Login Se connecter

Blog Archive

Blog Archive

Encouraging Breastfeeding on Demand

August 2020

“Encourage breastfeeding on-demand,” (1) states Step 8 of the 2020 Baby-friendly Hospital Initiative Guidelines and Evaluation Criteria for Facilities Seeking and Sustaining Baby-friendly Designation.  During the month of August, we will be looking at several aspects of demand, baby-led, or cue-based feeding. This week we will take a closer look at infant stomach capacity and feeding frequency.

on demand

In a 2013 journal article, Dr Nils Bergman noted that the standard current practice of having full-term healthy infants feed every 3 to 4 hours is widely accepted but has “no randomized controlled trials (RCTs) or observational studies identified which address[ed] feeding frequencies or feed intervals. Only case series and descriptive studies were found, and it was not possible to provide additional recommendations due to insufficient evidence,” (2).

In a literary search, Bergman located only 6 research articles containing any data identifying infant stomach capacity for newborns, all of which supported a stomach capacity of 20 mL. In conclusion, Bergman discusses this capacity, saying “A stomach capacity of 20 mL translates to a feeding interval of approximately 1 hour for a term neonate. This corresponds to the gastric emptying time for human milk, as well as the normal neonatal sleep cycle. Larger feeding volumes at longer intervals may, therefore, be stressful and the cause of spitting up, reflux, and hypoglycaemia,” (2).

The Cochrane Database of Systematic Reviews, in 2016, compared baby-led with scheduled (or mixed) breastfeeding and found no evidence from randomised controlled trials evaluating them on the success of breastfeeding for healthy newborns. They, therefore, recommended, “that no changes are made to current practice guidelines without undertaking robust research, to include many patterns of breastfeeding and not limited to baby-led and scheduled breastfeeding... that [also] takes the mother's perspective into consideration,” (3).

Although at first glance these two studies may seem to contradict each other, it is good evidence to show how little we actually know about how much and how frequently newborns feed. Cue-based feeding has been shown in multiple studies to lead to more breastfeeding initiation, exclusivity, and duration. Scheduled feeding methods were popular in the early and mid-1900s, and some of those same types of scheduling can be found in books, on websites, and through some healthcare professionals. The most powerful statement from the Cochrane Review reads, “It is important especially in the early days that someone sits with the mother for the duration of a breastfeed and provides guidance on practical aspects such as recognising infant feeding cues, milk production and transfer, responsive breastfeeding, attachment and positioning,” (3).

 Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC

Professional Development Educator

This email address is being protected from spambots. You need JavaScript enabled to view it.


1. Baby-Friendly USA, Inc. (2020). The Baby-Friendly Hospital Initiative. Interim Guidelines and Evaluation Criteria for Facilities Seeking and Sustaining Baby-Friendly Designation. https://www.babyfriendlyusa.org/news/bfusa-releases-interim-guidelines-and-evaluation-criteria/
2. Bergman, N.J. (2013). Neonatal stomach volume and physiology suggest feeding a 1-hr. intervals. Acta Paediatrica; 102: 773-777.
3. Fallon, A., Van der Putten, D., Dring, C., Moylett, E.H., Fealy, G., and Devane, D. (2016). Baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding (Review). Cochrane Database of Systematic Reviews; Issue 9, Art. No. CD009067.

Remember me Login Se connecter Logging in...
Your country information is auto-filled based on information from your browser, please update if necessary. This information helps us provide the most relevant information for your region. Submit Sending... Sent! Clear
Your country information is auto-filled based on information from your browser, please update if necessary. This information helps us provide the most relevant information for your region. Submit Sending... Sent! Clear

This Privacy Policy describes how your personal information is collected, used, and shared when you visit or make a purchase from https://step2education.com (the "Site").


When you visit the Site, we automatically collect certain information about your device, including information about your web browser, IP address, time zone, and some of the cookies that are installed on your device. Additionally, as you browse the Site, we collect information about the individual web pages or products that you view, what websites or search terms referred you to the Site, and information about how you interact with the Site. We refer to this automatically-collected information as Device Information."

We collect Device Information using the following technologies:

  • "Cookies" are data files that are placed on your device or computer and often include an anonymous unique identifier. For more information about cookies, and how to disable cookies, visit http://www.allaboutcookies.org.
  • "Log files" track actions occurring on the Site, and collect data including your IP address, browser type, Internet service provider, referring/exit pages, and date/time stamps.
  • "Web beacons," "tags," and "pixels" are electronic files used to record information about how you browse the Site.

Additionally when you make a purchase or attempt to make a purchase through the Site, we collect certain information from you, including your name, billing address, shipping address, payment information (including credit card numbers), email address, and phone number. We refer to this information as "Order Information."

  • Users who are undertaking a course as part of a group or organization have certain data tracked as part of the service we provide to Clients and Facilitators. This includes information showing if you have logged in and when, dates of completion and what and when particular study topics, resources and assessments were viewed and completed. We refer to this information as "Student Access Information"

When we talk about "Personal Information" in this Privacy Policy, we are talking about Device Information, Order Information and Student Access Information.


We use the Order Information that we collect generally to fulfill any orders placed through the Site (including processing your payment information, arranging for shipping, and providing you with invoices and/or order confirmations). Additionally, we use this Order Information to:

  • Communicate with you;
  • Screen our orders for potential risk or fraud; and
  • When in line with the preferences you have shared with us, provide you with information or advertising relating to our products or services.

We use Student Access Information to provide accurate tracking to Users and Clients on completion and use of the courses, as well as for analysis on how to improve our services.

We use the Device Information that we collect to help us screen for potential risk and fraud (in particular, your IP address), and more generally to improve and optimize our Site (for example, by generating analytics about how our customers browse and interact with the Site, and to assess the success of our marketing and advertising campaigns).


We share your Personal Information with third parties to help us use your Personal Information, as described above. For example, with your employer who needs to verify your completion or progress of your studies. We also use Google Analytics to help us understand how our customers use the Site--you can read more about how Google uses your Personal Information here: https://www.google.com/intl/en/policies/privacy/. You can also opt-out of Google Analytics here: https://tools.google.com/dlpage/gaoptout.

Finally, we may also share your Personal Information to comply with applicable laws and regulations, to respond to a subpoena, search warrant or other lawful request for information we receive, or to otherwise protect our rights.


As described above, we use your Personal Information to provide you with targeted advertisements or marketing communications we believe may be of interest to you. For more information about how targeted advertising works, you can visit the Network Advertising Initiative's ("NAI") educational page at https://www.networkadvertising.org/understanding-online-advertising/how-does-it-work.

You can opt out of targeted advertising by:

Additionally, you can opt out of some of these services by visiting the Digital Advertising Alliance's opt-out portal at: http://optout.aboutads.info.


Please note that we do not alter our Site's data collection and use practices when we see a Do Not Track signal from your browser.


If you are a European resident, you have the right to access personal information we hold about you and to ask that your personal information be corrected, updated, or deleted. If you would like to exercise this right, please contact us through the contact information below.

Additionally, if you are a European resident we note that we are processing your information in order to fulfill contracts we might have with you (for example if you make an order through the Site), or otherwise to pursue our legitimate business interests listed above. Additionally, please note that your information will be transferred outside of Europe, including to Canada and the United States.


When you place an order through the Site, we will maintain your Order Information and Student Access Information for our records unless and until you ask us to delete this information. We are required to keep course completion records for at least 5 years in order to comply with certain accreditation requirements.


We may update this privacy policy from time to time in order to reflect, for example, changes to our practices or for other operational, legal or regulatory reasons.


For more information about our privacy practices, if you have questions, or if you would like to make a complaint, please contact us by e-mail at info@step2education.com or by mail using the details provided below:

5890 Monkland Avenue, #16, Montreal, QC, H4A 1G2, Canada

Last Updated: September 2018