Many breastfeeding parents wonder if it's possible to sleep train if they are breastfeeding. After all, isn't it important to breastfeed around the clock in order to maintain supply?
Well, first off, I always support breastfeeding for those who want to do it. I also support bottle feeders while sleep training. Your body, your choice. You will have a fabulous kid either way. The advice that many parents get from lactation consultants is to feed frequently around the clock, especially in the early weeks and months. This is excellent advice for supporting a breastmilk supply but less than ideal for sleep. Here’s what i recommend, to optimize both breastfeeding and sleep. You will not get this controversial advice from your ICBLC, but with in almost all cases, I have found that it works beautifully for sleep while also preserving the breastfeeding relationship. (In those couple of cases, breastmilk supply was negatively impacted and those parents decided to supplement with formula... but in both cases, they have supplemented with their older children, too, and had planned to do so with these newer babies.) For the first six weeks of life, or longer if your baby was born early, breastfeed around the clock, on demand. At age 6-8 weeks old, if your milk supply is well established, start to gently encourage a schedule of eating every 3 hours during the day and same at night. This change doesn't need to happen overnight. Take it slowly, monitor your baby's wet diapers as well as your milk supply. Consider pumping once a day or more if you have supply concerns or if you want your baby to take a bottle sometimes. At eight weeks and older, if breastfeeding and milk supply are continuing to go well, start gently encouraging the feedings to be on an every four-hour-schedule during the day and at night. You can add in an extra feeding in the late afternoons if you have any concerns about your baby getting enough to eat. Continue to count wet diapers -- you should have at least six in a 24-hour period. You may find that your baby starts to sleep a longer stretch at night when you switch to an every-four-hour schedule during th day. If this is the case, and if your pediatrician has no concerns about your baby's weight gain, congratulations! Please take advantage of this and get some extra sleep yourself! This is exactly what happened with all three of my babies, and it was glorious. My oldest was sleeping an 8-hour stretch by 8 weeks old, and my middle was sleeping 10 hours by 10 weeks. My youngest was born very small after fetal growth restriction so she didn't sleep through the night until 4 months old. In every case, there was minimal to no crying. Want to get your newest member of the family sleeping longer stretches at night? You've come to the right place. Book a complimentary sleep consultation today and find out how you can have a well-rested family in two weeks or less, guaranteed.
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"Before working with Abby, my three-year-old nursed. All. Night Long.
It was affecting both of our sleep, and also negatively impacting his teeth. I worked with Abby to create a really clear plan to wean my son off nursing at night. She took the time to really hear my goals and understand our relationship. She understood my priorities. She gave me guidance on how to gently prepare him for the transition so that he felt like a participant in the transition. He understood the change that was coming so that he could get on board and be excited. I had been dreading the transition for months and months, and had been wanting to make the change for a year... but avoiding it because I just didn't know how. Within one night, we made the transition and it changed everything for us. I'm getting better sleep, Jude's getting better sleep, and his teeth are healthier. Abby's way of working with people is incredibly nurturing, customized, and effective." "Happy Saturday! We talked about the plan all week long, leading up to Friday night. Then last night, we spent the evening coloring our “plan”. I could see him integrating and really absorbing it all. Then we went to bed...not a peep, or a cry, no attempt to nurse. I had no idea it could be that easy. I can’t believe I’ve waiting so long thinking it would be brutal. Your help was essential!!!! Thank you!" "I Know It's Time to Night Wean My Three Year Old But I'm Scared of Losing Our Connection."2/1/2021 My beautiful friend Kris asked for advice on weaning her three year old. In three years, they’ve only spent one night apart. Every other night, he’s nursed throughout the night. (In their one night apart, he woke up only once, for 30 minutes, and then went back to sleep!)
“It’s hard to stop,” she says, “because it’s a really primal connection.” But, she adds, “I know we need to stop. For my health -- I don’t do well when I’m not sleeping well -- as well as his. He’s definitely having dental issues.” Here’s what we discussed:
I'm here to help. Schedule a free consult and see if support might make the process easier for you, too. I conceived both of my children on my own, with an anonymous sperm donor. So that meant there was no eager partner offering to help at night... and no tired partner grudgingly willing to help, either. My mother helped with my first during daytime hours, but she was totally off duty at night. And so with my first baby at night, I did it all. Despite being weak from a postpartum hemorrhage, I roused myself with each cry. I changed the diapers, nursed the baby, and soothed her back to sleep. Luckily for me, she was mostly a good sleeper and usually went back to sleep after a feeding. That doesn't mean I wasn't occasionally in tears from fatigue. In hindsight, I can see I made a mistake. I should have gotten nighttime help. I was beyond exhausted. Some days, emptying the dishwasher was an insurmountable task. Luckily we were staying with my mother -- I was too weak to take care of us at home -- so she cooked and washed dishes and changed diapers and burped the baby. And by the time we returned home, I was more or less okay. But still. I would have enjoyed those early days a lot more if I had had some nighttime help. Even once or twice, for a few hours, would have made a huge difference. With my second, my mom was gone. I had no family member offering to pitch in. I had great friends but they were busy with their own young children. And I had a three-year-old who needed me, too. A three-year-old that tended to burst into my room at 6 am, ready to start the day. Whether or not I had been up half the night with my colicky second-born or not. Let's just say I was not a great mother to my older child in those early days. It was miserable. For all of us. Finally, I realized that I needed help. Through the grapevine, I learned of a baby "nurse" (not actually a registered nurse) in the neighborhood. Laurel ran a local daycare and a friend recommended her highly. Sold. Laurel came one night at 10 pm. I felt all kinds of wrong, handing my newborn over to a stranger. Leaving them alone in my living room and going to my bedroom to pump and then go to sleep (with my white noise machine on high) was surreal. But I did it anyway. Albeit nervously. I sent an alarm to wake up and pump four hours later. Four hours after that, Laurel crept into my bedroom and eased the baby into the bassinet and quietly departed. It felt so good that I had her come back the next night to do it again. I was stressed about the money but it was amazing to feel semi-human again. After two nights of help, I could imagine a world in which I actually enjoyed having two children. I started to think my older child was kind of cute, after all. From then on, Laurel came every few nights. I continued to worry about spending so much money while on maternity leave but I just couldn't see a way to survive without her. My breastmilk supply was fine with pumping at bedtime and again once during the night. My little one was not any worse at nursing for taking the occasional bottle (she never had a great latch in the early weeks -- despite visiting a lactation specialist, her mouth was just too small -- but she didn't get worse). And then at five weeks, everything shifted. Amelie's tummy troubles eased. The long hours of newborn fussing lessened. She started to sleep a longer stretch at night. And it was clear I didn't need help anymore. I gratefully bid Laurel a fond farewell... and started to recommend her to my friends. In hindsight, I wish I had had her come more often. I was scared that I would need her for a long time, but it turned out that the newborn period of mixed up days and nights, plus colic, didn't last long. Most babies start to sleep a longer stretch at night by about six weeks from the due date, though some don't start to recover from colic until about 4 months of age. I wish I could go back and tell myself that even with my firstborn, it would have been a great idea to get paid (or not) help. It would have been okay to ask for a baby gift of contributing to a night nanny instead of unecessary baby clothes. And so I want to tell all of you that there is no shame in accepting nighttime help, or even asking for it. When people ask how they can help, say, "would you be willing to do an evening shift with the baby?" It's not too much to ask a friend or family member to watch the baby from 8 pm for a few hours so you can go to sleep and get a few uninterrupted hours. Even just three or four hours of unbroken sleep when you aren't straining to listen for a newborn cry can be amazingly restorative. There's a myth in our culture that moms have to do it all. And effortlessly fit back into our pre-pregnancy jeans by six weeks postpartum, to boot. This is a disservice to new families everywhere. The newborn period is incredibly hard (for many, not all). I promise, it will get easier. In the meantime, accept all the help you can. When someone says, "Let me know if you need anything," say "yes, actually, would you be willing to watch the baby while I sleep?" The worst they can say is no. But most people relish the opportunity to cuddle a newborn. And truly want to contribute. Pay someone if you need to. It doesn't mean you are a bad mother (or father). It doesn't mean you didn't want to become a parent. It doesn't mean you are lazy, or weak, or unloving. Getting better sleep will make a better, more loving parent. And your newborn is most likely happy with any warm body. It doesn't have to be you in the early days (except for breastfeeding, of course). Take advantage of this and get yourself some sleep. And hopefully it goes without saying but please don't bake or clean or even shower to prepare for these helpers. They are there to help you. Focus on your own needs. Take the best care of you that you can so that later, you can take care of your new little family member. Massive sleep deprivation is not good for breast milk production, family bonding, or postpartum blues and depression. You are doing your whole family a favor by accepting help. Motherhood is a long game. You are not going to make or break it as a parent in the first few weeks. Do yourself a favor and build up your strength so that you have more to give in later weeks when the offers of help dry up. And rest assured, there are things you can do to make things easier in the early days, even when you don't have help. My number one suggestion is always to keep wakeful intervals very short for newborns. I aim for about 45 minutes awake, or the first yawn, whichever comes first. Preventing overtiredness will make it much easier for your newborn to go back to sleep, whether during the day or at night. Beyond that, use Dr. Harvey Karp's 5 S's to help soothe your little one and get her sleeping: sucking (pacifiers worked great for both my children and didn't affect breastfeeding... the latest research supports this), shushing (white noise or even the oven exhaust fan works great), swaddling (even if she seems to hate it at first), swinging (in your arms or in a stroller or baby swing), and sidelying (only while being supervised). If you need more support -- and remember, there's no shame in that! -- let's set up a free chat and see if we can't get you and your little one sleeping better. Ah, the sweetness of snuggling your little baby against you in the dark to breastfeed or bottle feed as she drifts off to sleep. There's nothing quite like it.
But as your baby (or toddler) gets bigger and heavier and continues to want those snuggles and nighttime feedings, your arms and your sleep-deprived brain may no longer appreciate those moments quite so much. Does this sound like you? Do you feel guilty about wishing you could get more uninterrupted sleep? The guilt is normal. And so is the need for better sleep. Rest assured, your baby needs better sleep, too, once she is out of the newborn period. For the first six weeks, most pediatric providers recommend your baby have unlimited access to breastmilk or formula. I would add that even in those first weeks, if your baby has recently eaten (less than 90 minutes prior) and you are confident that he had a good feeding -- drank several ounces from the bottle or your breasts are noticeably more empty -- you don't need to offer food again right away if your baby begins to fuss. In that scenario, he is probably tired, not hungry. Try putting him to sleep with other comforts, such as a pacifier, rocking, walking (in the stroller or baby carrier or your arms), white noise, swaddling, or even just laying him in his bed and gently patting and shushing him. It's not too early to teach him self-soothing. It may actually make future sleep training uneccesary! If he is unable to put himself to sleep without nursing or bottle feeding, that's fine. Keep trying, at least once a day. He'll get it eventually. After about six weeks adjusted age (from the due date), you can expect that your baby will begin to have a longer stretch of sleep. It usually starts as about a 4-6 hours stretch and is usually at the beginning of the night. Her bedtime will move earlier around the same time. I encourage you to go to bed when she does, to make the most of that longer stretch. After that one longer stretch, she will likely wake every few hours to eat. By 4 months old, you can expect 0-2 feedings per night. If you are enjoying feeding your baby at night, that's great, no need to change anything! If you want to start cutting back on feedings, that's fine too. I recommend a gentle approach of gradually reducing the feeding volume or time (if breastfeeding) at the earlier feeding first. Only start to eliminate the later feeding when the first one has successfully been eliminated. Once a feeding has been eliminated, try not to offer a feeding at that time again. Try other methods of soothing first. Of course you'll want to confirm with your pediatric healthcare provider before beginning night weaning. By 9 months old, your baby no longer needs a feeding at night (assuming your healthcare provider doesn't have a concern about her weight). But if you and she are both enjoying a night feeding, there's no reason you need to eliminate it quite yet. I do, however, encourage you to put her down awake at bedtime, at least. If she always nurses or bottle feeds to sleep, she won't know how to put herself back to sleep alone and will need your help every time she wakes up. It's normal for people of all ages to wake momentarily between sleep cyles -- we do this too, but it's so brief we don't remember it -- and we want her to know how to go back to sleep when this happens. After about a year of age, I recommend that parents night-wean because of the risk of cavities when a toddler has milk on his teeth during the night. Seeing a two-year-old get multiple fillings in his teeth would be traumatizing for any parent. I think it's easier to save the nursing or the bottle for the morning. It's fine to offer a sip of water if your baby wakes up during the night, though. Please also make sure you don't put your baby in the crib with a bottle of milk as this is a risk for cavities, too, as well as a risk for ear infections. It's wonderful to continue nursing or having a cup or bottle of milk at bedtime after the first birthday, though! Just make sure to brush those tiny teeth before bed. By this age, I recommend you incorporate a story and a song, or some other consistent screen-free ritual, to help your child learn to anticipate bedtime. By doing the same thing every night, your child is able to prepare for the upcoming separation from you and is less anxious. (Some separation anxiety at this age is normal but when we do things like this, we lessen it.) If your child is past one and is still bottle or breast feeding to sleep, don't panic. Just work on moving the feeding earlier in the evening and putting your baby in bed awake. It's normal for little ones to protest a change like this in the routine. Parents often worry about their little ones crying at a time like this. But it's perfectly natural for her to dislike the change... and it is very healthy for her to express her feelings. An important part of parenting is sympathetically supporting children while they express their feelings about our consistent boundaries. Just like insisting on car seats and tooth brushing, sometimes we do things that children don't like. It's part of being a parent. Our children will not be traumatized by loving, clear limits. And the good news is that if you are consistent, your child will quickly adjust to the new routine and her protests will end. It's when we are inconsistent that things are much more confusing and challenging for children. Night weaning sounds simple but the emotional aspect of it can be challenging for parents. I am here to help. Set up a free consultation and look forward to great sleep for the entire family. |
AuthorAbby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and certified life coach for parents. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico. Archives
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