Sleep and the Breastfed Baby: What Parents Should Know

There are all kinds of expectations, myths and realities when it comes to sleep and infants, and these can greatly influence how we view infant sleep. Some of the expectations and myths in particular can set up new parents for unnecessary struggle. And, sometimes they’re even dangerous.

Western society places such an emphasis on how a baby sleeps, even equating sleep with how “good” a baby is. It’s often a question new parents are asked: “Is she a good baby? Does she sleep well?”

Pro-tip: Baby sleep is completely different from adult sleep. It’s biological. Babies come out that way.

From the start, tiny humans are born with a different set of sleep needs than the people taking care of them. It doesn’t take long to figure out that they seem to require much less sleep for 1,000 times more energy. It’s a mismatch from the get go.

So the quest begins for the elusive right amount of sleep for everyone in the family with a balanced routine that allows the parents and their infants and children to get what they need. Everyone has an opinion and strategy on sleep and even strangers in the grocery store may share with parents their magic tricks for getting babies to sleep through the night (which is actually only considered 6 hours without waking).

When it comes to sleep and breastfed babies, the advice and myths abound. But sleep, like many other aspects of a child, is very much an individual thing. Personality, developmental stages, individual body quirks, etc. can have a major impact on sleep.

A common misconception is that breastfed babies wake more frequently and sleep less than formula fed babies. However, a 2007 study found that breastfeeding increases sleep duration of new parents by an average of 40–45 minutes more than parents of infants given formula.

Still, the sleep fears we typically associate with the breastfed baby are that for some reason the breastfed baby will wake more often than their formula-fed peers, become dependent on the breast to fall asleep, and have sleep struggles for longer. While formula-fed babies may wake less frequently to feed in the early months because formula takes longer and more work to digest, evidence shows that there’s no guarantee that will be the case.

Further evidence suggests that formula-fed babies and breastfed babies (and their parents!) still get the same total amount of sleep. Plus, by 9 months, all sleep differences between breastfed babies and formula-fed babies have leveled out anyway. With the lowered risk of health issues including diarrhea and ear infections (talk about sleep disruptors!) and the reduced risk of SIDS (sudden infant death syndrome), breastfeeding is still the normal biological way to feed a baby and recommended by experts.

So does breastfeeding mean poor sleep?

Nope!

Whether or not to breastfeed is a personal choice you should make based on you and your baby. But, if you are planning to breastfeed (or are in the throes of it!), here is some useful information to help you understand the relationship between breastfeeding and sleep.

Frequent wakes to feed are completely normal so adjust your expectations accordingly. Babies have small stomachs, breastmilk is digested quickly because it is exactly what their bodies need, and the part of their brain that regulates sleep hasn’t developed to differentiate between day time sleep and night time sleep or naps and long sleeps. Frequent wakings actually reduce the risk of SIDS, a blessing in disguise.

The oxytocin release that comes with breastfeeding is relaxing and naturally makes babies and parents sleepy. It isn’t a bad habit for breastfed babies to fall asleep at the breast and to want to return to the breast to help them settle when they wake in the night – it is normal.

Including breastfeeding as part of the consistent bedtime routine is a good way to help babies get to sleep. If your baby has started solids, just be sure to brush their teeth before breastfeeding so that there aren’t any other food particles on their teeth that could lead to tooth decay. Breastmilk itself is fine for teeth as long as they are clean. Needing to breastfeed to sleep won’t become a lifelong crutch, I promise.

Prolactin levels (milk making hormones) are highest at night, which means that your baby’s desire to breastfeed at night actually works together with those higher prolactin levels to help your body make more milk. A baby that starts sleeping through the night too early could lead to a lower milk supply. It may help to think of your baby waking to feed during the night as protecting your milk supply.

Research shows that only 43% of babies over 6 months regularly sleep for 8-hour stretches without waking during the night. That leaves 57% of babies over 6 months that do wake in that time and need help getting back to sleep. By 12 months, those numbers flip. And, 72% of babies are making it 6-hour stretches without waking during the night by that age.

The expectation that the majority of babies are going to be sleeping through the night by 6-12 months is a myth and causes unnecessary pressure based on unrealistic expectations. If your baby isn’t sleeping through the night, they’re in good company.

Though your baby may prefer settling back down to sleep with nursing, they also wake if they’re cold, hot, wet or soiled, scared, were startled, and any other number of reasons. Just like adults. The difference is that adults usually wake and fall back asleep without needing assistance in doing so, a skill that takes some time to develop. A comforting connection that helps your baby feel secure is the best way to help them calm and settle back to sleep.

No matter how they are fed, all babies need a safe sleep space. A firm flat surface (no inclined sleepers) free of blankets, toys, and crib bumpers is a must. Keep in mind that infants up to a year old need 12-16 hours of sleep a day and toddlers need about 11-14 hours a day. That’s a lot of time spent in their sleep space, so consider the materials your child will be spending a significant portion of their day sleeping on. In addition to addressing health and safety concerns, you can also set up your baby’s nursery to promote better sleep.

Most breastfed babies aren’t ready to go 8 hours without a feed until after 12 months. Due to stomach size and development, it is normal for them to need a snack and comfort in the middle of the night. Night weaning can actually lead to more wakings if done too early. For more information, see this study.

It may seem like night wakings are lasting forever but most children do eventually settle into the normal sleep patterns we all crave. Even the worst sleepers improve, but not everyone ends up with the “sleep through the night” pattern society tells us to expect.

My 10-year-old still sometimes wakes during the night in need of some comfort after a bad dream or difficulty falling back asleep. Even I have times where I struggle with frequent wakings and have a hard time getting back to sleep. There’s a wide range of normal at all ages.

Keep in mind that, with that wide range of normal, there’s also a number of factors that can contribute to disrupted sleep for infants and toddlers. Having realistic expectations goes a long way in being patient with the process. If you’re concerned that your child may be exhibiting signs of abnormal sleep, speak with your child’s healthcare provider about your concerns. Sometimes sleep issues are a sign of something more serious going on that should be explored by a qualified healthcare professional.