Addressing Infant Feeding Concerns: Breast Milk Intake and Health Tips

Issues with milk intake?

Dear Doctor (I apologize for the interruption, and thank you for taking the time to read this letter): My baby was born on April 4th weighing 3440 grams, and she will be 3 months old on July 4th.
She is currently exclusively breastfed, and I have a few questions:
1.
Last week, due to my husband being hospitalized, I had family members take care of her and switched to bottle feeding.
I found that I can pump 90-120 cc every 3-4 hours.
My baby eats approximately every 2-3 hours, but sometimes she only takes about 50 cc and refuses to eat more.
She currently weighs 5.4 kg.
Is this feeding pattern considered normal?
2.
Recently, I have noticed that her urine has started to have a strong odor.
Could this be related to my increased meat consumption? Is this putting a strain on her small kidneys?
3.
She rarely cries due to hunger.
If she is sleeping soundly at night, do I still need to wake her up every 3-4 hours to feed? Would this disrupt her brain cell connections, and could it have any negative effects?
I kindly ask for your patient guidance on these matters.
Thank you very much!

Shan, 30~39 year old female. Ask Date: 2005/07/02

Dr. Cai Zhengxian reply Pediatrics

Dear Mom of Shanshan,
Congratulations on your baby reaching three months of age! With a weight of 5.4 kg, your baby is at the 25th percentile according to the Taiwanese growth chart in the child health handbook.
This is within the normal range, although slightly below the average.
I encourage you to continue breastfeeding.
From your description, it seems your baby has varying feeding patterns, which is common among breastfed infants.
I encourage you to try to breastfeed directly as much as possible, as this can help increase your milk supply and allow your baby to feel your love directly!
My wife also exclusively breastfed, and now our baby is seven months old and doing well.
However, in the initial months, we faced many challenges.
I have two excellent resources to support your breastfeeding journey: one is the National Health Bureau's breastfeeding hotline at 0800-870-870 (the Taiwanese phonetic sounds like "want to breastfeed"), where you can ask questions during business hours.
The other is the website Baby's Garden (http://www.babysgarden.org/main.php), which contains many shared experiences from other mothers, including useful tips that even pediatricians may not have heard of—definitely worth checking out with your husband.
Lastly, regarding whether your meat consumption affects breastfeeding, please don't worry.
You are providing your baby with the best human protein, which is broken down and absorbed by you before being passed on.
As for whether you need to wake a sleeping baby for feeding at night, if your baby is three months old and weighs over 5 kg, there is no need to worry.
If you are breastfeeding, you will find that in a semi-awake state, your baby will naturally find the nipple and continue feeding before falling back asleep!
Wishing you and your baby a safe and healthy growth!
Sincerely,
Dr.
Tsai Cheng-Hsien, Attending Physician, Pediatrics, Tainan City Hospital

Reply Date: 2005/07/02

More Info

Dear Parent,
Thank you for reaching out with your questions regarding your infant's feeding and health. It's completely understandable to have concerns as a new parent, especially when it comes to ensuring your baby is getting the right nutrition. Let’s address your questions one by one.

1. Feeding Amounts and Frequency: Your baby, who was born at 3440 grams and is now 5.4 kg at three months, is within a normal range for growth. Generally, infants will consume about 150-200 ml of breast milk per kilogram of body weight per day. Given that your baby is taking around 90-120 ml every 3-4 hours, this seems to be appropriate. It's also common for babies to have varying appetites; some may eat less at times, especially if they are more interested in their surroundings or are going through developmental milestones. As long as your baby is gaining weight steadily and is active, there is usually no cause for concern.

2. Urine Odor: The change in the odor of your baby's urine could be influenced by your diet, particularly if you are consuming more protein-rich foods. While a strong-smelling urine can sometimes indicate dehydration, it is also common for breastfed infants to have varying urine odors based on their mother's diet. As long as your baby is producing a normal amount of urine (at least 6-8 wet diapers a day) and is not showing signs of distress, it is likely not a significant issue. However, if you notice any changes in your baby's behavior or if the odor persists, it would be wise to consult your pediatrician.

3. Nighttime Feeding: It is not uncommon for infants to sleep soundly and not wake up for feedings. If your baby is gaining weight well and is healthy, it may not be necessary to wake her every 3-4 hours for feeding, especially if she is sleeping deeply. Many pediatricians recommend allowing babies to sleep through the night if they are healthy and gaining weight appropriately. Waking her for feedings may not significantly impact her brain development, as long as she is getting enough nutrition during the day. However, if you have concerns about her growth or feeding patterns, it’s always best to discuss these with your pediatrician.

In summary, your baby’s feeding habits seem to be within normal limits, and it’s important to continue monitoring her growth and development. Breastfeeding is highly beneficial, and as you continue, try to maintain a balanced diet to support both your health and your baby's. If you have any further concerns or if her feeding patterns change significantly, do not hesitate to reach out to your healthcare provider for personalized advice.

Wishing you and your little one all the best!
Warm regards,
Doctor Q&A Teams

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