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 lose 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. Every baby is different and the size of your baby can impact how much they require/can take in by supplement. Small term/preterm babies will often have trouble taking in the same volume as an 11lb newborn baby. Seeking support will help customize supplementing based on your unique situation.
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
https://www.facebook.com/BabiesFirstLactationAndEducation
*Original image has been updated 2 times to improve clarity and quality. This image and any others on this topic by Babies First Lactation and Education may not be altered in any way or used without permission. For information on using this image please contact Katie at info@babiesfirstlactation.com
Hi Katie, I LOVE, LOVE, LOVE your website, and info. Pix of milk above are great!!! But, one question… isn’t the first day 5-7ml which is 1-1.5 TEAspoons….. Not TABLEspoons???? 🙂 thank you
Sharon,
Thank you for your positive feedback and keen eye! My hubby did the editing of the photo for me and I totally didn’t realize he had written tablespoon instead of teaspoon. I will be fixing it. The exact conversion for 5-7ml into teaspoons was 1-1.4 tsp so that was what I went with instead of the 1.5 tsp you wrote above 😉 I’ll fix it here on my blog and will most likely repost on facebook.
I really appreciate it. I love making these images to help my clients and for use when I am teaching courses so there will definitely be more to come!
Sincerely,
Katie Wickham RN BScN, IBCLC
Whilst all this is fantastic news and what mothers need to see, do you not think you are making some women feel more guilty when they cant breast feed for some reason?. My first time i was 20, had inverted nipples and No One helped me or mentioned it at the clinic. The second time i did fine as i was given positive feed back from a midwife.
Hi Rosemary,
Thank you for your feedback. My goal in creating these images and sharing the essential information is purely to help new Mothers understand how this all works and support them in their breastfeeding goals. If a Mother is feeling guilty for the way her breastfeeding journey ended, I feel sad for them that they were not given the proper support to make breastfeeding work for them. It is very rare to not be able to breastfeed and even mothers who are impacted by medical conditions like IGT that cause very low supply of milk can still ‘breastfeed’ it is never all or nothing and as a Lactation Consultant I make breastfeeding work the best way it can for each Mother/Baby. My images cannot make anyone feel guilty unless they are already there themselves. It is not my responsibility to manage other peoples feelings. With my clients and anyone who asks me for support I do everything in my power to make them feel supported and reach their goals in every way I can- including educating with images and blogs like this. I’m sorry you struggled the first time around and did not have the proper support to makes things work for you but I am happy to hear you had a positive experience the second time around.
Katie
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Hello,
Thanks for referencing my blog in your blog. Did you want the updated photo? Please email me info@babiesfirstlactation.com
this is such a valuable resource for reassuring Mum’s about what their baby needs/gets. My son was a forceps delivery and was in a lot of pain feeding so it was a distressing process learning to breastfeed for both of us. First off though he was simply knackered from the whole process and barely woke to feed. In hospital this was seen as an issue by the junior midwife monitoring us that first day so I was pressured into giving him formula and feeling bereft at not being able to feed him myself. When I look back now and compare to your amounts here it makes total sense of why my community midwife was so cross that I’d been put in that position saying ”your milk is enough” when she visited me in hospital on day 5. I’d been expressing day and night into a syringe and feeling my 1ml each feed was inadequate compared to the 10ml formula. Thankfully after 2 days I felt strong enough to trust my instinct and ditch the tops ups (increased to 20ml on day 2) encouraged by a different midwife who simply said ”missing a feed isn’t the end of the world if he’s tired or not interested – he’ll soon get the hang of it when he gets hungry”.
this is awesome. would’ve loved this when i had my babies!
Very good article. Bravo.
How often should baby eat at 3wks and 1 mo, etc? Same, or when does it space out further? My 19-day-old won’t stay awake long enough at breast to get full or stimulate my production, so I’m supplementing along with bfing and some pumping. He takes 1.5 to 2oz. from the bottle after bfing, but a couple times he has burped and some has come out his nose. He had gotten down to 87% of birth weight and was scary skinny, so I’m desperate to get some weight back on him and him not end up in the hospital, but obv. don’t want to drown him either. We’re working with an LC and see her tomorrow but wanted another opinion too. Thanks!
Beverly, Learning to nurse is hard, bottles are easy. When you are supplementing with the bottle you are removing the stimulation to your breast that triggers production. I hope you have a great visit at the LC. Just remember you both are learning, baby’s mouth and suckling skills are getting stronger. Most babies lose weight in the beginning that is to be expected. Trust the LC and have confidence in yourself. You mentioned when baby burps it comes out his nose? He could be over full. Hope you update here about how it went with your LC. Many blessings and hugs to you! ~Pam~
Hi Beverly,
It is really hard for me to know with out doing an assessment on both of you, so I am so very glad you met with a LC! How did it go? Hopefully you will get some good guidance on how to boost weight gain while meeting your breastfeeding goals!
Take Care,
Katie
Does this also go for preemies? By their actual or adjusted age?
Hi Amber,
Preemies would be very different and will be impacted by their weight, development, their course (whether they had illnesses), progress with feeding, how they were fed etc. So a preemie would be very different. This is not meant to be a ‘feed your baby this much’ it is just an illustration so Mom’s can visualize what they often hear from nurses or lactation consultants. The ideal is to have your baby tell you how much they need by feeding on demand, then watching diapers and weight to know they are doing well breastfeeding. Preemies are very different. I really recommend you receive support from a lactation consultant so you can get some guidance with feeding your little one! I had preemies too so I hope your little one is doing well!
How to find a lactation consultant: http://www.ilca.org/i4a/pages/index.cfm?pageid=3432
Take Care,
Katie
What an awesome article – every new mother should go home with this information whether breast or bottle feeding. Do you have something similar for toddlers, preschoolers and elementary children?
can you make something similar with toddlers..im always confused if im feeding my child enough
Hi Suboohi,
Check out this information for toddler nutrition:
http://kellymom.com/ages/older-infant/ebf-benefits/
http://kellymom.com/nutrition/starting-solids/toddler-foods/
I hope that helps!
Katie
This was great information. I am an RN with nursery, OB, and NICU background. Family intervention is, in my opinion, the biggest roadblock in teaching a new mom about feeding. Although well intentioned, it is difficult to convince a new mom, who isn’t quite committed to breast feeding, that she is doing the right thing in nesting, etc. I liked your illustration in stomach size. I think helping the new mom to visualize that will be very helpful.
Sincerely
Carol Buckley, RN
We were told by our hospital LC that the first day is the size of a chickpea and 3rd day is cherry
Hi Lala,
Each baby is slightly different, a small term baby (6lbs) would be more like a chickpea. It is roughly what research tells us but it is not an exact measurement. I hope that helps clear up the differences. The Cherry, Walnut, Appricot, Large Egg is a commonly seen illustration here in Canada so I took the illustration from Beststart and made a photo out of real objects.
Katie
What a fantastic article! Thank you! A great way to reassure especially new moms…
hi there …please help my daughter is 4 wks old 91b 15oz …bottle feeding her she taking 5 oz ……every evening around 8pm tummy ache starts and lasts for 3 4 hrs
Hi Sue,
I’m not sure from your comment if you are just bottle feeding or if you are mostly breastfeeding. Give this a read: http://kellymom.com/parenting/parenting-faq/fussy-evening/ and if you want some more guidance send me an email to info@babiesfirstlactation.com
Thank you,
Katie
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Help! How do I get my milk supply to come in better? I pump nothing comes out my son is flinging his hands and head screaming..I can get beads iof milk to come out.what else can I do?
Hi Alicia,
Please send me an email with more details (how old baby etc) and I can help refer you to some resources!
info@babiesfirstlactation.com
Thank you,
Katie
Reblogged this on myholisticapproachblog and commented:
A great explanation with a visual of babies first few meals. Relax, Momma, you’re doing it right.
Thank you my holistic approach!
This is an excellent article but I think it’s also worth mentioning that you will be able to “measure” how much your baby is getting by their output. If they’re getting enough, there will be plenty of wet and dirty diapers.
You do need to trust your body, but there are VERY rare cases where baby is eating constantly and fussing because you’re not producing enough. Unfortunately, legitimate low-supply is becoming more common and the more you know, the better you can help those moms. I was told my supply should be fine. I barely produced enough for one feeding throughout the entire day because I have IGT.
Thanks for giving valuable information to help all moms!!
Hi Annie,
I’m so sorry you struggled with IGT. I highlighted the importance of supplementing under the guidance of a lactation consultant- the LC would be able to diagnose/help with moving forward with IGT or any other potential causes of low supply. Take Care, Katie
Wish I had read this a year ago. Was battling between the urge to feed my son formula and believing that my supply was enough for him, but managed to exclusively fed him regardless until now. Now that he is 13 month, I still wonder if he is getting enough supply of calcium and nutrition (despite being on solids). What advise can you give as I plan to continue brestfeeding until he is 2 years old.
Thanks!
Aina
Hi Aina,
Way to go!
Here is some great facts of breastfeeding a toddler: http://kellymom.com/ages/older-infant/ebf-benefits/
Here is some information on how to include calcium in his diet: http://www.wholesometoddlerfood.com/toddlercalcium.htm
I hope that helps!
Katie
I know your information is specifically for breast feeding but it is valid to take into account that stomach size will affect bottle fed babies as well. I see so many moms that bottle feed and are searching for answers with regards to increased GI symptoms vomiting and overall fussiness with the doctor telling them the baby suffers from GERD and will prescribe medication. When in actuality the culprit is most likely over feeding! I think if this information was provided to parents in general regardless of breast vs bottle it would help them tremendously, I for one will pass it on. Thanks
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Great information, will pass onto pregnant friends. Support, support, support is so vital. I panicked with my first child, I didnt produce huge amounts or suffered engorgement or strong let down of milk, but my baby was happy to drip feed all day long for 6 weeks and never lost weight. He would typically stay on the breast for 5 hr stints during the day (nickname the limpet). Unfortunately I suffered post natal depression and ended up giving him one bottle a day from 10 days of age so I could get out of the house for 2 hours a day and leave him with my mum. I felt guilty and demoralised knowing he would down the bottle within minutes of leaving the breast. Thankfully I had a great health worker who never once mentioned nipple confusion and after a few weeks that bottle no longer contained formula but my own expressed millk. I successfully breast fed for another 8 months. 2nd child and I was the human equivalent of a Holstein cow and had a struggle free 14 months. Each person and each experiene is different.
She did write TEA Spoons. You read it wrong somehow.
This was an awesome and very informational read. I really wish I would have read this with my 1st child. I got a lot of pressure from people wanting me to give my baby extra, but I reassured them that my body provided adequate supply. This is also a good refresher for when my new arrival gets here. Thank you for the great info.
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This helps but what about pumping while bfing? I am going back to work in a few weeks and need to pump to have milk for the daycare but when I pump, I barely get 2-3 oz. He’s nursing every two hours for 30 mins at least. I feel like I’m not making enough milk. Any advice?
How does this help with pumping? My son is 3 wks and I go back to work soon. Need to start pumping to have milk for daycare but he eats so much that I’m only able to pump a couple ounces at a time… feel like I’m not making enough. Any advice?
These links may help you:
http://kellymom.com/bf/pumpingmoms/pumping/pumping_decrease/
http://kellymom.com/bf/pumpingmoms/pumping/bf-links-pumping/#working
I hope that helps, and good luck with your return to work!
How can I get permission to reproduce this picture for staff education at my hospitals?
Send me an email Chasta to info@babiesfirstlactation.com
Thanks,
Katie
Very good article! I breastfed my first son, as well as my twin boys. I felt that while I was in the hospital my LC was helpful in some aspects and not in others. All of kids have always been little piggys and it was my sister (breastfed all of her 6 kids until the age of 2) that really helped me. Her advise was let the babies go to the breast as often as possible, let them Pacifi on you while your milk is coming in, this will help your supply. The lactation nurse told me 20 mins every 2-3 hours. Because I took my sisters advise I made enough milk to nurse twins without supplementing!
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I often wondered about this. Thank you! My 1st son (He is almost 7yrs) I started supplementing when I went back to work before I didn’t prepare before and had no idea what to expect. This time around I knew what was going on….my little guy is 11months and still going strong! It took my milk 5days to come in, but then I was overproducing for more than 3 months… 😉 I remember one point he fed for his nap and when he fell asleep I still felt over full so I pumped and got 6oz!
Our hospital in our town has an amazing LC on staff. I wish that my sister in law had one available when she had my nephew…I tried to help her as best as I could but the only breast milk he got was mine.
We would love to use this at WIC in Omaha, NE. Do you have a larger JPEG available?
Hi Jessica,
Send me an email please info@babiesfirstlactation.com
Thanks,
Katie
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Thanks for the great article! I have always been a proponent of breastfeeding, but struggled to do so successfully myself. One of my major struggles was that I felt a great amount of unexplained anxiety during nursing or pumping. When describing this to several people, they assumed the problem was that nursing hurt in the first weeks, so I’d developed a nervousness about it. Sometime later, I read a book that referenced a sense of gloom that some women experience because of the rush of hormones during letdown. I felt like someone finally knew what I was talking about! Do you have any experience with this, and if so, do you know any ways to overcome it? I’d like to do better if I have another baby. I tried watching movies with headphones to distract myself, but then felt like I wasn’t bonding with my baby.
Hi Angie,
I’m sorry you went through that last time!
What you are talking about is called D-MER and there is a whole website with great information dedicated to it. http://www.d-mer.org/ I hope that is helpful!
Katie
Reblogged this on memomuse's Blog.
Thank you for this. I’m in hospital awaiting my c section. I’m hand expressing some milk just in case…and this has helped me get a more realistic idea of how much she will need. (I’ve gotten 1ml so far 🙂 )
Congratulations Keira! Glad it is helpful for you! Wishing you a safe delivery!
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Hi I was anaemic on the verge of blood transfusion and had a water infection that wasn’t diagnosed until baby was 6 weeks old. The cluster feeding you talk about and feeding for 45 mins and being hungry again half an hour later is very familiar to me! However this was still going on by the time baby was 6 weeks old so I quit breastfeeding because bany would drink 180ml of formula as a top up aftet feeding off me for 45 mins. Health visitor told me I mustn’t have enough milk for him to be taking so much top up afterwards. I would just like to know your opinion if you think this was due to me being anaemic and having an infection? I would like more children and am worried I don’t produce enough milk as I would like to try breastfeeding again. Thanks and sorry for long post.
Hi Stacey,
Both being ill/infection and being anaemic can really impact your milk supply amongst other issues that may have been going on.
Each Mom/Baby nursing relationship is totally different, so take what you learned the first time, maybe even meet with a LC in advance to create a plan and go in to your next breastfeeding relationship with lots of hope and determination and I hope it would be a very different/positive experience for you!
Take Care,
Katie
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Thank you so much for this post. My son was born a week ago at 36 weeks gestation and we are struggling a bit. He has lost a pound so the Dr. wants me to give him 20ml of formula every two hours with each feeding. I am really concerned its effecting my supply because he is nursing less and less.
Hi Felicia,
I’m not sure where you are located but get in to see a Lactation Consultant so they can help guide you with the supplementing and helping you wean off when ready. These near term babies are tricky and often need a little bit of time (and help with supplementing) until they get closer to term. You can go to http://www.ilca.org and click on the find a lactation consultant to find one near you!
Enjoy your little one!
Katie
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In hospital my baby woke and cried so I went to put him to the breast and a midwife told me not to or I would create a ‘snacky baby’. As i was not able to pump 60mls my baby was given formula in hospital and so this continued at home as well. I wish I new then what you have just said in this article.
Hi Kelly,
I’m sorry you were given poor advice. I hope my article helps in case there is another baby in your future 😀
Thanks for reading,
Katie
Hi there,
I have just finished a breast feeding support group to become a breast feeding peer support worker to help mothers to over come any problems they may have when breast feeding. The training we had lead us to believe that a baby’s stomach in the first few days is the size of a small marble not the size of a cherry. There is a small but significant size difference here.
Just thought impasse on this info.
Sammi
Hello Sammi,
Thanks for your feedback but this is coming from well researched evidence based information.
It is just a visual but I am aware there are many renditions of this out there.
I’m an IBCLC and prior to creating this image I did research it. A small term baby can certainly have a tummy the size of a marble or using food imagery I use a chick pea but that is a small term 5-6lbs. A normal term size baby has a stomach capacity closer to a cherry. (of course each cherry is a different size so obviously this is not an exact science.) It is purely meant as an easy visual to dispel the myth that a baby needs a full bottle of formula or that a Mother couldn’t possibly have enough colostrum.
Good luck with your peer support,
Katie Wickham RN BScN IBCLC
Reblogged this on drsharryn.com and commented:
This is spot on!
You article is so helpful for me, keep sharing great information.
Hi, I really think this is a great and very helpful website. I wish I had discovered it before. I have breastfeed all 4 of my children and I am currently still feeding my youngest who is now 20 months. My family is putting me under such pressure to stop feeding him as they say he is to old now and that upsets me as he still enjoys feeding and is still feed on demand and I enjoy feeding him. Please can you tell me is there any benefits from still feeding him at his age? 🙂
Hello Teresita,
What a great gift you are giving your son! There is absolutely value in continuing to feed him. Breastmilk never loses its value just because your baby is a certain age, infact it continues to change and meet his needs as he grows. Here is some information you may find helpful to share with your family! http://kellymom.com/ages/older-infant/ebf-benefits/
I hope that helps!
Nurse On!
Katie