Star wrote:
Do you know how many feeds this baby
had per 24 hours? Also, in your opinion how many ounces or cc's
should a 5 month old baby consume in 24 hours and what references are
you using?
Star, I welcome your questions. This particular baby ate 9 times in this 24
hour period. Mom told me that this is a typical day for her. The baby
usually feeds about every
2 1/2 to 3 hours, day and night.
I think that it is very important for lactation consultants to have a gauge
for milk supply volume. Since most of the mothers I work with understand
ozs better than kgs, I use the requirement of 2.5 oz/lb/24 hour day. (This
translates to 90-120 kcal/kg/24 hours.) Biancuzzo and others have reported
that this is an appropriate intake for normal, healthy babies under 4
months of age. I am not aware of specific guidelines for babies over 4
months of age. If anyone has research on this, please share. My
understanding is, and my experience has shown, that babies between 4 and 6
months require fewer calories per lb (or kg) of body weight. However, it
would be unlikely that the 5 or 6 month old would require fewer total
calories (and therefore total volume of milk) than the 4 month old. I have
also noticed that the required proportional caloric (and milk volume) intake
seems to decrease when the baby reaches 12 lbs, pretty much regardless of
age.
For example, the baby I was describing had a birth weight of 7 lbs, 8 ozs.
Multiply that by 2.5 oz/lb and it is likely that (after the first few days
of colostrum) he would consume approximately 18.75 oz/24 hours. I have
noticed that when a baby eats the appropriate amount he usually gains weight
steadily at approximately 1-2 oz per day in the first 4-6 weeks and then
somewhere around .5-1 oz per day thereafter.
At 5 months of age, this baby weighed 12 lbs. Multiply that by 2.5 oz/lb
and I would estimate that this baby should require approximately 30 ozs/day
to show a weight gain.
On day 2 of working with this family, I instructed mom to do triple feedings
- breastfeed, supplement and pump. She used previously stored breastmilk
from her freezer as well as some of her freshly pumped milk as a supplement.
In addition to the 20 oz that he breastfed again on day 2, she supplemented
with 7 extra ounces. In 24 hours, the baby gained 3 ounces! It was very
clear to me that the baby's intake was the reason for the inadequate weight
gain during the last month.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
Tarzana, CA
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