• Dr. Alison Mildon

How much breastmilk are babies receiving? Exploring the nuances of breastmilk feeding practices

Updated: Apr 13


How much breastmilk are babies receiving?


The World Health Organization and Health Canada recommend that babies receive only breastmilk for the first six months to support lifelong health. This is known as ‘exclusive breastfeeding.’ It is an important recommendation because breastmilk contains a tailor-made mix of nutrients, immune system molecules and other components babies need to grow and develop.


However, exclusive breastfeeding is a 24/7 job. In reality, it can be very challenging to feed breastmilk exclusively for six whole months. Therefore, despite the recommendation, it is essential to recognize that feeding breastmilk for less than six months or not exclusively is not ‘bad’ or ‘a failure.’ What matters is that babies receive as much breastmilk as possible, and this will vary between families. Many babies who don’t meet the strict definition of exclusive breastfeeding for six months may still receive quite a lot of breastmilk, which is terrific!


To better understand the amount of breastmilk babies might be receiving, we studied the feeding practices of more than 140 birth mothers. These mothers were registered in three Canada Prenatal Nutrition Program sites in Toronto. At two weeks after birth and each month up to six months, study participants told us the average number of times each day their baby was fed breastmilk, formula and other fluids. If applicable, we also recorded the date breastfeeding stopped and the date the baby started eating solid foods.


What we found:


All study participants started breastfeeding, but only 18% exclusively breastfed for six months. This number would lead us to believe that there is much room for improvement to meet health authority recommendations for breastfeeding. However, digging a little deeper showed that study participants provided a lot of breastmilk to their babies!

  • Nearly half (48%) exclusively breastfed for at least three months, and 31% did so for five months or more.


  • At least 60% provided breastmilk for more than 75% of daily feeds at all of our time points. This includes participants who stopped breastfeeding at some point during the first six months. When we only looked at data from participants who were still breastfeeding, over 80% provided breastmilk for at least 75% of daily feeds at all our time points. That’s a lot of breastmilk feeding!


  • Many participants used some formula during the first month after birth. Some switched to exclusive breastfeeding after this.


  • After four months, some study participants who had been exclusively breastfeeding started providing water or solids as well but did not use formula.


You can read the full paper, led by PhD Candidate Alison Mildon, here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13260


 

Tips to help you provide as much breastmilk to your baby as possible:


  • Skin-to-skin contact starting from birth gives the baby lots of access to the breast and helps build the breastmilk supply.


  • Worried about whether your baby is getting enough breastmilk? Tracking the number of diaper changes is one of the best ways to tell that the baby is drinking enough. By the end of the first week of life, there should be at least 6 wet diapers every 24 hours.

 

Learn more breastfeeding tips from these resources:

 
  • Water feeds are not harmful in places like Toronto with a clean water supply, but they aren’t necessary as breastmilk is 70% water. Exclusively breastfed babies are already well hydrated, and water doesn’t contain nutrients to support your baby’s growth.


  • Starting solids is recommended around six months, depending on the baby’s developmental readiness. For most babies, there’s no need to rush to start solids early. A young baby’s stomach is small, and breastmilk contains more nutrients in the same volume than solid foods. Your baby will let you know when they are ready for solids. Before starting solids, your baby should be able to sit unassisted with good head and neck control and show interest in food by leaning forward and opening their mouth. Toronto Public Health has information about introducing solids here: https://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/feeding-your-child/feeding-your-infant/


 

This research was funded by the Canadian Institutes of Health Research, The Sprott Foundation, and the Joannah and Brian Lawson Centre for Child Nutrition

 

Citation: Mildon, A., Francis, J., Stewart, S., Underhill, B., Ng, Y. M., Rousseau, C., Di Ruggiero, E., Dennis, C.-L., O'Connor, D. L., & Sellen, D. W. (2021). High levels of breastmilk feeding despite a low rate of exclusive breastfeeding for 6 months in a cohort of vulnerable women in Toronto, Canada. Maternal & Child Nutrition, e13260. https://doi.org/10.1111/mcn.13260