When do I switch sides?

“How do I know when it’s time to switch?”
This is a question that has plagued moms for years. 
Many well meaning friends and even some healthcare professionals will give you a time frame, with “15 minutes on one side and 15 minutes on the other” being the one I hear most often. However, breastfeeding is never as easy as a simple matter of timing. In fact, if you ONLY consider the timing of your baby’s feed, you are likely to run into trouble. 
Consider the following three babies:
Baby A:  This baby latches to mom’s right breast.  He sucks vigorously and mom can hear swallows. As the feeding progresses, the swallows become more and more spaced out.  At the 15 minute mark, mom switches baby, and he gives a similar performance on the left side. At the 30 minute mark, mom detaches him and the feeding is over.
Baby B: Baby B latches to the right breast, sucks a few times, and then falls asleep. Mom rubs her back and feet, and when she does, baby perks up and starts sucking again for a few seconds..then falls asleep again.  The feeding continues on like this for 30 minutes, mom dutifully switching breasts at the 15 minute mark.
Baby C: This kid latches to the right breast and begins to loudly gulp milk, coughing and sputtering at certain points. At the 7 minute mark, he comes off on his own and will not relatch. Mom becomes upset because her baby did not even reach the 15 minute mark on one side.
Which baby do you think got the most milk?  Did Baby A and B get the same amount of milk because they fed for the same amount of time? (Probably not.) Did Baby C get less because he fed for only a few minutes? (Probably not.)
Do you see how a timed feeding can cause confusion about understanding your baby’s intake?  There is no way to know how much any of these babies got, (unless they were weighed before and after eating), but I’d put money on Baby C as getting the most milk, and Baby B not getting much at all. Baby A probably took an average amount of milk, but perhaps would have gotten more if he hadn’t been arbitrarily stopped.
Because of the trouble that timed feedings can cause with understanding your baby’s intake, a different strategy is required. Instead of watching the clock, you need to tune in to what’s happening on the boob.  What you want to see is a baby who is actively sucking and swallowing, and as long as your baby is doing this, he shouldn’t be switched, no matter what the clock says.  Most babies start out strong, and then gradually take longer and longer pauses while the swallows become fewer and fewer. Eventually, most babies will fall asleep on the boob, or take themselves off of the ’empty” breast, and this tends to happen between the 10-20 minute mark of the feed.  And in most cases, switching at this point in the feed would probably be fine for baby’s overall intake. 
But wouldn’t it be great to know for sure that your baby had really and truly emptied your breast before switching him? To feel confident that he took as much milk as possible?
 And of course, there is a way: use breast compressions!  And a breast compression is exactly what it sounds like – you squeeze your boob.
Here’s how to do a breast compression: when baby starts to slow down on his sucking, squeeze your breast and watch his response. If he starts swallowing again, hold the squeeze until he has stopped. If he doesn’t respond, or once he has finished swallowing, move your hand to a new spot on your breast, wait for him to start sucking again, and repeat the squeeze. Once baby no longer responds to compressions (or takes himself off), it’s time to switch sides. And you should always offer the second side. Baby may or may not take it, but always offer!
You should also try breast compressions if:
  • You have a very sleepy eater. The faster flow of milk can help to keep baby awake and interested.
  • You have a low supply/poor gainer. The breast compressions will allow your breast to be most fully drained, which will give your baby more milk and should help to boost your production over time.
  • You have a slow initial letdown. Some babies are impatient and aren’t happy to wait for the fast flow of a letdown. Squeezing out what you have might help your baby to stop fussing and perhaps even encourage your letdown to occutr more quickly.
  • Your baby is a slow eater. If your baby regularly takes 45 minutes or longer to eat, try some breast compressions to see if you can make feedings more efficient. (And call an IBCLC while you’re at it as there might be something else up with the lengthy feeds.)
So the next time your baby eats, put your eyes on your baby, and give your breasts a squeeze!

photo credit: Yachichurova август60 via photopin (license)
photo credit: UNICEF Ethiopia World Breastfeeding Week 2016 via photopin (license)
photo credit: Chris Alban Hansen Breastfeeding on the Museum Island, Berlin via photopin (license)

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