Dear Dr. Greene, I am a first time new mom. My precious baby is three weeks old and I have to go back to work when she is six weeks old. I have been trying to nurse my daughter, but it is not going well at all! She eats a little bit then goes to sleep. As soon as I put her down she wakes up and wants to nurse again. I can’t get anything done and I don’t get to sleep very much. I’m really afraid that I won’t be able to keep this up when I go back to work. Will it hurt her health too much if I change her over to a bottle?
Burlingame, California

Dr. Greene’s Answer:

The situation you are describing sounds very difficult. The fear of what life will be like after you have to go back to work is undoubtedly an added pressure. You are to be commended for continuing to this point! I can see how you would feel like giving up, but there are so many benefits from nursing that I encourage you to consider the following suggestions before deciding. Even in your situation, it is quite possible to turn nursing into a wonderful experience for you and your daughter!

Your daughter has fallen into a common pattern of “nibble nursing.” Because of this she never gets really full. It is only natural that she wakes up when you put her down because she is still hungry.

The way to solve this problem requires help, ideally from your daughter’s father, but if that is not possible, you will need the help of a loving, supportive family member or friend. Your support person may need to spend an entire day and night with you, though sometimes the pattern can be broken very quickly. The sooner you can arrange to do this the better.

If your daughter is nibbling frequently, you may not be currently producing enough milk to satisfy her. In order to increase your milk supply, you will need to begin pumping your breast milk after each day-time feeding. (You need to get as much rest as possible, so I do not recommend pumping at night.) When you pump, you are sending a signal to your body that it needs to make more milk to keep up with your baby’s needs. Miraculously, your body starts to produce more milk to meet the demand.

In order to break the pattern of nibble nursing, it is important that you do not feed your baby more often than every hour-and-a-half to two hours. By encouraging her to wait when she is hungry, she will be determined to eat more when she has the chance. As a result she will get full and be able to sleep for a longer period.

When she wakes up she will again be hungry and eat until she gets full. You can easily see how the habit of nibbling is broken. Sometimes the turnaround takes as little as one cycle!

If you do not yet make enough milk to satisfy her needs, you can use the milk you have pumped to supplement breast feeding. Preferably, have someone else give her a bottle immediately after nursing, to “top her off.”

It is very difficult for most mothers to hear their babies cry. If your daughter is used to eating on demand, she will not like being forced to wait. If she becomes fussy before the appropriate time for nursing, you may need to physically leave the room or the house so that you can maintain your commitment to not nursing her until the hour-and-a-half is up. This is another reason why you need a support person— to be present with her while you are gone. An additional benefit of waiting at least an hour-and-a-half from start time to start time of feedings is that it allows your body the time necessary to produce high quality milk.

I understand how overwhelming the situation feels right now. Sleep deprivation is a large part of that, so while your support person is there to help you, get as much rest as you can.

Even after your support person leaves you will need to continue to get lots of rest. Whenever your daughter takes a nap, do the same. You may feel like napping is being lazy, but it is not! It is very important for you to sleep when the baby is sleeping!!! By doing so you will have a more positive outlook on your situation and you will be able to produce more milk to meet your daughter’s needs.

This situation is only temporary. In most cases of this nature the resolution is quick and positive!!

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