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Question: How much milk does my baby need while I’m at work?

I have recently returned to work and am concerned about the amount I'm pumping and how much my daughter should be taking in at each feeding. Here's the scoop. She was 7lbs 4oz at birth. At her two-month check-up she weighed 9lbs 8oz. She is three months old now and she weighs approximately 10 pounds. At work I use a Medela Pump In Style and pump three times a day. I get about 3 ounces at each pumping. My mom watches her during the day and has been giving her the 3 ounce bottles from the previous day of pumping. She seems to be doing fine (although a little fussy right after the feeding, I think because it goes so much quicker than she's used to at the breast). But I have read that at her age and weight she should be taking in between 4-6ounces at each feeding. Is she getting enough? How much should I give her for each daytime feeding? And how will I know when and by how much to increase the amount as she gets older? If she seems happy with 3 ounces, if I do pump a little more than that, can I go ahead and store that or should I let her have the extra?

Answer:

Congratulations on continuing to breastfeed your baby after returning to work! It is a real labor of love and presents many challenges, but is well worth the effort. It sounds like your baby may need more milk than she is getting at this point. Her weight gain was excellent up until the past few weeks, and it is kind of unusual for her to change her pattern of weight gain after gaining so quickly in the beginning. Has she had a cold or any kind of illness? Sometimes that can slow down baby’s weight gain temporarily.

The average baby will gain four to eight ounces a week during the first few months, so if she only gained eight ounces in the past month, I would encourage you to try feeding her more. The average baby who isn't eating anything but milk needs about two and a half ounces per pound of weight. Some babies need more, some need less in order to gain weight adequately. A ten-pound baby needs about twenty-five ounces in twenty-four hours (round up a few ounces to be on the safe side - say twenty-eight ounces), which means that if she eats eight times in 24 hours, she would need a little over three ounces at each feeding. Usually babies this age will take in over three ounces, because ideally she would weigh more than ten pounds at this point.

Your best guide as far as how much milk to offer her is weight gain. If she is gaining four to eight ounces a week and seems contented after feedings, then she is getting enough to eat. On the other hand, she may seem satisfied even if she isn't taking in the volume of milk she needs, and her weight gain will let you know if she's getting enough.

I would try offering her an extra one half to one ounce of milk at each feeding, and see if she takes it. Breastmilk is always the best supplemental food, but if you can’t increase your production, then I would offer breastmilk first, and follow it up with formula. If you mix the two together, then you may waste some of your milk if she doesn’t finish the bottle.

If she takes the supplemental feedings and her weight is still on the low side, then she may just be a baby who is going to be thin. Not all babies can be at the 90^th percentile, and lots of perfectly normal babies are at the 10^th.

It sounds like you are pumping as often as you can at work. Your options for increasing your milk output include nursing or pumping more often (which may not be realistic for you), supplementing with formula, using techniques to facilitate let-down (like breast compression, massage, or relaxation exercises), or trying some herbal remedies for low milk supply. Herbs like fenugreek or blessed thistle may help some, but probably won't make a dramatic difference.

The articles "Increasing Your Milk Supply" and "Collecting and Storing Breastmilk" on my website may have some helpful suggestions for you.  

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