Night sleeps longer than five hours

What are the risks of a baby sleeping more than five hours?

When a baby sleeps for more than five hours at night, the mother’s breasts become full. This may be fine for mothers whose breasts have a large storage capacity, but others can find their breasts overfull and their nipples becoming tender. Over time, the lack of regular milk removal can result in a reduced milk supply and poor growth in the baby. Some mothers will also notice their periods back within two months of the long night sleeps starting. These babies need to be woken by five hours or if the baby will not breastfeed at night, the mother needs to express her breasts. If a newborn baby is very sleepy and feeding less than seven times in one day, the baby may be underfed and may urgently need to be given extra milk.

A) Describing long night sleeps

Sometimes during the first year after birth, breastfeeding babies sleep longer than five hours in one stretch at night (long night sleep). This may be fine; their mothers may be able to handle the longer sleeps because their breasts have a large storage capacity and can tolerate being fuller. For other mothers and babies, however, this can cause short- and long-term problems.

C) Problems caused by long night sleeps

Long night sleeps in the first two weeks after a baby's birth may be a sign of an underfed or starving newborn who urgently needs to be supplemented with milk.

During the first year after birth, long night sleeps can result in infrequent and poor emptying of the breast which can cause a number of painful problems for the mother and poor growth in the baby.

Long night sleeps also increase the risk of a mother’s periods returning early which can further decrease milk supply and result in a pregnancy.

In our clinic, we regularly see babies growing slowly and mothers struggling with the above problems. The following is a typical pattern:

  1. The baby starts sleeping through the night at two to three months.
  2. The mother immediately notices very full breasts in the morning but this settles in the following weeks.
  3. The baby's weight gain slows within six weeks of the long night sleeps starting.
  4. The mother's periods return within two months of the long night sleeps starting.

D) Solving the problems caused by long night sleeps

Solving problems caused by long night sleeps may include regular milk removal and increasing the baby's milk intake.

1) Regular milk removal

These babies need to be woken to breastfeed by five hours. If the baby will not breastfeed by five hours, such mothers need to express instead. Emptying the breasts by five hours will both maintain or increase the milk supply and keep the breasts from becoming overfull and painful. Any expressed milk can be given to the baby if supplements are needed.

2) Feeding the baby

If the baby is gaining poorly and waking the baby at night does not result in good weight gain within one week, milk supplements should be started and mothers should consider taking more steps to increase their milk supply. Supplements may need to be started immediately if the baby has been gaining very poorly or shows other signs of being very underfed.

Many mothers in this situation will return to a full milk supply within one month and the supplements can be stopped. Occasionally the milk supply is permanently reduced and they will need to continue supplementing their baby for the duration of breastfeeding.