periods and may still be struggling to nurse effectively. Breastfeeding keeps them close to their mother’s bodies, so if they can’t get the milk, they may just go to sleep instead.
Ow explains, “They feel safe and relaxed as the environment they feel, hear and smell remains very much like in the womb (before they are born).”
One reason they tire easily is because of the drugs given during the labour and delivery process, such as epidurals and other painkillers. These enter the mother’s bloodstream and affect the baby in the early days following birth.
Some babies also react to too much stimulation by going to sleep, such as when the environment is very noisy or the lights are too bright.
Older babies who do not latch on properly before feeding will quickly lose interest if the milk flow is too slow. And if they merely suckle for comfort but are not drinking milk, the motion will also lull them to sleep very soon.
So, what should you do if your baby tends to doze off during breastfeeding? Here are ways to wake baby up if she starts nodding off:
#1 Don’t get too comfy Lim advises mums not to let baby get too cosy while breastfeeding. If baby’s all bundled up, unwrap her, take off her mittens and rub her palms. The idea is to keep her awake, so she says mothers can also tickle baby’s cheeks gently or get up and move around. Other areas to tickle or massage baby include her back and feet.
#2 Break the suction New mum Rita Tan says her own mother taught her this method that works. She puts one finger between her breast and her sleepy son’s mouth to break the suction. “The minute he feels the breast being removed, it encourages him to suck again.”
#3 Burp or talk to her Hold baby upright to talk gently to her or to burp her. These actions can be done until she has spent at least a good 15 minutes of feeding on each breast.
#4 Put some breastmilk on her lips Dribble some milk into the corner of your baby’s mouth with a syringe or dropper or simply express milk onto her lips to encourage her to start sucking again.
#5 Increase your milk flow Lim says it’s important to observe if baby is drinking milk (open mouth wide – pause – close mouth type of suck) and not just passive sucking (rapid sucks without pause). Try breast compression, a technique developed by Canadian paediatrician Jack Newman, which helps to increase the flow of milk from your breast to baby and encourages her to start suckling again.
Put baby in a less “sleep-inducing” position, such as in the football hold or straddling position.
#6 Clean her up Wipe baby’s head, tummy or feet with a damp face cloth to gently wake her up.
#7 Change her diaper When you notice baby starting to fall asleep, change her diaper or switch breasts.
#8 Dim the lights A newborn’s eyes are sensitive to light. Dim the lights in the room before feeding as bright lights may make her keep her eyes closed.
#9 Try a different position Put baby in a less “sleep-inducing” position, such as in the football hold or straddling position. Babies cuddled in the cradle hold tend to fall asleep more readily.
If you have a sleepy baby, breastfeeding experts say that it’s important to remember that you ensure that she gets enough to eat.
* Take note of her output… Looking at her nappy can tell if a baby is getting enough breastmilk. So, monitor her urine and stool output and weight gain closely, especially during the first few weeks.
* Supplement… With expressed breastmilk, if necessary.
* Seek professional advice… If baby is not gaining enough weight or continues to feel sleepy despite your efforts to wake her up.
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