[Editor’s Note: I’m so happy to have Annie from PhD in Parenting back for part two of her piece on breastfeeding and sleep management during postpartum depression. (If you missed it, here’s part one.) -Katherine]
Things You Can Do to Help Protect Your Milk Supply and Get More Sleep
Nap with your baby: Catch up on some of your sleep during the day by napping at the same time that your baby does if you’re a stay at home mom.
Offer the breast more often during the day: Most babies *love* to breastfeed. When you’re awake, put your baby to the breast more often. That way they may take in more milk while you are also awake, which could minimize their night waking (no guarantees here; each baby is different). Offering the breast more often during the day also helps stimulate your supply. If you’re a working mom, try to mimic this by pumping more often. In addition to your complete 20 to 30 minute, double pumping sessions with the electric pump. If you have a handheld pump, you may be able to sneak in some extra five minute pumping sessions here and there during the day.
Keep your baby with you in the evening to encourage cluster feeding: If you’re not feeling completely touched out by the end of the day, consider keeping your baby with you in the evening (in a sling, or on your lap) as you go about quiet evening activities (reading, catching up on e-mails, talking to your spouse). Most babies can sleep anywhere and don’t really need complete quiet to sleep. I spent many, many evenings cluster feeding at my keyboard while reading, writing, chatting with friends, or providing mom-to-mom breastfeeding support.
Wake your baby to nurse before you go to sleep: I always woke up my baby to nurse before I went to sleep. Sometimes she was hard to wake, so I’d change her diaper (sure fire way to wake her up!) and then lay down and nurse her before going to sleep myself. That way I knew she had a dry diaper and a full tummy when I went to sleep, which made it more likely that I’d get a good stretch of sleep in before she woke me up. It also helped me take advantage of the sleep-inducing hormones that are produced during breastfeeding.
Consider co-sleeping: Having your baby close to you makes it easier to tend to their needs at night without fully waking up the way you would if you had to walk down the hall and sit on a rocking chair or couch in another room. You can have the baby close by in a bassinet or co-sleeper or bring them into bed with you if you follow strong co-sleeping safety practices. Deliberate, planned co-sleeping is very safe, whereas falling asleep with your baby by mistake or out of desperation when unprepared can be very dangerous.
Find a daytime baby walker: Once you’ve passed the first few weeks, you’ll probably have a better idea of your baby’s internal clock. If there is a time of day when your baby is happy to go without nursing for a few hours and you have a friend, partner, neighbour, or relative who is willing to take the baby out for a walk in a stroller or a sling, then book them several times a week to do that. Nurse the baby, then push them out the door and lay down for an uninterrupted nap. Not only do you get some extra sleep during the day, but the baby also gets much needed fresh air to help them sleep better. Fresh air is great for mom too, so head out with baby yourself for a second walk at another time of day.
Okay, but I’m still not getting enough sleep!
What if you’ve tried all of that and you’re still not getting enough sleep? Some babies wake more often than others. Some moms need more sleep than others. Some babies nurse and then go right back to sleep, while others think that nighttime is play time. If you’re still at a loss and aren’t getting enough sleep, you can try implementing shifts with your partner, but you need to do so in a way that respects your baby’s nursing needs and also protects your supply.
Here are a couple of variations you could try.
Dad on baby duty, mom on breastfeeding duty: Just because the mom is the one who breastfeeds, doesn’t mean she needs to be on nighttime baby duty. The dad could sleep in the same room as the baby (e.g. sleeping on a mattress in on the floor in the baby’s room) while the mom sleeps alone in the parents’ bed with ear plugs or a white noise machine. Instead of the mom having to be “on alert” for a waking baby, dad is “on alert” and mom can sleep soundly. The dad would be responsible for diaper changes, rocking the baby, re-settling the baby, etc. and for bringing the baby to the mom to breastfeed around once every three to four hours (i.e. if the baby wakes and it has been more than 3 hours since the last nursing session ended, dad would wake mom to nurse).
Splitting the night: You can implement shifts, but they may need to be a bit shorter than the ones mentioned in the quote earlier in this article. For example, instead of 8pm to 1am and 1am to 6am, you might do 10pm to 2am and 2am to 6am, so that no shift is ever any longer than 4 hours. If you occasionally need a guaranteed longer stretch of sleep, you could leave a bottle of breastmilk out for your partner to take a nighttime feed. In that case, shifts of 8pm to 2am and 2am to 8am could even work every once in a while. Just be sure that you add in an extra pumping session after your long sleep stretch and that you don’t do it too often (or you’ll be signalling to your body not to make milk at that time of day, which will decrease your milk supply overall).
We used these tactics a few times on a temporary basis to get over a bad sleep period, but you could also implement them permanently if you needed to as long as you nurse, nurse, nurse as frequently as you can during the day. That may mean offering the breast even more often than the baby asks and could also mean adding in a pumping session or two during the day (e.g. pumping after the baby nurses or during a long nap). Whenever we did any of the nighttime shifts, I always nursed the baby as soon as I got up in the morning and then pumped on the other side to save that milk for another time.
Did you struggle with managing sleep, breastfeeding and PPD? What tactics worked your family?
Annie has been blogging about parenting, feminism and social change at PhD in Parenting since May 2008. She is a social, political and consumer advocate on issues of importance to parents, women, children and the earth. She regularly uses her blog as a platform to create awareness and to advocate for change, shedding light on positions, policies and actions that threaten the rights and well-being of parents and their children.
Hi Annie – Great common sense suggestions. I love the idea of a “prescription to sleep” as the Dr. Samantha Meltzer-Brody (the folks from UNC) and also Dr. Michelle Preminger, a reproductive psychiatrist, here in NJ advocate. And I love that you, too, share this prescription for sleep here on the Kat’s blog. I love too, that you know how to keep a milk supply up as that is a concern for accidental weaning. Good loving, family-oriented suggestions! Warmly, Kathy
Thank you for writing this wonderful post. I help to facilitate a PPD support group. We have been talking about sleep deprivation. I will definitely point moms to this article.
These are good suggestions and might work for a lot of people. However in our situation some of them still wouldn’t have been helpful. Now that I’m 18 months postpartum, I have learned that my depression is super correlated to my sleep quality & quantity; to this day, if I have 2 or 3 nights in a row of poor sleep, and 7.5 hours is optimal for me, I have a mini-relapse for a few days/a week. For the first 3 months pp I was lucky to ever get 3 hours of uninterrupted sleep. I would usually get 4-5 hours per day, broken up into chunks of 20 minutes to an hour and a half. No wonder I got depression to begin with. When I stopped nursing completely, and found a good therapist, at around 8-9 months, I started to finally improve.
We had baby in a bassinet in our bedroom for the first 3 months. He was such a noisy sleeper, he would be asleep but I would lie there awake hearing him grunting and gurgling, and wiggling, I would just lie there thinking “he’s about to wake up, no point in sleeping,” and even if it was an hour later when he actually did cry out, I couldn’t sleep in the meantime despite my exhaustion. In addition, I had unresolved pain when baby latched on, my LC said it was a vasospasm, that never really went away, I would usually have to unlatch and re-latch my baby 10-12 times every time I nursed to get the latch right so it didn’t hurt, so even though sharing a room theoretically made breastfeeding easier & I wouldn’t have to be so awake, in reality I would get super alert and emotional because of the pain and effort breastfeeding required. I used to think it was like refueling an F-16 in the air at night, with one drunk pilot. Nursing with baby in a carrier wouldn’t have been practical, since every time I was holding my own breast and baby’s head and trying with everything I had to get the two to line up right, and holding baby like that for the entire nursing session. I also never could produce much from pumping, I would nurse baby and then pump to store for later when I went back to work, and only get half an ounce, even first thing in the morning. Once I was pumping at work, I would spend literally 3 hours a day hooked up to the damn thing, and not even get 8 ounces all day. I tried everything I could think of, had the pump suction checked, tried a different pump, three different sizes of flanges, and those weird downward-angled flanges, listened to my baby cry, watched vidoes of myself nursing him, squeezed the dickens out of my breasts, took a ton of fenugreek and drank a gallon of water a day, nothing helped. It was so stressful, and I don’t know how I could have spent any more time on the pump. It always hurt like hell to turn up the suction more than the lowest setting. Breastfeeding is super hard and although I knew it was best for my baby, and it made me feel good to feed him with my body, in my case I think the interplay between breastfeeding, and the additional stress and lack of sleep it resulted in, was a major contributor to my PPD.
After 3 months, having my husband sleep in the baby’s room to be “on alert” would have helped me tremendously, except that we didn’t have another mattress for him to sleep on, we would have had to go buy one, which at the time seemed an impossible task (Shopping?! are you kidding?). There were so many times when I would ask him to change and re-swaddle the baby back in his crib or bassinet after I nursed him, or we would do 3-hour “shifts” at night, I would put in ear plugs, but he couldn’t get the baby back to sleep, he just couldn’t settle him, and my husband would get panicked and angry, and come wake me up for help, so it was pointless. I ended up being “on alert” even when it was his turn to be “on alert,” because I was scared he was going to get mad and shake the baby, or lie down on the sofa with him, which he kept doing, and it made me so scared and angry at my husband. My husband would bring me the baby to nurse, and then fall asleep while I nursed him, and since by then I was depressed, I had lots of negative thoughts about how he deserved the sleep and I didn’t, I was the mom and this is just how it is, even though we were both working, I felt awful waking him up again to put the baby back down, especially because he had been so bad at it. We basically needed a third person, someone more experienced, who could sleep during the day, and be a night nurse, for the first 5-6 months.
When I decided that it was OK to stop pumping at work, it was a huge relief to me. My supply dropped pretty fast, my depression still didn’t get better for a long time, but my sleep slowly did, since my husband bottle fed baby at night and around 5 months we worked on getting baby to fall asleep on his own so he could re-settle himself if he woke up at night and wasn’t hungry. I also knew by then that having a functioning, happier mom was more important to my baby than getting exclusively breastmilk, or even any breastmilk. I don’t know how couples survive the newborn period, it’s so hard, let alone single moms. I’m really scared to ever do it again, I might not at all. I often think that if I could just not breastfeed, then things would be a lot easier.
OMG this sounds exactly like my life.i would like to ask did your baby have a hard time taking a bottle?mine doesn’t know what to do with it, I’ve tried and tried. I’ve tried a pacifier too, he won’t take either…I know your post was quite a while ago but I hope this reaches you.
Wow, you sound exactly like me! Everything went well in the beginning but after months of waking up in the night, my brain changed and I was unable to fall asleep anymore. Like I literally would lay in bed all night on alert since my husband is the deepest sleeper and would never hear the baby. I tried putting the baby in the room with me but his noises kept me up. I suffered through it for 12 months! By the end I had severe insomnia and anxiety and depression. It’s now 2 years pp and a year after stopping and I still am suffering from insomnia. Been on sleeping pills and therapy and am slowly learning how to sleep again but I have rebound episodes. If I don’t sleep well I’m horrible anxious and depressed. If I do sleep well I’m a totally different person and mom. This is the ONLY issue that is making me hold back on having another baby. I can go through anything but not insomnia. The breastfeeding I know would trigger it. It scares me so much. I would love to have another baby. I am trying to research if I can bf during the day and not the night. Would that effect supply? Some people just can’t be woken up at night otherwise they can’t get back to sleep.
I know the OP wrote this a year ago, but this is also what happened to us for both children. It felt impossible and I would also sleep maybe 4 broken hours in a day… try to nap but felt like I was on caffeine and couldn’t. 9 months later…
By then I was destroyed. I had a 4 year old and 9 mo old and massive post partum anxiety due to sleep deprivation. Hallucinating, intrusive thoughts, anger. My therapist and I blame the breastfeeding and pumping all night for how bad it got. (Breastfeed 30 min, pump for 20, repeat 90 min later the lactation ladies said… I’m telling them to go to h*ll next time).
We are expecting our 3rd child in a few months and I have a plan:
Breastfeed as much as possible during the day, especially evening. Pump 1 bottle for husband’s baby shift at night and 1 bottle for a friend or sitter during during the day when I can nap. I’ll get a sleep aid to use safely and hopefully sparingly. Move to formula if necessary.
I tried everything to increase supply and help baby sleep and it cost me dearly. Next time I’m taking care of myself too.
I am so sorry you had this experience Jen. As a lactation consultant I firmly believe the mother’s health is as important as the baby’s. The best breastfeeding plan is the one that works for you and your baby.
Hi problem is that my baby sleeps at night but I don’t get sleep my health is getting worst