The Mechanics of Night Nursing

Dear 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.