Scheduling the baby's feeds

Should I schedule my baby’s feeds?

Most babies should not be fed on a schedule. Rather, they should be fed when they show hunger signs. Like adults, they don’t always want to eat at a set time. An arbitrary schedule can make the baby upset and cause problems such as poor growth or obesity. The mother can develop painful nipples and breasts. Schedules are only needed if the babies are unable to breastfeed normally such as those who are weak newborns or are born very prematurely. Babies who sleep more than five hours may need to be woken to feed.

A) Why mothers are told to breastfeed on a schedule

In the late 1800s, health-care providers advised mothers to breastfeed on a rigid schedule. This advice was never supported by research and was dangerous. The transition to a more child-centered approach began in the 1940s with the publication of Dr. Benjamin Spock’s book, The Common Sense Book of Baby and Child Care (Spock 1946).

If your baby is healthy, can give hunger signs, and breastfeeds effectively, you do not need to schedule your baby’s feeds. 

B) Risks of breastfeeding schedules

Just as adults do not always want to eat lunch exactly at the noon hour, babies become hungry at different times. Healthy full-term babies will tell you when they are hungry and when they are not. How often they want to feed varies from day to day and between babies.

Scheduling a baby’s feeds may increase the risk of early weaning (Brown 2014; Miranda 2020) and obesity (Mihrshahi 2011).

Arbitrary schedules can cause an upset baby, as they are:

Abitrary schedules can prevent adequate milk removal from the breast. This can cause: 

C) When scheduling feeds is appropriate

Normal babies should be fed when they give hunger signs.

The only exception is babies who are not breastfeeding effectively and need extra support. These may be:

Babies who sleep more than five hours at night may need to be woken to feed.

References

Brown A, Arnott B. Breastfeeding duration and early parenting behaviour: the importance of an infant-led, responsive style. PLoS One. 2014 Feb 12;9(2):e83893
 
Mihrshahi S, Battistutta D, Magarey A, et al. Determinants of rapid weight gain during infancy: baseline results from the NOURISH randomised controlled trial. BMC Pediatr. 2011 Nov 7;11:99

Miranda C, Sousa TM, Carmo ASD, et al. Use of Artificial Nipples Among Brazilian Infants and Associated Factors. J Trop Pediatr. 2020 Feb 12:fmaa007

Spock B. The Common Sense Book of Baby and Child Care. New York: Duell, Sloan, and Pearce; 1946