To us mothers, we have been told a thousand times that breastfeeding should be done on demand. What does that mean? That every time the baby wants to breastfeed or seems they will want to, the baby must be given access to the breast to nurse for the length of time and as often as they need. With no limit.  

The expectations of the demand that we have before becming mothers differs greatly from the reality we find afterwards. Once the baby is in our arms we find out the demand is greater than what we imagined. And of course that the neighbor’s baby sleeps better, eats less frequently, gets full quicker and gains weight at a better pace than your baby. The baby’s demand may be very high, moderate or sometimes exasperating.

Some mothers, especially during certain phases of lactation, should respond to a high demand from the baby day or night. It can be exhausting.

Let us attempt to respond to some doubts on the subjects and see if we can help these mothers a bit that find themselves in this situation:

 

Why should breastfeeding be done on demand?

 

The bottle feeding culture has made schedules part of lactation. With the formula from a few years back it made sense for babies to drink a specified amount at certain times since that milk was difficult to digest and would be very heavy in the stomachs of babies.

Doctors would prescribe formula in reference to amount of milk and time between bottles.

The mammary gland should synchronize with the needs of the baby in response to their demand. This way the gears start turning, the baby is capable of regulating the nourishment they need and the gland responds to that greater need to feed or if not, diminishes production.

Any interference affects production and the baby that cannot regulate the amount of milk they need.

It is true that there are babies that learn to manage schedules and breastfeeding that way could work but most of the time it does not and lactation ends prematurely.  

Is an increase in demand what they call a “lactation crisis”?

Some crisis or ruts in growth go hand in hand with an increase in demand, other times it does not. When we talk about a crisis we refer to a temporary period during which babies appear to be hungrier or with a greater need of nursing.  

Other increases in demand exist that are non related to a crisis. A baby could want the breast when they are not feeling well, are nervous, or they feel something different is happening from what they are used to day to day. Through that increase in demand we understand that any situation that causes the baby to nurse more breaks the frequency you’ve already become accustomed to.

Is breastfeeding always on demand?

Not always. In general, it should be. The exceptions depend on the situation, cases when the mother should offer the breast to the baby.

These cases present themselves when the baby does not increase in weight, is premature or is sick. Under these circumstances it is important for the mother to monitor the demand and if the baby is not able to nurse, to give supplemental milk.

What if the opposite occurs? If my baby does not demand enough, what can I do?

There are babies we lovingly call “Sleeping Beauties” and are babies that only sleep and do not eat. In these cases, it is necessary to use a clock. It has been said that the clock is lactations worst enemy but under these circumstances the clock may become your best friend.

A baby that does not nurse and that sleeps too much is a baby that does not gain weight, or in fact, may lose weight.

Maintaining control over the feedings until the baby gains weight and is able to request to nurse is essential. Once the birth weight is achieved once again or is capable of waking up and asking to nurse, the clock will then be unnecessary.   

What could be a reason for an increase in demand?

When a baby breaks their routine and habitual rhythm, it tends to surprise us. It is a situation that does not happen inadvertently because all of a sudden the baby seems to be stuck on the breast.

With babies younger than 15 days old, the first thing to consider is adequate weight gain. Many babies nurse a lot but do not drink enough and incessantly continue to ask to nurse; they put their hands in their mouths and never seem satisfied.   

If the weight is all right or the child is older it can be considered a dip in growth and review other factors that characterize a crisis.

Secondly, check if the baby may not be feeling well: congestion, pain, digestive problems, etc. To confirm any of these it is important to take your baby to be seen by a pediatrician.

If nothing can be found that explains the increase in demand, review the baby’s day-to-day schedule. There may be something causing them anxiety or making them nervous such as starting daycare, being separated from you because you began working again, a change in habits, etc.

Is there a level of demand considered  “normal”?

The increase in demand that disrupts the usual feedings and at the times you have the feeling that you do nothing but breastfeed, can both be normal if they coincide with the times highlighted in the last question (lactation crisis). But never if the baby is attached to the breast constantly but does not gain weight adequately.

When faced with any situation you don’t feel is normal, do not hesitate in seeking out help from a breastfeeding support group or oyur pediatrician to evaluate the baby.

Ideas to handle the situation a bit better…

Patience, knowledge on what is happening and support.

Patience because you will be doing nothing but breastfeeding.

Knowledge: to understand what is happening, be sure that it will eventually end and that you are helping your baby to overcome a bad time.

Support: so your partner and family members can take care of you and therefore you can take care of your baby.