I wanted to say thank you to all who had suggested the ABM Clinical Protocol #3: Hospital Guidelines for the Use
of Supplementary Feedings in the Healthy Term Breastfed Neonate. Thank you very much, it was very helpful.

The researchers suggested the following table:

TABLE 3. AVERAGE REPORTED INTAKES OF COLOSTRUM BY HEALTHY BREASTFED INFANTS
Time Intake (mL/feed)
1st 24 hours 2–10
24–48 hours 5–15
48–72 hours 15–30
72–96 hours 30–60

However, since this information is mainly directed at supplementing the breastfed baby, I'm not sure if the Peds will consider using this for exclusively formula fed infants. Although they should. Same stomach size, after all. And they do say in the article that based on this information, it's likely that formula fed infants are being overfed and it's contributing the high rate of childhood obesity. I agree.

I know many are concerned that having these large volume feeds for breastfed babies can cause rapid volume expansion of the infant's stomach and make them less satisfied with future colostrum feeds. However, new research shows that this may not be true. Actually, it looks as if the infant's stomach may not have the capacity to expand in the first few days of life. What is actually happening instead is that their stomach can't expand, and they are having rapidly increasing gastric pressure.

http://www.nature.com/pr/journal/v50/n5/full/pr2001232a.html


The higher the feed volume, the higher the gastric pressure. Which in my mind, may be even worse than stretching out their stomach. It's causing terrible stomach pain, gassiness, and spitting up for them instead. Whether breastfed baby supplemented with formula, or exclusively formula fed, I think these babies are having way too much formula in the first few days. Thanks again.

Tricia Shamblin, RN, IBCLC

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