The sleep regression
I hear the phrase ‘my baby has a sleep regression’ mentioned a lot and I’m going to explore this little hot potato. Breastfeeding your baby to sleep after 4-months of age is the most likely culprit. As a midwife, I totally support breastfeeding. The thing I have a big issue with is when mums are told by other midwives and nurses, ‘Feed your baby to sleep, it won’t do any harm’. In the short term, under 4-months of age, this is true, it won’t. However, long-term past 4-months this is not the truth.
A typical scenario I get asked
“We have a nearly 6 months old who perfectly self-settles for her day naps, including the 7 pm one. Although she usually wakes at least twice before midnight. When for whatever reason she’s not able to resettle without the boob. And then again somewhere around 4ish. She’s on solids, three times a day. Lunch and dinner before her breast milk feed. She wakes in the morning at 630am. Day naps are from 9 to 10am and afternoon nap from 1 to 3pm. Do you have any tips?”
It’s only taken me 30 years of being a midwife to work out the culprit…and I’m taking a detailed look at breastfeeding and nutritive vs. non-nutritive sucking.
My baby could be hungry
Breasts don’t have a volume measure on the outside like a feeding bottle does. A mother’s natural instinct is to breastfeed her baby until satiated and fill their baby full of as much milk as they can. It wouldn’t be natural to do half a breastfeed, would it? And once the little gremlin at the back of your brain starts saying, ‘but what if my baby is hungry?’ ‘have they had enough to drink?’ and ‘they could still be hungry’, your brain and logic start to doubt itself. And this is how the whole feeding to sleep thing starts. You think I’ll just top up my baby, maybe they need a little more…oh they’re still not looking sleepy…maybe they haven’t had enough? Then you read a parenting book or something online saying...feed your baby until they’re milk-drunk or drowsy. You also read…put your baby down to sleep drowsy but awake. So I can see how logic would lead you to feed your baby to sleep. As baby’s get older, usually past 6 weeks it’s really hard to feed till milk drunk or drowsy anyway, this is more of a newborn behaviour. After 6 weeks most babies are really wide awake after a feed.
Put your baby to sleep FULLY-AWAKE
I’d like the books to say instead..put your baby to sleep fully AWAKE. There is no drowsy but awake. A baby is either drowsy or awake, they cannot be both.
Avoiding baby sleep regressions
Drowsy but awake means you are feeding your baby to sleep which is as far away from self-soothing as you can get. Then the 4-month sleep regression is literally tapping you on the shoulder. I’m here to prevent months of sleepless nights for you.
Newborn baby and breastfeeding
In those heady newborn days where you wander through in a haze of night and day and twilight sleep, you can feed to sleep to your heart’s content. Frequent breastfeeding increases supply, especially in those early weeks. The first 6 weeks of breastfeeding are governed by hormonal influences, then supply and demand take over.
When your baby breastfeeds you will notice they do several long sucks that drain the breast and involve the jaw muscles at the side of their face near their ear. We know this sucking as nutritive sucking and active milk transfer occurs. A let-down reflex may or may not be felt after these active nutritive sucks whilst the baby takes a slight break. In this time they are waiting for the pituitary gland to use its feedback mechanism to produce more milk. There may be 10 or more active nutritive sucking episodes whilst the baby is draining the breast of its milk supply. Here is a lovely video demonstrating exactly this activity.
Towards the end of a breastfeed, the baby starts to move to non-nutritive sucking. They have drained the breast of milk and start to comfort suck on the nipple and areola. Non-nutritive sucking doesn’t achieve milk transfer, it is purely a comfort suck and looks like soft fluttery movements of the lips. You will notice the suck is gentle and the jaw is hardly engaged at all. A baby has more touch receptors on their face and neck than anywhere else on their body so non-nutritive sucking is a pleasurable feeling for the baby. Non-nutritive sucking aids digestion and eliminates gas and discomfort. For young babies, under 3 months this can be a useful side-effect of this type of sucking. Once a baby gets to 3 months plus they develop hand awareness and are able to put their hand, fingers and thumb into their mouth. Once we prevent this natural reflex occurring by leaving the baby on the breast at the end of a nutritive feed and moving into non-nutritive; rather than allowing them to self-soothe in the cot, we interfere with the baby’s ability to calm themselves.
I’m not saying you should avoid non-nutritive sucking/nursing completely. It’s OK now and again as long as your baby is going down for a nap fully awake the majority of the time. This is allowing your baby to learn how to calm themselves. Extended breastfeeding with non-nutritive sucking can lead to overtired babies. Some babies would suckle at the breast forever if you let them!