Advice on Breastfeeding "On Demand"

Updated on November 01, 2009
R.C. asks from Phoenix, AZ
29 answers

My pediatrician said that I should cut back on feedings because my 4 month son is 20 lbs. 8 oz. (100% for weight, but also 100% for height) He is 100% breastfed. I nurse on demand, but he may just nurse sometimes to soothe himself. Do you think I should cut back? Do you think it will hinder his development? How many times per day do you think is typical to breastfeed in a 24 hr. period? Any thoughts or opinions would be appreciated.

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W.W.

answers from Washington DC on

Try a pacifier. Baby will let you know if he's hungry or just wanting to soothe himself, and if all he wants to do is suck, a pacifier helps both of you. He'll refuse it if he hates it (try a few times to give him a chance to get used to it).

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A.H.

answers from Phoenix on

I am a SAHM to 4 wonderful little boys (ages 11 years to 11 months). I first want to say CONGRATULATIONS on the birth of your son! And KUDOS to you for giving him the best food a baby could get...his mommy's milk!

Reading your post reminded me of my firstborn who was lucky to be my firstborn because I had all the time to sit and literally nurse him all day long. The longest stretch he had between feedings was at the most 1 1/2 hours. He was born weighing 9 pounds and was over 20 pounds by 3 months. He wasn't even on the charts for his weight! Waaaay off the chart. My doctor never told me to "cut back" on his eating because he always said his "fat to height ratio" was ideal, but if he had told me to cut back, I doubt I would have followed his advice. I knew my son would eat as much as he needed and no more.

I know that every baby is different, but chances are, your little guy will very soon taper off in his weight gain. My son stopped gaining so quickly by 4 months and was maybe 24 pounds by 6 months and maybe 28-29 pounds by the time he reached a year old. Now, he was truly exclusively breast fed. He absolutely refused bottles, and any kind of food we offered him until after he was a year old. All he got was what I gave him.

I think it's normal for some babies to just grow like gangbusters the first few months of their life, then by the time they are 6 months old, they start slowing down. I've only breastfed my babies so I can only speak from breastfeeding experience. And again...every baby is different. But if you think your baby needs to eat, especially since you are nursing, I wouldn't refuse him. Not while he's only 4 months old! I wouldn't worry about it until he's at least 6 months old. He'll become more active, stay awake longer and I'm telling you, unless he's a freak of nature, I'm sure he will start to taper off and not gain so much weight. ALWAYS go with your god-given instinct. Keep up the good work with your little one and enjoy every single moment. The time goes by SO FAST!!

P.S. - My mother in law thought I was overfeeding my baby because she was told by her pediatrician (back in the late 60's early 70's) to only feed her babies FIVE times a day...which she did!! Her kids gained one pound a month for the first year of their life and she thought that was perfect. Once she came to visit and saw how much my son was eating and growing (he was a month old at the time) and was convinced that he really was getting "too much". But after he nursed for 45 minutes, she was sure he would be good for several hours. Well, just like clockwork he got fussy again and acted like he was ready to eat an hour later. So to "prove me wrong", she decided to take him and try and console him some other way. After about 10 minutes of his hysterical crying and rooting around on her chest, she finally conceded that he really must be hungry. So I took him and nursed him again and he ate for another 45 minutes. She was speachless. I tried to tell her, but she was convinced I was just feeding him for the sake of feeding him. I was so relieved that she got to witness for herself that he was truly hungry.

Sorry to be so long winded, but I have definately had some experience in this area!

Happy mothering!
A.

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K.R.

answers from Phoenix on

Don't worry about it! My oldest was 16lbs at 4 months old and my youngest was 20lbs at 4 months old, both breastfed on demand. They all grow at different rates and as long as he is healthy than you are doing a great job. I agree with previous posters, pediatricians sometimes give opinions as facts and you have to do what YOU think is best. They don't have to go home with your child and hear it cry from following through on their advice.

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N.W.

answers from Tucson on

My daughter grew that fast, breastfed as well... I wouldn't change a thing!!! He may need a pacifier, both of my breastfed babies lost interest in the pacifiers before 9 months of age, and I believe that breastfeeding would fortify his development rather than hinder. your 4 month old is about the size of my 10 month old son, but like I said before my daughter grew like your son, she is now 4 yrs old nearly 4 feet tall and 45lbs... a little bigger than her 5 and 6 yr old friends... so do what YOU FEEL IS RIGHT! don't let anyone interfere with what you feel is right with your baby. ( but if you do need a break every now and then and he does not want a pacifier... try giving him a warm bottle of tea, herbal of course no caffeine, my homeopathic pediatrician suggested teas like mint & chamomile, I sweeten them with a little agave nectar (low glycemic and natural) no more than 12 oz. a day, that way baby is still getting what's most nutritious, your milk. Best of luck!!!

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A.

answers from Albuquerque on

Keep doing what you're doing! If only everyone else were in your place, our kids would be SO MUCH healthier as adults.

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M.P.

answers from Phoenix on

Your baby's interest in nursing is your best guide to what he needs, not your doctor's scale. Breastfed babies generally level out themselves and don't tend to be obese later on. If he were drinking formula - it would be a different story.

Keep feeding him when he needs it! Even if he's just soothing, you're teaching him he can trust you to listen to his needs and meet them.

M.

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J.V.

answers from Phoenix on

Breastfed babies SHOULD be nursed on demand. You are doing exactly the right thing! My son was BF on demand and was always a big chunk. Now my daughter is also and is just a little thing. You are doing the right thing! Also, your milk is on supply-and-demand, so demand feeding is the best way to keep your supply up. Here are some links with research on demand feeding a breastfed baby :).

http://www.llli.org/ba/May99.html
http://www.gentlechristianmothers.com/articles/cuefeeding...
http://www.fix.net/%7Erprewett/evidence.html

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L.N.

answers from Flagstaff on

I did nurse on demand, and I now my daughter is almost 2 yeras old. There is a balance even with nursing on demand, but you find that more after they are depending more on solids. From what I remember 4 months is a growth spurt time, so it's pretty hard to know if they are nursing for just comfort or food. From my experience, especially at an older age, nursing for comfort lasts only a couples minutes and then they're done. Oh, but what I meant on finding a balance happens more at the toddler stage. There are times where I feel like my daughter is too often, and at that age, it's appropriate to express your feelings and have them accept a few limits. But at your son's age it's just to young to expect them to understand why you deny them.

In response to the reply about needing to introduce solids soon, I've never seen any proof that waiting to introduce solids makes them picky. On the flip side, I've seen studies that show that solids before 6 months increases chances of allergies. Personally, I like more of a child-led introduction to solids. We rarely fed our daughter solids. If she wasn't able to feed herself with the food, then she didn't end up eating it. She did do quite a bit of gnawing on food after we started offering at 6 months. But it wasn't until about 9 months that she actually started eating any significant amount of solids.
One advantage we've noticed - just circumstantial though - is comparing her to a friend's kids who is 5 months younger, who was fed his solids (still is). They have had to worry about him choking on things, but we have never worried about that with our daughter. Since she feeds herself, she knows what she can and can't swallow.

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S.B.

answers from Tucson on

When my daughter was 4 months she was BF every 2 hours or less. She is small though - currently at 9 mo in the 25%. But I have always fed her on demand. I did try to schedule her and stop at night (she was up to 5 times a night) but she won over and still gets fed on demand.
Even now that she is eating some solids she still BFs about every 2-3 hours.
Is your son hitting his milestones and is happy and healthy?
I would not worry too much as long as it does not bother you. Peds don't know everything. They keep telling me to give my daughter a bottle because I "obviously" do not make enough milk for her to grow - I make PLENTY often leaking still at her being 9 months. She is just very very active!

Do not stress over feeding your son. It is such a joy to BF! Do what you think is best for him. Mothers are normally right!

Congrats to you and enjoy your son and being a mama!

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S.L.

answers from Tucson on

feed him as much as he wants right now within reason - every couple or three hours can be normal - it may seem like that's all you do for a while but it doesn't last forever - he is obviously using it to grow - I nursed all three of my sons until they were at least a year old and stopped by two - the oldest is now 6'6" and does security work and second is in college doing a double engineering major - third is a 6' tall 8th grader - nursing makes them strong and healthy - just be sure you rest as much as possible and feed yourself the most excellent pure chemical-free nutrition you can find - enjoy your son ;-_)

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E.M.

answers from Phoenix on

I would get a second opinion. Breastfed babies are often little chunks, especially at that age. If he is 100% on both, rather than 100% weight and 50% height, I wouldn't be worried. My son was on the breast what felt like 24-7, including night nursing on demand (co-sleeping). He has always been around 75% height and peaked at 95% weight. That was only for a few weeks, and he quickly leveled off at 75/75, where he has stayed since about 9 months. Babies do nurse for comfort, but that motion is more gentle and will yield little if any milk. There is NOTHING wrong with allowing your baby to nurse for comfort. I had another mom put it to me this way- do you want your baby to be soothed by being close to you or by a piece of rubber and plastic? Don't get me wrong, I used pacis from time to time, but don't feel like you must. For more info, I recommend checking out www.llli.org
I would not limit your baby's food without another opinion, or some indication other than weight that there is a problem (allergies, etc.).

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T.S.

answers from Phoenix on

It sounds like your son is a healthy breast fed baby! It's fantastic! As someone mentioned before his height to weight ratio is in proportion so he's just a big boy.

Breastfeeding for comfort is NOT a bad thing. They want to feel and have that closeness to you and at his age it is healthy. If you want to cut back on soothing him at the breast it is one thing but as far as the health of your child, you are doing great and I would continue the road you started on.

My daughter at 4 months was in the 80-85% for height & weight and still is @ 10 months. My husband and I are small so it was and continues to be surprising. However, it's just a sign of a healthy breastfed child. There's no reason to stop.

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A.G.

answers from Phoenix on

Don't stop feeding on demand. Your child canno have too much fat right now. It is both bonding between you two and nourishing for your baby. Once your baby starts to crawl he will burn off a lot of calories. So trust your instincts and keep doing what you're doing.

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D.P.

answers from Phoenix on

honestly the doctors need a growth chart for nursing babies and formula fed babies- they are so different:)
I also read other responses on solids and it is highly recommended that you wait until 9 months or even a year to introduce solids due to allergies. My daughter waited this long and eats more foods that many kids do not due to waiting. Too many kids have life threatening allergies so it is so important to wait.
Keep breastfeeding and dont worry about adding in foods.

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K.B.

answers from Yuma on

My daughter was a chunky monkey! I breastfed on demand and I am positive that sometimes it was jsut for comfort. Her pediatrician wanted to sit her in the front of his office and show people what a "haelthy baby" should look like. He was thrilled that she was chunky (still proportional, but well-fed). Once she started rolling and trying to crawl, she stretched out and wasn't so chunky. I think the opinions of doctors vary so much and some are starting to worry too much about childhood obesity. I personally think that has to do with candy, fast food and too many snack...not breast milk. If your son is healthy in every way, then I say you stick with what you are doing. Sounds like you are on top of things and doing a great job for your little boy.

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B.R.

answers from Phoenix on

Follow your instincts. My son is now 17 months and although he is still in the 95% for height his weight is only the 50th %. He fed on demand and he fed frequently. He was in the high 90's for height and weight all his first year. The more active he becomes the more the numbers will adjust.

L.W.

answers from Phoenix on

Your son sounds well proportioned (100% weight and height) so what you are doing now seems to work well.

My 1st and 3rd children were EBF and were also 100/100... they slimmed down when they started walking around 12 MO (chunky babies may walk a little bit later than their counterparts) My 2nd child was bottle fed and also 100/100... all 3 kids (ages 6, 3 and 2) are very active and very healthy. As you can see, I have a history of big babies! LOL

And as a PP stated, pediatricians are not gods. You can do one of two things with their advice... you can take it or leave it. I've done a lot of smiling, nodding, and telling the pediatrician that "I will consider it." But you are the mother, and you are around your child way more than the pediatrician is. Ultimately it is your decision. And if YOU decide you want to nurse on demand, then so be it. Case closed, end of discussion- pediatrician can't do anything about it.

At the young age of 4 MO, I think I nursed DD#1 about every 3-4 hours... well, I also started supplementing with a bottle at this point for her because I was going back to work and didn't build up a supply of breast milk. With my DS I was still EBFing and feeding about every 2-3 hours.

I know that your decision will be the right one for you and your son. Enjoy the time with him, he's only going to be 4 MO once. Soon he'll be walking and running and won't want to be with you 24/7... no need to hurry your son. Enjoy and congrats on a healthy baby!

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K.P.

answers from Phoenix on

Congratulations on your new baby! Glad to hear that you are able to breastfeed so well - so, many new mom's have trouble. Great job.

I went through this same issue with my son and the pediatrician. Rule of thumb is: If you baby is over 8 lbs and 8 weeks old - they do not need to be feed through the night - they can go between 10-12 hours without feeding. You need to start a night time routine that will help your baby learn how to sleep through the night (that they need so desperately for their development). During the day, you should be feeding your baby every 3 hours (both sides). They can wait the 3 hours trust me - also, if you only do one side at a time then every 1 1/2 hours then. (oh, and you should pump a little bit before you feed your baby in the morning - because at first you will be really full. Good luck to you!

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L.M.

answers from Tucson on

The vast majority of doctors know little about breastfeeding sans a class or two they may have taken in medical school. No joke, I used to work for several family practice docs and that is exactly what one told me...he felt LLL was a much better resource then himself.
No, don't cut back on feedings, he's not obese. A breastfed baby is very different then a formula-fed baby in terms of growth. It won't hinder his development, feed him and comfort him as much as he likes--breasts are NOT just for food!! He sounds like a very healthy little guy :)

Babies need to eat through the night....their tummies are generally about the size of their fists (or a little bigger) and BM is quickly digested, which is why they eat more often then a formula-fed baby...so NO they can't and shouldn't go 10-12 hours without eating. I don't know any adult that can do that! Don't time the feeds, just let him eat when he wants, how much he wants. I use peds for sicknesses only since that's their area of expertise--I don't use them for breastfeeding or parenting advice at all.

ANd, this "The problem with feeding on demand is that later on in life they will learn to soothe their emotions with food and become emotional eaters" is not only NOT true, but there is NO scientific evidence, studies, ANYTHING to back this up. Sounds like someone was parroting more antiquated advice from a doc (much like you HAVE to start solids by 6 months or they'll be picky--they apparently haven't met my kids LOL). THis is just not true at all, believe me LLL has plenty of great data that disproves this. Myself and many other people would be VERY overweight if this was a fact.

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S.C.

answers from Phoenix on

My ped always said that the numbers didn't matter so much as long as they were fairly equal between weight and height. 100% for weight, but only 50% or less for height (or vice versa) would be alarming, but 100% for both simply means that he's the right weight for that height. And even if the numbers weren't equal, my ped didn't worry if it was a normal trend for that particular child.

I would definitely get a second opinion before refusing feedings at only four months old. Unless he's acting sick or vomitting afterwards, he's not over-eating.

You're a new mom, so I'll let you in on a secret. Pediatricians are generally great people but they are not gods. And what one swears by, five more will swear against. Every single one of them will give you advice that falls well outside the realm of their medical expertise. Like when to get rid of the bottle/paci, how to handle temper-tantrums, etc.

So you need to take what they say with a grain of salt. And if they tell you to do something (or NOT do something) that makes you feel uncomfortable, you need to either:

A) Tell them you're not comfortable with that and ask for a detailed explanation of the logic and reasoning behind their recommendation.

B) Get a second opinion and (in doing so) shop around for a better pediatrician. They're like OB's...you never really know you have a bad one until you get a better one.

C) Ignore their advice completely and do what mothers have done for thousands of years (long before statistics were invented) which is feeding your baby when he's hungry.

You should know that your pediatrician might have had other reasons for telling you to cut back, like helping your son learn to self-soothe, or possibly take more from each feeding (because he's hungrier) thereby getting more of the "good" hind-milk. If that's the case, then he/she should have explained that reasoning to you so you could make your decision accordingly.

No matter what, though, it's your decision. And since your son sounds like the picture of health, you really don't HAVE to change a single thing about how you care for him.

Best of luck to you, Sweetie.

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K.M.

answers from Flagstaff on

I don't see anything wrong with nursing on demand. I personally prefer to get my babies on a schedule of a feeding no closer than 3 hours from the beginning of the previous feeding though ( sometimes I will go sooner if the baby really insists that they are hungry). I typically nurse 7-8 times a day on this schedule but tend to get down to 5-6 times as they get older, and then less and less around a year to start weaning. I agree with whoever it was that said you should make sure and follow the babies cues and not to just nurse at every little peep. Good luck with whatever you decide to do, it is your baby, and don't forget it!

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J.C.

answers from Phoenix on

I breastfed both of my babies on demand and neither one of them were big babies. They both were breastfed over a year and were pretty average in size. I had a friend who breastfed all of her kids and they were all HUGE! Now, I would have just chalked it up to be their metabolism or their genes, but one day I observed her feeding her baby and I was astounded at what I saw...everytime her son made a peep, she picked him up and stuck him on her breast and he would eat for 10-15 minutes! What????? This went on for about three hours. In that three hours she fed him at least six times!!! I never had the courage to ask her why she was feeding him so much and not reading the other cues he was giving her. A baby doesn't always fuss because they want to eat. One time she fed him, he was fussing because the sun was shining in his eyes through the window, another time I am assuming it was because the other kids were too loud!

I guess my point is this, are you actually feeding him on demand or are you misreading his cues? Does he just want to be held, or does he really want to eat? My kids let me know when they needed to eat, they had a certain cry. I guess I agree with the doctor on this one, I think you should get your son more on a schedule or try to monitor his feedings by only allowing him to eat every two to three hours. The problem with feeding on demand is that later on in life they will learn to soothe their emotions with food and become emotional eaters. Don't get me wrong, I am all for breastfeeding on demand, you just have to make sure you are feeding them when they actually need it. Sorry if I have offended you in any way, this is just my opinion.

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P.M.

answers from Albuquerque on

R.,

I too have a 4 1/2 mo old and breastfeed solely, on demand. My son is 15 lbs..., at least that was 2 weeks ago, so he may weigh more. This baby is my 3rd and I've done the same things with all 3 with no trouble. I always thought that it wasn't possible to over-feed a breastfed babies because your body only makes as much milk as your baby needs. Breastfeeding is so natural and your body gets in-sync with baby's body. I don't think I'd worry. Maybe you can get another opinion. None of my kids are over-weight as a result of on-demand feeding, so I don't see a problem with it. I have recently introduced rice cereal with breastmilk so he's nursing a little less, but he's pretty healthy and strong with what we are doing.

Pamela

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A.D.

answers from Phoenix on

As far as breastfeeding goes I wouldnt listen to that Dr. My son is now 13 mths and still breastfeeds on demand. It is the very best thing for them. I dont think there is a typical amount of times to feed, I feed him when he is hungry or sad or hurt or when he just wants to be close to me! He has just recently decided he would eat regular food and not every day either.

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J.A.

answers from Phoenix on

I was always told that at that age, if they're thriving as your son seems to be, than you could reduce the feedings to every 3 hours. I did notice when I started this that my kids slipped into the routine fairly easily but would occassionally "cluster" feed during growth spurts or before bedtime. I too had very large babies and faced the same advice. You may find as your babies starts to become more active that he will thin out considerably. If you still have concerns though, contact your local La Leche league and you can talk to a registered lactation consultant for free...they are amazing! Just look them up in information. Good luck!

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K.V.

answers from Albuquerque on

You can't overfeed a breastfed baby. Personally I wouldn't cut back so long as all he is consuming is breast milk. Mine would feed every two-three hours. He was off the charts for a while, but it evens out. Now mine is 95% in both height and weight. Your son seems to be equal on both growth chart measurements. I would understand if he was 100% on weight and 50% on height, but he is not. Personally I would not take this advice of cutting him off. He is obviously growing proportionately<sp>.

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S.B.

answers from Albuquerque on

I think you should feed the baby when the baby is HUNGRY. If he is just fussy try another method. Also being a new mom you may not have known the difference. I have breastfed all 3 of my boys and also care for a child who is breastfed. She is 3 months and eats every 3 hours about 2.5-3oz a feeding during the day. She sleeps all night already for mom though.

MOST breastfed babies are hungry every 2 hours and can go a little longer as they get older and consume more at the feedings. ALL babies are different. If you pump at all see how much you are pumping and see how much your little one eats at a feeding. He may not be getting enough and that is why he is eating so frequently. Unlike a bottle you can't measure what he is truly eating. He should be eating around 4oz every 3-4 hours.

There are tons of books out there that are for breastfeeding moms that can help with questions and problems.

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W.A.

answers from Rochester on

My son is a big boy too (18.5 lbs) and I nurse on demand (he's 5 mos), and I find he nurses every 2-3 hours during the day and 3-4 hours at night. I can tell if he is just "sucking" for comfort, either at the beginning or end of the feed and I pull him off as it hurts me :), so check for this. I know ppl will say try to soothe in other ways first aside from the breast and then use it. You could try a pacifier if he's just sucking at your breast for comfort versus food...that's what they're there for and I've done that a few times. Good Luck!

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M.D.

answers from Phoenix on

Good for you to have a healthy baby and be fortunate enough to only breastfeed. The doc might just be suggesting "cutting back" a bit because your boy is obviously getting enough nourishment and you will be introducing some solids between 4-6 months, usually. It's just a way to help transition him to eating when he's hungry, not when he wants comfort.

I don't think your doc is saying you feed him too much or too often, just that you will be moving into a new phase and it will likely be easier on both of you if he learns to nurse for hunger and finds soothing in rocking, cuddling, etc. rather than the breast. Also, you do want to get him interested in other foods soon. Babies that are not introduced to solids by about 6 months can have issues with textures, or can reject solids.

Talk to your doc with more specific questions. I don't think he/she is in any way suggesting you restrict or discourage nursing; I think doc is just encouraging the transition to more food, less breastmilk in the near future.

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