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The Mechanics of Night Nursing

Jul13

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Advice Smackdown ArchivesDear Amy,

First of all I want to say that I have been a faithful reader of your blog and all things Amalah since around 2007.  I hope that doesn’t sound stalkerish.  Anyway, I have a question and haven’t found my answer in the archives, so I thought I’d try going directly to the source.

I am going to have a baby girl in August.  This is my second child, I have a son who is two and a half.  I nursed my son successfully until around 14 months, and everything about nursing him was great.

Sleep, not so much.  We ended up co-sleeping because that’s what got us the most sleep, however, I didn’t really nurse him in bed.  With our new baby we want to hit the ground running and co-sleep from the start.  This is where I run into some logistical questions.  Since I know you’re co-sleeping with Ike I’m hoping you can offer me some answers about what has worked for you and him.  I’m sorry if they seem a bit ridiculous, but I can’t seem to find/get answers from anywhere else.

First, access to the milk.  Do I sleep topless?  In just a nursing bra?

Second, controlling mess.  Do I put some sort of towel/sheet under the two of us so I’m not washing milky/spit-up sheets all the time?

Third, burping.  After the baby is done nursing, do I sit up and burp her then lie back down and hope she’ll fall back asleep?

Fourth, positioning.  How do I have her nurse from both sides?  Do I just plop her on whatever side of me is next, even if that means she’ll be near the edge of the bed 50% of the time?

As you can see, I’m a bit neurotic about something that seems to be instinctual to many women around the world.  I just want to make sure I have some bases covered before she’s here.

Thanks!
Stuck on details

Ahh, the mythical night nursing! The promise of maximum sleep via only having to wake up a teeny tiny only halfway bit!

Before I get to your specific questions, lemme lay down some truth: It takes practice, and it’s not always doable right from the get go. Your newborn might be too small at first, or might require so much two-handed (and visual) guidance to latch on correctly that attempting to nurse lying down is about as restful as trying to wrestle an eel. (Especially if you have any nipple damage. OW.) So don’t be frustrated if it takes awhile. Plan on nursing upright for at least a week or two, probably. If you get the hang of it earlier, awesome, but if not, be assured that it’s completely normal.

I managed to nurse Ike lying down once in the hospital, on our very last night there, and I was wildly impressed with us. Look at us go! We’re all advanced and stuff! And then we got home and I tried again that night and it was all annoying and dark and awkward and I was trying to sleepily eyeball his latch by the light of my iPhone and pulling him off to relatch when it hurt too much and after two nights of that nonsense I went back to sitting up, propped up by pillows, nursing while my head sort of lolled around on the headboard behind me.

Then he got a teensy bit bigger and was able to do a little bit of the latching-on work all by himself and I’d say somewhere in the two- to three-week range it all clicked and started working the way it should. We slept curled up together, flopping from side to side for each feeding while I at least managed to stay in a mostly sort-of twilight sleep state through it all. (With the exception of a handful of inexplicable I FULLY AWAKE AND CRANKY NAO post-nursing fits.)

And then he turned out to be the NOISIEST newborn I have ever freaking encountered in my life — just non-stop sighs and grunts and squeaks and coos and whines, even when he’s sound asleep. So now, at all of six weeks, I’m more or less saying goodbye to co-sleeping and transitioning him to his crib, because he sleeps longer there, and I sleep better without jolting awake at every single urp and burp he makes. I KNOW, RIGHT? THESE KIDS KEEP CHANGING ALL THE RULES.

Anyway! That has nothing to do with your question…other than I guess to remind you that the best-laid and most-obsessed-over plans can also turn out to be the most useless. And sometimes it’s best to go into things with a “we’ll just wing it and see how it goes” mindset rather than definite plans.

That said, co-sleeping and side-nursing was absolutely the best call for a couple weeks there, and for MONTHS with Ezra. (And part of our crib transitioning with Ike still sometimes includes Jason getting up to fetch and retrieve the baby, while I stay in bed and nurse lying down.)

So let’s get to your specific questions:

1) Dress code. Completely up to you. Personally, I found that nursing tanks (the clippy-fold-down style) worked the best and were the most comfortable. Remember that your arm will likely be extended up over your baby’s head, so anything that requires being pulled down your arm/off your shoulder might not work very well. Likewise, I found that the nursing tops and sleep bras that were supposed to just get pulled to the side and tucked under my boob were a pain because the fabric tended to “pop” back up and get in Ike’s way unless I manually held it down with my fingers. But this PROBABLY has more to do with the shape/size of my personal boob anatomy than any across-the-board comfort rule.

Once I hit a month in and my supply regulated and I no longer needed clothes-staining lanolin on my nipples or tops designed to hold in nursing pads or those soothing/healing gel pads, I wore whatever I felt like. Lots of stretchy v-necks, or nothing at all. But be forewarned that when you go commando you run the risk of your baby randomly adding another hour or two in between feedings. Which is great! Except for the waking up in a puddle of milk with unsupported boulders strapped to your chest. Ah, you live and you learn. And wear a bra the next night.

2) Mess Containment. I swiped a (non-disposable) bed pad from the hospital. You can buy these yourself — they’re reusable incontinence pads. I liked it because it was big and heavy enough to STAY PUT on the bed, thus minimizing my fear that it would shift and bunch up and end up covering my baby’s face. (You can also fasten it down with safety pins or small plastic clips — and the same goes for a towel.) The only downside to it was that it was kind of hot to sleep on. Not very breathable waterproofing, I guess. (Could have just been that particular hospital brand/version, though.)

After awhile I downsized to just a simple cloth diaper burp rag. Again, I was nervous about Mysterious Baby-Smothering Shifting Fabric but it never happened. And if it got puked on, I simply yanked it out, tossed it in the general direction of our hamper, and grabbed the fresh rag I had hanging over our bed’s headboard. (We also have a really, REALLY good water- and stainproof pad on our mattress, under our sheets. Protect-a-Bed Premium. Absolutely essential for co-sleeping babies and puking toddlers and beyond.)

Some nights, yes. There is some mess involved. Leaky milk and spit-up honestly don’t bother me that much — it dries without staining and I don’t rush to change the sheets every time it happens. (GROSS BUT TRUE.) Leaky diapers are your real enemy, so you might want to stick with the oversized incontinence pads or towels just for that problem. Not really any way to accurately predict or prevent that 100% of the time, besides making your partner change the diaper at some point overnight (THAT IS ONLY FAIR IMHO) and then just…stripping the bed and washing the sheets as-needed. *Shrug*

3) Burping. This TYPICALLY isn’t a huge problem — little teeny babies tend to get pretty zonked out on milk that you can usually coax a burp out of them without fully waking them up. To save myself from having to sit up, I burp my babies over my hip, while still lying on my side. If I can’t get a good burp that way, I’ll sit up and continue the patting.  (Giving their little left side a gentle squeeze right where their full tummy is usually speeds the process up, too.)

Once babies get a little older (like, several months, depending on how generally barfy they are anyway) (IKE = VERY, OMG) you may find you can even skip the burp entirely and just let them slide of the boob and sleep in peace. Worst case, if they do wake up after burping, let them have a couple extra sucks on the side they just emptied to soothe them back to sleep.

4) Switching sides. In the very beginning, I used an iPhone app to keep the whole “last side nursed on” thing straight. (It was called iBaby Feed.) I relied on it pretty darn religiously for the first few weeks, until I was able to tell on my own (via which side felt fuller). At night, I was using my phone for light to get a good latch anyway, so it wasn’t a big deal to keep on using the app then as well and double-check which side had been nursed off of last. Something like this (you could also use a bracelet or a rubber band around your wrist) makes it easier to keep the baby in the middle of the bed, if that’s where you’re most comfortable having her. (Though note that it is generally considered safer for baby to simply stay as close to you as possible, rather than right in between both parents. Fathers generally do not have the super-strong arousal instinct and hyper-awareness of a sleeping infant’s body, at least not at first. Mothers do, because we are awesome.)

For going old-school and sans app, I usually would just let my babies fall asleep on the side they’d just finished and then make the switch to the other side as soon as they woke up, or after my husband returned them post-diaper change. Edge-of-the-bed concerns were easily solved with an inexpensive bed rail. Go to Amazon and look at mesh safety rails designed for toddler beds. (It’s not like you need something the length of your entire mattress, you know?) I bought one that folded down, which was really handy.

So…I think that’s everything. I would like to direct you to this list of guidelines and tips for safe co-sleeping/bed-sharing from Dr. Sears, and remind you that most of bed-sharing is half new-motherly instinct and half plain old regular common sense. AND remember that it doesn’t have to be an all-or-nothing thing, or The Sleeping Plan That Will Be Implemented No Matter What. Once your baby is here, you might decide a bedside co-sleeper is more your style, or having her start the night in a bassinet or crib and then co-sleep from her first nighttime waking on. No matter how you do it, good luck, and I hope we all get more sleep soon.

Amazon Mom

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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20 Responses to “The Mechanics of Night Nursing”

  1. Ha there’s an iPhone app for EVERYTHING! 

  2. bhn Jul 13 at 10:30 pm Reply Reply

    Depending on the size/shape/engorgement level of your breasts, and size of baby, you can also do the Cross-Boob Dangle (TM). This involves, when you are lying on your side and you’ve nursed from the “bottom” boob, shifting your weight towards baby a bit, almost leaning over them, and then liberating the “top” boob which will, in theory, then be accessible to baby. Of course when they’re done you have to roll back a bit, and you might have to use a finger to hold back some breast tissue in order to avoid smothering.

  3. Angela Jul 13 at 10:40 pm Reply Reply

    My tip for latcing on…I put my index finger on my nipple, and feel for baby’s mouth with the back of my finger. Once they’re lined up I slide out the finger and everyone’s in place. I also second the mesh bedrail…works great!

  4. Angela Jul 13 at 10:44 pm Reply Reply

    *latching*  Stupid tiny keyboard!

  5. Martha Jul 13 at 11:11 pm Reply Reply

    Once they get bigger, you don’t have to flip them from side to side – you can kind of roll over and offer them the other boob, I found. But for the first few weeks, I found it easiest to sit up and nurse, rather than trying to it lying down. Sometimes our son was between us but husband did find he didn’t sleep as well because he must have a bit more of that spidey-sense of not wanting to roll on the baby!

  6. bethany actually Jul 13 at 11:59 pm Reply Reply

    In our king-size bed, my 7-month-old daughter is always either between me and the wall (against which our mattress is VERY firmly shoved) or between me and my husband. My husband sleeps on his side facing the center of the bed when the baby is there, because he hates sleeping on his stomach, so he never rolls in that direction.

    With my older daughter, we had a queen size bed, and I would change places with my husband if I needed to switch sides while nursing. It got to be a routine pretty quick and my husband was often awake for a diaper change or something anyway.

    Note that during the night, I generally don’t feed my daughter from both sides every time. I nurse her from the right one time, the left the next time. Somehow it all works out just fine.

    Also, if you don’t want to invest in bedrails or you are paranoid about the baby rolling out of the bed, you could always put the mattress on the floor, as we do, to minimize the drop. I have friends who sleep on a futon mattress on the floor when their kids are nursing and co-sleeping with them, which is surprisingly comfortable.

    Co-sleeping has been fantastic for our family with both kids, but the second has definitely been different from the first. My older daughter always wanted to be in bed with us. She started sleeping in her own bed in our room when she was 10 months old, but she often came into our bed at some point until she started sleeping through the night at 14 months. After two years of sleeping through the night in her crib, when we got her a toddler bed for her third birthday, she went back to getting in our bed with us during the night almost every single night. That continued until she was 6.5, when our second daughter was born, and we had to ask her to stop because of the baby. (We told her she was always welcome to come ask Daddy to get in her bed with her, but so far she hasn’t needed that more than once or twice.) In contrast, our younger daughter occasionally makes it clear that she does not want to be in our bed, she wants to be in her own bed, and she’s only seven months old. So you just never know what’s going to work till you meet your kid, you know? :-) Good luck!

  7. Olivia Jul 14 at 8:49 am Reply Reply

    I did pretty much what Amy said. Mesh bed rail, a towel underneath me until the leaking stopped, switched sides after the baby woke up, sat her up (not me) for burping…I think it was around 3 weeks when I was able to latch her on without turning on a light.

    For clothing I found nightgowns with buttons down the front and I would just put the shirt to the side. My boobs fell out of those sleeping bras (I’ve got DDDs), and the nightshirts were great for when the weather turned cold because I could keep my arms covered and still keep the blankets below my waist and well away from the baby. In winter I added a zip up hoodie. 

    A tip for switching the baby side to side: put baby on a folded receiving blanket and when it’s time to switch sit up on your knees and slide the blanket with the baby to the other side. I found that much easier than lifting her up and over me. Once she was bigger, around a year, I was able to just lean forward for her to nurse from the “top” boob.

    And here is a good post with pics for what bedsharing and nursing looks like. http://www.hobomama.com/2010/06/side-lying-nursing-breastfeeding.html

  8. shannon Jul 14 at 1:57 pm Reply Reply

    We did not/ do not cosleep, but we did develop a routine while I was on maternity leave where my husband brings the baby to me when she wakes up for the first feed of the morning and I nurse her laying down. This did not work for us until she was maybe 5 or 6 weeks old because, as Amalah mentioned, she was too small to latch properly in that position. I have found that I usually fall back asleep while she is nursing. When I was still on leave, she would often sleep for a couple of hours like this, which was one of the few longer sleeps we got. Now, I usually get to sleep for another hour until I have to start getting ready for work. Some days, that extra hour makes ALL the difference in the world.

    Logistics-wise, I wear a Bravado nursing bra pretty much 24-7. I find it pretty comfortable, whereas the tanks always feel binding to me. I don’t do anything special to prevent milky leaks, though we do have a mattress pad just as part of our normal bed dressing. And I don’t usually burp the baby, but our girl has been a nearly spit-up free baby and did not always need the help. I also didn’t necessarily worry about switching sides because she usually fell asleepbefore that.

    I would try it a few times to see what works for you. It’s just so dependent on individual anatomy and baby’s disposition, etc.

  9. Julie Jul 14 at 2:46 pm Reply Reply

    I agree that side laying nursing doesn’t really work till the baby has enough neck control to stay attached once he’s latched on – sometime in the first few weeks, depending on you and on the kid.

    For the sleeping thing – I started out with a drop side crib with the drop side taken off and side-carred to the bed with my first kid. (instructions I followed here http://www.freewebs.com/sidecarcrib/) With the second, since the crib is still in use as a toddler bed, we borrowed an arm’s reach co-sleeper.

    In both cases, it gave me room to give the baby his own space for at least part of the night – I usually start him out there, then grab him when he wakes the first time and may or may not slide him back in depending on whether I’m awake when he’s done feeding and how sound asleep he is. But that way, the crib is there so he’s either between me and my husband if I”m nursing that side, or between me and the crib so if he rolls he’ll roll into the crib. I stayed with that set up till he was mobile enough to make me not comfortable with it. Then I did the crib freestanding, put a bed rail on our bed, and would start the baby out in the crib, and get him and bring him to bed with me when he woke up for his first night feeding. I know friends who have just put the mattress on the floor, and put a crib mattress on the floor next to the adult mattress if they want a little extra space.

    Either way, yes I just plop the baby on whatever side I’m nursing from, and let him fall asleep there.

    For sleepwear, I found button front shirts work great. I just leave them open – in winter I do flannel PJs, in summer I have some nightgowns that have buttons far enough down to provide easy access. As the baby gets bigger, I found I can also just wear a t-shirt and hike it up to nurse.

    A nightlight is key for me for the first few months – my baby is 4 months old and I’m finally comfortable enough getting him latched on without seeing what I’m doing that I stopped turning it on at night. If you can’t sleep with a nightlight, I have also found a book light hooked to the headboard worked well – I could turn it on to get settled, then easily reach up to turn it off.

    Good luck!

  10. Stuck Jul 14 at 3:58 pm Reply Reply

    Thank you so much for your help and advice. It’s really helping me get a better picture of how things (may) go with a newborn. Hopefully everything will go great, but I still bought a Moses basket and crib for her, ready to go, just in case.

  11. Stefanie Jul 14 at 6:06 pm Reply Reply

    I second the recommendations from others for pushing your mattress VERY firmly against the wall. That’s what we did with my daughter and I never worried about her falling off. I would just roll from side to side when I needed to switch. It did end up keeping her between me and my husband at times, but I just kept my arm extended across the bed so if he rolled it would wake me. He is a very still sleeper. We had a nightlight in our room as well.

    A word of caution about tops with buttons–they’re super convenient and do a great job keeping you warm since you can’t use blankets when you co-sleep, but I did wake up one morning to find a button had fallen off one of my pajama tops. My daughter didn’t choke or anything, but it scared me enough to make me stop wearing buttons when in bed with her.

  12. Emoly Jul 14 at 11:27 pm Reply Reply

    I recommend a night light as well.  I’ve always liked to be able to open my eyes and immediately see where he was–it lets me go back to sleep quickest.  I often slept in just a sleep bra with nursing pads and put a blanket under both of us.

  13. Erin Jul 15 at 10:41 am Reply Reply

    I wear the clippy nursing tanks and have found that the best way to avoid milk puddles (for me) is to stuff a trifolded prefold diaper in it across my boobs (I use one of the Gerber ones that are really only suitable for burp cloths, not diapers). The first few months I wrapped it around a cloth diaper insert for maximum absorption until my boobs figured out how to not leak all over the place all night long.

    Regular nursing pads never worked for me overnight because my boobs would shift around too much. Even on the nights I wear the nursing sleep bras, I stuff the prefold in there. It’s a little bulky but far more comfortable than milk puddles.

  14. Brooke Jul 15 at 1:13 pm Reply Reply

    So I’m a lot more endowed than most women, and I discovered that I can nurse my kiddo while he’s lying on his side in his Boppy. I lay on my side facing him and flop the top breast onto the Boppy. Also, be aware if you go commando that you could be very rudely awakened- this morning my son let me know it was time to get up by twisting my nipple. Ouch!

  15. kate Jul 15 at 9:50 pm Reply Reply

    I’ve co slept with both my kids from the start and love nursing lying down.  The baby sleeps between me and the edge of the bed and we use a foam bumper that fits under the sheet to keep the little one from rolling out.  It’s worked great and is very portable (for Grandma’s house or hotel rooms. http://www.gobedbug.com/ (I’m sure they regret the name now…)  This might be the slacker way but I don’t roll over to switch sides, just lean over a bit more when it’s time to nurse from the upper boob and I never woke the baby up to burp.  It’s really helped to have a pillow at my back too.  We didn’t have problems with spit up but for the first three months my daughter would leak milk from her nose while nursing.  It was a bit weird and soggy but ultimately harmless.  

  16. bhn Jul 15 at 10:41 pm Reply Reply

    I know you didn’t ask about this, but one thing you might not know as this is your first baby is that MANY newborn babies poop every time they are fed (it’s some kind of reflex). I found that in the first few weeks it was easier to feed baby in his room since I was going to be changing his diaper in there afterwards anyway (or husband would be).

  17. tasterspoon Jul 18 at 2:36 pm Reply Reply

    Echoing bhn immediately above. For that reason but mostly because I just found it incredibly awkward I wasn’t able to nurse lying down till almost three months. Also because I was trying to avoid aluminium so not wearing real antiperspirant and, as we all have learned, Tom’s of Maine does not actually WORK so half the time I get up to wash my pits so she doesn’t get her hair full of B.O. so…yeah, sometimes it’s just easier to get up.

    And it’s still not that great, I’ve never been able to sleep through it, and I find that half asleep fog more irritating than being fully awake. Jeez, how about a constructive tip? The back pillow helps a lot.

  18. Kelly Jul 20 at 2:16 pm Reply Reply

    This sounds great, but what about changing diapers?  Aren’t the baby’s diapers wet each time you nurse at night?  How does that work?

  19. Olivia Jul 21 at 9:49 am Reply Reply

    Kelly, I guess that falls under “every baby is different”, but I didn’t change my daughter’s diapers at night unless there was poop. We used disposables at night (cloth during the day) and I found them to be so absorbent they could handle a full night. And if the baby does need changing at night maybe the nursing mother can trade off doing that with her partner if she has one.

  20. Jen Jul 21 at 9:59 am Reply Reply

    I only coslept and nursed for a few weeks (now we’re the most opposite we can get – she sleeps in a crib and is formula-fed – ah, the best laid plans..) but for diaper changes, I just skipped one or two. So, at the time she was getting up every 2 hours or so, and I would change her diaper every other time. Nursing in bed was still worth it because I would change her diaper before I nursed her (we were in tune enough because we were cosleeping that I’d know she was hungry before we got to full-out scream, so I didn’t have to deal with an upset baby while changing her diaper), and then I could fall asleep while she was nursing. My side of the bed had a waterproof liner underneath the sheet for the inevitable night leakages.

    I actually got great sleep when we were cosleeping..it was amazing. But, she was latching incorrectly all night, which destroyed the nipples, I only nursed from one side each time because we didn’t have a rail set up on the edge of the bed which also just destroyed whichever boob it was, and my back was kiiiiiiling me because of the way we curled into one another. All I wanted to do was to sleep on my back with my arms flailed out, which obviously I couldn’t do with an itty bitty newborn in my bed. So in the end we transitioned to bassinet, and then she started becoming the loudest baby ever, so off to the crib she went. But it was a godsend the first 3 weeks or so.

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