What is Nursing on Demand and What are the Benefits?

 

Breastfeeding success is often based on social expectations of what is “normal”. These expectations can lead to a loss of confidence and early weaning, especially because they are often unrealistic or unsupported.

Newborns want to eat often and for good reason, their stomachs are only the size of a cherry. They know exactly what they need and when they need it.

Babies are born with the ability to self-regulate their food intake, eating until satiated. In those early days, when it seems like your baby won’t leave your breast, they are working hard to make sure your milk supply is well established. It’s a hard stage to be sure and can leave you feeling discouraged.

Most importantly, I want you to understand that you and your baby are unique and that it’s normal for breastfeeding behaviors to vary. There is a wide range of normal. If you don’t understand the importance of on demand feeding, you may feel frustrated, and this might even put a damper on your nursing journey.

So what does nursing on demand mean? And what are the benefits? I’m going to help break it down so you can feel confident in your abilities.

Ashley McClammy Lactation RN for The Little Milk Bar | breastfeeding Tips 3.png
 


What is Nursing on Demand?

Nursing on demand simply refers to feeding your baby anytime they show hunger cues and feeding until they decide to be done. Feeding on demand is also referred to as baby-led, responsive feeding, and feeding on cue.

Feeding cues can be rooting (moving head side-to-side), smacking/licking lips, bringing hands to mouth, sucking on hands/toys, fidgeting, fussing, and crying.

Remember crying is a late sign of hunger. There’s no need to switch breasts while baby is actively feeding, no need for timers, and no schedules. Nursing on demand is letting your baby, who knows exactly what they are doing, set the rhythm.

This can be tricky because our culture values schedules and timetables. From the moment your little nugget enters the world there’s pressure to be on a schedule. It’s understandable if the idea of nursing on demand seems daunting. Let’s discuss the benefits of nursing on demand so you feel confident and empowered in your decisions.

Photography by April Newman @aprilnewmanphoto

Photography by April Newman @aprilnewmanphoto

The Importance of Nursing on Demand

Milk production is a supply and demand system. The more stimulation and emptying of the breast the more milk you will make. In the newborn phase babies can nurse a lot!

When baby is constantly at your breast stimulating and emptying them, it says to them “Hey, make more milk.” Milk supply studies have shown that more frequent feeding, such as 10 feedings per 24 hours versus 7 feedings per 24 hours, results in a greater milk supply and weight gain in newborns (according to Pediatrics.org). Your baby may eat more or less frequently, but what’s important is following their lead. Trust them and yourself.

Nursing on demand offers additional benefits such as more skin-to-skin opportunities with your newborn. Skin-to-skin contact not only helps regulate baby’s temperature and reduces stress, but also helps increase your milk supply.

During skin-to-skin contact your body releases the “love hormone” oxytocin but also a hormone responsible for stimulating milk production and ejection (according to Retrieved from JOGGN.org). You can rest assured these frequent nursing sessions during the first few postpartum 2 weeks are setting you up for long-term success.

Photography by April Newman @aprilnewmanphoto

Photography by April Newman @aprilnewmanphoto

How to Know If Baby Getting Enough

Often parents are told to primarily use infant fullness cues as an indicator of milk production. These include: relaxed hands, a relaxed baby, falling asleep at your breast, turning their head away, spitting out your nipple, or seeming more interested in surroundings.

When you and baby are first bonding these cues can be hard to interpret and that’s O.K.! Take a look at the number of wet and dirty diapers baby is making. In the early days babies usually have 1 wet and dirty diaper per day of life, so 1 on day 1, 2 on day 2, and so forth.

After your milk comes in, at 3-5 days, you can expect 3-5 wet and soiled diapers a day. Expect the stool to be yellow and loose (Pediatrics.org). Some babies may stool every time they eat. After 6 weeks some breastfed babies may continue to stool every time they eat or go as long as 7-10 days without stooling. This is normal as long as they are gaining weight well.

Speaking of weight, it is normal for them lose up to 7% to 10% in the first week (according to Pediatrics.org). You should expect baby to be back to birth weight in 10-14 days. If baby was premature, lost a good bit of weight in the beginning, or was sick it can take longer.

You may feel pressure from your provider to supplement with formula if baby is not gaining as expected. There is a place for supplementation and absolutely no shame if you need to, and it’s good to know you have options.

It may not be necessary or you may be able to use donor milk. I would encourage you to work with a lactation specialist if you’re concerned about baby’s weight. They can develop a plan, offer you support and reassurance, and track baby’s progress so you feel confident.

Photography by April Newman @aprilnewmanphoto

Photography by April Newman @aprilnewmanphoto

On Demand Isn’t Forever

By 4-6 weeks babies usually start settling into a rhythm. On average, exclusively breastfed babies will nurse 8 times a day, but it can range anywhere from 4-13 breastfeeding sessions a day (onlinelibrary.wiley.com). I always tell parents if you feel it’s working, it is, and there's only a problem if you feel 5 there is.

You are the expert on your baby. Having a newborn is hard. Nursing on demand is just that, demanding. The most important factor in the early days is your health and mental well-being. I’m going to ask you to forgive yourself. If nursing on demand becomes too much, it’s O.K. to have someone feed baby a bottle of expressed milk.

You may be asking yourself, “Wait! What about nipple confusion?” Here’s the thing, scientific data is lacking in documenting the “prevalence and the mechanisms involved, or various factors that predispose an infant to the phenomenon” of nipple confusion (The Journal of Pediatrics). Many lactation specialists and providers are adamantly against introducing a bottle before 6 weeks “however, the notion that offering a single bottle is likely to result in breastfeeding failure runs contrary to experience” (The Journal of Pediatrics).

I want to be clear, I am not advocating for frequent bottle feeding before 6 weeks, (unless you want). What I am advocating for is you, your mental health and wellbeing. If you need sleep or just a break, you DESERVE it.

Please hear this, you get to enjoy breastfeeding. That’s right. Let’s focus on longevity and enjoyment rather than exclusivity. It’s important to keep your supply up and pump/express often, but don’t deny yourself 2-3 hours of sleep. If you’re uncomfortable bottle feeding so early, cup feeding is a great alternative.

Bottle and Formula Feeding

If you are unable or choose not to breastfeed, you can still practice nursing on demand. Pay attention to your baby’s cues as discussed above. Offer baby small and frequent feedings.

From 1-6 months of age exclusively breastfed babies need on average 25 oz a day, typical range 19-30 oz/day (Pediatrics.org). In the first few weeks, formula fed babies will take 2-3 oz a feed every few hours and 8 increase as they grow.

A good rule of thumb is 2.5 oz of formula per pound of body weight. Try to resist the urge to get baby to finish the bottle if they aren’t interested.

Listening to your baby and allowing them to set the time and regulate their intake will help baby stay in tune with their natural satiety signals. There are many reasons that you may choose to pump or formula feed. Know that you deserve to feel supported in your choices.

When will it end?

Nursing on demand isn’t always going to be as demanding as the early days. Your baby will slowly fall into their own pattern. Remember, in the first few weeks it is normal for baby to nurse 8-12 times a day.

You cannot nurse too often. Know that breastfeeding is so much more than just milk. It’s comfort, reassurance, and closeness. Just because baby is at your breast frequently doesn’t mean you have a supply issue or a fussy baby.

If you find yourself frustrated or feel something is off don’t hesitate to reach out to a lactation specialist for help. It’s tempting to use Google, but a lactation specialist will take your and your baby’s personal and medical history into consideration because context matters.

You know your baby better than anyone. Trust yourself and trust your baby.