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Cluster Feeding and Fussy Evenings
... My baby nurses and fusses
all evening! What's wrong?
By Kelly Bonyata, BS, IBCLC
It
is very common for babies to be fussy and nurse very often in the
evenings, particularly in the early months.
My daughter
had a fussy time every evening for a couple of months (yes, it
does go away!). I spent weeks camped out on the end of the sofa
with a constantly nursing and/or fussy baby every evening from
about 6 to 10 PM.
With my
son, we didn't have the luxury of being able to sit down. Alex
was unhappy and crying unless he was upright and being walked
around at this time of day (and sometimes this only helped him
to be less unhappy). He would occasionally have a very fussy time
during the day, too. Nursing rarely helped to calm his fussiness
(unlike with my daughter), so I usually didn't have that tool
to work with (though I always tried). His fussiness was such that
I looked into other causes (such as food
sensitivity), but we never determined any reason for it and
he was all smiles the rest of the time. The fussiness gradually
went away between 3 and 4 months, as is the norm, but the first
few months were hard. Nowadays, the typical comment that I hear
about him is "Is he always this happy?" So remember:
this, too, will pass...
Cluster
feeding, also called bunch feeding, is when babies
space feeding closer together at certain times of the day and go
longer between feedings at other times. This is very common, and
often occurs in the evenings. It's often -but not always- followed
by a longer sleep period than usual: baby may be "tanking up" before
a long sleep. For example, your baby may nurse every hour (or even
constantly) between 6 and 10 PM, then have a longish stretch of
sleep at night - baby may even sleep
all night.
Cluster feeding often coincides with your baby's fussy
time. Baby will nurse a few minutes, pull
off, fuss/cry, nurse a few minutes, pull off, fuss/cry... on and
on... for hours. This can be VERY frustrating, and mom starts wondering
if baby is getting enough milk, if something
she is eating is bothering baby, if EVERYTHING she is doing
is bothering baby... It can really ruin your confidence, particularly
if there is someone else around asking the same questions (your
mother, your husband, your mother-in-law).
This
behavior is NORMAL! It has nothing
to do with your breastmilk or your mothering. If baby is happy the
rest of the day, and baby doesn't seem to be in pain (as with colic)
during the fussy time - just keep trying to soothe your baby and
don't beat yourself up about the cause. Let baby nurse as long and
as often as he will. Recruit dad (or another helper) to bring you
food/drink and fetch things (book/remote/phone/etc.) while you are
nursing and holding baby.
Does this mean that baby needs more milk than I can provide?
No. Don't give baby a bottle -- supplementation will only
tell your body that you need LESS milk at this time, and that will
not help matters. Also, keep in mind that formula fed babies experience
fussy periods in the evening, too -- fussy evenings are common for
all young babies, no matter how they are fed. The Academy of Breastfeeding
Medicine spells this out in their supplementary
feeding guidelines:
There are common clinical situations where evaluation
and breastfeeding management may be necessary, but supplementation
is NOT INDICATED including... The infant who is fussy at night
or constantly feeding for several hours.
Why do babies fuss in the evening?
One frequently-heard explanation for baby's fussiness in the evenings
is that milk volume tends to be lower in the evening due to the
natural cycling of hormones throughout the day. However, Dr. Peter
Hartmann, a breastfeeding researcher, has said that in the women
he has studied, milk volume is not low at this time of day.
Even if milk volume is lower in the evening, fat content is typically
higher in the evening (particularly if baby is allowed to control
this via cue feeding), so the amount of calories that baby is getting
should not be significantly different. Milk flow can be slower
in the evening, which may be frustrating for some babies.
Doctors often attribute evening fussiness to baby's immature nervous
system (and the fussiness does end as baby gets older, usually by
3-4 months). However, Dr. Katherine Dettwyler (who does research
on breastfeeding in traditional societies) states that babies in
Mali, West Africa and other traditional societies don't have colic
or late afternoon/evening fussiness. These babies are carried all
day and usually nurse several times each hour.
So perhaps none of these explanations is a complete answer to
baby's evening fussiness. For many
babies, the fussy time seems to be characterized by a need to have
small quantities of milk at frequent intervals, combined with lots
of holding, cuddling and movement. Babies who are offered as much
expressed milk or formula as they will take by bottle [note: this
practice will decrease your milk supply!] often behave in exactly
the same way in the evenings. Baby takes a small amount and dozes
(and fusses), then a little more, and so on. Perhaps babies "remember"
mom being very active during her pregnancy at these times, and want
to be held, rocked, and nurtured constantly again.
Perhaps
babies simply need to nurse more often at this time -- rather
than consume more milk.
- Wear baby
in a sling
or baby carrier. This will free one or both hands for other tasks
(fixing dinner, caring for other children) while you hold, soothe
and nurse your baby.
- Change
of pace. Let dad have some "baby time" while mom takes
a shower or simply gets some time to herself to relax and regroup
after a long day.
- Go outside.
Relax baby (and mom too) with a walk, or just sit and enjoy the
outdoors. Try this a little before baby's regular fussy time.
- Soothe
with sound. Sing, hum, talk, murmur shhhh, listen to
music, or use 'white noise.' Try different types of sound, different
styles of music and singers with different types of voices.
- Soothe
with rhythmic motion. Walk, sway, bounce, dance, swing,
or even try a car ride.
- Soothe
with touch. Hold or bathe baby, try baby
massage.
- Reduce
stimulation. Dim lights, reduce noise, swaddle baby.
- Vary nursing
positions. Try side lying, lying on your back to nurse
with baby tummy to tummy, etc.
- Nurse
in motion (while rocking, swaying, walking, etc.).
- Combine
rhythmic motion with soothing sounds.
- Avoid
scheduling,
even more so in the fussy evening hours.
- More soothing techniques.
Page last modified:
05/17/2006
Written: 10/29/1998
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Helpful books
The
Happiest Baby on the Block:
The New Way to Calm Crying and Help Your Baby Sleep Longer
by Harvey Karp, MD
The
Fussy Baby Book:
Parenting Your High-Need Child From Birth to Age Five
by William Sears, MD and Martha Sears, RN, IBCLC
