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By Dr Lara Batchat - MBBS, BSc (hons), MRCGP, DCH, DRCOG at Netdoctor.co.uk
If your newborn baby suddenly starts cluster feeding in the middle of the night it can be alarming, uncomfortable and extremely tiring! But while feeding on demand in the small hours might make you feel like you're never going to sleep again, rest reassured that cluster feeding is a perfectly normal part of baby development. It might be exhausting in the moment, but this challenging newborn phase usually passes quickly.
To put your mind at ease, family GP Dr Lara Batchat shares her advice on cluster feeding including why it happens, what a normal baby feeding pattern looks like, and how to navigate the newborn feeding phase with aplomb:
Cluster feeding is the term used to describe a newborn baby suddenly feeding much more than usual. It’s difficult to define, because every baby is different, but generally you will notice your baby feeding more frequently for several hours at a time, usually during the night-time or evening.
Although cluster feeding is a perfectly natural phenomenon which helps your baby grow and develop, it can be an exhausting and challenging time. Understanding cluster feeding and how to deal with it, can help you to get through this period successfully and preserve your sanity that little bit more!
Cluster feeding is more common in breastfed babies, but that’s not to say it can’t occur in those that are formula-fed too, and so this article will be useful for anyone looking after a newborn baby.
We don’t really know exactly why babies cluster feed. The likelihood is that it’s the baby’s way of fulfilling its increased nutritional needs during a growth spurt or new stage in social or motor development.
During one of my clinics, a fraught first-time mum once asked me what a normal feeding pattern was. It turned out, she had recently met up with a friend for a morning coffee, and on arrival was asked, “What should the baby be doing right now?" This simple question resulted in feelings of inadequacy as a mother - she had no idea what the baby should be doing – the baby was little and there was no routine. Parental guilt set in and when she saw me, she had lost all confidence.
If this sounds familiar – read on and have faith in yourself! Every baby is different and there are no strict routines that newborns should follow. Yes, it’s important that they feed enough (more details on this later), but in the early days especially, while their tiny stomach is only the size of a marble, they will need to feed frequently and unpredictably in order to grow and develop.
It’s hard to define normal, but as a rough guide, your baby should be fed at least three times in the first 24 hours of life. From day two onwards, you can expect your baby to feed at least 8 to 12 times per 24 hour period, for between 10-30 minutes each time.
There are lots of myths surrounding breastfeeding, but it’s important to remember that you can’t overfeed a breastfed baby and feeding them on demand won’t cause them to become spoilt. The National Breastfeeding Helpline (0300 100 0212) is a great resource if you have any concerns, would like to be connected to other people with similar experiences, or you need some simple breastfeeding tips.
Cluster feeding is usually seen in the early weeks and months of a baby’s development, often coinciding with growth spurts. Again, these can vary in timing from baby to baby, but commonly growth spurts are seen at beginning of the 2nd week, followed by at weeks 3, 6 and 12 of a baby’s life.
It can be tricky to identify cluster feeding because young babies rarely have established routines and so a change may not be obvious at first. It can also be challenging to work out if what you are experiencing is cluster feeding as opposed to anything else, but some common themes for cluster feeding are:
Babies have some very useful ways of communicating that they are hungry, including:
Caring for a newborn baby can feel scary – it’s hard looking after a small, vulnerable little thing who can’t tell you in words how they are feeling and why. Some babies might be more fractious in the evenings for other reasons, such as:
It might be worth exploring these issues if you feel they may have a part to play, and using one or more of the following tips may also help to soothe your baby:
Irritability in the evenings could also be suggestive of infantile colic – a benign condition which is still little understood. Strictly speaking, colic is defined as crying or irritability in an infant up to four months of age for no apparent reason, lasting at least three hours a day, on at least three days a week for at least a week. There must be no evidence of faltering growth or other symptoms, and the crying should not be completely inconsolable – if that is the case, it’s important to seek urgent medical attention, in case there is something else going on.
In the same way as cluster feeding, colic can start suddenly and often occurs in the evening - but the important distinction is that a cluster feeding baby will be pacified by their milk, whereas a colicky baby won't be. Typically, a colicky baby will go red in the face, pull their knees to their chest and cry in a screaming sort of way – those who have experienced it, will recognise it well! It’s usually at its worst at six weeks and will have passed by three months, but colic can be frightening and so if you are unsure, it’s best to take your baby to a doctor.
The human body is one very sophisticated machine, with a mechanism for breastfeeding that works on a very clever supply and demand model. In the same way as supermarket buyers boost their wholesale orders if they detect increased customer demand, the body does likewise – the more a baby feeds, the more milk is produced. Therefore, feel reassured that cluster feeding won’t cause you to run out of breast milk – quite the contrary, it will stimulate you to produce more, keeping your baby growing and developing healthily.
Equally, don’t worry that the cause of the cluster feeding is that you are not producing enough milk. Cluster feeding is stimulated by the baby’s need for milk due to the stage of growth and development that they are in, it’s not a sign that you are not producing enough milk, and it’s not a reason to supplement with formula. If you are worried that you may not be producing enough milk for some other reason, such as the baby not putting on weight well, a visit to your health visitor or GP would be best.
One way of knowing if your baby is getting enough milk is to be guided by their behaviour – being aware of the signs of a hungry baby will enable you to react to these and satisfy their needs.
Another way to check your baby is feeding well is by monitoring their nappies. After the first five days, expect at least six heavy wet nappies in every 24-hour period, but remember that as the baby grows, this will change and by two months they may be producing around four wet nappies a day. Soiled nappies can be a bit more variable, but in breastfed babies during the first week of life they are likely to produce about four soiled nappies a day, reducing to about one dirty nappy by the time they turn one-year old.
In the early stages of a baby’s life it is vital to keep a close eye on their weight and this is the best indicator that your baby is feeding well. Weight is checked soon after birth and within the first two weeks of life a midwife will check the baby’s weight again to ensure things are going well. It’s normal for babies to lose some weight in the first couple of weeks after birth, but at two weeks, they should have regained their birthweight and then grow steadily. If you have any worries after your routine checks, you can always visit your local health visitor drop-in clinic, where you can check your baby’s weight to ensure they are growing as expected.
Managing cluster feeding can be draining and challenging – the frequent feeds can be exhausting, especially the lack of sleep they incur. Keep in mind that this period will pass quickly and will soon be a distant (and probably hazy!) memory. Here are some tips to help you through:
Set up feeding stations in different areas of the home – perhaps one in the bedroom and one in a living area. Be sure to include comfortable seating, a bottle of water and some healthy snacks, to keep you fed and watered, too.
It can be a time to bond with your baby, connect with a friend on the phone, read, listen to a podcast or catch up on your favourite TV series.
To avoid sore, cracked nipples, change breastfeeding positions frequently and use a nipple cream to protect your skin. Your health visitor or lactation consultant are also great to go to for advice, or read our breastfeeding pain relief tips.
If you have older children, having a box of special ‘feeding toys’ for them to play with during feeds can be useful.
Communicate with your partner or support network and tell them what you need – accept help from others, who can often pitch in with household chores, or can feed the baby too.