Everything you need to know about the bedtime feed
While its true that the bedtime feed is an important aspect of sleep, it’s not the volume or what’s in the bottle that makes the difference! Lets dive in to some of the most common questions I get about this topic!
Will a bigger bottle or more nursing at bedtime help baby sleep for a longer stretch?
I know, it seems logical to think that an extra full tummy will lead to a longer stretch of sleep before baby needs to eat again...but it just doesn’t work that way!
Instead of stuffing baby extra full at bedtime we need to consider their 24h caloric intake! We as humans work on a 24h cycle, requiring a certain amount of calories during that time period. Even if a baby has a super big bedtime feeding they may still be "missing" some daytime calories…and will have to make those up overnight.
Rather than worrying about how many ounces you can fit in at bedtime, try to focus on nice full feedings throughout the day, slowly fill up baby's calorie tank, then think of the bedtime feed like a top up! How much a baby takes at this last feeding will depend on their age, daytime feeds, and when they last ate. Some babes take a large bedtime feed, others only have room for a snack...and some don't need a bedtime feed at all! Follow your baby's lead and resist the urge to force them to take more ounces, or stretch their wake window longer in the hopes they will become hungrier (overtiredness is not worth it- trust me!).
One thing you CAN do to optimize your bedtime feed is to offer it to your baby while they are alert and awake! When baby’s become sleepy and dozy on the breast or bottle at bedtime they may treat it like a little power nap, leading to a LOT more crying at the put down, or frequent wakings soon after. Remember - drowsiness is the first stage of their sleep cycle, and a few minutes of drowsiness on a feeding is enough to give baby a second wind! Its also pretty difficult to read baby's fullness cues when they are snoozing and snacking, and an awake feeding is typically a better feed overall.
Does a bottle of formula at bedtime lead to better sleep for breastfed babies?
Again, probably not.
You may have heard the common myth that formula fed babies sleep better…its easy to trace where this idea comes from! We know that formula takes longer to digest than breastmilk, and therefore breastfed babies need to eat more frequently than their formula fed counterparts. This may lead us to think that formula fed babies just sleep better overall, but its just not that clear cut!
The research on this topic is a bit of a mixed bag, some studies have shown that breastfed babies do wake more frequently, especially when those babies are breastfed back to sleep. Other research hasn’t been able to identify any significant difference in night wakings over the first year of life between formula fed and breastfed babies. To complicate things further, a well-known study surveying over 6,000 mothers suggests that exclusive breastfeeding actually led to slightly MORE sleep than other feeding methods. Its hard to isolate the reasons behind this difference, but some possibilities include time considerations for overnight bottle preparation (due to the formula preparation the entire feeding process takes longer), or co-sleeping arrangements between breastfed infants and their moms. Overall, studying babies and their parents feeding and sleep habits is tricky as data is typically self reported, and night waking and night feeding can be defined in different ways.
Here are my thoughts:
Babies wake up for lots of different reasons- not just hunger.
Both formula fed and breastfed babies can struggle with sleep…if formula was somehow a magic sleep fix, half of the families I work with wouldn’t need my support! In my experience, breastfed babes tend to keep that last night feed a little longer but both formula and breastfed babies can learn to connect their sleep into longer stretches between feedings (I see this in my practice on a weekly basis!).
Regardless of how your baby is fed, you should see night feeding needs decrease over their first year of their life (the research on this is pretty straightforward!). So, if baby is continuing to wake frequently during the night as the months tick by we can be fairly confident this has nothing to do with what they are being fed.
Bottom line: your feeding choices have very little impact on your baby’s sleep overall!
What about solid food...will adding cereal to the bottle help my baby sleep?
Another popular question! I often speak with families who are counting the days until their doctor gives the green light for solid introduction in the hopes it improves their baby’s sleepless nights. Sorry to be the bearer of bad news here, but solid food is typically not a magical fix for night waking…and may actually make sleep more challenging temporarily!
Here are two reasons why:
Parents often choose low calorie first foods. If high amounts of these solids reduce daytime breastmilk/formula consumption, it's likely your baby will wake MORE frequently for night feeds to compensate for those missing calories.
Some babies have tummy trouble (gas, constipation!) when starting solid foods, which can of course temporarily contribute to sleep challenges. I never recommend starting sleep training the same week as first solids are offered for this reason.
Another commonly suggested fix for frequent night waking is to add baby cereal in a bedtime bottle! Though this is sometimes recommended by older generations (and sadly still some doctors!), it has been shown to be totally ineffective when it comes to improving sleep, AND it’s a choking risk for baby.
What age should I stop offering my baby a bedtime feed?
This depends! For bottle fed babies, the AAP recommends eliminating all bottles (day and night) sometime between 12-18 months. This recommendation is based on a few factors: risk of tooth decay, improper dental development, and formula intake interfering with solid food intake. I personally recommend transitioning away from the bedtime feed sometime prior to 14 months! I find older babies and toddlers become quite emotionally attached to the bedtime feed, making it hard to eliminate even if they aren’t relying on it to fall asleep. Generally speaking, I don’t suggest replacing the bottle with a sippy cup of milk or a snack as part of your baby’s bedtime routine- these things can impact your baby’s dinner intake AND don’t improve their sleep. For breastfed babies there isn’t the same timeline for weaning, or concerns about dental health. Though not necessary for a good night’s sleep, often families choose to keep a bedtime nursing session well into the toddler years.
How can I help my baby to sleep in longer stretches overnight?
Instead of focusing on ways to make your baby's tummy even fuller, focus on HOW your baby falls asleep at bedtime! The biggest predictor of consolidated night time sleep is whether a baby has the ability to fall asleep independently or not. This has been shown by multiple studies from around the world, including a cross-cultural study of more than 29,000 babies from 17 different countries. Babies who have the ability to go from fully awake to fully asleep without the reliance of things outside of their control at bedtime (think feeding, rocking, pacifiers, or parent presence!) can connect their sleep into longer stretches overnight, and easily sleep through the night when they are ready!
Separating your baby’s bedtime feed from their put down is a great first step! Here is how to do this:
1) Move the bedtime feed to be the first step of your bedtime routine. This will help reduce drowsiness and separate that feed/sleep association.
2) Work to keep baby awake throughout the feed - feed in a brightly lit space, talk to your baby, undress them if necessary. Follow their cues and end the feed once they seem full.
3) Move through the rest of your babies bedtime routine.
3) Support your little one to learn to fall sleep in a new way! If baby is older than 4 months, and independent sleep is your goal then I recommend using a responsive sleep training method you are comfortable with. If you or your baby aren’t ready for that, try assisting them to sleep in a different way!
Are you feeling overwhelmed by your baby’s frequent night wakings? We are here to help! Every week I work 1:1 with families just like yours find better sleep in ways they feel good about. The first step in getting started is to book a sleep evaluation call with us here so we can learn more about your little one, and your sleep goals!