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how-much-milk-breastfed-babies-eatWhen you’re exclusively pumping for your baby – or even if you’re both nursing and bottle feeding pumped milk – it can be hard to know exactly how much your baby should be eating. How much should your baby get per feeding? How much should he or she eat in a day?

Many people feeding pumped breast milk (including me, when I was a new, confused, and sleep-deprived exclusive pumper) refer to formula feeding guidelines for an idea of how much they should be giving their babies. However, formula and breast milk aren’t the same – for example, breast milk is metabolized faster than formula. And because most breastfed babies are nursed, there is no way to tell how much they are taking in (short of weighing them before and after every feeding with a baby scale).

I recently did a survey of women that exclusively pumped for their babies, and one of the questions that I asked the respondents was how much milk their babies ate on a daily basis. I’ll go through these results first, and then go through the recommendations for formula fed babies to see how they compare.

What is the average milk intake per day for breastfed babies drinking from bottles?

The overall average intake for babies across the first year was 26.8 oz (792.5 ml); after one month of age, the minimum reported daily intake for was 16 oz (473 ml) and the maximum was 48 oz (1,420 ml). Below is a chart showing how the results were distributed:

how-much-do-breastfed-babies-eat

Here we can see that most babies eat between 24 (710 ml) and 30 oz (887 ml).

As one might expect, breast milk intake varied slightly with the baby’s age, with it averaging slightly lower in the first month of life and then increasing up to between 26 and 28 oz (770 and 828 ml) until about 10 months of age. At this point, presumably, solids are making up a more substantial part of the baby’s diet, and the average drops down to 25 oz (740ml) at 10 months and 19.5 oz (577 ml) at 11 months.

milk_baby_eats_by_age

I also looked to see if breast milk intake varied by any other factors that I had asked about in the survey, such as the age of the mother, whether the baby was a first baby or a subsequent child, and race. I didn’t find any statistically significant differences based on maternal or child characteristics, except for the age of the baby as described above.

The one relationship that I did find with regard to a baby’s intake of breast milk was the amount of milk that the mother pumped. Mothers that pumped more milk tended to feed their babies more milk.

This could be for a few different reasons. For example, mothers that switched from nursing to exclusive pumping might be closely in sync with the amount of milk that their baby needs. Additionally, women with supply on the low end of the spectrum that have babies that also don’t need as much milk might not work to bring it up as much as mothers whose babies take in more.

How does this compare to formula feeding guidelines?

I was curious whether or not the results that I got in survey would be similar to formula feeding guidelines, so I looked up the American Academy of Pediatrics guidelines. Reading them is a bit confusing, as the descriptions of appropriate intake use three ranges – the age of the baby (i.e., 1-3 months), the amount of formula (i.e., 2-3 oz), and the number of feedings (i.e., every 3-4 hours).

To simplify things, I broke the guidelines down into the below table:

baby_formula_guidelines

Here we can see that the total daily recommended intake is fairly close to the averages reported above for babies by age. The recommendation is slightly lower in the beginning, but on par with actual totals for breastfed babies by six months.

The guidelines specifically state not to feed a baby more than 32 oz (946 ml) of formula per day. I’m not sure whether or not that recommendation would also apply to breast milk, but over 10% of the respondents’ babies drank more breast milk than that on a daily basis.

(Including mine! The baby that I exclusively pumped for was a really big baby who ate 40 oz of breast milk on the regular, so hopefully it’s not an issue for breast milk.)

Note: The typical feeding schedule for breastfed babies may be very different from that of formula-fed babies. It’s more common for breastfed babies to eat more often and less on schedule than formula-fed babies, likely because (as noted above) breast milk is metabolized more quickly than formula. This discussion is only about total intake.

So, what should you do with this information?

I get frequent questions as to how many ounces should be in a baby’s bottle at given ages. My goal with this post was to be able to give mothers a ballpark as to what is “normal” for breastfed babies to eat in a given day, and if you want, you can use this as a starting point that you can tweak based on your baby’s needs. As you can see from the first chart, there is a huge variation in what breastfed babies will eat in a given day – your baby might be one that only needs 20 oz per day or one (like mine) who needs a lot more.

Ultimately, though, I would let your baby be your guide. If he finishes his bottle and still seems hungry and isn’t soothed by a pacifier or any of your other tricks, then I would go ahead and feed him more. If he’s on the other end of the spectrum and just doesn’t like to eat much, I wouldn’t push it unless there is an issue with weight gain (and then I would discuss the best approach with your pediatrician).

Note: If you’re a data geek like me and interested in more survey data, I wrote an e-book about exclusive pumping and milk supply that makes extensive use of it; you can check out here. I’ve also written this post and plan on additional ones in the future.

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exclusive pumping story

Today we have another exclusive pumping story! Below is Ashley’s story about exclusively pumping for her son after he wasn’t gaining weight through nursing. 

I was upset one night because I couldn’t figure out why my son and I couldn’t get the hang of nursing. My husband told me that we should only ask Mother Nature for one favor, and I had used up that favor in avoiding a medically necessary c-section by having my partial placenta previa move itself (at 35 weeks) so that I could have the natural delivery that I so badly wanted. I thought nursing would be easy; I read a lot of books about it, how good it was for the baby and I’ve seen many women in my family do it, as well. Why wasn’t it working for my little guy and me? It’s a natural thing, so it should be easier than this, I thought.

In the hospital, after delivery having no luck with the first few hours of my son’s life, I asked the nurse to grab me a pump so I could get him some milk. That first night I pumped almost a 1/2 ounce of colostrum for him and fed him with a cup. Every nurse we had while in the hospital tried to help us, but we just couldn’t get the hang of it, so I continued to pump and tried to nurse.

Nurse, Bottle Feed, Pump

We saw a lactation consultant a few days after we were home and she gave us a lot of pointers, but he still wasn’t getting anywhere near enough milk from me. She gave us this plan: I would try to nurse him, then feed him a bottle, and then I would pump. I would need to do this 8-12 times a day. She had also said that since he was born about 2 1/2 weeks early, he was considered a late preterm baby, and he wouldn’t have some of the full term newborn feeding instincts until we were closer to his due date.

I left that appointment in tears; it was so overwhelming. I was a first time mom, absolutely exhausted, and I had to try and complete a three step program to get him to eat every two hours. Even with the help of my husband to bottle feed him while I pump, it was too long of a process when he needed to eat every 2 hours. How was I going to keep this up when he went back to work? I had a ton of self-inflicted guilt, mostly from all the books I read about how feeding a baby from the breast is the absolute best and how they only get certain benefits from eating that way versus drinking expressed milk.

Needless to say, I tried as much as I could, but I couldn’t do it at every feeding. Not only was I physically exhausted, but this drained me emotionally. During all this, I was also trying to recover from heavy blood loss during delivery and high blood pressure for weeks after. I felt so overwhelmed.

Possible Tongue Tie?

We had our second lactation appointment after what would have been his due date. When they weighed him, it showed he took in no milk. I think the lactation consultant had no answers for us because she said that my son was tongue tied and when we had that corrected he would be able to nurse. I held onto this hope even though our pediatrician had already checked my son for this after he was born. My son also had a habit of clicking his tongue, so I was in denial about this possibility. My husband and I brought this up to him at his next appointment and he said he wasn’t tongued tied.

That was my last of glimmer of hope that we would figure this out. I still felt guilty that we couldn’t get the hang of this; like it was somehow my fault. I continued to pump regularly and try to breast feed him, maybe once a day, was my goal but with no continued success.

Making the Decision to Exclusively Pump

At our little guy’s one month appointment, the doctor asked how his latch was. I said, embarrassed, that he wasn’t latching, and I was still just pumping. He told me “that’s okay – you’re still breastfeeding! You’re getting him what’s best for him, your milk.”

I left that appointment feeling SO much better. I thought to myself, “He’s right. I am still breastfeeding, just not nursing.” I did a little research on exclusive pumping, I found this blog, and came to the decision that this was right for me and my son. I felt relieved for the first time since he was born about what I was doing. At the end of the day, no matter how much I wanted nursing to work, I had to look at what was really important to me, and it was my son getting my milk whatever way he could.

I felt such a relief once I made the decision to exclusively pump. We had really gotten into a routine, and it was working well for us.

9 Months of Exclusive Pumping

I exclusively pumped for 9 months. I chose to stop at 9 months because my son was becoming very mobile, getting into everything, and it was hard to stay hooked up to the pump long enough. Fortunately I had oversupply while pumping, and I managed to save about 1750 oz. (We had to buy a deep freezer to store it all!) I am very lucky to have had the oversupply, and even now that I have stopped pumping, my son is still getting my milk. We should have enough until he is about 1 year old.

There were times I wish we could have gotten the hang of nursing (like when my sink was filled with bottles and pump supplies to wash or when I had to plan where I could pump if I was out of the house for more than 3-4 hours). It wasn’t always been easy, and it was a lot of work, but when I look at his little face that is growing every single day, it is worth it to me.

I wanted to share my story because reading about others’ experiences with exclusive pumping helped me so much with my decision. It was really hard on me at first not being able to nurse, but looking back on it, I did the best I could with the situation I had, and I’m proud of myself.

A big thank you to Ashley for sharing her story! Fantastic job pumping for 9 months! 

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exclusive pumping story

Today we have another exclusive pumping story! Below is Kristine’s story about exclusively pumping after her daughter had both a tongue tie and a lip tie. 

Why did you decide to exclusively pump?

I decided to exclusively pump because my daughter had major issues with latching on – it was terribly painful for me, hard to get her to latch on, etc. Before she was born I “just knew” I would exclusively breastfeed, had intended to breastfeed her for at least a year, and understood the importance of breast milk.

I was devastated when breastfeeding just wasn’t working out, especially since my daughter was born a tad early and very thin due to complications. I had never heard of exclusive pumping, but got on the pump at the hospital, and then learned online about exclusive pumping. I was bound and determined to give her as much breast milk as I could make, and decided this was the only reasonable solution.

As an aside, we were able to take our daughter to a pediatric dentist who evaluates and treats babies for tongue and lip ties on the recommendation of a lactation consultant. It turns out she had both (which apparently can and often do cause a very painful latch), and we were able to correct them when she was about 6 weeks old. By then I was already in a good rhythm with exclusive pumping, and was somewhat mentally scarred from the nursing experience, so I actually decided to just continue with exclusive pumping instead of trying to nurse again.

How long did you end up exclusively pumping?

I pumped long enough to have enough milk to get my daughter to six months of breast milk. That ended up being right around 5.5 months of pumping, including the time it took to wean from the pump.

One of my big reasons for breast milk was to expose her to various tastes and allergens, so I felt good about getting her to the point where once she switched to formula, she would also be taking in some solids.

How did you make exclusive pumping work for you? Was there anything in particular that made it easier for you (products, tips, etc.)?

There were several factors that were key to making exclusive pumping a success.

First, both I and my husband were on board with it and committed to making it work. For example, unlike nursing, where I could have taken my daughter with me if I was away from home and fed her wherever I was, lugging my hospital-grade pump to a restaurant or a friend’s house or most any other place realistically wasn’t going to work. So we had to be okay with curtailing normal life as well as working around my pumping schedule (e.g. being flexible about going out to eat after I was done pumping). I also had a lot of issues with blocked ducts, etc., so it would have been extremely easy to give up but for our determination.

Second, renting a hospital grade pump. This pump was instrumental in getting my supply up because my daughter never really breastfed, therefore it took a long time to get my milk to come in via the pump and to get it up to the point where I was able to provide her with all of her intake. The hospital grade pump was amazing.

Third, buying extra pump equipment. I think I have at least six sets of all the supplies. This was key because I wasn’t constantly washing my supplies after every pump. Usually we only had to wash them once every 24 hours, and that made it more bearable.

Fourth, getting on a schedule and sticking to it. I was obsessed with my pumping schedule, partially because I needed to get my supply up, and partially because I had issues with blocked ducts if I didn’t pump enough or waited too long to pump. But this led to my being able to pump 36 ounces every 24 hours, which helped with the fear of not having enough milk for my daughter as well as keeping up with her intake. Because of my small “storage capacity,” I had to still wake up in the middle of the night up until I started to wean from the pump, but I stuck with it.

Fifth, your website and the Kellymom website, have a ton of valuable and useful information. [Thank you!] They really answered all my questions and provided great tips about breast milk intake, exclusive pumping information, etc. You both got me through some terribly rough patches!

What was your biggest challenge with exclusive pumping?

There were a couple of big challenges with exclusive pumping. Granted, I’ve only done exclusive pumping, so my perspective is likely skewed.

First, I had a lot of issues with plugged ducts, even though I stuck to a very rigid schedule of pumping and used a hospital grade pump. I’ve gathered that those are more common with pumping versus breastfeeding. They were awful, and each episode took a ton of consistent pumping and active massaging throughout the day to get rid of. (Soy Lecithin also really helped me).

Second, getting up to pump at night was exhausting. I was able to get my supply up through round the clock pumping, but then I still couldn’t sleep through the night because of my large supply, plugged ducts, etc. I don’t do well without unbroken sleep, and getting up at least once a night to pump (long after our daughter began to sleep through the night) was very destructive. Granted, this might also be a problem for me with breastfeeding too though.

Another big challenge was my perceived “loss” from not being able to breastfeed, have that connection, etc. But in a lot of ways I realized there are a lot of advantages to exclusive pumping. First, I realized that plenty of breastfeeding women are on their phone, etc. while breastfeeding, and so I felt I was “connecting” just as much or even more when I held my daughter and fed her a bottle and paid attention to her. Also, now my husband and others could feed her and feel that connection too. And, because we could tell exactly how much she was eating at every feeding, we both felt more at ease and worried less about her intake.

Another challenge was the worry of keeping up with my daughter. For the longest time I worried I couldn’t make enough to keep up with her demands. Eventually I was able to boost my supply AND simultaneously stockpile a large amount of extra breast milk, but until then I was really worried. However, I’ve come to personally realize that formula isn’t evil, and that you shouldn’t beat yourself up if your baby needs more than you can produce. The stress of worrying about all of that was really ridiculous, and in hindsight I shouldn’t have beaten myself up!

What advice would you give to a new exclusive pumper?

My one piece of advice is that with the right pump and your commitment, you can get your supply up, keep it up, and make exclusive pumping a success. I’m not a doctor, but I feel that if you are committed to providing breast milk and keep at it, you will achieve a lot with exclusive pumping and likely be able to provide your baby with breast milk.

A big thank you to Kristine for sharing her story! 

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