Expressed Milk , working Mom Question !

[sixzigma]

I leave about 8-9 Oz of expressed Milk for LO for the 7 hours I am away from home (for work) .The practice currently followed by the nanny is about one oz per hour(1 oz in 1 bottle in one hour ) and the next bottle if he seems more hungry and if all the 8-9 bottles are done before I get back she uses formula (about 30 ml)
My question is does one oz per hour sounds ok ? he is 4 Months old (and after I am back from work he feeds every 2 hours directly )?

 

[Biotechick829]

If he's wanting formula then he's probably still hungry after the 8-9oz of breastmilk. My LO doesn't follow the "1oz/hr" rule at all. From 2.5 months to 5 months she's been eating 17-20oz of breastmilk at daycare (she's there 8-9 hrs). Every baby's different though and I know she's definitely on the high side.

Do you have any extra milk you could send with him? I've had to pump before bed and in the morning after her feed to make sure I can give her enough for the day.

Edit: re-reading your post, I'm confused. Are they giving him 1oz/hr?? As in one ounce in one bottle every hour? If so, that's certainly not how he should be fed. At 4 months he should be feeding once every 3 hrs or so. For instance, my LO took a 6.5 oz bottle ONCE every 3 hrs at 4 months (again, she's on the high side)

 

[sixzigma]

6.5 OZ at once ?? good lord.so that will be like 13 oz for the 7 hours I am away .. hmmm i need to increase my supply then or pumping schedule .For I pump at work for the next day so I manage to get 8-9 0z while at work .
So this means I will have to pump 12 oz (atleast)....
Can somebody suggest when to pump to get maximum output especially when My lo is almost always latched on

Edit ; My LO has always been a snacker since birth ...so i am confused as to what should I be doing

 

[Biotechick829]

Yes, 6.5 oz at once.

All BF babies are "snackers" when they're young - they usually camp out on your boob all of the time because they're working on getting your supply up. The older they get, the more milk they can and should take at once over a longer period of time (with the exception of growth spurts, which your LO very might well be going through).

Also, between 1-6 months BF babies will eat 19-30 oz of milk (average 25 oz) per 24 hrs (some babies are on the lower end and some are on the high end, either is normal). For a 4 month old he should be eating every 3 hrs or so. If he's on the low end and nursing 1-2 times at night, he should be eating ~2.5 oz per feed every 3 hrs.

So you may need to increase your supply. Pump anytime you can. If LO is nursing, pump the other side. Pump before bed or wake up in the middle of the night to pump (silly as it sounds, it does help). Keep pumping a few minutes after the milk stops coming - it will tell your body it needs to make more. Also, on the weekends or time home just let your LO nurse as long as he wants even if he's not eating. The suckling will stimulate you to make more milk.

This is also very helpful in terms of how often babies should be eating:

The First 3 Days

Breast-feeding: 1st day – 5 min. at each breast (all day, whenever baby wants); 2nd day – 10 min. at each breast (every 2 hrs); 3rd day – 15 min. at each breast (every 2 1/2 hrs); 4th day or once milk comes in – Hogg recommends emptying one breast before switching (every 2 1/2 hrs).
Breast-feeding moms should feed more often to get the milk flowing at this time.

Up to 6 weeks Old

Breast-feeding: Up to 45 minutes
Feed every 2 1/2 – 3 hrs during the day; cluster feed in the early evening (feed at two-hour intervals in the early evening, at 5 and 7 or 6 and 8)
“Dream Feed” your baby somewhere between 10 and 11 pm. This means you feed your baby while she’s asleep. Not talking, turning on the lights, or changing diaper. Just feed and plop baby back in the crib.
Babies are capable of going 4-5 hours during the night, depending on weight and temperament.

6 weeks-4 months

Breast-feeding: Up to 30 minutes
Feed every 3 – 3 1/2 hrs; by 16 weeks, should be able to go 6-8 hrs during the night. Don’t continue cluster feeding past 8 weeks.
Goal should be to extend the time between feedings during the day, so that at 4 months, your baby lasts around 4 hrs between feeds. Exception for babies going through a growth spurt.


4 – 6 months

Breast-feeding: Up to 20 minutes
Feed every 4 hrs; should be able to go 10 hrs during the night.
Between 4 and 6 months, some babies’ appetites are affected by teething and their newfound mobility. So, they may consume less.

6 – 9 months

Breast-feeding: Give food first and then the bottle or 10 min. on breast. Since they can gulp liquids quickly at this age, it will probably only take 10 min. (versus the 30 minutes).

 

[sixzigma]

ok so today i have upped the amount to 2.5 oz per bottle and a total of 13 oz ( vs the normal 7 the nanny usually gives him) for 6-7 hours . I will figure out how he responds to this and then up the amount again if needed.

if cluster feeding aint good for DS then i think i should ask the nanny to change the feeding routine instead of 2 oz six times , it should be made 3 oz 4 times or 4 oz 3 times or 5-6 oz 2 times in a span of those 6-7 hours that i am away .should i gradually be increasing the amount per feed or just go ahead and c if he feeds 5 oz a feed?

 

[Biotechick829]

The only way I knew it was time to increase the oz per feed was when Daycare told me she'd finished her entire bottle. I'd then send her with more milk per bottle and have a daycare report back to me on how much she ate. Using this method, since 10 wks old she's gone from 6 x 3.5oz bottles, to 5 x 4oz bottles, 4 x 5oz bottles to now 3 x 6.5oz bottles.

Unfortunately it might mean you "wasting" some milk if you over estimate how much he can eat in one feed, but you'll never know until you offer it to him. At his age his stomach can hold many oz of milk so I don't think you'd need to ease into it. Try the 4 x 3oz bottles. If he's finishing every last drop and needing a feed less than every 2.5 hrs then up them again the next day to 3 x 4oz and so on. Once he's leaving 0.5-1 oz in the bottle, you've figured out how much he'll eat per fed. He really should be feeding every 3 hrs or so at his age.

The only other thing I can think of is to give him a pacifier (if he has one) if he acts hungry an hr after a feed because he might be so used to sucking/nursing so frequently. Good luck!

 

[sunnylove]

My LO were in NICU for over 3 months and he started the majority of his feedings from a bottle (expressed breastmilk). The speech therapists told us that he should not be "snacking" throughout the day, which is what I would consider 1oz every hour. She said it's not constructive to get into a "grazing pattern" and that (at least when they are taking bottles) they need to be taking a bigger amount every 2-3 hours.

 

[sixzigma]

so he takes 2-2.5(2.5 is rare though ) oz now per feed now .Hoping his intake per feed increases in the coming weeks .
Thanks ladies !!
so 12-13 oz for 6-7 hours is what he takes while I am away now .Just that he still takes it at a gap of 1.5-2 hours and at 2-2.5 oz only (anything above 2.5 is wasted )

 

[misspriss]

I don't see anything wrong with small amounts. My LO is 7.5 months and I still make him 2oz bottles. He takes ~1.5 oz at a time, multiple times throughout the day (every 2 hours or so). He takes about 7.5 ounces while I am at work (10 hours). We cosleep so he nurses a lot at night.

There is nothing bad about taking small bottles. There is nothing wrong with cluster feeding, especially at 4 months (big growth spurt time!). There is no reason to force a baby to adapt to adult eating/feeding schedules. If your baby acts hungry every two hours but only wants 2.5 ounces, then for goodness sake feed him 2.5 ounces every 2 hours!

You are lucky, you have a nanny, so your baby doesn't need to take large feeds infrequently (this is beneficial for nursery staff so they have time to feed all the babies, not for babies who digest milk quickly).

From Kellymom:

Moms may find it surprising that the breastfed baby often takes less milk in the bottle than formula babies take in. This is because breastmilk is so well utilized by the baby’s body that less is needed. Since breastmilk is so easily and completely digested, the breastfed baby needs to eat more often, but they don’t need as much per bottle.

” According to the most current breastfeeding research, exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. This may vary a little from baby to baby, but the average range of milk intake is 19-30 oz per day (570-900 mL per day).

To estimate the average amount of milk baby will need at a feeding:

Estimate the number of times that baby nurses per day (24 hours).
Then divide 25 oz by the number of nursings.
This gives you a “ballpark” figure for the amount of expressed milk your exclusively breastfed baby will need at one feeding.

Example: If baby usually nurses around 8 times per day, you can guess that baby might need around 3 ounces per feeding every 3 hours when mom is away. (25/8=3.1).

NOTE: Current breastfeeding research does not indicate that breastmilk intake changes with baby’s age or weight between one and six months.”

Ideally bottlefeeding the baby should mimic how a mother breastfeeds her baby. The baby should be fed on cue, or demand, and not according to a rigid schedule. Breastmilk digests in about 90 minutes, so one would expect the feedings to be anywhere from 1.5 hrs to 3 hours apart. (younger babies often need to eat more frequently than older babies).

Taking over 4-5 ounces of breastmilk at a time surprises me completely. The most I have heard is 5 before, most usually take 4 or less. My lactation consultant said to start with 3 and adjust for intake, we settled on 2.

Again, there is absolutely nothing wrong with what your baby wants to eat, why force him to change? What benefit would you get by forcing him to stretch his stomach to accommodate considerably more than he wants?

 

[Noo]

At 2 months my LO takes 2-3oz then would be satisfied for a couple of hours x

 

[Biotechick829]

Sixzigma - that's great he's taking a couple oz's a feed! Just follow his cues. If he ever finishes an entire bottle and seems to want more than increase the bottle by 0.5 oz and see how it goes.

misspriss - you're right, there's nothing wrong with a baby taking small bottles but OP's issue was that he was only being offered 1 oz and wanting another 1 oz only an hour later, likely because he wasn't full from the first oz. We're not encouraging OP to "stretch" her baby's stomach. A 4 months old baby's stomach is considerably larger than it was in the first few weeks and they can physically take more at a feed to feel satiated. He's clearly wanting more to eat since he can only last 1 hr since the last feed.

If I were to give my 5 month old 3 oz she would through a crying fit (and has when I've given her a 6.5 oz bottle and tried to burp her half way through). No way have I ever tried to stretch her stomach or overfeed her (we even just switched to the Stage 1 nipple a month ago to try and slow the flow as much as possible!). She's 93rd percentile for length and 83rd percentile for height and her intake just about matches how much I can pump. Every baby is different

 

[Biotechick829]

Also, for my LO she only takes one dreamfeed at 11pm and nurse again when she wakes at 6:30am, which also contributes to the fact that she eats more during the day. With cosleeping and feeding throughout the night, it results in not as many oz eaten during the day since they're getting them at night (with the exception of a growth spurt). Same oz over 24 hrs eaten, just at different times of day. Just wanted to mention that

 

[misspriss]

Sixzigma - that's great he's taking a couple oz's a feed! Just follow his cues. If he ever finishes an entire bottle and seems to want more than increase the bottle by 0.5 oz and see how it goes.

misspriss - you're right, there's nothing wrong with a baby taking small bottles but OP's issue was that he was only being offered 1 oz and wanting another 1 oz only an hour later, likely because he wasn't full from the first oz. We're not encouraging OP to "stretch" her baby's stomach. A 4 months old baby's stomach is considerably larger than it was in the first few weeks and they can physically take more at a feed to feel satiated. He's clearly wanting more to eat since he can only last 1 hr since the last feed.

If I were to give my 5 month old 3 oz she would through a crying fit (and has when I've given her a 6.5 oz bottle and tried to burp her half way through). No way have I ever tried to stretch her stomach or overfeed her (we even just switched to the Stage 1 nipple a month ago to try and slow the flow as much as possible!). She's 93rd percentile for length and 83rd percentile for height and her intake just about matches how much I can pump. Every baby is different

Yep every baby is different! Your baby just let you know she was NOT just having that 3oz bottle!

My baby does NOT match my pumping output at all, it's halfway through my day and I've pumped 10oz already, he takes 8 at most, and I will pump again in the afternoon. Just adding to that freezer stash...But judging by my pumping output when I get two let downs (4oz on right side), when he is nursing and nurses straight through the second let down (on the right, lefty doesn't produce as much), I figure his stomach probably holds more than I think. He just reverse cycles.

 

[sixzigma]

thanks ladies ....For LO now i keep 3 bottles of 2 oz each and one of 3 oz and two bottles of of 2.5 oz each-the nanny gives it to accordingly (depending on how hungry he is , like after a play/tummy time or poop etc ) ...a lot of trial and error happened over the last week to arrive at these volumes ...aint I proud of myself :-D