Minutes And Millilitres – When they matter, and when they don’t.
One of the most frequently asked questions I get asked about feeding is ‘how much should my baby be drinking ?’ and I’m sure I drive my clients crazy with my answer ‘as much as they want’
I know every time I say it that it is not what my clients want to hear, but even when they push me to give them some sort of figure ‘just as a rough guide’ I still refuse.
This is not because I like being annoying, but because I have seen too many parents over the years, on being given a specific number of minutes or mls, fixate to an unhealthy degree on those numbers.
Everywhere you look you will find guidelines, estimates, averages and targets in books, on breastfeeding equipment, on formula tins, in educational information from NHS and ante-natal classes, as well as from Health Professionals but all these numbers are averages, or sometimes even just guesses…and your baby is not an average any more than you are.
If we are talking about a normal, healthy, full term baby the only ones who know how much milk they need to thrive are the babies themselves.
I know, another annoying answer !
The thing is, even though I am being annoying, I promise you I am not being unsympathetic.
Listen To Your Baby
I know that for new parents, the most powerful, primal instincts are to protect and to feed, and that what we want most of all is some evidence we are doing it right. We want numbers that we can count, measure off and record to boost our confidence, and that without some sort of guide to reassure us we feel adrift on a sea of uncertainty.
However, you do have a guide, the best in the world…your baby.
In some ways babies can be extremely complicated, winding, for instance, still drives me crazy even with all my many years experience.
In other ways though, they can be remarkably simple.
Take a typical newborn.
When they are born the majority of them are hungry, plus they have the instinct to feed which is the perfect combination.
Whether you are breastfeeding or formula feeding, your baby will do its best to latch on to anything that touches their faces, be that nipples, teats, fingers, noses, chins…they will try and feed.
The first feed or two can be unpredictable due to the birth but, as a rule, in the first few hours they are usually more tired than they are hungry so they will drink until either the initial urge to suck has been satisfied, or their hunger/thirst is quenched and they fall asleep. (I will go into feeding in the first few days in more detail in a separate post)
After that their responses become more predictable, and you will be able to tell how much milk your baby needs by observing how they behave, rather than by counting minutes at the breast or mls in a bottle.
Set aside an hour for each feed to start with. They may not need all that time but it is theirs if they do need it. Feed your baby until they seem tired or full, then wake them up, wind them, change their nappy, then feed them again (what I call a ‘business feed’) giving them the best chance of getting a full feed rather than a snack.
If they seem ‘milk drunk’ i.e. sleepy, relaxed, content, then the likelihood is that they have had enough milk. If they seem restless, then spend some time winding them, but if they continue to not settle to sleep even when swaddled and/or cuddled then they are probably still hungry so, regardless of any average or guideline, offer them more milk until they are content.
In the first 2 to 3 weeks babies do little more than eat and sleep, with only a few minutes of awake time, if any. This is totally normal, so if your baby is spending a lot of time awake and/or crying, then they are trying to tell you something. They may be tired/over tired, in discomfort from wind, or hungry so start by trying to wind them (because they can’t sleep or drink with tummy ache), then try feeding them. If they take more milk then that is what they were trying to tell you. Once they have a full tummy, wind them well, and make sure they get chance to have a good sleep.
In the UK babies are pretty regularly monitored in the first 2 weeks, firstly in the hospital, then with visits from the midwife, handing over to the health visitor at around 10 days/2 weeks so there will be a lot of people around to keep an eye on you and your baby.
Babies weight often dips a little in the first couple of days after birth but after that it should start increasing. Even I am guilty of being a bit pushy/persistent with feeds until I can see the weight starting to increase but once they have regained their birth weight you can begin to relax a little because it is an indication that whatever you are doing is working.
Once a baby has regained their birth weight and has been signed off by the midwifes I am happy to let a baby take whatever they need from each feed because they will self-regulate their intake over 24 hours…and this is important for you to know because most parents try to get their baby to drink the same quantity of milk at each feed, and then worry if they don’t.
But think about it…is your appetite the same at every meal ? Or your thirst ?
Don’t you eat more or less depending on how tired or stressed you feel ? Or whether your last meal was big or small ?
Well, babies are no different, except perhaps that things affect them more than they affect us e.g half an hour being stressed for you might be no big deal, but it could be so exhausting for your baby that what they need most is sleep. When they have caught up on sleep they will be in a much better frame of mind to have a good big feed to make up for the previous small feed.
What they don’t need is a worried parent nagging them to drink more when they are actually already full or just want to go to sleep.
Equally, they don’t want a parent that limits their milk because they are working towards an arbitrary number of minutes breastfeeding or mls of formula suggested by a book, a facebook group, or a fellow parent.
A Healthy Feeding Attitude.
I know those first 2 or 3 weeks are fraught with worry, and it is normal and natural for you to be more reliant on quantity and timing so if that is what you need to reassure you, then by all means, count those numbers. As time goes on, however, you will grow in confidence and begin to have faith in your own instincts, and those of your baby, and at this point it will be in everyone’s best interests if you can then try and wean yourself off focusing too much on numbers.
I am not suggesting you don’t bother checking how much your baby is drinking, rather that you should try and focus on a healthy attitude towards their intake.
Imagine if someone tells you drinking 8 glasses of water a day is good for you.
A healthy attitude would be to assess how much you drink at the moment, then try and remember to drink a bit more each day.
If you think it really matters you might buy fill a couple of water bottles and make sure you drink them.
But is it still healthy if you started to force yourself to drink more water when you were uncomfortably full ?
What if you started measuring every millilitre and writing it down in a book or in an app ? Or set alarms in the night to make sure you reached the required target, and stressed if you didn’t drink exactly the same amount as you did yesterday ? What if the amount of water you drank became the overriding obsession in your life ?
This sort of obsession would be obviously unhealthy for you, and it is just as unhealthy for your baby.
When you see it written like this it is easy to see how unhealthy that way of thinking would be, but somehow, amid all the excitement, emotion, overwhelming responsibility, and worry that surrounds a new baby, it is very easy to fall in to the numbers trap that can lead to such an unhealthy focus.
I have seen parents withhold formula from their baby to the point where she was crying almost continuously, from hunger, because they have been warned by a midwife about the ‘dangers’ of overfeeding a formula fed baby, and were worried she would end up obese.
I have seen a breastfed baby develop a breast aversion because he was put to the breast (and almost forced to feed) because the parents had read that babies ‘should’ have a certain number of minutes at the breast at each feed.
I have seen a breastfeeding mother who became so obsessed with feeding 10 times a day (because a friends mum who was a lactation consultant told her that was the optimum schedule for increasing milk supply), for exactly 20 mins each side, that not only was she exhausted from lack of sleep, but her nipples were so cracked and sore from the relentless regime that she dreaded baby coming anywhere near her, and I felt her mental health was suffering.
I have seen triplets where there was a big greedy boy, a medium boy, and a tiny petite girl. The mum was trying so hard to get the girl to put on weight that she was force feeding her to take the same amount as the biggest boy and making her daughter so unhappy that she spent every feed crying, being sick and fighting the bottle.
I have seen both mums and dads develop such a severe obsession that it extended to other aspects of their baby’s life to the point that everything was counted or measured, they panicked if their baby took 10mls/mins less at a feed, and rushed to and from outings to ensure baby had the exact number of minutes sleep.
I recently had a case where I went in to try and undo the harm caused by a bad sleep trainer, whose method of getting newborn babies to sleep through the night was to make them wait 4 hrs between feeds, then force feed them large quantities of milk. By 8 weeks everything was a terrible mess, baby had a bottle aversion, and mum had PND. My advice was to totally relax the feeds and let baby take as much as she wanted, whenever she wanted for a few days to overcome the bottle aversion and lessen the negative feeding associations, before then rebuilding a gentle routine that worked for that family. The mum agreed this made sense, but the counting of every ml in order to get her baby to sleep at night had become such a strong habit, that she really struggled to break it. She was literally terrified of letting go of the numbers.
These are extreme examples, but I have also seen a great many parents who allowed too much focus on numbers that stopped them from relaxing and enjoying their baby.
Don’t Get Hung Up on Numbers
Because of this I don’t tend to recommend apps and complicated feed record keeping systems, but rather, that you keep simple records in a notebook that help you record basic information about feed times, quantity/minutes fed, which breast you start each feed on if breastfeeding , sleep times, and bowel movements…you don’t need more than that.
Be a bit more relaxed about the numbers and round amounts up or down to the nearest 10mls, count minutes, not seconds, and then add up the days intake and look at it over a 24hr period to learn your babies own particular feeding patterns.
Accept that your baby will take more at some feeds, and less at others and don’t worry about it.
Look at your baby. If they sleep well between feeds, are alert when awake, seem happy and content, and are putting on weight then it’s a good bet that they are getting enough milk.
Don’t expect conformity…there is nothing linear or predictable about babies, they are people in their own right, and are not programmed to take the same amount of milk at each feed, day in day out, so don’t worry if your baby has some big feeds and some small ones.
Don’t compare…your baby will not take the same amount as your first baby did, or as much as your friends baby, or a baby in a book, or in a social media group.
Do keep a sensible eye on your baby’s feeds, learn their feeding patterns and preferences, and relax and enjoy your baby xx
Sarah Norris is one of the UK’s most accomplished maternity nurses, with over 25 years experience caring for hundreds of babies and families in the UK and internationally.
She treats all babies and families as individuals, and respects all forms of parenting and feeding, aiming to help and empower new parents with sensible, practical tips and advice that is always non judgemental and non biased.
She is the author of ‘The Baby Detective’ with Orion Books, out now.