I don’t have my six and a half week old daughter on a schedule. Many of my friends hear this and say “OF COURSE NOT!” and some ask “why not?” I’m of the opinion that schedules are harmful for breastfed babies and for the breastfeeding relationship. I have three reasons.
Reason One: The baby needs to thrive. In order for an infant to thrive, the baby needs to eat enough and the food has to meet the right nutritional balance. The way breasts and babies work together is designed to make this work. Schedules interfere with the way breastfeeding works, which can interfere with the baby thriving. When eating is baby-driven the baby will not eat unless the baby is hungry, and the baby will not go without eating when the baby is hungry. When the baby eats the type of milk that the baby gets will depend on the last time that the baby nursed. If the baby has gone some time without nursing then the baby will get a rapid flow of foremilk which will fill the baby up quickly and which is digested quickly. If the baby is still hungry the baby will eat more and more until the baby also gets higher fat hindmilk which is digested less rapidly. The more frequently the baby eats, the more hindmilk baby gets. The more hindmilk baby gets the less rapidly the milk is digested and the less often baby will need to nurse. The longer baby goes without nursing, the more foremilk.. You get the idea. It’s self-regulating and a baby-driven balancing act driven by the question of “what does baby need?”
Now throw a monkey wrench in the works. Baby’s hungry. Baby gets told “No baby, it’s not time to eat yet.” Suddenly baby has to wait exactly three hours between feedings. Baby has 20 minutes on each breast, and then baby has to wait another three hours between feedings. Three hours means that baby gets a lot of foremilk. Maybe baby fills up on it since there’s so much. Baby is then full of rapidly digesting food that doesn’t have much fat, and needs to wait another three hours to feed again even though it doesn’t contain what baby needs and even though it digests rapidly. Instant recipe for infant weight loss exactly when infants need to gain.
To make matters worse, breasts are designed to scale supply according to demand. So you have reduced demand (feeds every 3 hours, baby can’t take all the milk, doesn’t empty the breasts completely) and the breasts recognize this. Your milk contains a protein called “Feedback Inhibition of Lactation” (FIL). When your breasts are emptied there is less FIL and production speeds up. When your breasts are not emptied there is more FIL and your breasts make less milk. Full breasts make less milk, empty breasts make more milk. Spacing out feedings lowers your supply.
Remember. Baby needs to thrive. You suddenly have a baby whose feeds are infrequent, rapidly digested and low in fat. And you have a feeding pattern that decreases milk production. You also have a rule about the baby only getting a certain amount of time on the breast, so they cannot work to increase supply.
In order for baby to thrive on a schedule mom must have a supply that is not very sensitive, she must store just enough milk so that baby gets enough milk to not become dehydrated but not enough that baby is only eating foremilk at each feeding. Baby must be able to take in enough milk, digest slowly enough to use all of the portions of the milk, and must not have any physical issues such as reflux, spitting up, a high palate, a faster metabolism, a tongue tie, a lip tie, etc. that interfere with either digestion, weight gain or nursing effectiveness.
In other words, everything must be eerily perfect in order for baby to thrive on a schedule without supplementation.
Reason Two: Supply. Supply is regulated by demand. Both “Amount eaten” and “frequency of eating”. As mentioned before, your milk contains FIL which reduces supply. Infrequent spaced out nursing decreases supply. This is a good thing because if baby’s not hungry and goes a while without eating, supply reduces so mom is not overproducing and wasting her resources on milk that is not needed, and the milk isn’t sitting in mom’s breasts raising the risk of mastitis. With scheduled feedings that space out feedings this is NOT the case. Baby IS hungry, baby would nurse if allowed to nurse. Supply is reduced not because of decreased demand, but because of spaced out feedings.
Breastmilk is not present in mom’s body in a static amount. It is created according to demand. An artificial reduction to demand results in a very real reduction of supply.
Reason Three: Duration of breastfeeding. The AAP recommends that exclusive breastfeeding happen for at least the first six months of baby’s life and that breastfeeding continue to at least a year with complementary solids. Exclusive breastfeeding can only happen if baby is thriving. A schedule which means that EVERYTHING has to meet a delicate balance that many babies and moms are not able to meet.. Means that the duration of exclusive breastfeeding is drastically reduced. A schedule in the early weeks means that mom’s supply may be damaged for the long haul and that in order to restore breastfeeding mom has to feed more frequently than she would have if no schedule had been in place during the early weeks and mom’s supply was allowed to regulate according to baby’s demand and needs.
ROUTINE is different from schedule. My partner wakes up at 6:30. His alarm clock tends to wake up the baby who nurses and then wants a diaper change, and then nurses again and falls back to sleep for her first nap of the day. Her brothers and I have lunch at 12:00 which means I’m sitting down so she wakes up in her wrap and eats as well. The routine encourages feeding at a certain time, but it does not require feedings to be spaced out. Before we go anywhere I nurse her so that she can wait until we get where we are going. An offered feed is very different from a delayed feed. Routine is different from schedule.
You can have all of the benefit of convenience without spacing out feeds or being on a rigid schedule. Offer feeds, have a good consistent routine. Everything falls into place without needing to watch the clock and push a pacifier into your baby’s mouth because “it’s not time to eat yet”.