It's natural for babies to fall asleep while breastfeeding, but “natural” doesn’t mean free from complications. Discover the advantages and potential disadvantages linked to breastfeeding a baby to sleep.
Is it ok to breastfeed baby to sleep?
Is it a good idea to breastfeed a baby to sleep? Some say ‘yes’, claiming it’s natural and helps babies sleep. Others say ‘no’, maintaining it causes infant sleeping and feeding problems.
As a lactation consultant and child health nurse, I am often consulted regarding concerns about milk supply and infant sleeping problems. I say there is no single ‘right’ answer. What works for some babies and families will not work for others. Breastfeeding a baby to sleep has advantages, but there can also be disadvantages. It’s up to you to decide if breastfeeding your baby to sleep is a good idea, or not.
Advantages of breastfeeding to sleep
- It’s a quick and easy way to get your baby to fall asleep. (Provided he’s tired and accustomed to falling asleep in this way)
- He will fall asleep without tears.
- You can assist him to fall asleep while you’re lying down, dozing.
- You don’t need to decide when he has finished feeding. (Once he’s deeply asleep your nipple will slip from his mouth).
Cholecystokinin, a digestive hormone released when food from the stomach reaches the first part of the small intestine, causes feelings of drowsiness. Hence, young babies in particular, both breast and formula-fed, have a natural tendency to fall asleep while feeding because in general it takes them longer to feed compared to older babies. It’s the food and not the act of breastfeeding that causes drowsiness.
Potential disadvantages of breastfeeding to sleep
Repeatedly breastfeeding your baby to sleep will encourage him to develop a breastfeeding-sleep association; regardless of whether this is your intention or not. This means he learns to psychologically link the act of falling asleep with suckling at your breast.
The following are ways in which a breastfeeding-sleep association might affect your baby’s feeding and sleeping patterns and behavior.
- Frequent demand for feedings - beyond what you might expect: Once your baby associates falling asleep with suckling at your breast, he will appear hungry and seek to breastfeed whenever he’s tired and ready to sleep in addition to times of hunger. Attempts to ‘stretch out’ the time between feedings are unlikely to succeed because he will become increasingly more upset owing to tiredness if he’s not offered your breast. A breastfeeding-sleep association can also make it hard for you to tell the difference between your baby’s hunger and tired cues.
- Prolonged feeds: Your baby may want to remain firmly attached to your breast until he’s deeply asleep. Breastfeeds can appear to be prolonged, possibly up to an hour or longer, depending on how long it takes for him to fall deeply asleep. (He will not actively feed the entire time he’s attached to your breast; rather he will spend much of this time comfort sucking as he drifts off to sleep).
- Appear unsatisfied by the feed: If you try to remove your baby before he’s deeply asleep, he may sense this, wake fully and immediately search for your breast again. (This is not necessarily because of unsatisfied hunger, but rather because he’s not yet deeply asleep).
- Broken sleep: If during light sleep your baby senses that he’s no longer attached to your breast, he’s at risk of waking prematurely… still tired. His daytime naps may be brief, consisting of only one sleep cycle (20-40 minutes depending on age). If he hasn’t had enough sleep, it won’t be long before he’s fussing due to tiredness and wanting to be attached to your breast again in order to return to sleep.
- Over-tiredness: If you don't offer your breast when your baby is ready to sleep, he’s likely to remain awake despite being fatigued. The longer you delay offering him your breast the greater the risk of him becoming distressed owing to over-tiredness. Once overtired he will find it difficult to fall asleep. Overwrought, he might refuse your breast at this time.
- Excessive night feeds: You might find that once your baby is 4 months old he starts to wake more often during the night, possibly every hour or two, wanting to be breastfed back to sleep. (A baby’s awareness of his surroundings is enhanced around the age of 4 months owing to advancements in intellectual development. By this age a baby can become more acutely aware of the absence of his sleep associations during light sleep than he was at a younger age).
- Continued night feeds: Most healthy, thriving babies no longer require nighttime feedings from around the age of 6 months. However, a baby who relies on breastfeeding as a way to fall asleep is likely to continue to demand frequent breastfeeds during the night long after the time that he reaches the stage where he no longer requires night feedings. He many continue to demand frequent feedings at night for as long as he associates falling asleep with suckling at his mother’s breast.
- Early cessation of breastfeeding: Despite the fact that their babies are thriving, many mothers mistakenly blame low milk supply for the behaviors described above. In an attempt to get her baby to sleep longer and/or go long periods between feedings, a mother (or father) might give baby bottle-feeds in addition to breastfeeds, give formula in place of breastmilk, and/or start giving baby solids before the recommended age. Each of these steps has the potential to create additional problems that further complicate the situation. The situation can become so confusing that many breastfeeding mothers believe it will be easier to bottle-feed so ‘I can tell how much baby is getting’.
- Decreased appetite for solid foods: Continued night feed beyond the age of 6 months could decrease your baby’s appetite the next day. Some parents find their baby eats very little solids or refuses solids completely because his appetite is satisfied by multiple breastfeeds day and night.
- Settles only with his mother’s help: Other caregivers may find it very hard to settle your baby to sleep because of his learned dependence on breastfeeding as his preferred way to go to sleep.
In USA, Canada, UK and Australia less than half of all babies are exclusively breastfeed by the age of 3 months, and less than one quarter are exclusively breastfed by 6 months. It is my opinion that failing to forewarn mothers about the potential effects that a breastfeeding-sleep association can have on their baby’s feeding and sleeping behavior is a major contributor to this rapid decline in breastfeeding rates.
How to stop breastfeeding to sleep
What one mother sees as problematic another accepts as normal. Like many experienced breastfeeding mothers, you might recognize, or have been reassured, that the behaviors described above are normal for a breastfed baby - which they are when a baby has developed a breastfeeding-sleep association. You might be happy to breastfeed your baby as often and for as long as a he wants, and you might enjoy cuddling your sleeping baby. In this case, there is no need to do anything different. The purpose of this article is not to dissuade you from breastfeeding your baby to sleep, but rather to alert mothers of how a breastfeeding-sleep association can affect a baby's behavior and thus avoid mistakenly blaming low milk supply.
Alternatively, if you're finding your baby’s frequent and prolonged feeding sessions, short daytime naps and/or repeated awakenings at night wanting to be breastfed back to sleep are tiresome, you're not alone. Many breastfeeding mothers find such behaviour to be confusing and tiresome, and hence the reason they stop breastfeeding sooner than planned. You will be pleased to learn that it is possible to greatly improve the situation and continue to successfully breastfeed your baby over the long-term. In this case, I recommend you download an ebook version or purchase a paperback copy of my infant sleep book called ‘Your Sleepless Baby: The Rescue Guide’. 
In this book you will find a comprehensive guide on different types of infant sleeping problems; what babies need from parents and caregivers to sleep well; 7 ways to change a baby’s sleep associations that will support him or her to get the amount of sleep his/her little body needs; and much more.
If you have already started to head down the path of giving formula or solids in addition to breastfeeds, and would like to return to exclusive breastfeeding, this might be possible (depending how often your baby currently breastfeeds). In this case, you may need to work on re-establishing breastfeeding before trying to resolve any sleeping issues your baby might have. Seek the support of a qualified lactation consultant, ideally someone who holds International Board Certified Lactation Consultant (IBCLC) qualifications. Alternatively, you can receive individualized breastfeeding advice from one of our IBCLC qualified lactation consultants through Baby Care Advice website.
Written by Rowena Bennett.