There are many characteristics and patterns that all babies follow as they develop mentally, emotionally, and physically. As a mother, especially a breastfeeding one, it will help to be aware of these stages and the changes they can bring to the nursing experience. This will prepare you to handle them with as little frustration as possible, and to respond appropriately in order to meet your growing baby's needs best. Remember that your particular baby may approach these nursing milestones at varying times, just as he does with his other milestones, and that some milestones may overlap others.

In order to increase your milk supply to meet his growing needs, your baby will probably experience a growth spurt around 10 days to 3 weeks, 6 weeks and 3 months; although variations on these time periods are normal as well. These increased periods of growth, which usually result in a baby who suddenly increases his frequency of nursing and may be fussier and less satisfied than normal, may cause you to worry that you have "lost" your milk. Normal changes in your breast size about this time, due to loss of prelactation fluids and a milk supply that now more closely matches your baby's needs, may increase your fears. During these times of insecurity, it will help to remember that as long as your baby is meeting the parameters of adequate intake, you are producing sufficient milk for him and can rest assured that you and he are working together to provide him with the precise amount of milk he needs for optimal growth and development.

As the baby grows he also may spend less time at each nursing session because he has become more efficient at the breast and therefore requires less time to milk it effectively. He may also only need to nurse one side per feeding, rather than both sides as he did before. Always *offer* the second side but don't worry if your baby doesn't seem to want it or need it.

A baby this age can NOT be spoiled! By giving him the attention he needs now and continuing to nurse on demand, you will be rewarded with a child that is emotionally secure and less demanding later. By not insisting on a schedule for feedings, you will ensure that your baby gets all that he needs and that your milk supply is well-established

The 3-6 month old is beginning to clearly recognize that he is separate from his mother. He has a need for outside stimulation and may at times show disinterest or distractibility at the breast by straining his body away to have a better look at his mother or his surroundings, or by even pulling off the breast after only a few sucks. Night waking may begin again or become more frequent as the baby tries to make up for what he missed out on during the day.

Breastfeeding can successfully be continued during these periods by nursing in a place that is dark, quiet, and uninteresting, and nursing the baby when he is more willing, such as when he is just waking up or is already a little sleepy. Try not to misread the baby's initial pulling off as a cue that he is finished. Instead, try to coax him back to the breast a few more times before giving up.

By the fourth month, teething may cause the baby to begin drooling, sucking on his fingers, or chewing on objects. Don't necessarily misread this need to suck or chew on things as a sign that your baby is still hungry after a feeding.

You may find that your nipples become sore during a period of teething as the amount of saliva that the baby produces is increased. Sucking may induce pain which may in turn cause the baby to suddenly pull off the breast without releasing the nipple first.

Some babies will want to nurse more often while teething while others may nurse less often, some even refusing to nurse completely, often referred to as a nursing strike. These erratic nursing patterns may result in your breasts not being thoroughly softened with each feeding, perhaps putting you at risk for plugged ducts and mastitis.

Rinsing your nipples with clear water after each feeding and making sure that your breasts are regularly softened either through nursing, hand expession, or pumping will ease the discomforts associated with this new physical development in your baby. You also may find that offering your baby a chilled bagel, cold, wet washcloth, or cold teething toy prior to nursing helps ease any discomfort he may feel with sucking. Giving him Advil or Tylenol may help as well.

Also around 5-6 months of age, a lot of babies become highly sensitive. You may notice that your baby is easily upset during feedings if you have to raise your voice, cough, sneeze, or if a sudden noise is made close by. The baby may become so upset that he stops nursing or may even go on a nursing strike. Again, nursing in as quiet a place as possible should lessen this occurrence.

Most babies experience another growth spurt around six months of age.

With increased mobility through creeping, crawling, standing, and maybe even walking, your baby is even more able to discriminate himself from you and you from other people. He may freely move away from you only to return soon thereafter to reassure himself that you are still there. Separation anxiety may result in him waking up again at night or increasing his night waking.

His nursing patterns may become erratic. On some days he may so "busy" that he almost forgets to nurse. On such days, you will want to periodically offer your breast to him even if he does not first indicate a need or desire to nurse. On other days, when exploration becomes overwhelming, he may nurse almost constantly.

You also may have to be inventive in finding a nursing position that allows for feeding but that also lets your baby feel some degree of freedom. Try straddling your baby on your lap as you face each other. Or find a position that will allow your baby to actually stand at breast height and nurse. Some babies like to perch up on all-fours on mom's chest to nurse while she reclines on her back.

Don't be mislead into believing that your baby's temporary lack of interest in breastfeeding is a sign he is ready to wean. It is extremely rare for a child to self-wean before one year of age! With your patience and encouragement, your baby - and you - should be able to move right on through this period while still continuing to benefit from all that breastfeeding affords.

This age continues to bring vigorous and enthusiastic practicing of new motor skills. Your baby may become so involved in physical achievements that he is easily overwhelmed with outside stresses, such as contact with strangers, separation from you, and changes in his routine. He may react by increasing both his nursing frequency and duration. Due to overstimulation or separation anxiety, he may continue to wake frequently at night and find nursing a soothing way to fall back to sleep.

Last Revision: January 26, 2000

• Counseling the Nursing Mother (1983) by Judith Lauwers and Candace Woessner
  
• La Leche League's,"The Breastfeeding Answer Book"(1997) by Nancy C. Mohrbacher, IBCLC and Julie Stock, BA, IBCLC
• The Nursing Mother's Guide to Weaning (1994) by Kathleen Huggins and Linda Ziedrich