Often new moms ask some variation on the question:

I’m curious as to how you ladies handle breastfeeding a brand newborn. One of the visiting lactation consultants said that if he’s sleepy we should let him sleep. He slept 6 hours in the hospital and the nurses said let him sleep. We are off to a great start so far nursing, but I want to do this right. What should I do? Let him sleep and feed on demand, or wake every 2-3 hours?

So what do I think? In the first 24 hours newborns sleep at lot, so what you are told in the hospital is not necessarily what you should continue long term. I’ve seen too many babies who did not wake to feed frequently in the early weeks, and this led to weight gain or milk supply problems. In order to make sure baby is getting enough milk AND you are developing a good supply for long term nursing, it is very important to make sure you are nursing a minimum of 8 times in every 24 hours, but often more than that is needed in the early weeks.

Because “non-demanding babies” are often “content to starve,” the American Academy of Pediatrics statement on breastfeeding recommends that non-demanding newborns should be woken to nurse at least every 3 hours in the daytime (measured beginning of feed to beginning of the next feed), and every 4 hours at night. But again, remember that baby should be getting a minimum of 8 feeds per day, so if you are getting 4 hour stretches between feeds at night, you need to have some feeds that are closer together than 3 hours in the daytime.

Though the AAP doesn’t say this…my general rule of thumb is that as long as baby is gaining weight well, once he reaches 5 weeks you can start going by age to determine how long you will allow him to sleep at night…5 hours at 5 weeks, 6 hours at 6 weeks… If you are lucky enough to have a baby who will go that long. Most breastfed babies stick at 4-5 hours between feeds at night for a while. New moms should also keep in mind that once they are consistently having a period of 6 hours or longer between nursing sessions, ovulation prior to the first menstrual period is likely, so “lactational amenorrhea” should not be relied on for birth control in that case.