Breastfeeding and Sleep Training: What You Need To Know
As parents we want the best of both worlds. Children who have leadership skills, but listen and obey quickly. Kids who have fun while keeping their white shirts spotless.
And when we have new babies, we want to breastfeed, because the benefits are well known, but we also want our sleep!
What’s a conscientious parent to do?
Often parents try to both sleep train and breastfeed. It seems like a win-win, right? A baby who gets the gift of breast milk and parents who get the gift of a solid 8 hours at night?
If only parenting was so simple.
In truth, sleep training isn’t biologically normal for any infant, no matter how they are fed.
What is sleep training?
Simply put, sleep training entails helping a baby sleep through the night for long periods, early in their life-span. There are a variety of experts with various methods of sleep training babies. Many include some version of cry-it-out where a baby is left to cry themselves to sleep with limited or no caregiver contact. Sleep training also typically avoids any "crutches" that baby may become reliant upon for sleep.
Sounds simple enough and pretty heavenly for both parents and baby to get enough sleep. After all, we all NEED sleep.
Sadly, these programs don't often understand normal infant development or the needs of the breastfeeding mother.
What is normal sleep for a newborn?
While newborns are sensitive to light, sound, and touch, their brains are very immature and need lots of time to develop normally and grow quickly. This rapid growth, combined with a small stomach, make frequent feedings, every few hours or so, a necessity.
Breast milk is the optimal and biologically normal food for a human infant; it digests quickly and must be replenished often so babies usually eat every 2-3 hours throughout the day and night.
Infant sleep patterns are very different than those of adults. They will spend about half of their sleep in REM (rapid eye movement sleep where dreaming and less deep sleep occur) making their sleep more wakeful than an adult, even though they sleep more hours per day.
These frequent periods of wakefulness may be protective for infants in many ways and are more than just an annoyance.
Frequent waking can protect the infant by:
- Helping prevent SIDS, sudden infant death syndrome.
- Ensuring that their care provider is kept close.
- Keeping the baby fed frequently throughout the night to ensure proper growth.
- Increasing breast milk supply, a need for survival, especially when artificial milks are not available, are inferior, or are unsafe.
Sleep trainers, rather than seeing that infant sleep is very different (purposefully so) from adult sleep, seek to adjust the biologically normal infant sleep to fit that which is normal for human adults.
How can sleep training harm the breastfeeding relationship?
Breastfeeding is an incredibly complex process that is still not fully understood by scientists. This online resource has a great breakdown on how breastfeeding works.
- In the very beginning, lactation is driven by hormone changes, so when you give birth, you produce milk, even if you aren't planning on breastfeeding.
- The hormone prolactin must be present for milk to be produced. When milk is emptied from the breast, it increases prolactin levels.
- This means that the more you nurse, the more you produce; it's a basic supply and demand relationship.
- Women have different storage capacities in their breasts, so some women can go longer periods of time between feedings and still maintain a good supply, but some cannot.
When we put all this information together, it becomes clear why sleep training can have a negative impact on breastfeeding and adequate milk supply. If you don’t breastfeed for long periods of time, even at (or especially) at night, your milk supply can be diminished, sometimes a lot.
Sleep training by its very design prevents frequent breastfeeding for a large part of every 24 hour period.
“Bad” baby habits
One major tenant of baby training is that we must strictly avoid allowing “bad” habits for the baby. These “bad” habits can include many things, but specifically discourage sleeping at the breast.
Many adults use sound, a comforting embrace, human contact, reading, and even medications in order to fall asleep. While we are perfectly comfortable with these behaviors in adults, we have higher expectations for our babies.
Mellanie Sheppard, IBCLC, offers sound insights.
“It is normal for babies to fall asleep at the breast. Trying to train them not to "rely on breastfeeding," especially in the early months, makes absolutely no sense. Especially if they are being trained to rely on tight swaddling, swinging, rock-n-plays, etc., which can cause problems such as plagiocephaly (flat head) and other body structure issues because they are not able to move around normally.”
Not only can the methods used to encourage sleep without breastfeeding used by sleep trainers harm the breastfeeding relationship, they can cause physical harm to the infant. Sleeping at the breast isn't something to be avoided, it's normal.
But they’re still getting breast milk!
Breastfeeding is about so much more than food. The idea that breastfeeding is simply about fulfilling a nutritional quota is also a misunderstanding. Just as human adults eat to satisfy human needs like companionship, community, family togetherness, and socialization; human infants also feed for far more than simple calories.
Let’s consider what other things a baby may get from breastfeeding besides breast milk.
Our resident IBCLC (International Board Certified Lactation Consultant), Mellanie Sheppard, puts it like this;
“From a breastfeeding perspective, most sleep training or scheduling "programs", i.e. Baby whisperer, Baby Wise, etc., really miss the point that breastfeeding is about relationship. Babies do not nurse simply for food, they nurse for comfort, for pain relief, for reassurance, to block out stimulation from the environment, to help poop, and many, many more reasons. They imply that nursing for any reason other than food is a bad habit to be broken. That could not be farther from the truth. All of these "extra" nursing sessions serve to keep prolactin levels high, which in turn creates more prolactin receptors in the breast. If there are not enough prolactin receptors in the breast, then milk supply will drop at around 3-4 months, when prolactin levels naturally fall.”
While it is true that sleep trained babies can still be breastfed, it can also profoundly and negatively impact milk production. In addition, sleep trainers forget that babies are humans, and humans have needs beyond calories.
What CAN you do to optimize sleep with an infant?
We know that sleep training isn’t ideal and can sabotage the breastfeeding relationship. Yet we still live in a 9 to 5 world where we are expected to be fresh, functional, and intelligent, 40 hours a week.
There ARE still things you can do to optimize sleep with even a very young baby.
- Have a routine. This can help baby settle into a loose schedule. Babies often do this naturally if we facilitate it.
- Use movement, baby wearing, bouncing, and other things that simulate the womb. These are age-old and effective.
- Sleep when your baby sleeps. This oft-given, but more often ignored, advice is highly useful. Babies sleep a lot- around 18 hours out of 24. They just don’t sleep when we want them to. So, for a brief period of time, try to sleep when they do, even if it seems foreign to you.
- Enlist help. The partner, older children, grandparents, paid care providers, and others can help ease the burden of combining modern life and biologically normal sleep patterns.
- Sleep near your baby or safely co-sleep. Many women report that sleeping near their baby prevents baby from becoming hysterical and very wakeful and also allows mom more sleep. Find tips for safe co-sleeping here.
- This is temporary. As your baby grows, their needs change and sleep stretches at night do increase. This varies from one baby to another, but usually there are longer stretches of around six months and sleep comparable to adult sleep patterns by around two years. Developmental milestones, however, can cause sleep disturbances again as they grow, even for those babies that were formerly sleep trained.
It's true that night-time parenting of newborns can be incredibly difficult and emotionally taxing. Understanding the basic biologically needs of an infant and their purpose; to ensure survival and optimize breastfeeding supply, helps us understand where the constant needs of our babies are coming from.
Our culture is not patient with babies or even familiar with their needs as new humans. Addressing cultural misunderstandings that have lead to frustration over normal infant behavior and an industry of baby sleep training is necessary, both for happier babies and more aware parents.