Nursing My newborn. What's Normal?

QUESTION

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?

ANSWER

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

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.