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How much expressed milk will my baby need?

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By Kelly Bonyata, BS, IBCLC

How much milk do babies need?

Many mothers wonder how much expressed breastmilk they need to have available if they are away from baby.

In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts). Current breastfeeding research does not indicate that breastmilk intake changes with baby's age or weight between one and six months. After six months, breastmilk intake will continue at this same level until - sometime after six months, depending in baby's intake from other foods - baby's milk intake begins to decrease gradually ( see below).

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The research tells us that exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. Different babies take in different amounts of milk; a typical range of milk intakes is 19-30 oz per day (570-900 mL per day).

We can use this information 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 when mom is away. (25/8=3.1).

What if baby is eating solid foods?

Sometime between six months and a year (as solids are introduced and slowly increased) baby's milk intake may begin to decrease, but breastmilk should provide the majority of baby's nutrition through the first year. Because of the great variability in the amount of solids that babies take during the second six months, the amount of milk will vary, too. One study found average breastmilk intake to be 30 oz per day (875 ml/day; 93% of total intake) at 7 months and 19 oz (550 ml/day; 50% of total energy intake) at 11-16 months.

Several studies have measured breastmilk intake for babies between 12 and 24 months and found typical amounts to be 14-19 oz per day (400-550 mL per day). Studies looking at breastmilk intake between 24 and 36 months have found typical amounts to be 10-12 oz per day (300-360 mL per day).

Is baby drinking too much or too little expressed milk?

Keep in mind that the amount of milk that baby takes at a particular feeding will vary, just as the amount of food and drink that an adult takes throughout the day will vary. Baby will probably not drink the same amount of milk at each feeding. Watch baby's cues instead of simply encouraging baby to finish the bottle.

If your baby is taking substantially more than the average amounts, consider the possibility that baby is being given too much milk while you are away. Things that can contribute to overfeeding include:

Fast flow bottles. Always use the lowest flow bottle nipple that baby will tolerate. Even with a slower flowing nipple, it is important to pace the bottle feed to allow baby to better control his intake.

Using bottle feeding as the primary way to comfort baby. Some well-meaning caregivers feed baby the bottle every time he makes a sound. Use the calculator above to estimate the amount of milk that baby needs, and start with that amount. If baby still seems to be hungry, have your caregiver first check to see whether baby will settle with walking, rocking, holding, etc. before offering another ounce or two.

Baby's need to suck. Babies have a very strong need to suck, and the need may be greater while mom is away (sucking is comforting to baby). A baby can control the flow of milk at the breast and will get minimal milk when he mainly needs to suck. When drinking from a bottle, baby gets a larger constant flow of milk as long as he is sucking. If baby is taking large amounts of expressed milk while you are away, you might consider encouraging baby to suck fingers or thumb, or consider using a pacifier for the times when mom is not available, to give baby something besides the bottle to satisfy his sucking needs.

If, after trying these suggestions, you're still having a hard time pumping enough milk, see I'm not pumping enough milk. What can I do?

If baby is taking significantly less expressed milk than the average, it could be that baby is reverse-cycling, where baby takes just enough milk to "take the edge off" his hunger, then waits for mom to return to get the bulk of his calories. Baby will typically nurse more often and/or longer than usual once mom returns. Some mothers encourage reverse cycling so they won't need to pump as much milk. Reverse cycling is common for breastfed babies, especially those just starting out with the bottle.

If your baby is reverse cycling, here are a few tips:

Be patient. Try not to stress about it. Consider it a compliment - baby prefers you!

Use small amounts of expressed milk per bottle so there is less waste.

If you're worrying that baby can't go that long without more milk, keep in mind that some babies sleep through the night for 8 hours or so without mom needing to worry that baby is not eating during that time period. Keep an eye on wet diapers and weight gain to assure yourself that baby is getting enough milk.

Ensure that baby has ample chance to nurse when you're together.

Other ways of estimating milk intake

There are various ways of estimating the amount of milk intake related to the weight of the baby and the age of the baby, based upon formula intake - research has shown that after the early weeks these methods overestimate the amount of milk that baby actually needs. These are the estimates that we used for breastfed babies for years, with the caveat that most breastfed babies don't take as much expressed milk as estimated by these methods. Current research tells us that breastmilk intake is quite constant after the first month and does not appreciably increase with age or weight, so the current findings are validating what moms and lactation counselors have observed all along.

More:

References

Onyango, Adelheid W., Receveur, Olivier and Esrey, Steven A. The contribution of breast milk to toddler diets in western Kenya. Bull World Health Organ, 2002, vol.80 no.4. ISSN 0042-9686.

Salazar G, Vio F, Garcia C, Aguirre E, Coward WA. Energy requirements in Chilean infants. Arch Dis Child Fetal Neonatal Ed. 2000 Sep;83(2):F120-3.

Kent JC, Mitoulas L, Cox DB, Owens RA, Hartmann PE. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999 Mar;84(2):435-47.

Persson V, Greiner T, Islam S, and Gebre-Medhin M. The Helen Keller international food-frequency method underestimates vitamin A intake where sustained breastfeeding is common. Food and Nutrition Bulletin, vol.19 no.4. Tokyo, Japan: United Nations University Press, 1998.

Cox DB, Owens RA, Hartmann PE. Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996 Nov;81(6):1007-20.

Dewey KG, Heinig MJ, Nommsen LA, Lonnerdal B. Maternal versus infant factors related to breast milk intake and residual milk volume: the DARLING study. Pediatrics. 1991 Jun;87(6):829-37.

Neville MC, et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr. 1988 Dec;48(6):1375-86.

Dewey KG, Finley DA, Lonnerdal B. Breast milk volume and composition during late lactation (7-20 months). J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):713-20.

Butte NF, Garza C, Smith EO, Nichols BL. Human milk intake and growth in exclusively breast-fed infants. J Pediatr. 1984 Feb;104(2):187-95.

Dewey KG, Lonnerdal B. Milk and nutrient intake of breast-fed infants from 1 to 6 months: relation to growth and fatness. J Pediatr Gastroenterol Nutr. 1983;2(3):497-506.

Brown K, Black R, Robertson A, Akhtar N, Ahmed G, Becker S. Clinical and field studies of human lactation: methodological considerations. Am J Clin Nutr 1982;35:745-56.

Jelliffe D, Jelliffe E. The volume and composition of human milk in poorly nourished communities: a review. Am J Clin Nutr 1978;31:492-515.

Summary of Research Data

Baby's Age

Average Milk Intake per 24 hours

Reference

Specific Gravity of Mature Human Milk = 1.031, so Density of Mature Human Milk ~ 1.031 g/ml;1 oz = 29.6 ml;Numbers in gray were derived using the above conversion factors.

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How much expressed milk will my baby need? * KellyMom.com

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Many mothers wonder how much expressed breastmilk they need to have available if they are away from baby. In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts).

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Am I expressing enough?

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About half a feeding if she is pumping between regular feedings (after about one month, this would be about 1.5 to 2 ounces (45-60 mL)

A full feeding if she is pumping for a missed feeding (after one month, this would be about 3 to 4 ounces (90-120 mL)

Time of day. Most women pump more milk in the morning than later in the day. That's because milk production varies over the course of the day. To get the milk they need, many babies respond to this by simply breastfeeding more often when milk production is slower, usually in the afternoon and evening. A good time to pump milk to store is usually thirty to sixty minutes after the first morning nursing. Most mothers will pump more milk then than at other times. If you're an exception to this rule of thumb, pump when you get the best results. No matter when you pump, you can pump on one side while nursing on the other to take advantage of the baby-induced let-down. You can offer the other breast to the baby even after you pump and baby will get more milk.

Your emotional state. If you feel upset, stressed, or angry when you sit down to pump, this releases adrenaline into your bloodstream, which inhibits your milk flow. If you're feeling negative and aren't pumping as much milk as usual, take a break and pump later, when you're feeling calmer and more relaxed.

Your breast storage capacity. This is the maximum amount of milk available in your breasts during the time of day when your breasts are at their fullest. Storage capacity is based on the amount of room in your milk-making glands, not breast size. It varies among mothers and in the same mother from baby to baby.5 As one article describes, your largest pumping can provide a clue to whether your storage capacity is large, average or small.6 Mothers with a larger storage capacity usually pump more milk at a session than mothers with a smaller storage capacity. If you're exclusively breastfeeding and pumping for a missed breastfeeding, a milk yield (from both breasts) of much more than about 4 ounces (120 mL) may indicate a larger-than-average storage capacity. On the other hand, if you never pump more than 3 ounces (90 mL), even when it has been many hours since your last milk removal, your storage capacity may be smaller-than-average.

What matters to your baby is not how much she gets at each feeding, but how much milk she receives over a 24-hour day. Breast storage capacity explains many of the differences in breastfeeding patterns and pump yields that are common among mothers.7

Your pump quality and fit. For most mothers, automatic double pumps that generate 40 to 60 suction-and-release cycles per minute are most effective at expressing milk.

Getting a good pump fit is important, because your fit affects your comfort and milk flow. Pump fit is not about breast size; it's about nipple size. It refers to how well your nipples fit into the pump opening or "nipple tunnel" that your nipple is pulled into during pumping. If the nipple tunnel squeezes your nipple during pumping, this reduces your milk flow and you pump less milk. Also, either a too-large or too-small nipple tunnel can cause discomfort during pumping. Small-breasted women can have large nipples and large-breasted women can have small nipples. Also, because few women are completely symmetrical, you may need one size nipple tunnel for one breast and another size for the other.

You know you have a good pump fit if you see some (but not too much) space around your nipples as they move in and out of the nipple tunnel. If your nipple rubs along the tunnel's sides, it is too small. It can also be too large. Ideally, you want no more than about a quarter inch (6 mm) of the dark circle around your nipple (areola) pulled into the tunnel during pumping. If too much is pulled in, this can cause rubbing and soreness. You'll know you need a different size nipple tunnel if you feel discomfort during pumping even when your pump suction is near its lowest setting.
What About Pump Suction?
Mothers often assume that stronger pump suction yields more milk, but this is not true. Too-strong suction causes discomfort, which can inhibit milk flow. The best suction setting is the highest that's truly comfortable and no higher. This ideal setting will vary from mother to mother and may be anywhere on the pump's control dial. Some mothers actually pump the most milk near the minimum setting.

Could the pump be malfunctioning? It's normal for a pump's suction to feel less strong over time as its user adjusts to its feel. Many pump users ask how often certain pump parts should be replaced. A rule of thumb is that the parts that directly affect the pump's suction should be replaced every six months or so. On a Medela pump, this is the round white membrane that hangs down into the collection bottle on a yellow plastic piece. On an Ameda, Ardo, or Spectra pump, this is the white valve, which looks like a cake-decorator tip and hangs down into the collection bottle from the underside of the piece that you press against your breasts. In most cases, extra membranes and valves are provided with new pumps. Extras can usually be ordered online or bought at large baby stores. If you see a hole in the membrane or the white valve stays open even when the pump is not in use, replace these pump parts sooner. Other pump parts are unlikely to affect your milk yields.
Hands-on Pumping
Hands-on pumping is one evidence-based strategy to increase milk yield while pumping. Click here for a post describing this effective technique.

Worries are a normal part of new motherhood, but you can make milk expression a much more pleasant experience by learning what to expect. For many mothers, pumping is a key aspect of meeting their breastfeeding goals. A little knowledge can go a long way in making this goal a reality.
References
1 Butte, N.F., Lopez-Alarcon, & Garza, C. (2002). Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant During the First Six Months of Life. Geneva, Switzerland, World Health Organization.

2 Heinig, M.J. et al. (1993). Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity: the DARLING study. American Journal of Clinical Nutrition, 58, 152-61.

3 Dewey, K.G. (2009). Infant feeding and growth. Advances in Experimental Medicine and Biology, 639, 57-66.

4 Islam, M.M, Peerson, J.M., Ahmed, T., Dewey, K.G., & Brown, K.H. (2006). Effects of varied energy density of complementary goods on breast-milk intakes and total energy consumption by healthy, breastfed Bangladeshi children. American Journal of Clinical Nutrition, 83(4), 851-858.

5 Kent, J. C. (2007). How breastfeeding works. J Midwifery Womens Health, 52(6), 564-570.

6 Mohrbacher, N. (2011). The magic number and long-term milk production. Clinical Lactation, 2(1), 15-18.

7 Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics, 117(3), e387-395.

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How Much Milk Should You Expect to Pump?

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Do you ever second-guess your milk production after pumping? Do you compare it with the volume of milk your friend or neighbor pumps? Do you compare it with the milk you pumped for a previous baby? Before you start to worry, you first need to know how much pumped milk is average.

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Responsive bottle feeding

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Infant formula and bottle feeding

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Guide to infant formula

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At-breast supplementation: an alternative to bottles

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Breastfeeding Using a Lactation Aid with Dr. Jack Newman

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Please subscribe, vote, comment, and visit TheBreastfeedingDoula.com! Shows how to use lactation aid. Note that when it is working, the baby shows he is getting more milk because the pause in the chin is more obvious. In the second attempt to use the lactation aid, though the tube seems to be well placed, it is not.

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Expressing and storing your milk

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Mixed feeding: combining breastmilk and formula

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When it comes to feeding your baby, it's not always a question of only breastfeeding or only formula feeding; many women do a combination of both, often called combination feeding, combined feeding, mixed feeding, or partial breastfeeding.

You may want to try mixed feeding because you want to breastfeed for some of your baby's feeds, but give infant formula for one or more feeds, or because you're bottle feeding your baby and want to start or resume breastfeeding.

It can be helpful to talk to your midwife, health visitor or breastfeeding counsellor about your options when it comes to combining breastfeeding and bottle feeding, as well as find out about the potential impact of mixed feeding.

What effect will combining breastfeeding and formula feeding have?

One thing to consider is that breastmilk supply is generally driven by frequent, effective breastfeeding. This means feeding your baby as often as they show they need to by responding to their feeding cues. You can tell a feed is effective if your baby is well attached to the breast, you are both comfortable and your baby often starts with rapid sucks then slows to a more rhythmic suck, swallow pattern and comes off the breast looking full.

Giving your baby formula can affect the frequent feeds needed to ensure you're making the right amount of milk, especially when you first start breastfeeding. It usually means your baby breastfeeds less often, and therefore you make less milk.

However, if your baby is older, beyond the newborn stage, you can usually maintain your breastmilk supply alongside formula feeding, as long as you breastfeed every day. Much older babies - from eight or nine months - can breastfeed just a handful of times a day, and there is still a supply. Very well-established breastfeeding, with a baby of a year or so or more, can continue with as few as one or two feeds in 24 hours.

Your baby will enjoy the benefits of breastmilk, even if you're not exclusively breastfeeding. For instance, they will still gain some of the antibodies that will protect them against infection.

There can be health implications of introducing formula as it changes babies' gut bacteria so it's therefore important to discuss this with a suitably qualified health professional or breastfeeding counsellor.

How can I combine formula feeding and breastfeeding?

If you want to cut down on breastfeeds to introduce formula milk, you and your baby will adjust more easily if you reduce the number of feeds gradually.

You can offer formula feeds before, during, after or instead of a breastfeed. Do talk to your midwife, health visitor or breastfeeding counsellor about this as different options will suit different circumstances. There are some cases when formula might be given before a breastfeed (for example, with sick or vulnerable babies who are not breastfeeding well). In other cases, the formula feed might be given instead of a breastfeed. This might happen if you're separated from your baby and can't be there to breastfeed. Sometimes, formula given in the middle of a breastfeed is an option, if the baby needs the comfort and closeness of a breastfeed to settle.

Gradually cutting down breastfeeding reduces the chance of your breasts becoming uncomfortably engorged and leaky. It will also reduce your risk of developing mastitis.

If you substitute a breastfeed with a formula feed, it will take around three to seven days for your breasts to adjust to missing that one feed.

If you 'top up' with formula at one or more feeding sessions, rather than replacing an entire feed, this is likely to extend the gap between breastfeeds, which will signal to your breasts to make less milk. You can then drop the breastfeeds you want to drop, replacing them with formula. On the other hand, if you are advised to 'top up' as a temporary measure and want to return to exclusive breastfeeding, you can express milk between feeds to increase the amount of milk you make.

Introducing a bottle to a breastfeed baby

If you have breastfed your baby so far, they may be reluctant to take a bottle at first. The different sucking actions needed may confuse them and they may not take it from you. There are lots of different things you can try to help your baby.

To begin with, maybe ask someone else to offer a bottle and you could also try softening the teat with warm, boiled water. Another tip is to hold your baby in a different position from your usual breastfeeding one. It may help your baby get used to the new way of feeding. If this doesn't work, there are a variety of bottle teats which may make a difference. For more suggestions, read our article about introducing bottles.

You could also ask your midwife, health visitor or breastfeeding counsellor about using a nursing supplementer, as an alternative to bottles. This is a gadget which you use at the same time as your baby is at the breast - the supplementer delivers formula, through a tube attached at one end to the teat on a bottle, and at the other end, it's taped to your nipple. The baby gets formula (or expressed breastmilk) through the supplementer, at the same time as breastfeeding.
Last updated: January 2016
Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

Healthtalkonline.org has a comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues.

NHS Choices has information on bottle feeding and breastfeeding in public.

Best Beginnings has video clips from the 'Bump to Breastfeeding' DVD.

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Mixed feeding: combining breastfeeding and bottle feeding

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When it comes to feeding your baby, it's not always a question of only breastfeeding or only formula feeding; many women do a combination of both, often called combination feeding, combined feeding, mixed feeding, or partial breastfeeding.

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Bottle-feeding for breastfed babies

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Baby-led bottle feeding

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Going back to work

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Breastfeeding and going back to work - NHS.UK

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Information for employees and employers on returning to work and breastfeeding, including tips on expressing and storing breast milk.