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Breastfeeding on Demand

06/08/2021 Pediatrics

On-demand refers to breastfeeding without worrying about schedules or specific duration during or between feedings. You should feed your baby anytime they demand it; this will ensure that all the nutritional requirements are met, and it also helps with bonding.

Even today, it is recommended by health specialists to breastfeed every 3 hours, and with a duration of 15-20 minutes for each breast; this in itself does not have a scientific basis and mainly attends to obsolete concepts about breastfeeding or mom's comfort.

It is not about romanticizing breastfeeding; it is about informing ourselves as much as possible to face it with courage in difficult moments and enjoy the beautiful aspects. Free demand requires much commitment from mom to feed baby regularly, interrupting her daily activities and sleep cycle.

We recommend that you take into account all the enormous and proven benefits that breastfeeding offers your baby to find the best way to cover the free demand; it will take a couple of days so that you find a routine between you and your baby and on this routine build and adapt both spaces and breastfeeding positions so that it is comfortable, and if you can, include your partner in this new routine.

Many things help meet the free demand; for example, many moms choose to collect (sleep together with the baby in the same bed) or at least have a crib near their bed for nighttime feedings so that mom can also rest.

Talking about the times previously mentioned (3 hours between feeds, 15-20 min each feed), let's look at it from an updated perspective:

The basic signs to detect if your baby is hungry are: 

  • Time between takes. Nature is wise, and precisely by having your baby close by, we can anticipate their need. Babies can only communicate with crying; you are a little late for the feeding when the crying happens. You can anticipate a feeding if you see:
    • Sucking movements of the mouth
    • Head and mouth movements open (such as searching for the chest)
    • Sucking on hands or any nearby object.

Find out what other signals your baby gives you!

  • Duration of the feeding. The time between feedings becomes relevant to avoid removing the baby prematurely, rather than leaving them sucking for a long time.

Mature milk (which is produced when breastfeeding is established correctly, approx. 15 days after the birth of your baby) generally has two compositions in each feeding. When your baby is sucking greedily, the first milk released is rich mainly in sugars (predominantly lactose). It is of a lighter, watery and sweet consistency, and its primary function is to quench the baby's thirst and provide the energy requirements of the brain.

After this need is satisfied, little by little, the composition of the milk is modified, and it becomes denser and thicker; in it, the fatty acids are concentrated to support the baby's weight gain as part of their growth.

Both kinds of milk additionally have large amounts of proteins, vitamins, antibodies, and other nutrients that we talked about in a previous blog; the difference lies precisely in the light and sugary composition of the first milk vs. the dense and natural composition of the second.

There is no way of knowing when the first milk switches to the second, but it ranges from 10 to 15 min. Therefore, if we follow the breastfeeding rule of 15-20 min for each breast, we leave little or no time for the baby to generate the second milk, leaving only the first one rich in sugar and watery. The result? A baby who does not gain weight or gains it very slowly, a false lactose intolerance (high sugars in stool study or greenish, explosive, and phlegmy stools) this can all lead to restricting the mother's diet or, what's even worse, stopping breastfeeding completely.

The false intolerance is actually a logical response to excessive consumption of lactose that the baby's small intestine cannot fully digest, and associated with this, reducing sugars are triggered, increasing intestinal acidity, causing a failure in the bacterial flora. This does not mean that all cases are similar; indeed, there are babies with a lactose intolerance known as "galactosemia", a congenital disease; however, its incidence is very low (approximately 1 in 50,000 people), a Pro Lactation Pediatrician must appropriately diagnose this.

Poor management of breastfeeding coupled with ignorance can stop breastfeeding early, ignoring the great proven benefits.

So what is the rule? Regulate your baby's feedings so that they satisfy their hunger one breast at a time; this way, it will not only cause the second milk to drop, but you will begin to develop your breastfeeding pattern. Remember that the higher the suction, the higher the production, which can help build your milk bank if you need it. Many moms tend to dedicate feeds to one breast and, with the support of a bow (which you can make or buy) that they place in their bra, identify which breast their baby fed from the last time, to start with the other in the next feeding.

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