It's not me, its him!

[AndreaR]

I recently returned to work and am having trouble keepign up with my three month old son who is 14 lbs. He is drinking about 34 oz of milk a day while I am at work, and I am only able to pump about 16-20 oz at work, five times a day. I pump another 5 oz at home in the morning, and have started pumping before bed and in the middle of the night as well. I am not keeping up, my freezer supply is gone and I am struggling. Also, I am pumping far more than I want to. I started taking fenugreek today, and am hoping this helps me to pump more, but I really feel like there is a problem with the amount my son is drinking - 10 or 11 oz at a time. He also nurses about five of six times when we are home together. He is generally a healthy, content baby.

[KerrySmithIBCLC]

Wow! No wonder you're frustrated. 34 oz. during what I assume is around a 10-hour period is A LOT. I think your childcare provider is seriously overfeeding him. It is absolutely not necessary to give 10-11 oz. of EBM at a feeding. A typical feeding should be HALF that, if not less.

A good rule of thumb is that the average breastfed baby needs to take in 20-30 oz per DAY in breastmilk. If he's nursing from you 5 times during that period, and getting 4 bottles, that's 9 feedings per day. We'll be generous and say he needs 30 oz/day, divided into 9 feedings, and that's about 3 1/2 oz. per bottle.

It's very common and very easy to overfeed a breastfed baby. I would question whether they're giving him a bottle every time he peeps, and really trying to get him to "finish every drop" instead of stopping when he's full. They should be using the slowest flow nipple possible and pausing between every ounce to burp him and see if he's satisfied with that amount. It should take approximately 5 minute to feed him each ounce (so for a typical 4 oz. bottle, about 20 minutes to eat it). If he's eating much faster than that, then they're feeding him too fast, which is a common reason for overfeeding.

Here is a link to instructions on how to properly bottlefeed a breastfed baby:
http://www.kellymom.com/bf/pumping/bottle-feeding.html

More info on how much a baby should take in during daycare:

http://www.kellymom.com/bf/pumping/milkcalc.html

In summary, during a typical 10-hour workday, your baby shouldn't need more than about 10-15 oz. of milk. Much more than that and they're probably overfeeding him. A baby's stomach capacity isn't more than 5-8 oz. at a time, so 10-11 oz. is way too much to be given at once. 4 oz. is a much more appropriate amount to be offered. I would talk to your care provider about ways they can try to soothe him other than offering the bottle, and make sure they're taking their time and not feeding him too quickly.

Hope this helps!

[AndreaR]

Thanks so much. Unfortunately my husband takes care of the baby while I'm at work and insists he only feeds him when he is obviously hungry. I leave four to five ounce bottles for him, and he will drink two at a time. Is it safe to give him water at this age?

[KerrySmithIBCLC]

No, water should be avoided until they're eating solid food, and even then, only sips.

I would really try to talk to your husband about cutting back on the amounts given. At the very least, we KNOW scientifically that an infant's stomach capacity is only 5-8 oz. at that age so by giving him 10-11 oz. at a time, he's really overstretching his stomach, which can lead to obesity as he gets older.

Will he take a pacifier?