Dear Lactation Consultant,
How long should a baby breastfeed at one sitting to know they are getting enough nutrition? My son is 6 days old and his nursing time varies from 20 minutes to 1 hour total feeding time. I worry when he only eats for 20 minutes, should I be? Is he still getting milk at 1 hour or is he just pacifying at that point? Is it ok to nurse only on one breast at a time rather than switching after a while?
You ask good questions! Many new mothers are confused about what's normal. An average length of a breastfeeding for a newborn is 20 to 40 minutes total, but some babies are faster than average and some are slower. I count at least 10 minutes of active nursing as a feeding.
The recommended way to handle a feeding to to allow the baby to "finish the first breast first," meaning let the baby stay on the first breast until he comes off on his own (falls asleep or pops off), then burp him and/or change him and then offer the second breast. Babies tend to take one breast at some feedings and both breasts at some feedings. You know you're baby is doing well if he gains at a rate of at least 3/4 to 1 ounce per day. If that is happening, whatever else you're doing must be all right.
A baby who nurses for an hour can definitely still be getting milk at that time, but I would check to make sure he is staying active at the breast. Some babies do what we call "hanging out at the bar without drinking," meaning they are on the breast but not actively taking milk. If your baby is doing this, he probably needs to be stimulated to feed more actively. An easy way to do this is to wait until he stops sucking actively and then squeeze the breast firmly and keep squeezing until he stops sucking actively, then release the pressure. Give your hand a rest and then move it about an inch in one direction so that you're on another part of the breast. When he stops sucking actively again, squeeze again and stay squeezed until he is no longer actively sucking. Keep this up on one breast until the compression no longer keeps him active, then switch to the other breast. You can go back and forth from breast to breast as many times as needed at a feeding.
Also, most babies need to breastfeed at least 8 times every 24 hours, although in the early weeks it is rarely at regular intervals. Newborns tend to "cluster nurse," meaning they tend to bunch their feedings together at certain times of the day (often evenings) and take one longer sleep stretch of about 4 to 5 hours. As long as they get in at least 8 feedings, the time intervals between feedings is not important. Babies wanting fewer than 8 feedings per day may need to be awakened to feed more times.
-- Nancy, IBCLC