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Thread: Is baby being overfed at daycare? And what to do about it?

  1. #1
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    Default Is baby being overfed at daycare? And what to do about it?

    My son is 6 months old and has been in daycare full time for about a month (part time for a month before that). He is exclusively breastfeed, but we did start some solids at 5 months.

    Before returning to work, I had no issues with supply, in fact had an oversupply. DS has been sleeping through the night since he was about 8 weeks old (8-9 hours per night), and during the day when we are together he nurses every 1.5 hours.

    DS goes to daycare at about 7:30am, and is usually picked up at about 5:30pm - give or take 30 minutes. His last nursing session at home varies but it is usually around 6:30am. So that means it can be anywhere from 11-12 hours before he nurses again in the evening.

    At first when I went back to work I was able to pump on average 22 ounces. And DS was drinking about 16oz per day. But now for the last couple of weeks he has been consistently drinking 20oz per day at daycare (I send five 4oz bottles each day). He is also now eating solids at daycare twice a day, but this has not affected his milk intake.

    They are offering him a bottle about every 2 hours. And as I mentioned above, when he is home with me he nurses every 1.5 hours. Given the amount of time we are apart, do you think 20oz per day is too much?

    Here's the other problem... although I was able to pump MORE than 20oz per day initially... I recently had a bout of mastitis followed immediately by my period (my cycles have been back since 7 weeks postpartum), and so my supply took a major hit. For the last 2 weeks I have only been able to pump on average 14oz per day.

    So since DS continues to drink 20oz and I continue to pump only 14, that means my freezer stash is rapidly disappearing.

    My period has now ended and I expected to see an increase in my supply again, but that hasn't happened. The mastitis has been cleared up for 2 weeks. I have also been taking More Milk Special Blend for almost a week but have not noticed a difference.

    One more thing - DS was using medium flow nipples at daycare, but today I sent his bottles with all slow flow nipples on them. I am not sure this will make any difference, because daycare sticks by the (stupid) policy of throwing out unused milk after 1 hour. So even if he takes longer to finish a bottle, the milk is either going to be tossed, or it will be finished and they will offer him another bottle in 2 hours anyway.

    Please help me figure out if he is in fact being overfed, or if 20oz is a reasonable amount. It's so hard for me because with my first son he only drank about 14-16oz per day and I was able to pump enough for him up until he was 11 months old, even after cutting back a pump session after a while. Also with DS1 we were only apart about 10 hours a day, not closer to 12 like with DS2.

    Oh also, I pump at least 3 times a day, 15-25min per session, and frequently I pump 4x per day. On the days that I pump 4x I do not notice an increase in supply, so it hasn't felt worth it. But if it will help in the long run I will try to do at least 4x a day when possible.

  2. #2
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Based on everything I've read, they typically take 1-1.5 oz. for every hour apart. So based solely on the math, it's possible he's being overfed by around 4-8 oz. per day (he would take, on average, 12-18 oz.). I think if it were me, I'd cut back on the size of the bottles - send no more than 3 oz. servings - and I'd send only 4, with maybe a 1 to 2 oz. "topper" as backup. My DCP has a few 1 oz. servings of my frozen milk, in case she were to spill or if my daughter is still hungry, and she's only had to break into that stash once. Smaller bottles means less waste, too, since if he's not actually finishing a 4 oz. bottle in an hour, then there's less for them to dump!

    I would also reiterate that they should be using paced feeding techniques. If he's working on a bottle over the course of an hour, are they holding him while he drinks?

    As to the 4th pumping session, I don't think you'd see increased output unless you made it a regular thing. I don't think you're going to see it from one off sessions...

  3. #3
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Quote Originally Posted by @llli*aml1676 View Post
    Based on everything I've read, they typically take 1-1.5 oz. for every hour apart. So based solely on the math, it's possible he's being overfed by around 4-8 oz. per day (he would take, on average, 12-18 oz.). I think if it were me, I'd cut back on the size of the bottles - send no more than 3 oz. servings - and I'd send only 4, with maybe a 1 to 2 oz. "topper" as backup. My DCP has a few 1 oz. servings of my frozen milk, in case she were to spill or if my daughter is still hungry, and she's only had to break into that stash once. Smaller bottles means less waste, too, since if he's not actually finishing a 4 oz. bottle in an hour, then there's less for them to dump!

    I would also reiterate that they should be using paced feeding techniques. If he's working on a bottle over the course of an hour, are they holding him while he drinks?

    As to the 4th pumping session, I don't think you'd see increased output unless you made it a regular thing. I don't think you're going to see it from one off sessions...
    Thanks for the advice. I will try cutting back the size of the bottles gradually (so that daycare doesn't freak out). Unfortunately they will not allow me to keep any frozen milk there as a backup, so if they run out of milk I would have to rush across town to bring more milk, which is why it makes me nervous to think about not bringing that 5th bottle, or making it a really small one. But maybe with the slow flow nipples and only 3oz per bottle, that might help.

    They do hold him while feeding him, at least that has been the case when I have arrived mid-bottle to pick him up. The teacher is always in the rocking chair holding him. Then again, it was also the end of the day and the other 2 babies in his class were already gone so perhaps during the day when things are busy they prop him up on the boppy to feed him while he lays on the floor (I think they do this to feed 2 babies at a time).

    I will get consistent with the 4th pump session.

  4. #4
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Oh one more thing, I have definitely read about the 1-1.5oz/hour guideline before, but I've always kind of wondered if that applies to babies who do NOT sleep through the night, and therefore get extra nursing sessions in the middle of the night. Both of my babies STTN early and both of them nursed frequently during the day at every 1.5 hours. So that tends to make me think that my baby would need more than the average 1-1.5oz per hour... ?

  5. #5
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Quote Originally Posted by @llli*fujiapple View Post
    Oh one more thing, I have definitely read about the 1-1.5oz/hour guideline before, but I've always kind of wondered if that applies to babies who do NOT sleep through the night, and therefore get extra nursing sessions in the middle of the night. Both of my babies STTN early and both of them nursed frequently during the day at every 1.5 hours. So that tends to make me think that my baby would need more than the average 1-1.5oz per hour... ?
    Nothing I've ever read differentiates between babies sleeping through the night and those who don't... but since those are just average amounts, I'd suppose it's possible that your baby might need more. And 20 oz. isn't *that* far over the high end of that range, anyway. I still think I'd send smaller bottles - more of them, if it makes you more comfortable to do so - and see what feedback you get from day care. It's possible that he might begin reverse-cycling - so, taking less at day care and nursing more when he's with you. Some babies do that, and thrive! My daughter takes just 8 oz. in the 8 hours we're apart, but then nurses pretty much all evening until she falls asleep. I wake her when I go to bed for a dream feed, and since we bedshare, she kind of helps herself throughout the night. I don't think either of us fully wakes for those sessions

    I wonder if adding a dream feed would help with the amount you need to pump during the day?

  6. #6
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    Default Re: Is baby being overfed at daycare? And what to do about i

    My understanding is that Night nursing is the savior of many working moms in helping them keep supply up and being able to fill the necessary bottles for daycare.

  7. #7
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Just a couple of points. Paced bottle feeding does not mean that the caregiver holds baby. (EDIT: Yes of course they hold the baby while feeding, but there is way more to it.) It is also not dependent on a particular type of nipple, although generally the slowest flow that "works" is probably a good place to start.

    Paced bottle feeding is a very specific way of positioning both the baby and the bottle, as well as caregiver allowing/encouraging a baby to take natural pauses during a feeding. It is designed to make bottles more "like" breastfeeding in that baby is given more control over milk flow and that is why it helps prevent overfeeding and "flow confusion" . Here is more information: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    and video: https://www.youtube.com/watch?v=UH4T70OSzGs

    Also, daycare is offering a bottle every 2 hours? Is this based on baby's cues or other? Cue feeding remains important even when a baby is bottle fed. Yes it is not always easy for a day care to provide this level of attention to a baby in their care. But sometimes all that is needed is education about how to promote normal feeding.

    I have also always wondered if the rule of thumb that a baby needs about 1 to 1.5 ounces per hour of separation changes if a baby is not nursing at night. As far as I know, this suggested hourly amount is based on the average total daily intake of a breastfed baby, which is (for a baby living entirely or nearly so on breastmilk) about 25-35ounces per day (Edit-per 24 hours) generally.

    However, even that number may not be accurate. That is the normal daily intake for a newborn of about a month of age and above. But does this change over time? I know it does not increase. But might the total needed decrease? Weight gain rate begins to slow after 3 months and so, by 6 months, is much slower than in the newborn period. I have not found reliable information on what a breastfed/breastmilk fed baby actually NEEDS as far as daily total intake goes in the period post 6 months and/or the introduction of solids. If anyone has a source, I would be interested.

    But if your baby is sleeping a very long time at night, more than 5 or 6 hours as a regular thing, I suspect that may very well mean baby needs more milk during the day. Long stretches can also negatively impact milk production if many hours go by each day (night) with no milk removal. I guess I would say it depends on how you define "through the night."
    Last edited by @llli*maddieb; August 21st, 2014 at 08:58 AM. Reason: for clarity

  8. #8
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Quote Originally Posted by @llli*maddieb View Post
    Just a couple of points. Paced bottle feeding does not mean that the caregiver holds baby. (EDIT: Yes of course they hold the baby while feeding, but there is way more to it.)
    Absolutely, and I hope I didn't imply otherwise! I guess the point I was trying to make was that if he were being held, it's not likely they would let a feeding go on for an hour. I doubt most DCPs have an hour to spare with just one infant, unfortunately

  9. #9
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    Default Re: Is baby being overfed at daycare? And what to do about i

    This link gives a rough guide of how much total a baby might be expected to eat during given age ranges
    (again it's kinda a rough estimate.)
    http://www.lowmilksupply.org/supplem...-howmuch.shtml

  10. #10
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    Default Re: Is baby being overfed at daycare? And what to do about i

    Quote Originally Posted by @llli*maddieb View Post
    I have also always wondered if the rule of thumb that a baby needs about 1 to 1.5 ounces per hour of separation changes if a baby is not nursing at night. As far as I know, this suggested hourly amount is based on the average total daily intake of a breastfed baby, which is (for a baby living entirely or nearly so on breastmilk) about 25-35ounces per day (Edit-per 24 hours) generally.
    This was my understanding of where the 1-1.5 oz/hr rule comes from, as well. My understanding was that it is expected for babies who are feeding less frequently at night to be closer to the 1.5 oz/hr range, and that frequent night feeds can take the pressure off a mom who is having difficultly pumping and allow her to stay closer to the 1 oz/hr range. But I too have never actually been able to find any research or literature that spells this out; this is just the general advice and information I have always received from breastfeeding support professionals.
    Apologies for the short responses! I'm usually responding one-handed on my smartphone!

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