IS MY BABY EATING ENOUGH?

From week two on, you should already have a sense of his eating habits such as:

 

• how well your baby latch

• how fast he swallows

• how active he is on the breast

• how frequently does he burp 

• how often he show signs of hunger etc..

 

but generally speaking during the first month of life, most babies feed at about every 3 hours. This is a common feeding cycle you should aim for to promote a healthy routine beneficial for both baby and mother, but reachable only if your baby has effective feeding sessions. Unfortunately, most mothers struggle right on this key point, “effective feeding sessions”, especially mothers that choose to exclusively breastfeed. A common scenario is having your newborn constantly falling asleep on the breast when he should eat, using your nipple as a pacifier.

As you can imagine this can easily turn into an exhausting cycle of having to feed your baby much more often than you wish for, since he keeps falling asleep during his feeds, learning to "snack" frequently rather than eating full meals.

 

This is by far one of the most common mistakes among new mothers because unaware of techniques that can help them keep their baby active on the breast and improve his eating habits.

Think of it this way…breastfeeding for a baby it’s equal to a workout session!

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During those first weeks of life, babies are very sleepy and have little to zero energy in their small bodies. It takes lots of effort for them to suck milk out of your breast. On top of that the cuddling position they found themselves in while breastfeeding, together with Momy's body warmth, makes them fall asleep on the breast in no time!

As per consequence, your baby will end up frequently taking small quantities of milk rather than eating full meals, asking for food more often than he should because constantly hungry. A domino effect of bad sleeping patterns will inevitably follow, since your baby will wake up more often from hunger, never reaching deep sleep which is crucial for his development.

 

This is why many mothers end up feeding their baby as often as every 2 hours, some of them even every 1.5 hours. This is obviously super unhealthy and extremely unsustainable, and one of the reasons why too many women experience post-natal depression. As you can imagine if not corrected in the early days, this way of feeding is not efficient, and you’ll end up with a baby that is constantly “snacking” and using your breast as a pacifier that aids him to sleep.

Check my breastfeeding post in here to learn more about effective feedings and latching positions.

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Anyway, let's start understanding how frequently and how many ml, (or oz), your baby should eat per feed each day from week one to weaning age...

Assuming you have managed during those first weeks of motherhood to channel the 3-hour routine, the next step would be to help your baby transition into the 4-hour routine.

As the name suggests in this routine you are supposed to space out your baby's feeds farther apart, (every 4 hours), since he will start eating bigger quantities. Bigger feeds not only will help him satisfy his growing appetite, but it will also give him the chance to have longer breaks in between meals which are essential for him to properly digest before approaching his next feed..a great way to avoid frequent posseting!

 

He will also have the chance to enjoy longer naps and go into a deeper state of sleep which is crucial for his development, something not possible when feeding too frequently.

You see how everything is connected to each other and how healthier the whole process gradually becomes. 

But again, this is only achievable if your baby eats full feeds at each feeding session.

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Some babies are able to transition into the 4-hour routine quite early on, (from week 3-4), while others may need more time to reach that progress but this goes hand in hand with how quickly you’ll be able to increase your milk intake quantity per feed.

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When I say "full feeds" I mean the maximal capacity your baby's stomach is able to take at that time, as you can imagine this changes as your baby grows and is slightly different in each infant as we have to take into account variables such as age, weight, and metabolism.

It's also important to mention that full-feeding sessions are easier to achieve with bottle-fed babies or mix-fed babies, (when a bottle top-up is given after a shorter breastfeeding session).

Mixed feeds are the most common approach in most families as they are much easier to manage without compromising the prioritization of breastfeeding.

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Babies are always easier to keep awake when feeding through a bottle as the milk flow it's much faster and it takes less effort for them to suck, so they can take bigger quantities in less time and without getting too tired.

But of course, there is also the other side of the coin; you don't want your baby to constantly fall asleep on the boob, yet you don't want him to get too used to the bottle and become lazy on the breast.

As for anything in life, I believe balance it's the answer, that's why mixed feeds are usually the best option for most mothers. You can start with 20-30 minutes of active breastfeeding, (when your baby is at his hungriest), and complete his meal with a small top-up in the bottle before he gets too tired, (which can be either made with formula or expressed milk, depending on your supply).

This way you have the best of both worlds, granting your little one full meals without exhausting him with long latching sessions.

I know breastfeeding is a top priority for most women, (as it should be), and I am always encouraging women to practice good latching sessions, even when breastfeeding it's particularly challenging, however, it's important to be realistic and understand that it's nearly impossible for babies to breastfeed for long chunks of time without falling asleep.

So unless you are ok with feeding as often as every 2 hours and are completely sleep-deprived, you need to promote good feeding habits since the early days.

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As previously mentioned breastfeeding is physically exhausting for newborns and long latching sessions are not ideal when trying to channel babies into a healthy routine.

So although I will always encourage mothers to prioritize breastfeeding, I also encourage them to do it the proper way as keeping your baby asleep on your breast for over an hour, with your tit in his mouth, it's not really  feeding, (I'll see it all the times!)

Remember it's all about quality, not quantity..your baby can take double the milk in 20 minutes of active feeding than in 1 hour of bad latching, so it's absolutely pointless to exhaust both yourself and your baby with long feedings if your baby is not really eating. It's also very difficult for mothers to estimate how much milk their baby is taking from their breast since you don't really have a way to visually measure the quantity as you do instead with a bottle.

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For all these reasons most mothers who choose to exclusively breastfeed their babies are usually struggling with the "baby-led" approach, (feeding on demand at random times), since a routine it's much harder to achieve this way.

Anyway, there is an actual equation you can use as a guide to calculate the optimal milk quantity your baby should have per day, and it works as follows:

 

180ml (milk) x kg (body weight): number of feeds (per 24h)

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So..if for example your 2-week-old baby's weight is 4kg, his ideal milk intake should be around 720-750ml per 24 hours, and assuming he is feeding 8 times per day, each feed should be around 90ml.

If instead we take as an example a 2-month-old baby that weight about 5.5 kg his daily milk intake should be around 990ml and assuming he is into a good routine, feeding only 6 times per day, (as older babies can often do), each feed should approximately be around 160ml

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As you can see I've rounded each quantity as this is an approximate calculation only designed to be a reference point since variables are always to be taken into account and babies are not computers.

Body weight is a good reference point but metabolism and personal appetite can drastically affect the milk quantity your baby will take. For instance, we all have that skinny friend who is constantly hungry and eats double the food quantity we can eat while being half our size...so as you can understand body weight it's one value of the equation but other factors can impact the result.

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Now the structure of the 4-hour routine should be a steady achievement you maintain until weaning age, (6 months on), the only difference should be the gradual increase of your baby's milk per each daily feed with the parallel gradual disappearance of his night feeds.

Remember, the better he eats during the day the less he will ask in the night.

But let's go back to breastfeeding for a moment, how can you tell how much milk your baby has eaten?

Well, experience will be your best teacher and with time you will get a sense of how much your baby is eating even on the breast as you will build more confidence and learn to read his cues.

However, the best indicators that can help you estimate an approximate quantity are burps.

Yes, in this case, burps are your best friends!

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In the first couple of weeks, newborns usually need to burp after every 10 to 15ml of milk (approximately). From week 3 on you get great burps out every 20 to 30ml. After that, burps are almost always ready to come out every 30 ml.

It's important to burp frequently but not too early.

If you try to burp your baby too soon, you will most likely upset him as he won't have eaten enough milk for him to push air out and he will get easily crossed because hungry.

So let him actively latch for a few minutes until he starts slowing down, (which is usually a great indicator for a burp).

When he looks like he is about to fall asleep, try to go for a burp.

The action of burping itself will help you keep your baby awake, as the air trapped in his belly is giving him a false sense of fullness, very similar to a post-feed "milk coma".

So as you can understand, proper burping is another key factor to achieve full feedings otherwise you will end up with a sleepy baby that will give you the illusion of being full of milk, (while full of gas instead), only to end up crying for hunger again a few minutes later. 

Other side effects of not burping well your baby are:

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• hiccups

• posseting

• colics

• crying

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So remember,..use the formula I gave you to calculate the approximate daily milk quantity your baby should take based on his body weight, promote active feeds, and burp well.

If you can master these basic fundamentals you are already in a good place.