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All Time at Breast is Not Created Equal

As new breastfeeding moms, we often think that all time spent at breast is valuable time in which baby is drinking milk, gaining weight, and draining our breasts to boost milk production. However, not all time at breast is created equally. Our babies breastfeed for many reasons other than to get breast milk. Baby is eager to feel close to mom and hear your heartbeat, enjoy the warmth and comfort of your breast, and enjoy the action of sucking. It can be beneficial to both mom and baby to spend time at breast, however it is also important that baby spends time effectively pulling milk to ensure adequate weight gain and to protect your breast milk supply. Once baby is latched, it’s important that we watch baby to ensure that he is actively pulling milk from the breast. A baby can often latch at breast and appear to by nursing but may in fact be passively nursing and not pulling any milk. This will end up with time spent at breast, little weight gain for baby and lower milk production and lack of sleep for mom.

Active Sucking aka Nutritive Sucking

Once baby is latched, it’s important that we watch baby to ensure that he is actively pulling milk from the breast. If a baby is hungry and ready to feed, his elbows flexed allowing his hands to come to his mouth and toward your breast. During an active suck, the baby will have a deep latch with as much of the nipple and areola in his mouth as possible. His lips will be flanged outward and tongue will be cupped under the nipple. His suck will feel like a firm and consistent pull-tug. During each pull of milk, you will see his chin rise and fall deeply and consistently, you will hear frequent swallowing or an audible “kah” sound. (Audible swallowing is typically only heard after baby is about 3 days. Before day 3, baby will be drinking colostrum and the small volume swallowed you may not hear actual swallowing). It is normal for your baby to take breaks or to pause occasionally at breast, however the breaks should last for about 5 seconds or less. Once the breaks start to consistently reach 10 seconds or more, baby may be transitioning from an active suck to a passive suck. Typical active nursing time may range from 5 minutes to 25 minutes at each breast.

Passive Sucking aka Non-Nutritive Sucking

Once your baby begins to have a full belly, he will start to change the way he sucks to help slow the flow of milk and reduce the amount of milk he is swallowing. Your baby may continue to suck for all the reasons listed in the beginning section of this article. As a new breastfeeding mom, how can you tell the difference? When your baby is passively sucking and no longer drinking milk, your baby will begin to “tickle” your nipple with a weak and quivering suck, he may take multiple long pauses that are greater than 10 seconds. When you watch your baby, he will reduce the amount of swallowing and eventually stop swallowing completely. Baby may also start to clamp down on your nipple rather than suck. These are all signs he will give you based upon his suck and latch. His body and arms will also be floppy, and he may be relaxed or sleeping.

When to Unlatch Baby

Should you un-latch baby at this point? The answers can vary. If you are comfortable, your nipple and breasts are comfortable and you don’t feel like you need to take this precious time to catch up on sleep, you can hold your baby and allow them to continue to comfort suck until you are ready to unlatch him. This will comfort baby and will flood your body with valuable breast-feeding hormones. However, if you have sore or tender nipples or experience vasospasm (nipple blanching and pain) you will want to unlatch your baby. Your baby may confuse you when you try to unlatch him because he may begin to suck again, this is simply a reflex and not typically a sign that baby is still hungry. If he is, he will show hunger cues once unlatched. At this point, you can offer him the other side. Typically, once a baby is passively sucking, you will be able to lay baby down in his bassinet. You can use that valuable “me” time to get much-needed sleep or that overdue shower that you have been missing. As always, if you have any questions about the time baby spends at breast, you can always reach out to your local lactation consultant for support.

– Katie Kunz, RN, IBCLC