Feeding on Demand in the Early Weeks

The American Academy of Pediatrics recommends feeding newborn babies on demand, or whenever they show signs of hunger like rooting and sucking motions, in the early weeks and months of life. Medical terminology defines a newborn as the first 28 days but often in popular culture the term is applied as less than 4 months. In this article, we'll use the term newborn to denote the first month of life. 

Feeding on demand allows your breastfed baby to eat as much as they want, which helps establish your milk supply during this crucial newborn stage. There are two main premises that help your milk supply become established in that first month - frequent sucking and transferring of the milk.  Feeding on demand also meets your formula-fed newborn's needs of filling up their small stomach frequently.   As a lactation counselor and baby sleep expert,  I work with parents who need help with feeding and sleeping. 

While feeding on demand is the best way to feed a brand-new baby, it can also mean feedings happen around the clock in those first few months. Some new parents have a hard time figuring out when baby wants to eat and if they are getting enough at each feeding session. Look for rooting, mouthing motions, sucking sounds, and hands to mouth as late signs of hunger in newborns. Crying is a very late sign of hunger that you'll want to avoid.  Ideally you want to be feeding a newborn when they are in REM sleep as crying is a late stage feeding sign and can make it harder for a newborn baby to latch.  

Signs of REM sleep:

1. Eye movements -REMstands for rapid eye movement. You may notice your newborn's eyes moving back and forth under their eyelids during REM sleep. The eyes aren't open, but it looks like they are looking around.
2. Irregular breathing - Breathing during REM sleep may be more irregular, faster, or shallower compared to non-REM sleep. You may see their chest and belly moving more rapidly.
3. Twitching - Tiny muscle twitches or jerky movements may occur during REM sleep, particularly in the face, fingers, arms and legs. This happens as the brain is very active. They may also make sounds or smile.
4. Closed eyes - REM sleep is different than wakeful alertness where eyes are open. REM by definition occurs with closed eyes, even if they are moving beneath the lids.
5. Relaxed muscles - Despite the eye and muscle twitches, the rest of the body and face remain relaxed in REM sleep. Arms and legs will be limp.

Moving Towards a Schedule After 4-6 Weeks

Many parents like to have a schedule for their baby to know when to feed.  The breastfeeding institutions strongly dislike this idea.  They would prefer that you continue to feed on demand reading cues.  In my 10 years of experience helping parents get their newborns, babies and toddlers to sleep what I've found is that it can be very difficult for many parents to accurately "read the feeding cues."  This was my own personal struggle as well.  Never wanting him to "wait for a feed" and wanting to be the best mother I could be I jumped and breastfed him frequently.  Is there anything wrong with that?  Not really, unless you want to get longer stretches of night time sleep because what happens is you "ruin his dinner" or "create a snacker."  I talk about this more in my Amazon best selling book, The Helping Babies Sleep Method.  I see this happen in many of my well meaning clients, we are tired and anxious and have trouble reading the cues and use feeding, be it breast or bottle to mute the tears rather than develop other skills to troubleshoot the tears.  That's why I created The Helping Babies Sleep Method which helps tired parents get their baby on a daily flow, rather than a strict schedule so they can hone their troubleshooting skills and learn reasonable expectations on feeding and sleeping needs and goals. 

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A newborn feeding schedule, I prefer the term daily flow because it's not rigid,  can be introduced after 4-6 weeks when breastfeeding is well established and newborn babies are more alert. A daily flow helps busy new parents anticipate their day while still meeting baby's needs by watching for hunger cues.  Strict schedules are not recommended as feeding times can vary.

A newborn feeding schedule for breastfed babies aged 1 month old may look like this:

1. 7 am - Feed upon waking
2. 9 am - Feed
3. 12 pm - Feed
4. 3 pm - Feed
5. 6 pm - Feed
6. 9 pm - Feed
7. 12 am - Dream feed

Formula-fed newborns may last a bit longer between feedings:

1. 7 am - 3-5 ounces of formula
2. 10 am - 3-5 ounces of formula
3. 1 pm - 3-5 ounces
4. 4 pm - 3-5 ounces
5. 7 pm - 3-5 ounces
6. 10 pm - 3-5 ounces

On average, your baby should take in about 2½ ounces (75 mL) of infant formula a day for every pound (453 g) of body weight. But they probably will regulate their intake from day to day to meet their own specific needs, so let them tell you when they've had enough. If they become fidgety or easily distracted during a feeding, they're probably finished or need to be burped. If they drain the bottle and continues smacking their lips, they might still be hungry.

Remember feedings may vary day-to-day based on growth spurts, baby's appetite, and sleep schedules. Watch baby's hunger cues and offer more frequent feedings if needed.

Sources, my own experience and The American Academy of Pediatrics

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Bottle Feeding vs. Breastfeeding Schedules

There are some key differences between bottle feeding and breastfeeding schedules in the first year:

1. Breastfed babies need to feed more often to stimulate milk production. Breastfeeding about 8-12 times in a 24-hour period helps maintain milk supply.
2. Formula-fed babies can go longer between feeds as formula digests slower than breastmilk. They often eat every 3-4 hours compared to 2 to 3 hour newborn
3. Bottle fed babies know exactly how much they are eating at each feeding based on ounces consumed. It's harder to know much breastmilk a baby takes in.
4. Breastfed newborns tend to wake more often at night as breastmilk digests quickly. Formula keeps them fuller longer but be aware it is NOT the thing that will solve your short stretches of night sleep if you're having them. 

Feeding Solids and Transitioning Schedules

Around 4-6 months, breastfed or formula fed babies can begin experimenting with solid foods. This allows you to expand the feeding schedule.

1. Start with rice cereal mixed with breastmilk or formula. Slowly introduce pureed fruits and vegetables.
2. Follow baby's signs of readiness like sitting unassisted and good head control. Wait until 6 months for finger foods.
3. Offer solids after breast or bottle feeding sessions so they still get nutrients from milk.
4. Over time, add in 3 solid food meals per day. Breast or formula feedings can reduce to about 5-6 times in 24 hour by 6 months.
5. Sippy cups can be introduced for water as early as 6 months of age.  Open cups are even better for oral development, but can be messy.  Here's a video from an occupational therapist. 

Tips for Adjusting Schedules

1. Use wake windows to determine the best times for feeds. Newborns are only awake for about 60 minutes at a time.
2. For quality feeding time, try to feed away from sleeping time when baby is alert. Sleepy babies may not take full feeds.
3. Cluster feeds are normal in the evenings when babies want to snack frequently. This signals the body to produce more milk overnight.
4. Implementing dark room, white noise, swaddling, and pacifiers can prolong sleep between feeds. But don't force a sleeping baby to eat.

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Newborn Night Wakings and Feedings

Newborn babies wake frequently at night in the first few months needing to be fed. This can leave groggy new parents wondering if baby is hungry or just looking to be comforted back to sleep.

1. Newborns have tiny stomachs so breastmilk and formula digests quickly, meaning they need feeds about every 2-3 hours in the first month. This includes overnight feeds.
2. It's normal for newborns to cluster feed in the evenings when establishing milk supply.  We refer to this as the witching period, read more on that here. They may wake more frequently overnight after cluster feeding.
3. Some parents try dream feeds to fill baby's tummy around 10-11 pm so they sleep longer until the next feeding. But this doesn't work for all babies.
4. Breastfed babies nurse more often at night than formula-fed babies. The composition of breastmilk changes overnight to help promote sleep.
5. By 4-6 months, breastfed babies can go longer stretches at night, like 6-8 hours. Formula-fed babies may sleep 8 hours earlier.
6. This first month is not the time to be trying to minimize night feeding.  To get longer stretches of night time sleep.
7. Great sleep isn't just about what happens before the sleeping period.  It's about 24 hours of your newborns day starting from when they wake up. This is what we teaching in side of The Helping Babies Sleep Method. 
8. ​Pillar 1 - Understanding sleep is a learned habit.  It's never too early to be intentionally feeding and sleeping and working on good sleep habits. 
9. Pillar 2 - TIming; the timing of feeding and sleeping is key to your success. 
10. ​Pillar 3 - Intentional Feeding; Using food to fuel and come to the breast or bottle and take a full feed.
11. Pillar 4 - Assisting; Your newborn is too little to self soothe and you need to be assisting and we teach you how to do so in a sustainable manner
12. Pillar 5 - Troubleshooting; If you're having a hard time, what are the things you need to be thinking about to help meet your baby's root needs.