Night feeding is a hugely controversial topic. It is a multifaceted matter and is integrated with sleep and development. It is also a subject which is influenced by culture and societal expectations of ‘normal’ baby behaviour. In this blog I am going to discuss why babies feed at night, age-appropriate night feeding, and how and when to drop night feeds if appropriate.
Why do babies feed at night?
There is a common myth that babies should be sleeping ‘through’ the night from an early age. However, it is normal and essential that young babies feed during the night. When babies are born, they have small stomachs and need frequent around the clock feeding to ensure healthy growth and development and stable blood sugars.
Age-appropriate night feeding
Trying to change the perception about sleeping behaviour and therefore night feeding behaviour is a huge challenge. In the first few months of life, babies sleep and feed sporadically throughout the day and night. This is due to the immaturity of their body clock and biological need for frequent feeding.
At around 3-4 months the circadian rhythm known as the body clock is matured. Then melatonin (the sleep-inducing hormone) is released. Once the body clock develops, babies will then start to respond to light and darkness and natural bodily rhythms are formed. At this point, babies might sleep for longer periods at night and at more predictable times during the day. Research shows babies under 6 months regulate their appetite over a 24hr period. Therefore night waking for feeds is common.
At six months, when solid food is introduced, the body clock develops further, due to increased insulin signals being released by the body. Regular, predictable mealtimes encourage metabolism, strengthening the body clock and encouraging babies to sleep for longer periods at night. Again, research shows most babies between 6-12 months will continue to wake once or twice a night. But this may not necessarily be to feed.
Around 10-12 months as solid food and day time calorie intake increases babies may naturally reduce their night waking. However, it is very common and sometimes needed for babies up to one year to have at least one or two feeds overnight. But not always necessary IF baby is getting enough calories during the day. From 12-18 months night waking is still common but not necessarily for feeding.
It is important to highlight every baby is so different with their own individual needs. Some babies will sleep ‘through’ earlier than others than others. Similarly, to the weaning journey some nights a baby may sleep all night and other nights they may wake for feeding. It can depend on the weather, on what they ate that day and on their developmental stages.
*This is a rough guide, all children are very different please seek advice from your GP or Health Visitor if concerned.*
Will formula help baby sleep at night?
It is a common belief that introducing formula at night will help babies to sleep ‘through the night’. Research suggests there is no difference in night time waking and feeding methods. Formula-fed babies might sleep for longer periods overall as breast milk is easier to digest. However, new born formula-fed babies should still have feeds at night to ensure healthy growth and development. As a baby grows and day feeds increase in ounces nightly feeds may decrease.
When to drop night feeds?
This question is the hardest to answer in a blog because it is so individualised to the child, the family and the situation. Dropping night feeds has to be when parents feel ready and when the baby is age-appropriate, taking a good amount of solid food and continuing to follow their centile. As health professionals we are always guided by parents because they know when is the best time. If a child is still feeding frequently (every two hours) at night and they are older than 6 months, a holistic assessment of feeding and sleeping should be considered, analysing why they are frequently waking. This is why sleep and night feeding are so integrated.
A rough guide of when to drop night feeds is when the baby is;
- Having three meals of solid food a day,
- Baby continues to follow their centiles,
- Lots of wet nappies during the day,
- Alert and active during the day,
- Parents feel ready and want to.
It is not recommended to make any radical changes to a babies’ night routine when they are ill or teething as this can cause babies and parents extra distress.
Sleep associated feeding
When assessing and intervening with night feeding it is important to contemplate how a baby falls asleep. Feeding to sleep is a normal baby behaviour as breast milk and formula contain sleep inducing hormones. If a baby feeds to sleep, this will form a strong sleep association and they may need this continued association to aid them back to sleep during the night. Increasing their variety of sleep associations, can help reduce reliance on feeding back to sleep. Sleep associations may include rocking, white noise, lullaby music, shushing, comfort and cuddles etc. Therefore, if they wake in the night and they are not hungry one of these other sleep associations may help them fall back to sleep.
How to drop night feeds?
Again, this question is difficult to answer because it is dependent on individual family circumstances. How are they feeding? Where the baby is sleeping? How many times they are waking up? Why are they waking? Is this a feeding issue or a sleep issue? It is important to recognise that when children are going through a growth spurt or a developmental period they may wake more or eat more and that should be compensated. However, a general suggestion, if a baby is following their centile, they are happy, alert and well during the day, is to not offer milk as soon as they wake.
- Introduce a variety of other sleep associations when falling asleep therefore not solely relying on feeding to sleep.
- Offer comfort first – before reaching for breast or bottle, attempt to settle with cuddles, comfort and love. Potentially rocking or shushing back to sleep.
- Offer water – this will quench thirst if this may be the reason they have woken.
- Check environmental factors – e.g. room temperature, light etc
- Consider pain as a cause especially if teething.
- Cut down on feeds slowly and gently, one feed at a time.
- Ask partners or family members for support.
- Seek professional advice and support if you need it.
- UNICEF Baby Friendly Initiative – https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/sleep-and-night-time-resources/caring-for-your-baby-at-night/
- National Breastfeeding Helpline 0300 100 0212
- Association of Breastfeeding Mothers 0300 330 5453
- La Leche League 0345 120 2918
- The Breastfeeding Network supporter line in Bengali and Sylheti: 0300 456 2421
- Research – Brown, A. and Harries, V. (2015). https://pubmed.ncbi.nlm.nih.gov/25973527/
- Research – Ramamurthy et al (2012). https://pubmed.ncbi.nlm.nih.gov/22616943/
I hope this blog has alleviated some anxieties around night feeding. If you are struggling with any of the points covered please contact your local health visiting team for support or you can contact me for a consultation email@example.com
Written by Charlie Blyth, Specialist Public Health Nurse (Health Visitor) and founder of The Healthy Child co. You can follow @thehealthychildco for more tips, advice and support or visit www.thehealthychildco.com for health and parenting courses and workshops.