Is your Baby having Enough Milk?

One of the biggest concerns of new parents (and new grandparents, aunts, uncles, and anyone in any way involved with your baby) is whether baby is getting enough to eat. While it’s easy to tell how much is going in with babies who are bottle-fed, the volume nursing babies take in is a mystery. Regardless of the feeding method, the size of your baby’s stomach may come as a surprise.

“How do you know she’s getting enough?”
“He’s always crying. He’s hungry!”
“She needs to eat more than that, surely!”

Whether they mean to or not, some well-meaning people in your life can make you doubt yourself when it comes to whether your baby is getting the all-important “enough” to eat.

One of the most surprising things I heard when I watched the “Simply Breastfeeding” DVDs was the size of a baby’s stomach and how it grows during the first few weeks. 

Days 1 and 2: The Size of a Thimble or Marble
Have you ever wondered why your body produces so little colostrum? Think about it: here’s “nature’s immunization,” something so important to your baby that it’s often referred to as “liquid gold.” Yet the volume of this fluid is miniscule. Can you guess why? It’s simple: a newborn’s stomach can only hold the volume equivalent of a thimble or a marble. On top of that, over the first two days, a newborn’s stomach does not – cannot – stretch to accommodate more. Many parents and nurses have found out the hard way that feeding a newborn an ounce or two of anything is an exercise in futility: when that much goes in, that much is going to come right back out. Spitting up in newborns is due to a number of factors, not the least of which is the size of their tiny tummies.

Your body knows that your baby’s stomach can only handle about 5 to 7 milliliters (think of a marble or thimble) of milk. Your body is smart, because it only produces as much colostrum as your baby can hold. The size of your baby’s stomach and the volume of your colostrum are matched, and frequent feedings (approximately 10 to 12 times each day) are normal.

Day 3: The Size of a Ping-Pong Ball or Your Baby’s Fist
Your baby’s stomach grows like gangbusters in the first three days until it’s about the size of a ping-pong ball or the baby’s fist (22 to 27 milliliters). By this time, your milk probably hasn’t come in yet, so there’s really no point in your baby’s stomach capacity growing any faster than that. On the third day, feeding your baby anywhere from eight to 12 times each day is normal

It’s better to feed your baby several small meals rather than fewer, larger ones. First, because your baby’s stomach simply can’t hold that much, and second, because long nursing sessions at this stage can actually lead to sore nipples. Frequent nursing sessions, not lengthy ones, are the way to go at this stage. The time for long nursing sessions will come later, when your baby’s stomach has grown large enough to accommodate larger volumes of milk.

Day 10 or So: The Size of a Large Egg
By the time your milk has come in and the supply is established, let’s say day 10, your baby’s stomach can handle a volume equivalent to 60 to 81 milliliters, which is roughly the size of a large chicken egg. And how large is an adult’s stomach? You may be surprised, but it’s only about the size of your fist, a grapefruit, or a softball.

“Enough” Is Relative

So now you know that “enough” to eat is quite relative. Your body is remarkable: it has produced a baby and will nourish your newborn with the right amount of colostrum and the right amount of breast milk, once it’s come in. 

What is colostrum? How does it benefit my baby?
Your breasts produce colostrum beginning during pregnancy and continuing through the early days of breastfeeding. This special milk is yellow to orange in color and thick and sticky. It is low in fat, and high in carbohydrates, protein, and antibodies to help keep your baby healthy. Colostrum is extremely easy to digest, and is therefore the perfect first food for your baby. It is low in volume (measurable in teaspoons rather than ounces), but high in concentrated nutrition for the newborn. Colostrum has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.

When your baby is breastfed early and often, your breasts will begin producing mature milk around the third or fourth day after birth. Your milk will then increase in volume and will generally begin to appear thinner and whiter (more opaque) in color. In those first few days it is extremely important to breastfeed your newborn at least 8-12 times each 24 hours, and more often is even better. This allows your baby to get all the benefits of the colostrum and also stimulates production of a plentiful supply of mature milk. Frequent breastfeeding also helps prevent engorgement.
Your colostrum provides not only perfect nutrition tailored to the needs of your newborn, but also large amounts of living cells which will defend your baby against many harmful agents. The concentration of immune factors is much higher in colostrum than in mature milk.

Colostrum actually works as a natural and 100% safe vaccine. It contains large quantities of an antibody called secretory immunoglobulin A (IgA) which is a new substance to the newborn. Before your baby was born, he received the benefit of another antibody, called IgG, through your placenta. IgG worked through the baby's circulatory system, but IgA protects the baby in the places most likely to come under attack from germs, namely the mucous membranes in the throat, lungs, and intestines.

Colostrum has an especially important role to play in the baby's gastrointestinal tract. A newborn's intestines are very permeable. Colostrum seals the holes by "painting" the gastrointestinal tract with a barrier which mostly prevents foreign substances from penetrating and possibly sensitizing a baby to foods the mother has eaten.

Colostrum also contains high concentrations of leukocytes, protective white cells which can destroy disease-causing bacteria and viruses.
The colostrum gradually changes to mature milk during the first two weeks after birth. During this transition, the concentrations of the antibodies in your milk decrease, but your milk volume greatly increases. The disease-fighting properties of human milk do not disappear with the colostrum. In fact, as long as your baby receives your milk, he will receive immunological protection against many different viruses and bacteria.

Stomach capacity of the newborn
When mothers hear that colostrum is measurable in teaspoons rather than ounces, they often wonder if that can really be enough for their babies. The short answer is that colostrum is the only food healthy, full-term babies need.

The following is an explanation:

  • A 1 day old baby's stomach capacity is about 5-7 ml, or about the size of a marble. Interestingly, researchers have found that the day-old newborn's stomach does not stretch to hold more. Since the walls of the newborn's stomach stays firm, extra milk is most often expelled (spit up). Your colostrum is just the right amount for your baby's first feedings!
  • By day 3, the newborn's stomach capacity has grown to about 0.75-1 oz, or about the size of a "shooter" marble. Small, frequent feedings assure that your baby takes in all the milk he needs.
  • Around day 7, the newborn's stomach capacity is now about 1.5-2 oz, or about the size of a ping-pong ball. Continued frequent feeding will assure that your baby takes in all the milk he needs, and your milk production meets his demands.