7 Tips that Keep Your Sleepy Baby Feeding At The Breast

One of the most common problems  new breastfeeding parents ask me about is “How do I get my s;eepy baby to stay awake while breastfeeding?” 

Maybe you are struggling with this too. 

A typical scenario goes something like this:

You get your baby latched onto the breast. They take a few sucks and then drift off to sleep. You spend the rest of the feeding trying to get them to wake up. Maybe you are tapping their face, or tickling their toes, or using a wet wash cloth - but baby just sleeps on. Then you take baby off the breast and they suddenly wake up, start to cry and act hungry, only to repeat the whole process again.

Latch... Suck...  Sleep... Unlatch. .. Wake.. Cry... Repeat ...

Another scenario  might go something like this: 

Baby latches on and sucks for hours! Maybe baby is latched on to the breast all night long. Maybe baby is latched for an hour or even more. You think “Wow, baby is feeding so good!” But when you take baby off the breast, baby immediately wakes and becomes fussy and still seems hungry. You say “You can’t possibly be hungry, you just ate for an hour!!” Someone may say “That baby is using you like a pacifier”. But, baby doesn't stop crying until you put them back to the breast. And then they fall asleep again. 

Is this something you have experienced? I suspect so, since you are here. 

Probably all new breastfeeding parents have been there, so don’t feel alone. 

These are examples of real life situations I see often when working with breastfeeding families. 

Those sleepy babies can fool you.  It would naturally make sense to think that  a baby who is at the breast that long must be getting a lot of milk. And for some babies this is true. 

But, sleepy babies are often not suckling with a strong enough suck to actually transfer milk from the breast to the baby. Babies have a natural sucking reflex that is comforting to them. But, that doesn't mean that they are actually sucking strong enough to feed. 

This Sleepy Baby phase is most common in babies in the first few days after birth. But, there are other  situations when you might have an extra sleepy baby at the breast that need you to help keep them awake to feed. These include: 

• Premature babies
• Early babies (even if “considered” full term)
• Babies with jaundice
• Babies whose parent received medications during labor and delivery
• Babies whose moms are taking pain medications
• Babies who have difficulty with their sucking skills  (like babies with tongue tie, babies with illnesses, or health conditions that may cause them to be weaker than usual,) 
• Babies who are not gaining enough weight
• Parent with a delay in milk production or low milk production
• Parent who is pumping or using a milk collection device before baby feeds 

Babies who are sleepy at the breast have a hard time staying awake long enough to get the milk flowing.

Flowing milk is what will keep a baby awake at the breast ( not the tapping, tickling etc). But babies who are sleepy will latch on and begin to suck but will fall asleep before the milk “lets down” or starts to flow fast enough to keep baby sucking and swallowing. Or the baby might stay awake for a few minutes when the milk is flowing fast but falls asleep when the milk flow slows. 

These babies can look like they are feeding and can stay at the breast a long time. Or they might fall asleep and pull off the breast very quickly. 

Because these babies are so sleepy, they may not be getting enough milk to gain and grow without help.

This is why timing a baby at the breast doesn’t assure that the baby is getting enough milk. Your baby can be on each breast for 20 minutes like you might have been instructed to do, and still not be getting enough milk. Your baby could be asleep that entire time.I  teach parents how to notice the difference between a feeding suck and a comfort suck. This is important to notice.  Your baby's feeding pattern will tell you more than the clock. It is important to recognize when your baby is sucking and swallowing milk or just sucking for comfort. Both are important, but babies must get enough milk in during the feeding to grow.

If your baby is not sucking and swallowing and is sleepy at the breast, here are 7 ways to keep your baby active, awake and feeding at the breast. 

1. Take your baby’s clothes off 
2. Allow baby to wake at the breast
3. Use hand expression to get milk flowing
4. Use breast compressions to keep baby feeding
5. Use switch nursing 
6. Supplement first 
7. Seek help from a lactation professional

Let's discuss each of these in detail. 

Take your baby’s clothes off 

Undress baby before the feeding and put your baby skin to skin. This will help baby to wake up and it will help your body release more milk for the baby. Remember the baby needs flowing milk to stay awake. Skin to skin is always a good response to pretty much any new baby situation, but in this case, it is a game changer. A baby who is swaddled up and warm in their blankets will fall right back to sleep. The oxytocin release of being skin to skin will help you and baby during feeding. 

Allow baby to wake at the breast 

Instead of feeding your baby by the clock and waking your baby out of a deep sleep to feed, watch your baby for signs of early waking ( eyes fluttering, squirming, lips smacking etc).  When baby shows those early waking and hunger cues, get baby up and place baby skin to skin and allow baby to wake up at the breast. Baby will smell your milk, look for the breast and wake and latch better.  This also helps your letdown. If you wake baby from  a deep sleep to feed , baby may be too sleepy to feed well. 

Use hand expression to get milk flowing

This is my #1 favorite tip for keeping sleepy babies awake. By now you know that babies need flowing milk to stay awake at the breast. But if your baby is too sleepy, they may not have to strength to suck strong enough and long enough to get your milk flowing.

If you use hand expression to get your milk to let down before latching baby, milk will already be flowing and baby doesn’t have to work so hard for it. This flowing milk will help baby get in milk right away and help to keep baby awake. (If you don’t know how to use hand expression to get milk to flow from your breasts, you need to learn this skill. Your hands are much better than a pump and much more convenient!) Heres a link for  how to do hand expression. 

Use breast compressions

 This is actually tied for my favorite tip for keeping babies awake at the breast! Maybe your baby started sucking well then falls asleep really quickly. The normal pattern of sucking and swallowing is to have bursts of about 5-7 sucks in a row followed by short pauses in sucking. Your baby should swallow after 1-3 sucks. If your baby is taking LONG pauses between sucking and very infrequent swallows, then  your baby will probably start to fall asleep.

Using breast compressions,, you can help your baby to start sucking again by pushing some milk toward to baby.  Remember, flowing milk keeps the baby awake. When baby stops sucking, gently compress and hold your breast to push milk toward the baby. This will cause baby to start sucking again. When baby is sucking well, stop the compressions. If baby is sucking well, you don’t need to compress the breast.at all. Let the baby do the work.  Allow baby to suck at their own pace. But, if the pauses are getting too long and baby is falling asleep, gently press your breast to give baby more milk. This is what will wake the baby (not the tickling or tapping their feet or stroking their face) Flow of milk toward the baby will wake baby enough to start sucking again. If baby, won’t start back to sucking or sucks once or twice and stops, then you can stop the compressions. 

Use Switch nursing 

Our goal is for baby to stay on one breast for a full feeding,  then switch and offer the second breast to the baby. But if a baby is falling asleep at the breast, then the  baby is not getting milk. It doesn’t help baby to stay at the breast for long periods of time if they aren’t getting milk flow. If this is the case for your baby, then you will want to go ahead and switch baby to the second breast when they are no longer actively feeding. This is a temporary measure used to help baby get in MORE milk during a feeding by keeping the baby awake at the breast. 

Every time the baby latches on to the breast, baby wakes and sucks more vigorously and gets a “rush of milk”. But between the let down or ejections of milk, these sleepy babies fall asleep. By switching the baby, you can wake baby and get them to latch and suck more actively - getting in more milk. If baby is again  falling asleep quickly, then you can switch baby back to the first breast tand even back again  to the second breast. Baby will get more milk by feeding actively for short periods on each breast twice, then by staying on one breast for a long period of time without sucking and swallowing. This looks like feed on Side A, switch to Side B, switch back to Side A, Finish on Side B . Once baby is growing and is stronger, you won’t need to use switch nursing any longer. 

Supplement first

For very sleepy babies who are having difficulty waking at the breast or babies who are too weak to stay awake or are losing weight, it is sometimes helpful to offer the baby a little milk or colostrum  from a spoon or syringe or cup before putting baby to the breast. This gets a little bit of nourishment into the baby so that the baby will have the strength to suck stronger at the breast. (If you are needing to use this tip, you should contact a lactation professional to help with your breastfeeding)

Don’t pull milk away from baby 

The use of silicone pumps and “milk catchers” is a very popular practice right now. But, use of these silicone pumps is one of the most problematic practices I shave ever seen in lactation care. This is an entire subject all unto itself, that I will discuss in detail later. But, briefly, the practice of using the silicone pump to “catch the extra milk” from one breast while baby is feeding on the other breast can lead to a lot of problems with babies. The most dangerous and problematic ones is that by pulling this milk off before the baby feeds, the flow and volume  of the milk is decreased and baby often will not continue to suck and stay awake on that breast. Then you have a baby who is not gaining weight, but you have a lot of milk in your freezer. The baby actually needs that milk for growth and weight gain. 

There are many parents who are using these devices without this problem.but for many babies who I see, this is a big contributor to weight loss or poor weight gain. 

The thinking is that these silicone devices are just collecting leaking milk but if they are suctioned onto the breast, they are actually causing a vaccuum which pulls out milk from the breast. These sleepy babies may not have the strength to feed on one breast only.  All parents don't have the breast storage capacity to feed on one breast only. Babies need that flow of milk from the breast to keep them actively feeding.  If volume of milk has been pulled off already before the baby feeds from the breast, that flow is slower and a sleepy baby cannot stay awake to get that milk out.

If a collection device is used, it should only be used AFTER a baby has completely finished a breast and never before a baby feeds on a breast. The same goes for a breast pump. Pumping off milk before a sleepy baby feeds may lead to slower flow of milk that will not keep baby awake. 

Seek Guidance from a Lactation Expert

Try these tips and see how they work to keep your baby awake and feeding more actively at the breast. All babies are sleepy in the first few days of life. But, if you are having a difficult time keeping your baby awake after the first week, or if your baby is having difficulty gaining weight, or if your baby is fussy and hungry after a feeding, then seek help from  lactation professional right away. 

I would love to help you with your breastfeeding goals. I offer home visits, office visits and virtual visits so that you can have a consultation no matter what your needs or where you live. I have insurance and self pay options.You can check to see if your insurance participates in our network https://go.lactationnetwork.com/DreamBabyCafe or see my other options at www.DreamBabyCafe/Breastfeeding 

You can also find a lactation professional in your area at www.zipmilk.org or www.lactationnetwork.com