Amy’s PhD: How routines might damage breastfeeding

On the off chance anyone would like to plough through an entire PhD, you can download a copy of mine here!



My PhD explored how beliefs about feeding routines and interactions during feeding might differ between breast and formula feeding, and how this might affect whether a baby is breastfed or not.

When I had my first baby I realised that the world of when and how babies were fed was a minefield. Should they feed to a set routine? What happens if they are hungry in between? What is demand feeding? Does it matter?

I noticed that the babies who were breastfed for the longest tended to be fed on demand, and on reading up on why this was important to build milk supply, I decided to explore whether beliefs about when babies were fed might damage breastfeeding.



My research explored the interactions mothers had with their babies during a feed in terms of timing of the feed (Was it to a routine? At a set time?), whether they worried about intake (too much? too little?) and beliefs about feeding and weight gain (again, too much? too little?).

It showed that mothers who breastfed for the longest were more baby-led. They fed on demand, whenever their baby wanted, not thinking about amounts or timing. Mums who formula fed tended to feed to a set routine, feeding less often and keeping a closer eye on intake. 

But what it also showed was that trying to have a strict routine whilst breastfeeding could damage ability to breastfeed. I asked mums during pregnancy how they planned to feed e.g. to a routine or not, and those who planned to breastfeed and use a routine were more likely to stop in the first few days and weeks, compared to those who planned to be more baby-led. Moreover, they were more likely to report that they stopped breastfeeding because it was difficult, painful or they didn’t have enough milk.

I also looked at why mums might want to use a routine. Some wanted to use it because they felt it was more convenient but others were very anxious about their baby getting enough milk and putting on enough weight, so wanted to try and measure, track and control intake. However it was these mothers who ended up stopping early, because they didn’t have enough milk, quite possibly because feeding to a routine damaged their milk supply.

The key message was that baby-led breastfeeding was very important for carrying on breastfeeding, and trying to feed to a strict routine can damage milk supply. More needs to be done to highlight the importance of responsive feeding and build confidence in mums that they can feed their babies. 

The message is also important to formula feeding, because other evidence suggests that having too much control during feeding and encouraging a lot of milk intake may increase obesity risk, even if milk supply isn’t damaged. 

You can download a copy here: PhD Amy Brown Maternal control of early milk feeding