Breastfeeding: How much milk is enough for a newborn?

POV: You have a sleepy, hungry, tiny human who is only minutes old. Now what? 

Do you remember how fast those months of pregnancy went and how much your baby (or babies!) grew in that amount of time? It started from a bundle of cells into a package of joy. That trend continues outside of the womb, with a lot of change happening in a relatively short amount of time. Feeding trends are no different, from milk consistency to time at the breast. The first two weeks of a newborns life are considered the most challenging, as the mother and co are on learning curves trying to keep up with hunger cues and satiety affirmation. 

In this blog, we will cover: 

• Newborn Feeding Milestones
• Hunger and Fullness Cues
• Amount Ranges by Age
• Concerns of Over- and Under-Feeding

Days 1-3 coincide with the change from colostrum to mature breast milk, which takes 3-5 days to transition to its full volume and consistency. In fact, the stomach cannot physically stretch to accommodate more than 10 ML at a time until Day 3 of life. This means that feedings will be slow and frequent, aiming for 10-12 times in a 24 hour period. At times, it will feel like an on-going feed, due to how clustered together the feedings can and should be. This is necessary to get the required calories and stave off jaundice, low blood sugar, and fatigue. Amounts will fluctuate from half an ounce to an ounce per feeding until full volume and longer stretches occur over the next few days. Luckily, colostrum and transitional milk are quite concentrated in calories- so a little goes a long way! In the case of a newborn, their hunger cues start with the act of waking up! They sleep most of the day, waking only to eat, which can be every 1-3 hours. 

With mature milk transitioning in completion, milk is lighter in color and more liquid. Stools need to have changed in color from black to dark green, to mustard yellow with flecks, as well as amounts/frequency. This timeframe is when we can assess how well the baby is eating, as these markers can signal if there are any problems. If by day 4 the baby still has black or dark green stools, has developed jaundice, and breasts are hard and sore, we can assess for latching, positioning, and frequency of feedings. Hunger cues in a newborn? Simply waking up. If a baby cannot wake fully to eat, they will stay on the breast, but not gain weight, and will have issues with blood sugar and bilirubin buildup (jaundice).

Tip: Check diapers! The easiest way to ensure intake is to count diapers, and monitor the ever-growing number of wet diapers a day. By day four, there should be four or more diapers a day for breastfed babies. As for stools, they, too, change with the transition of milk! Starting with meconium, black, and tarry, to dark green by day 2, and a golden mustard appearance by the time milk has transitioned completely.

We start to see a pattern established when the baby is feeding well. As long as the baby is transferring milk effectively from the breast, they can be trusted to feed on demand, which means by hunger cues. Breast-fed babies feed less per feeding, but more often, in comparison to formula- or bottle-fed babies. This is important for stimulating the brain just frequently enough for SID prevention and adequate weight gain. Up to 10% weight loss is normal for the first few days postpartum, but now we need to be on the pathway to gaining it back and then some. Feedings may now take up to 20 minutes, and happen as often as 2 hours. Around 2 weeks, the weight should be returned to or close to birth weight, but something else also occurs around this time: Cluster feeding. 

You may notice the baby may be fussier in the evenings and want to nurse more often than during the day. This looks like spurts of 10-minute “snacking”, a 10-20 min nap, and then another feeding. Some babies may want to nurse every 30 minutes to an hour in the evenings. This is a normal phase, and it does not mean your baby isn't getting enough milk. It may just be your baby's way of filling up before a longer stretch of sleep to grow, and to also boost milk supply for down the road! 

Amounts per feeding: 2-4 oz, less for clustering 
Amounts per day: 12-24 oz

By this time, hunger cues are starting to change, as your baby may stay awake long enough for two feedings before a good nap. Hand-to-mouth, rooting, and smacking tongue and lips will be other cues to look for alongside them waking up. Waiting to use pacifiers until this time is recommended to avoid non-nutritive sucking and energy expenditure, and because of how frequent feedings need to be. Slow but steady increases in milk intake may be noticed, and gradual, consistent weight gain. This milestone is worth celebrating. 

Information provided in blogs should not be used as a substitute for medical care or consultation.