The science of lactation + infant sleep
We need sleep. Sleep deprivation is not only difficult, but it can be debilitating. This post is not meant to shame or guilt a parent who wants more sleep, but I just want to iron out something that you may have encountered:
sleep training and maintaining a full milk supply don’t always work together.
Here’s why: your infant is built to remove what they need from your breasts. They establish that supply on demand throughout the first three months of their lives. Sometimes they take up to 12 feedings in a day, and sometimes as little as seven, but it is their frequency of feeding that establishes our milk supply. So, when we encourage an infant to sleep longer stretches than they would otherwise do on their own with sleep training - we push them out of their natural feeding pattern and we risk a dip in supply. This is especially true in the first 3 months of an infant’s life, which is part of the reason why we don’t recommend sleep training before 4 months of life.
This doesn’t mean that you can’t sleep train your infant and also maintain a full supply, but it means that if your priority is to do both (breastfeed with a full milk supply and sleep train your infant) you have to be aware that the priorities of each approach can oppose one another.
I’ve had too many patients tell me that no one mentioned that they risk losing a full breast milk supply if they prematurely get 5+ hour stretches of sleep. So what does prematurely mean?
Your body needs consistent milk removal, generally around 8 times in 24 hours, in order to maintain a supply in the first 3-6 months of an infant’s life. Might some infants take longer stretches before then naturally? Yes, but I usually advise on this on a case-by-case basis:
If the infant is younger than 3 months, I would advise to pump at a 5 hour interval if the infant is sleeping longer than that. Another option would be to add a dream feed (feeding an infant during sleep to encourage more removal and sleep at the same time).
If the infant is greater than 3 months and they have slowly weaned into longer stretches of sleep naturally, I advise that you slowly wean with them. But, I would keep an eye out for a drop in supply and add back a pumping session if you need it at the 5 hour mark of sleep at night.
Once an infant starts solids around 6 months, they usually take longer stretches and may drop that midnight feeding and keep the 3am feeding. This 3am feeding may naturally remain through their first birthday (on and off depending on their pattern of growth). It also may not - every infant's natural sleep progression looks different.
As a nurse and a lactation consultant, I support whatever my patients decide on their journey with sleep training and lactation, but I do want everyone to understand what kind of consequences one can have on the other before making a plan.
So, I usually recommend working with both a lactation consultant and a sleep consultant when the priority is to do both breastfeeding and sleep training simultaneously. To learn more, check out Nesting Lactation Blog. You can schedule a lactation consultation by using this link: Lactation with Sarah.
Written by: Sarah Peck, RN, MSN, IBCLC
