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Instinctual Infant Feeding- Is A Newborn Feeding Schedule Necessary?

rozlyn September 10, 2013

Instinctual Infant Feeding- Is a Newborn Feeding Schedule Necessary? ~ RealFoodFamily.com and ModernAlternativePregnancy.com

You’ve just given birth to your beautiful new baby. The first few minutes, hours and days of meeting your new child are so exciting and emotional. With those emotions comes vulnerability and possibly a little anxiety, especially if it is your first birth and you are in a hospital with a nursing staff checking on your status every half hour.

Now that the birth process is over you have a new mountain to climb: breastfeeding. In my personal experience as well as my experience as a birth doula, breastfeeding is generally not easy, especially for first-time moms. Forget the picturesque idea that baby will climb up your belly, find your breast and begin to breastfeed from a breast full of creamy milk while you giggle at the unusual, yet incredible, feeling. That typically doesn’t happen right away. (But let me emphasize that is DOES happen soon and it’s SO worth the pain and effort in the beginning.)

Challenges with Breastfeeding

Typically transitioning into a new breastfeeding relationship is painful, frustrating and emotional, especially if you are struggling with inverted nipples, mastitis, yeast infection, thrush, problems with latching and many more common breastfeeding problems. I believe you have to be educated and ready for the challenges if you want to have success. With dedicated and skilled support, mothers can overcome most of these common problems. (Again, it is SO worth the effort.) I recommend reading The Ultimate Breastfeeding Book of Answers and The Breastfeeding Book- Everything You Need To Know About Nursing from Birth Through Weaning before the baby comes (these are affiliate links).

Besides the physical challenges of breastfeeding, one of the challenges new moms face is the newborn feeding schedule that most hospitals and many birthing centers enforce during “recovery”. You’re given a piece of paper with a chart on it to record every time your baby breastfeeds, pees or poops, and someone will be in to check on you to make sure you are sticking to the schedule.

Is it just me, or does this seem like a sort of test you have to pass? I don’t believe new parents need to worry about passing a test, especially because during this time parents are so emotional and vulnerable that they could be persuaded to follow biased advice that the hospital staff claims is “necessary”, but is, in fact, completely unnecessary.

The Newborn Feeding Schedule

I’m sure many nurses and doctors will defend this standard procedure as necessary to ensure proper weight gain, digestion and blood sugar levels. They might even say that they just use the chart to keep an eye on what’s happening, but I just have a problem with the pressure and frustration I’ve seen that little paper give parents. In fact, the World Health Organization declared in 1998 that the newborn feeding schedule is “clearly harmful or ineffective”. There may be an arguable benefit to it, but God has given mothers a better tool to gauge if their newborn is doing well: instinct.

  • Is your baby actively attempting to breastfeed?
  • Are you establishing a proper latch?
  • Is the baby losing weight at a “normal” rate? (They will re-gain it soon, don’t worry.)
  • Is there pee and poop in the diaper?

Dr. William Sears says these are signs that everything is okay, and that you should trust those signs.

Your newborn baby’s stomach is the size of a cherry. The baby does not need that much to fill their tummy! What they do need is the constant comfort of your skin and breast to remain calm and transition well into life outside the womb. Overfeeding and unnecessary stress from supplemental feeding could actually increase digestive problems and even cause blood sugar problems.

Low Blood Sugar?

Don’t give in to pressure to supplement your baby with formula or glucose water. This practice is totally unnecessary unless it is firmly established that your baby is diabetic or hypoglycemic, and even if that is the case, establishing a breastfeeding relationship is the best thing you can do for your diabetic or hypoglycemic baby. It should also be noted that the testing level for newborn hypoglycemia is arbitrary, meaning no official “low blood sugar” level has any evidence to support it, and true hypoglycemia can only be determined in a laboratory (source). This study showed that the markers used for testing newborn hypoglycemia had no practical importance if the baby had no symptoms. It has even been suggested that the “low blood sugar” test was designed to “derail successful breastfeeding”. In most cases there is no reason to accept formula or glucose water, and doing so will certainly interfere with successful breastfeeding.

Let Your Baby Create The Schedule

There is no official amount of times your newborn should nurse. Your baby CAN’T nurse too often, but CAN nurse too little. If the baby is crying, fussing, or rooting (turning their head or wiggling their tongue in and out of their mouth), then NURSE! Just because that little newborn feeding chart shows that you are feeding your baby “on schedule” doesn’t mean that your baby shouldn’t be nursed 10 times that amount. Remember, nursing isn’t just about eating…it’s about nurturing and giving your baby the customized attention they need, and not the amount that someone else tells you they need.

The baby also doesn’t have to poop or pee on schedule. My first baby was constantly passing her waste while my second baby’s digestion was VERY slow. There were no signs of discomfort with baby #2 and she was regularly getting stuff out, so we weren’t worried and my midwife or the pediatrician weren’t worried either .

Is Baby Getting Enough Nutrition?

Hopefully your midwife or doctor kept the umbilical cord uncut until it naturally stopped pulsing (talk to your midwife or doctor about this before the birth and have it in your birth plan). This final stage of umbilical cord pulsing is delivering a gush of nutrients to the baby, giving him a final boost of nutrition to sustain him during his first few days until your milk comes in. A healthy newborn isn’t going to starve while receiving your colostrum before the flow of milk comes in. It’s not about the quantity of food at this point, it’s about the quality of those little drops of nutrient-dense colostrum. (Don’t forget! Your milk doesn’t come in right away, and may take a few days to come in.) It will be very clear if your baby has a (rare) case of severe malnourishment upon birth, but the majority of babies are just fine with mom alone, even if the first few days of feeding are difficult. Just make sure you are getting the proper nutrition you need during lactation.

Take Charge Of Your Role As The Parent

When you search “newborn feeding schedule” on the Internet, you will find that formula companies pop up first, and they seem to be the only ones promoting a newborn feeding schedule. That should signal a red flag in your mind! Formula companies love the newborn feeding charts and schedules because they can get a baby started on formula if parents “fall short”. If your goal is to breastfeed your baby, then be aware of this tactic because “women whose babies receive routine supplements are up to five times more likely to give up breastfeeding in the first week and twice as likely to abandon it during the second week as women who are encouraged to feel that their own colostrum and milk are adequate without supplements” (Enkin et al 1995).

Remember to trust your instincts as you establish your breastfeeding relationship with your newborn, knowing that it is just that: a relationship. Some relationships require more time and effort than others and the breastfeeding relationship is no exception. You are not a “bad parent” if you decide to challenge a hospital’s standards of practice, especially if they go against your will (unless you are truly endangering the health of your baby). Do not mistake my suggestions here as medical advice and always seek the advice and support of your doctor, midwife and/or pediatrician as you make health-related choices for you and your baby.

What was your experience feeding your newborn baby?

 

Un-linked Reference:

Enkin M, Keirse MJNC, Renfrew M, Neilson J. A guide to effective care in pregnancy and childbirth. 2nd edition. Oxford, Oxford University Press, 1995.

Photo Credit: Lindy Rojas Photography

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6 Comments

  1. […] very excited to be a guest contributor for Modern Alternative Pregnancy. In my first guest post for them, I write all about my thoughts on the Newborn Feeding Schedule […]

    Reply

  2. I’m not a mom yet, but I guess the clock is ticking if I’m reading all sorts of baby/mama blogs?! lol. Thank you for this great advice. I look forward to breastfeeding, and I feel confident that I will be able to handle those first couple weeks a bit more easily. Very well-written, thank you!

    Reply

  3. […] Feeding Schedule I wrote an article for Modern Alternative Pregnancy all about this topic called, “Instinctual Infant Feeding- Is The Newborn Feeding Schedule Necessary?” I bet you can guess what my opinion is on this based on that […]

    Reply

  4. I’ve been a nurse in a postpartum unit for quite some time now and for some mothers this would be absolutely true. They have their baby skin-to-skin often, and whenever they start to root put him/her to the breast. Especially on that second night (the transition night) where most babies are extremely fussy and want to cluster feed, these moms are up with them feeding all night. Feeding logs and schedules are absolutely not necessary.

    Let me rephrase. I think feeding SCHEDULES are absolutely unnecessary – but feeding logs are. There are way too many obstacles in the way for some parents to not have a feeding log and still appropriately feed their newborn. Some babies for whatever reason are completely exhausted for more than a day after birth, and their parents are exhausted as well. If they didn’t wake their babies to eat, they never would. In this case the feeding log is essential- when the parents are delirious with exhaustion and have no idea how much time has passed since they last fed and the baby is giving them no cues, looking at the written down time helps emensely.

    There are also some of the reasons you mentioned for not using a log/schedule (is there a wet/poopy diaper? Is the baby actively wanting to eat?) that parents never remember unless they write it down. A lot if times if I come in to give the mom a med and casually ask of everything is going okay or if they changed a diaper, they almost always say, “I have no idea. Hopefully I would’ve written it down.” Many of these women are up for days prior to delivery and then need to be up with their newborn breastfeeding often, time all blurs together. What I hear often is the feeding log helps a lot especially with two parents (the dad thinks the baby hasn’t ever peed while the mom has changed two- but if they look in one place, the log, they can see they’ve just missed them.)

    We’re all human, and exhausted moms after giving birth can’t be relied upon for memory, and new babies can’t be relied upon for giving accurate cues especially when the mom had heavy drugs, was on mag sulfate, etc. They still should eat. It is an extremely useful tool.

    I’m fortunate enough to work in one of the few hospitals who adopted the breast feeding friendly initiative; we encourage exclusive breastfeeding at all costs, rooming in, etc. We don’t even have sugar water in the hospital. I completely agree about the formula… I think pediatricians jump WAY too fast on formula supplementation and it infuriates me. As mothers you do have a right to say no! We as nurses do and have used the feeding log to convince the pediatrician that the baby is feeding often and doing well (actively wanting to eat, the mother is complying and feeding on demand, etc), and the mom’s milk should therefore come in soon. (The more often and the longer you feed in the first couple days, the faster your milk comes in and the more you ultimately have!). A feeding log showing all the feedings really helps the pediatrician back off pushing formula and it helps us out (the nurses) to advocate for our patients! We’re on your side!

    Ultimately, babies don’t understand time and shouldn’t feed by the clock. They should feed on demand. But when other factors come into play and everything isn’t perfect, the feeding log can be extremely useful and knowing that your baby should be eating roughly 8-12 times daily is beneficial.

    Reply

  5. I agree with Anna about the feeding log. I have a week-old baby right now, who was born in a breastfeeding-friendly hospital. They actually didn’t give us a feeding log till we were going home with instructions to come back the next day for a check-up because he still had some jaundice (and feeding frequently, and bowel movements, are key to clearing it up.) I’ve never seen a feeding schedule, but I understood the point of the log very well, which seems to be quite different from the point of schedules: not to make sure you feed the baby at certain times, but to look back over the day when it’s done and set your mind at rest that he’s eating often enough. More often is not a problem–but less often could be.

    Incidentally, after all the bad things I keep hearing about hospitals, it turns out I’m very grateful for ours. (Illinois Valley Community Hospital… in case anyone reads this who lives near there. Highly recommended.) Even beyond the excellent care we got in general; where we live we could not have gotten a lactation consultant nor transportation to go see one, on our own–but there was one in the hospital who was so attentive and helpful. And without that lactation consultant I might have failed already–and not because of interventions, I had a completely drug-free birth and they put him on my chest as soon as he was out, pausing only to wipe off the excess blood. Then they asked me to nurse him right away to help stop my bleeding–but I couldn’t, he didn’t even try to suck. It turns out that my son for some reason lacks several of the breastfeeding reflexes. If you stroke his cheek he doesn’t turn his head, he rarely opens his mouth wide enough, and he doesn’t start sucking till something actually bumps the roof of his mouth. I could never have figured out that was what was going on without all the good help I got, nor invented the strategies I was taught that help me get around these hurdles. Instinct is a wonderful thing–except when it isn’t. I’m grateful for knowledge as well. Not to replace instinct, but to check up on it that it’s working, and fill in the gaps when it’s not.

    Reply

  6. […] Feeding Schedule I wrote an article for Modern Alternative Pregnancy all about this topic called, “Instinctual Infant Feeding- Is The Newborn Feeding Schedule Necessary?” I bet you can guess what my opinion is on this based on that […]

    Reply

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I’m Kate, mama to 5 and wife to Ben.  I love meeting new people and hearing their stories.  I’m also a big fan of “fancy” drinks (anything but plain water counts as ‘fancy’ in my world!) and I can’t stop myself from DIY-ing everything.  I sure hope you’ll stick around so I can get to know you better!

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