Category: 7. Nutrition

All babies spit up― especially after gulping down air with breastmilk or formula. When the stomach is full or a baby’s position suddenly changed after a feeding, you’d better have a cloth handy. The stomach contents can force the sphincter open and flood back up the esophagus.

Some babies spit up more than others. So, what can you do―if anything―to reduce the amount? How do you know if your baby’s symptoms are part of a larger problem?

Here are some answers for the American Academy of Pediatrics (AAP).

Common Parent Concerns About Spit Up

My baby spits up a little after most feedings.

• Possible cause: Gastroesophageal reflux (normal if mild)
• Action to take: None. The spitting up will grow less frequent and stop as your baby’s muscles mature. It often just takes time.

My baby gulps her feedings and seems to have a lot of gas.

• Possible cause: Aerophagia (swallowing more air than usual)
• Action to take: Make sure your baby is positioned properly.

My baby spits up when you bounce him or play after meals.

• Possible cause: Overstimulation
• Action to take: Keep mealtimes calm. Limit active play for about 20 minutes afterward.

My baby’s spitting up has changed to vomiting with muscle contractions that occur after every feeding. The vomit shoots out with force.

• Possible cause: Pyloric stenosis or another health problem that requires diagnosis and treatment.
• Action to take: Call you pediatrician right away so he or she can examine your baby.

I found blood in my baby’s spit-up or vomit.

• Possible cause: Esophagitis or another health problem that requires diagnosis and treatment.
• Action to take: Call you pediatrician right away so he or she can examine your baby.
  

What’s the difference between vomiting and spitting up?There’s a big difference. Vomiting is the forceful throwing up of stomach contents through the mouth. Spitting up is the easy flow of stomach contents out of the mouth, frequently with a burp. Spitting up doesn’t involve forceful muscle contractions, brings up only small amounts of milk, and doesn’t distress your baby or make him uncomfortable.
What causes vomiting?Vomiting occurs when the abdominal muscles and diaphragm contract vigorously while the stomach is relaxed. This reflex action is triggered by the “vomiting center” in the brain after it has been stimulated by:- Nerves from the stomach and intestine when the gastrointestinal tract is either irritated or swollen by an infection or blockage (as in the stomach bug)- Chemicals in the blood such as drugs- Psychological stimuli from disturbing sights or smells- Stimuli from the middle ear (as in vomiting caused by motion sickness)Always call your pediatrician if your baby vomits forcefully after every feeding or if there is ever blood in your baby’s vomit.

 

Remedies for Spitty Babies

Regardless of whether or not your baby’s spit up warrants watchful waiting or medical intervention, there are some simple feeding suggestions that can help you deal with the situation at hand.

Here are 5 tips to reduce your baby’s spit up:

• Avoid overfeeding. Like a gas tank, fill baby’s stomach it too full (or too fast) and it’s going to spurt right back out at you. To help reduce the likelihood of overfeeding, feed your baby smaller amounts more frequently.
• Burp your baby more frequently. Extra gas in your baby’s stomach has a way of stirring up trouble. As gas bubbles escape, they have an annoying tendency to bring the rest of the stomach’s contents up with them. To minimize the chances of this happening, burp not only after, but also during meals.
• Limit active play after meals and hold your baby upright. Pressing on a baby’s belly right after eating can up the odds that anything in his stomach will be forced into action. While tummy time is important for babies, postponing it for a while after meals can serve as an easy and effective avoidance technique.
• Consider the formula. If your baby is formula feeding, there’s a possibility that his formula could be contributing to his spitting up. While some babies simply seem to fare better with one formula over another without having a true allergy or intolerance, an estimated 5% of babies are genuinely unable to handle the proteins found in milk or soy formula―a condition called milk-soy protein intolerance (MSPI). In either case, spitting up may serve as one of several cues your baby may give you that it’s time to discuss alternative formulas with your pediatrician. If your baby does have a true intolerance, a 1- or 2-week trial of hypoallergenic (hydrolyzed) formula designed to be better tolerated might be in store.
• Try a little oatmeal. Giving babies cereal before 6 months is generally not recommended—with one possible exception. Babies and children with dysphagia or reflux, for example, may need their food to be thicker in order to swallow safely or reduce reflux. In response to concerns over arsenic in rice, the American Academy of Pediatrics (AAP) now recommends parents of children with these conditions use of oatmeal instead of rice cereal.

Remember:

The best way to reduce spit up is to feed your baby before he or she gets very hungry. Gently burp your baby when he or she takes breaks during feedings. Limit active play after meals and hold your baby in an upright position for at least 20 minutes. Always closely supervise your baby during this time.

The American Academy of Pediatrics (AAP) recommends infants be fed breast milk (also known as human milk) exclusively for the first 6 months after birth. Human milk contains a natural balance of vitamins, especially C, E and the B vitamins. So, if you and your baby are both healthy, and you are well nourished, your child may not require any supplements of these vitamins. However, breastfed infants need supplemental vitamin D.

Why do babies need vitamin D supplements?

Our bodies need sunlight to produce vitamin D, which is why exposure to sunlight is good in moderation. However, children should wear sunscreen, hats, and protective clothing when outdoors for extended periods of time to prevent sunburn and reduce the risk of skin cancer later in life. For this reason, the AAP recommends that all infants receive a vitamin D supplement (unless they are consuming more than 27 ounces per day of commercial formula that has the vitamin D supplement added.

How much vitamin D do babies need?

Vitamin D supplements of 400 IU (10 mcg) per day are recommended for babies up until age one year, with 600 IU (15 mcg) per day for children over one year. Talk to your pediatrician about supplemental vitamin D drops.
Do babies need iron supplements?

For the first four months, your breastfed baby needs no additional iron. The iron in their body at birth was enough for their initial growth. But now the reserves will be low and as their growth increases, so will their need for iron. At four months of age infants who are partially or completely breastfeeding should be supplemented with 1 mg/kg per day of oral iron until appropriate iron-containing complementary foods (including iron-fortified cereals) are introduced in their diet.

Universal screening for iron deficiency

The AAP recommends that all babies be screened at 12 months of age for iron deficiency and iron deficiency anemia.

If there were pregnancy or birth complications such as diabetes, low birth weight, or prematurity, or if your baby was small for gestational age and is taking breast milk, iron supplementation may start in the first month after birth. Fortunately, once you start your baby on solid foods, they’ll also receive iron from meats, iron-fortified cereals and green vegetables.

Babies under 6 months old should not get fluoride supplements. After that time, however, breastfed and formula-fed infants need appropriate fluoride supplementation if local drinking water contains less than 0.3 parts per million (ppm) of fluoride.

• If your home is supplied by its own well, have the well tested to determine the amount of natural fluoride in the water. If your baby consumes bottled water instead or your home is connected to a municipal water supply, check to see if the water is fluoridated.
• If your family prefers bottled water, you should consider purchasing water marketed for babies with fluoride added; sometimes called “nursery water.” It is available in the baby food aisle in grocery stores, and can be used when mixing formula.

Your pediatrician or pediatric dentist can advise you on whether there is a need for fluoride drops for your baby and prescribe the appropriate dosage. Formula-fed infants receive some fluoride from their formula if the drinking water is fluoridated.

The American Academy of Pediatrics recommends that you check with your pediatrician or pediatric dentist to find out if any additional fluoride supplements are necessary.

Remember, appropriate fluoride supplementation is based on each child’s unique needs. A supplement should be considered by you and your doctor until all of a child’s permanent teeth are present in the mouth.

Yes, arsenic. It occurs naturally in our environment in both organic (typically non-toxic) and inorganic forms. Inorganic arsenic is toxic and carcinogenic (cancer-causing). The biggest health risks from exposure to inorganic arsenic occur during pregnancy, infancy, and early childhood.

FDA Proposes Limit for Inorganic Arsenic in Infant Rice Cereal

In April 2016, the U.S. Food and Drug Administration (FDA) released a proposal to limit inorganic arsenic in infant rice cereal. The FDA’s announcement was based on its assessment of a large body of scientific information. However, the FDA is not recommending specific limits on how much rice or rice products we should eat. Rather, the FDA is continuing to recommend that all consumers, including infants, children, and pregnant women, should eat a variety of foods, including a variety of grains. The American Academy of Pediatrics (AAP) supports the proposed action level and offers tips for parents on the issue.

How You Can Reduce Your Baby’s Arsenic Exposure:

• Breastfeed. The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire. Check with your child’s doctor about vitamin D and iron supplements during the first year.
• Vary your baby’s diet. Rice cereal fortified with iron is a good source of nutrients, but it shouldn’t be the only source, and does not need to be the first source. Other options for parents to introduce as first foods besides rice cereal include oat, barley, and multigrain cereals. When introducing any new foods, the AAP recommends doing so slowly and watching for any reactions.
• Limit fruit juices. In 2012, similar questions were raised about arsenic in juice products. For years, the AAP has recommended limited intake of all sweet beverages, including juice. Infants can be encouraged to eat whole fruits that are mashed or pureed. Toddlers and young children can be encouraged to eat whole fruits instead of juice.
• Avoid brown rice syrup as a sweetener in processed foods for kids. The arsenic in rice is concentrated in rice syrup, which is sometimes used as a sweetener in toddler snacks or puffs.
• Do not use rice milk as a dairy substitute for cow’s milk. In many cases, dairy-sensitive children can be given other dietary sources of calcium instead of a highly processed dairy substitute.

Talk with your pediatrician

If you’re concerned about arsenic in your child’s food, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

Which infant cereal or other foods will be on the menu for your baby’s first solid meal? Have you set a date?

At this point, you may have a plan or are confused because you have received too much advice from family and friends with different opinions.

Here is information from the American Academy of Pediatrics (AAP) to help you prepare for your baby’s transition to solid foods.

When can my baby begin solid foods?

Remember that each child’s readiness for solid foods depends on their own rate of development.

• Can they hold their head up? Your baby should be able to sit in a high chair, a feeding seat or an infant seat with good head control.
• Do they open their mouth when food comes their way? Babies may be ready if they watch you eating, reach for your food and seem eager to be fed.
• Can they move food from a spoon into their throat? If you offer a spoon of cereal, they push it out of their mouth and it dribbles onto their chin, they may not yet be able to move it to the back of their mouth to swallow it. That’s normal. Remember, they have never had anything thicker than breast milk or formula before, and this may take some getting used to. Try diluting it the first few times; then, gradually thicken the texture. You may also want to wait a week or two and try again.
• Is your baby big enough? Generally, when infants double their birth weight (typically at about 4 months of age) and weigh about 13 pounds or more, they may be ready for solid foods.

NOTE: The AAP recommends providing your baby only breastmilk for approximately 6 months after birth. After that, the AAP supports continued breastfeeding, along with introductory foods. You should continue breastfeeding after introducing foods at six months for as long as you and your child wish, for 2 years or beyond. Check with your child’s doctor about the recommendations for vitamin D and iron supplements during the first year.

How do I feed my baby?

Start with half a spoonful or less and talk to your baby through the process (“Mmm, see how good this is?”). Your baby may not know what to do at first. They may look confused, wrinkle their nose, roll the food around inside their mouth or reject it altogether.

One way to make eating solids for the first time easier is to give your baby a little breast milk, formula or both first; then switch to very small half-spoonfuls of food; and finish with more breast milk or formula. This will prevent your baby from getting frustrated when they are very hungry.

Do not be surprised if most of the first few solid-food feedings wind up on your baby’s face, hands and bib. Increase the amount of food gradually, with just a teaspoonful or two to start. This allows your baby time to learn how to swallow solids.

If your baby cries or turns away when you feed them, do not make them eat. Go back to breastfeeding or bottle-feeding exclusively for a time before trying again. Remember that starting solid foods is a gradual process; at first, your baby will still be getting most of their nutrition from breast milk, formula or both. Also, each baby is different, so readiness to start solid foods will vary.

NOTE: Do not put baby cereal in a bottle because your baby could choke. It may also increase the amount of food your baby eats and can cause your baby to gain too much weight. However, cereal in a bottle may be recommended if your baby has reflux. Check with your child’s doctor.

Which food should I give my baby first?Your baby’s first foods are your choice. Whether you decide to make your own baby food or buy premade baby food, you have many options. However, keep the following in mind:Foods should be soft or pureed to prevent choking.Introduce one “single-ingredient” new food from any food group every 3 to 5 days. Look out for any reactions.There is no evidence that waiting to introduce baby-safe (soft) foods, such as eggs, dairy, soy, peanut products or fish, beyond 4 to 6 months of age prevents food allergy. However, testing for peanut allergy is recommended for babies with severe eczema and/or egg allergy. Check with your child’s doctor about how and when to give peanut products.There is no evidence that your baby will develop a dislike for vegetables if fruit is given first.
Be sure to include foods that provide iron and zinc, such as baby food made with meat or iron-fortified cereals.If you feed your baby premade cereal, make sure it is made for babies and is iron fortified. Baby cereals are available premixed in individual containers or dry, to which you can add breast milk, formula, or water.Within a few months of starting solid foods, your baby’s daily diet should include a variety of foods, such as breast milk, formula or both; meats; cereal; vegetables; fruits; eggs; and fish.

When can I give my baby finger foods?

Once your baby can sit up and bring their hands or other objects to their mouth, you can give them finger foods to help them learn to feed themselves. To prevent choking, make sure anything you give your baby is soft, easy to swallow, and cut into small pieces. Some examples include small pieces of banana, wafer-type cookies or crackers; scrambled eggs; well-cooked pasta; well-cooked, finely chopped chicken; and well-cooked, cut-up potatoes or peas.

At each of your baby’s daily meals, they should be eating about 4 ounces, or the amount in one small jar of strained baby food. Limit giving your baby processed foods that are made for adults and older children. These foods often contain more salt and other preservatives.

If you want to give your baby fresh food, use a blender or food processor, or just mash softer foods with a fork. All fresh foods should be cooked with no added salt or seasoning. Although you can feed your baby raw bananas (mashed), most other fruits and vegetables should be cooked until they are soft. Refrigerate any food you do not use, and look for any signs of spoilage before giving it to your baby. Fresh foods are not bacteria-free, so they will spoil more quickly than food from a can or jar.

NOTE: Do not give your baby any food that requires chewing at this age, or any food that can be a choking hazard. Foods to avoid include hot dogs (including meat sticks, or baby food “hot dogs”); nuts and seeds; chunks of meat or cheese; whole grapes; popcorn; chunks of peanut butter; raw vegetables; fruit chunks, such as apple chunks; and hard, gooey, or sticky candy.

What changes can I expect after my baby starts solids?

When your baby starts eating solid foods, their stools will become more solid and variable in color. Because of the added sugars and fats, they will have a much stronger odor, too. Peas and other green vegetables may turn the stool a deep-green color; beets may make it red. (Beets sometimes make urine red as well.)

If your baby’s meals are not strained, their stools may contain undigested pieces of food, especially hulls of peas or corn, and the skin of tomatoes or other vegetables. All of this is normal. Your baby’s digestive system is still immature and needs time before it can fully process these new foods. If the stools are extremely loose, watery, or full of mucus, however, it may mean the digestive tract is irritated. In this case, reduce the amount of solids and introduce them more slowly. If the stools continue to be loose, watery, or full of mucus, talk with your child’s doctor to find the reason.

Should I give my baby juice?

Babies do not need juice. Babies younger than 12 months should not be given juice. After 12 months of age (up to 3 years of age), give only 100% fruit juice and no more than 4 ounces a day. Offer it only in a cup, not in a bottle. To help prevent tooth decay, do not put your child to bed with a bottle. If you do, make sure it contains only water. Juice reduces the appetite for other, more nutritious, foods, including breast milk, formula, or both. Too much juice can also cause diaper rash, diarrhea or excessive weight gain.

Does my baby need water?

Healthy babies do not need extra water. Breast milk, formula, or both provide all the fluids they need. However, it is OK to offer a little water when you begin to give your baby solid foods. Use an open, sippy or strawed cup and limit water to no more than 1 cup (8 ounces) each day. Also, a small amount of water may be needed in very hot weather. If you live in an area where the water is fluoridated, drinking water will also help prevent future tooth decay.

Good eating habits start early

It is important for your baby to get used to the process of eating—sitting up, taking food from a spoon, resting between bites and stopping when full. These early experiences will help your child learn good eating habits throughout life.

Encourage family meals from the first feeding. When you can, the whole family should eat together. Research suggests that having dinner together, as a family, on a regular basis has positive effects on the development of children.

Remember to offer a good variety of healthy foods that are rich in the nutrients your child needs. Watch your child for cues that they have had enough to eat. Do not overfeed!

If you have any questions about your child’s nutrition, including concerns about your child eating too much or too little, talk with your child’s doctor.

The following are some possible warning signs of feeding problems, and should be discussed with your pediatrician.

Too Much Feeding:

• If bottle-fed, the baby is consuming more than 4 to 6 ounces (120 to 180 mL) per feeding.
• She vomits most or all the food after a complete feeding.
• Her stools are loose and very watery, eight or more times a day. (Keep in mind that breastfed babies normally tend to have much more frequent and looser stools.)

Too Little Feeding:

• If breastfed, the baby stops feeding after ten minutes or less.
• She wets fewer than four diapers per day; particularly if she has begun sleeping through the night, she may be feeding inadequately (since most babies feed at least once during the night), and may urinate less often and become mildly dehydrated.
• She has infrequent or very hard stools in the first month.
• She appears hungry, searching for something to suck shortly after feedings.
• She becomes more yellow, instead of less, during the first week.

Feeding Allergy or Digestive Disturbance:

• Your baby vomits most or all food after a complete feeding.
• She produces loose and very watery stools eight or more times a day or has blood in the stools.
• She has a severe skin rash.

Now that your baby is eating solid foods, planning meals can be more challenging. At this age, your baby needs between 750 and 900 calories each day, of which about 400 to 500 should come from breast milk or formula (if you are not breastfeeding)—roughly 24 ounces (720 mL) a day. Breast milk and formula contain vitamins, minerals, and other important components for brain growth.

At about eight months, you may want to introduce foods that are slightly coarser than strained pureed foods. They require more chewing than baby foods. You can expand your baby’s diet to include soft foods such as yogurt, oatmeal, mashed banana, mashed potatoes, or even thicker or lumpy pureed vegetables. Eggs (including scrambled) are an excellent source of protein, as are cottage cheese, Greek yogurt, and avocado.

Sample menu ideas for an 8- to 12-month-old baby:

1 cup = 8 ounces = 240 ml
¾ cup = 6 ounces = 180 ml
½ cup = 4 ounces = 120 ml
¼ cup = 2 ounces = 60 ml

Breakfast

• 2 to 4 ounces cereal, or 1 mashed or scrambled egg
• 2 to 4 ounces mashed or diced fruit
• Breastmilk or 4 to 6 ounces formula

Snack

• Breastmilk or 4 to 6 ounces formula
• 2 to 4 ounces diced cheese or cooked pureed or diced vegetables

Lunch

• 2 to 4 ounces yogurt or cottage cheese, or pureed or diced beans or meat
• 2 to 4 ounces cooked pureed or diced yellow or orange vegetables
• Breastmilk or 4 to 6 ounces formula

Snack

• 1 whole grain cracker or teething biscuit
• 2 to 4 ounces yogurt or fork-mashed or diced soft fruit
• 2 to 4 ounces water

Dinner

• 2 to 4 ounces diced diced poultry, meat, or tofu
• 2 to 4 ounces cooked green vegetables
• 2 to 4 ounces cooked soft-whole grain pasta or potato
• 2 to 4 ounces diced or mashed fruit
• Breastmilk or 4 to 6 ounces formula

Before bedtime

Breastmilk or 6 to 8 ounces formula, or water. (If breastmilk or formula, follow with water or brush teeth afterward).

Babies and young toddlers should get about half of their calories from fat. Healthy fats are very important for normal growth and devel­opment at this stage of their development.

All fats are not created equal, though. Healthy fats like those found in avocado, olive oil, fish, nut butters, and dairy are good for your child (and you). Unhealthy fats such as those found in fried foods, fast foods and many packaged foods are not healthy at any age. If you keep your child’s daily caloric intake at about 1,000 calories, you needn’t worry about overfeeding and risk of weight gain

Here is a sample menu for a one-year-old child who weighs about 21 pounds (9.5 kg):

1 cup = 8 ounces = 240 ml1 ounce = 2 tablespoons = 30 ml½ ounce = 1 tablespoon = 15 ml = 3 teaspoons1 teaspoon = ¹⁄³ tablespoon = 5 ml

BREAKFAST

• ½ cup iron-fortified breakfast cereal or 1 cooked egg
• ½ cup whole or 2% milk
• ½ banana, sliced
• 2 to 3 large sliced strawberries

SNACK

• 1 slice toast or whole-wheat muffin with 1–2 tablespoons cream cheese or peanut butter, or ½ cup yogurt with cut-up fruit
• Water or ½ cup whole or 2% milk

LUNCH

• ½ sandwich: sliced turkey or chicken, tuna, egg salad or peanut butter
• ½ cup cooked green vegetables
• ½ cup whole or 2% milk

SNACK

• 1 to 2 ounces cubed or string cheese, or
• 2 to 3 tablespoons fruit or berries
• Water or ½ cup whole or 2% milk

DINNER

• 2 to 3 ounces cooked meat, ground or diced
• ½ cup cooked yellow or orange vegetables
• ½ cup whole-grain pasta or potato
• ½ cup whole or 2% milk

Remember

Talk with your child’s pediatrician if you have any questions or concerns about your baby’s diet.

• Bottle feeding can be a warm, loving experience—cuddle your baby closely, gaze into her eyes, and coo and talk to her. Never prop the bottle and let your baby feed alone; not only will you miss the opportunity to bond with her while she feeds, but there’s also a danger that she’ll choke or the bottle will slip out of position. Propping the bottle also increases the risk of ear infections. We do not recommend devices to hold a bottle in a baby’s mouth—they could be dangerous.
• Although some babies will drink a bottle straight from the refrigerator, most prefer milk warmed to room temperature. You can warm a bottle by placing it in a bowl of hot water for a few minutes. Sprinkle a few drops on your wrist; it should feel lukewarm. If it’s too warm, wait for it to cool a bit and test again.
  • Note: Never warm a bottle of formula or human milk in the microwave. The bottle itself may feel cool while the liquid inside can be too hot. Microwaving also heats unevenly. Even though a few drops sprinkled on your wrist may feel OK, some of the formula or human milk may be scalding. The composition of human milk may change if it is warmed too much, as well.
• Make sure the nipple hole is the right size. If your baby seems to be gagging or gulping too fast, the nipple hole may be too large. If your baby is sucking hard and seems frustrated, the hole may be too small.
• Try different nipple shapes to see which your baby prefers. There is no correct shape.
• Angle the bottle so your baby isn’t sucking in air. Burp your baby a couple of times during the course of a feeding.
• Encourage your partner to give your baby a bottle now and then, perhaps one of the late-night feedings. This not only allows you some extra rest, but it also fosters bonding with your baby.
• Don’t let your baby fall asleep sucking on a bottle of milk, especially if she is beginning to cut teeth. Milk pooled in your baby’s mouth can cause serious tooth decay, known as nursing-bottle caries. After feeding and before putting your baby to sleep, gently wipe any milk residue from her gums. If she needs to suck herself to sleep, give her a pacifier instead of a bottle.
• Repeated sterilization may distort nipple openings. Test to make sure milk flow through the nipple is adequate.

One of the most common questions new parents have is how often their baby should eat. The best answer is surprisingly simple: in general, babies should be fed whenever they seem hungry.

How do I know when my baby is hungry?

For babies born prematurely or with certain medical conditions, scheduled feedings advised by your pediatrician are best. But for most healthy, full-term infants, parents can look to their baby rather than the clock for hunger cues. This is called feeding on demand, or responsive feeding.

Hunger cues

A hungry baby often will cry. But it’s best to watch for hunger cues before the baby starts crying, which is a late sign of hunger and can make it hard for them to settle down and eat.

Some other typical hunger cues in babies:

• Licking lips
• Sticking tongue out
• Rooting (moving jaw and mouth or head in search of breast)
• Putting his/her hand to mouth repeatedly
• Opening her mouth
• Fussiness
• Sucking on everything around

It is important to realize, however, that every time your baby cries or sucks it is not necessarily because he or she is hungry. Babies suck not only for hunger, but also for comfort; it can be hard at first for parents to tell the difference. Sometimes, your baby just needs to be cuddled or changed.

General guidelines for baby feeding

It is important to remember all babies are different―some like to snack more often, and others drink more at one time and go longer between feedings. However, most babies will drink more and go longer between feedings as they get bigger and their tummies can hold more milk:

• Most newborns eat every 2 to 3 hours, or 8 to 12 times every 24 hours. Babies might only take in half ounce per feeding for the first day or two of life, but after that will usually drink 1 to 2 ounces at each feeding. This amount increases to 2 to 3 ounces by 2 weeks of age.
• At about 2 months of age, babies usually take 4 to 5 ounces per feeding every 3 to 4 hours.
• At 4 months, babies usually take 4 to 6 ounces per feeding.
• At 6 months, babies may be taking up to 8 ounces every 4 to 5 hours.

Most babies will increase the amount of formula they drink by an average of 1 ounce each month before leveling off at about 7 to 8 ounces per feeding. Solid foods should be started at about 6 months old.

Concerns about overfeeding or underfeeding your baby

Too full?

Babies are usually pretty good at eating the right amount, but they can sometimes take in more than they need. Infants who are bottle feeding may be more likely to overfeed, because drinking from a bottle may take less effort than breastfeeding.

Overfed babies can have stomach pains, gas, spit up or vomit and be at higher risk for obesity later in life. It’s better to offer less, since you can always give more if your baby wants it. This also gives babies time to realize when they’re full.

If you are concerned your baby wants to eat all the time―even when he or she is full―talk with your pediatrician. Pacifiers may be used after feeding to help sooth healthy-weight babies who like to suck for comfort, rather than nutrition. For babies who are breastfed, it’s best to wait to offer pacifiers until around 3 to 4 weeks of age, when breastfeeding is well-established.

Trouble gaining weight?

Most babies will double their birth weight by 5 months of age and triple their birth weight by their first birthday. If your baby is having trouble gaining weight, don’t wait too long between feeding―even if it means waking your baby. Be sure to talk with your pediatrician about how often and how much to feed your baby.

How do I know if my baby is getting enough to eat?

Daily diapers

A newborn’s diaper is a good indicator of whether he or she is getting enough to eat. In the first few days after birth, a baby should have 2 to 3 wet diapers each day. After the first 4 to 5 days, a baby should have at least 5 to 6 wet diapers a day. Stool frequency is more variable and depends whether your baby is breastfed or formula fed.

Growth charts

During regular health check-ups, your pediatrician will check your baby’s weight and plot it on a growth chart. Your baby’s progress on the growth chart is one way to tell whether or not they are getting enough food. Babies who stay in healthy growth percentile ranges are probably getting a healthy amount of food during feedings.

Remember

Talk with your pediatrician if you have any questions or concerns about your baby getting the right amount to eat.