Beth has referred to my lecture at ILCA on supplementation and the stomach
capacity of the newborn. I use this as an illustration of the amount of milk
that a newborn can consume. I quote these numbers to parents and providers
who continue to try and stuff unreasonable amounts of food into little
babies. The stomach has both a physiologic capacity (the amount held
comfortably after a meal) and an anatomic capacity (the amount that you can
put in on Thanksgiving). These two amounts are different. The physiologic
stomach capacity of a newborn between 2-4kg on day one is 7ml per feeding as
in the amount of colostrum mother is producing (not 3 ounces like in the
bottles of formula).

Beth asked about the anatomic capacity of the stomach. For a newborn between
2-4kg in weight the anatomic capacity is 30-35ml. A one week old infant of
all weights is about 45ml and a two week old infant is about 75ml. I have
used these numbers for many, many years to illustrate to parents and
providers with a dropper or syringe what 7ml looks like. It does not look
like 3-4 ounces!

Now you say, WHERE ARE THE REFERENCES!!! There are very few current
references on something as simple and elementary as this. One of the
references is actually older than I am which makes it an antique but still
worth listening to.

Scammon RE, Doyle LO. Observations on the capacity of the stomach in the
first ten days of postnatal life. Am J Dis Child 1920; 20:516-538.

I am always amazed at the lack of understanding we have about the normal
newborn anatomy and physiology. If we just looked at things like this we
would see how outrageous it is to try and mimic bottle feeding with a
breastfed baby. Health care providers show the same lack of knowledge about
other things like newborn glucose metabolism, which explains the downright
bizarre hypoglycemia protocols I see floating around the country. We let
babies cry to exercise their lungs! When did the lungs become muscles? Crying
directly contributes to the low blood sugars we see so often as the glycogen
stores get depleted at the speed of light while we worry about spoiling the
baby!

I think we need a conference on what is normal!!

Marsha Walker, RN, IBCLC
Weston, MA

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