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Breastfeeding: On Schedule or On-demand?

Mom Breastfeeding BabyA recent report issued by Reuter’s reveals a new study from the United Kingdom that suggests “traditional scheduled” feedings are better for infant weight gain. This new study is in contrary to the advice given by lactation consultants world-wide and by the American Academy of Pediatrics.

Based on evidence presented in the article “Does breastfeeding method influence infant weight gain” by C.A. Walshaw et al. in the April issue of the Archives of Disease in Childhood, the Reuter’s article asserts:

The traditional breast-feeding approach involves breast-feeding using both breasts at each feeding for no more than 10 minutes per breast.

They found that infants were more likely to be exclusively breast-fed for up to 12 weeks when their mothers followed traditional rather than baby-led breast-feeding practices.

Furthermore, feeding more than 10 minutes from the first breast was associated with poor weight gain during the first 6 to 8 weeks of exclusive breast-feeding, the researchers report in the Archives of Disease in Childhood.”

While the report does find an increase in infant weight gain with scheduled feedings, what it did not cite was the amount of prenatal breastfeeding education or lactation support that the mothers had access to or took advantage of. On-demand or on-schedule, mothers who have such a support system (and their infants) fare better in terms of weight gain, length of breastfeeding and other outcomes, according to the CDC’s report card for breastfeeding outcome and other sources.

Walshaw’s study further suggests that by draining the breast each time, that it allows for the more important, fatty hind milk to be consumed by the child. (But any nursing mother knows, that your child may not drain the breast in 10 minutes.) Lactation specialists still recommend on-demand nursing and with the exception of certain cases, draining the breast completely before switching sides, since it is the emptiness of the breast that tells the system to produce and how much the next time?in essence, breastfeeding is about the laws of supply and demand.

Other research on understanding the physiology of breastfeeding has shown that:

the rate of milk synthesis between feedings varies according to the degree of fullness of the breast; the fuller the breast, the slower the milk production rate, and conversely, the emptier the breast, the faster the rate at which the milk is replaced…

and contrary to what Walshaw has found, that:

When feed frequency and duration are restricted by predetermined feeding schedules, the result may well be lowered infant fat intake, symptoms of breast milk insufficiency, and underfeeding.

So far, there has been no other evidence or research to prove Walshaw’s study which used a very small set of test subjects. To determine its validity, it would need to be replicated on a much larger scale. Either way, on-demand on on-schedule, bodies such as the APA suggests that among the most important keys for breastfeeding success and proper infant nutrition is watching for infant cues to determine the proper feeding “schedule” for your child.

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