Bottle feeding breastfed baby how much

Introducing a Bottle to a Breastfed Baby

The information in this post is also contained in our Working & Breastfeeding.

Here is one approach to beginning pumping and introducing bottles that has worked well for many mothers as they prepared to return to work:

Once breastfeeding is well established – usually after about four weeks – begin pumping after one feeding a day where your breasts still feel a little full. Remember you are pumping “leftovers” and should only expect a small amount.
Freeze that first pumping immediately. You can add other pumpings to it after they have been cooled in the freezer.
Your pediatrician may have given you a total number of ounces your baby may feed in a day or a range from the smallest probable amount to the largest, based on your baby’s weight.
- If dealing with a total volume over a 24-hour period, divide that by the typical number of times your baby feeds for a target volume for the first bottle.
- If dealing with a range, store volumes of the lower amount.
- Store some extra small volumes in case baby is hungrier than expected.
- When you have enough stored to equal the expected volume and a bit more, you can begin to plan a time to introduce a bottle.
- EXAMPLE for offering the first bottle:
  - Your pediatrician suggests that your baby probably takes about 24 ounces a day.
  - You know that he feeds between eight and 12 times a day.
  - That means he could take anywhere from 2 to 3 ounces.
  - You pump until you have a 2-ounce bottle and then have several 1/2 ounce bottles to equal at least three ounces or more saved.
  - Choose a day that your primary support person will be available and a feeding time where baby tends to be more pleasant and patient for his feeding.
  - Baby may accept a bottle more easily from someone other than you. He knows milk comes from you and may not understand why he’s not going there instead of to this foreign object.
  - Thaw out the 2-ounce bottle in the refrigerator overnight.
  - When baby begins to stir, place the bottle from the refrigerator in a bowl of warm water (bath temperature) or a bottle warmer while the person offering the bottle goes to get baby from his bed, changed and ready for the feeding.
  - Often it helps to run the bottle nipple under warm water, if it was also in the refrigerator, to make it more acceptable to the baby.
  - Baby should be held in an upright, almost sitting, position that is similar to the position usually used by the support person.
  - The warmed bottle should be held at an angle tilted just enough to fill the nipple to allow baby to keep control of when and how fast the milk comes.
  - Tickle the baby’s mouth to encourage an open mouth then bring baby up onto the bottle nipple, aiming the nipple toward the palate.
  - Some have found that it can help to have an article of clothing you have worn, like a nightgown or t-shirt, to place on their arm, shoulder, or chest where the baby can smell your scent.
  - It is usually best if you are close but not present in the room during this first “experiment” with bottle feeding. Your baby is very wise and will wait for you to come feed her if she knows you are nearby.

Once the feeding is completed, you will pump to create a bottle equal to what the baby consumed. Remember that the baby is always better than a pump! If you do not pump as much as the baby took, it is more likely a pump issue than an issue of not enough milk. Just pump after another breastfeeding and add that amount to what you pumped to get the amount baby took.

You will continue this pattern until you have enough milk stored in your freezer to get you through a normal work day plus a few extra for any hectic day at work where you may not have been able to pump as often. Plan to fully breastfeed for all feedings when not separated from your baby.

Working and Breastfeeding
Feeding Breastmilk From a Bottle
Pumping
Cleaning and Sanitizing Pumping Accessories
Hand Expressing

Published August 2018.

How much expressed milk will my baby need? • KellyMom.com

By Kelly Bonyata, BS, IBCLC

How much milk do babies need?
What if baby is eating solid foods?
Is baby drinking too much or too little expressed milk?
Other ways of estimating milk intake
References

Image credit: Jerry Bunkers on flickr

How much milk do babies need?

Many mothers wonder how much expressed breastmilk they need to have available if they are away from baby.

In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts). Current breastfeeding research does not indicate that breastmilk intake changes with baby’s age or weight between one and six months. After six months, breastmilk intake will continue at this same level until — sometime after six months, depending in baby’s intake from other foods — baby’s milk intake begins to decrease gradually (see below).

The research tells us that exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. Different babies take in different amounts of milk; a typical range of milk intakes is 19-30 oz per day (570-900 mL per day).

We can use this information to estimate the average amount of milk baby will need at a feeding:

Estimate the number of times that baby nurses per day (24 hours).
Then divide 25 oz by the number of nursings.
This gives you a “ballpark” figure for the amount of expressed milk your exclusively breastfed baby will need at one feeding.

Example: If baby usually nurses around 8 times per day, you can guess that baby might need around 3 ounces per feeding when mom is away. (25/8=3.1).

What if baby is eating solid foods?

Sometime between six months and a year (as solids are introduced and slowly increased) baby’s milk intake may begin to decrease, but breastmilk should provide the majority of baby’s nutrition through the first year. Because of the great variability in the amount of solids that babies take during the second six months, the amount of milk will vary, too. One study found average breastmilk intake to be 30 oz per day (875 ml/day; 93% of total intake) at 7 months and 19 oz (550 ml/day; 50% of total energy intake) at 11-16 months.

Several studies have measured breastmilk intake for babies between 12 and 24 months and found typical amounts to be 14-19 oz per day (400-550 mL per day). Studies looking at breastmilk intake between 24 and 36 months have found typical amounts to be 10-12 oz per day (300-360 mL per day).

Is baby drinking too much or too little expressed milk?

Keep in mind that the amount of milk that baby takes at a particular feeding will vary, just as the amount of food and drink that an adult takes throughout the day will vary. Baby will probably not drink the same amount of milk at each feeding. Watch baby’s cues instead of simply encouraging baby to finish the bottle.

If your baby is taking substantially more than the average amounts, consider the possibility that baby is being given too much milk while you are away. Things that can contribute to overfeeding include:

Fast flow bottles. Always use the lowest flow bottle nipple that baby will tolerate. Even with a slower flowing nipple, it is important to pace the bottle feed to allow baby to better control his intake.
Using bottle feeding as the primary way to comfort baby. Some well-meaning caregivers feed baby the bottle every time he makes a sound. Use the calculator above to estimate the amount of milk that baby needs, and start with that amount. If baby still seems to be hungry, have your caregiver first check to see whether baby will settle with walking, rocking, holding, etc. before offering another ounce or two.
Baby’s need to suck. Babies have a very strong need to suck, and the need may be greater while mom is away (sucking is comforting to baby). A baby can control the flow of milk at the breast and will get minimal milk when he mainly needs to suck. When drinking from a bottle, baby gets a larger constant flow of milk as long as he is sucking. If baby is taking large amounts of expressed milk while you are away, you might consider encouraging baby to suck fingers or thumb, or consider using a pacifier for the times when mom is not available, to give baby something besides the bottle to satisfy his sucking needs.
If, after trying these suggestions, you’re still having a hard time pumping enough milk, see I’m not pumping enough milk. What can I do?

If baby is taking significantly less expressed milk than the average, it could be that baby is reverse-cycling, where baby takes just enough milk to “take the edge off” his hunger, then waits for mom to return to get the bulk of his calories. Baby will typically nurse more often and/or longer than usual once mom returns. Some mothers encourage reverse cycling so they won’t need to pump as much milk. Reverse cycling is common for breastfed babies, especially those just starting out with the bottle.

If your baby is reverse cycling, here are a few tips:

Be patient. Try not to stress about it. Consider it a compliment – baby prefers you!
Use small amounts of expressed milk per bottle so there is less waste.
If you’re worrying that baby can’t go that long without more milk, keep in mind that some babies sleep through the night for 8 hours or so without mom needing to worry that baby is not eating during that time period. Keep an eye on wet diapers and weight gain to assure yourself that baby is getting enough milk.
Ensure that baby has ample chance to nurse when you’re together.

Other ways of estimating milk intake

There are various ways of estimating the amount of milk intake related to the weight of the baby and the age of the baby, based upon formula intake – research has shown that after the early weeks these methods overestimate the amount of milk that baby actually needs. These are the estimates that we used for breastfed babies for years, with the caveat that most breastfed babies don’t take as much expressed milk as estimated by these methods. Current research tells us that breastmilk intake is quite constant after the first month and does not appreciably increase with age or weight, so the current findings are validating what moms and lactation counselors have observed all along.

Breast Versus Bottle: How much milk should baby take? By Nancy Mohrbacher, IBCLC, FILCA
Supplementation Guidelines from LowMilkSupply.org

References

Onyango, Adelheid W., Receveur, Olivier and Esrey, Steven A. The contribution of breast milk to toddler diets in western Kenya. Bull World Health Organ, 2002, vol.80 no.4. ISSN 0042-9686.

Salazar G, Vio F, Garcia C, Aguirre E, Coward WA. Energy requirements in Chilean infants. Arch Dis Child Fetal Neonatal Ed. 2000 Sep;83(2):F120-3.

Kent JC, Mitoulas L, Cox DB, Owens RA, Hartmann PE. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999 Mar;84(2):435-47.

Persson V, Greiner T, Islam S, and Gebre-Medhin M. The Helen Keller international food-frequency method underestimates vitamin A intake where sustained breastfeeding is common. Food and Nutrition Bulletin, vol.19 no.4. Tokyo, Japan: United Nations University Press, 1998.

Cox DB, Owens RA, Hartmann PE. Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996 Nov;81(6):1007-20.

Dewey KG, Heinig MJ, Nommsen LA, Lonnerdal B. Maternal versus infant factors related to breast milk intake and residual milk volume: the DARLING study. Pediatrics. 1991 Jun;87(6):829-37.

Neville MC, et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr. 1988 Dec;48(6):1375-86.

Dewey KG, Finley DA, Lonnerdal B. Breast milk volume and composition during late lactation (7-20 months). J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):713-20.

Butte NF, Garza C, Smith EO, Nichols BL. Human milk intake and growth in exclusively breast-fed infants. J Pediatr. 1984 Feb;104(2):187-95.

Dewey KG, Lonnerdal B. Milk and nutrient intake of breast-fed infants from 1 to 6 months: relation to growth and fatness. J Pediatr Gastroenterol Nutr. 1983;2(3):497-506.

Brown K, Black R, Robertson A, Akhtar N, Ahmed G, Becker S. Clinical and field studies of human lactation: methodological considerations. Am J Clin Nutr 1982;35:745-56.

Jelliffe D, Jelliffe E. The volume and composition of human milk in poorly nourished communities: a review. Am J Clin Nutr 1978;31:492-515.

Summary of Research Data
Baby’s Age	Average Milk Intake per 24 hours			Reference
Baby’s Age	g	ml	oz	Reference
5 days	498 +/- 129 g	483 ml	16 oz	Neville 1988
1 mo	728 g	706 ml	24 oz	Salazar 2000
1 mo	—	673 ml	23 oz	Dewey 1983
1 mo	708 +/- 54. 7 g	687 ml	23 oz	Cox 1996
1-6 mo	453.6+/-201 g per breast	440 ml x2 = 880 ml	30 oz	Kent 1999
3 mo	818 g	793 ml	27 oz	Dewey 1991
3-5 mo	753 +/- 89 g	730 ml	25 oz	Neville 1988
6 mo	—	896 ml	30 oz	Dewey 1983
6 mo	742 +/- 79.4 g	720 ml	24 oz	Cox 1996
7 mo	—	875 ml (93% of total energy intake)	30 oz	Dewey 1984
11-16 mo	—	550 ml (50% of total energy intake)	19 oz	Dewey 1984
11-16 mo	502 +/- 34 g	487 ml (32% of total energy intake)	16. 5 oz	Onyango 2002
12-17 mo	563 g	546 ml	18 oz	Brown 1982
12-23 mo	548 g	532 ml	18 oz	Persson 1998
15 mo	208.0+/-56.7 g per breast	202 ml x2 = 404 ml	14 oz	Kent 1999
18-23 mo	501 g	486 ml	16 oz	Brown 1982
>24 mo	368 g	357 ml	12 oz	Brown 1982
24-36 mo	312 g	303 ml	10 oz	Persson 1998
Specific Gravity of Mature Human Milk = 1.031, so Density of Mature Human Milk ~ 1.031 g/ml;1 oz = 29.6 ml;Numbers in gray were derived using the above conversion factors.

How to properly bottle feed

Feeding your baby is not only an important process for healthy growth and development, but also a way to establish close emotional contact with the baby and build trusting and loving relationships. The transition from breastfeeding to bottle feeding should be carried out after the mother and the child are fully prepared for this. We are talking about both the moral aspect, and about choosing the right bottle and getting adults the necessary skills so that eating brings only positive emotions and benefits to the baby. In this article, we will talk more about how to properly bottle feed your baby and where to start. nine0003

How to prepare your baby for bottle feeding

If this method of feeding is a completely new experience for the baby, or if parents decide to bottle feed their baby from a very young age, slow flow nipples should be preferred. So you protect the child from the possibility of choking while eating. Over time, you can gradually switch to bottles with nipples, which would provide faster and more intense feeding.

Feeding bottle selection and daily care

All baby accessories should be kept clean and sterilized regularly and thoroughly.

There are several ways to sterilize dishes:

select the appropriate mode when using the dishwasher;
or place the bottle and teat in a vessel of boiling water for 5 minutes.

Before using this method of cleaning the bottle, make sure that the material it is made of can be exposed to high temperatures. Since some types of plastic contain various chemicals in their composition, after sterilization they can become dangerous for their little user. For this reason, experts recommend choosing glass bottles. nine0003

The need for thorough cleansing of everything that the baby will touch is caused by the fact that in the first months of life, the child's immune system is just beginning to strengthen. Before sterilizing the teat, it can be cleaned with dishwashing detergent. There are special products for washing children's dishes, without a strong odor and with a safe composition.

How to bottle feed your baby

Before starting a meal, mom or dad should wash their hands well with soap and warm running water. Particular attention should be paid to the area between the fingers and under the nails. The hand washing process should take at least 20 seconds. And after carrying out this hygienic procedure, hands should be wiped dry with a paper towel or clean towel. nine0003

The next step is to prepare for the meal. If you plan to fill the bottle with formula, then dilute it with water in accordance with the instructions in the instructions. Improper proportions can lead to dehydration or bloating. It should also be remembered that for the preparation of the mixture you need to use only clean drinking water.

Breast milk is the most beneficial for a newborn. Despite this, pediatricians advise breastfeeding babies for as long as possible. Even if the mother is ready to give up breastfeeding, milk can be expressed into a bottle and gradually accustom the baby to the nipple. If, for one reason or another, the mother does not have the opportunity to feed herself, then the only alternative is feeding with a special mixture. nine0003

In the first six months after birth, cow's or goat's milk or its substitute in the form of soy milk should not be included in the baby's diet. Valid options for supporting healthy development of a newborn are breast milk or formula milk only.

What temperature should the bottle filler be? Under no circumstances should the bottle be heated on the stove or in the microwave. If the temperature of the bottle and its filling exceed 37°C, the baby may be burned. It is recommended to use special bottle warmers. If this is not possible, then use the following method:

put a saucepan on the stove with a little water;
bring the water to a boil, then remove the pan from the heat;
place a bottle of milk in a vessel and heat it up to 37◦С;
check the temperature with a pre-cleaned thermometer or a special device for measuring the temperature of foodstuffs.

You can also check the temperature of the ready-to-use bottle as follows:

turn the bottle over;
drip several times into your wrist area.

In this way, you can check not only the temperature of the milk or formula, but also how well the liquid flows out of the bottle. If you have to shake or squeeze the bottle hard to drip, the nipple is blocked and needs to be cleaned out. If, on the contrary, the filler pours out when the bottle is turned over, this means that the nipple is damaged and another nipple should be used to feed the baby, having previously sterilized it. nine0003

How to bottle feed your baby lying down

There are several techniques for feeding your baby. However, it is the feeding of the child lying down from the bottle that young parents consider the most comfortable. It is worth noting that eating in this position will only be safe when the baby's head is slightly raised. Otherwise, the child may simply choke. In the prone position, the child should be placed on his arm bent at the elbow. After feeding, you should place the baby in an upright position, taking him in your arms and putting his stomach to your chest. nine0003

Make sure that the feeding bottle is closed correctly: the ring at the connection of the nipple to the bottle must not be too tight. Air must enter the bottle, otherwise a vacuum will be created there, which, in turn, will complicate the consumption of food for the child.

How to bottle feed without spitting up

Since the newborn is not able to fully control the process of feeding, along with milk, he can also take in air. This may be the reason that at one meal the child could not master the planned portion. In view of this, it is recommended to take small breaks during feeding. nine0003

As soon as you notice that the baby has stopped sucking on the pacifier, is tired or thoughtful, pick him up and press his face to you, holding his head and back. To help burp excess air, you can make a light massage between the shoulder blades, pat on the back or pope.

The air will quickly rise up and the baby will burp it without any extra effort. However, you should be prepared for the fact that, along with the air, part of the consumed mixture or milk may also return. Therefore, before taking the baby in your arms, cover yourself with a diaper, because it will be easier to wash it than clothes. nine0003

Never leave your baby alone with the bottle or let him fall asleep while using it. After eating, mom or dad must help their child burp. This will help to avoid colic, bloating and other manifestations of stomach discomfort.

Where to buy baby accessories

It's safe to say that I Love Mommy online store is one of the best places to buy baby food. Our catalogs feature products from world-famous brands, the quality of which you will not have to doubt for a minute. Bottles, baby dishes, pacifiers, baby bibs - all this and much more you can buy for your son or daughter from us at affordable prices in just a few minutes. nine0003

Bottle feeding | Canpolbabies.com

Find out how to bottle feed your baby safely, how to help your baby feel safe while feeding, and how to set feeding times based on your baby's needs.

The most important thing is to choose the right position when feeding

When bottle feeding, avoid lying down as the milk flows out of the bottle under the force of gravity (at a constant speed controlled by alternating pressure on the nipple). nine0003

An infant may choke on milk if fed in a horizontal position. Therefore, it is very important to choose the right - more upright - position for feeding (the baby's head should always be slightly higher than the rest of the body).

Your baby's head should be in the crook of your arm, in line with his spine. The bottle feeding position should resemble the natural feeding position - especially when you feed him with two different feeding methods. nine0003

Remember:

Never leave your baby alone with a bottle as they may choke
Never let a baby sleep with a bottle in his mouth

How to give your baby a bottle

Put the bottle in your baby's mouth so that it forms a right angle with his face. Your baby should not encircle the entire nipple with his lips, but only its oblong part, while the lips should rest against the rounded part. The oblong part should always be full of milk. Otherwise, the baby will swallow a lot of air during feeding, which can cause colic. Air bubbles in the bottle mean your baby is suckling properly. nine0003

Emotional connection

Young children need parental love and affection. Your closeness helps him feel safe. Therefore, it is very important to talk affectionately with the baby as often as possible, hug and stroke him. Feeding is the best time to build an emotional relationship with your baby.

This is very easy to do when you are breastfeeding because you are already in physical contact with each other. However, bottle feeding also allows you to be closer to your baby as he feels the warmth of your body. Bottle feeding also allows other family members - the father, brothers and sisters to get closer to the child, since not only the mother can feed the baby in this way. nine0003

Calm emotional background

Never feed your baby when you are irritated or tense. Take some time for yourself first, take a deep breath and try to relax. When you have calmed down, sit in a comfortable chair, place a pillow under your arm, place your baby on the pillow, and start feeding while speaking gently to your baby. Your child feels your emotions. If you are tense, he will also feel restless. Also, never feed your baby when he is excited, crying or screaming. When he is in this state, his airways are not protected and food can enter his larynx instead of his esophagus. nine0003

Feeding by the hour

Formula milk is not as easily digested by the baby's stomach as breast milk, so according to generally accepted rules, it should be given every 3 hours.

Some pediatricians say it's best to give your baby formula on demand, that is, when the baby is hungry. In their opinion, it is better to feed the child than to wait another hour and keep him in suspense because he wants to eat. However, you still need to control the number of feedings and your baby's weight gain. nine0003

During the first month of life, the baby should eat > 7-8 times a day, 90-100 ml for each feeding, in the second month of life: 6-7 times a day, 100-120 ml for each feeding. During the first six months, the baby should gain approximately 150-200 g per week.

Feeding breaks

When your baby suckles milk from a bottle, he also swallows air. Therefore, he may feel full even before he drinks half the bottle. When feeding a child, breaks should be taken every few minutes to allow the baby to take in air - after such a break, he should ask for food again. During feeding, hold the baby in an upright or semi-recumbent position for a while (sometimes even for several minutes) to give him the opportunity to release air accumulated during feeding from the digestive tract. Help the child by holding him on your shoulder, putting his hands on your back. Bend and spread his legs a little.