Like just about anything in life….it depends. I'll start with the 1951 advice from a physical education teacher named Patricia Hagman (I've quoted her before).
"Until the secretion of milk is established the baby may have to be given both breasts at each feeding. After the milk is well established the baby will probably get enough food by nursing about 20 min from one breast. If one breast does not supply enough milk, let the baby nurse 10 min or so on one breast and as long as he wants to on the other. Some mothers who have plenty of milk may find it more comfortable to nurse the baby on each breast for 10 min or so at each feeding."
- From Good Health For You And Your Family by E. Patricia Hagman, Ed.D., 1951.
As per her style, Dr Hagman offers pretty specific advice here. And this plan very well may work for you and your baby. But don't fret if it does NOT work, as there can be many variances of "normal" to draw from, and you and baby can make up your own song, your own rhythm, for feeding.
For instance, most women make more milk on one side than the other (typically the right makes more, but sometimes it's the left) so no worries if they're not exactly symmetrical. The breast that produces less milk may have less glandular tissue OR it may have not been stimulated as much (baby spent more time on the other side for a variety of reasons) in the early days and thus makes more now. This is not that big of a deal, however, if it's a big difference, you may need to offer both sides, especially if baby is not acting satisfied on the lower-producing side. And that's OK.
Some women can get away with just lifting one side of their shirt for each feeding, offering just one breast. Will they be a little lopsided? Maybe. But again, that's not the end of the world. If she makes enough milk for a full feeding in just one breast, it truly is a woman's choice of whether she offers both or just one side. Let your baby communicate with you just how hungry (or full) they are.
A word of caution when it comes to feeding baby based solely on time. As Dr Hagman notes above to feed for 20 minutes off one side, one thing she omits is the fact that some women have a really fast flow AND the baby is super-efficient, so they could get 3-4 oz in 8 minutes (I've seen it plenty of times in my office!) – by all means, you do not have to keep baby at breast the remaining 12 minutes, trying to coax a super full baby to keep feeding!
If you heard a lot of consistent swallowing, if your breasts feel softer, if your baby looks very content and "milk drunk" passed out (AND they are having plenty of wet/dirty diapers and gaining weight well – around 2/3-1 oz/day in the first 3 months) then you're good to go.
Alternatively, another baby may meander at the breast, taking 25-30 minutes to finish their meal, and may want to burp or fill a diaper half-way through that feeding, so that will take time to deal with. So, if a feeding isn't ending in 20 minutes for this baby, look at what is happening (is my baby actively swallowing, just taking breaks? Are they happy or are they frustrated? Are they having good weight gain and diaper output, as well?). Whether baby feeds in 8 minutes or 30 minutes, all can be normal (and can change feeding to feeding within the same baby!). Just like we sometimes scarf down our pasta, but then linger on our risotto the next day.
I always recommend, when in doubt about whether to offer both breasts or just one, it doesn't hurt to make the offer to baby. They may want just a few minutes on the other side ("dessert", if you will) or they may clamp their lips together and say "No thank you, I'm stuffed." Either way, your job is to lift your shirt and then watch baby for the next signs of what to do. It can be that easy. Sometimes we want dessert, and sometimes we don't (or we want it 45 minutes later!). Babies are human and can act like us sometimes.
Now if you have a premature infant, one who is jaundice or has other medical issues, this advice may or may not apply to your situation. In those cases, it would be best to meet with an IBCLC for a feeding session to get a better picture of their intake/rhythms. Contact me at Kelly@babybelovedinc.com if you need some help.
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