Sleep Training and the Breastfeeding Infant (The Newborn Sleep Book)

There’s a “New Method” to help newborns sleep through the night and it’s been making its rounds in all of the groups that I’m in. It doesn’t even matter which method it is at this point. A method like this routinely crops up under new names with different explanations. The general idea is this:  You teach your infant to expect to be fed at certain intervals and no sooner. So the child’s body adapts to those feeding times and you get sleep.

Sounds good, doesn’t it?

So why are people so against it? Why are the lactation consultants, the breastfeeding advocates, and everyone with knowledge of breastfeeding up in arms? Is it a conspiracy to deprive us all of the sleep we need?

There is a geeky saying. ‘It’s not only not right, it’s not even wrong.” Where something cannot be argued against in a logical manner because the understanding that it was built on is ridiculously flawed. The phrase is attributed to Wolfgang Pauli, a theoretical physicist known for colorful objections to sloppy thinking.

These methods are like that for people that know how breastfeeding works, how the human body works, how the mother-infant relationship work. The idea that you can space out feedings to encourage a newborn to adapt to a specific feeding pattern? It reduces us to jaw-hanging horror because it’s… Not only not right. It’s not even wrong. It’s incredibly naive and… It just doesn’t work. You can’t say that two plus two is five. How do you even go about talking about something that is… that.. off?

You have to back up. All the way. Start from the beginning and teach a person how a baby’s body works. What human milk is made of. How different types of milk mean different things. You have to teach them… Everything. That is how flawed the method is. You can’t even say “the conclusion is wrong”. The entire thing is broken.

Let’s try this.. Did you hear about the method of reducing gasoline consumption by spacing out refilling to once a month so that your car learns to expect to only be refilled then? It works.. technically. Just with some obvious pitfalls for most people.

The newborn sleep training method that spaces out feedings so that the baby will only expect to eat at certain intervals? Remarkably similar. But instead of running out of gas mom’s supply tanks and baby may end up with failure to thrive.

You cannot change how something works without understanding it and respecting it.

These methods capitalize on the mystique and misunderstanding surrounding the most basic biological process. It is snake oil and glitter promising to change how biology functions.

This method should have a huge glaring informed consent warning label on it. “USING THIS METHOD WILL INVOLVE FORMULA SUPPLEMENTATION EXCEPT IN RARE SITUATIONS“.

Let me introduce you to the human mother. The human mother’s body performs a balancing act between her baby’s needs and her own physical health. If a human mother is making unlimited milk constantly across the day and is making more milk than her baby needs then she is rapidly burning through her own resources by funneling all of her energy and vitamin intake into the production of milk. If the human mother makes unlimited milk then she will have constant engorgement and leaking. This places the human mother at a high risk of mastitis and thrush. So how does mom stay healthy? Mom’s body is protected by how breastfeeding works. Human milk has a protein in it called “Feedback Inhibitor of Lactation” or FIL. When mom’s breasts are full of milk they are also full of this protein which signals to mom’s body that her breasts are not being emptied and that her body should make less milk to conserve resources and prevent infection. If mom’s breasts are not emptied regularly then her milk supply decreases.

Let me introduce you to the human infant. The human infant acts as the counterbalance to mom’s body’s natural drive to decrease supply.  The human infant is biologically hardwired to cry to be near mom, to suck when awake, to sleep when full (human milk contains tryptophan which naturally encourages sleep), and to wake when their body needs more milk. Their stomach capacity is small- from the size of a marble up to the size of a chicken egg. They rapidly digest human milk so that they will be ready to nurse again and keep mom’s supply where it needs to be. This on-demand feeding is what helps the small weak infant with an under-developed brain grow healthy and strong. It promotes normal human development and growth. Human infants are categorized as “carry mammals” by science, which has analyzed the milk of different species that rear their young in different ways. Human milk is similar to the species that carry their babies around and feed all across the day and night. The human baby requires frequent feedings.

We now have the basis of the cycle. Mom’s breasts need to be kept empty in order to produce milk. Baby’s natural biological rhythms of hunger and nursing encourage baby to keep mom’s breasts empty by nursing frequently.

You cannot change the human mother’s milk into the milk of a deer which feeds around once every twelve hours and you cannot change the human infant’s digestive system into that of a baby deer which requires the specific balance of its mothers milk.

It doesn’t work. You  just break the cycle.

So now we’ll throw in a “gotcha”. Mom has been told to space out feedings to no more than once every three hours or once every four hours. Mom’s body doesn’t know this. Mom’s body knows that she has a young infant that is feeding on demand. Mom’s breasts fill up with milk. Mom’s milk is full of that nifty little thing that tells mom’s breasts to make less milk. That milk stays in mom’s breasts. Baby screams in hunger while their parents bounce and shush and distract and attempt to pacify the baby that needs to eat. Mom’s breasts start making less and less milk. Baby eats what baby can eat in the time that mom allows him to nurse. (Typically fifteen minutes per side) and consumes either what mom’s breasts are able to let down in that time or what baby’s stomach capacity is. Either way… IT IS NOT ENOUGH. Mom’s supply reduces and instead of taking in what baby needs baby is taking in what mom’s body is able to produce on the schedule that is allotted.

In some mother-baby pairs this will work. Maybe mom has oversupply that is higher than usual in calories. Maybe baby’s rhythm is different.

Let’s go back to the car thing.. Maybe the car that you’re not refilling is a small fuel efficient hybrid or has an unusually large gas tank. Maybe you don’t drive much, or maybe knowing that you won’t be refilling the car as much makes it so you change your patterns. There are ways in which it can work.

There are also ways in which it will fail because it is completely and totally incompatible.

If your baby is asking to be fed more than once every three hours… That’s the low fuel light on your dash. It’s the thing that is telling you that less frequent refillings don’t work for your baby.

To summarize it- if this method is appropriate then your baby is one of those that only wants to feed at that interval. If your baby wants to feed more frequently it is NOT a safe method to use. Not for your baby and not for you.

The methods that purport to “fix” the natural rhythm of infants… Are BROKEN. They are fundamentally flawed from the bottom up. They cannot work any more than you can look at a potato and say “I’ll spell you like tomato instead and you will be red!”

There is nothing wrong with a parent trying a method with the knowledge that it will decrease their supply and require formula supplementation. As long as it is an INFORMED CHOICE and as long as they know that it’s not “my body doesn’t make enough milk” or “I failed to breastfeed”, it is “I made an informed choice to choose a method of sleep training that is incompatible with breastfeeding.”

Even if a baby is fully formula fed you still have to be cautious about restricting feeds this way because a baby’s stomach is tiny. It cannot hold much food. And a baby on a liquid diet simply needs to eat often in order to thrive.

The body can adapt to less frequent feedings. Certainly. But it is far from ideal.

  5 comments for “Sleep Training and the Breastfeeding Infant (The Newborn Sleep Book)

  1. Jen/@guidemd
    August 22, 2014 at 11:01 am

    I love this sentence, “I made an informed choice to choose a method of sleep training that is incompatible with breastfeeding” – I plan to remember that idea for future conversations about anyone re: certain sleep training methods, ie. “it’s your choice if you wish to try it, but be aware that because it doesn’t take into account normal infant development and sleep cycles nor the physiology of breastfeeding you’re likely going to need to supplement, are you ok with that?”

  2. neversummer
    August 25, 2014 at 10:03 am

    It is interesting that you mention how all experts agree that a three hour feeding schedule is wrong. When our daughter was born premature and had to spend considerable time in the neonatal intensive care unit (nicu) the very knowledgeable doctors and nurses there, who care not only for infants but the most delicate and fragile of all infants, feed them on a three hour schedule. And yes they feed breast milk when ever possible. I was also instructed to pump on a three hour schedule because it most properly replicated the natural feeding cycle of a new born.

    • Rabbitfoot
      September 5, 2014 at 2:07 am

      Same with my premature baby. She came home trained to feed every 4 hours. Wonderful. Or so i
      thought at the time. Guess what? My milk supply dwindled and baby didn’t put on enough weight. I was told my milk was not fatty enough. I had to supplement with formula. She still didn’t put on enough weight so was put on solids and finally gained weight. I am now breastfeeding my second baby on demand (every 1-2 hes in day and 2-3 hrs at night) Guess what? She is thriving, gone from 25%ile at birth to 75th%ile at 6 weeks. I don’t even know what she weighs now at 3 months as I’ve never had to weigh her. She is nice and chubby. My milk has suddenly become ‘Gold top’? No. She is simply feeding when she is hungry, keeping up my supply. I am exhausted and we are both happy. The NICU does 3/4 hourly feeds as that is the way they can cope with so many babies/resources. I’m grateful to them and understand why it must be but not convinced it is ideal for all babies. Not for mine anyway, however she is a happy and healthy 4 yo now and I will always be so thankful to the Dr’s and nurses that cared for her so devotedly.

      • Carrie
        September 24, 2014 at 10:31 am

        As a fellow nicu parent I had the same experience. My daughter was full-term but had surgery for intestinal blockage shortly after birth so she spent close to 2 weeks in the nicu. They actually kept her for a couple extra days because she didn’t do well on the 4-hour feed schedule – she wanted to eat smaller portions every 1-2 hours. Why they think that breastfed babies will do well on a formula fed schedule is beyond me. I am very grateful for the wonderful care she received, but it does seem like the needs of breastfed babies and mothers is not well understood by nicu nurses. The lactation consultants had me pumping every 2 hours during the day and no further apart than 4 hours at night, but that wasn’t the schedule she was fed on.

  3. Allie
    August 26, 2014 at 10:13 am

    neversummer, I don’t think she’s talking about a medical context, in which the infant’s weight, hydration and blood chemistry are being closely monitored around the clock. This “new” method sounds a lot like Babywise, which has, indeed, been thoroughly lambasted by medical professionals. It has a strong correlation with dehydration and failure to thrive, and is not recommended by the American Academy of Pediatrics. There is nothing wrong with a loose 3-hour schedule, if the infant is not showing an interest in nursing in between, but I suspect the neonates are actually being fed on demand, and not left to cry in hunger, which would expend precious calories and be counterproductive.

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