Should Partner Give a Bottle at Night?

If you've been working with breastfeeding families for any amount of time, you've probably been asked, "When can I start pumping so my partner can give a bottle at night?"   I've heard the thought of not sleeping through the night described as, "not do-able," "terrible," and "a disaster."  Family members sometimes agree that there's no way a new mother could do all night feedings. 

How to respond to that?  There are so many factors to consider that with this fairly common question, my IBCLC brain goes into overdrive.   

Active Listening

So, I take a deep breath and remember my communications skills. Number 1: listen to the mom. Really listen. Yes, I’ve heard this 100 times before, but this is this mom’s first baby and her first time expressing her worry. Hear what she is saying. Acknowledge her concerns.  

“So what I hear you saying is that you’re afraid that breastfeeding during the night will mean that you’ll get no sleep, is that right?”

Ask Permission

I’ve clarified her concerns and now I’d like to answer her but first I’d like to share some important information. Since I’m not answering her original question, it’s best for me to ask permission to share.    “Would you be comfortable with me sharing some information about nighttime breastfeeding?”  Most times mom will say “yes,” and now I can ask her what her breastfeeding goal is, establish any risk factors, and comfortably explain why breastfeeding at night, at least initially, may be easier than she imagines.

Considerations

Before providing information, I need to take some important things into consideration that will influence how I present information and answer mom’s question:

• Has mom breastfed before, and did she have a good milk supply?
• If this is her first baby, does she have risk factors for low milk supply?
• What is mom’s breastfeeding goal?
• Does mom have any medical and/or mental health concerns?
• Would she be willing to feed during the night until her milk supply is established?
• Will she have help at home?

Providing Information

Here are some important things moms should know before making the decision to interrupt feedings.

• New mothers get about 7 hours of interrupted sleep per night. (1)
• When mom breastfeeds, the hormones oxytocin and prolactin are released. Both of these hormones have a relaxing effect on mother.   
• At night, prolactin is released in even higher amounts than during the day.
• Prolactin peaks about 30 minutes after feeding. This is just the right amount of time for mom to settle baby and get back to sleep herself. 
• Breastfeeding mothers actually get more sleep than non-breastfeeding mothers, and this may be due to the hormonal effect of breastfeeding. (1)
• High prolactin levels at night not only help mom get back to sleep, but they increase milk production.
• Long periods of feeding interruption, especially in the early weeks will lead to low milk supply.  
• Low milk supply is stressful and leads to all kinds of other issues for both mom and baby which arguably are more difficult than interrupted sleep.
• If mom is fortunate enough to have a good milk supply and skips feeding at night, she may become uncomfortably full and be at higher risk for plugged ducts and mastitis.
• Mom will have to pump either during the day or at night in order to have milk for partner to feed. Either way, this can take away from times of rest.
• Studies suggest that the diurnal fluctuations in breast milk evolved to send vital time-of-day information (chrononutrition) to promote the development of a circadian clock. Human milk expressed during the day contains higher levels of cortisol, tyrosine, and immune factors, whereas night milk is comprised of increased levels of leptin, melatonin, and tryptophan.  (1)  Or, as a colleague describes to families – mom’s body makes “sleepy milk,” and “wake-up” milk.

Alternatives to Feeding Interruption

Instead of interrupting breastfeeding, we can help new parents find alternate ways to cope with interrupted sleep:

• Sleep when the baby sleeps – this is an “oldie but a goodie.” Resist the urge to run around “doing,” when baby naps.   Take this time to nap or at least relax. 
• Get help – When family and friends offer to help – let them! Helping with household chores such as cooking, cleaning, shopping and laundry can go a long way in helping parents get some rest.
• Partner helping – While I’m not an advocate for interrupting feedings at night – partners can still be helpful with other things such as bringing baby to mom or changing diapers at night.
• Taking turns – Once baby is fed, day or night, if baby remains awake, partner can take over so that mom can get some uninterrupted sleep time, and then parents can switch off so that both parents can get some sleep.
• Avoid caffeine – Caffeine is a stimulant and can interfere with normal sleep cycles
• Avoid electronics – We all want to reach for our phones. It’s your watch, your calendar, your baby tracker-I get it.   But for the sake of sleep – consider turning it off during the night because it can cause interruption of your total sleep time.

Re-Framing Thoughts about Sleep

As providers we can help new families re-frame their thoughts about interrupted sleep. Cognitive reframing is a technique used to shift the mindset so individuals are able to look at a situation, person, or relationship from a slightly different perspective. (2)  It’s easy for new parents to get into a mindset  that interrupted sleep is a “disaster,” but cognitive reframing can teach them to ask themselves questions like, “Is there another way to look at this situation?” Only they can answer this for themselves, but we can help to point out some of the positives of responding to baby’s needs, and to the fact that this is a temporary situation.

We Educate; Families Decide

Ultimately, the choice to pump and bottle feed is up to each individual family.  As with any recommendation, there are variables that we can’t always foresee. While the majority of mothers adjust well to the interrupted sleep associated with breastfeeding, some do not – and each family will have to decide for themselves which path to choose. Our role is to educate and support choice.

So What IS the Answer?

Once I’ve been able to discuss mom’s goals, evaluate risk factors and provide information to mom, the ball is in her court. If uninterrupted sleep is a priority, I recommend that she wait about three weeks if possible, before introducing any routine pumping and/or interruptions to breastfeeding. This allows her baby to become “expert,” at breastfeeding and decreases the risk of baby rejecting the breast for the bottle. It also allows time for the establishment of milk supply. After three weeks of breastfeeding, she will also be in a better position to judge how interrupted sleep is affecting her, and whether or not she is ready to begin a pumping routine. I also strongly recommend that all new breastfeeding mothers participate in a breastfeeding support group – whether in-person or virtual. Hearing from other mothers who are currently breastfeeding, and how they cope with interrupted sleep goes a long way in helping mothers feel understood.

My goal is not to convince mothers one way or the other but rather to empower, educate, and support their individual goals. I hope these tools help you to support your clients, and help them to reach their personal breastfeeding goals, while still getting some sleep!

References

1. Wong SD, Wright KP, Spencer RL, et al. Development of the circadian system in early life: maternal and environmental factors. J Physiol Anthropol, 2022;41(22)2.

2. Morin, A. How cognitive reframing works. Verywell Mind. May 4. 2022.  Retrieved April 5, 2023, from https://www.verywellmind.com/reframing-defined-2610419