2. The mother should feed the baby on one breast, as long as the baby actually gets milk from the breast, (see videos at nbcionling.org) until the baby comes off himself, or is asleep at the breast from being full or is nibbling even with compression. Use breast compression (see the information sheet Breast Compression) to keep baby drinking and not just sucking. Follow the Protocol to Manage Breastmilk Intake.
Please note that a baby may be on the breast for two hours, but may actually be drinking milk for only a few minutes. In that case the milk taken by the baby may still be relatively low in fat. This is the rationale for using compression. If, after "finishing" the first side, the baby still wants to feed, offer the other side. Do not prevent the baby from taking the other side if he is still hungry.
3. This is not a suggestion to feed only one breast at a feeding. You might be able to do it, and that's fine, but not all mothers can manage it. You might find it possible in the morning when you have more milk (as most mothers do) but not in the evening when you have less milk (as most mothers do). If you insist on feeding on just one side, you may find your baby is "colicky" in the evening when he is, in fact, hungry.
4. At the next feeding, start the baby on the other breast and proceed in the same way.
5. Your body will adjust quickly to the new method and you will not become engorged or lop sided after a short while. But remember this: feeding on one side at a feeding, if you can manage it, will reduce the milk supply so that what may work now (breastfeeding on one breast at a feeding) may not work as the milk supply decreases. Therefore do not keep the baby to one breast, but "finish" one side and if the baby wants more, offer the other side.
6. It is not a good idea to feed the baby on just one side, to follow a rule. Yes, making sure the baby "finishes" the first side before offering the second can help treat poor weight gain or colic in the baby, but rules and breastfeeding do not go together well. If the baby is not drinking, actually getting milk, there is no point in just keeping the baby sucking without getting any milk for long periods of time. You should "finish" one side and if the baby wants more, offer the other.
How do you know the baby has "finished" the first side? The baby is no longer drinking, even with compression (see the video clip and information sheet on Breast Compression). This does not mean you must take the baby off the breast as soon as the baby doesn't drink at all for a minute or two (you may get another milk ejection reflex or letdown reflex, so give it a little time), but if it is obvious the baby is not drinking, take the baby off the breast and if the baby wants more, offer the other side. How do you know the baby is drinking or not? See the video clips at the above website.
If the baby lets go of the breast on his own, does it mean that the baby has "finished" that side? Not necessarily. Babies often let go of the breast when the flow of milk slows, or sometimes when the mother gets a milk ejection reflex and the baby, surprised by the sudden rapid flow, pulls off. Try him again on that side if he wants more, but if the baby is obviously not drinking even with compression, switch sides.
7. In some cases, it may be helpful to feed the baby two or more feedings on one side before switching over to the other side for two or more feedings, as long as baby has come of the breast from drinking. Putting a baby back on a breast that was just "emptied" may cause baby to fuss or pull at the breast or fall asleep but not be full.