Many infants are sleepy in the first several weeks of life. This is especially true for premature or late preterm infants¹. The sleepiness can be most evident when the infant is nursing. Sleepy behavior at the breast is often coined ‘living on the let-down’, meaning that the infant will sleep at the breast until the milk ejection occurs. The sleepy infant will awaken sufficiently to swallow milk from the letdown, but won’t continue to nurse effectively to continue milk transfer. This is the most common reason why a nursing newborn does not gain weight despite mother having an adequate supply. An initial approach is to teach parents strategies to keep the infant awake at the breast by stripping off clothing, tickling the feet and back, and teaching the mother to use breast compression to improve milk transfer.