Dear American Academy of Pediatrics,

Yesterday I received this message from a woman who follows me on my Facebook page:


She then followed with a photo of the handout she received:


and I’ll highlight one of the parts that she starred (and the thing that jumped out at me immediately)…



This one simple sentence that you threw into the middle of your handout,

“Check on, but do not pick up the baby if she wakes at night.”… I’m sorry, what?

Yet, a few sentences down you then go on to say, “Help your baby when she needs it.”

…so I guess you are saying that we need to “help” our babies when they need it, just not at night. The confusing thing is, you are not only contradicting yourself within these “guidelines” you are handing out to families, but you are also giving advice that can completely derail a mother’s breastfeeding journey. It confuses her own understanding of what is normal for babies’ sleep patterns and her own, awesome ability to bring comfort and security through breastfeeding. Because you see, babies do not only need our help during the day, they need it at night as well. Mothering does not stop just because the moon came out and our exhaustion has set in. Babies can get scared, bored, tired, confused. The breast meets all of those needs.

breastfeeding at night

It’s as if you have forgotten your own policy on breastfeeding. From within your own policy statement you say, “Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.”  I’d like to note here that considering it a “public health issue” means supporting women to offer the breast when their nine month old wakes. Considering it a “public health issue” means acknowledging that the needs of a breastfed nine month old still matter at 2am. Considering it a “public health issue” means that we educate families on the importance of meeting our child’s needs through breastfeeding both during the day, and at night.


You go on to say, “Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad.”  Supporting this breastfeeding dyad means supporting the mother to trust her own instincts to mother through breastfeeding, if that is what feels right for her…not writing one sentence to completely take away any reassurance that her baby is waking for a reason and breastfeeding meets virtually any reason they may have. I go into detail here about why it’s so important for babies to wake, and the science behind it.


Take a moment to just think back to last night, do you remember that time you rolled over and woke for a few minutes? Remember when you reached out for your partner for a cuddle? How are you any different to the little baby that you saw today for a doctor’s visit? Imagine if your partner just looked at you to “check” on you instead of returning your cuddle. “No dear, I can’t actually touch you I just have to look at you and speak little whispers at you to help settle you back to sleep.” No…you receive a cuddle back.


Instead of telling women to stop picking up their babies and comforting them through breastfeeding, it might be time to actually stand up for these women, babies and their families. Stand up for the rights of these babies and their basic human rights to be cuddled, comforted and soothed at the breast both day and night. It’s time to stand up against the mainstream wave of “anti-cuddles and breastfeeds”. How can we expect women to trust their own instincts and understand what their babies are telling them when we offer advice that goes directly against what we feel is exact thing our babies need.

-Meg Nagle, IBCLC. Author of “Boobin’ All Day…Boobin’ All Night. A Gentle Approach To Sleep For Breastfeeding Families”. 

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