All about cluster feeding
So often I hear mums say, "My baby wants to breastfeed all evening - I'm worried about my milk supply."
It's common for young babies, especially, to cluster feed, meaning they feed very frequently, or almost continuously, over a period of a few hours. This can happen at any time of the day but is common in the evening. It can mean that as your baby feeds almost constantly, your breasts feel 'empty'.
When this happens it's perfectly reasonable to worry that your milk supply is lower during the evening. However, Dr Peter Hartmann, a breastfeeding researcher at the University of Western Australia, has said that in the women he has studied, milk volume is not low at this time of day. Even if milk volume is lower in the evening, fat content is typically higher at that time (particularly if your baby is allowed to control this via cue feeding), so the amount of calories your baby is getting shouldn't be significantly different.
However, there's research to suggest that when your baby cluster feeds over a few hours, your letdown reflex - and therefore your milk flow - can become a bit slower because of a slower hormonal response. Your letdown reflex can also be affected by tiredness and stress, especially the stress of worrying about whether you have enough milk for your baby. What a vicious cycle!
If your baby has been feeding for a while and you're starting to feel 'empty', one solution is to take a break - pass your baby to your partner, if they're around, and have a drink, something to eat, or a warm shower to help you relax. Your partner won't smell like milk so your baby is likely to be fairly calm as you take this little break. Then you can come back and try feeding your baby again, and he'll be more likely to settle at the breast.
The best way to boost your evening milk flow is to pre-empt this time: have a rest in the afternoon when your baby sleeps, so you aren't exhausted by late afternoon/evening, and make sure you eat a healthy lunch and afternoon snack. Late afternoon ('three-thirty-itis') seems to be a danger time for junk food snacking: it's when your blood sugar is low and your energy reserves are running out, so you reach for caffeine or chocolate. As these foods pass through your milk, it's likely they can contribute to your baby's evening restlessness too.
To avoid the temptation of junk food binges, keep healthy snacks handy - some boiled eggs in the fridge, avocado, tuna or smoked salmon and crackers. Also remember to drink plenty of fluids.
By allowing your baby to feed whenever he shows hungry signals, your breasts will get the signal to make more milk. Conversely, if you start offering formula 'top-ups', your breasts will miss out on signals to produce more milk and your supply will reduce - then you'll offer more bottles until either your baby starts to prefer the faster flow of milk from the bottle, or your supply is insufficient and soon he is completely weaned. The thing is that even if you give your baby a formula top-up he may still be fussy anyway. Besides risking early weaning, research shows that mums who give babies an evening top-up bottle actually get an average of 45 minutes less sleep overnight - so that's not a helpful solution if sleep is your goal.
It's also worth considering that evening fussiness and cluster feeding may not be just about hunger; instead, it can be a way of your baby calming his immature nervous system because he's actually feeling quite overwhelmed after a 'busy' day getting used to the big new world outside your body. According to Dr Katherine Dettwyler, who researches breastfeeding in traditional societies, babies in Mali, West Africa and other traditional societies don't have colic or late afternoon/evening fussiness. These babies are carried all day and usually nurse several times each hour. There is also evidence that babies who are carried more during the day fuss less in the evening. Perhaps wearing your bub in a baby carrier or sling earlier in the day could help to regulate his little nervous system and give you both a calmer evening.
Whether you're worried about your milk supply or you feel your baby may be overstimulated, one of the best ways to 'reboot' your milk supply and your baby's nervous system is to snuggle your baby skin to skin. Relax in a quiet, dimly lit room, remove or open your own top, dress your baby in only a nappy, and give him a cuddle. This will boost your breastfeeding hormones and you'll notice every subtle hunger cue - and by allowing your baby unlimited access to your breasts and feeding him whenever he wants, he'll feel comforted, relaxed and secure, and you'll be encouraging a healthy milk supply.
The good news is that babies who cluster feed usually take a good long nap afterwards, so if your evenings involve sitting on the couch with your baby attached, consider that you're stocking him up for a nice night's sleep. You're also boosting your milk supply for the following day.
And remember the Mummy Mantra for when the going gets tough: "this too shall pass". It usually does, by around the magical three month mark.
Pinky McKay is an International Board Certified Lactation consultant and the creator of Boobie Bikkies, all natural and organic cookies made to boost mothers' energy and support a healthy milk supply. Grab a free sample and Pinky's free ebook Making More Mummy Milk, Naturally at boobiebikkies.com.au.