The Early Days
How much milk does a baby really need in those first few days of life?
By Angela Cahill, Cuidiú BFC
Nature doesn't get it wrong. Before birth your baby never felt hunger, following birth your baby feels hunger for the first time. To make this transition easier nature starts baby off gradually, with small frequent feedings rather than large amounts per feed.
Small feeds are all your newborn requires in those first few days of life. When newborns are fed 1 - 2oz (30 - 60ml) by bottle during the first day of life, most will probably bring a lot of it right back up.
How big is a newborn's stomach?
On day one, it's about the size of a large shooter marble (seammon and Doyle 1920) At each feed a baby can keep down approx 5 -10ml, and of course this is the amount of available colostrum that is ready and waiting at the breast – again, nature doesn't get it wrong.
Newborn babies stomachs are tiny, and they don't expand like an adult stomachs would. In a 2001 study Samuel Zangen and colleagues found that during the first 24 hours of life a newborn's stomach doesn't yet stretch. The walls of the newborn stomach stay firm, expelling extra milk rather than stretching out to hold it. By day 3 (approx) the stomach can expand to the size of a ping-pong ball in order to hold more milk (Zangen et al. 2001).
Small frequent feeds set up a healthy eating pattern right from the start.
Reassuring signs in the early days include the passing of meconium, the sticky greenish substance that has built up in your baby's intestines, followed by a graduation to yellow or mustard coloured stools after a couple of days. Babies tend to urinate very little in the first few days. Your milk production should begin around 72 hours after your baby is born (sometimes a little later for mothers who have had a cesarean, this varies from mother to mother). There may be a noticeable change in breast fullness.
Hearing your baby swallow and feeling your breasts soften during feeds are reassuring signs, as is a good nappy output. In the early days you can expect one dirty nappy for each day of life (1 on day one, 2 on day two etc.). You can also expect one wet nappy for each day of life (1 on day one, 2 on day two etc.). From around day 4, stools should be yellow (mustard) and you can expect on average 3-4 stools daily, and 5 - 6 wet from when your milk 'comes in' (volume increases and changes from colostrum to mature milk).
Reference: Breastfeeding Made Simple (2nd Edition) Mohrbacher & Kendall - Tackett