Responsive Breastfeeding: Watch Your Baby, Not The Clock

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Once upon a time, scheduled feeding was the norm for infants. You may have heard of breastfeeding “on-cue” or “on demand,” also known as “responsive breastfeeding.” So what’s the difference? Why is this difference important and why does it matter?

First, absorb this couldn’t-be-truer quote by Dr. Nils Bergman: “Breastfeeding’s worst enemy is separation.”

Why Is On-Cue Breastfeeding Important?

It’s absolutely crucial (and normal) to feed on demand. Frequent feedings are important for a baby to thrive because caloric and fat content is higher in milk that’s replaced more often.

Anthropology professor and researcher Kathy Dettwyler explains that human children are biologically designed to nurse very frequently:

“[T]he composition of the milk of the species[,] all higher order primates keep their offspring in the mother’s arms or on her back for several years, the size of the young child’s stomach, the rapidity with which breast milk is digested, theneed for an almost constant source of nutrients to grow that huge brain (in humans, especially), and so on. By very frequently, I mean 3-4 times per hour, for a few minutes each time.

The way in which some young infants are fed in our culture — trying to get them to shift to a 3-4 hour schedule, with feedings of 15-20 minutes at a time, goes against our basic physiology. But humans are very adaptable, and some mothers will be able to make sufficient milk with this very infrequent stimulation and draining of the breasts, and some children will be able to adapt to large meals spaced far apart.

Unfortunately, some mothers don’t make enough milk with this little nursing, and some babies can’t adjust, and so are fussy, cry a lot, seem to want to nurse “before it is time” and fail to grow and thrive. Of course, usually the mother’s body is blamed — ‘You can’t make enough milk’ — rather than the culturally-imposed expectation that feeding every 3-4 hours should be sufficient.”

In other words, lactation is a supply/demand system. When your baby has opportunities to freely graze, including nursing for comfort and not only sustenance, without restriction to frequency and length of feedings, your body receives the signal to regulate milk production well.

For most breastfeeding people, supporting the supply/demand nature of this system will manifest the perfect amount of milk. However, putting feeds on a timer can throw a wrench in this system, especially for those who already struggle to produce enough. Read more about the process of making milk here.

How Can You Tell If Your Baby Wants To Nurse?

  • Look at baby’s hands. Are they open (relaxed, palms visible) or closed (in a fist, clenched)?
  • Is baby rooting? (Mouthing, chewing on hands, turning a cheek to the nearest surface, or making gnawing, sucking motions)

People often suggest following this protocol (or something similar) if baby is crying: make sure baby has a fresh diaper, is warm, has recently napped, is entertained, and a myriad of checklist items before turning to nursing, which is treated as a last resort.

Parents, nursing is your ally and first line of defense! It is the original pacifier, so don’t hesitate to milk it for all it’s’ worth (the only time this phrase might ever be used literally).

I understand this requires a sharp mindset change for those accustomed to a bottle-feeding culture. If baby is upset, or happy, or bored, or hungry, or has an owwie, or just looks irresistibly delicious and cute… the answer is… try breastfeeding. It’s impossible to overfeed an exclusively breastfed baby, because breastfeeding is not just about food — it’s love. Breastfeeding is a tool that exists to help new parents as much as it helps babies.

“Mothers of the bottle-feeding set often consider feeding times a big deal. They have to sterilize the bottle and prepare the formula. Then they have to count the ounces and number of feedings, wondering if baby has gotten too little or too much. No wonder they space them out as much as possible. With breastfeeding, you can think of it as a social interaction rather than a mathematical exercise. Just as you don’t count the number of times you kiss your baby…neither do you need to count breastfeedings.” – Martha Sears, RN, and William Sears, MD in The Breastfeeding Book

So In Our Modern Culture, What Can We Do?

  • Avoid premature introduction of solids. Timing looks different between babies, cultures, and even pediatric tomes, so come up with a research-based game plan before getting started.
  • If you must be separated from your baby, express milk to maintain supply and don’t supplement with formula without necessity.
  • Avoid forced sleeping through the night (sleep-training), particularly in the early days when your body is learning the signals for how much milk to produce.
  • Don’t limit time at the breast. Always offer both sides (though it isn’t necessary for baby to always take both). You don’t need to nurse for a prescribed number of minutes, and you don’t need to wait a certain number of hours before “it’s time” again.
  • Relax (okay, try to relax!). The milk flows best when you can let go of the need to “measure”: watch your baby, not the clock.
  • Even if you’re separated often (for work, etc), use the time you do have together doing skin-to-skin and babywearing, which help boost the bonding hormones that make breastfeeding easier.
  • Frequent nursing isn’t an “inconvenience” if you remind yourself that this is a huge part of your parenting role right now. If you don’t nurse, your child will require something else from you to meet his needs. Normalize the habit now and you may enjoy fewer struggles and greater rewards in the long-run.

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