Many newborns sleep as much as 20 hours a day. Breast fed babies need to eat between 8- to 12- hours a day. Doing the simple math, this is every 2-3 hours, but a newborn is not very good at math and has trouble telling time! If your baby goes longer than 3- hours during the day or 4- hours at night, she should be wakened to eat. If there are concerns about baby’s weight gain, then more frequent feeding and waking are needed. When your baby is a few weeks old and has been gaining weight steadily, then let your baby take the lead when to wake up and eat. Babies are sleepy in the newborn period as a result of many things—medications given to mom in labor are most frequently felt to contribute.

Here are some suggestions to help you wake your sleepy baby and encourage successful breastfeeding. Remember, frequent nursings help establish your milk supply!

Watch for feeding cues. Moving hands and mouth, sucking a thumb or fist, making cooing noises and fluttering eyelids are the early cues when baby is starting to wake from sleep.

• Crying is a late cue. If your baby is crying and fussy, calm her before putting to breast. Babies swallow air when crying—try burping him before putting to breast.
• Undress your baby, change his diaper, or otherwise try to gently wake him.
• Position him next to your bare chest—between your breasts—with only a diaper on and a light blanket over both of you, him may wake and try to position himself to your breast. Gently help him get into position and latch.
• Try a football hold. He may be more alert to feed.
• Express a small amount of colostrum or milk onto your nipple so baby can taste and smell it.
• Use the “C” hold on your breast and gently compress your breast with your thumb to increase the amount of milk your baby receives if he stops sucking while at the breast.
• Do not change breasts if baby is sucking and swallowing well. He may refuse the second breast.
• If she falls asleep after 5 to 10 minutes, switch to other breast and continue nursing. If he falls asleep again switch back to first breast. (“Switch” nursing should really only be done in the early newborn period as this can “rob” baby of the fat-rich hind milk that comes longer feedings.)

Never use water supplements as water can make him feel full and lead to missed feedings. Your baby does not need water, even during the warm summer months. Everything your baby needs is in your breastmilk that stabilizes his blood sugar, eliminates bilirubin that causes jaundice and allow your baby to gain weight.

• Nurses less than 6 to 8 times in 24 hours
• Has less than 6 wet diapers in 24 hours
• Has less than 3 stools after he is 3 days old
• Does not have yellow stools by 4 to 5 days of age
• You do not hear frequent swallowing while breastfeeding

A mother-led feeding schedule in the first week or two of life—even if you have to wake up your baby—will help him gain weight and help you establish a good milk supply.