Amount of supplement

How much milk should I use for the baby’s supplement?

Different babies need different amounts of supplement. The amount of supplement depends on the baby’s feeding ability, age, and hunger signs, among other things. The amount tends to be higher if the baby is very underfed or cannot latch onto the breast and lower if the baby is getting significant amounts of milk by breastfeeding. If the baby is alert after feeds and not sleepy or sick, it’s best to rely on the baby’s hunger signs when deciding how much supplement to provide. If the baby is premature, a sleepy underfed newborn, or is sick, the baby will need a structured feeding plan. It’s important for the baby to show signs of getting enough milk.

A) Describing amounts of supplement

Some babies do not breastfeed effectively and need to be supplemented with extra milk. The amount of milk varies between babies but all babies need to show signs of getting enough milk

If the baby is alert after breastfeeding and not weak or sleepy, it is best to follow the baby’s hunger signs when deciding how much to supplement.

Sleepy, underfed, newborns sometimes do not wake easily or show hunger signs. They often breastfeed ineffectively and need a more aggressive supplementation plan as do weak, premature babies.

Babies will start eating solid foods around six months of age and the mother’s milk supply will very gradually decrease. However, milk remains the baby’s most important food for the first year of life and a large part of the diet afterward. If a baby requires supplements of more than about 150 millilitres (5 U.S. fluid ounces) during the first six months, these will often be required for the second six months.

Solid foods are not a replacement for milk in the first year of life.

If your baby requires supplementing, please work with your health-care providers during this time.

B) Estimating the amount of supplement

Supplementing can be a little confusing because different babies need different amounts. The amount of supplement depends on:

  • The baby’s:
    • Feeding ability
    • Age
    • Hunger signs
  • How underfed the baby is
  • The mother’s milk supply
  • How much milk the baby can get by breastfeeding

The amount of supplement tends to be higher if:

The amount of supplement tends to be lower if the baby is getting significant amounts of milk from the breast.

Below is a rough summary of how much milk a typical baby needs per day and per feed. If the baby gets very little milk from the breast, the supplements would be in this range and less if the baby can get some milk by breastfeeding. Remember to also follow your baby’s hunger signs and ensure that the baby is happy when held after feeds and is gaining well.

Table: Expected total milk intake per day and per feed for various ages (estimate based on 7 feeds in 24 hours)

Larger amounts of milk intake can result in obesity (Huang 2018) and early weaning (Flaherman 2019).

References

Flaherman VJ, McKean M, Braunreuther E, et al. Minimizing the Relationship Between Early Formula Use and Breastfeeding Cessation by Limiting Formula Volume. Breastfeed Med. 2019 Oct;14(8):533-537

Huang J, Zhang Z, Wu Y, et al. Early feeding of larger volumes of formula milk is associated with greater body weight or overweight in later infancy. Nutr J. 2018 Jan 24;17(1):12