Answer to an obstetrician-gynecologist engaged in breastfeeding guidance: Can breastfeeding and sleeping be separated?

We can have different viewpoints, but we must also have objective understanding.

Pictures/by Wang Meimei

Last week, I saw a doctor in the circle of friends who is engaged in breastfeeding guidance posted a message in the circle of friends, mentioning this point of view: breastfeeding It is inseparable from sleep, so out of professional habits, I had this interaction with this doctor (no real name is mine on WeChat):

Let me first explain that I am very fond of this doctor. Respectfully, she is professional both in her profession as a doctor and as a breastfeeding guide. We have had brief contact with each other, and this doctor is also a very affectionate and warm doctor.

But we still have to talk about breastfeeding.

Foreword

Are breastfeeding and sleep training in conflict with each other?

My case mothers often ask me: There are always breastfeeding guides who tell them not to always think about giving up night feeding or breastfeeding. Breastfeeding is the most important thing. If the child cannot eat well, he will not be able to sleep well. , the child needs the comfort of breast milk, please fully meet the child's needs...

Mothers are confused, which is more important, breastfeeding or sleeping?

I am very surprised that this is not a mutual issue at all. I don’t understand why it always rises to the level of opposition.

Breastfeeding is important, and sleep is also important. The most important thing is that breastfeeding and sleep are complementary to each other, not antagonistic. Ignore either party and the other will be affected.

As IPHI sleep consultants, the feeding philosophy we have received has always been to breastfeed and wean naturally. Because there is no contradiction at all. Just like holding and sleeping are two different things - I have been sleeping on my own since I was 4 months old. I have never held her to sleep except when I went out. But when she wakes up and cries for comfort, I hold her no less than any other child. I hear at least an average of "Mom! Hug!" two or three times.

Therefore, giving up cuddling to sleep does not mean giving up cuddling, and giving up breastfeeding to sleep certainly does not mean giving up breastfeeding.

Scientific Parenting Breastfeeding and Sleep (Part 1)

Scientific Parenting Breastfeeding and Sleep (Part 2)

Therefore, I don’t quite understand why as a sleep consultation Teachers never ask mothers to stop breastfeeding or wean early, and encourage everyone to insist on natural weaning, but breastfeeding guidance always requires mothers to insist on night feeding to soothe and unconditionally breastfeed to sleep? Or even one-sidedly regard "falling asleep independently and sleeping through the night" as a lack of maternal behavior?

The first question

Can breastfeeding and sleeping be separated?

Can be separated. But it doesn’t have to be separate. Breastfeeding is not a problem, but it can cause problems.

Come and review.

Can I sleep with breast milk?

If you are too lazy to open the link, let me summarize it again using different logic:

First of all, when do you need to stop breastfeeding?

For babies aged 0-3 months, due to imperfect neurological development, they are prone to flatulence, hiccups, vomiting, etc., and a considerable number of children are very uncomfortable with the extrauterine environment in the first 2 months of life. If you get used to it, you may cry easily and wake up easily. For example, some mothers report that their children cry all the time at night and sleep well during the day. Are they sleeping upside down? No, it's because it's too quiet at night.

Basics: If a baby sleeps well during the day but sleeps poorly at night, is this a reversal of day and night?

They have not established a circadian rhythm and a regular schedule at this time, and the physiological wake-up interval is very short. They basically eat, sleep, and sleep without separation.

Breast milk contains a sedative molecule that can quickly calm the baby. In addition, sucking can stimulate the baby's calming reflex. Therefore, in the first few months, breast milk is the baby's favorite way to soothe.

But at this time, you don’t need to worry too much about the problem of breastfeeding -

Because many of the children’s sensitivities in the first 2 months are congenital, and you have no way to control these phenomena and problems caused by developmental level, and Their work and rest have no regular rhythm, which is determined by physiological development; what we can do is to let the baby sleep enough. Sleeping enough is more important than how to sleep. The foundation of sleep is very important; and the baby does not form a cause-and-effect connection in the first 3 months. Don’t worry about your child developing a dependence on being able to sleep only with milk – in fact, it’s more of a dependence on the parents.

However, I want to make an important point - the premise is that you must first make sure that your child is indeed a born baby with high needs, and not because of poor sleep foundation High demand and serious dependence on milk to sleep are two different things. In the cases I have dealt with, most of the mothers told me that their children were high-need babies from the very beginning. After doing sleep tracking, they discovered that their children actually had angelic personalities - so-called high needs, clinginess, and explosive tempers. Irritability is all caused by the accumulation of sleep problems.

Please read this article in detail: Think: Is your child really a high-needs baby?

The impact of sleep dependence on children also varies from person to person. Some children have been accustomed to sleeping on the breast since they were young, but their sleep quality is not affected - basically they nurse when they cry, sleep when they are fed, and sleep until dawn - for example, my sister's child, now 2 years old, still sleeps on the breast But the quality of sleep is indeed very good. Except for having to hold my mother’s breasts every time she goes to sleep to nurse, everything else is good. My sister calls it “breast-obsessed”, and of course I tell her it’s just a dependence on falling asleep.

I have analyzed the sleep conditions of those angel babies who sleep until dawn after feeding, and summarized some of their common characteristics (personal summary reference):

< p> So, what is the impact of breastfeeding?

Usually after the baby is 4 months old, it is not recommended to continue to use milk to put the baby to sleep. Because most children can already form a very regular schedule around 4 months old, and after 4 months, the child’s sleep cycle will become longer, and they will first enter non-rapid eye movement sleep, and the sleep periodicity will become more obvious-that is, at this time At first, the child's waking performance during cycle transition will become more and more obvious, especially for children with poor sleep and weak ability.

However, please note that I am not making any judgments - I am not telling you that as long as you are over 4 months old, you must not sleep with breast milk. This is not a standard, it is just one of the reference factors, because there are indeed a small number of them. The baby really does not affect the quality of sleep - that is because the mother fully meets the child's sleep needs.

So, what are the effects of excessive breastfeeding? ——

Why is it not recommended to sleep with milk?

Let’s talk about the difficulty of sleeping with milk

Your baby can fall asleep as soon as he feeds milk. You can sleep with milk. Way to put you to sleep?

Can I sleep with breast milk?

The second question

Is the core of sleep consultation about falling asleep independently?

If you are looking for a sleep consultant to consult about sleep problems, and he talks about sleep training, then you have to consider whether this is a professional consultant who has received systematic training, or whether he is a professional consultant who specializes in sleep behavior training. Instructor?

The sleep health emphasized by sleep consultation is the overall sleep quality and sleep status, which includes the child's schedule, growth and development, sleep state, emotional state, family environment and the child's ability to fall asleep, etc. Sleep problems It is necessary to comprehensively consider and analyze all factors. The solution to the problem is by no means complete with formulaic training - babies are human beings.

The way we fall asleep is one of the factors we use to troubleshoot problems, and the child's ability to fall asleep is one of the factors we use to evaluate the baby's sleep quality. It is just one of the factors, not the core. The ability to fall asleep must be closely related to sleep quality, but it is not the most important thing.

What is falling asleep on your own?

The entanglement between independent sleep and cuddling

If cuddling to sleep is not a problem, what is the problem?

Sleep training has once again been pushed to the forefront. I have broken it apart and crushed it. I just want to help you clarify it - as sleep consultants, how do we use sleep training?

Sleep adjustment | Skills in sleep management

What is so important about certification? ——Revealing the IPHI certification

The third question

Most children cannot fall asleep on their own before the age of 3?

Richard Ferber, MD, Children's Medical Sleep Disorders Center, Boston, USA, and professor of neurology at Harvard Medical School, um, the Ferber of the Farber method, proposed: Falling asleep is a learned behavior, just like walking and talking. , needs guidance and training from parents. As a sleep consultant and a junior in sleep research, I naturally follow sleep medicine professors and other senior experts in the sleep field, such as Traccy Hogg, Dr. Mark Villan, etc., in terms of sleep cognition.

Many children are prone to dependence on falling asleep instead of falling asleep on their own. This is not because they have no ability to fall asleep on their own, but because they lack the opportunity to learn to fall asleep. But the mother wants to ask, the child cries. No, is he really unable to fall asleep on his own?

Let’s first analyze how we came to this conclusion——

Of course, if a child cries so much that he cannot fall asleep on his own. Because children need to be comforted. Children's ability to self-soothe is very limited compared to adults, so they are very likely to ask for a hug or milk when they are emotionally intense, physically unwell, or overtired and unable to calm down. This is the most natural way for children to express themselves. Of course, comfort is needed. Whenever the child's self-soothing ability is exceeded, parents need to give comfort and response. This is the satisfaction of needs and emotional connection.

And why did the child have such an emotional breakdown? What's the reason? This needs to be investigated and adjusted, rather than just blindly focusing on behavioral guidance: he just wants to cry, he just wants to be hugged, he just wants to breastfeed, and then he just hugs and breastfeeds exhaustingly, and the child is still moved. You're a sleeper, you're still falling apart - I've hugged you like this, and you're still crying? Because of the lack of sufficient awareness, the root cause of sleep problems has not been solved. In the end, you will blame it all on: the child has high needs and cannot fall asleep on his own.

However, being soothed and falling asleep are two different things. Soothing is just to calm the child's emotions, because the child cannot fall asleep when the emotion is intense. But soothing is not about lulling you to sleep.

The problem with holding the baby to sleep while breastfeeding is - hold her until she falls asleep, and nurse her until she falls asleep. So everyone came to the conclusion: My child will never learn to fall asleep on his own.

Have you given him enough patience and opportunities?

Case sharing The impact of self-soothing ability on the ability to fall asleep

"Case" How to soothe a baby whose sleep is interrupted?

Why do babies and young children always cry when they fall asleep?

Talk about security, behavior and needs

Can sleep adjustments be made if "can't stand the baby crying"?

Is sleep training cruel for infants?

Finally

Some words from my heart

We are all first-time parents, so we often hear different voices. There are many controversies and different opinions on the parenting journey. Many times, we really don’t know who to listen to.

Listen to yourself. Listen to the communication between you and your child. What will your child tell you he really needs? What are you willing to give him? What do you want to give yourself? What can you give? What do you want to gain?

There is no standard answer, every person and every family is unique.

All we can do is make weighed choices. As long as you have a clear conscience. But the premise is that you must know what the pros, cons and impacts of different choices are. Only when you understand in your heart can you make the choice that is best for you.

As for child care workers and colleagues with original aspirations, what I want to say is:

I believe that every profession has profound meaning and deserves to be respected; At the same time, I think there are boundaries between industries, because there are specializations in the field, and we need to stay in awe when we are involved in issues outside our own areas of expertise. Before judging, we must first determine whether the truth is the case.

For example, during our sleep tracking, if we find that the child may have a medical problem, we will refer it to a pediatrician; if we find that the mother has problems with breastfeeding and the child’s milk intake, we will also refer the child to a pediatrician. Refer to a professional breastfeeding consultant or pediatrician.

Skills have specializations, and this specialization refers to depth and deep cultivation.