Breastfeeding to sleep

Why does my baby need to breastfeed to sleep?

Breastfeeding a baby to sleep is often the quickest way to get a baby to sleep, generally more effective and safer than a pacifier, and faster than rocking, holding, and singing. Breastfeeding a baby to sleep also reduces crying. During the first month, babies are often asleep after breastfeeding. After the first month, breastfeeding is often followed by a period of wakefulness, but a little while after that, babies will rub their eyes, look sleepy, or indicate that they want to breastfeed to sleep. Five minutes of breastfeeding usually puts them to sleep. Mothers who need to give the baby extra milk after breastfeeding can breastfeed the baby to sleep after the extra milk. One common issue is that babies will fall asleep at the breast but then wake when they are put down. Mothers can try to prevent the baby from waking by wearing the baby in a wrap during the day and sleeping with the baby nearby at night.

A) Describing breastfeeding to sleep

Breastfeeding babies may be asleep at the end of a normal breastfeeding session or may use breastfeeding as a way to get to sleep when tired. The ability of the breast to induce sleep probably results from a mix of neurological and hormonal factors present when breastfeeding including:

  • Providing warm breast milk and settling hunger
  • Providing nutrients that cause relaxation (Gaitán 2018)
  • Providing nutrients that can train the baby's internal clock (chrononutrition)
  • Returning the baby to a safe, warm, and familiar environment

Breastfeeding a baby to sleep is generally more effective, quicker, and safer than using a pacifier and quicker than rocking, holding, and singing. Breastfeeding to sleep reduces infant crying (Douglas 2015).

Breastfeeding a baby to sleep is normal for all mammals and not a way of spoiling the baby.

B) The newborn

Newborn babies are usually asleep at the end of the feed. No baby, including newborns, should be woken up to burp.

C) After the first few weeks

Once a baby is a few weeks old, they are increasingly awake after breastfeeding. Once they are tired, they will ask to breastfeed to sleep. Here is a typical pattern:

  1. The mother starts a feed on one breast.
  2. The baby is still hungry after the first breast and the mother offers the second.
  3. The baby is contented and awake for a little while if held.
  4. After a little while, when the baby is tired, the baby may:
    • Rub the eyes.
    • Look drowsy.
    • Give mild hunger signs indicating they want to breastfeed to sleep.
  5. The mother offers the first breast.
  6. The baby is asleep in 5 – 10 minutes.

Some babies are not hungry after the first side. They are happy to be held and will not take the second side. Once they need to breastfeed to sleep, they should be offered the second side.

Babies and older children will ask to breastfeed to sleep for as long as they are breastfeeding; it is a normal human behaviour.

D) Other situations

1) A large milk supply

Babies may have difficulty breastfeeding to sleep when their mothers have a large milk supply.

2) A low milk supply

Mothers who are breastfeeding with a low milk supply will offer both breasts at one feed and will then supplement their babies with extra milk. The baby can be breastfeed to sleep after the supplement. This is called the third breast.

3) A baby who is not breastfeeding

For babies who are not breastfeeding, ways of settling babies include:

  • Rocking and holding
  • Walking with the baby
  • Singing to the baby
  • Pacifier use
  • Lying down near the baby

E) The down-up sleep cycle

In our clinic, we regularly meet mothers and babies who are stuck in a cycle in which the baby falls asleep after breastfeeding but wakes upon being placed down.

It looks like this:

  1. The baby breastfeeds to sleep.
  2. The mother places the baby down.
  3. The baby wakes and cries because it is not being held and is afraid.
  4. The mother picks the baby up to calm it.
  5. Once calm, the baby is ready to sleep again and asks to breastfeed to sleep.
  6. The mother breastfeeds the baby to sleep.
  7. The mother places the baby down.
  8. The baby wakes, and so on.

Babies need to breastfeed to sleep and they need to be held. This cycle is normal.

Some mothers mistakenly assume the baby is waking from hunger because there isn’t enough breast milk, the baby has reflux or some other illness, or is spoilt. Rather, it’s because the baby does not feel secure and is afraid when not being held. While frustrating, it is important to understand that it is normal.

Most mothers will find a solution to this issue or the baby just grows out of this pattern. To prevent the baby from waking, mothers can keep the baby close by wearing the baby in a wrap during the day and sleeping with the baby nearby at night.

References

Douglas PS, Miller Y, Bucetti A, et al. Preliminary evaluation of a primary care intervention for cry-fuss behaviours in the first 3-4 months of life ('The Possums Approach'): effects on cry-fuss behaviours and maternal mood. Aust J Prim Health. 2015;21(1):38-45
 
Gaitán AV, Wood JT, Zhang F, et al. Endocannabinoid Metabolome Characterization of Transitional and Mature Human Milk. Nutrients. 2018 Sep 12;10(9). pii: E1294