Typical Volumes of Human Milk Intake Among Infants and Young Children
by Anne Eglash MD, IBCLC, FABM
What is the average amount of breastmilk needed by an infant?
Many new parents wonder how much breastmilk a typical baby drinks in 1 day, especially if they are planning to send their infant to daycare. According to the authors of this week’s research, several studies have been done world-wide on breastmilk volume intake, using different methods of measurement, but there has not been an updated systematic review on this topic since the World Health Organization’s research in 1998. This paper was commissioned by the Food and Agriculture Organization of the United Nations and the World Health Organization.
This systematic review and meta-analysis included 167 studies that measured breastmilk intake among 20,857 participants. The studies were well distributed internationally, with all continents represented. The majority of studies included healthy lactating individuals, while 61/167 studies didn’t specify health status. A few studies included lactating individuals with diabetes, thyroid disease, ovulatory disturbance, HIV, mastitis, nipple pain, and ankyloglossia. The methods used to determine milk intake included deuterium dilution and/or test weighing.
Deuterium oxide dilution is considered safe and involves giving the lactating parent a dose of deuterium-labeled water, which mixes in the body’s water pool. The amount of deuterium-labeled breastmilk consumed by the infant when directly feeding is then measured over time by monitoring the deuterium in the infant’s urine.
The meta-analysis and meta-regression of the data demonstrated that for healthy term exclusively breastfed infants, the average intake per body weight peaks at 1 month, at 135ml/kg/day. It gradually declines from there, with the average intake at 6 months being 107ml/kg/day, and 61ml/kg/day at 12 months. What else? See the question!
- Infants of mothers with a high BMI took more milk than those with a lower BMI.
- The intake of breastmilk peaks at 3-4 months, then plateaus until complementary foods are started.
- The volume of breastmilk intake is influenced by infant body weight.
- The global average peak breastmilk intake is 724-755ml/day, or 24-25 ounces/day.
See the Answer
Abstract
Objective
The objective of this study was to provide global breast milk intake estimates for infants and children from 0 to 3 years old.
Materials and Methods
A systematic search of online databases (Embase, MEDLINE, and CENTRAL) was conducted and complemented with a manual search of additional databases (African Journals Online and LILACS), reference lists, and unpublished data. Studies with apparently healthy mothers and their children 0–3 years old worldwide were included. Random effects meta-analyses, subgroup analyses, and meta-regressions were conducted.
Results
A total of 167 studies on breast milk intake were identified. The mean daily breast milk intake among all the studies included was 670 mL per day and 117 mL/kg per day. Breast milk intake was influenced by infant age, infant body weight, and breastfeeding practices. The deuterium dilution method tended to yield higher estimates than test-weighing methods. Breast milk intake over time was modeled with a nonlinear metaregression: breast milk intake (mL/day) = 51–1.4 · days +180 · log(days). When restricting to studies involving healthy term infants exclusively breastfed up to 6 months, breast milk intake was 624 mL per day and 135 mL/kg per day at 1 month, 735 mL per day and 126 mL/kg per day at 3 months, 729 mL per day and 107 mL/kg per day at 6 months, and 593 mL per day and 61 mL/kg per day at 12 months.
Conclusions
This review provides global breast milk intake estimates for infants and young children. It demonstrates differences in intakes according to region and measurement method, as well as longitudinal changes over the first year of life.
The researchers found that there was no association between maternal BMI and breastmilk intake.
This is a resourceful study, as it includes global data with detailed charts demonstrating typical breastmilk intake/day during 2 years of a child’s life. Their data is very similar to the results in the 1998 study.
One major limitation of this systematic review and meta-analysis is that 61/167 of the studies did not define the health status of the lactating mothers. Therefore, the data describes infant breastmilk intake in a variety of populations in their current state (a reference) but does not describe breastmilk volumes in optimal health and socioeconomic conditions (a true standard). An analogy would be comparing growth charts in populations where the health of the family and infant are not optimized (a reference), vs the WHO curves that measured growth trajectories in healthy populations living in optimal conditions (a true standard).
Jo
Thanks for this. I’m confused however how the answer D reflects the result of the study ie
D. The global average peak breastmilk intake is 724-755ml/day, or 24-25 ounces/day.
I can’t see these numbers in the study abstract.
Could you clarify please?
Carrie Walker
Look through the actual article to find this, these numbers represent the peak intake which occurs at 5 months of age according to this review. I know because your question made me look harder to find it but you have to look at the article not just the abstract to see the data. Hope that helps!
Jo
Many thanks for taking the time to check and reply Carrie!
Jessica Clayton
This is so so helpful! I’m curious, for pumping moms, recommendations encourage pumping AT LEAST 24 ounces/day. I recently had a physician who said “if she’s only pumping 24 she’s not going to make it, she needs to be getting more.” With this meta-analysis pointing to 24-25ounce being the peak volume, would this be reason to have mom’s stick to “24 ounces in 24 hours” pumping wise? While I believe there is a consensus of pumped milk being a little lower in caloric quality, and often babies will take more from the bottle-I have found so many mothers who pump more than 24 ounces in a day suffer from hyperlactation issues. Double edge sword. Would love to hear what you and other subscribers think.
IABLE
This is an average peak, so some babies take more, and some take less. I see plenty of infants who take 30-32 oz a day whose parents are tall, and who are growing appropriately. I also see infants who take 20 oz a day who are also growing beautifully along the 5th percentile.
Jessica Clayton
Thank you so much for your thoughtful reply!
IABLE
The following is the results section of the abstract:
A total of 167 studies on breast milk intake were identified. The mean daily breast milk intake among all the studies included was 670 mL per day and 117 mL/kg per day. Breast milk intake was influenced by infant age, infant body weight, and breastfeeding practices. The deuterium dilution method tended to yield higher estimates than test-weighing methods. Breast milk intake over time was modeled with a nonlinear meta-regression: breast milk intake (mL/day) = 51–1.4 · days +180 · log(days). When restricting to studies involving healthy term infants exclusively breastfed up to 6 months, breast milk intake was 624 mL per day and 135 mL/kg per day at 1 month, 735 mL per day and 126 mL/kg per day at 3 months, 729 mL per day and 107 mL/kg per day at 6 months, and 593 mL per day and 61 mL/kg per day at 12 months.
Rachel
How do you know how much they are taking and how much to offer at feedings when mom isn’t home and they get the bottle?! So hard to know
IABLE
It is best to follow an infant’s feeding cues when bottle feeding, while pacing the bottles to avoid over feeding (https://www.youtube.com/watch?v=OGPm5SpLxXY&t=11s). A typical infant who is past 4 weeks of age will take 90-120 ml in a bottle every 2-3 hours. A very petite baby will take less, and a very large baby will take slightly more. Generally breastfed babies take lower volumes and feed more often as compared to formula fed infants.
Thzuska Pico Mawyin
Decimos que el bebe toma a libre demanda, cuando es directo de pecho. Evaluamos a traves de curvas crecimiento . Podemos tomar este resultado del metaanálisis de aproximadamente 24 a 25 onzas al día, y la satisfacción del niño como parámetros iniciales de control y luego su curva de peso y longitud nos dirá si requiere cambios. Agregamos el control de su evaluación nutricional, que nos informara como su demanda ha sido satisfecha. Creo que, en principio, debemos seguir escuchando al niño. Él nos demandara más , de necesitarlo.
IABLE
Hi, thank you for your comments. I 100% take your approach, rather than calculating expected amounts per body weight.