Care Plan: What to Do if Your Baby is Not Getting Enough at Each Feeding

One of the most common breastfeeding problems you might experience as a new mom is your newborn isn't getting a full feeding at your breast. Often it's because he falls asleep before finishing.

If your baby doesn't get a full feeding, he's likely to wake up in 20 minutes or so, crying and rooting for more food. That can result in feeding around the clock, which can be tough on you.

So why does this happen? Newborn babies need a steady flow of milk to keep going. If your milk flow slows down, your baby slows down too. As a result, he won't swallow so much and he might fall asleep at your breast.

The simplest solution to make sure he's getting what he needs at each feeding is to help your milk flow steadily. In other words, you must temporarily increase the flow so feeding is easier for your baby and he won't "peter out."

Here's what you can do if your baby slows down, stops swallowing or falls asleep too soon:

Breast compression

• Gently pull you baby in closer by putting the palm of your hand between his shoulder blades and drawing him near.
• Once he's closer, compress your breast to hand-express some milk into his mouth. Swallowing is a reflex, and if he gets a mouthful of milk he'll swallow it. This also wakes him up a bit and reminds him of what he's supposed to be doing.
• Keep watching for his swallows and compressing as needed until he no longer responds.

If your baby isn't responding to breast compression anymore, so not swallowing regularly or falling asleep again, you can try switching breasts.

Switch nursing

• Before switching, wake your baby up a bit by burping or undressing him.
• When your baby latches onto your other breast, he's getting a whole new reservoir of milk, one where the flow rate is faster. This is because let-downs are simultaneous. When your baby was drinking from the first breast, your milk was pooling in your other one.
• You can switch breasts 3 or 4 times per "meal" to help your sleepy newborn get a full feeding.
• Don't be concerned about foremilk and hindmilk at this point because your baby is getting the nutrients and fat content he needs. Think of it this way: The foremilk in your breast is the hindmilk from the last feeding.

Tips for success

• The most common reason newborns stop feeding or fall asleep at the breast is because milk flow has slowed down.
• If you increase the flow, your baby will have a better chance at getting a full feeding.
• You can increase the flow by using breast compression or switch nursing.

Source: Heather Kelly is an International Board Certified Lactation Consultant (IBCLC) who also sits on the Bravado Breastfeeding Information Council Heather has been practicing in New York City since 2001.