You may be wondering how often you need to breastfeed your new baby, and whether your baby’s feeding frequency or length of feedings indicate an issue where you need some guidance.

For most new moms whose breasts have experienced typical development, our bodies start making milk simply because of the breast development in pregnancy followed by the hormonal changes that birth initiates.

However, within a few days’ time, the production of milk shifts toward being a feedback system. If we get breast stimulation in the form of suckling and/or milk removal, that process tells our bodies to make more milk. If we do not provide breast stimulation or milk removal, then the breasts begin to close down the milk production. This happens in part because the milk-making cells get overly full with milk, and that fullness signals to those cells to die.

This feedback system explains how a mom with twins—who gets much suckling—is often able to produce enough milk for both of them, and how a mom who has had a stillborn baby—who does not have a baby suckling—will usually cease to produce milk within weeks of giving birth.

In the first week, there are two times that tend to panic parents:

In the first couple of days of a baby’s life, there’s often some period of time in which it is difficult to wake the baby to nurse. Babies can nurse in their sleep, and it’s good to try them at the breast in this sleepy stage, but generally speaking, they’ll pass through this sleepy stage and they’ll get to nursing frequently soon enough. (If the baby isn’t nursing at least eight times a day by the third day, it’s time to get some help.)

And there’s often a period of time in the first week, after the milk has ‘come in,’ where the breasts get engorged for a while. Get more information about that engorgement here:

Beyond those two issues . . .

When our babies want to nurse ‘sooooooo often’—8 to 16 times a day in the first month, 8-12 times a day in the first six months—in the early weeks of breastfeeding, that’s actually a system well-designed by evolution to establish a good milk supply for us. It’s true that babies aren’t always hungry when they nurse—sometimes they are instinctually driven to nurse for comfort and connection—but that doesn’t mean the feedback system is broken. In the early days, your breasts need consistent signals from your baby to figure out how much milk to produce. Your milk supply needs to gradually increase until your baby is about six weeks old, when it generally evens out until the baby is starting solid foods (advised to be around six months of age). So you especially need frequent feedings at both breasts in the first six weeks.

In the first month of breastfeeding, if we try to put the baby on a schedule we decide on for feeding, or if we interrupt the frequent feedings with things like giving her a pacifier, giving her a bottle of formula at night, or swaddling the baby to keep her asleep longer, we run the risk of disrupting the feedback system that our bodies are designed for. These disruptions at times result in families experiencing issues such as breast engorgement, plugged ducts, mastitis, insufficient weight gain, low milk supply, and so on.

(As a side note: The baby doesn’t ‘use you as a pacifier/dummy’; the pacifier/dummy is an attempt at being a replacement for you. I am not universally against pacifiers. We just have to be careful about when to introduce them and how often to use them.)

It’s important to know that there are times in the first month when parents are trying to convince themselves that everything must be okay, but they really feel that the feedings are not going right. These are often good instincts. In these scenarios, healthcare providers who don’t necessarily know much about breastfeeding will often tell parents ‘everything is fine’ as a method of trying to support breastfeeding, even as what they really need to do is refer the family for help. I regularly see clients whose babies are 10 weeks to 5 months old where the parents only wish they had listened to that voice inside their head and gotten help sooner, when the issues were not quite so complicated yet.

In the first month, here are some of the symptoms that give a clear indication that families need professional breastfeeding help:

  • mom has pain with feedings (it doesn’t matter how the feed looks; it matters how it feels)
  • mom has nipple damage
  • mom has pain or discoloration in breast
  • baby is not back to birth weight by two weeks of age, and/or then not gaining at least 200 g per week in the first three months of age
  • baby can’t stay latched with a wide open mouth
  • baby’s weight gain percentile is dropping down on the WHO growth chart
  • baby needs to nurse every 60-90 minutes every day as time passes
  • baby regularly is eager (or even frustrated) to eat but then struggles to latch and stay latched
  • baby regularly falls asleep (or otherwise goes inactive) after less than five minutes at the breast, but then needs to eat again shortly afterward
  • baby doesn’t nurse at least eight times in 24 hours
  • baby’s suck seems weak
  • baby chokes regularly when nursing
  • baby is regularly fussy while at the breast or in the half hour after nursing
  • baby has to be supplemented by pumped milk or formula to gain weight appropriately
  • the initial feeding challenges in the first week are not getting easier
  • baby nurses more than 20 minutes on one breast (40 minutes total) regularly
  • baby nurses well on one breast and has trouble on the other
  • mom has to pump as well as breastfeed (or instead of breastfeeding), not because she wants to but because the baby can’t nurse well

And here are symptoms that sometimes indicate families need help with feeding, especially if the symptoms are in combination with others on these lists:

  • mom has experienced symptoms of mastitis
  • mom has experienced symptoms of thrush
  • mom has plugged ducts (firm spots) in her breast repeatedly
  • baby has trouble napping for more than an hour, day and night
  • mom is feeling anxious or depressed about how feedings are going
  • baby leaks milk out of sides of mouth
  • baby regularly has diapers with mucous in the poop, or where the poop isn’t mustard yellow
  • baby is not pooping daily
  • mom did not experience significant breast changes in pregnancy or in the week after birth
  • mom suspects the baby may have a tongue tie
  • baby can nurse well at night but not the rest of the time

These concerning issues aside, in general, this sudden transition to a baby being so reliant on us—eating so frequently, and also wanting to sleep on us, and wanting to be constantly held by us, etc.—is hard for many of us.

Recovering from birth consumes energy and requires rest, so having a baby to care for frequently while we recover can be quite challenging. This is doubly so if we have had complications with birth that have affected us emotionally or physically. And this is why they say it takes a village to raise a child. We need people around us to support us, whether they are family members, friends, community organizations, or professionals we pay. For people who have no reliable and loving family around to provide support after birth, a postpartum doula can often be a lifesaver.

We are a generation that has generally lived with great independence, with great control of our time, our activities and our routines, and in the first month of having a baby, we find we are now ruled by the needs and whims of a tiny infant. Even as we generally fall in love with our babies soon after birth, it’s normal for us to have a period of time where we really struggle with, and rebel against, taking on the role of the constant caretaker. It’s understandable to have hard feelings about wanting our old lives, our old selves, and our old freedoms back again. For many of us, the process of ‘matrescence,’ of becoming a mother, is a gradual and unexpected relinquishment of our old ways of doing things into a new way of life. Our identity undergoes a shift that, for most of us, is permanent. Our ability to control our activities and time will largely return when our babies are older, but the early period of mothering does not offer that sort of lifestyle. Surrendering to the phase we’re in is sometimes hard, but the hardness doesn’t mean we’re doing it wrong. It just means we’re in a big transition.

And getting used to frequent feeds is part of that transition.