Guidelines for Child Care Providers
Breastmilk: How Much is Enough?
Many parents may ask you “how much breastmilk should my baby have each day?”. Below are some tips on feeding breastfed infants. Remember that each infant will be different and to watch for hunger cues. If parents express any concerns, encourage them to speak with their health care provider or lactation consultant.
Amount and Time of Feedings
A breastfed infant often nurses 8 to 12 times in 24 hours. In other words, an infant usually nurses 10-15 minutes per breast every 1 ½ to 3 hours. It is important for a breastfeeding mother to provide breastmilk to an infant when he/she is hungry, not when it is a certain time. This is called on-demand feeding. At child care centers, feed the infant breastmilk in a bottle when showing signs of hunger (e.g. sucking on hands, fussiness).
Signs of Adequate Nutrition
A good way to tell if a breastfed infant is receiving enough breastmilk is to check his/her diapers.
- Urinating – A breastfed infant should have colorless urine at least 6 to 8 times per day. Infants will normally urinate after every feeding. This amount will often decrease once the infant gets older. If you notice problems, it is important to tell the parents and encourage them to discuss this with their health professional.
- Stooling – For many infants, they may stool after every feeding. This amount will often decrease once the infant gets older. Stools should be soft, if they are not, let the parents of the infant know and encourage them to discuss this with their health professional.
Increases in appetite often occur in the breastfed infant around the same time that he/she is having a growth spurt – 3 weeks, 6 weeks and 3 months. It is important for mothers to breastfeed more often to provide the breastmilk that the infant needs for their growth. Mothers may not be expecting growth spurts and may express concern to you that her infant wants to eat more. They might feel that they are not “making enough milk”. This is not true; the infant just needs more breastmilk since they are growing. The mother’s milk supply will often increase within 72-96 hours. After this time, the infant will normally go back to a normal feeding pattern.
A nursing strike is when a breastfed infant suddenly refuses the breast. This is a normal process that happens with some infants. This normally occurs around 4 to 7 months. The infant will often cry, arch and pull away from the breast. At this time, he/she normally accepts bottle feedings with no problems. Reasons why this may occur include urinary tract infections, ear infections, teething, rushed feedings, overactive milk let-down and/or exposure to bottle feeding. A nursing strike often becomes more complicated because of a decrease in breastmilk supply. It is important for mothers to continue to offer the breast to the infant and express milk with a pump to maintain milk supply. Offer reassurance and encouragement to mothers to continue breastfeeding by:
- Increasing skin-to-skin contact;
- Creating a quiet and distraction-free environment;
- Increasing cuddle time;
- Consult with their health care provider and/or lactation consultant.
Updated April 5, 2014