Variations in breastfeeding rhythms occur between mothers and among cultures. Nursing patterns typically include 8-12 feedings a day¹, often with an interval of 1-3 hours from the start of one feeding to the start of the next feeding.

It is ideal for health care providers to distinguish between non-nutritive and nutritive sucking².

Non-nutritive sucking is defined as a series of sucks with very few swallows. The sucks may appear in an irregular pattern, and are short. Little milk transfer occurs during this period. This suckling pattern often occurs at the beginning of a feeding, and stimulates the milk ejection reflex. Non-nutritive suckling also occurs at the end of a feeding when milk flow has slowed and the infant is relaxing or sleeping.

Nutritive sucking is a slower in order to accommodate swallows, and is a more rhythmical pattern with a wider mouth excursion. There are one or two sucks per swallow and milk is transferred. An audible swallow makes a quiet “cuh” sound.

Teaching parents the difference between nutritive and non-nutritive sucking during infant feeding can help parents determine when the infant is done transferring milk, and when it is OK to end a feeding particularly for infants who desire non-nutritive sucking for long periods of time.

The volume of colostrum at a single feeding matches the newborn’s very limited stomach capacity. Colostrum has laxative properties and is easily digested, so the infant may want to nurse very frequently, such as every 1-3 hours, or 10-12 times in 24 hours. The frequency and effectiveness of milk removal is the most important driver of production throughout lactation: REMOVE IT OR LOSE IT³. It is very important that healthy, term newborns are allowed to nurse ad lib and not placed on a feeding schedule to feed, as they do best if they eat very frequently while waiting for the transitional milk to “come in.” Frequent sucking also helps to keep mom’s prolactin level elevated, which is a vital message to the glandular tissue to continue the milk manufacturing process. A term healthy newborn will typically have one good feeding right after birth and then sleep for several hours on the day of birth. As long as mom and infant are in close proximity, ideally skin-to-skin, feedings should naturally resume when infant is ready. An infant who is having difficulty waking up to nurse at least 7-8 times in 24 hours by day 2 may need coaxing to wake up and nurse at least every 3 hours to maintain hydration and to maximally stimulate mother’s breasts to establish a healthy milk supply.