Even though it is a pretty well-known fact that breast milk is the best option when it comes to an infant’s diet, many care givers have no idea how much milk to feed a breast fed baby. Formula fed babies and breast fed babies will develop different feeding habits and take in different amounts of milk.
A breastfed baby should not be getting fed the same amounts as a formula fed baby. Unfortunately, since many care givers do not understand this concept, this commonly leads to overfeeding.
Today I am going to talk about the details of breast milk and child care, the problems with overfeeding, and how to address your concerns with your child’s routine care provider.
The idea for this post came to me from my own personal experience with my baby getting overfed at daycare.
Like many other new moms who plan to breastfeed, I spent countless hours of my maternity leave pumping to try to build up a freezer stock of breast milk for when it was time to go back to work. Although I did not stock up as much as I would have liked to, I had ended up saving enough for about 30 feedings.
My baby was scheduled to go to daycare 3 days a week (Mondays, Tuesdays, and Wednesdays) from 8am to 4pm. Initially, I assumed my baby would continue the same feeding routine she had at home and eat around 9am, 12pm and 3pm, taking in about 4 ounces at each feeding. Because I have been exclusively pumping and bottle feeding my expressed milk, I knew exactly how much she typically drinks.
With her regular schedule in mind, I took a total of twelve 4 ounce bags of frozen breast milk to daycare to get her through her first week. My thought process was that she would typically eat about 3 times between the hours of 8am and 4pm, but I sent her with enough for 4 feedings each day, that way should would be covered if she needed some extra.
I was a little surprised when I picked her up from daycare the first day around 3:30 pm and the teacher informed me that she only had 8 packs left, but I figured she may have been extra hungry and the change of environment may have affected her eating habits. Also, I know that the nutritional content can be slightly lower in frozen milk vs fresh milk which may have caused the baby to not stay full as long.
The next day, I went to pick her up and discovered she had eaten 4 times again. I had talked to the teacher this day, and she informed me that she makes sure to offer the smaller babies a bottle every 2 hours. At that time, I decided to wait it out and see what happened, especially since the fat content of the milk may be decreased, and she was not used to drinking that much thawed frozen milk in one day.
Maybe she really did need to be fed every two hours while she was there. It also did not seem to affect her eating habits at home, so I thought I would let them continue this schedule.
When I went to pick her up on that day, I was informed that she needed more breast milk and they had to supplement her with formula because she drank two 8 ounce bottles of breast milk that morning!
I was completely shocked at the thought of this, and very concerned.
First of all, I had never fed my baby more than 4 ounces at a time, I had tried to give her 5 ounces once, and she spit up as soon as she was finished with it. That was part of the reason I sent her to daycare with bottles that held only 4 ounces, and frozen milk in 4 ounce increments. They literally had to give her 2 bottles back-to-back.
Second of all, I had never given her formula, and was not really thrilled at the thought of her having formula at daycare for the first time instead of in my care in case she had a bad reaction to it. Plus, I really was not planning on giving her formula, unless I stopped producing enough breast milk for her.
I left the daycare in tears that day, as I thought about what had happened, and how I was going to address it. I did not want my baby to be overfed, and there was no possible way my body would produce enough milk for her to continue drinking 8 ounces of milk every 2 hours.
In order to prevent a similar heartache from happening to you, keep reading!
So how much expressed breast milk should a baby drink?
In general the amount of formula given to a baby throughout the day is adjusted based on his weight. Amazingly enough, that is not the case for breastfed babies. There has been extensive research that shows that the amount of breast milk a baby drinks throughout a 24-hour period does not change much between the ages of 1 month and 6 months.
After 6 months the amount of milk will actually decrease as the baby starts eating solid foods. The normal range of expressed milk a baby consumes is between 19 and 30 ounces a day.
If you are nursing and want to figure out how much breast milk your baby will need while you are away, figure out how many times your baby nurses on average during the day.
Then take the number 25 and divide it by the average number of nursing sessions. Use the number 25 because it is in the middle of the normal range.
The result should be the typical amount of breast milk you would need for each bottle, give or take a little depending on if your baby is on the higher or lower end of the range
If you want to be more specific about how much breast milk your baby drinks at each feeding, you could check out the Hatch Baby Grow Smart Changing Pad and Scale. You can use it to weigh your baby before and after each feeding and it will use an app on your phone to keep record of how much milk she is taking in.
Obviously if you are exclusively pumping, you will already have an idea of how much milk your baby normally drinks.
Talk to your care provider about these ranges and your expectations of how much your baby should be eating.
Back to my baby
Since I have been exclusively pumping, I already know that my baby eats 6 times a day, taking in an average of 24 ounces total a day on a regular day, and will occasionally want an extra feeding and have a total of 28 ounces on those days.
When I picked her up from daycare that third day, she had consumed a total of 24 ounces in 8 hours. That is typically the amount she eats in a 24-hour period on a regular day. I had already given her 4 ounces prior to dropping her off, and knew that she would normally want to eat at least two more times.
That would be a total of 36 ounces in one day! Luckily she took a bottle around 7 pm and did not want to eat again until morning, I was surprised.
A baby is going to take in milk much faster when drinking from a bottle vs strait from the breast.
That is why it is best to pace feed a breast fed baby, so that it is easier for her to process when she has had enough milk.
In order to do this, angle the nipple of the bottle a little lower so that she has to work a little hard to pull the milk in, and stop the flow of the milk multiple times throughout the feeding to allow her time to catch up. Also, try to burp the baby half-way through the feeding to give her a break from drinking and to help get rid of any access air she may have swallowed.
Ask your care giver if he or she pace feeds the baby, if not it could contribute to overfeeding because the baby is not going to process that she is full as easily, when the milk is flowing so quickly.
You are also going to want to make sure you use the slowest flow nipple the baby will tolerate. You may want to consider finding a bottle that is designed for breastfeeding babies. These bottles usually make it easier for the baby to switch back and forth between breast and bottle and typically have a slower flow.
Know your baby’s cues
Some care givers overfeed a baby, simply because it seems like the baby is still hungry.
My baby spends a lot of time with her hands in her mouth. Even though many people will tell you that is a “hunger cue”, I know that my baby, like many other babies, finds comfort in sucking.
When I see her with her fingers in her mouth, I will offer her a pacifier before offering her more food. I also offer her a pacifier after she has finished a bottle if she does not seem satisfied. Most of the time, all she wants is to continue sucking, and since the bottle is taken away when it is empty, she has the tendency to get upset about it.
I understand why a caregiver would see that and think that she is still hungry, however, if they had just tried giving her a pacifier instead of another entire bottle, she probably would have been fine.
Some care givers use feedings as a comfort measure whenever the baby gets fussy. If you know that your baby likes to be soothed a certain way, let your care giver know about it.
Sometimes a baby just want to be held or rocked, or something else entirely non-food related.
Things to remember
Make sure to discuss your concerns about feeding with your care provider before your baby is in their care. Overfeeding can be prevented and sometimes it just take a little extra communication and education.
Talk about how much your baby normally eats and ways your baby is normally comforted. Ask about pace feedings, and make sure you are using the right bottle and nipple combination. If you have discussed all of these things with your care provider and find that your baby is still being overfed in their care, talk to them about how much a breastfed baby typically eats and that they do not eat the same way as a formula fed baby.
It could be as simple as they do not realize that a breastfed baby does not need to drink as much volume as a formula fed baby.
Breast milk is very valuable to the mother that put in the work pumping it out, do not let it get wasted while your baby is being overfed in the process.
I truly hope you find this post helpful, please leave any comments or thoughts in the comments section. I would love to hear your stories if you have any! As always I will do my best to respond as quickly as possible!