Newborn baby feeding guidelines


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 responsive feeding.

Hunger cues

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:

  • Licking lips

  • Sticking tongue out

  • Rooting (moving jaw and mouth or head in search of breast)

  • Putting his/her hand to mouth repeatedly

  • Opening her mouth

  • Fussiness

  • 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


Too full?

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?

Daily diapers

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.

Growth charts

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.

Remember

Talk with your pediatrician if you have any questions or concerns about your baby getting the right amount to eat.

More information:

  • 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)

About Dr.

Jain:

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.

Amount and Schedule of Baby Formula Feedings

  • ​In the first week after birth, babies should be eating no more than about 1 to 2 ounces (30 to 60 ml) per feed.
  • During the first month, babies gradually eat more until they take 3 to 4 ounces (90 to 120 ml) per feed, amounting to 32 ounces per day. Formula-fed babies typically feed on a more regular schedule, such as every 3 or 4 hours. Breastfed babies usually take smaller, more frequent feedings than formula-fed infants.

If your baby sleeps longer than 4 to 5 hours during the first few weeks after birth and starts missing feedings, wake them up and offer a bottle.

  • By the end of the first month: Your baby will be up to at least 3 to 4 ounces (120 mL) per feeding, with a fairly predictable schedule of feedings about every 3 to 4 hours.

  • By 6 months: Your baby will consume 6 to 8 ounces (180–240 mL) at each of 4 or 5 feedings in 24 hours.

Formula feeding based on body weight

On average, your baby should take in about 2½ ounces (75 mL) of infant formula a day for every pound (453 g) of body weight. But they probably will regulate their intake from day to day to meet their own specific needs, so let them tell you when they've had enough. If they become fidgety or easily distracted during a feeding, they're probably finished. If they drain the bottle and continues smacking their lips, they might still be hungry.

There are high and low limits, however. If your baby consistently seems to want more or less than this, discuss it with your pediatrician. Your baby should usually drink no more than an average of about 32 ounces (960 mL) of formula in 24 hours. Some babies have higher needs for sucking and may just want to suck on a pacifier after feeding.

On-demand feeding

Initially it is best to feed your formula-fed newborn a bottle on demand, or whenever they cry with hunger. As time passes, your baby will begin to develop a fairly regular timetable of their own. As you become familiar with their signals and needs, you'll be able to schedule their feedings around their routine.

Eating & sleeping patterns

Between 2 and 4 months of age (or when the baby weighs more than 12 lb. [5.4 kg]), most formula-fed babies no longer need a middle-of-the-night feedings. They're consuming more during the day, and their sleeping patterns have become more regular (although this varies considerably from baby to baby). Their stomach capacity has increased, too, which means they may go longer between daytime feedings—occasionally up to 4 or 5 hours at a time.

If your baby still seems to feed very frequently or consume larger amounts, try distracting them with play or with a pacifier. Sometimes patterns of obesity begin during infancy, so it is important not to overfeed your baby.

Getting to know your baby's feeding needs


The most important thing to remember, whether you breastfeed or bottlefeed, is that your baby's feeding needs are unique. No book―or website―can tell you precisely how much or how often they need to be fed or exactly how you should handle them during feedings. You will discover these things for yourself as you and your baby get to know each other.

More information

  • How Often and How Much Should Your Baby Eat?
  • Making Sure Your Baby is Getting Enough Milk
  • Is Your Baby Hungry or Full? Responsive Feeding Explained (Video)
  • Remedies for Spitty Babies
Last Updated
5/16/2022
Source
Adapted from Caring for Your Baby and Young Child: Birth to Age 5 7th Edition (Copyright © 2019 American Academy of Pediatrics)

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.

WHO recommendations on breastfeeding

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Medela fully supports the World Health Organization's recommendation for breastfeeding duration.

WHO recommends that mothers around the world exclusively breastfeed their babies for the first six months of their lives to ensure optimal growth, development and health. After that, they should be given age-appropriate complementary foods and continue breastfeeding up to two years or more.

International health organizations recognize that breastfeeding, as the best way to eat during this period, promotes brain development in children, stimulates their growth, improves their school performance and reduces the risk of diseases such as diabetes and obesity in the future life. 1 Medela fully recognizes this.

The first thousand days of your baby's life—from conception to two years of age—gives you an excellent opportunity to lay the foundation for his future health and well-being. 2 As soon as pregnancy occurs, your body begins to create a new person. And within a month, the development of a new amazing feeding system also begins. 3 Not only is your breast milk perfectly matched to your baby's protein, mineral, vitamin, and fat needs, it contains thousands of protective substances, growth factors, and cells that fight infection, support baby's brain development, and lay the foundation for future health for babies. you and your child. Breastfeeding gives you protection against breast cancer and may also protect you from ovarian cancer and type 2 diabetes. 1

At each stage of development from birth to one year, the needs of the baby change daily, and milk changes with them. 4 Your breast milk contains thousands of ingredients, the vast majority of which cannot be replaced with artificial additives.

You don't have to lead a perfect life to breastfeed. In fact, studies around the world show that even with malnourished moms 5 Breastfeeding has many advantages over formula feeding. 1

And that's not all! Breastfeeding is better for the environment than formula feeding because it does not require intensive animal husbandry and excessive water consumption, it does not require fossil fuels and factory emissions, it does not use transportation fuels and there is no exhaust fumes, and it does not require packaging. . In the US alone, 550 million packages of artificial formulas are used each year. 6

Formula is not recommended in addition to breastfeeding. Your breasts need frequent stimulation through breastfeeding in order to produce enough milk now and in the future. If you want to introduce bottle feeding, it is recommended to wait until milk production and breastfeeding have improved. When bottle-fed, babies become full quickly and do not ask for food as often as when breastfeeding. This, in turn, reduces the breast's ability to produce enough milk. Artificial mixtures should be used only when there is a medical indication for this, which should be discussed with your healthcare provider.

Breastfeeding a newborn | What to Expect in the First Week

The first week of a baby's life is a wonderful but hectic time, especially if you haven't breastfed before. Our breastfeeding tips will help you settle in as quickly as possible

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The first time after childbirth, mothers are often confused. The body is still recovering, and you are already starting to get to know your newborn baby. The emotional state during this period can be unstable, especially between the second and fifth day, when many women have milk 1 and at the same time postpartum depression begins 2 . In addition, people around often expect (and demand) that a woman come to her senses as soon as possible and become a “super mom”. But the best thing to do this first week is just to be with your baby and get breastfeeding going.

When should I start breastfeeding my newborn?

Try to breastfeed your baby within the first hour after birth. When the baby latch onto the breast and begins sucking rhythmically, it stimulates the mammary gland cells and starts milk production. 1 It is not for nothing that this time is called the “magic hour”!

“Ideally, the baby should be placed on the mother's stomach immediately after birth so that it can immediately attach to the breast. He won't necessarily eat, but he should be able to,” explains Cathy Garbin, an internationally recognized expert on breastfeeding.

“Hold your baby and let him find the breast on his own and put the nipple in his mouth. This is called the breast-seeking reflex. On the Internet you can watch videos that show what this process looks like. If the baby does not latch onto the nipple on its own, the midwife will help to properly attach it to the breast. But for starters, it’s good to give the baby the opportunity to do it on their own. In this case, the optimal position for the mother is reclining. ”

Don't spend that special first hour of your baby's life weighing and swaddling—or at least wait until he's suckling for the first time. Enjoy hugs and close skin-to-skin contact. This promotes the production of oxytocin, the hormone of love, in you and your baby, and oxytocin plays a key role in the supply of the first breast milk - colostrum. 3

“As soon as the obstetricians were convinced that our son was healthy, the three of us — me, my husband and our baby — were left to give us the opportunity to get to know each other. It was a very special hour - an hour of awkwardness, turbulent emotions and bliss. During this time, I breastfed my son twice, ”recalls Ellie, a mother of two from the UK.

Did you know that breastfeeding helps to recover after childbirth? This is because oxytocin stimulates uterine contractions. In the first hours after childbirth, this contributes to the natural release of the placenta and reduces blood loss. 4

What if the birth didn't go according to plan?

If you had a caesarean section or other complications during childbirth,
You can still establish skin-to-skin contact with your baby and breastfeed him in the first hours after birth.

“If you can't hold your baby, have your partner do it for you and make skin-to-skin contact with the baby. This will give the baby a sense of security, care and warmth so that he can hold on until you recover, ”Katie advises.

If the baby is unable to breastfeed, it is advisable to start expressing milk as early as possible and do so as often as possible until the baby is able to feed on its own. “While breastfeeding in the first hours after birth lays an excellent foundation for the future, it is not so important,” Cathy reassures. “It is much more important to start lactation so that in the future, if necessary, you can start breastfeeding.

To start milk production, you can express milk manually or use a breast pump that can be given to you at the hospital. 5 And with expressed precious colostrum, it will be possible to feed the child. This is especially important if the baby was born premature or weak, since breast milk is extremely healthy.

If a baby was born prematurely or has a medical condition and cannot be breastfed immediately, this is no reason not to continue breastfeeding. “I have worked with many new mothers who were unable to breastfeed their baby for the first six weeks due to preterm labor or other reasons. Nevertheless, all of them later successfully switched to breastfeeding,” says Kathy.

Does the baby latch on correctly?

Correct breastfeeding is a prerequisite for successful breastfeeding 6 , as it determines how effectively the baby will suckle milk, and therefore grow and develop. Latching on the breast incorrectly can cause sore or damaged nipples, so don't hesitate to ask your doctor to check that your baby is properly attached to the breast, even if you are told that everything is fine and you do not see obvious problems - especially while you are in the hospital.

“While I was in the hospital, I called the doctor at every feed and asked me to check if I was breastfeeding correctly,” says Emma, ​​mother of two from Australia. - There were several cases when it seemed to me that everything seemed to be right, but it was painful to feed, and the doctor helped me take the baby off the breast and attach it correctly. By the time I was discharged, I had already learned to do it confidently.”

When applying to the breast, point the nipple towards the palate. This will allow the baby to take the nipple and part of the areola under it into their mouth. It will be easier for him to suck if he has both the nipple and part of the areola around in his mouth. 6

“When a baby latch on properly, it doesn't cause discomfort and it causes a pulling sensation, not pain,” Cathy explains. - The baby's mouth is wide open, the lower lip may be slightly turned outward, and the upper one lies comfortably on the chest. The body language of the child indicates that he is comfortable. There isn't much milk at this early stage, so you probably won't notice your baby swallowing, but he will suckle a lot and nurse frequently."

How often should a newborn be fed?

The frequency and duration of breastfeeding in the first week can vary greatly. “The first 24 hours of life are completely different for different children. Someone sleeps a lot (after all, childbirth is tiring!), And someone often eats, says Katie. - Such a variety greatly confuses young mothers. Everyone gives different advice, so it's important to remember that every mother and child is different."

“Colostrum is thicker than mature breast milk and is produced in smaller amounts, but has many benefits. When the baby eats colostrum, he learns to suck, swallow and breathe until milk begins to flow in more volume, ”explains Cathy.

Milk usually arrives on the second or fourth day after birth. Until this time, the baby is applied to the breast 8-12 times a day (and sometimes more often!), including at night. 7 Feeding may take 10-15 minutes at this stage, or 45 minutes or even an hour, as the baby is just beginning to develop the muscles and coordination needed to suckle effectively.

“At first, the intensity of feeding is very high, often higher than many people realize, and this is shocking to most new mothers,” says Cathy. - Sometimes mom has no time to go to the toilet, take a shower and have a snack. It usually comes as a surprise."

Camille, a mother from Australia, experienced this. “The first week, Frankie ate every two hours, day and night, and each time it took half an hour to an hour to feed,” she recalls. “My husband and I were completely exhausted!”

Should I feed my newborn on a schedule?

The good news is that frequent feeding promotes lactation and stimulates milk production. 7 The more your baby eats, the more milk you will have. Therefore, forget about feeding your newborn on a schedule - this way he will have less chance of feeding. Try to feed your baby when he signals that he is hungry 8 :

  • tossing and turning in her sleep;
  • opens eyes;
  • turns his head if he feels a touch on his cheek;
  • sticks out tongue;
  • groans;
  • licks lips;
  • sucks fingers;
  • is naughty;
  • whimpers;
  • is crying.

Crying is the last sign of hunger, so when in doubt, just offer your baby the breast. If he bursts into tears, it will be more difficult to feed him, especially at first, when both of you are just learning how to do it. As your baby grows, he will likely eat less frequently and take less time to feed, so breastfeeding will seem more predictable.

Does breastfeeding hurt?

You may have heard that breastfeeding is not painful at all, but in fact, in the first days, many new mothers experience discomfort. And this is not at all surprising, given that the nipples are not used to such frequent and strong sucking.

“Breastfeeding can be uncomfortable for the first couple of days – your body and your baby are just getting used to it. If a baby eats for too long and does not latch well, the sensations are almost the same as from unworn new shoes, Cathy compares. Just as tight shoes can rub your feet, improper suckling can damage your nipples. Prevention is always better than cure, so if the pain persists after a few days of feeding, contact a lactation consultant or healthcare professional.”

Maria, a mother from Canada, agrees: “Although my son seemed to latch onto the breast well, he damaged his nipples while feeding, and I was in pain. As it turned out, the reason was a shortened frenulum of the tongue. The breastfeeding specialists at our city clinic have been of great help in diagnosis and treatment.”

In addition, you may experience period cramps during the first few days after breastfeeding, especially if this is not your first baby. This is the so-called postpartum pain. The fact is that oxytocin, which is released during breastfeeding, contributes to further contraction of the uterus to restore its normal size. 4

When milk arrives, the breasts usually become fuller, firmer and larger than before delivery. In some women, the breasts swell, harden and become very sensitive - swelling of the mammary glands occurs. 10 Frequent breastfeeding relieves these symptoms. For more breast care tips, read our article What is Breast Swelling?

How often does the newborn urinate and defecate?

What goes into the body must go back out. Colostrum
has a laxative effect, helping to eliminate meconium - the original feces. It looks a little scary - black and sticky, like tar. 11 But don't worry, it won't always be like this. Breastfed babies usually have a slightly sweet smell of stool.

How many times a day you will need to change diapers and how the contents should look like, see below.

Day one

  • Frequency: once or more.
  • Colour: greenish black.
  • Texture: sticky like tar.

Second day

  • Frequency: twice or more.
  • Colour: dark greenish brown.
  • Texture: less sticky.

Day three

  • Frequency: twice or more.
  • Colour: greenish brown to brownish yellow.
  • Texture: non-sticky.

Fourth day and then the entire first month

  • Frequency: twice or more.
  • Color: yellow (feces should turn yellow no later than by the end of the fourth day).
  • Texture: grainy (like mustard with grains interspersed). Leaky and watery.

The baby's urine should be light yellow. On average, babies urinate once a day for the first two days. Starting around the third day, the number of wet diapers increases to three, and from the fifth day onwards, diapers have to be changed five times a day or more often. In addition, during the first few days, the weight of wet diapers increases. 11

Is the baby getting enough breast milk?

Since very little milk is produced at first,
You may feel that your baby is not getting enough milk. But if you feed your baby on demand, you will produce exactly as much milk as he needs. If you want to keep the process under control, be guided by the frequency of diaper changes above. If your baby soils less diapers, check with your doctor.

“For the first three or four weeks, most babies just eat and sleep. If the child is worried and constantly asks for a breast, you should consult with your doctor, ”Katie recommends.

Sometimes the baby may vomit after feeding. If the vomit is the color of milk, this is not a cause for concern. But if there are orange, red, green, brown or black blotches in it, or the child vomits with a "fountain", consult a doctor. You should also consult a doctor if the baby has a high temperature, the fontanel (soft spot on the head) has sunk, blood is found in the stool, and also if the weight recorded at birth has not recovered within two weeks. 11

But if there are no frightening symptoms and the baby is growing at a normal pace, then he has enough milk. Soon you will both get used to breastfeeding and establish a more stable routine.

For the next step in breastfeeding, see Breastfeeding the First Month: What to Expect.

Literature

1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia . 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.

2 Shashi R et al. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry . 2015; 57( Suppl 2): S 216– S 221. - Shashi R. et al., "Postpartum mental disorders: early diagnosis and treatment." Indian J Saikiatri. 2015; 57(App 2):S216-S221.

3 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206. - Moberg K, Prime DK, "The effects of oxytocin on mother and child during breastfeeding." Infant. 2013;9(6):201-206.

4 Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc . 2004;79(1-2):1-12. - Sobhi SI, Moham NA, "Early initiation of breastfeeding and its effect on vaginal bleeding in the fourth stage of labor." G Egypt Public Health Assoc. 2004;79(1-2):1-2.

5 Meier PP et al. Which breast pump for which mother: an evidence-based approach to individualizing breast pump technology. J Perinatol . 2016;36(7):493. - Meyer P.P. et al., Breastpump Selection: A Scientific Approach to Customizing Pumping Technology. J Perinatol (Journal of Perinatology). 2016;36(7):493-499.

6 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women s 2007;52(6):638-642. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding." F Midwifery Women Health. 2007;52(6):638-642.

7 Kent JC et al. Principles for maintaining or increasing breast milk production. 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.

8 Australian Breastfeeding Association [ Internet ].


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