They say you can’t over feed a breast fed baby. They’re usually pretty good about taking what they need and stopping when they’re full. This is because of stomach and breast anatomy. Remember how sucking and milk flow rate at the breast are different than the bottle? This directly links to stomach anatomy.
There are two kinds of receptors in the stomach: density and stretch. Density receptors tell you how calorically dense or fat-rich your food is. It’s why at the Cheesecake Factory your belly starts to feel really full after about ten bites of Godiva chocolate Cheesecake but you can eat 3 bags of popcorn at the theater. Chocolate is much richer and calorically denser than popcorn. Stretch receptors tell you how full your stomach is from a volume perspective. Your stomach at rest is on average the size of your fist. That’s true throughout your entire life. But the stomach can stretch. Just like my stretchy pants at Thanksgiving. It can still only fill to a certain capacity. The only problem is, it takes approximately 20 minutes for your stretch receptors to tell your brain that the stomach had stretched to capacity. This is what I call the twenty minute phenomenon. You know, when a group of college boys order a pizza, they each eat a whole pizza in ten minutes and then twenty minutes later feel over full and sick. They as much as they could as fast as they could but paid for it in the twenty minute window. Exclusively breast fed babies don’t typically over eat because again, breast milk flow varies over a feeding. It starts slow, mommy goes into let down, then milk shows, mommy changes the baby to the other side, milk starts slow, mommy goes into let down, 15-20 minutes later the baby’s stomach tells the brain it’s full and the baby stops eating. Anatomy and physiology in perfect harmony.
Unfortunately bottle fed can be over fed. Bottles have these lovely ounce markers on them that tell us how much the baby needs to eat to be full. At every feeding my baby NEEDS to get a full 5 ounces of she will be hungry. She NEEDS to eat 24 ounces in a day or she will starve to death. And when baby stops eating at 3.5 ounces, I just jiggle the bottle or wait a few minutes and jiggle the bottle until baby takes that full feeding. Jiggle, wiggle, look at that she took the full feeding. Instead of listen to baby’s cuts that she’s full, we let the bottle dictate how much baby needs. And we wonder why formula feed babies have a significantly higher rate of obesity. Here’s the thing. Bottles are not the enemy. My daughter takes breast milk from a bottle five days a week while I’m at work. They are lovely devices that do an essential job. But we need to be mindful to not over feed our bottle fed babies.
Tips to not over feed a bottle fed baby (regardless of what’s in the bottle)
1. Always use a show flow nipple until 1 year of age. Slow flow most closely mimicks the flow at the breast. It also shows a baby down so the brain can keep up with the stomach (aka be mindful of those stretch receptors).
2. Watch your baby’s cues. Does he push the bottle away? Did he become sleepy? Do his hands and body relax? Does he release his iron grip on the nipple? These are signs he’s done. Over fed babies tend to spit up or vomit more because their tummies are at capacity. Don’t try to force in that last half an ounce. Respect your baby and stop feeding. Your baby will let you know if he’s still hungry.
3. In reality, babies only ever need 3-5 ounces of milk per feeding. In the first four to six months when your baby isn’t eating any solids, here’s a simple rule of thumb: Offer 2.5 ounces of formula per pound of body weight each day. For example, if your baby weighs 6 pounds, you’ll give her about 15 ounces of formula in a 24-hour period. Once a baby is six months of age and starting solid foods, offer the breast or bottle first (3-5 ounces), then offer well balanced, nutritious, solids. The solids will provide them the additional nutrition they need. (**Disclaimer : if your baby is not ready for solids at six months, that’s FINE. Your baby is ready to start solids when they can sit unsupported for a good amount of time, uses a pintcher grasp, and has the hand eye coordination of hand to mouth. If your baby is over six months and not taking solids, your baby may need additional milk per feeding.)
4. It is OK for volumes of feedings to be didn’t throughout the day. We take for granted that babies can know their bodies. They can tell us when they’re hungry and when they’re full. Sometimes I’m really hungry in the morning and I eat a Grand Slam breakfast. Other times I only want a piece of toast. It’s OK to have your baby eat a ton one meal and very little the next. Remember, there are no ounce markers on the breast. Exclusively breast fed babies do this all the time. And there’s no amount of nipple jigging that will get them to take more in a feeding.
Here’s the big take away: it’s OK to take the pressure off feeding, especially if your a working mom trying to keep up with pumping. As long as your baby is following their growth curve, making enough wet and dirty diapers, and happy, keep doing what you’re doing. If your baby is not getting enough nutrition, not gaining weight, or unhappy, please have your pediatrician write a referral to a pediatric clinic ASAP or give me a call and we can dialogue through a plan of action.