Whether you aim to breastfeed for a few days or for several months, you are probably asking yourself how much and how often you should feed your child. Here is your expert breastfeeding guide from Healthy Matters, covering every breastfeeding stage from newborns to toddlers.
In the early days, you should ideally nurse ‘on demand’. This is usually at least 8-12 times per 24 hours to avoid engorgement and establish a good milk supply. Aim to feed regularly throughout the day and night – a good rule of thumb is every 2 hours during the day and every 4-5 hours at night if baby is sleeping, counting from the start of one feed to the start of the next feed. Nurse at the first signs of hunger (sticking their tongues out, sucking on anything close by, hands in the mouth, stirring), rather than waiting until the baby becomes frantic and fussy. Newborns are very sleepy in their first few weeks and may need to be woken in order to receive enough milk.
We’re used to being able to measure everything but it’s not so straightforward to determine how much milk a newborn has taken in. A lot of factors affect milk intake including latch, sucking ability and milk supply – feeding duration is not necessarily an indicator of volume. Nurse until baby stops actively sucking and swallowing and then offer the second breast.
As your baby grows, they will get increasingly efficient at drinking milk so won’t need to feed as often and will likely be sleeping longer. From 4-6 weeks old, you can expect your baby to be feeding 7-12 times in 24 hours, depending on their efficiency, any growth spurts, and supply.
Between the ages of 1 to 3 months, babies who are exclusively breastfeeding take in an average range of 570-900ml per day. Weight gain will also start slowing down after their one month growth spurt and dirty diapers may become less frequent.
By about 4 months old, many babies cut down on their frequency of feeding and are down to 5-8 breastfeeding sessions per day.
Babies this age take in an average of 570-900 ml per day as well. Keep in mind this is an average and the amount may vary day-to-day and baby-to-baby.
From between 6 and 12 months old, your baby will slowly start to replace some breast milk feeds with solid foods. At 6 months, your baby will still need 4-6 feeds per day but by 12 months, they will be down to 3-4 breast milk feeds.
At 6 months, most of your baby’s calories will still be coming from breast milk. This gives them room to learn to chew, swallow and explore the new world of solid food without worrying about their intake. By 12 months, most babies will be getting a larger portion of their calories from solid food and will be quite efficient at getting their milk. Some feeding sessions may be quite short as they can get their fill quite quickly.
As their eating skills and independence increases, most toddlers start feeding less and less – usually 1-2 times per day.
Breastfeeding toddlers are efficient at getting their milk and highly distractible and sometimes have overwhelming emotional needs. Their feeds can range from a few minutes during the day to twenty minutes or more in the morning or evening. At this point, breastfeeding is for comfort as well as nutrition.
The amounts we have stated are all average amounts as there are many ‘bumps’ on the breastfeeding journey. When babies are experiencing growth spurts or major developmental milestones, they may cluster feed.
We asked one of Hong Kong’s most well-known lactation consultants, Yvonne Heavyside from the Family Zone, to tell us a bit more about cluster feeding.
“Cluster feeding is common when the breasts have less volume (for many women this is around late afternoon/early evening). The baby may feed frequently at this stage but take heart as they are actually binging on hind milk and as a result of this the baby will often suddenly fall into a long period of deep sleep.”
Unlike bottle feeding (of breast milk or formula), it is very difficult to assess whether your baby is getting enough milk. Yvonne Heavyside shares some helpful tips to assess whether your new baby is taking in enough milk.
“The most important breastfeeding tool in the early days is to know if your baby is using an effective latch. Many babies will suck on the nipple but this is not necessarily achieving good milk transfer from the breast to the baby. Look for swallows, not just sucks. Dads can often do this more effectively as they can see if the lower jaw is dropping as the mouth fills up with milk. Once the milk is flowing easily, after the first few weeks, you may also be able to hear the baby swallow. It's like a "ku ku ku" sound.”
Since we can’t measure how much milk breastfed babies are getting, we use a couple of other measures. After the first month, babies with sufficient breast milk will generally be content, active and alert.
Your doctor, midwife or lactation consultant will weigh your baby at each appointment to ensure they’re on the right track.
Newborns to 3 month olds: After the initial 5-10% body weight loss in the first few days, young babies should be gaining roughly 170g/week.
4 to 6 month olds: 113-142 grams per week.
6 to 12 month olds: 57-113 grams per week.
Newborns: In the first four days of life, newborns should have one dirty and one wet diaper per day of life. On day 2, that’s 2 dirty and 2 wet diapers. From four days onwards, 3-4 dirty and 5+ wet diapers per 24 hours is a sign your baby is taking in sufficient milk.
Once breastfeeding is established and the baby is over a month old, the frequency of dirty diapers can range from one a day to even as infrequent as every eight days. There is little waste in breast milk so not as much need for bowel movements. However, it’s important that your baby passes urine 5+ times per day or roughly with every feed.
If you have any concerns, get in touch with your private doctor or your cluster’s Maternal and Child Health Centre (MCHC) for public health services.
Yvonne Heavyside is a UK-trained and registered general nurse. She is also a registered nurse in Hong Kong and a Health Visitor (maternal & child health specialist), Lactation Consultant, and First Aid & CPR Instructor. Yvonne has over 30 years’ experience as a nurse both in the UK and in Hong Kong. She previously worked in the Matilda International Hospital running their well-baby clinic. Yvonne founded her own company, the Family Zone, specifically to provide a personal, professional, hands-on service for new mums.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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