Nursing Cues

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Since the birth of my second baby, I have been thinking about nursing frequency, the nitty-gritty of why and when babies need to nurse.

New mothers will hear a lot of conflicting things about this (and about everything pertaining to their newborns!).  Thankfully, most experts don’t recommend anymore that moms nurse every 3-4 hours. Frequencies like this were based more on bottle fed babies’ schedules and are not appropriate for breastfeeding since breastmilk is digested faster than formula.  If a number is given, it is usually every 2-3 hours, or 8-12 times in 24 hours.  Others will tell you to “nurse on demand,” which generally works out better for most babies because most of us would rather eat when we’re hungry rather than when the clock says it’s time to eat.

But even so, it is sometimes unclear about what “on demand” means.   For a healthy, full-term baby, there are some clear “nursing cues,” or instinctual reflexes that babies are born with and will exhibit when they want to nurse.  These include rooting, sucking on hands, licking lips.  But many mothers have never been around babies before, or have never been told what these cues are and how to look for them.   And some babies (preterm babies, babies who’ve had difficult births, babies who are having  trouble latching or transferring milk, babies who have been given bottles early on, etc.) will not be able to give clear signals that they want to nurse.

My first son was very sleepy when he was born, and it was difficult for me to get him to latch consistently and easily in the first few days.  I was instructed by his pediatrician to wake him up every two hours to nurse him.  Looking back, I probably was just missing many of his cues, because oftentimes babies appear to be sleeping, but will be moving their lips, or searching for the breast in their sleep.  If I had simply stripped him down to his diaper and let him sleep against my bare breast, his instincts would have taken over, and he may have even found the breast himself.  But his pediatrician felt that I needed to control things so that he would regain his birth weight and nurse efficiently.  Since he didn’t seem to be waking on his own, this was useful advice, and once he began getting more milk, he most certainly did wake up, and all semblance of a “schedule” flew out the window.

This time, with my second son, there was absolutely no schedule, no clock-checking, nothing of the sort.  Basically, in the first few days, before my milk came in, he was on my chest all the time, and anytime he moved, or made a peep, I nursed him.  I have no idea how many times a day this was, but there were certainly times it happened more than once in an hour, and times that several hours would go by (probably when I was sleeping too).

Some might ask, “He couldn’t have possibly been hungry that frequently?”  While it is true that babies in the first few days have very limited stomach capacity (the size of a marble) and do need to nurse VERY frequently, it is probably true that nursing several times in an hour is not strictly necessary for the nourishment of a newborn.  But I knew something with my second son that I didn’t quite understand with my first son: Nursing is about more than nourishment.  With my first son, I was very concerned about his livelihood in those first few days.  I had created a human being, and somehow my body had to continue nourishing him outside the womb.  I needed to make sure he “got enough.”  With my second son, I had confidence that I could do that, and I also knew he was coming to my breast for other reasons as well, even in those first few days.

Yes, he nursed because he was hungry, because nursing like crazy in the first few days and weeks could ensure a plentiful milk supply for him.  But there was more to it.  I nursed him when he’d been woken up and wanted to go back to sleep, but couldn’t do it himself.  I nursed him when the bath water had been a little too cold (oops!) and it upset him.  I nursed him when he needed to poop but couldn’t quite move it out (the sucking was just the thing to get everything going).  I nursed him because sound of the vacuum was kind of soothing, but also kind of overwhelming.  I nursed him because there was a little piece of blanket near his mouth and it reminded him of nursing, and so, why not?  I nursed him because he missed me when he was in the car seat for the first time.  I nursed him because his brother accidentally knocked the swing mobile against his head.  I nursed him because he was fussing and I didn’t know why, but I thought that nursing might solve it.

I feel like I have been let in on a little secret this time, with my second son.  Nursing this way, for any and all reasons in the world, makes tending to a newborn so much easier.  Not only do I not have to worry about whether he’s getting enough, but I can feed him and comfort him at the same time.  I remember when my first son was a baby and he had fussy times.  The hardest of the fussy times was when he fussed and I couldn’t figure out why.  Nursing was usually one of the first things I tried, but if he’d nursed very recently, I’d consider other things too – is he too hot, is he too cold, does he need a diaper change, does he need  to burp,  etc.  When this baby fusses and I don’t know why, there is no need to figure out what is wrong.   Even if I just nursed him five minutes ago, I try nursing first.  Nine times out of ten, the problem is solved.  It’s almost as though nursing resets the baby, sweeps away the angst that twisted his baby soul into a little knot.  Nursing brings him home again.

I owe my first son all the credit for teaching me that nursing is about so much more than the milk.  After those first few days of sleepiness and difficulty, my first son became very vocal about when he wanted to nurse.  For months, and then years, he came to my breasts for meals, for snacks, for dessert, and for the times when neither of us quite knew why, but we knew that a good nurse could solve it.

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