Feeding on demand or by the hour: advantages and disadvantages of each method

Let's look at the pros and cons of each feeding approach.

Pros of feeding according to the schedule:

• The biggest advantage for many parents in routine feeding is the fact that the mother is not attached to the baby. A father, grandmother, or any relative can feed a child; to do this, it is enough to express the milk and offer it to the baby in a bottle;
• there is no need for co-sleeping. This is more likely the desire of the parents themselves, and not an urgent need. Mom can fully rest for several hours before the next feeding. Family relationships between spouses do not deteriorate;
• unlike feeding on demand, when feeding according to a schedule, the mother can understand whether the child is crying from hunger or the reason is something else, since in 2-3 hours the child will definitely have time to get very hungry;
• according to many experienced pediatricians, feeding according to a schedule relieves the child of abdominal discomfort, promotes better absorption and digestion of food, and avoids overeating (but this issue is also a subject of debate among pediatricians);

Disadvantages of regimen feeding:

• There is a risk of breast problems if there is not enough breastfeeding. This may manifest itself in a decrease in the amount of milk, stagnation, mastitis;
• strong emotional stress of the child with strict adherence to the regime and unwillingness to deviate from it, the child may cry;
• if the baby is offered a pacifier rather than a breast, this can lead to disruptions in lactation and makes it necessary to wean off the pacifier in the future;
• the emotional connection between mother and baby is not so strong (but this point cannot be taken as evidence, rather as an assumption not supported by a sufficient number of weighty arguments or research);
• the feeling of hunger may not appear after the prescribed 3 hours, but earlier - 1.5-2 hours after feeding, in which case the child will regularly feel hungry;
• If the baby is sick, experiencing discomfort due to teething or stomach problems, then he may eat less during feeding due to lack of appetite. In these circumstances, eating according to the schedule will negatively affect the baby’s weight gain and general well-being during illness;
• the absence of night feedings in the early morning hours inhibits milk production and disrupts lactation. Since it is between 3 and 4 am that the maximum amount of prolactin, the hormone responsible for lactation, is produced;
• All children have different characters, different types of breastfeeding. For some, it is enough to spend no more than half an hour with her, while others may not get enough to eat even in an hour.

Frequent and prolonged feedings

Lactation consultants often repeat the same phrase: milk production is a hormone-dependent process. That is, one that depends on the presence of two hormones in a woman’s body - prolactin and oxytocin. The higher their level, the more milk a nursing mother has and the more complete lactation. How can we ensure that enough of these hormones are produced? The answer is very simple: the amount of “maternal” hormones is affected only by the frequency and duration of the baby’s breastfeeding. That's all! The more often and longer the feeding (provided that the baby latches onto the breast correctly!), the more milk is produced. If the amount of milk depended on other factors, then we would observe the filling of a grandmother’s breasts after drinking tea with milk, or a nulliparous neighbor would turn into a lactating woman after a course of homeopathy and taking medications. By the way, it was the discovery of these patterns that made it possible to explain the mechanisms of milk production in wet nurses, and in our time helps foster mothers to feed their adopted child.

What is meant by “frequent and prolonged feedings”? First of all, this is an orientation toward requests for sucking from the child himself. The baby grunts in his sleep, opens his mouth, sticks out his tongue, puts his fists in his mouth, tries to suck on the diaper - don’t wait until he starts crying and “demanding” the breast! Start feeding him at the first sign of anxiety. Even while changing clothes, having a massage or walking. Even if this means interrupting your swim or going into seclusion in a public place.

Usually, during the first two months, the mother learns to accurately guess the baby’s requests for milk: he wants to suck in order to fall asleep; upon awakening (if he begins to whine or cry); often - in a dream (sometimes it is enough to react quickly and quickly give the breast so that the baby, after eating, falls into sleep and further); when you feel physical discomfort (wants to have a bowel movement, is already wet, pain or cold, heat or headaches due to changes in atmospheric pressure...); with any, even the most minimal, psychological discomfort (missed without mom, scared of a new person, tired of being in an unfamiliar place, got too many vivid impressions...). And there may be many more reasons to receive those substances that are contained in mother’s milk! The frequency and duration of attachments are very dependent on the age of the child - his needs change, his sense of self and relationship with his mother change, sucking skills and behavior under the breast improve. But they usually talk about the need for 10-12 applications per day to maintain full lactation.

When providing on-demand feeding, care must be taken to ensure that both breasts are offered approximately the same number of times. As a rule, mothers do this: if the baby suckled for a long time from one breast, next time we give him the other breast to feed. If the baby is attached for a short time, then the same breast is offered several times. This recommendation is associated with the peculiarities of changes in the composition of milk depending on the duration of sucking (sometimes they talk about dividing the milk into front milk, which comes to the baby at the beginning of latching, and back milk - later in time, more caloric and fatty), as well as with the peculiarities of the lactation process itself: if If you feed less from one breast than from the other, it will produce less milk.

An important addition: the hormone prolactin is produced not least due to night breastfeeding. There should be at least three of them per night. If your baby takes a long break from sucking at night, the milk will most likely run out soon. And if you have weaned your baby from waking up at night (tried to calm her down without breastfeeding, ignored signs of anxiety and crying, offered her a bottle or pacifier to suck on) - then you can also not count on long-term maintenance of lactation. Night feedings are most complete and convenient when the mother feeds while lying down and sleeps with the baby. There are different options for organizing feeding and sleeping - find the one that works best for you and your family by studying the experiences of other long-term breastfeeding mothers or consulting with a lactation consultant. Baby needs milk at night - and your breasts absolutely need stimulation in the dark! It’s possible to combine mother’s need for rest and night feedings!

Now I would like to take a closer look at feeding on demand

Benefits of on-demand feeding for mother and baby:

• the baby gains weight better, he is not limited in breastfeeding either in time or quantity, which means he has the opportunity to receive food in sufficient quantities;
• Regular presence near the mother, near the breast, is important from a psychological point of view. It helps the baby to quickly adapt to the new environment, gives a feeling of security, helps to establish close contact and emotional connection between mother and baby (this issue can also be called controversial, since there are situations when breastfeeding is impossible for various reasons, but this does not make the connection between the baby and mom is not getting worse);
• Feeding on demand is a good prevention of lactostasis, even during milk crises, the child himself can regulate the amount of milk he needs due to frequent and unlimited feedings;
• Children who are fed on demand are less likely to experience this phenomenon in the first months of a baby’s life, such as regurgitation, and these phenomena end earlier than in children “on a regimen.”
• Regular breastfeeding helps in the production of oxytocin, which helps the mother recover faster after childbirth (active contraction of the uterus, reduction of discharge).

Disadvantages of feeding on demand.

It is worth noting that there are more disadvantages for parents, in particular for the mother, than for the baby.

• the mother cannot be absent for a long time, since there is no clear schedule for when the baby can “demand” the breast.
• Feeding on demand involves the baby and mother sleeping together in the same bed. Not all parents can accept this; many mothers cannot fully rest, they are afraid of harming the child by accidentally touching him in his sleep.
• According to many specialists in the field of pediatrics and gastroenterology, frequent breastfeeding may not allow food to be completely digested and cause colic and bloating in the child.
• Frequent breastfeeding increases the amount of milk, which means the baby's breastfeeding period increases. The mother may simply get tired of breastfeeding (WHO advises to continue breastfeeding at least in the first year of the child’s life).
• By receiving the breast on demand, the child may develop a so-called association - to calm down, to fall asleep. The baby will ask for the breast not only when he feels hungry, but also on any occasion.

It is worth noting that the older generation often has a negative attitude towards the now popular feeding on demand. Mothers of the 20th century were confident in the need for a routine, additional water and the unsafety of sleeping together for the baby. Let's try to figure out what the essence of the generational conflict is, what principles, methods and opinions about feeding existed then and what has changed today. And is it possible to find a compromise on this issue, based on the experience of generations and new trends and recommendations.

What does it mean to “feed on demand”? What conditions must be met?

• feeding at the first sign of hunger. Don't wait for a hungry roar. Signs of hunger can be exploratory movements of the head, smacking, attempts to cling to a sheet or diaper.

In the first month, feedings can occur almost every hour.
Such frequent breastfeeding improves milk production in sufficient quantities. Then the intervals between meals gradually increase. The baby himself comes to his own routine;

• mandatory night feedings. They contribute to the intense production of the hormone prolactin, which is responsible for milk production. The best time is from two o'clock in the morning until eight in the morning.

Despite all the benefits of night feedings, mom also needs to get enough sleep. Don't forget about this;

• A child receives breastfeeding not only because of hunger. In this way, the mother can console him, relieve pain, smooth out unnecessary experiences and emotions. With the breast in the mouth, it is even easier for the baby to pee and poop.

We must not forget that a child’s anxiety can arise due to illness or injury, and not just hunger or discomfort;

• Do not use pacifiers or supplement with water or decoctions. This reduces the effectiveness and duration of sucking;
• Staying at the breast should be regulated by the child. Children eat differently. Active ones satisfy their hunger in 15-20 minutes and turn away. “Lazy suckers” can “hang” for hours. In this situation, they should be encouraged or offered another breast.

Control your sucking time. Prolonged breastfeeding can lead to cracked nipples.

What has changed in the approach to breastfeeding over the past 20 years

Opinion 1. Feed the baby strictly according to the schedule at regular intervals (3-4 hours), observing a six-hour night break.

Of course, this approach used to be convenient when mothers went to work early and children went to nurseries from 6 months. The child immediately had to get used to the feeding schedule.

What changed:

Feeding the baby is a priority. It is worth applying to the breast on demand, regardless of whether enough time has passed. Night feedings are mandatory, as they increase the amount of milk and maintain lactation.

Opinion 2: Introduction of complementary foods at 5 months.

Pediatricians recommended introducing complementary foods, citing the lack of sufficient nutrients in milk. In fact, this led to a significant suppression of lactation.

What changed:

It has been proven that the properties of mother's milk do not change at 6 months, or at a year, or at one and a half months. It is recommended to start introducing complementary foods at 6 months.

Opinion 3: Eat for two. More fatty foods

Eat a lot (only permitted foods), drink tea with condensed milk, nuts, etc.

What changed:

It has been proven that the amount of food or certain foods do not affect the amount of protein-fats-carbohydrates a child receives. This amount can be influenced by properly organizing breastfeeding and latching the baby correctly.

Opinion 4: “Non-dairy” woman.

If women in the mother’s family breastfed for a short time or did not breastfeed at all, then this “breed” means that the young mother will not be able to breastfeed either.

What changed:

The concept of “non-dairy” does not exist. It has been established that every woman in labor is able to feed her child. Even a “non-dairy” grandmother could, but due to reasons this did not happen: she rarely breastfed, used a pacifier, and did not feed at night.

Opinion 5: Express to the last drop.

It was suggested to express until the breasts were completely empty.

What changed:

In medical circles, the opinion has been established, confirmed by experiments, that during feeding, as much milk is produced as the child needs. Full pumping increases the amount of milk produced, which leads to stagnation and mastitis.

As you can clearly see, over time, many approaches and opinions about feeding have changed and improved. Whatever feeding option you choose, you should take into account all the pros and cons, the experience of previous generations, and also take into account the basic feeding rules of a particular approach.

In what cases should you contact a breastfeeding consultant?

98% of young mothers suffer from a lack of information and qualified assistance regarding breastfeeding. Sometimes it happens that no one can help a young mother, and it is simply impossible to cope with some of the problems of breastfeeding on her own, even if she wants to. Never and nowhere has a first-time nurse coped with breastfeeding on her own: next to her there were always wise and experienced women of her family and clan, a midwife, mother, aunt, mother-in-law... They explained to her how to feed the baby and helped her with everything at first. Today, breastfeeding consultants have taken on this role, since our mothers are already so divorced from nature that they cannot help us in any way (they were taught to feed by the hour and according to a schedule, and not according to nature, the worldly wisdom of previous generations in their time was replaced by controversial achievements of modern science).

The goal of a breastfeeding consultant is not to calm the nerves of an insecure mother (although this happens) but to correct latch or improper attachment, recognize thrush on the nipples, or help cure lactostasis or mastitis. If everything is perfect for you, you don’t need to call a consultant, although it won’t hurt for prevention, unless of course the consultant has the appropriate training, not only professional, but also knows how to work with people, and especially such sensitive people as a woman in labor or a young mother .

Many young mothers believe that it is easier to feed a child according to a schedule, that it is difficult to be a “natural mother”, and even more difficult to completely adhere to any one method. Therefore, when they cannot fully comply with the chosen style of child care, they begin to doubt their abilities. How to avoid this?

It is important to remember that there is not a single person who always does everything “according to the system.” Even the consultants themselves (for example, me) sometimes give a pacifier, a bottle, or cannot immediately respond to the baby’s crying. They also sometimes use a stroller or crib rather than just a sling. You need to have your head on your shoulders and understand that the life of a mother is full of compromises, both breastfeeding and non-breastfeeding, and you shouldn’t be upset about these, so to speak, “violations,” if, of course, everything is fine and the baby is sucking well and developing well , in general, calm and happy with life.

Being a mother is difficult. Both breastfeeding and non-breastfeeding, both “natural” and “traditional”. It simply won’t happen, in either case, I can guarantee you that. There will be mistakes, and we will learn from them. Some people think that being a “natural” mother is more difficult, others think that it is easier. Don't know. I know that from the point of view of a baby this is more correct, and any baby will tell you about it himself: he will scream when you let him off your hands or put him to sleep alone in the crib, he will ask for boob as often as he needs, etc.

It is also fundamentally incorrect to say that natural feeding is only suitable for spoiled rich women, women with a large number of relatives, or some primitive creatures. Properly organized natural feeding, with reasonable compromises, greatly simplifies the life of mother and child.

Feeding on demand: rules

These rules are based on recommendations from the World Health Organization.

• We apply it to the breast at the baby’s first request. We do not limit the time the baby spends at the breast.
• We do not use “substitutes” for the mother’s breast – pacifiers, bottles. If it is necessary to give your child medication, we recommend using a spoon or measuring syringe.
• the ability to apply to the breast correctly for high-quality emptying of the breast.
• Offer both breasts during feeding.
• We express the breasts after feeding, not until they are completely empty, but until they feel relieved.
• postpone the introduction of complementary foods until the baby is 6 months old.
• Continue breastfeeding for as long as possible (at least a year).

Water and complementary foods

Babies in the first six months of life do not need to be given additional fluids or nutrition in addition to natural breastfeeding.
The World Health Organization conducted special studies in the countries of the equatorial belt to clarify the issue of supplementing infants with water. The conclusions are clear: even in the hottest climate, babies do not require anything other than mother's milk, which they receive on demand. Milk itself is approximately 90% water. Moreover, it is the most sterile, balanced and ready to use! The minimum period for starting the introduction of complementary foods is six months. Until this age, milk fully satisfies all the nutritional needs of an infant. And the gastrointestinal tract has not yet matured for the high-quality absorption of adult food. When trying to feed a baby with complementary foods at an earlier age, the digestibility of breast milk may deteriorate and the immature abdominal organs may suffer from untimely loading. Even formula-fed babies are not recommended by WHO to be fed adult foods until they are six months old.

How to give medication to a baby? We offer it from a spoon (pipette, cup and any other objects that cannot be sucked). We try to ensure that treatment does not lead to a decrease in the number of applications. Since milk is not strictly a food, does not overload the gastrointestinal tract and has the ability to digest itself, there is no need to maintain intervals between taking the medicine and feeding. If the medicinal substance is recommended to be diluted in water, in some cases you can use expressed milk. We strongly recommend that you resolve questions about the need to give medicine to your baby with a doctor who understands the importance of long-term breastfeeding and has a good knowledge of the composition of milk and the characteristics of its production. Why do we consider this an essential point - knowledge of the composition of milk? The fact is that, as a rule, many of the advertised products for improving the health of a baby simply duplicate those substances that are already contained in human milk. A good example in this sense is drugs “for intestinal colic” and bacteria for “normalizing microflora”. But it is precisely the function of regulating the activity of the baby’s immature intestines that is performed by the Bifidus factor of breast milk! Therefore, giving such medications to a baby who is fully breastfed is simply pointless - everything necessary for his health is already in his mother’s milk! It is also important to know that if the volume of the drug exceeds 40 ml per day, there is a risk of a decrease in milk supply (the baby’s sucking activity changes and the amount of time spent at the breast decreases). What to do in this case? Of course, get treatment. And then, if there really is less milk, make every effort to return lactation... We will try to talk about how and when it is best to introduce complementary foods in the following articles.