My experience of this has been nine times out of ten hunger is the primary cause – even if baby drops right back off to sleep again the second a nipple is found. Suspect hunger more than you think you should.
Most people it seems to me wildly underestimate how much a BF baby needs to feed. Think how much you would need to eat yourself if you were trying to double your weight every few months. If night waking is a sudden change then a growth spurt* or mental developmental period* may be the cause. But if it’s a more long term thing, ask yourself has my baby has got to that distracted stage*? Do they always concentrate while feeding, or are they distracted during daytime feeds by their curiosity in the world.
If there’s any possibility it’s the latter, then before you try anything else to get them to sleep, I seriously urge you to try offering a feed twice as often during the day. If it’s feeding related there’s a pretty good chance you’ll see a change. Make a dramatic change like this in the day and the change at night should be more clear cut. Pick a day when you haven’t got too much on to give it a go.
It works for growth spurts too.
Why? What’s my evidence for this? When we had a particularly bad growth spurt (4 months) I tried this and it worked wonders! The first night was hourly feeds all night. Day two I made a concious effort to offer feeds hourly, and though she wasn’t really asking yet when it was offered she was very interested. Night two we got a lot more sleep. Day three was busy and I couldn’t do the same again. Night three we were back to hourly feeding. Day four I reasserted my efforts and night four was again better.
Out of growth spurt territory, before N started solids, we recognised this sleep pattern: feed hourly after going to bed, waking up to 3 times, then a longer sleep would start. This I think is the distracted baby’s equivalent of evening cluster feeding in a newborn. If I fed frequently enough during the day I could make it go away. But I really do mean frequently!
After N started solids the cluster feeding shifted to the middle of the night. My interpretation of this is she would be full from dinner (slower and harder to digest) at the start of the night. Then as capacity in her digestive system opened up later on, if she hadn’t had enough calories during the day the hourly feeding would begin.
Further evidence comes from two friends who were both convinced their babies woke every two hours in the night for comfort and it was just a habit. One tried cry-it-out, formula before bed, … everything under the sun. But both finally got some sleep by breastfeeding way more during the day.
One reason they were confused as to whether it was hunger or not, was sometimes the babies fell asleep without really feeding as soon as they found the breast. I have experienced this sometimes too. My interpretation here is that tiredness and hunger compete and on these occasions tiredness wins… but only until the next light sleep phase when hunger causes another wake up.
So how can I know N is hungry, not awake for some other reason? One clue is if she can not be comforted back to sleep by her dad, or will not stay asleep/be put down after this. Tiredness and hunger needs are competing, so when N is tired she will happily fall asleep again with daddy, but if she’s hungry it prevents that turning into deep sleep and she wakes again. This is what we have often observed in our daughter.
So back to the frequent day feeding. To be honest I rarely avoid night feeding completely nowadays even though I know how. It’s actually very hard to concentrate on feeding so frequently in the day if you want to get any housework done, or go out somewhere. And actually if N slept all night through I’d have unpleasant engorgement preventing my sleep instead. But if we have a few too many tiring nights and I need more sleep, I remind myself to make more feeding efforts during the day. It encourages me to rebalance our lives a little. N’s job after all is to grow!