There are lots of opinions about how often a baby should breastfeed. You might hear that it is quite normal for babies to breastfeed all the time, or conversely, that frequent feeds mean your baby is comfort nursing and shouldn’t be allowed to use you as a dummy (pacifier). If your baby isn’t gaining much weight there will be more conflicting advice… offer both breasts or stay on one breast per feed, top up or don’t top up, use breast compressions to keep baby feeding actively or “wait for the flutter sucks”. How can parents tell when a baby is breastfeeding well and where do “flutter sucking” and “comfort nursing” fit into it?
This article
This article answers frequently asked questions about flutter sucking and comfort nursing. It’s a companion article to Is My Baby Getting Enough Milk?, One Breast or Two Per Feed? and Breastfeeding to Sleep.
What is comfort nursing or comfort sucking?
Babies breastfeed for reasons other than just for food or to quench their thirst. Babies breastfeed to feel safe, to calm down, to warm up, for reassurance, to connect with mother, for pain relief, to fall asleep and because they love to suck. Reasons to breastfeed other than to eat or drink are sometimes called breastfeeding for comfort, comfort nursing, comfort sucking, “non nutritive” sucking or even “using the breast as a dummy”.
Non nutritive?
“Non nutritive” means not providing any nourishment (calories), however, breasts have a habit of releasing milk whenever a baby latches so babies will often get a little extra breast milk while they are comfort nursing. Even so-called “non nutritive sucking” therefore offers an opportunity to snack between meals. Snacking between meals and eating a lot of the time is a good way to gain weight and babies are looking to double their weight in the first four to six months.
Is comfort nursing good or bad?
Comfort nursing is a normal part of breastfeeding. Whether for hunger or comfort, breastfeeding is usually the answer to whatever is troubling your baby with the added bonus of some extra calories and sleep inducing hormones built in along the way. However, sometimes comfort nursing is portrayed negatively by health care workers, friends or relatives because some people seem to think a baby uses it as a way of manipulating the mother with unreasonable sucking demands (see below).
Is my baby using me as a dummy or pacifier?
You may hear that comfort nursing should be limited to avoid “spoiling” your little one. After all, goes the argument, babies need to learn some patience, and the old favourite: to “self-soothe”. This is nonsense. Babies will learn these things when they are biologically ready but they are not capable of wilfully manipulating a parent or problem solving for themselves. Those who complain that a baby is “using you as a dummy” don’t usually seem to mind the baby having an actual dummy or sucking their thumb or fingers. If a baby needs to suck, and mother is available, why not offer them the biological original rather than a man made silicone substitute? Comfort nursing to calm a fractious baby is a natural part of mothering through breastfeeding and makes for healthy brain development and well adjusted, well fed, securely attached children.
Growth spurts
Sometimes a baby may feed more often than usual because they are having a growth spurt. If they are hungry or having a growth spurt, refusing to breastfeed on cue for fear of baby using the breast as a dummy could miss hunger cues and prevent a baby from regulating their milk intake.
Is comfort nursing ever a problem?
Every mother and baby are unique and although comfort nursing is normal baby behaviour for a baby who is breastfeeding well and growing appropriately, occasionally it could indicate an underlying problem with breastfeeding. For example, if a baby is “feeding all the time” so that one breastfeed merges into another and especially if they are not gaining much weight, this could be a sign that they are not breastfeeding effectively and are comfort nursing because they are hungry. If a baby is not breastfeeding effectively—with a big mouthful of breast tissue as well as the nipple—a milk supply can quickly drop. With less milk available, a baby’s energy levels go down giving less energy to feed actively causing lower milk intake, lower energy, and so on in a downward spiral. Left unchecked, breastfeeding can become long sessions of flutter sucking with very little milk swallowed. If you’re worried that your baby is spending a lot of time breastfeeding but is not gaining much weight see Baby Not Gaining Weight and contact an IBCLC lactation consultant to help you get feeding back on track. If supplements are needed, see Supplementing an Underweight Baby.
What is flutter sucking?
Flutter sucking describes the type of slow, sleepy sucking babies do at the end of a breastfeed. During a breastfeed babies tend to move through three sucking stages:
- Stimulating the let down. Babies start a breastfeed with some quick strong sucks to initiate the let down. Their tongue cups the breast and you will see the baby’s lower jaw moving up and down as it opens and closes on the breast. Breastfeeding hormones are released when nerves close to the nipple are triggered, and milk will usually begin to flow within a minute or two.
- Active feeding. Once the milk lets down (milk ejection reflex), sucking will be interspersed with swallows of milk while babies are actively feeding. You will see the lower jaw moving up and down rhythmically and you might hear a pattern of one suck per swallow or a few sucks followed by a swallow of milk. A baby may take a break during active feeding, they might hold the breast in their mouth for a minute or two without moving their jaw and then start to suck and swallow again.
- Flutter sucking. Towards the end of the feed, sucking slows down, the jaw movements get less pronounced, there are fewer and fewer swallows, and baby may fall asleep or let go of the breast when they are full. Some people call the fluttery, quivery sucking movements at the end of the feed “flutter sucking”. This means different things to different people so some mothers are getting confused whether flutter sucking is particularly important nutritionally or whether it is a type of comfort sucking.
Is flutter sucking the same as comfort nursing?
Flutter sucking is a form of comfort nursing but tends to be used to describe a baby who is sucking lightly without many swallows and is falling asleep at the breast. Some breastfeeding helpers are confusing flutter sucking with active feeding and are encouraging mothers to feed from one breast per feed with the idea that the longer a baby stays flutter sucking on one breast, the more high calorie milk (hindmilk) baby will swallow and the more weight they will gain. This is misleading for parents because flutter sucking is not active feeding and staying on one breast as a general rule is a way to reduce a milk supply. See How to Make More Breast Milk and One Breast or Two Per Feed? for information on how breasts work, and Forget About Foremilk and Hindmilk explains why you don’t need to worry about foremilk and hindmilk.
Is flutter sucking baby getting hindmilk?
Your baby will not be getting very much hindmilk when they are flutter sucking, because, by definition, flutter sucking is not active feeding. And at the end of a breastfeed, although the milk might be slightly higher calorie, there is not very much of it once the breast has been drained. Unless you can see your baby’s jaw moving actively and hear your baby swallowing they are unlikely to be getting much milk. However, there are always exceptions, if you have another let down of milk while your baby is sleeping at the breast, your baby might start sucking and swallowing again.
Do I need to look for flutter sucks at every feed?
Not really, if you’re worried about milk intake, it’s better to look out for active feeding rather than flutter sucks. Active sucking and swallowing are how your baby gets milk and empties the breasts. And efficient breast drainage is the key to making more milk. This is why breast compressions and switching breasts can be useful to simulate another let down and get a baby sucking actively again if he has fallen asleep before he has taken a full feed. There are lots of ways to increase your milk supply but waiting around for fluttery sucks while staying on one breast for set periods of time isn’t one of them.
Breastfeeding on demand and letting your baby finish the first breast on his own before offering the second side is how your baby regulates his milk supply. And flutter sucking is a natural part of the sequence of feeding and falling asleep contentedly at the breast. It is only if your baby is not gaining much or any weight, that it is important to be aware that when sucking slows right down to “flutter sucks” a baby is not swallowing much milk. Not hindmilk, not foremilk, not any milk. If your baby is spending a large portion of every feed flutter sucking, and is not gaining weight check in with your health professional and a breastfeeding specialist and see Baby Not Gaining Weight.
Is baby asleep when he is flutter sucking?
Once sucking slows down and there are hardly any swallows and your baby’s eyes have closed, your baby has fallen asleep. Lots of babies like to sleep with the breast in their mouth after they have finished feeding. The shallow movements of a baby flutter sucking without swallows indicate a baby who is dreaming about sucking. Some babies do continue to feed well in their sleep, but in that case, their mouths will be moving more deeply than tiny shallow quivers and you will hear swallows. For more information on the pros and cons of sleeping at the breast see Breastfeeding to Sleep.
Video clips of babies flutter sucking
The first clip shows a baby making the same fluttery mouth movements in their sleep they might make at the end of a breastfeed while still latched to the breast.
In the second clip you can see the tongue making light fluttery movements
How can I tell if my baby is getting enough milk?
There are several ways to tell if your baby is getting enough milk even though you can’t physically see what has been drunk. Is My Baby Getting Enough Milk? discusses these in more detail and includes a video clip that shows a baby who is feeding actively. If you’re not sure whether your baby is feeding actively or has a “good latch”, contact an IBCLC lactation consultant for a feeding assessment.
Baby not gaining weight
If your baby is not gaining much weight, and your baby’s doctor has checked there are no underlying health issues causing low gain, contact an IBCLC lactation consultant. The latter will be able to assess a breastfeed, take a full history and make suggestions to keep your baby well fed while you build your milk supply. For helpful further reading see Baby Not Gaining Weight, Understanding Your Baby’s Weight Chart, Supplementing an Underweight Baby and How to Make More Breast Milk.
My baby’s jaw sometimes trembles is that the same as a flutter suck?
A jaw or tongue tremor is different from flutter sucking. It looks more as if the jaw or tongue are trembling or shaking. There are different explanations for this such as an immature nervous system, neurological disorder or muscle fatigue due to a tongue-tie. In Supporting Sucking Skills in Breastfeeding Infants 2017, Cathy Watson Genna, IBCLC explains:
Tremors associated with neurological issues tend to be seen at the start of a feed and will be frequent and persistent, whereas fatigue tremors in tongue-tied infants are more likely to occur later in the course of the feeding (p.366)
Always contact your baby’s doctor and a breastfeeding specialist for a thorough assessment if you have any concerns about any unusual behaviours, tremors or noises while your baby is feeding.
Summary
Comfort nursing is the name sometimes used to describe breastfeeding for reasons other than for food such as breastfeeding a baby to sleep, calming a crying baby or because baby enjoys sucking. Babies will still get a little milk while they are comfort nursing and it’s a great mothering tool. Flutter sucking is a form of comfort nursing but is a term usually reserved for the pattern of light fluttery sucking with few swallows seen at the end of a breastfeed. Some mothers are being told that flutter sucking is when their baby is getting all the higher fat milk. This is misleading as there is very little milk transfer going on during flutter sucking compared with active feeding. Babies who are not gaining weight well and who spend a lot of time sleeping and flutter sucking at the breast can be encouraged to feed more actively by using breast compressions and switching breasts whenever sucking slows.