Demystifying Cluster Feeding: What’s Normal...What’s Not
"Cluster feeding" can be a
daunting term to a new mother and her partner.
By definition, cluster feeding means that baby is constantly at the
breast: nursing and snoozing and crying…and nursing and snoozing and crying…and
hiccupping and nursing and nursing and nursing and nursing---you get the
idea. It is important, however, to manage cluster feeding before it
becomes unbearable and before the mother is in too much pain or is too
exhausted to continue. In order to understand the behavior of cluster
feeding fully, it is important to separate out the two different time periods
during which newborns may cluster feed.
When a baby is born and goes to the breast right away, he gets the potent and healthy colostrum from the mother's breast. His needs on Day 1 post-partum may be very low---a few swallows may be fine for him. But newborn babies are in a tremendous state of flux for the first several days of their life; while a newborn baby may need only a few swallows on Day 1, his needs quickly increase to the extent that by Day 7 post partum, he may need 3-4 ounces, every three hours---that's 24 ounces of milk within a 24-hour period! Meanwhile, at the mother's end, around Day 3 post-partum, she is just beginning lactogenesis and her milk is "coming in."
In an ideal world, the baby's increasing
needs and the mother's increasing supply of mature milk coincide and dovetail
nicely, so that the baby's increasing daily needs are satisfied with whatever
increased volume the new mother is producing on each consecutive day after the
birth. However, nature---while miraculous and wonderful---does not always
hit the mark with perfect timing in these early days. Many newborns' needs
increase before the mother's volume of milk does, and as a result, they may
appear fussy at the breast and may persistently feed in the early days
post-partum, in an attempt to bring in the mature milk and increase its
volume. In primitive societies, this is easily solved by handing the newborn
baby off to a fully-lactating woman to get a full feeding. However, we no
longer live in these times of "cross-nursing." Sometimes, when the gap is too big between a baby’s demands and his
mother’s milk coming in, we need to supplement and have the new mother begin pumping to bring in the supply
faster. This type of cluster-feeding is short-lived, and can easily be solved
within the first week of nursing with some knowledgeable guidance.
Once nursing is established---within the first couple of weeks of the baby's life---cluster feeding can crop up from time to time, even daily for certain periods. It is important to be informed about the difference between "normal" cluster feeding and problematic cluster feeding. What does it mean when we say, "once nursing is established"? Typically what this means is that the baby is capable of getting a full feeding from the breast (with no supplement needed), that he is having plenty of stools and wet diapers a day, is gaining weight and---in general---is giving the new mother discreet breaks between feedings; that is to say, each feeding has a beginning, a duration and---most importantly---an end. When nursing is properly established according to these guidelines, there will be occasional periods of persistent feeding (where you can't "put the baby down" and he seems to constantly be at the breast), which typically occur from 4:00 pm onwards.
If the baby persistently
feeds around the clock and is fussy at the breast constantly, this may indicate that he is
not able to access a full feeding at the breast. It is important to take
note of the frequency of these cluster feeding periods so that you can
determine if they are an early sign of a breastfeeding problem, or within the
norm of young infant behavior. If you
sense that the baby is not getting enough at each feeding, consult with your
pediatrician or a local Board Certified lactation Consultant for a care plan.
New fathers can help mothers tremendously during normal periods of cluster feeding; holding the baby, walking with him and trying to soothe him between feedings or giving a bottle if the feeding has been going on for hours, are all valuable contributions that a new father can offer to help give mom a break. If a bottle is given, the mother just needs to make sure that she pumps to drain the breasts for that particular feeding. Remember to cherish these early weeks and months; although they may be trying, they are ultimately short-lived and transient.
Heather Kelly, MA, IBCLC