“I put her to the breast, she is awake and eager to feed. She starts to suckle, but after two minutes or so she falls asleep. And no matter what I do, she stays asleep. What can I do to stop her from falling asleep at the breast?”

All babies, up to about three months of age, seem to “fall asleep” within a few minutes of starting to nurse at the breast. This surprises most new mothers, and in addition, often outdated healthcare staff encourages them to practice all kinds of “tricks” to keep babies sucking: tickling the feet, tickling the back, or putting some water on the face. Babies usually keep feeding, but these “tricks” are uncomfortable for them, and some babies stop feeding when they are angry and fed up with being bothered. So here we explore the question: do I need to keep my baby awake at the breast?

But what should I do when my baby falls asleep?

A good option is to let them sleep. Babies with closed eyes but latched onto the breast are not asleep; they are just in pause mode and are still feeding. When a baby really sleeps, they let go of the breast.

Do they really keep feeding?

For a baby, breastfeeding is something that requires effort and time. Unfortunately, the legacy of outdated advice like feeding 10 minutes at each breast still lingers, and some people still assume if babies stay any longer at the breast, they don’t get any more milk. However, forcing such a small baby to suckle in 10 minutes (or however limited time) is a mistake that prevents babies from getting the feed they need. To understand why it takes a small baby so long to complete a feed, we must understand what happens during the feed.

So what happens?

When a baby starts suckling rapidly, it stimulates the milk ejection reflex (or let down), which causes milk to be released from the inside of the breast into the ducts and from there to the nipple. This first stimulation is achieved within a few minutes, and then babies start suckling and actively swallowing milk for 2 to 3 minutes.

Then, at this point, they usually begin to relax and close their eyes. And so the sucking becomes slower and more spaced out: babies make short sucks and accumulate small amounts of milk in their mouths.

When a certain amount of breastmilk is collected in their mouth, they swallow. They can stay in this slow feeding mode for much longer than in the previous one until they change the way they feed again and produce a new milk letdown, and then the whole process starts all over again.

So don’t they feed all the time at the breast?

During a complete feeding cycle, which in the first few weeks can last for as long as one hour, a baby spends the majority of time not actively eating. They need time to rest. As they grow, they learn, and the feeding cycles become shorter and faster. Until they are about three months old, they will spend a lot of time feeding, and from that point on, they will become experts and will be able to do so in a very short time, sometimes even in minutes.

So I don’t need to do anything if my baby doesn’t actively suckle at the breast?

Whether a baby is gaining weight or not, there is no need to disturb them during the feed at the breast. Being tickled while eating can be the most uncomfortable thing in the world, and many babies stop eating altogether and fall asleep tired of being disturbed.

What if my baby doesn’t put on weight or does so slowly?

In this case, it’s necessary to help your baby, but without disturbing them. When a baby has difficulties suckling or does not manage to extract all the breast milk they need, we can help them by performing breast compressions. Imagine that your breast is like a sandwich of 4 layers that you hold between your hands and squeeze so it fits into your mouth. This is the same movement you make with your hands on your breast while your baby is latched on. When your baby does not swallow and pauses, you squeeze your breast and hold the pressure until the baby stops swallowing. When the baby stops swallowing, you try to find another place of pressure on your breast and perform the same technique. And so on, until your baby doesn’t swallow anymore, no matter how hard you squeeze. You can find more information about the breast compression technique in this article.

Active breast compressions help babies much more than any annoying tickles on their back or feet.

Falling asleep at the breast doesn’t have to be avoided; it is part of breastfeeding, and trying to avoid it is like trying to prevent babies from growing.