I see many new families in the hospital, breastfeeding clinic, and in their homes with my private practice, and I hear many common questions. One of the recurring themes comes across in statements like “my baby can’t be getting very much” or “my baby is feeding so frequently, I must not have milk. This cannot be normal!” There are many charts on the Internet that show an illustration of the size of a newborn’s stomach, I felt putting these illustrations into real world sizes we can see would be helpful.
Below is an illustration I have created showing the approximate size and volume of a newborn’s stomach on day one, day three, at one week, and at one month. Newborns’ tummies are tiny, and cannot/should not take in large volumes, so they need to feed frequently. In the first day or two, their little tummy fills with 2-20 ml during a breastfeed, and then, snuggled in close to your warm chest and familiar heartbeat, they fall asleep. Just as you may be drifting off to sleep or decide that you too should eat something, they start to wake up and show signs of hunger; their sweet little fists fly frantically to their mouth and their lips start smacking together. Their little tummies have started to digest that perfect amount of colostrum, and they are starting to get hungry again. A newborn baby feeds 8-12+ times in 24 hours, which means they will be feeding about every 1-3 hours. After the first 24 hours and for the first week or two the baby should feed the minimum of 8 times in 24 hours to ensure they stay hydrated (shown by pees and poops), assist with things like jaundice and weight loss/gain, establish Mom’s milk supply properly and get lots of practice at the art of breastfeeding.
They often cluster feeds together; this means your precious little one may breastfeed for 45 minutes then fall asleep, then wake 30 minutes later and feed for another 30 minutes, and fall asleep. The next feed may happen 2 hours later, then 3 hours after that, then an hour later… I’m sure you get the idea; there is no set schedule. This is the best way to establish a healthy milk supply and to allow baby to control when they eat and how much. You can not breastfeed your baby too much, but you can breastfeed them too little.
Many families feel the need to supplement their baby; maybe they are concerned with the frequent feedings, or feeling pressured from their doctor or family. I often hear my clients comment that they hear their well-meaning family members say “The baby is crying again, she must be hungry” or “The baby is fussing, are you sure you have milk?” or “the baby just ate an hour ago, you must not have enough if he is hungry already.” This can create, or further feed the insecurity a new mother may already be feeling, and often leads to unnecessary supplementation. Some families feel they need to supplement due to pressure from the Doctor, and other families are supplementing for legitimate medical reasons (these reasons should be clearly communicated to you). When you are supplementing it is crucial that you keep in mind how small those little tummies are. If you supplement too much this will cause baby to sleep longer and feed less frequently and any time they are supplemented away from the breast you losing the stimulation and removal of milk needed to signal your body to make more milk; this will directly impact your milk supply. If you are supplementing always seek guidance from an expert in feeding- a board certified lactation consultant (IBCLC) will help guide you through how to supplement, how to protect your supply while supplementing and how to wean the supplements when the time is right.
Understanding the size of your Baby’s stomach, the average volume taken in during a breastfeed and typical newborn feeding frequency can help alleviate some anxiety a mother feels when she is trusting her body to nourish her child. Newborns are only this tiny for a short time, those stomachs grow quickly and they get more efficient at breastfeeding which means breastfeeding sessions become less frequent and shorter. For now enjoy those snuggles, and feel encouraged that your baby is feeding frequently and doing a fantastic job of “demanding” a healthy supply of breast milk. The great effort you and your baby put in during the first few days establishes a solid start for a happy and healthy breastfeeding relationship.
Katie Wickham RN BScN, IBCLC