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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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One product that I have been wanting to try with baby #3 (that was introduced since I weaned my last baby) is the Freemie.

The Freemie is a completely different kind of milk collection system. Most pumping systems have three major parts – a breast shield that fits over your nipple, a pumping mechanism (breast shield body, membrane/valve, etc.), and then a bottle that the milk is collected in. The Freemie has the same three things, but instead of being pumped into a bottle, the milk flows into a collection cup that surrounds the breast shields and pumping mechanism. The collection cups are compatible with the Medela Pump in Style and quite a few other pumps (here is a full list).

freemie_milk_collection_system

One of the great things about the Freemie is that you don’t need a hands-free pumping bra – you can just put the collection cups in your bra and you’re all set.

However …. the Freemie manufacturer advertises that you can “pump anywhere, in front of anyone” with your shirt on using these cups. In fact, the box shows a woman chopping vegetables while pumping (well, presumably she’s pumping – I’m not sure why else there would have been a lady chopping vegetables on a box of pumping equipment).

I am not sure that it is as easy and freewheeling as they make it sound. First, in terms of pumping in front of anyone – yes, you can definitely do that. Just to be clear, though, it’s not like no one will know what you are doing/you could do this at your desk or something undetected. First, the collection cups are rather large, so it’s obvious that you’ve stuffed your bra with something. Additionally, you still have to actually be attached to the pump itself, which means that you have tubing coming out of the top of the collection cups, and you’d have to thread that back down through your bra so that it can be connected to the pump from the bottom of your shirt. And, of course, there is still the sound of the pump.

So you can pump in front of anyone, but (in my opinion) it’s the same experience that you get with a cover and hands-free bra.

I used the Freemie system for a day when I was working from home. I wanted to love them, but to be honest, I didn’t really like them, for the following reasons:

  • Normally, I refrigerate my pump parts in between pumping sessions and only wash them at the end of the day. With these, I really think you’d have to wash everything after every use because you have to remove the collection cups to get the milk out, and I ended up needing to touch the valve and the “inside stuff” of the pump when doing that.  You don’t generally need to do that with traditional pumping systems; you can just disconnect the tubing, remove the bottle, and throw it in a ziploc bag in the fridge.
  • I found these a bit painful, as if the flanges were too small. I normally use a 27mm flange, and I used the 28mm that came with the Freemie (it comes with a 25mm and a 28mm), but by the end of the day there was definitely some irritation.
  • I was pretty concerned about spilling the milk at three different points each time I’d finished pumping – when I disconnected the tubing from the collection cup, when I opened the collection cup, and when I poured the milk into a bottle. It was sort of stressful, and this isn’t an issue with traditional pumping systems.
  • It’s not compatible with the Medela Freestyle, which I prefer over the Pump in Style because I don’t have to deal with plugging the pump into an outlet.

To be fair, it may also be that I am having a hard time adjusting to the completely different way that these work after pumping “the old way” for 3 (non-consecutive) years now.

Here are some photos of my collection cups after pumping, which might help you visualize how it works:

freemie-reviews

In summary, I love the idea, and I can see how other people might really like it – not having to deal with a hands-free bra is great! However, I am not sure that I’ll be using mine again.

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babynumberthreeSo I had (another) baby! My third (and last).

She is super easy-going, a decent sleeper, and remarkably tolerant of her older brother and sister being in her face some of the time. I also got lucky this time as nursing has been working out really well. The first few days were a bit painful, as it was a struggle to get her to open her mouth as wide as I needed to her to in order to avoid a shallow latch. But after that, it was pretty smooth – and now I’m back at work and am becoming very well reacquainted with my pump.

(I also pump at home in the mornings before work, and my four year old is obsessed with it. How it works, how much I pump, when am I going to feed her the milk I pump, can he wash the bottles, etc. I think it is sort of cute how obsessed he is with pumping since he was the baby I exclusively pumped for!)

Milk supply has been okay. Like a lot of mothers, I don’t have any problems with my supply when I’m with her and nursing, but I am struggling a bit with pumping enough. My baby eats 20 oz of milk each day at daycare, and it’s hard to keep up with that. I’m taking my own advice and am currently trying oatmeal (it does seem to help; I might do another experiment), and I’m going to give fenugreek another shot next week.

Also, I finally got myself some Pumpin’ Pals, and I am a huge fan so far.

Pumpin’ Pals are breast shields with a slightly different design, which you can see below (the Pumpin’ Pal is on the left and the Medela flange is on the right):

pumpin-pal-compared-to-medela-flangeI did a few pumping sessions with one breast in a Pumpin’ Pal flange and the other in a Medela flange, just to see how they compared. Overall, I found the Pumpin’ Pal breast shield to be more comfortable in a few ways:

  • The nipple is gradually eased in to the Pumpin’ Pal thanks to the wider, rounder design, whereas it’s a bit more “stuffed” into the Medela flange. (I thought about posting a picture of my nipples to show you what I’m talking about, but then I thought better of it. You’re welcome.)
  • Pumpin’ Pals have an angled design, making it possible for you to lean back in a chair while you pump. (I tried leaning back with the Medela flanges too, and while it could theoretically work it’s a lot more likely you’ll spill than with Pumpin’ Pals.) All you need to do is lean forward again before disconnecting yourself.
  • Because the flanges encompass more of your breast, it’s much easier to hold onto them (if you’re not using a hands-free bra). Also, when you hold onto them, the rounder bottom means that the edges don’t dig into your hands.

About the only negative that I had with the Pumpin’ Pals is the price – they are $35 for three sets (one of each of the three sizes). I have conflicting thoughts on this – I had to buy four different sizes of Medela flanges to figure out what was the right size, so it was nice to have them all to try at once (and this cost less than the four separate Medela purchases). However, now that I know what Pumpin’ Pal size I need, I’d like to be able to just buy a few extra sets in just that one size, but they only sell all three together. (Although, looking at the website, they say that most moms can use two of the three sizes, so I’ll have to try that.)

However, if you’re an exclusive pumper, you’re going to be spending enough of your time with breast shields on your breasts that it probably makes sense as an investment, particularly if you have nipple pain related to pumping. They also have a 100% money back guarantee if it doesn’t work out, so that’s nice.

The other thing that has been a little weird for me is that you can’t really massage while pumping with these flanges, because they cover so much more of your breast. The website says that that is a feature, not a bug – you shouldn’t need to massage because the flange is doing that work for you. I haven’t been able to get used to that, though!

I’m going to try out a few other products that weren’t around the last time that I pumped – the Freemie for one and maybe the Kiinde. Any other recommendations?

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