How often should a month old baby feed
How Often and How Much Should Your Baby Eat?
By: Sanjeev Jain, MD, FAAP
One of the most common questions new parents have is how often their baby should eat. The best answer is surprisingly simple: in general, babies should be fed whenever they seem hungry.
How do I know when my baby is hungry?
For babies born
prematurely or with certain medical conditions, scheduled feedings advised by your pediatrician are best. But for most healthy, full-term infants, parents can look to their baby rather than the clock for hunger cues. This is called feeding on demand, or
A hungry baby often will cry. But it's best to watch for hunger cues before the baby starts crying, which is a late sign of hunger and can make it hard for them to settle down and eat.
Some other typical hunger cues in babies:
Sticking tongue out
Rooting (moving jaw and mouth or head in search of breast)
Putting his/her hand to mouth repeatedly
Opening her mouth
Sucking on everything around
It is important to realize, however, that every time your baby cries or sucks it is not necessarily because he or she is hungry. Babies suck not only for hunger, but also for comfort; it can be hard at first for parents to tell the difference. Sometimes, your baby just needs to be cuddled or changed.
General guidelines for baby feeding
It is important to remember all babies are different―some like to snack more often, and others drink more at one time and go longer between feedings. However, most babies will drink more and go longer between feedings as they get bigger and their tummies can hold more milk:
Most newborns eat every 2 to 3 hours, or 8 to 12 times every 24 hours. Babies might only take in half ounce per feeding for the first day or two of life, but after that will usually drink 1 to 2 ounces at each feeding. This amount increases to 2 to 3 ounces by 2 weeks of age.
At about 2 months of age, babies usually take 4 to 5 ounces per feeding every 3 to 4 hours.
At 4 months, babies usually take 4 to 6 ounces per feeding.
At 6 months, babies may be taking up to 8 ounces every 4 to 5 hours.
Most babies will increase the amount of formula they drink by an average of 1 ounce each month before leveling off at about 7 to 8 ounces per feeding. Solid foods should be started at about 6 months old.
Concerns about overfeeding or underfeeding your baby
Babies are usually pretty good at eating the right amount, but they can sometimes take in more than they need. Infants who are bottle feeding may be more likely to overfeed, because drinking from a bottle may take less effort than breastfeeding.
Overfed babies can have stomach pains, gas, spit up or vomit and be at higher risk for obesity later in life. It's better to offer less, since you can always give more if your baby wants it. This also gives babies time to realize when they're full.
If you are concerned your baby wants to eat all the time―even when he or she is full―talk with your pediatrician. Pacifiers may be used after feeding to help sooth healthy-weight babies who like to suck for comfort, rather than nutrition. For babies who are breastfed, it's best to wait to offer pacifiers until around 3 to 4 weeks of age, when breastfeeding is well-established.
Trouble gaining weight?
Most babies will double their birth weight by 5 months of age and triple their birth weight by their first birthday. If your baby is having trouble gaining weight, don't wait too long between feeding―even if it means waking your baby. Be sure to talk with your pediatrician about how often and how much to feed your baby.
How do I know if my baby is getting enough to eat?
A newborn's diaper is a good indicator of whether he or she is getting enough to eat. In the first few days after birth, a baby should have 2 to 3 wet diapers each day. After the first 4 to 5 days, a baby should have at least 5 to 6 wet diapers a day. Stool frequency is more variable and depends whether your baby is breastfed or formula fed.
During regular health check-ups, your pediatrician will check your baby's weight and plot it on a growth chart. Your baby's progress on the growth chart is one way to tell whether or not they are getting enough food. Babies who stay in healthy growth percentile ranges are probably getting a healthy amount of food during feedings.
Talk with your pediatrician if you have any questions or concerns about your baby getting the right amount to eat.
- Making Sure Your Baby is Getting Enough Milk
- Amount and Schedule of Formula Feedings
- Is Your Baby Hungry or Full? Responsive Feeding Explained (Video)
- Remedies for Spitty Babies
- Ask the Pediatrician: With the baby formula shortage, what should I do if I can't find any?
- Ask the Pediatrician: How should we feed our baby if we're running low on money?
Airplane Choo Choo: A Feeding Guide for Children (National Dairy Council)
Sanjeev Jain, MD, FAAP, is a Clinical Associate Professor of General Pediatrics and Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health. Within the American Academy of Pediatrics, he is a member of the Section on International Child Health and the Wisconsin State Chapter.
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
With the baby formula shortage, what should I do if I can't find any?
Since the outbreak of
COVID-19, there have been significant shortages of
infant formulas nationwide. Current shortages have been largely caused by supply chain issues and the recent
recall of several baby formula products over contamination concerns.
Here are some tips on finding baby formula during the shortage, and what you may safely consider if you absolutely can't find any.
Keep in mind, this advice is strictly during this current URGENT formula shortage. If you have any concerns about your baby's nutrition, please talk with your pediatrician.
What if baby formula is out of stock everywhere I look?
Call your pediatrician if you can't formula you need for your baby. They may have samples in stock, connections to other local organizations or ideas of other places to call, such as your local WIC clinic. Also consider:
- If you can afford it, buy formula online until store shortages ease. Purchase from well-recognized distributors, grocers, and pharmacies rather than individually sold or auction sites.
- Check social media groups. There are groups dedicated to infant feeding and formula, and members may have ideas for where to find formula. Make sure to check any advice with your pediatrician.
This formula crisis is hitting families who are already grappling with stresses of parenting young children in a pandemic. It can be tempting to buy as much formula as possible right now, but the American Academy of Pediatrics (AAP) advises buying no more than a 10-day to 2-week supply of formula to help ease shortages.
I found small amounts of several different baby formulas. What is the best way to switch among the brands?
For most babies, it is OK to switch to any available formula, including store brands. It is likely that your baby will do just fine with different formulas as long as they are the same type. (The exception would be if they are on certain specialty formulas for medical reasons. Read more below.) If your baby does not like the taste or has a hard time tolerating a different formula, you may want to try gradually introducing small amounts of the new formula mixed with the usual formula. Slowly increase the amount of the new formula.
Be patient, since it may take some time for your baby to get used to a new formula. If you have questions about whether your baby is tolerating the new formula, call your pediatrician.
My infant needs a specialty metabolic baby formula, but I can't find any. What should I do?
Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic or amino-acid formulas for babies in urgent need. Your pediatrician's office can fill out a request and, if it is approved, the formula can be shipped to your home. Talk to your pediatrician about safe, comparable specialty formulas for your baby.
Only one brand of baby formula is covered under the WIC program, but I can't find any. What should I do?
Most states are allowing parents who use WIC benefits to buy other brands of baby formula or different sizes and forms like ready-to-feed formula. To find out what your state is allowing, you can check this map.
I have a 3-month-old infant and can't find my usual baby formula.What should I do?
This is a very difficult problem. If you can find another similar formula, it's OK to make the switch. If you use a special formula for allergies or other special health needs, the North American Society For Pediatric Gastroenterology, Hepatology & Nutrition provides a list of comparable formulas here.
Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?
This should never be done. Adding extra water to formula can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders that may require hospitalization. Always follow label instructions or those given to you by your pediatrician.
Can I make my own baby formula? I've seen a recipe online using evaporated milk that people say was used safely in the 1940s.
Evaporated milk, also known as unsweetened condensed milk, is a form of concentrated milk. Mixing it with water can cause contamination or an incorrect balance of nutrients.
For similar reasons, AAP does not recommend using homemade baby formula. Although homemade formula was used in the past, it also came with many risks to infants. Online recipes for homemade baby formula have significant safety concerns regarding contamination and nutrient concentration. Using homemade baby formula can harm your infant. Some babies have been hospitalized from reported use of homemade formulas.
What is the earliest age I can start giving my baby solid food to stretch my formula supply?
Solid foods should not be used to stretch baby formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are about 6 months old, but it depends on their stage of development. Talk with your pediatrician about when your baby may be ready for solid foods.
Is it safe to get breast milk from a friend or online group?
We can't know for sure whether breast milk from a friend or online group is safe. It is better to check with a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, check here.
I heard the government is importing baby formula from other countries. Is that safe?
The Food & Drug Administration (FDA) is working to verify safe production standards, labeling and shipping of some imported baby formula brands not previously sold in the United States. European baby formulas are regulated by the European Food Safety Agency similar to how the FDA regulates U.S. formula, and are highly reliable.
The most important safety consideration if using imported formulas is to read the label carefully. Many imported formulas use milliliter (ml) rather than ounce (oz) in the mixing directions. If your baby bottles don’t have ml scale markings, you may have to convert from ounces to milliliters. Too much or too little water used with powder or concentrate is dangerous for your baby.
It is also important to select the right imported formula for your baby’s age. Imported formulas may be labeled as "Stage 1" (for the first six months after birth, but generally can be used throughout the first year), and "Stage 2" (just for babies who are over 6 months of age).
Can toddler "formula" substitute for regular baby formula?
Toddler drinks, often found in the formula aisles, are not recommended for infants. However, if you absolutely have no other choice, these products can be safe for a few days for babies who are close to a year of age.
Can I give my full-term baby premature formula?
Formulas designed for babies who were born premature (and have "catch-up" growth to do) can safely be used for a few weeks to feed full-term babies if nothing else is available.
Is cow's milk a safe alternative to baby formula?
If your child is older than 6 months of age and is usually on regular formula (not a specialty product for allergies or other special health needs), this may be an option. In a pinch, you could feed them whole cow's milk for a brief period of time (no more than a week).
This is not ideal and should not be done for more than one week. One concern with giving cow's milk to a baby who is 7-12 months old on a long-term basis is that it does not contain enough iron. This can lead to anemia. If you have to use cow's milk to feed your infant, ideally do so for as short a time as possible. It's also important to give your baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.
If you need to give your baby whole cow's milk for a week during the shortage, talk with your pediatrician.
What about feeding my baby goat's milk?
Remember that raw goat's milk, like raw cow's milk, is not safe for a baby since it has not been pasteurized to kill harmful bacteria. But some goat milk-based baby formulas made in other countries are among those being imported and distributed in the United States to help ease the national shortage. These are considered safe.
Can I use plant-based milk instead of baby formula if needed?
Plant-based milk alternatives generally are not recommended for babies under a year of age. Soy milk may be an option to give babies who are close a year old during the shortage, but not for more than one week. If you can't find formula and have to use soy milk, be sure to buy the kind that is fortified with calcium and vitamin D. Make sure to change back to formula as soon as some is available. Be especially careful to avoid almond milk or other plant milks as these are often low in protein and minerals. Talk with your pediatrician if you are considering using plant-based milk.
How long can baby formula be used past a "best by" date?
Generally, formula should not be used past the "best by" date because it may no longer be safe or have the required levels of nutrients.
This is a stressful and scary time for families. Your pediatrician is a resource who can help advise on the best and safest ways to feed formula-fed formula babies during the shortage.
- Ask the Pediatrician: Why are we seeing baby formula brands on the shelves from companies I haven't heard of before?
- How to Safely Prepare Formula with Water
- How Much and How Often Should Your Baby Eat?
- Choosing a Baby Formula
- Low Milk Supply: 5 Steps That Can Help
- North American Society For Pediatric Gastroenterology, Hepatology & Nutrition Tools for Infants and Children Affected by Formula Shortages
Helping Families Find Formula During the Infant Formula Shortage (HHS.gov)
Breastfeeding after 1 month: what to expect
Do you know when breast milk production stabilizes? And how does the frequency and duration of feedings change as the baby grows? You will find answers to these questions in our recommendations for breastfeeding after the first month.
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Congratulations: You made it through the first month of breastfeeding. Your breast milk has reached full maturity 1 , its production stabilizes, and it leaks almost or not at all from the chest. Don't worry, it's not getting less milk, it's just that your breasts are better able to produce and store it now. 2 At the age of six weeks, your baby will begin to please you with his charming toothless smiles, and by two months you will already have 500-600 feedings behind you. With a favorable development of events, problems with latch on by this point will already be resolved, and you can simply enjoy the convenience and benefits of breastfeeding.
When does breastfeeding decrease?
"Normal" feeding frequency for babies aged one to six months varies considerably, with some needing four feedings a day, others asking to be breastfed 13 times a day. 3
“From the age of one month, the amount of milk a baby consumes per feed increases, so that he can go without food for longer,” explains Cathy Garbin, a recognized international expert on breastfeeding, “A baby’s stomach grows, so he eat more at one time. In addition, mature milk allows him to stay full longer.”
Feeding can last from 12 minutes to one hour -
the habits of babies vary so much! 3 But if the child is gaining weight and falls within this range, there is no cause for concern.
What is most surprising, no matter how often the baby eats, he consumes approximately the same amount of milk per day - both at one month and at six, when it is time to start complementary foods with solid food. 4
“However, sometimes the baby eats more and sometimes less, especially when he is unwell. It’s better to just listen to his needs,” Katie explains.
Is breast milk enough for the first six months?
Yes. Breast milk contains everything a baby needs for the first 90,023 six months of life—exclusively breastfed babies don't even need to drink more water! 5 Until about six months of age, a child's digestive system is simply not adapted to the digestion of solid food, and he will be able to drink cow's milk only after a year.
In addition, breastfeeding during this period prepares the child for further development. It strengthens the muscles of the mouth, develops the jaw and helps straighten the teeth 6.7 . All this will come in handy when the baby begins to eat and talk. And because what you eat and drink affects how your breast milk tastes, your baby discovers new tastes even before he starts eating solid foods. 8
In addition, when your baby is sick, your body produces breast milk that is
rich in antibodies that help fight infection. 9 In other words, milk continues to protect the baby for many months as he grows and becomes more active.
Breastfeeding is also very comfortable once you get used to it. Claudia, a mother of two from the UK, notes: “No need to sterilize a mountain of bottles, prepare formula, carry it all with you, warm it up - in general, breastfeeding turned out to be very convenient, especially when my babies grew up and we began to leave the house more often. ".
At what age does a breastfed baby start sleeping through the night?
Waking up at night is normal for babies. Most babies between the ages of one and six months consume a fifth of their daily milk requirement at night, so nighttime feedings should not be neglected if you want your baby to get the required amount of calories. 3
"It really depends on what you mean by 'sleep through the night'," says Cathy. "And it's better than waking up every two hours anyway! I have met infants who, starting at six weeks old, fell asleep at 19:00 and woke up at 7:00, but most continue to wake up frequently at night after this age. All children are different."
In Wales, a study of more than 700 infants showed that almost 80% of children aged 6 to 12 months wake up at least once a night, and 25% of them wake up three times or more. And it did not depend on what type of feeding the child is on - breastfeeding or artificial. 10
And if nighttime awakenings are unavoidable anyway, breastfeeding is at least comfortable! Maina, a mother of two from Australia, agrees: “You can even take a nap while feeding in the middle of the night - both the body and the baby do their job on autopilot. No need to plan, measure, sterilize anything - ready-made food at the right temperature is right in your chest. I think it's ideal."
My child wakes up more often. Perhaps he is hungry?
Around four months of age, a baby's sleep patterns change as they develop deep and light sleep phases like an adult. Because of this, he may wake up more often at night. “At four months, sleep is more of a problem than feeding,” Cathy admits. “It can be exhausting, but try to adapt and be patient.”
Some call this " a four-month sleep regression ", but "progress" is more appropriate here. From the outside it may look like a step back, but in fact the child is approaching an important stage of development. He learns quickly, begins to become aware of the world around him, his perception is sharpened and, perhaps, there is anxiety about being separated from his mother. Crying when waking up and being able to eat milk cuddled up to mommy’s chest is a way for a baby to calm down. 11–13
Resist the urge to “supplement” your baby with formula or start solid foods early
in an attempt to improve his sleep. Breast milk contains
hormones that make you sleepy and help you both relax
. Research shows that breastfeeding mothers actually sleep longer at night than mothers of formula-fed or mixed-fed babies
How does teething affect breastfeeding?
Teething usually begins around four months of age. When a baby has gum pain, he becomes restless, throws his chest and cries. All this, of course, is unpleasant.
However, breastfeeding can be an excellent sedative.
Studies have shown that babies who are breastfed
during the vaccination period cry less and forget pain more quickly. 15 Breastfeeding during teething can have the same calming effect.
An unpleasant side effect may be the child's attempts to try out his new teeth on the mother's breast. “Sometimes children flirt and bite their mother’s nipples. This can be felt in advance by how the behavior of the child changes when feeding: before biting, he removes his tongue, explains Cathy, “Usually this is not a problem and only happens a couple of times. It is enough to stop feeding, affectionately say that biting is not good, and the baby will soon leave this fun.
How to continue feeding if you have to be separated from the baby?
It happens that during the first six months, when the baby is still fully breastfed, the mother needs to be away for several hours - or even longer if she has to go to work or go away on business for a couple of days.
But this does not mean that you should stop breastfeeding. You can still feed your baby healthy breast milk - just express it and have someone give it to your baby when you're away. Here's Katie's advice:
“Start expressing milk a couple of days in advance, in small batches, 40-60 ml at a time. So you will have the necessary supply for the time of your absence, but at the same time the amount of milk produced will remain the same.
If you have to return to work, check with your employer about your daily schedule. Many mothers breastfeed their babies in the morning, evening and night, and pump milk at lunchtime to relieve discomfort and create a reserve for the next day.
This usually turns out to be much easier than one might think, and today many companies are well placed to do this, notes Cathy. “Breast pumps make it easy to solve this problem.”
Natalie, mother from the USA, shares her experience: “I feed Dylan as soon as he wakes up, and sometimes again before leaving for work, in order to maintain milk production and not lose contact with the child. At work, I pump twice the next day (in my absence, he eats two bottles of breast milk), and after work I rush home for the evening feed. I don't pump on the weekends - we resume regular breastfeeding."
Can breastfeeding continue after the introduction of solid foods?
When your baby begins to show interest in food and can sit up on his own - usually around six months of age - it's time to start solid foods. However, it is not necessary to stop breastfeeding, Cathy explains: “A baby’s iron stores during pregnancy are depleted by six months, so he needs additional sources of this element.
Start complementary foods with solid foods, but remember that breast milk remains a more important source of calories and nutrients until the baby is eight to nine months old. By this time, he will be eating much more solid food, but he will still need to breastfeed four to five times a day. By 12 months, the frequency of feeding may be two to six times a day. All babies are different, and many of them at this age are still getting half their daily calorie intake from breast milk.”
Don't forget that breast milk can be added to solid foods, such as cereals and purees, so that the baby can taste the familiar taste. If possible, use milk expressed just before feeding (not thawed) and add just before serving to keep bacteria and nutrients alive. 16
You may be pressured by others to stop breastfeeding when your baby is six months old, but the longer you breastfeed or pump milk, the better for you and your baby.
How long can I continue breastfeeding?
“The World Health Organization recommends breastfeeding along with solid foods until at least two years of age because it plays an important role in supporting immunity,” says Cathy. feels bad".
At eight months, the baby sometimes breastfeeds four times a day, but by one year old, the frequency of feedings can be reduced to two times a day. You yourself will understand which feeding regimen is more suitable for you and your baby. For example, Jane, a mother of two from the US, breastfed until the age of two: “I breastfed when I was at home - in the evenings and on weekends, when the children wanted to be close to me,” says Jane, “It helped a lot when they were sick . Breastfeeding has become my favorite form of comfort."
“When my son got a little older and bolder, he still often asked me to breastfeed him - as if to calm down and gain strength,” recalls Amy, a mother of two children from Canada, “When he happened to hit or skin his knee , breastfeeding was a wonderful way to comfort him. ”
If your baby is over a year old and you are still breastfeeding, people around you will probably tell you that this way he will never wean. But if children are not pressured, they usually refuse to breastfeed themselves between the ages of two and four. 17
“I didn’t intend to breastfeed for so long, but as a result, I still breastfeed my four-year-old daughter and 22-month-old son,” says Suzanne, mother of two from the UK, “I breastfeed my youngest before and after work, and in I express milk on business trips. The eldest daughter likes to breastfeed a little before bed or when she is upset - this is a great way to make contact. When I get tired of it, I remind myself what great benefit and comfort it brings them. I now plan to pursue a baby-initiated end breastfeeding strategy — let them decide when to stop.”
For more information on what to expect and lots of tips and tricks, see our guide Breastfeeding Problems After the First Month.
1 Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am . 2013;60(1):49-74. - Ballard O., Morrow A.L., "Composition of breast milk: nutrients and biologically active factors." Pediatrician Clean North Am. 2013;60(1):49-74.
2 Kent JC et al. Principles for maintaining or increasing breast milk production. J 2012;41(1):114-21. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol and Neonatal Nurse. 2012;41(1):114-121.
3 Kent JC Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.
4 Kent JC et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breast Med . 2013;8(4):401-407. - Kent J.S. et al., Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Brest Med. 2013;8(4):401-407.
5 Almroth S, Bidinger PD. No need for water supplementation for exclusively breast-fed infants under hot and arid conditions. Trans R Soc 1990;84(4):602-604. - Elmroth S., Bidinger P.D., "No need for supplementation of exclusively breastfed infants in hot, dry conditions." Trans R Sots Trop Med Hyg. 1990;84(4):602-604.
6 Victora CG et al . Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet 2016;387(10017):475-490.
7 Peres KG et al. Effect of breastfeeding on malocclusions: a systematic review and meta - analysis. Acta Paediatr. 2015;104( S 467):54-61. - Perez K.G. et al., "The impact of breastfeeding on malocclusion: a systematic review and meta-analysis". Akta Pediatr. 2015;104(S467):54-61.
8 Mennella JA, Beauchamp GK. Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics. 1991;88(4):737-744. - Mennella, JA, Beauchamp, GK, "Maternal nutrition influences the organoleptic properties of breast milk and infant behavior." Pediatrix (Pediatrics). 1991;88(4):737-744.
9 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl immunology. 2013;2(4). - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4).
10 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.
11 Infant sleep information source. [Internet]. Normal Infant Sleep Development; December 2017 [cited 2018 Feb] - All about baby sleep. [Internet] "The development of normal sleep in a child", December 2017 [cited February 2018].
12 Baby sleep science. [Internet]. The-Four-Month-Sleep-Regression-What-is-it-and-What-can-be-Done-About-it. March 2014 [ cited 2018 Feb ] - The science of baby sleep. [Internet], "Four-month sleep regression: what it is and what to do about it." March 2014 [cited February 2018].
13 The Myth Of Baby Sleep Regressions – What’s Really Happening To Your Baby’s Sleep? [Internet]. Pinky Mckay ; December 2017 [ cited 2018 Feb ] - "The Myth of Baby Sleep Regression - What's Really Happening to Your Baby?" [Internet]. Pinky McKay, December 2017 [cited February 2018].
14 Kendall - Tackett K ET Al . The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. Clinical Lactation . 2011;2(2):22-26. - Kendall-Tuckett K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.
15) Harrison D et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev . 2014;10. — Harrison D. et al., "Breastfeeding for Relief of Medical Pain in the Neonatal Period." Cochrane Database of System Rev. 2014;10:CD11248
16 Czank C et al. Retention of the immunological proteins of pasteurized human milk in relation to pasteurizer design and practice. Pediatr Res . 2009;66(4):374. - Zhank S. et al., "Retention of immunological proteins in pasteurized milk depending on the technique and practice of pasteurization". Pediatrician Res. 2009;66(4):374.
17 Weaning from the breast. (2004). Paediatr Child Health, 9(4):249–253. - "Weaning from the breast" (2004). Pediatrician Child Health, 9(4):249–253.
Breastfeeding in the first month: what to expect
Not sure how to establish lactation and increase milk production? If you need help, support, or just want to know what to expect, read our First Month Breastfeeding Recommendations
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The first weeks of breastfeeding are a very stressful period. If at times you feel like you can't handle it, know that you are not alone. Feeding your baby all day long is completely natural and helps produce breast milk, but can be quite tiring at times. Be patient, think about yourself and remember: after the first month, when milk production stabilizes, it will become easier.
How often should a baby be breastfed?
Babies are born with a small stomach that grows rapidly with increasing milk production: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large chicken egg. 1.2 Let the child eat as much as he wants and when he wants. This will help him quickly regain the weight lost after birth and grow and develop further.
“Be prepared to feed every two to three hours throughout the day. At night, the intervals between feedings can be longer: three to four or even five hours, says Cathy Garbin, a recognized international expert on breastfeeding. Some eat quickly and are satiated in 15 minutes, while others take an entire hour to feed. Do not compare your breastfeeding regimen with that of other mothers - it is very likely that there will be nothing in common between them.
At each feed, give your baby a full meal from one breast and then offer a second one, but don't worry if the baby doesn't take it. When the baby is full, he lets go of his chest and at the same time looks relaxed and satisfied - so much so that he can immediately fall asleep. The next time you feed, start on the other breast. You can monitor the order of the mammary glands during feeding using a special application.
Why does the child always ask for a breast?
The first month is usually the hardest time to breastfeed. But do not think that because the baby is constantly hungry and asks for a breast almost every 45 minutes, then you do not have enough milk.
In the first month, the baby needs to eat frequently to start and stimulate the mother's milk production. It lays the foundation for a stable milk supply in the future. 3
In addition, we must not forget that the child needs almost constant contact with the mother. The bright light and noise of the surrounding world at first frighten the baby, and only by clinging to his mother, he can calm down.
Sarah, mother of three from the UK, confirms: “Crying is not always a sign of hunger. Sometimes my kids just wanted me to be around and begged for breasts to calm them down. Use a sling. Place the cradle next to the bed. Don't look at the clock. Take advantage of every opportunity to relax. Forget about cleaning. Let those around you take care of you. And not three days, but six weeks at least! Hug your baby, enjoy the comfort - and trust your body."
Do I need to feed my baby on a schedule?
Your baby is still too young for a strict daily routine, so
forget about breastfeeding schedules and focus on his needs.
“Volumes have been written about how to feed a baby on a schedule, but babies don't read or understand books,” Cathy says. - All children are different. Some people can eat on a schedule, but most can't. Most often, over time, the child develops his own schedule.
Some mothers report that their babies are fine with scheduled feedings, but they are probably just the few babies who would eat every four hours anyway. Adults rarely eat and drink the same foods at the same time of day - so why do we expect this from toddlers?
Offer your baby the breast at the first sign of hunger. Crying is already the last stage, so be attentive to early signs: the baby licks his lips, opens his mouth, sucks his fist, turns his head with his mouth open - looking for the breast. 4
What is a "milk flush"?
At the beginning of each feeding, a hungry baby actively sucks on the nipple,
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5
“Nipple stimulation triggers the release of the hormone oxytocin,” Cathy explains. “Oxytocin is distributed throughout the body and causes the muscles around the milk-producing glands to contract and the milk ducts to dilate. This stimulates the flow of milk.
If the flushing reflex fails, milk will not come out. This is a hormonal response, and under stress it may not work at all or work poorly. Therefore, it is so important that you feel comfortable and calm when feeding.
“Studies show that each mother has a different rhythm of hot flashes during one feed,” Kathy continues, “Oxytocin is a short-acting hormone, it breaks down in just 30-40 seconds after formation. Milk begins to flow, the baby eats, the effect of oxytocin ends, but then a new rush of milk occurs, the baby continues to suckle the breast, and this process is repeated cyclically. That is why, during feeding, the child periodically stops and rests - this is how nature intended.
The flow of milk may be accompanied by a strong sensation of movement or tingling in the chest, although 21% of mothers, according to surveys, do not feel anything at all. 5 Cathy explains: “Many women only feel the first rush of milk. If you do not feel hot flashes, do not worry: since the child eats normally, most likely, you simply do not understand that they are.
How can you tell if your baby is getting enough milk?
Since it is impossible to track how much milk a baby eats while breastfeeding, mothers sometimes worry that the baby is malnourished. Trust your child and your body.
After a rush of milk, the baby usually begins to suckle more slowly. Some mothers clearly hear how the baby swallows, others do not notice it. But one way or another, the child himself will show when he is full - just watch carefully. Many babies make two or three approaches to the breast at one feeding. 6
“When a child has eaten, it is noticeable almost immediately: a kind of “milk intoxication” sets in. The baby is relaxed and makes it clear with his whole body that he is completely full, says Katie, “Diapers are another great way to assess whether the baby is getting enough milk. During this period, a breastfed baby should have at least five wet diapers a day and at least two portions of soft yellow stool, and often more.”
From one month until weaning at six months of age, a baby's stool (if exclusively breastfed) should look the same every day: yellow, grainy, loose, and watery.
When is the child's birth weight restored?
Most newborns lose weight in the first few days of life. This is normal and should not be cause for concern. As a rule, weight is reduced by 5-7%, although some may lose up to 10%. One way or another, by 10–14 days, almost all newborns regain their birth weight. In the first three to four months, the minimum expected weight gain is an average of 150 grams per week. But one week the child may gain weight faster, and the next slower, so it is necessary that the attending physician monitor the health and growth of the baby constantly. 7.8
At the slightest doubt or signs of dehydration, such as
dark urine, no stool for more than 24 hours, retraction of the fontanel (soft spot on the head), yellowing of the skin, drowsiness, lethargy, lack of appetite (ability to four to six hours without feeding), you should immediately consult a doctor. 7
What is "cluster feeding"?
When a baby asks to breastfeed very often for several hours, this is called cluster feeding. 6 The peak often occurs in the evening between 18:00 and 22:00, just when many babies are especially restless and need close contact with their mother. Most often, mothers complain about this in the period from two to nine weeks after childbirth. This is perfectly normal and common behavior as long as the baby is otherwise healthy, eating well, gaining weight normally, and appears content throughout the day. 9
Cluster feeding can be caused by a sharp jump in the development of the body - during this period the baby especially needs love, comfort and a sense of security. The growing brain of a child is so excited that it can be difficult for him to turn off, or it just scares the baby. 9 If a child is overworked, it is often difficult for him or her to calm down on his own, and adult help is needed. And breastfeeding is the best way to calm the baby, because breast milk is not only food, but also pain reliever and a source of happiness hormones. 10
“No one told me about cluster feeding, so for the first 10 days I just went crazy with worry - I was sure that my milk was not enough for the baby,” recalls Camille, a mother from Australia, “It was a very difficult period . I was advised to pump and supplement until I finally contacted the Australian Breastfeeding Association. There they explained to me what was happening: it turned out that it was not about milk at all.
Remember, this is temporary. Try to prepare dinner for yourself in the afternoon, when the baby is fast asleep, so that in the evening, when he begins to often breastfeed, you have the opportunity to quickly warm up the food and have a snack. If you are not alone, arrange to carry and rock the baby in turns so that you have the opportunity to rest. If you have no one to turn to for help and you feel that your strength is leaving you, put the baby in the crib and rest for a few minutes, and then pick it up again.
Ask your partner, family and friends to help you with household chores, cooking and caring for older children if you have any. If possible, hire an au pair. Get as much rest as possible, eat well and drink plenty of water.
“My daughter slept a lot during the day, but from 23:00 to 5:00 the cluster feeding period began, which was very tiring,” recalls Jenal, a mother from the USA, “My husband tried his best to make life easier for me - washed, cleaned, cooked, changed diapers, let me sleep at every opportunity and never tired of assuring me that we were doing well.
If you are concerned about the frequency of breastfeeding, it is worth contacting a specialist. “Check with a lactation consultant or doctor to see if this is indicative of any problems,” recommends Cathy. “Resist the temptation to supplement your baby with formula (unless recommended by your doctor) until you find the cause. It may not be a matter of limited milk production at all - it may be that the child is inefficiently sucking it.
When will breastfeeding become easier?
This early stage is very special and does not last long. Although sometimes it seems that there will be no end to it, rest assured: it will get easier soon! By the end of the first month, breast milk production will stabilize, and the baby will become stronger and learn to suckle better. 2.3 Any problems with latch on by this time will most likely be resolved and the body will be able to produce milk more efficiently so inflammation and leakage of milk will begin to subside.
“The first four to six weeks are the hardest, but then things start to get better,” Cathy assures. It just needs to be experienced!”
The longer breastfeeding continues, the more benefits it brings, from saving on formula and improving sleep quality 11–13 to boosting your baby's immune system 14 and reducing your risk of certain cancers. 15
“When you feel like you're pushing yourself, try to go from feed to feed and day to day,” advises Hannah, a UK mom. “I was sure I wouldn’t make it to eight weeks. And now I have been breastfeeding for almost 17 weeks, and I dare say it is very easy.”
Read the resource Breastfeeding After the First Month: What to Expect
1 Naveed M et al. An autopsy study of relationship between perinatal stomach capacity and birth weight. Indian J Gastroenterol .1992;11(4):156-158. - Navid M. et al. , Association between prenatal gastric volume and birth weight. Autopsy. Indian J Gastroenterol. 1992;11(4):156-158.
2 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation . Am J Clinl Nutr . 1988;48(6):1375-1386. at the beginning and at the peak of lactation." Am F Clean Nutr. 1988;48(6):1375-1386.
3 Kent JC et al. Principles for maintaining or increasing breast milk production. J 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.
4 Australian Breastfeeding Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]
5 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Human Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Different Types of Electric Breast Pump Stimulation. J Human Lact (Journal of the International Association of Lactation Consultants). 2003;19(2):179-186.
6) Kent JC et al . Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.
7 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.
8 World Health Organization. [Internet]. Child growth standards; 2018 [cited 2018 Feb] - World Health Organization. [Internet]. Child Growth Standards 2018 [cited February 2018].
9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018].
10 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206.- Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206.
11 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2017 Feb] - Department of Health and Human Services [Internet], "Breastfeeding Facts from the Chief Medical Officer", Jan 20, 2011 [cited Feb 2017]
12 Kendall-Tackett K et al. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. clinical lactation. 2011;1;2(2):22-26. - Kendall-Tuckett, K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.
13 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.
14 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl immunology. 2013;2(4). - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4):e3.
15 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev .