While it is common for the baby to want to feed frequently, cluster feed, and sometimes faster weight gain more early-on compared to formula feeding, feeding directly from the breast is a scenario that does not contribute to overfeeding or obesity.
In fact, since the composition of breastmilk is perfectly made for their energy needs, and without fillers, and children who breastfed are actually less likely to become overweight later in life. The pace is also a huge factor in preventing overfeeding, as breastfeeding is very involved on their end, and releases slowly throughout the feed. This gives their stomach enough time to communicate to their brain when they feel full.
Breastmilk composition is an exact ratio of fats, carbohydrates and proteins, along with water and other nutrients, that absorb easily. This ease in absorption and balance regulates hunger, fullness, and therefore their eating patterns. It is important to allow your baby to eat on demand based on their hunger cues for this reason, without attempts to prolong or end the feedings prematurely for fear of overfeeding, in order to allow the milk to provide exactly what the baby needs.
Emphasizing breastfeeding directly at the breast is an important specification, too. Bottle feeding, regardless if it contains breastmilk or formula, can overfeed, and quite easily. Even with a slow-flow nipple, which has no real regulation on what that means from brand to brand, bottles rely on gravity and suction, and no other stimulation or internal regulation. Paced bottle feeding is a practice taught by many lactation consultants/ IBCLCs to combat overfeeding, spit up, and waste. That’s right: lactation consultants can help bottle-fed babies, too!
Spit Up
Spitting up is a common concern fueling fear of overfeeding for many new parents and veterans alike, but it is a culprit of other potential issues, and not from breastfeeding too much. Spit up is also something that will occur normally as infants’ stomachs are like jars with loose lids. Spit happens.
Some Causes for Spit Up:
- Movement after eating
- Crying
- Needing to burp
- Strangling on the milk
- Tongue Tie / poor tongue control
- Cranial Nerve regulation needs/ Torticollis
- Overfeeding from the bottle
- Fast letdown (most often in conjunction with poor tongue control to help with swallowing)
- GERD
- Collic
It is also a regulatory response to prevent overfeeding. Gastro Esophageal Reflux Disorder, or GERD, along with colic, get overly diagnosed during the first year due to lack of understanding from both the family and the pediatrician, as bottle feeding and breastfeeding, infant feeding in general, are sorely insufficient. Overfeeding from the bottle can eventually cause GERD from excessive spitting up, as the esophageal sphincter becomes overactive. This usually leads to outdated advice of adding solid food, such as infant cereal to thicken, which later can lead to weight issues, displacement of breastmilk needs, and food allergies from too early introductions.
Spit Up Myths
- Mother’s diet is the culprit
- Don’t use the boob as a pacifier
- lactose (lactose is the milk sugar found in ALL types of milk: human, cow, goat, etc)
- Baby fed on the breast too long or too often
- Formula-fed babies do not spit up as much (quite the opposite!)
- Healthy babies should not spit up
- Mother’s milk is not good enough
How to Know if Baby is Full
For the first months of age, a healthy baby will be doing a LOT of sleeping and eating. Once mature milk has set in, a baby will typically consume 1-1.5 ounces an hour, which typically looks like 1.5-2.5 ounces per feeding. Its common for them to have stages of fussiness during a feed, especially during growth spurts. The first growth spurt for a newborn baby happens around 2-3 weeks gestational age, and throws many mother’s off if they do not expect it.
Cluster feeding is a stretch of feedings that occur seemingly back-to-back, followed by a nice stretch of napping. When not understood, a mother may think one of two things: she’s overfeeding or her supply is suffering. When in actuality, this is a normal occurrence that boosts the supply.
Watching the baby is the number one way to gauge fullness, not the clock. Old, outdated advice states to feed on each breast for 10 minutes each, but breastfeeding is not that exact, and advice like that can be really uptight and confusing. Allow the baby to actively feed until they release or act fussy, and a good rule of thumb is to then offer the other breast, which may not always be needed depending on the baby and the mother’s body/storage capacity. When the baby is full, they may decide to pacify or fall asleep. Their body should be relaxed, including their fists.
If feeding from a bottle, pacing by removing the bottle every 5-10 ml helps to read fullness cues much easier and in a more timely fashion to prevent an overfed baby. It also helps to sit them as upright as possible.
Signs of Overfeeding
Spitting up is their way of removing excess milk in most cases. If bottle feeding and the baby is jumping percentiles, this may also be a sign. Pay close attention to amounts given, as breastfed babies usually cap out at 5 ounces per feeding, which means 4 ounces at a month of age is most likely too large of a feeding to handle. Small, frequent feeds are much better for their metabolism and much more feasible to keep up with if pumping!
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